A 17-year-old boy presents to the psychiatric-mental health nurse practitioner at the request of his mother. He has a chief complaint of anxiety. During the evaluation, he states that he worries about his friends who engage in risky behavior when they drink. He says he “sometimes” drinks on weekends, but his father was an alcoholic so he would never let it get “that far.” Which of the following is an effective screening tool for substance use and high-risk behaviors in children and adolescents?
CAGE
Alcohol Use Disorders Identification Test (AUDIT)
CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble)
Clinical Institute Withdrawal Assessment for Alcohol (CIWA-AR)
The Correct Answer is C
Choice A reason: The CAGE questionnaire is designed for adults and lacks sensitivity for adolescent substance use patterns. It does not address the social and behavioral context relevant to youth.
Choice B reason: The AUDIT is a validated tool for identifying alcohol use disorders but is more appropriate for adults. While it can be adapted for adolescents, CRAFFT is preferred due to its developmental appropriateness.
Choice C reason: The CRAFFT screening tool is specifically developed for adolescents and young adults. It assesses both substance use and associated risky behaviors, making it ideal for this scenario. It is brief, easy to administer, and validated for use in pediatric populations.
Choice D reason: The CIWA-AR is used to assess alcohol withdrawal severity in individuals already diagnosed with alcohol dependence. It is not a screening tool and is inappropriate for initial assessment in adolescents.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Naloxone is an opioid antagonist used primarily for emergency reversal of opioid overdose. It is not used as a maintenance medication in MAT, especially not during pregnancy, as it does not address withdrawal or cravings.
Choice B reason: Naltrexone is also an opioid antagonist used in MAT, but it is contraindicated during pregnancy due to insufficient safety data and the risk of precipitating withdrawal. It requires complete detoxification before initiation, which is not ideal for pregnant patients.
Choice C reason: Buprenorphine is a partial opioid agonist and is considered safe and effective for use during pregnancy. It reduces cravings and withdrawal symptoms without producing the same level of euphoria as full agonists. It is preferred over methadone in many cases due to lower risk of neonatal abstinence syndrome and better maternal outcomes.
Choice D reason: Buprenorphine/Naloxone combination is generally avoided during pregnancy because naloxone can precipitate withdrawal in the fetus. Monotherapy with buprenorphine is the recommended approach for pregnant women with OUD.
Correct Answer is B
Explanation
Choice A reason: Projection involves attributing one’s own unacceptable thoughts or feelings to another person. For example, someone who is angry may accuse others of being hostile. This does not apply to the woman’s behavior, as she is not externalizing her own feelings.
Choice B reason: Denial is the refusal to accept reality or facts, often to avoid emotional pain. In this case, the woman is denying the seriousness and danger of her abusive relationship. She minimizes the abuse and reframes her husband’s behavior as a result of his own trauma, thereby avoiding the painful truth of her situation.
Choice C reason: Rationalization involves creating logical explanations to justify unacceptable behavior or feelings. While the woman’s statements may contain elements of rationalization, the dominant mechanism is denial—she is refusing to acknowledge the abuse as a threat to her safety.
Choice D reason: Displacement involves redirecting emotions from a threatening target to a safer one. For example, someone angry at their boss might yell at their spouse. This mechanism is not evident in the woman’s response.
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