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1.5 CE Test Hours: Opioid Use Disorder: Pathophysiology, Assessment, and Effective Interventions

Contrada, Emily

AJN, American Journal of Nursing: June 2020 - Volume 120 - Issue 6 - p 47
doi: 10.1097/01.NAJ.0000668740.33023.9d

TEST INSTRUCTIONS

  • Read the article. Take the test for this CE activity online at www.nursingcenter.com/ce/ajn.
  • You'll need to create and log in to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Professional Development (LPD) online CE activities for you.
  • There is only one correct answer for each question. The passing score for this test is 13 correct answers. If you pass, you can print your certificate of earned contact hours and the answer key. If you fail, you have the option of taking the test again at no additional cost.
  • For questions, contact LPD: 1-800-787-8985.
  • Registration deadline is June 3, 2022.

PROVIDER ACCREDITATION

LPD will award 1.5 contact hours for this continuing nursing education (CNE) activity. LPD is accredited as a provider of CNE by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LPD is also an approved provider of CNE by the District of Columbia, Georgia, Florida, West Virginia, South Carolina, and New Mexico, #50-1223. Your certificate is valid in all states.

PAYMENT

The registration fee for this test is $17.95.

Opioid Use Disorder: Pathophysiology, Assessment, and Effective Interventions

GENERAL PURPOSE:

To provide information about the pathophysiology of opioid use disorder (OUD), available screening tools, medical treatments, and behavioral interventions that have demonstrated efficacy in reducing substance use.

LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be able to

  • review the background information about and the pathophysiology of OUD.
  • explain the neurobiology of OUD.
  • plan the appropriate interventions for patients with OUD.
  1. According to the Centers for Disease Control and Prevention (CDC), the rise in opioid use and overdose deaths in the United States occurred in 3 phases, the second of which was
    1. a rapid increase in overdose deaths from heroin.
    2. an increase in prescribing opioids for chronic pain.
    3. a significant rise in overdose deaths from synthetic opioids.
  2. By mid-2017, 23 states had limited opioid prescribing, with most taking which of the following actions?
    1. prohibiting prescription of opioids for treating chronic pain
    2. setting a maximum number of days for first-time opioid prescriptions
    3. supporting research into strategies that prevent and treat opioid use disorder (OUD)
  3. Many states require prescribers to review which of the following before prescribing an opioid?
    1. their state's prescription drug monitoring program
    2. the CDC Guideline for Prescribing Opioids for Chronic Pain
    3. the National Institute on Drug Abuse's Commonly Abused Drugs charts
  4. According to Muhuri and colleagues, nearly 80% of current heroin users in the United States report that they
    1. use heroin primarily to relieve stress.
    2. use heroin only sporadically, not routinely.
    3. previously used an opioid for nonmedical reasons.
  5. Piazza and Deroche-Gamonet suggest that drug use is a form of recreation that alters brain activity
    1. through the sensory system.
    2. as an emotional response to pain avoidance.
    3. as a direct result of the pharmacological substance.
  6. Piazza and Deroche-Gamonet posit that the transition to addiction occurs in 3 stages, the second of which is
    1. intensified drug use as a primary recreational activity.
    2. stimulation of a release of rewarding neurotransmitters.
    3. impaired neuronal structure in the brain's reward-related areas.
  7. The second phase of the transition occurs in a portion of people who use psychoactive drugs for nonmedical purposes, whose brains have
    1. altered neuronal signaling.
    2. an impaired prefrontal cortex.
    3. a hypoactive dopaminergic system.
  8. Opioids attach to which receptors in the brain's ventral tegmental area, thus increasing the release of dopamine?
    1. mu
    2. delta
    3. kappa
  9. Opioids elevate dynorphin neuropeptide levels, activating which receptors and thus reducing dopamine transmission?
    1. mu
    2. delta
    3. kappa
  10. Adaptations that result from opioid use likely raise the “set point” at which dopamine is released, making normally pleasurable activities
    1. no longer enjoyable without exogenous opioids.
    2. no longer enjoyable with or without exogenous opioids.
    3. intensely pleasurable with or without exogenous opioids.
  11. Opioids can substantially disrupt the hypothalamic–pituitary–adrenal axis, which controls the body's response to
    1. pain.
    2. stress.
    3. pleasure.
  12. Which of the following interventions helps patients with OUD identify triggers for relapse by helping them focus on their current situation and learn social techniques to support their recovery?
    1. contingency management
    2. motivational interviewing
    3. cognitive behavioral therapy
  13. A key facet of motivational interviewing is helping patients explore and resolve their ambivalence to
    1. change.
    2. abstinence.
    3. communication.
  14. One of the basic principles of motivational interviewing is to resist telling patients with OUD that they should
    1. verbalize why they want to stop using opioids.
    2. make health-promoting lifestyle changes.
    3. stop using opioids.
  15. According to the Substance Abuse and Mental Health Services Administration, the slow adoption of evidence-based, medication-assisted treatment options for opioid dependence is partly due to
    1. the lack of availability of effective medications.
    2. misconceptions about substituting one drug for another.
    3. resistance on the part of patients with OUD to achieving their rehabilitation goals.
  16. Which of the following drugs occupies the opioid receptor in the same way morphine does but has a much longer duration of action?
    1. naltrexone
    2. methadone
    3. buprenorphine
  17. Which of the following drugs is a partial mu-opioid agonist that is less likely than a full agonist to cause respiratory depression?
    1. naltrexone
    2. methadone
    3. buprenorphine
  18. Which of the following drugs attaches to the opioid receptor but causes no opioid effects, thus preventing patients with OUD from experiencing the “high” of opioid administration?
    1. naltrexone
    2. methadone
    3. buprenorphine
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