CARN Nursing Interventions and Treatment 5 â Questions and Answers
Question 1: A patient with benzodiazepine use disorder is being tapered using a long-acting agent. What is the clinical rationale for using a long-acting benzodiazepine like diazepam for taper?
- Long-acting agents have a stronger euphoric effect, reducing cravings more effectively
- The prolonged half-life produces a smoother, self-tapering effect that reduces withdrawal severity (Correct answer)
- Long-acting agents are safer because they do not affect GABA receptors
- They are preferred because they can be administered intramuscularly
Correct answer: The prolonged half-life produces a smoother, self-tapering effect that reduces withdrawal severity
Diazepam's long half-life and active metabolites create a gradual, self-tapering plasma level decrease, producing a smoother withdrawal and reducing seizure risk.
Question 2: Which nursing intervention is essential when caring for a patient receiving disulfiram (Antabuse) for alcohol use disorder?
- Monitor liver function tests periodically and teach the patient to avoid all alcohol-containing products, including mouthwash and some foods (Correct answer)
- Administer disulfiram intravenously for faster onset
- Instruct the patient that a small amount of alcohol is safe to test medication effectiveness
- Hold disulfiram if the patient's blood pressure is elevated
Correct answer: Monitor liver function tests periodically and teach the patient to avoid all alcohol-containing products, including mouthwash and some foods
Disulfiram inhibits aldehyde dehydrogenase; even small amounts of alcohol in products like mouthwash can precipitate a severe reaction, and hepatotoxicity monitoring is required.
Question 3: A nurse is implementing contingency management (CM) for a patient with stimulant use disorder. Which behavior best describes the core principle of CM?
- Providing insight-oriented therapy to explore childhood trauma related to drug use
- Offering tangible incentives (vouchers or prizes) contingent on verified negative drug screens (Correct answer)
- Using negative consequences such as loss of privileges to reduce drug use
- Encouraging peer support through group therapy attendance
Correct answer: Offering tangible incentives (vouchers or prizes) contingent on verified negative drug screens
Contingency management uses positive reinforcementâtypically vouchers or prize drawsâdelivered immediately upon verified abstinence to strengthen drug-free behavior.
Question 4: A 28-year-old patient with opioid use disorder who is pregnant is asking about treatment options. Which statement reflects current evidence-based practice?
- Opioid detoxification (withdrawal) is recommended in the first trimester to protect fetal development
- Buprenorphine or methadone maintenance is preferred over detoxification because it reduces fetal distress and preterm labor risk (Correct answer)
- Extended-release naltrexone is the safest MOUD option during pregnancy
- Opioid use disorder in pregnancy should be managed without medications to avoid fetal exposure
Correct answer: Buprenorphine or methadone maintenance is preferred over detoxification because it reduces fetal distress and preterm labor risk
ACOG and SAMHSA recommend opioid agonist maintenance (methadone or buprenorphine) during pregnancy because abrupt withdrawal increases risk of fetal distress, miscarriage, and preterm birth.
Question 5: A nurse is educating a patient about naloxone (Narcan) take-home kits. Which patient statement indicates understanding of when to use it?
- I should use it every time I take opioids to prevent overdose
- I should give it to someone who is unresponsive, has slow or no breathing, and may have taken opioids (Correct answer)
- I should only use it if the person is using heroin, not prescription opioids
- I should administer it and then wait 30 minutes before calling 911
Correct answer: I should give it to someone who is unresponsive, has slow or no breathing, and may have taken opioids
Naloxone is indicated for suspected opioid overdose characterized by unresponsiveness, slow/absent breathing, and known or suspected opioid exposure; 911 must also be called.
Question 6: Which intervention reflects trauma-informed care principles when working with a patient with substance use disorder who has a history of sexual abuse?
- Avoid discussing trauma to prevent re-traumatization during addiction treatment
- Routinely ask patients to describe their trauma in detail to facilitate emotional processing
- Create a safe, predictable environment; explain procedures before performing them; and never force disclosure (Correct answer)
- Use confrontational techniques to break through denial about how trauma contributed to substance use
Correct answer: Create a safe, predictable environment; explain procedures before performing them; and never force disclosure
Trauma-informed care emphasizes safety, trustworthiness, and choiceâincluding explaining what will happen before it does and never pressuring patients to disclose trauma.
Question 7: A patient in recovery from alcohol use disorder asks about the recommended duration of pharmacotherapy with naltrexone. What is the evidence-based guidance?
- Naltrexone should be taken for exactly 30 days then discontinued to prevent tolerance
- Treatment duration is individualized; many guidelines recommend at least 6â12 months and ongoing use for patients at high relapse risk (Correct answer)
- Naltrexone must be taken indefinitely without periodic reassessment
- Naltrexone is only appropriate for the first 7 days after detoxification
Correct answer: Treatment duration is individualized; many guidelines recommend at least 6â12 months and ongoing use for patients at high relapse risk
Evidence supports a minimum of 3â6 months with reassessment; longer treatment is recommended for patients with severe AUD or repeated relapse history.
CARN Nursing Interventions and Treatment 5
A patient with benzodiazepine use disorder is being tapered using a long-acting agent.
What is the clinical rationale for using a long-acting benzodiazepine like diazepam for taper?