CARN - Certified Addictions Registered Nurse Pharmacology of Addictive Substances Questions and Answers

Question 1

A client with alcohol use disorder is prescribed acamprosate. The nurse should explain that the primary mechanism of action for this medication is to:

Accepted Answer

Restore the balance between GABA and glutamate neurotransmission.

Answer

Acamprosate is believed to work by restoring the natural balance of chemical signaling in the brain that is disrupted by chronic alcohol use, specifically involving the GABA and glutamate neurotransmitter systems. It is not an aversive agent like disulfiram, nor does it block opioid receptors like naltrexone.

Question 2

A nurse is caring for a patient experiencing withdrawal from a short-acting opioid like heroin. Which of the following symptoms would the nurse expect to see peak within 1 to 3 days after the last use?

Accepted Answer

Rhinorrhea, muscle aches, and gastrointestinal distress

Answer

The peak of withdrawal from short-acting opioids such as heroin typically occurs between 24 and 72 hours. Symptoms are often flu-like and include runny nose (rhinorrhea), lacrimation, muscle and bone pain, diarrhea, nausea, and vomiting. The other options are symptoms of opioid intoxication, not withdrawal.

Question 3

A patient is being initiated on naltrexone for the treatment of opioid use disorder. Which statement by the patient indicates a need for further education?

Accepted Answer

"This medication is a partial opioid agonist that will prevent withdrawal."

Answer

Naltrexone is a pure opioid antagonist, not a partial agonist. It works by blocking the mu-opioid receptors, which prevents the euphoric and sedative effects of opioids and helps reduce cravings. It does not activate the receptors and therefore does not prevent withdrawal; in fact, taking it while physically dependent on opioids will precipitate acute withdrawal. Buprenorphine is an example of a partial opioid agonist.

Question 4

A nurse is providing education to a client who has been prescribed disulfiram. The nurse should warn the client to avoid which of the following products?

Accepted Answer

Mouthwash containing alcohol

Answer

Disulfiram works by inhibiting the enzyme aldehyde dehydrogenase, leading to an accumulation of acetaldehyde if alcohol is consumed. This causes a severe, unpleasant reaction. Many common products, including mouthwash, cough syrups, and some topical preparations, contain alcohol and can trigger this reaction.

Question 5

A patient who has been on long-term, high-dose benzodiazepine therapy abruptly stops taking the medication. The nurse should be most concerned about the patient developing:

Accepted Answer

Grand mal seizures

Answer

Abrupt cessation of benzodiazepines, which are GABA-A receptor agonists, can lead to a severe and potentially life-threatening withdrawal syndrome. This is characterized by central nervous system hyperexcitability, which can manifest as anxiety, insomnia, tremors, and in severe cases, seizures and delirium.

(CARN) Certified Addictions Registered Nurse Practice Test

(CARN) Certified Addictions Registered Nurse Practice Test

CARN - Certified Addictions Registered Nurse Pharmacology of Addictive Substances Questions and Answers