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PRESCRIBING CONTROLLED SUBSTANCES SAFELY: A DEA REQUIREMENT Self-Assessment Answers and Rationales
1. The correct answer is A. Rationale: Poison Control (1-800-222-1222) is available 24 hours a day to patients and clinicians to answer any questions concerning accidental ingestion or contact with known or unknown substances. 2. The correct answer is D. 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.
3. 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; 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. Educate the patient that complete elimination of pain should not be expected. 4. The correct answer is A. Rationale: Integrative medicine and integrative nursing are the same. In the past, these therapies were called complementary. 5. The correct answer is A. Rationale: (Remediation) 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.
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