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Quantum Units Education®

Medications for Opioid Use Disorder

Part 1: Introduction to Medications for Opioid Use Disorder Treatment

1. A 28-year-old male patient has questions regarding methadone. Which of the following educational points should be expressed to the patient?

A. Methadone is typically administered by intramuscular injection.

B. Methadone should not be taken for more than two consecutive days.

C. Methadone is used in the medically supervised withdrawal, maintenance phase of treatment.

D. Methadone is not associated with respiratory depression.


2. A fellow healthcare professional has questions regarding buprenorphine. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Buprenorphine is an opioid receptor antagonist.

B. Buprenorphine may not be administered sublingually.

C. Concurrent use with naloxone is contraindicated.

D. Buprenorphine is a Schedule III medication.


3. A fellow healthcare professional has questions regarding naltrexone. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Naltrexone is an opioid receptor partial agonist.

B. Naltrexone may be administered orally.

C. Naltrexone is not associated with possible nausea or anxiety.

D. Naltrexone is a Schedule II medication.


4. Which of the following medication therapies is most likely to cause QT prolongation?

A. Methadone

B. Naltrexone

C. Buprenorphine

D. Buprenorphine implant


5. Which of the following medication therapies is most likely to cause suicidality?

A. Methadone

B. Naltrexone

C. Buprenorphine

D. Buprenorphine implant


6. Ativan is ordered for a female patient taking buprenorphine. Which of the following possible adverse effects of buprenorphine may be most affected by the addition of Ativan to the patient's medication regimen?

A. Constipation

B. Excessive sweating

C. Muscle cramps

D. Respiratory depression


7. A fellow healthcare professional has questions regarding buprenorphine for subcutaneous injection. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Pharmacies may directly dispense buprenorphine for subcutaneous injection to individuals under the age of 18.

B. Pharmacies must be certified in the Sublocade REMS Program and only dispense the medication directly to a provider for administration.

C. Buprenorphine for subcutaneous injection does not require a waiver when prescribed outside OTPs.

D. Buprenorphine for subcutaneous injection does not require a waiver when prescribed outside OTPs to individuals over the age of 65.


8. Methadone is associated with which of the following?

A. Increased rates of cellulitis

B. Increased rates of HIV risk behavior

C. Reduced risk of HIV and hepatitis C infection

D. Reduced rates of long-term care facility admissions


9. The FDA approved buprenorphine extended release injection (Sublocade) in November 2017 to treat which of the following types of patients?

A. Patients with mild OUD

B. Patients with mild or moderate OUD who have not first received treatment with transmucosal buprenorphine for at least 1 week

C. Patients with moderate or severe OUD who have first received treatment with transmucosal buprenorphine for at least 1 week

D. Patients with moderate or severe OUD who have first received treatment with transmucosal buprenorphine for at least 1 month


10. Which of the following statements is most accurate?

A. OTPs cannot dispense buprenorphine under OTP regulations unless they receive a federal waiver.

B. OTPs cannot dispense buprenorphine to patients over the age of 65, under OTP regulations, until they receive a federal waiver.

C. Prescribing buprenorphine implants requires Probuphine REMS Program certification.

D. Prescribing naltrexone requires REMS Program certification.


11. A fellow healthcare professional has questions regarding OUD medications. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Any accredited OTPs, without federal certification, can dispense methadone to treat OUD.

B. Only federally certified pharmacies can dispense naltrexone.

C. Only federally certified prescribers can offer naltrexone.

D. Any prescriber can offer naltrexone.


12. Which of the following is necessary before a patient can start naltrexone?

A. Medically supervised withdrawal, which requires at least 4 days without short-acting opioids and 8 to 10 days without long-acting opioids.

B. Medically supervised withdrawal, which requires at least 7 days without short-acting opioids and 10 to 14 days without long-acting opioids.

C. Medically supervised withdrawal, that requires at least 7 days without short-acting opioids and involves a nutrition consult.

