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Use of Medication-Assisted Treatment in Emergency Departments

1. A health care professional has questions regarding buprenorphine. Which of the following informational points of interest should be communicated to the health care professional?

A. Buprenorphine is a full mu agonist and binds to the receptors without a ceiling effect or diminishing returns.

B. Buprenorphine is a full mu agonist and binds to the receptors with a ceiling effect and diminishing returns.

C. Buprenorphine is a full mu antagonist and binds to the receptors without a ceiling effect or diminishing returns.

D. Buprenorphine is a partial agonist.


2. A 22-year-old male patient has questions regarding naltrexone. Which of the following educational points should be expressed to the patient?

A. Naltrexone requires partial detoxification (2 - 4 days without any opioid use).

B. Naltrexone requires full detoxification (7 - 10 days without any opioid use).

C. Naltrexone cannot be administered to individuals under the age of 25 without prior consent.

D. Naltrexone is typically used in the ED to treat male individuals over the age of 25 suffering from OUD and depression.


3. Which of the following best represents an available strength of Suboxone sublingual film?

A. 1 mg/0.5 mg

B. 2 mg/0.5 mg

C. 3 mg/0.5 mg

D. 4 mg/0.5 mg


4. Which of the following best represents an available strength of Bunavail buccal film?

A. 2 mg/0.5 mg

B. 2.1 mg/0.3 mg

C. 4 mg/1 mg

D. 8 mg/2 mg


5. Which of the following statements is most accurate?

A. Buprenorphine can be administered by any licensed medical provider in a Drug Enforcement Administration licensed facility.

B. Buprenorphine can only be administered by buprenorphine certified medical providers.

C. Buprenorphine can only be administered by medical providers practicing in an OUD treatment facility.

D. Buprenorphine can only be administered by medical providers practicing in a psychiatric hospital.


6. A health care professional has questions regarding the recommended induction dose for buprenorphine/naloxone sublingual film. Which of the following informational points of interest should be communicated to the health care professional?

A. On day one, an induction dosage of up to 4 mg/2 mg buprenorphine/naloxone sublingual film isrecommended.

B. On day one, an induction dosage of up to 8 mg/2 mg buprenorphine/naloxone sublingual film isrecommended.

C. On day one, an induction dosage of up to 16 mg/4 mg buprenorphine/naloxone sublingual film isrecommended.

D. On day one, an induction dosage of up to 20 mg/4 mg buprenorphine/naloxone sublingual film isrecommended.


7. Which of the following best represents a strategy that can be used by health care professionals to help reduce the stigma associated with OUD?

A. Refer to OUD patients as addicts.

B. Refer to OUD patients as addicts with a disease.

C. Use person-centered language, in combination with the term addict, to address patients with OUD.

D. Use person-centered language, identifying an individual as a person who has an OUD.


8. Which of the following statements is most accurate?

A. Buprenorphine is not safe to initiate in the ED.

B. Buprenorphine is safe to initiate in the ED by any ED provider and permitted to be prescribed with a DATA waiver.

C. Buprenorphine is safe to initiate in the ED after 48 hours of patient observation.

D. Buprenorphine is safe to initiate in the ED after 72 hours of patient observation.


9. A health care professional has questions regarding the First Step Opiate Addiction Treatment Program. Which of the following informational points of interest should be communicated to the health care professional?

A. The First Step Opiate Addiction Treatment Program relies on ED methadone treatment.

B. The First Step Opiate Addiction Treatment Program relies on ED naltrexone treatment.

C. The First Step Opiate Addiction Treatment Program typically uses the following treatment: buprenorphine (4mg/1 mg) initiated in the ED, with repeated doses, as needed.

D. The First Step Opiate Addiction Treatment Program typically uses the following treatment: buprenorphine (2mg/0.5 mg) initiated when the patient is discharged from the ED.


10. Which of the following best represents a CORE treatment strategy?

A. For individuals with COWS scores less than four, a dose of 2mg, 4mg, or 8mg of buprenorphine is administered.

B. For individuals with COWS scores less than eight, a dose of 2mg, 4mg, or 8mg of buprenorphine is administered.

C. For individuals with COWS scores greater than four, a dose of 2mg, 4mg, or 8mg of buprenorphine is administered.

D. For individuals with COWS scores greater than eight, a dose of 2mg, 4mg, or 8mg of buprenorphine is administered.


11. Which of the following best represent a myth to implementing evidence-based practices and programs?

A. OUD is a disease.

B. OUD is often a recurring and continuous medical condition with long-lasting neurochemical changes that affect behavior and decision-making.

C. Improved outcomes, including morbidity and mortality, have been found with the use of methadone and buprenorphine compared to abstinence-based treatment models.

D. People can just stop using opioids whenever they want.


12. A health care professional is developing an educational lecture centered on the myths to implementing evidence-based practices and programs. Which of the following informational points of interest should be included in the health care professional's lecture?

A. It is a fact that often individuals suffering from OUD do not want treatment.

B. As with many other diseases and conditions, some people with OUD may not want treatment, but many will want treatment.

C. If the ED provides MAT, it will be seen as the de facto treatment facility.

D. Starting buprenorphine in the ED is too complicated for male patients.


13. Which of the following statements is most accurate?

A. The NIDA Quick Screen is appropriate for screening individuals who are age 18 or younger for OUD.

B. The NIDA Quick Screen is appropriate for screening individuals who are age 18 or older for OUD.

C. The NIDA Quick Screen is appropriate for screening individuals who are age 65 or older for OUD.

D. The NIDA Quick Screen is appropriate for screening individuals who are age 65 or older for depression-related OUD.


14. A health care professional has questions regarding the SOWS. Which of the following informational points of interest should be communicated to the health care professional?

A. The SOWS relies solely on a physician's observed experience of patient withdrawal.

B. The SOWS relies on a physician's observed experience of patient withdrawal, as well as patient reporting.

C. The SOWS contains 16 symptoms and signs associated with opiate withdrawal.

D. The SOWS contains 26 symptoms and signs associated with opiate withdrawal.


15. Which of the following tools combines screening and brief assessment for commonly used substances, eliminating the need for multiple screening and lengthy assessment tools?

A. COWS

B. DAST-10

C. DSM-5 Criteria for OUD Diagnoses

D. TAPS


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