NR547 WEEK 8 EXAM QUESTIONS &
UPDATED CORRECT ANSWERS
Substance use disorder occurs when: - CORRECT ANSWER the recurrent use of a
substance, such as alcohol or drugs, causes clinically significant impairment
-including health problems, disability, or failure to meet responsibilities at home, work, or
school
Tolerance - CORRECT ANSWER With repeated ingestion of a drug, the drug shows
decreased effect. Increasing doses are required to achieve the effects noted with the
original administration
Dependence - CORRECT ANSWER State of adaptation produced with repeated
administration of certain drugs so that physical symptoms occur when the drug is
discontinued abruptly.
Addiction - CORRECT ANSWER A change in behavior caused by biochemical
changes in the brain after continued substance use characterized by preoccupation with
and repeated use of a substance despite of negative outcomes.
Withdrawal - CORRECT ANSWER Physiological and psychological reactions that
occur when the use of a substance is stopped abruptly.
Intoxication - CORRECT ANSWER Condition following the ingestion of a substance
resulting in changes in level of consciousness, cognition, perception, judgment, and
behavior.
Bernita is a 64-year-old who has been using heroin for 6 years. She is currently
unemployed and lives with her daughter in the city center. She does not have health
insurance.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Methadone
Methadone is a full μ-receptor agonist with a long half-life, which can prevent withdrawal
symptoms for 24 hours and provide steady control of cravings throughout the day. It is
only administered in methadone federally regulated opioid treatment programs (OTP).
Methadone clinics incorporate psychosocial interventions and require daily attendance
for the first several months, so this is a good option for a client that has the flexibility to
,attend daily meetings. Use of methadone in MAT for opioid use disorder helps extend
client survival. When patients stop methadone, they have a high likelihood of relapsing,
even 10 years after starting treatment.
Antoine is a 34-year-old who has been abusing prescription oxycodone. He is employed
but is on probation at work for increased absenteeism. He desires MAT but is
concerned about his roommates stealing his medication to get high.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Buprenorphine plus naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is a mu opioid receptor antagonist
and can therefore block the effects of buprenorphine; however, because naloxone has
poor sublingual bioavailability, it does not interfere with buprenorphine's effects when
used properly. Naloxone does have good parenteral bioavailability; thus, if one tries to
administer the buprenorphine/naloxone formulation intravenously, naloxone will prevent
any rewarding effects from buprenorphine, making this drug a less desirable street drug.
Suboxone is a good option for a client who may not be able to leave work for medication
dosing, as it does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin, and booze" regularly. She lives
in a rural area and is employed part-time. She has a history of poor compliance with
past treatments.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Naltrexone
Naltrexone blocks mu opioid receptors, preventing exogenous opioids from binding
there and thus preventing the pleasurable effects of opioid consumption. This
medication also reduces alcohol consumption through modulation of opioid systems,
thereby reducing the reinforcing effects of alcohol. For those patients with alcohol use
disorder, who have poor adherence to a regimen, and are unable to maintain
abstinence, long-acting injection naltrexone (Vivitrol) administered monthly can be
efficacious.
Miranda is a 20-year-old who is 18 weeks pregnant and uses heroin. She wants to get
clean "for her baby."
prescribe the proper medication:
Methadone
, Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Buprenorphine
Buprenorphine is a partial opioid agonist which binds with strong affinity to the mu
opioid receptor, preventing exogenous opioids from binding at the receptor site,
preventing the pleasurable effects of opioid consumption. Buprenorphine is the
recommended MAT for pregnant women who use opioids.
Juan is a 19-year-old who has a history of using oxycodone that he has taken from his
grandfather and drinking occasional alcohol. He wants to stop using both substances.
prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - CORRECT ANSWER Naltrexone
Naltrexone is a good option for clients who use opioids and alcohol and are committed
to abstinence.
Nori is a 24-year-old who has a history of abusing opioid medications and binge
drinking. She is not committed to abstain from using at this time.
prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - CORRECT ANSWER Naloxone
Since Nori is not committed to abstaining at this time, it is important to provide naloxone
along with education to help her remain safe from overdose.