D. Medically supervised withdrawal, that requires at least 10 to 21 days without long-acting opioids and involves testing for sexually transmitted diseases, including HIV.


Part 2: Addressing Opioid Use Disorder in General Medical Settings

13. Which of the following questions may be used to complete a NIAAA Single-Item Screener for a 58-year-old male patient?

A. How many times in the past month have you had four or more drinks in a day?

B. How many times in the past month have you had five or more drinks in a day?

C. How many times in the past year have you had four or more drinks in a day?

D. How many times in the past year have you had five or more drinks in a day?


14. A healthcare professional asks a 40-year-old male patient the following question to conduct a Single-Item Drug Screener: how many times in the past year have you used an illegal drug or a prescription medication for nonmedical reasons? Which of the following patient answers would result in a positive screen?

A. 1 or more days

B. 2 or more days

C. 4 or more days

D. 6 or more days


15. A team of healthcare professionals utilizes a Two-Item Drug Use Disorder Screener for Primary Care Clinics to screen a 38-year-old U.S. veteran. The patient's answer to the first question of the aforementioned screener is "6 days." Based on the patient's answer to the first question how should the team of healthcare professionals proceed?

A. Determine the screen is positive.

B. Conclude the screen is positive and move onto the second question.

C. Proceed to the second question of the Two-Item Drug Use Disorder Screener for Primary Care Clinics.

D. Proceed to the second question of the Two-Item Drug Use Disorder Screener for Primary Care Clinics after a urine drug test is completed.


16. Which of the following best represents an open-ended question regarding OUD?

A. Has oxycodone caused your family trouble?

B. In what ways has oxycodone affected your life?

C. Has oxycodone caused you personal problems?

D. Are you in relationship trouble due to oxycodone use?


17. Which of the following endocrine/metabolic medical problems is associated with opioid use?

A. Osteopenia

B. Seizures

C. Sleep disturbances

D. Constipation


18. A team of healthcare professionals believes a 22-year-old male patient is experiencing opioid intoxication. Which of the following most represents a sign of patient opioid intoxication?

A. Highly alert

B. Drowsy but not arousable

C. Dilated pupils

D. Impaired memory or concentration


19. A patient enters Grade 2 early withdrawal from an opioid. Which of the following physical signs/symptoms is most likely to occur during Grade 2 early withdrawal from an opioid?

A. Lacrimation

B. Diaphoresis

C. Muscle twitching

D. Tachycardia


20. A fellow healthcare professional has questions regarding the duration of withdrawal from long-acting opioids. Which of the following informational points of interest should be communicated to the healthcare professional?

A. The expected duration of withdrawal from long-acting opioids is 6-8 days.

B. The expected duration of withdrawal from long-acting opioids is 7-10 days.

C. The expected duration of withdrawal from long-acting opioids is 8-12 days.

D. The expected duration of withdrawal from long-acting opioids is 14 days or more.


21. Which of the following statements is most accurate?

A. The typical opioid immunoassay will detect buprenorphine.

B. The typical opioid immunoassay will detect fentanyl, but not buprenorphine.

C. The typical opioid immunoassay will only detect methadone.

D. The typical opioid immunoassay will only detect morphine.


22. What is the window of detection for barbiturates?

A. 2-4 days

B. Up to 8 days

C. Up to 6 weeks

D. Up to 12 weeks


23.  A fellow healthcare professional has questions regarding urine drug testing for buprenorphine. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Buprenorphine will screen positive on opiate screen.

B. Tramadol can cause false positives.

C. Buprenorphine cannot be tested for specifically.

D. Buprenorphine cannot be tested for specifically in patients over the age of 65 on other medications.


24. A patient with a suspected OUD undergoes examination. Upon examination, a team of healthcare professionals identifies five DSM-5 related criteria. The patient receives an OUD diagnosis. Based on the aforementioned patient information, which of the following best represents the severity of the patient's OUD?

A. Mild

B. Moderate

C. Severe

D. Very severe


25. Which of the following best represents DSM-5 criteria for an OUD diagnosis?

A. A lack of a persistent desire to cut down or control opioid use.

B. A great deal of time is spent in activities to obtain the opioid, use the opioid, or recover from its effects.

C. Recurrent opioid use not resulting in a failure to fulfill major role obligations at work, school, or home.

D. A markedly increased effect with continued use.


26. A 24-year-old female patient has questions regarding the risk of medication induced respiratory depression with methadone. Which of the following educational points should be expressed to the patient?

A. There is no risk of medication induced respiratory depression with methadone.

B. The risk is lower, when compared to the risk associated with buprenorphine.

C. Rare, although it may be elevated during the first 2 weeks of treatment.

D. The risk is high.


27. A fellow healthcare professional has questions regarding the risk of precipitated withdrawal when starting buprenorphine. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Mild withdrawal is possible if a period of abstinence is inadequate before starting buprenorphine.

B. Severe withdrawal is possible if a period of abstinence is inadequate before starting buprenorphine.

C. It can occur if started too prematurely after recent use of other opioids.

D. Precipitated withdrawal is not associated with buprenorphine.


28. Which of the following best represents a possible treatment setting for methadone?

A. Office-based site

B. Outpatient SUD treatment program

C. Residential SUD treatment program

D. OTP


29. A healthcare professional is considering referring a patient who receives OUD pharmacotherapy to behavioral health therapy. What should be the healthcare professional's first consideration?

A. Patient transportation

B. Patient housing

C. Is the patient entering an OTP for methadone or intensive treatment?

D. Is the patient willing to engage in additional behavioral health therapies?


30. A caregiver has questions regarding opioid overdose identification. Which of the following informational points of interest should be communicated to the caregiver?

A. An increased heartbeat may be an indication of an opioid overdose.

B. The following may be an indication of an opioid overdose: an individual can be easily awakened but is unable to speak clearly.

C. The following may be an indication of an opioid overdose: an individual has mild abdominal cramping.

D. The following may be an indication of an opioid overdose: an individual's fingernails or lips are blue or purple.


31. A male patient undergoes an AUDIT-C. The patient's AUDIT-C score is 4. Based on the patient's AUDIT-C score, which of the following statements is most accurate?

A. The patient's score is considered negative.

B. The patient's score is considered negative, however due to AUDIT-C score criteria the patient should undergo another AUDIT-C within 48 hours.

C. The patient's score is considered positive.

D. The patient's score is considered positive, however due to AUDIT-C score criteria the patient should undergo an additional AUDIT-C, within 48-72 hours, to confirm the positive result.


32. A fellow healthcare professional has questions regarding the TAPS Tool Part 2. Which of the following informational points of interest should be communicated to the healthcare professional?

A. The TAPS Tool Part 2 is a brief assessment for tobacco use only.

B. The TAPS Tool Part 2 is a brief assessment for tobacco and alcohol use only.

C. The TAPS Tool Part 2 is a brief assessment for tobacco use, alcohol use, illicit substance use, and prescription medication misuse in the past 3 months only.

D. The TAPS Tool Part 2 is a brief assessment for tobacco use, alcohol use, illicit substance use, and prescription medication misuse in the past 6 months only.


Part 3: Pharmacotherapy for Opioid Use Disorder

33. A 22-year-old male patient is about to start methadone for OUD treatment. Which of the following education points should be expressed to the patient?

A. The first dose will be administered during opioid withdrawal.

B. The first dose will be administered 10-21 days after the last dose of an opioid.

C. The methadone dose will start low and build up slowly to avoid oversedation.

D. The methadone dose will start high.


34. A fellow healthcare professional has questions regarding the administration of XR-NTX. Which of the following informational points of interest should be communicated to the healthcare professional?

