CARN Treatment Planning & Implementation 5 — Questions and Answers
Question 1: A patient with alcohol use disorder has a history of severe withdrawal seizures. During treatment planning, the nurse prioritizes:
- Scheduling an EEG before starting any pharmacotherapy
- Medically managed withdrawal stabilization before initiating psychosocial treatment (Correct answer)
- Immediate referral to neurology for seizure disorder management
- Outpatient detoxification since the patient has completed treatment before
Correct answer: Medically managed withdrawal stabilization before initiating psychosocial treatment
A history of severe withdrawal seizures indicates high risk and requires medically managed inpatient detoxification before engaging in psychosocial rehabilitation.
Question 2: Which statement best describes the harm reduction approach in addiction treatment planning?
- Abstinence is the only acceptable treatment goal
- Any reduction in drug-related harm is a valid and meaningful treatment goal (Correct answer)
- Harm reduction enables drug use and should be avoided in treatment settings
- Harm reduction is only appropriate for patients who refuse all treatment
Correct answer: Any reduction in drug-related harm is a valid and meaningful treatment goal
Harm reduction accepts that any positive change, including reduced use or safer use practices, constitutes meaningful progress toward health.
Question 3: A patient receiving methadone maintenance therapy wants to eventually taper off methadone. The nurse advises that:
- Tapering should begin immediately after three months of stability
- Tapering decisions should be individualized and made collaboratively based on the patient's readiness and stability (Correct answer)
- Patients on methadone should remain on it indefinitely with no consideration of tapering
- Tapering can only occur if the patient has been in treatment for at least five years
Correct answer: Tapering decisions should be individualized and made collaboratively based on the patient's readiness and stability
Decisions about methadone tapering are individualized and require assessing stability, support systems, and patient readiness in a collaborative discussion.
Question 4: A nurse implements a disease management model for addiction care. A core component of this model is:
- Treating addiction as a moral failing requiring punitive interventions
- Providing acute episode care only with no chronic disease follow-up
- Ongoing monitoring, relapse management, and long-term patient engagement (Correct answer)
- Limiting treatment episodes to a single course of 28 days
Correct answer: Ongoing monitoring, relapse management, and long-term patient engagement
The chronic disease management model treats addiction like other chronic illnesses, emphasizing long-term monitoring, support, and proactive relapse management.
Question 5: When a patient with opioid use disorder is transitioning from inpatient to outpatient care, the nurse ensures which action is completed BEFORE discharge?
- The patient has completed a minimum of 30 days of sobriety
- A follow-up appointment with outpatient services is confirmed and documented (Correct answer)
- The patient has demonstrated mastery of all 12 steps
- Insurance pre-authorization is obtained for the next five years of treatment
Correct answer: A follow-up appointment with outpatient services is confirmed and documented
Confirmed outpatient follow-up appointments before discharge significantly reduce the risk of treatment dropout and overdose death in the transition period.
Question 6: A nurse is evaluating the effectiveness of a patient's current treatment plan. Which outcome measure is MOST directly linked to treatment plan goals for addiction?
- The patient's credit score and financial stability
- Days of abstinence or reduced substance use since last review (Correct answer)
- Number of group therapy sessions attended regardless of participation quality
- The patient's reported satisfaction with the treatment facility's amenities
Correct answer: Days of abstinence or reduced substance use since last review
Days of abstinence or documented reduction in substance use is the primary clinical outcome measure aligned with addiction treatment goals.
Question 7: A patient declines a recommended step-down to a less intensive level of care. The nurse's best response is to:
- Discharge the patient for refusing the clinical recommendation
- Document the decision and explore the patient's concerns and fears about stepping down (Correct answer)
- Override the patient's wishes because clinical judgment must prevail
- Immediately involve the ethics committee to resolve the dispute
Correct answer: Document the decision and explore the patient's concerns and fears about stepping down
Exploring the patient's concerns respects autonomy while allowing the nurse to address fears, provide education, and build agreement through shared decision-making.
CARN Treatment Planning & Implementation 5
A patient with alcohol use disorder has a history of severe withdrawal seizures.
During treatment planning, the nurse prioritizes: