CARN Pharmacology & Substance Use Disorders 2

Question 1

A patient on methadone maintenance therapy reports QTc prolongation on ECG. What is the most appropriate nursing action?

Accepted Answer

Notify the prescriber and monitor for arrhythmias

Answer

Methadone can prolong the QTc interval, increasing risk of torsades de pointes, so the prescriber must be notified and cardiac monitoring initiated.

Question 2

Which benzodiazepine is preferred for alcohol withdrawal management in patients with severe liver disease?

Accepted Answer

Lorazepam

Answer

Lorazepam (along with oxazepam and temazepam) undergoes direct glucuronidation and is preferred in hepatic impairment because it avoids extensive liver metabolism.

Question 3

Naltrexone is contraindicated in a patient who:

Accepted Answer

Is currently taking opioids for pain management

Answer

Naltrexone blocks opioid receptors and will precipitate acute withdrawal in patients physically dependent on opioids.

Question 4

A patient taking disulfiram consumes a small amount of alcohol in a mouthwash. Which reaction is most likely?

Accepted Answer

Mild flushing and tachycardia

Answer

Even small amounts of alcohol can trigger a disulfiram-ethanol reaction characterized by flushing, nausea, tachycardia, and hypotension due to acetaldehyde accumulation.

Question 5

Buprenorphine's 'ceiling effect' on respiratory depression is primarily due to its action as a:

Accepted Answer

Partial agonist at mu receptors

Answer

Buprenorphine's partial agonist activity at mu-opioid receptors creates a ceiling effect, reducing the risk of fatal respiratory depression compared to full agonists.

(CARN) Certified Addictions Registered Nurse Practice Test

(CARN) Certified Addictions Registered Nurse Practice Test

CARN Pharmacology & Substance Use Disorders 2