NRSADVN
RN Practice In Primary
Care & Substance Use
Disorder
Q & A w/ Rationales
2024
,1. A 45-year-old male patient presents to the primary care
clinic with complaints of fatigue, weight loss, and frequent
urination. He has a history of hypertension and smoking.
The nurse suspects that he may have diabetes mellitus.
Which of the following tests would be most appropriate to
confirm the diagnosis?
a) Fasting plasma glucose
b) Oral glucose tolerance test
c) Glycated hemoglobin (A1C)
d) Random blood glucose
*Answer: c) Glycated hemoglobin (A1C)*
Rationale: A1C is a measure of the average blood glucose
level over the past 2 to 3 months. It is a reliable indicator of
diabetes mellitus and does not require fasting or oral
glucose ingestion. A1C levels of 6.5% or higher indicate
diabetes mellitus. Fasting plasma glucose, oral glucose
tolerance test, and random blood glucose are also used to
diagnose diabetes mellitus, but they are less accurate and
more affected by factors such as food intake, stress, and
medication.
2. A 25-year-old female patient visits the primary care
clinic for a routine check-up. She reports that she has been
using heroin for the past year and wants to quit. She has
tried to stop several times but experienced withdrawal
symptoms such as nausea, vomiting, diarrhea, muscle
aches, and anxiety. She asks the nurse what treatment
options are available for her. Which of the following
, responses by the nurse is most appropriate?
a) "You should enroll in a methadone maintenance
program. Methadone is a synthetic opioid that can prevent
withdrawal symptoms and reduce cravings for heroin."
b) "You should try buprenorphine/naloxone (Suboxone). It
is a combination of an opioid agonist and an antagonist that
can help you taper off heroin gradually and safely."
c) "You should consider naltrexone (Vivitrol). It is an
opioid antagonist that can block the effects of heroin and
other opioids. It can also reduce your risk of relapse."
d) "You should seek counseling and behavioral therapy.
They can help you identify the triggers and coping
strategies for your heroin use. They can also provide
support and motivation for your recovery."
*Answer: b) You should try buprenorphine/naloxone
(Suboxone). It is a combination of an opioid agonist and an
antagonist that can help you taper off heroin gradually and
safely.*
Rationale: Buprenorphine/naloxone (Suboxone) is a
medication-assisted treatment (MAT) for opioid use
disorder. Buprenorphine is a partial opioid agonist that can
bind to the same receptors as heroin and other opioids, but
with less euphoria and dependence potential. Naloxone is
an opioid antagonist that can reverse the effects of opioids
in case of overdose. Suboxone can be taken as a sublingual
film or tablet once daily under the supervision of a health
care provider. It can reduce withdrawal symptoms,
cravings, and illicit opioid use. Methadone is another MAT
for opioid use disorder, but it has more side effects,
interactions, and risks than Suboxone. It also requires daily
RN Practice In Primary
Care & Substance Use
Disorder
Q & A w/ Rationales
2024
,1. A 45-year-old male patient presents to the primary care
clinic with complaints of fatigue, weight loss, and frequent
urination. He has a history of hypertension and smoking.
The nurse suspects that he may have diabetes mellitus.
Which of the following tests would be most appropriate to
confirm the diagnosis?
a) Fasting plasma glucose
b) Oral glucose tolerance test
c) Glycated hemoglobin (A1C)
d) Random blood glucose
*Answer: c) Glycated hemoglobin (A1C)*
Rationale: A1C is a measure of the average blood glucose
level over the past 2 to 3 months. It is a reliable indicator of
diabetes mellitus and does not require fasting or oral
glucose ingestion. A1C levels of 6.5% or higher indicate
diabetes mellitus. Fasting plasma glucose, oral glucose
tolerance test, and random blood glucose are also used to
diagnose diabetes mellitus, but they are less accurate and
more affected by factors such as food intake, stress, and
medication.
2. A 25-year-old female patient visits the primary care
clinic for a routine check-up. She reports that she has been
using heroin for the past year and wants to quit. She has
tried to stop several times but experienced withdrawal
symptoms such as nausea, vomiting, diarrhea, muscle
aches, and anxiety. She asks the nurse what treatment
options are available for her. Which of the following
, responses by the nurse is most appropriate?
a) "You should enroll in a methadone maintenance
program. Methadone is a synthetic opioid that can prevent
withdrawal symptoms and reduce cravings for heroin."
b) "You should try buprenorphine/naloxone (Suboxone). It
is a combination of an opioid agonist and an antagonist that
can help you taper off heroin gradually and safely."
c) "You should consider naltrexone (Vivitrol). It is an
opioid antagonist that can block the effects of heroin and
other opioids. It can also reduce your risk of relapse."
d) "You should seek counseling and behavioral therapy.
They can help you identify the triggers and coping
strategies for your heroin use. They can also provide
support and motivation for your recovery."
*Answer: b) You should try buprenorphine/naloxone
(Suboxone). It is a combination of an opioid agonist and an
antagonist that can help you taper off heroin gradually and
safely.*
Rationale: Buprenorphine/naloxone (Suboxone) is a
medication-assisted treatment (MAT) for opioid use
disorder. Buprenorphine is a partial opioid agonist that can
bind to the same receptors as heroin and other opioids, but
with less euphoria and dependence potential. Naloxone is
an opioid antagonist that can reverse the effects of opioids
in case of overdose. Suboxone can be taken as a sublingual
film or tablet once daily under the supervision of a health
care provider. It can reduce withdrawal symptoms,
cravings, and illicit opioid use. Methadone is another MAT
for opioid use disorder, but it has more side effects,
interactions, and risks than Suboxone. It also requires daily