A. XR-NTX should be administered daily.

B. XR-NTX should be administered orally daily.

C. XR-NTX is typically administered every 2 weeks or once-per-week via subcutaneous injection.

D. XR-NTX is typically administered every 4 weeks or once-per-month via intramuscular injection.


35. A team of healthcare professionals is considering treatment strategies for a 26-year-old patient. The team is using TIP expert panel recommendations to help guide their decision. Which of the following best represent a TIP expert panel recommendation that  may be used as a OUD treatment strategy for the patient?

A. Offer maintenance therapy with medication, not short-term medically supervised withdrawal.

B. Offer maintenance therapy with two days of medication treatment.

C. Offer short-term medically supervised withdrawal.

D. Offer short-term medically supervised withdrawal in an outpatient setting.


36. Which of the following medications may be used to manage opioid withdrawal-related  nausea?

A. Promethazine

B. Ondansetron

C. Loperamide

D. Ativan


37. What is the FDA indication for the generic buprenorphine sublingual, monoproduct tablet?

A. Medically supervised withdrawal and maintenance treatment of opioid dependence.

B. Treatment of opioid dependence.

C. Treatment of opioid dependence and the treatment of pain in patients under the age of 65.

D. Treatment of mild-to-severe OUD among patients initiated and taking transmucosal buprenorphine for at least 5 days.


38. Which of the following statements regarding methadone is most accurate?

A. Methadone is a partial agonist, with a ceiling effect that is typically reached after 10 days of treatment.

B. Methadone is a mu-opioid receptor partial agonist, with a ceiling effect that is typically reached after 12 days of treatment.

C. Methadone is a mu-opioid receptor antagonist.

D. Methadone has no ceiling effect.


39. A team of healthcare professionals is considering methadone for a patient. The patient's lab results indicate that the patient has abnormally high carbon dioxide blood levels. Based on the aforementioned information, how should the team of healthcare professionals proceed?

A. Administer methadone to the patient

B. Administer methadone with clonidine to the patient

C. Administer sublingual methadone with ibuprofen to the patient

D. Avoid methadone administration due to the patient's abnormally high carbon dioxide blood levels


40.  A patient is taking both abacavir and methadone concurrently. Based on the previous information, which of the following is most likely to occur due to the potential interaction between abacavir and methadone? 

A. Increased serum methadone levels

B. Increased serum methadone levels for a period of 24-48 hours

C. Reduced serum methadone levels

D. Possible decreased efficacy of abacavir and increased risk of methadone toxicity


41. Which of the following regulations apply to take-home doses of methadone?

A. Patients may have one earned dose/week in the first 30 days of treatment.

B. Patients may have two doses during the second 60 days of treatment.

C. Patients may have up to 2 weeks of doses after 1 year.

D. Patients may have up to 2 months of doses after 2 years.


42. Oral naltrexone is available in which of the following formulations?

A. Naltrexone hydrochloride 10 mg oral tablet

B. Naltrexone hydrochloride 25 mg oral tablet

C. Naltrexone hydrochloride 50 mg oral tablet

D. Naltrexone hydrochloride 100 mg oral tablet


43. A fellow healthcare professional has questions regarding the bioavailability of XR-NTX. Which of the following informational points of interest should be communicated to the healthcare professional?

A. XR-NTX IM injection causes a transient peak blood concentration 2 hours after injection and another at 2 to 3 days after injection.

B. XR-NTX IM injection causes a transient peak blood concentration 8 hours after injection and another at 9 to 10 days after injection.

C. About 21 days after injection, concentrations gradually diminish, with measurable blood levels for more than 2 months.

D. About 30 days after injection, concentrations gradually diminish, with measurable blood levels for more than 90 days.


44. A team of healthcare professionals is conducting a naloxone challenge for intravenous administration. How should the team of healthcare professionals proceed if patient withdrawal signs and symptoms are present?

A. Continue the naloxone challenge by injecting the remaining naloxone.

B. Continue the naloxone challenge by injecting the remaining naloxone and monitoring the patient for a period of 24 hours.

C. Stop the naloxone challenge for a period of 1 hour and then continue.

D. Stop the naloxone challenge and treat symptomatically.


45. A 32-year-old pregnant patient has questions regarding XR-NTX treatment. Which of the following education points should be expressed to the patient?

A. XR-NTX treatment may be initiated after a physical examination is completed.

B. XR-NTX treatment may be initiated after an opioid abstinence period of 7 to 10 days.

C. XR-NTX treatment may be initiated after an opioid abstinence period of 7 to 21 days.

D. Pregnant women are not appropriate candidates for XR-NTX treatment.


46. A patient is initiated on XR-NTX treatment. Which of the following  XR-NTX storage and preparation points should be considered by healthcare professionals to optimize care?

A. XR-NTX microspheres are not temperature sensitive.

B. XR-NTX must be frozen.

C. XR-NTX can be stored unrefrigerated for up to 14 days before administration.

D. Before preparing XR-NTX for administration, keep it at room temperature for about 45 minutes.


47. A healthcare professional is administering XR-NTX via intramuscular injection. Which of the following recommendations may help the healthcare professional reduce potential injection site reactions?

A. Inject XR-NTX into adipose tissue.

B. Use the 1.5-inch needle for patients who have more subcutaneous adipose tissue.

C. The suspension may be administered subcutaneously to patients over the age of 65.

D. Administer the suspension by deep intramuscular injection into the upper outer quadrant of gluteal muscle.


48. Bunavail is available in which of the following forms?

A. Sublingual tablet

B. Sublingual film

C. Buccal film

D. Intramuscular injection


49. A healthcare professional is reviewing therapy for a patient. The healthcare professional is attempting to determine the recommended maintenance dose range for Zubsolv. What is the recommended daily maintenance dose range for Zubsolv?

A. 1.9 mg/0.71 mg to 8.2 mg/4.2

B. 2 mg/0.5 mg to 4 mg/1 mg

C. 4 mg/1 mg to 8 mg/2 mg

D. 2.9 mg/0.71 mg to 17.2 mg/4.2


50. A 44-year-old female patient is taking Suboxone 24 mg/6 mg daily. A team of healthcare professionals is considering increasing the patient's dose. Which of the following points of interest should the team of healthcare professionals consider before they increase the patient's Suboxone dose? 

A. Dosages above 24 mg/6 mg buprenorphine/naloxone per day have shown clinical advantage.

B. Dosages above 24 mg/6 mg buprenorphine/naloxone per day have shown clinical advantage in female patients.

C. Dosages above 24 mg/6 mg buprenorphine/naloxone per week have shown no clinical advantage.

D. Dosages above 24 mg/6 mg buprenorphine/naloxone per day have shown no clinical advantage.


51. A 38-year-old female patient is taking buprenorphine. The patient is ordered fluconazole. Which of the following is most likely to occur from the concurrent use of buprenorphine and fluconazole?

A. An increase in buprenorphine serum levels

B. A decrease in buprenorphine serum levels

C. An increase in fluconazole levels, followed by QT prolongation

D. A decrease in fluconazole levels, followed by QT prolongation


52. A healthcare professional is developing a patient education checklist for buprenorphine. The healthcare professional would like to include key points of patient education for buprenorphine on the checklist. Which of the following key points of patient education for buprenorphine should be included on the healthcare professional's checklist?

A. Tell providers if you feel sedated or euphoric within 8 to 10 hours after your dose.

B. Constipation is not associated with buprenorphine.

C. Discontinuing buprenorphine increases the risk of overdose death upon return to illicit opioid use.

D. The use of benzodiazepines with buprenorphine decreases the risk of overdose and death.


53. A patient is undergoing home buprenorphine induction. When should the patient take the first dose of buprenorphine?

A. When the patient experiences opioid withdrawal and at least 4 hours after the last use of heroin or a short-acting prescription opioid

B. When the patient experiences opioid withdrawal and at least 6 hours after the last use of heroin or a short-acting prescription opioid

C. When the patient experiences opioid withdrawal and at least 8 hours after the last use of heroin or a short-acting prescription opioid

D. When the patient experiences opioid withdrawal and at least 12 hours after the last use of heroin or a short-acting prescription opioid


54. A 42-year-old male patient, with a history of tobacco use, is starting buprenorphine therapy. Which of the following education points should be expressed to the patient?  

A. Abstain from tobacco before dosing because nicotine causes vasoconstriction, which decreases the surface area of blood vessels that absorb buprenorphine.

B. Abstain from tobacco before dosing because nicotine causes vasoconstriction, which increases the surface area of blood vessels that absorb buprenorphine.

C. Abstain from tobacco before dosing because nicotine and buprenorphine may cause QT prolongation.

D. Nicotine does not affect buprenorphine.


55. A team of healthcare professionals is considering adjusting a patient's dose of buprenorphine. Which of the following points of interest should the team of healthcare professionals consider before they adjust the patient's buprenorphine dose?

A. If the patient is taking doses properly, decrease the dose if the patient is still having opioid withdrawal.

B. Craving can be a conditioned response. It may not decrease with dose increases if patients spend time with people who use opioids in their presence.

C. It will take about 10 to 12 days to reach steady-state plasma concentrations after an increase in dose.

D. Dose increases must occur in 8 mg to 16 mg increments.


56. A 50-year-old female patient has questions regarding buprenorphine/naloxone tablets. Which of the following education points should be expressed to the patient?

A. Suck on the medication. Do not let it dissolve under the tongue.

B. Chew the medication.

C. Do not eat or drink for 30 minutes after you take your medication.

D. Wait 1 hour between each dose.


57. A healthcare professional is considering TIP recommendations regarding the frequency of medical management visits. Which of the following best represents a TIP expert panel recommendation regarding the frequency of medical management visits?

A. Patients should be seen daily until they demonstrate significant reductions in or abstinence from illicit substance use.

B. Patients should be seen approximately once a week until they demonstrate significant reductions in or abstinence from illicit substance use.

C. Patients should be seen twice a month until they demonstrate significant reductions in or abstinence from illicit substance use.

D. Patients should be seen approximately once a month until they demonstrate significant reductions in or abstinence from illicit substance use.


58. A fellow healthcare professional has questions regarding buprenorphine prescribing. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Physicians who prescribe buprenorphine to more than 30 patients need a diversion control plan.

B. Physicians who prescribe buprenorphine to more than 100 patients need a diversion control plan.

C. Providers who give more than 200 patients buprenorphine must have oncall services.

D. Providers who give more than 400 patients buprenorphine must have oncall services.


59. Individuals on a team of healthcare professionals caring for a patient hospitalized on methadone maintenance treatment have questions regarding methadone. Which of the following informational points of interest should be communicated to the team of health care professionals?

A. Physicians in an inpatient setting cannot legally order methadone administration to patients admitted primarily for other reasons.

B. The patient's hospital, inpatient methadone dose may be based on patient self-reports.

C. Healthcare professionals should contact the patient’s OTP directly to confirm the outpatient methadone dose.

D. Patients in pain should only receive half of their full usual daily dose of methadone, barring contraindications.


60. A patient on oral naltrexone for OUD treatment is admitted into a hospital. How should healthcare professionals address the patient's naltrexone therapy in the hospital setting?

A. Immediately discontinue naltrexone because oral naltrexone for OUD treatment is not allowed in hospital settings.

B. Discontinue the patient's naltrexone because oral naltrexone provides full blockade of opioid receptors for up to 24 hours.

C. Immediately switch the patient to extended-release injectable naltrexone because it provides measurable naltrexone levels for up to 21 days.

D. Continue the patient's oral naltrexone for OUD treatment if the patient does not have and is not at risk for developing a painful condition requiring opioid analgesia.


