1. Nurses may only prescribe buprenorphine products for the treatment of addiction in States that allow them to prescribe Schedule III, IV, or V drugs.
A. True B. False2. The nurse's role with patients receiving buprenorphine for the treatment of addiction may include:
A. Conducting screening, assessment, treatment monitoring, counseling, and supportive services. B. Educating patients, their family members, or other supportive individuals about buprenorphine therapy as well as risks, benefits, potential side effects, interactions, program requirements, consents, and treatment contracts. C. Assisting patients in accessing care elsewhere when the present practice is not a suitable option for them. D. All of the above.3. Which is the receptor most relevant to opioid abuse and treatment due to exerting the majority of the analgesic, euphorigenic, and addictive effects?
A. Mu B. Kappa C. Delta D. All of the above4. Drugs that activate receptors in the brain are termed:
A. Antagonists B. Agonists C. Partial agonists D. All of the above5. Under which of the following conditions would full agonists and partial agonists produce effects that are indistinguishable?
A. At lower doses and in individuals who are not dependent on opioids. B. At lower doses and in individual who are dependent on opioids. C. At higher doses and in individuals who are not dependent on opioids. D. At higher doses and in individuals who are dependent on opioids.6. Buprenorphine is a mu opioid antagonist.
A. True B. False7. Typical signs and symptoms of the opioid withdrawal syndrome include:
A. Lacrimation B. Piloerection C. Yawning D. All of the above8. The primary distinguishing characteristic that differentiates dependence from addiction is the behavioral component of continued use despite negative consequences.
A. True B. False9. In an individual who is physically dependent on heroin, spontaneous withdrawal usually beings 6 - 12 hours after the last dose and peaks in intensity 36 - 72 hours after the last use.
A. True B. False10. Buprenorphine's __________ contributes to its long duration of action.
A. Intrinsic activity B. Slow dissociation C. High affinity D. Low affinity11. All of the following are associated with a higher abuse potential of a drug, except for:
A. A faster route of drug administration. B. A shorter half-life. C. A longer half-life. D. A faster onset of action.12. Typically, the total dose of either Subutex or Suboxone should not exceed:
A. 2 mg B. 4 mg C. 8 mg D. 16 mg13. Both naloxone and buprenorphine have:
A. Low sublingual bioavailability B. Good sublingual bioavailability C. Poor gastrointestinal bioavailability D. Both (B) and (C)14. Under which of the following circumstance would buprenorphine by itself precipitate withdrawal in opioid-dependent individuals?
A. With higher levels of opioid dependence. B. With higher doses of buprenorphine. C. With shorter time intervals between the dose of an opioid full agonists and a dose of buprenorphine. D. Any of the above.15. The maximal agonist effects of buprenorphine appear to occur in the dose range of 16 - 32 mg for sublingual tablets, and due to this ceiling effect, the drug is less likely than opioid full agonists to produce respiratory depression and other adverse effects.
A. True B. False16. Despite the fact that naloxone is classified as Pregnancy Category B, it should be used with caution in pregnant women who are addicted to opioids.
A. True B. False17. Drugs that require extra precautions and may require dosage adjustments include:
A. Ketoconazole B. Certain Antibiotics C. HIV protease inhibitors and non-nucleoside reverse transcriptase inhibitors D. All of the above18. Detoxification should not be considered for women who become pregnant while on buprenorphine products as this could be harmful to the fetus.
A. True B. False19. All of the following are advantages associated with providing office-based treatment, except for:
A. Increasing the availability of treatment. B. The ability to provide or recommend appropriate psychosocial services. C. The ability to tailor services to the needs of patients. D. Minimization of the potential stigma associated with treatment.20. Optimally, buprenorphine should be administered before the patient exhibits definite signs of withdrawal.
A. True B. False21. To avoid precipitous onset of withdrawal symptoms, long-acting opioids should be tapered to the equivalent of 30 - 40 mg of methadone daily, and the last dose of methadone should be taken at least 24 hours prior to initiation of the buprenorphine therapy for methadone and at least 48 hours for levomethadyl acetate.
A. True B. False22. Medically supervised withdrawal alone is almost always sufficient to achieve long-term abstinence.
A. True B. False23. The goal of induction is to find the minimum dose at which the patient markedly reduces or eliminates use of other opioids and experiences no withdrawal symptoms, side effects, or cravings.
A. True B. False24. Psychosocial counseling is a priority during the:
A. Induction phase B. Stabilization phase C. Maintenance phase D. All of the above25. Patients should be involved in the development of their treatment plans.
A. True B. False26. The best way to avoid precipitated withdrawal is to:
A. Assess accurately the individual's patterns of opioid use. B. Determine whether the patient was on short- or long-acting opioid medications before initiating buprenorphine. C. Monitor trial dosing. D. All of the above.27. It is important for patients to understand that once they being the medical withdrawal, they cannot return to a higher dose.
A. True B. False28. The first approach to the treatment of pain is nonpharmacological interventions including physical and cognitive behavioral modalities.
A. True B. False29. Nurses should periodically assess which of the following?
A. Activities of daily living B. Adverse effects C. Aberrant drug-related behaviors D. All of the above30. Nurses may assist in:
A. Ruling out comorbid acute or chronic pain disorders, opioid dependence, and/or polysubstance use. B. Questioning about potential pregnancy and child-bearing status. C. Screening for infectious diseases. D. All of the above.31. Treatment should be delayed pending complete patient assessment.
A. True B. False32. Nurses should be aware that all of the following medical conditions are commonly associated with opioid and other drug addictions, except for:
A. Type 2 diabetes B. Nutritional deficiencies and anemia C. Hepatitis D. Chronic obstructive pulmonary disease33. Maintenance treatment with buprenorphine is not recommended for patients who do not meet DSM-IV-TR criteria for opioid dependence.
A. True B. False34. Patients are less likely to be appropriate candidates for buprenorphine treatment for opioid addiction if they have any of the following, except:
A. Comorbid dependence on high doses of benzodiazepines or other central nervous system depressants, including alcohol. B. Active or chronic suicidal or homicidal ideation or attempts. C. The need to be opioid-free quickly, such as impending incarceration, foreign travel, or job requirement. D. Significant medical complications.35. Nurses should continuously monitor possible drug use during treatment, as it is not unusual for relapses to occur during treatment.
A. True B. False36. Before treatment induction, nurses should review which of the following instructions with patients to prepare them for the first day of induction?
A. Come to the doctor's office in mild withdrawal. B. Do not plan to drive for 24 hours after receiving the first dose(s) of buprenorphine medication. C. Do not talk, eat, drink, or swallow while the medication is in mouth. D. All of the above.37. When dispensing the first medication dose, it is crucial that nurses:
A. Watch the patient put the tablet in the right place under the tongue. B. Check periodically to see the tablet shrinking. C. Check that the tablet is completely gone. D. All of the above.38. SAMHSA confidentiality regulation, Title 42, Part 2 of the Code of Federal Regulations mandates that addiction treatment information in the possession of substance abuse treatment providers be handled with a greater degree of confidentiality than general medical information.
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