CARN Pharmacology & Substance Use Disorders 3

Question 1

A patient in opioid withdrawal is prescribed clonidine. The nurse understands this medication primarily addresses which symptom cluster?

Accepted Answer

Autonomic symptoms such as diaphoresis, tachycardia, and hypertension

Answer

Pain and euphoria

Answer

Seizure risk and hallucinations

Answer

Insomnia and psychosis

Question 2

Which of the following is a first-line pharmacological treatment for nicotine use disorder that works by partially stimulating nicotinic acetylcholine receptors?

Accepted Answer

Varenicline

Answer

Bupropion

Answer

Nortriptyline

Answer

Clonidine

Question 3

A patient receiving extended-release naltrexone (Vivitrol) for opioid use disorder requires surgery. The CARN nurse should advise the surgical team that:

Accepted Answer

Non-opioid analgesia must be used and opioids will be ineffective at standard doses

Answer

Standard opioid doses will be effective for pain control

Answer

Higher-than-usual opioid doses may be needed and sedation risk is increased

Answer

The injection must be reversed before any procedure

Question 4

Which statement best describes the role of GABA in sedative-hypnotic substance use disorders?

Accepted Answer

Alcohol and benzodiazepines enhance GABA-A activity, and chronic use leads to receptor downregulation and tolerance

Answer

Alcohol and benzodiazepines inhibit GABA-A receptors, causing CNS stimulation

Answer

Chronic alcohol use upregulates GABA receptors, explaining tolerance

Answer

GABA plays no significant role in sedative-hypnotic dependence

Question 5

A patient on buprenorphine/naloxone (Suboxone) sublingual film reports nausea and headache after switching to the generic. What is the most likely cause?

Accepted Answer

Differences in bioavailability between brand and generic formulations

Answer

Naloxone toxicity from the new formulation

Answer

Opioid withdrawal from reduced buprenorphine dose

Answer

Serotonin syndrome from a drug interaction

Question 6

For a pregnant patient with opioid use disorder, which treatment is considered the standard of care?

Accepted Answer

Methadone or buprenorphine maintenance therapy

Answer

Abrupt opioid detoxification in the second trimester

Answer

Naltrexone extended-release injection monthly

Answer

Clonidine-assisted withdrawal in the third trimester

Question 7

Cocaine's primary mechanism of action that produces euphoria involves:

Accepted Answer

Blocking reuptake of dopamine, serotonin, and norepinephrine

Answer

Activation of mu-opioid receptors in the VTA

Answer

Stimulating GABA-B receptors in the nucleus accumbens

Answer

Directly releasing acetylcholine at nicotinic receptors