CLINICAL MANAGEMENT OF SUBSTANCE USE DISORDERS Self-Assessment Answers and Rationales
1. The correct answer is C. Rationale: Risk factors increase the likelihood of developing substance use disorders, while protective factors decrease the risk. Options A, B, and D are all recognized risk factors for developing substance use disorders, according to the National Institute on Drug Abuse (NIDA, 2020b). Aggressive childhood behavior, lack of parental supervision, and drug availability at school are associated with an increased risk of substance use. Option C, positive relationships with family and friends, is a protective factor. Strong, positive relationships with family and friends can provide support, guidance, and a sense of belonging, which can help reduce the likelihood of engaging in substance use behaviors. 2. The correct answer is A Rationale: Established in 1973, the DEA enforces the Controlled Substance Act (CSA) in the United States. One of its main roles is to prevent the diversion and abuse of pharmaceutical controlled substances. The DEA works alongside state and other federal agencies to regulate the registration of manufacturers, distributors, and dispensers of controlled pharmaceutical substances and the import and export of these substances. Additionally, the DEA prosecutes individuals who violate the CSA. The other options listed (FDA, CDC, and NIH) have different responsibilities related to public health and medical research but do not have the primary authority for enforcing the CSA. 3. The correct answer is E. Rationale: Clinicians who are agents or employees of a hospital or other institution (e.g., interns, residents, staff physicians, advanced practice providers) may, in the normal course of their duties, administer, dispense, or prescribe controlled substances under the registration of the hospital or other institution in which they are employed, provided that the dispensing, administering, or prescribing is in the normal course of practice; practitioners are authorized to do so by the state in which they practice; the hospital or institution has verified the practitioner is permitted to dispense, administer, or prescribe controlled substances within the state; the practitioner only acts within the scope of employment in the hospital or institution, and the hospital or institution authorizes the practitioner to dispense or prescribe under its registration and assigns a specific internal code for each practitioner so authorized. 4. The correct answer is B. Rationale: Prescription Drug Monitoring Programs (PDMPs) aim to promote safe prescribing and dispensing practices for controlled substances. PDMPs collect prescription data from various sources and provide authorized users, such as prescribers and law enforcement personnel, access to this information.
5. The correct answer is E. Rationale: If the prescriber institutes long-term opioid therapy, a written informed consent and treatment agreement is recommended. The informed consent may address several issues, such as evidence that the benefit of opioids or other medications in managing chronic pain is limited (except for cancer); potential risks and benefits of opioid therapy; potential short- and long-term side effects of opioid therapy; the likelihood that tolerance to and physical dependence on the medication will develop; risk of drug interactions and oversedation; risk of impaired motor skills; risk of substance abuse disorder, overdose, and death; the clinician’s prescribing policies (e.g., number and frequency of refills, early refills, exceptions); reasons the drug may be changed or discontinued, and that the treatment may be discontinued without agreement from the patient, such as with violations of the treatment agreement; and educating the patient that complete elimination Rationale: Integrative medicine and integrative nursing are the same. In the past, these therapies were called complementary.. 7 . The correct answer is D. Rationale: If the prescriber institutes long-term opioid therapy, a written informed consent and treatment agreement is recommended. The informed consent may address several issues, such as evidence that the benefit of opioids or other medications in managing chronic pain is limited (except for cancer); potential risks and benefits of opioid therapy; potential short- and long-term side effects of opioid therapy; the likelihood that tolerance to and physical dependence on the medication will develop; the risk of drug interactions and oversedation; the risk of impaired motor skills; the risk of substance abuse disorder, overdose, and death; the clinician’s prescribing policies (e.g., number and frequency of refills, early refills, exceptions); reasons the drug may be changed or discontinued; and that the treatment may be discontinued without agreement from the patient, such as with violations of the treatment agreement; and educating the patient that complete elimination of pain should not be expected. 8 . The correct answer is A. Rationale: Any tapering schedule must be patient-specific to minimize withdrawal symptoms while maintaining adequate pain management. A general recommendation is to begin with a 10% decrease of the initial dose per week. of pain should not be expected. 6. The correct answer is A.
Course Code: ANCCUS05SD
Page 32
Book Code: AUS3024
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