PMHNP Certificate Study Addiction

Question 1

Addiction is believed to be the result of an entrenched neuronal system of chemical rewards caused by the release of

Answer 1

dopamine into the ventral tegmental area (VTA)

Question 2

Persistent and increased use of a substance or behavior that, when discontinued, causes distress and an urge to resume use despite related adverse consequences; sometimes known as psychological dependence

Answer 2

Addiction

Question 3

Repeated use of a substance for physical needs leading to increased tolerance, and, when discontinued, results in physical withdrawal symptoms.

Answer 3

Dependence

Question 4

The use of any substance that deviates from approved social or medical practice.

Answer 4

Abuse

Question 5

The learned behavior pattern characterized by enabling maladaptive coping motivated by fear of losing the relationship. Usually seen in the family members of an identified patient.

Answer 5

Codependence

Question 6

The physiological process caused by a physical change in the body due to repeated exposure to a substance.

Answer 6

Neuroadaptation

Question 7

The process by which one drug can be substituted for another drug producing the same physiological and psychological effect (e.g., benzodiazepine and phenobarbital).

Answer 7

Cross Tolerance

Question 8

A substance-specific cluster of signs and symptoms that occurs when reducing or stopping the consistent use of the substance.

Answer 8

Withdrawal

Question 9

The condition in which repeated administration of a dosage causes a decreased effect despite increasingly larger doses, which are required to obtain the effect observed of the original dosage.

Answer 9

Tolerance

Question 10

The co-occurrence of a substance use disorder with a primary mood disorder.

Answer 10

Dual Diagnosis

Question 11

Substance use disorder requires how many DSM V symptoms over how much time?

Answer 11

2 or more over 12 months

Question 12

How is substance abuse positively reinforced?

Answer 12

dopamine mediated in the ventral tegmental area and nucleus accumbens in the brain.

Question 13

How is substance abuse negatively reinforced

Answer 13

When they stop using it; GABA mediated response triggers symptoms of dysphoria and anxiety

Question 14

Agitation, restlessness, irritability, grandiosity, elatedness, euphoria, aggression, lability may indicate use of

Answer 14

stimulants

Question 15

Dysphoria, impaired attention, impaired memory, disinhibition, psychomotor retardation, paranoia may indicate use of

Answer 15

Depressants

Question 16

Mood swings, panic, aggression, paranoia, flashbacks, tremors, impaired cognition may indicate use of

Answer 16

Hallocinagens

Question 17

Paranoia, confusion, disorientation to time may indicate use of

Answer 17

Cannabis

Question 18

Irritability, delirium, confusion, stupor may indicate use of

Answer 18

inhalants

Question 19

Pinpoint pupils and or nystagmus indicate

Answer 19

Opioid use

Question 20

What labs will likely be elevated with alcohol abuse?

Answer 20

AST, ALT, GGT, PT, Potassium, Cholesterol, Triglycerides, Amylase, Homocysteine

Question 21

Would lab will likely be decreased with alcohol abuse?

Answer 21

sodium

Question 22

What is legal intoxication of blood alcohol level?

Answer 22

0.08%

Question 23

What is considered an impaired blood alcohol level?

Answer 23

0.08-0.4%

Question 24

At what blood alcohol level is there a risk of death?

Answer 24

> 0.4%

Question 25

Which type of withdrawals can be fatal?

Answer 25

Benzodiazepines and alcohol

Question 26

should not be used until the patient has been alcohol free for at least 12 hours. The client should avoid any alcohol-containing products (mouthwash, cough medicine, vinegar, extracts) for up to 14 days after the last dose.

Answer 26

Disulfiram (Anatabuse)

Question 27

Which medication Reverses opioid sedation?

Answer 27

Naloxone

Question 28

Which medication is longer acting, reduces cravings, enhances abstinence efforts by blocking reward associated with substance?

Answer 28

Naltrexone

Question 29

Which medication reduces opioid cravings, facilitates opioid detox, preferred for long-acting formulations

Answer 29

Buprenorphine

Question 30

Which medication reduces cravings, facilitates opioid detox, preferred for short acting formulations

Answer 30

Buprenorphine/ naloxone

Question 31

Which medication is long-acting opioid suppresses withdrawal, requires a government approved program

Answer 31

methadone

Question 32

Which medication reduces alcohol cravings and promotes abstinence-reducing tolerance effects

Answer 32

Acamprosate

Question 33

Which medication is aversive therapy when alcohol is consumed: vomiting, nausea, headache, flushing

Answer 33

Disulfiram

Question 34

Which two antidepressants can be prescribed for substance use disorder?

Answer 34

citalopram and bupropion

Question 35

Which Selective serotonin (5-HT3) antagonist can be prescribed to reduce cravings?

Answer 35

Ondansetron

Question 36

The patient’s reaction to a lapse, if attributed to self-failure; negative emotions may follow. Alternatively, if the lapse is viewed as a learning opportunity relapse is less likely to occur and the likelihood of future relapse is reduced.

Answer 36

Abstinence violation effect

Question 37

When is the most common time for drug and alcohol debut?

Answer 37

Adolesence

Question 38

In the older adult with substance use disorder you may opt for what treatment over detox?

Answer 38

harm reduction strategy rather than total abstinence given the physiological strain of detox; requires