CARN Nursing Interventions and Treatment 4

Question 1

A patient with opioid use disorder refuses all medications and prefers an abstinence-based program. What is the nurse's most appropriate response using a person-centered approach?

Accepted Answer

Respect the patient's preference, provide education on MOUD benefits and risks of refusal, and support their chosen treatment plan

Answer

Insist the patient accept MOUD because it is evidence-based and reduces mortality

Answer

Discharge the patient as they are non-compliant with standard of care

Answer

Contact the prescriber to override the patient's decision

Question 2

Which assessment tool is most appropriate for a nurse to use to quickly screen for unhealthy alcohol use in an outpatient primary care setting?

Accepted Answer

AUDIT-C

Answer

CIWA-Ar

Answer

DAST-10

Answer

ASI

Question 3

A patient with co-occurring PTSD and alcohol use disorder is beginning treatment. Which integrated treatment approach is recommended over sequential treatment?

Accepted Answer

Providing simultaneous treatment for both conditions in a coordinated plan

Answer

Treating PTSD first, then initiating alcohol use disorder treatment after 6 months of sobriety

Answer

Treating alcohol use disorder first until stable, then starting PTSD therapy

Answer

Referring to separate specialists who communicate quarterly

Question 4

A nurse is administering a daily supervised dose of buprenorphine/naloxone. The patient states they feel 'sick' despite taking the medication. What is the most likely cause?

Accepted Answer

The dose is insufficient and the patient is in partial withdrawal

Answer

Naloxone component is precipitating withdrawal

Answer

The buprenorphine dose is too high causing toxicity

Answer

The patient has developed tolerance to naloxone

Question 5

When developing a discharge plan for a patient completing inpatient detoxification from alcohol, which element most strongly reduces the risk of relapse and mortality?

Accepted Answer

Initiating pharmacotherapy (e.g., naltrexone or acamprosate) and linking to ongoing outpatient care before discharge

Answer

Scheduling a follow-up appointment in 90 days

Answer

Providing a prescription for a benzodiazepine to manage any residual anxiety

Answer

Advising the patient to attend AA meetings and call if problems arise

Question 6

A nurse notices a colleague taking controlled substances from a patient's medication tray. What is the nurse's immediate legal and ethical obligation?

Accepted Answer

Report the observation to a supervisor immediately per facility policy and state nursing board requirements

Answer

Speak privately with the colleague and encourage them to seek help before reporting

Answer

Document the behavior and wait to see if it recurs before acting

Answer

Confront the colleague directly and demand they return the medication

Question 7

Which statement accurately describes the concept of 'therapeutic limit setting' in addiction nursing practice?

Accepted Answer

Establishing clear, consistent boundaries that protect the therapeutic relationship and patient safety while conveying respect

Answer

Setting strict punitive consequences to modify manipulative behavior

Answer

Refusing to engage with patients who are actively using substances

Answer

Using negative reinforcement to extinguish drug-seeking behaviors