A 33-year-old man is seeking medication-assisted treatment (MAT) for opioid use disorder (OUD). He says he wants a medication that he will not become "addicted" to. Which of the following is the most appropriate choice?
Naloxone
Naltrexone
Buprenorphine
Buprenorphine/Naloxone
The Correct Answer is B
Choice A reason: Naloxone is an opioid antagonist used to reverse opioid overdose. It is not used as a standalone maintenance treatment for opioid use disorder and has no role in long-term MAT. It is short-acting and not suitable for daily use.
Choice B reason: Naltrexone is a long-acting opioid antagonist that blocks the effects of opioids without producing euphoria or physical dependence. It is non-addictive and does not cause withdrawal symptoms when discontinued. It is ideal for individuals who want a non-addictive MAT option and are fully detoxified from opioids.
Choice C reason: Buprenorphine is a partial opioid agonist that reduces cravings and withdrawal symptoms. While it has a lower risk of addiction than full agonists, it can still cause physical dependence and withdrawal upon discontinuation.
Choice D reason: Buprenorphine/Naloxone is a combination used to reduce misuse potential. However, it still contains buprenorphine, which can lead to physical dependence. It is not the best choice for someone explicitly seeking a non-addictive option.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Administering another 3 mg of flumazenil immediately after a failed response to the initial dose is not recommended due to the risk of precipitating seizures, especially in patients with chronic benzodiazepine use or co-ingestion of pro-convulsant substances. Flumazenil has a narrow therapeutic window and should be titrated cautiously.
Choice B reason: Although smaller incremental doses of flumazenil (e.g., 0.2–1 mg) may be used in some protocols, repeated dosing after a cumulative 3 mg without response is generally discouraged. The risk of adverse effects, particularly seizures, increases with higher cumulative doses.
Choice C reason: Waiting 20 minutes and administering another 3 mg would exceed the recommended maximum cumulative dose of flumazenil, which is typically 3–5 mg. This approach increases the risk of serious complications and is not supported by clinical guidelines.
Choice D reason: If a patient does not respond to a total of 3 mg of flumazenil, further administration is not advised. The lack of response suggests that the cause of altered mental status may not be due to benzodiazepines alone or that the patient has developed tolerance. Supportive care and airway management should be prioritized.
Correct Answer is B
Explanation
Choice A reason: The ACSS-FAD measures fearlessness about death, a component of suicide risk based on the interpersonal theory of suicide. It is more suitable for research and clinical settings and is not designed for general use by nonclinicians.
Choice B reason: The Columbia-Suicide Severity Rating Scale (C-SSRS) is widely recognized for its ease of use and effectiveness in various settings, including schools and community programs. It includes simple, structured questions that can be administered by nonclinicians to assess suicidal ideation and behavior. It has been validated across age groups and is endorsed by multiple national and international organizations.
Choice C reason: The SBQ-R is a validated tool for assessing suicide risk but is more appropriate for clinical or research environments. It requires interpretation of responses that may be challenging for nonclinicians without training.
Choice D reason: The INQ assesses psychological states like perceived burdensomeness and thwarted belongingness, which are associated with suicide risk. However, it is not a direct suicide risk assessment tool and is better suited for research purposes.
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