CARN Treatment Planning & Implementation 3 — Questions and Answers
Question 1: Which assessment tool is specifically designed to match patients to the appropriate level of addiction treatment based on six dimensions?
- CAGE questionnaire
- AUDIT-C
- ASAM Patient Placement Criteria (Correct answer)
- CIWA-Ar scale
Correct answer: ASAM Patient Placement Criteria
The ASAM Patient Placement Criteria uses six dimensions to guide clinicians in determining the most appropriate level of care.
Question 2: A patient with alcohol use disorder is being treated with acamprosate. The nurse understands that the primary mechanism of this medication is to:
- Block opioid receptors to reduce the rewarding effects of alcohol
- Cause an aversive reaction when alcohol is consumed
- Reduce post-acute withdrawal symptoms and alcohol craving (Correct answer)
- Prevent alcohol absorption in the gastrointestinal tract
Correct answer: Reduce post-acute withdrawal symptoms and alcohol craving
Acamprosate modulates glutamate activity to reduce protracted withdrawal symptoms and cravings, supporting abstinence maintenance.
Question 3: A treatment team is reviewing a patient's progress. The patient has missed three consecutive outpatient appointments. The most appropriate response is:
- Discharge the patient immediately for non-compliance
- Continue to hold the appointment slot without outreach
- Conduct outreach to re-engage the patient and assess barriers (Correct answer)
- Notify law enforcement of the patient's relapse risk
Correct answer: Conduct outreach to re-engage the patient and assess barriers
Active outreach to re-engage patients who disengage from treatment is a best practice that reduces the risk of relapse and overdose.
Question 4: When implementing Motivational Interviewing (MI) techniques in treatment planning, the nurse focuses on:
- Confronting the patient's denial directly and firmly
- Eliciting the patient's own reasons for change and strengthening commitment (Correct answer)
- Providing expert advice about why the patient should stop using substances
- Using peer pressure from group therapy to motivate change
Correct answer: Eliciting the patient's own reasons for change and strengthening commitment
MI is a collaborative, person-centered approach that elicits intrinsic motivation by exploring the patient's own values and goals.
Question 5: A nurse is developing a relapse prevention plan for a patient discharging from residential treatment. Which component is MOST essential to include?
- A list of substances the patient must avoid forever
- Identification of personal triggers and specific coping strategies (Correct answer)
- A contract promising the patient will never use substances again
- Weekly urine drug screens for the next five years
Correct answer: Identification of personal triggers and specific coping strategies
Effective relapse prevention plans are individualized and include the patient's specific triggers along with rehearsed coping responses for each.
Question 6: A patient with opioid use disorder is pregnant. The recommended pharmacotherapy approach is:
- Advise medically supervised rapid detoxification to protect the fetus
- Initiate methadone or buprenorphine maintenance therapy (Correct answer)
- Withhold all medications until after delivery to avoid neonatal exposure
- Prescribe naltrexone as the safest option during pregnancy
Correct answer: Initiate methadone or buprenorphine maintenance therapy
Methadone or buprenorphine maintenance is the standard of care in pregnancy as it reduces illicit opioid use, overdose risk, and fetal exposure to cycles of withdrawal.
Question 7: Which approach best describes person-centered care in addiction treatment planning?
- The clinician determines the treatment plan based solely on clinical evidence
- Treatment priorities are set by the insurance payer to control costs
- Goals and interventions are developed collaboratively based on the patient's values and preferences (Correct answer)
- The patient follows a standardized protocol regardless of individual circumstances
Correct answer: Goals and interventions are developed collaboratively based on the patient's values and preferences
Person-centered care prioritizes the patient's own values, preferences, and goals as central to all treatment planning decisions.
CARN Treatment Planning & Implementation 3
Which assessment tool is specifically designed to match patients to the appropriate level of addiction treatment based on six dimensions?