Part 4 and Part 5: Partnering Addiction Treatment Counselors With Clients and Healthcare Professionals and Resources Related to Medications for Opioid Use Disorder

61. According to DSM-5, OUD falls under the general category of SUDs and is marked by which of the following?

A. Compulsion without craving

B. Intolerance to opioids

C. Loss of control

D. Withdrawal while taking opioids


62. A fellow healthcare professional has questions regarding OUD and opioid-related physical dependence. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Physical dependence on a prescribed, properly taken opioid medication is considered to be a main criteria for OUD.

B. Physical dependence on a prescribed, properly taken opioid medication is considered to be part of opioid addiction.

C. Physical dependence and OUD are considered to be the same in the context of dependence on a prescribed, properly taken opioid medication.

D. Physical dependence on a prescribed, properly taken opioid medication is distinct from OUD and opioid addiction.


63. Which of the following statements is most accurate?

A. The law requires buprenorphine prescribers to be able to refer patients taking OUD medication to counseling and ancillary services.

B. The law does not require buprenorphine prescribers to be able to refer patients taking OUD medication to counseling and ancillary services.

C. The law does require naltrexone prescribers to refer patients to additional services.

D. The law doesn’t require naltrexone prescribers to refer patients over the age of 65 to additional services, however the law does require naltrexone prescribers to refer patients under the age of 65 to additional services.


64. A patient has questions regarding opioid use. Which of the following educational points should be expressed to the patient?

A. After taking opioids, molecules bind to and deactivate the brain’s opioid receptors.

B. Opioid molecules bind to and block opioid receptors from releasing dopamine.

C. Opioid use leads to a reduction in dopamine release.

D. Opioid use leads to an above-normal release of dopamine.


65. Which of the following changes in brain function is most likely to result from repeated drug use?

A. The amygdala, which is associated with feelings of danger, fear, and anger, becomes inactive.

B. The frontal cortex, which is associated with feelings of danger, fear, and anger, becomes inactive.

C. The amygdala, which is associated with planning and self-control, becomes overactive.

D. The frontal cortex, which is associated with planning and self-control, becomes underactive.


66. A patient is taking methadone. Which of the following is most likely to be a sign of potential, patient methadone overdose?

A. Overly alert behavior

B. Consistent diarrhea

C. Sleepiness

D. Chronic insomnia


67. A healthcare professional would like to adjust a patient's  dose of injected naltrexone. Which of the following informational points of interest should be communicated to the healthcare professional regarding injected naltrexone?

A. There is only one dose level for injected naltrexone.

B. There are only two dose levels for injected naltrexone.

C. Injected naltrexone doses can only be changed after 6 months of therapy.

D. Injected naltrexone doses can only be changed after a period of one year of continued treatment.


68. A counselor has questions regarding counselor-provider communication. Which of the following informational points of interest should be communicated to the counselor?

A. Counselors must obtain written consent from patients allowing communication directly with their providers if the counselor and the provider work in the same treatment program.

B. Counselors must obtain written consent from patients allowing communication directly with their providers, unless the counselor and the providers work in the same treatment program.

C. Patient consent does not have to state that the patient allows the counselor to discuss substance-use-related issues.

D. Counselors only have to obtain patient consent regarding counselor-provider communication, when the patient is under the age of 18.


69. A counselor is working with a 28-year-old male patient who is not using medications in his OUD treatment. Which of the following education points should be expressed to the patient?

A. Patients who don’t take an OUD medication after withdrawal are at a lower risk for return to opioid use.

B. Do not obtain naloxone.

C. Naloxone often leads to opioid relapse.

D. How to obtain naloxone in the community.


70. A 48-year-old patient has questions regarding naloxone. Which of the following educational points should be expressed to the patient?

A. Naloxone cannot reverse an opioid overdose.

B. Naloxone can only reverse an opioid overdose when used on patients under the age of 18.

C. An oral tablet of Naloxone is typically used to reverse an opioid overdose.

D. Naloxone comes in auto-injector and nasal spray formulations.


71. Which of the following statements is most accurate?

A. If a person takes a therapeutic dose of an opioid agonist medication as prescribed, he or she is not as capable as anyone else of driving.