John is a 56-year-old with a history of seizure disorder who has smoked 1 PPD for 30
years. He has tried to quit using nicotine gum without success. He is committed to
quitting smoking but feels he would benefit from medication to help.
prescribe the proper medication:
Bupropion
Chlorpromazine
UPDATED CORRECT ANSWERS
Substance use disorder occurs when: - CORRECT ANSWER the recurrent use of a
substance, such as alcohol or drugs, causes clinically significant impairment
-including health problems, disability, or failure to meet responsibilities at home, work, or
school
Tolerance - CORRECT ANSWER With repeated ingestion of a drug, the drug shows
decreased effect. Increasing doses are required to achieve the effects noted with the
original administration
Dependence - CORRECT ANSWER State of adaptation produced with repeated
administration of certain drugs so that physical symptoms occur when the drug is
discontinued abruptly.
Addiction - CORRECT ANSWER A change in behavior caused by biochemical
changes in the brain after continued substance use characterized by preoccupation with
and repeated use of a substance despite of negative outcomes.
Withdrawal - CORRECT ANSWER Physiological and psychological reactions that
occur when the use of a substance is stopped abruptly.
Intoxication - CORRECT ANSWER Condition following the ingestion of a substance
resulting in changes in level of consciousness, cognition, perception, judgment, and
behavior.
Bernita is a 64-year-old who has been using heroin for 6 years. She is currently
unemployed and lives with her daughter in the city center. She does not have health
insurance.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Methadone
Methadone is a full μ-receptor agonist with a long half-life, which can prevent withdrawal
symptoms for 24 hours and provide steady control of cravings throughout the day. It is
only administered in methadone federally regulated opioid treatment programs (OTP).
Methadone clinics incorporate psychosocial interventions and require daily attendance
for the first several months, so this is a good option for a client that has the flexibility to
,attend daily meetings. Use of methadone in MAT for opioid use disorder helps extend
client survival. When patients stop methadone, they have a high likelihood of relapsing,
even 10 years after starting treatment.
Antoine is a 34-year-old who has been abusing prescription oxycodone. He is employed
but is on probation at work for increased absenteeism. He desires MAT but is
concerned about his roommates stealing his medication to get high.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Buprenorphine plus naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is a mu opioid receptor antagonist
and can therefore block the effects of buprenorphine; however, because naloxone has
poor sublingual bioavailability, it does not interfere with buprenorphine's effects when
used properly. Naloxone does have good parenteral bioavailability; thus, if one tries to
administer the buprenorphine/naloxone formulation intravenously, naloxone will prevent
any rewarding effects from buprenorphine, making this drug a less desirable street drug.
Suboxone is a good option for a client who may not be able to leave work for medication
dosing, as it does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin, and booze" regularly. She lives
in a rural area and is employed part-time. She has a history of poor compliance with
past treatments.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Naltrexone
Naltrexone blocks mu opioid receptors, preventing exogenous opioids from binding
there and thus preventing the pleasurable effects of opioid consumption. This
medication also reduces alcohol consumption through modulation of opioid systems,
thereby reducing the reinforcing effects of alcohol. For those patients with alcohol use
disorder, who have poor adherence to a regimen, and are unable to maintain
abstinence, long-acting injection naltrexone (Vivitrol) administered monthly can be
efficacious.
Miranda is a 20-year-old who is 18 weeks pregnant and uses heroin. She wants to get
clean "for her baby."
prescribe the proper medication:
Methadone
, Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - CORRECT ANSWER Buprenorphine
Buprenorphine is a partial opioid agonist which binds with strong affinity to the mu
opioid receptor, preventing exogenous opioids from binding at the receptor site,
preventing the pleasurable effects of opioid consumption. Buprenorphine is the
recommended MAT for pregnant women who use opioids.
Juan is a 19-year-old who has a history of using oxycodone that he has taken from his
grandfather and drinking occasional alcohol. He wants to stop using both substances.
prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - CORRECT ANSWER Naltrexone
Naltrexone is a good option for clients who use opioids and alcohol and are committed
to abstinence.
Nori is a 24-year-old who has a history of abusing opioid medications and binge
drinking. She is not committed to abstain from using at this time.
prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - CORRECT ANSWER Naloxone
Since Nori is not committed to abstaining at this time, it is important to provide naloxone
along with education to help her remain safe from overdose.
John is a 56-year-old with a history of seizure disorder who has smoked 1 PPD for 30
years. He has tried to quit using nicotine gum without success. He is committed to
quitting smoking but feels he would benefit from medication to help.
prescribe the proper medication:
Bupropion
Chlorpromazine