B. A therapeutic dose of an opioid agonist medication typically affects an individual's ability to work productively.

C. A therapeutic dose of an opioid agonist medication typically makes an individual feel and appear to be "high."

D. If a person takes a therapeutic dose of an opioid agonist medication as prescribed, he or she may be as capable as anyone else of being emotionally open.


72. A 38-year-old male patient would like to taper his OUD medication and stop it all together. How should a counsel proceed with the aforementioned patient?

A. Encourage medication tapering.

B. Encourage medication tapering if the patient has been taking an OUD medication for at least 6 months.

C. Inform the patient's prescriber for the purposes of shared decision making.

D. Inform the patient's prescriber and immediately set a medication tapering timeline.


73. A patient has questions regarding OUD medication use and employment. Which of the following education points should be expressed to the patient?

A. An individual may not take OUD medications while employed in any capacity.

B. Employers have the right to ask individuals about their OUD medication and refuse employment based on OUD medication use.

C. Under the Americans With Disabilities Act, employers cannot discriminate against patients taking medication for OUD.

D. The Americans With Disabilities Act does not apply to individuals taking OUD medications.


74. A patient has questions regarding OUD medication use and potential legal issues. Which of the following education points should be expressed to the patient?

A. A jail may not continue methadone treatment or allow methadone delivery by patients’ OTPs.

B. Legally, a jail cannot deny patients’ buprenorphine prescriptions.

C. Patients taking OUD medication cannot be forced to go without medication during incarceration for a period longer than 60 days.

D. Patients taking OUD medication cannot be forced to go without medication during incarceration for a period longer than 90 days.


75. A fellow healthcare professional has questions regarding the treatment of pregnant women with OUD. Which of the following informational points of interest should be communicated to the healthcare professional?

A. Treatment with methadone or buprenorphine without naloxone during pregnancy is not recommended.

B. Medically supervised withdrawal during pregnancy is typically advisable.

C. Newborns of women who take OUD medication often do not show symptoms of NAS.

D. Mothers stabilized on medication for OUD are encouraged to breastfeed.


76. A patient would like to attend a mutual-help group. Which of the following educational points should be expressed to the patient regarding mutual-help groups?

A. Legally, local chapters of NA have to allow all individuals to participate.

B. Local chapters of NA may decide not to allow people taking OUD medication to participate.

C. Legally, AA must allow people taking OUD medication to participate in, at least, one meeting.

D. AA does not allow people taking OUD medication to participate in any capacity.


77. How should a counselor respond to an OUD patient, taking OUD medication, that complains of continued cravings?

A. Immediately discontinue the patient's OUD medication.

B. Encourage the patient to use naloxone when experiencing cravings.

C. Avoid the topic of dose adjustment.

D. Discuss medication adherence with the patient.


78. How should a counselor respond to an OUD patient attempting to discuss chronic pain issues?

A. Avoid all patient discussions regarding chronic pain issues.

B. Provide the patient with refills on existing OUD medication prescriptions.

C. Immediately confiscate all OUD medications.

D. Direct the patient to a healthcare professional for assessment of pain and medical treatment as necessary.


79. A healthcare professional is interested in obtaining buprenorphine waiver training. Which of the following resources is most likely to provide buprenorphine waiver training for a healthcare professional? 

A. PCSS for Medication Assisted Treatment

B. HHS

C. AAAP, Education & Training

D. American Psychiatric Nurses Association, Tobacco & Nicotine Use Screening Tools & Assessments


80. A healthcare professional would like to obtain information on medications that may increase QTc intervals. Which of the following decision-support tools may be the best option for the healthcare professional to find a list of medications that may increase QTc intervals?

A. Prescribe To Prevent

B. PCSS Models of Buprenorphine Induction

C. Credible Meds

D. ASAM Appropriate Use of Drug Testing in Clinical Addiction Medicine


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