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NR 546 WEEK 6 ACTUAL EXAM GUIDE|LATEST UPDATE |BRAND NEW VERIFIED EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS ALL GRADED A+|GUARANTEED SUCCESS$11.49
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NR 546 WEEK 6 ACTUAL EXAM GUIDE|LATEST UPDATE |BRAND NEW VERIFIED EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS ALL GRADED A+|GUARANTEED SUCCESS
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NR 546
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NR 546
NR 546 WEEK 6 ACTUAL EXAM GUIDE|LATEST UPDATE |BRAND NEW VERIFIED EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS ALL GRADED A+|GUARANTEED SUCCESS
Substance Use Disorder - ANSWER-Occurs when the recurrent use of a substance, such as alcohol or drugs, causes clinically significant impairme...
NR 546 WEEK 6 ACTUAL EXAM
GUIDE|LATEST UPDATE 2024-
2025|BRAND NEW VERIFIED EXAM
QUESTIONS WITH CORRECT DETAILED
ANSWERS ALL GRADED
A+|GUARANTEED SUCCESS
Substance Use Disorder - ANSWER-✅Occurs when the recurrent use of a substance,
such as alcohol or drugs, causes clinically significant impairment, including health
problems, disability, or failure to meet responsibilities at home, work, or school.
When does drug use typically begin? - ANSWER-✅Adolescence
Common Comorbidities of substance use disorder - ANSWER-✅Anxiety disorders
depression
bipolar disorder
psychotic illness
borderline personality disorder
antisocial personality disorder
Neurological basis: Genetic factors of SUD - ANSWER-✅40-60% of a client's
vulnerability to substance use disorders may be attributed to genetic factors
Vulnerability involves complex interactions between multiple genetic factors/.
Genetic involvement may impact an individual's experience of a drug as pleasurable
or not or how long a drug remains in the body.
Epigenetic factors in SUD` - ANSWER-✅influence whether genes associated with
substance use disorder are activated
, Neurological Basis: Neuroanatomy in SUD - ANSWER-✅Brain circuits that mediate
reward, impulse control, decision making, learning, and emotions play a role in
substance use disorder.
Mesolimbic Dopamine pathway in SUD - ANSWER-✅has been identified as the key
pathway that mediates reward.
Connects the ventral tegmental area of the midbrain to the ventral striatum of the
basal ganglia.
The pathway begins in the ventral tegmental area (VTA) and connects to the ventral
striatum/nucleus
Neurobiological Basis: Neural Networks - ANSWER-✅Mesolimbic pathway is most
associated with reward. Drugs and alcohol act directly on brain receptors leading to
a release of dopamine.
As substance use increases, brain circuits adapt by reducing sensitivity to dopamine,
leading to tolerance and the need to increase use of a substance to achieve the same
high.
Neurological Basis: Neural Signaling - ANSWER-✅Dopamine is responsible for
regulating the brain's motivation, pleasure, and reward center.
Dopamine is release in response to natural pleasurable activities or situations such
as achieving an accomplishment, enjoying a good meal. or participating in an athletic
activity. Addictive drugs cause a surge of dopamine in the ventral striatum or nucleus
accumbens.
Repeated use can lead to changes in brain circuitry leading to craving, addiction,
dependence, withdrawal.
What neurotransmitter is the target when treating SUD? - ANSWER-✅Dopamine.
Tolerance - ANSWER-✅With repeated ingestion of a drug, the drug shows
decreased effect. Increasing doses are required to achieve the effects noted with the
original administration
Dependence - ANSWER-✅State of adaption produced with repeated administration
of certain drugs so that physical symptoms occur when the drug is discontinued
abruptly.
Addiction - ANSWER-✅A change in behavior caused by biochemical changes in the
brain after continued substance use characterized by preoccupation with and
repeated use of a substance despite negative outcomes.
Withdrawal - ANSWER-✅Physiological and psychological reactions that occur when
the use of a substance is stopped abruptly.
, Intoxication - ANSWER-✅Condition following the ingestion of a substance resulting
in changes in level of consciousness, cognition, perception, judgement, and behavior.
Treatment - ANSWER-✅The PMHNP must ascertain what substance the client is
using, how much and how often the substance is used, and when the substance was
last ingested to determine the most appropriate course of treatment.
Treatment is different when a client is actively using vs during withdrawal, following
detoxification, and abstinence.
Tolerance and dependence impact treatment decisions, sometimes necessitating
increased medication dosing.
Medication Assisted Therapy (MAT) - ANSWER-✅clients use prescription
medications as part of a treatment plan for SUD. Substitutes the drug of abuse for
the prescribed medication that targets the same receptor as the preferred substance.
Can reduce cravings, improve relapse rates, reduce mortality from overdose, and
increase the likelihood of abstinence either alone or in combination with with
psychosocial interventions. Most prescribed for opioid use disorder but may also be
used for clients with alcohol or tobacco use disorder.
Goals of MAT - ANSWER-✅Improved Survival
Improved treatment retention
Decreased illegal activity
Increased Quality of Life
Improved birth outcomes in people who use substance while pregnant
Reduced HIV and Hep B&C infections
Impulsive/Compulsive Disorders - ANSWER-✅Other mental health disorders shar
similar neurobiological characteristics with substance use disorders.
Pharmacological management for Obesity - ANSWER-✅Phentermine or
phentermine/topiramate
Bupropion or bupropion/naltrexone
lorcaserin
zonisamide
Pharmacological management for Anorexia Nervosa - ANSWER-✅Olanzapine may
lead to modest weight gain
Pharmacological management for Bulimia Nervosa - ANSWER-✅High dose
fluoxetine
, Pharmacological Management for Binges Eating Disorders - ANSWER-
✅Lisdexamfetamine
Topiramate
Bupropion
What medication do you avoid in individuals with anorexia nervosa and bulimia
nervosa and why? - ANSWER-✅Avoid bupropion as it lowers the seizure threshold in
these patients putting them at risk for new onset seizures.
Opioid Use Disorder - ANSWER-✅Chronic Use of opioids that causes clinically
significant distress or impairment
How do clients present with opioid use disorder? - ANSWER-✅They experience
overwhelming cravings to use the drugs, dependence, increased tolerance, and
withdrawal symptoms when stopped abruptly.
Bernita is a 64-year-old who has been using heroin for 6 years. She is currently
unemployed and lives with her daughter in the city center. She does not have health
insurance.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANSWER-✅Methadone
Methadone - ANSWER-✅a full u-receptor agonist with a long half life, which can
prevent withdrawal symptoms for 24 hours and provide a steady control of cravings
throughout the day. It is only administered in methadone federally regulated opioid
treatment programs (OTP).
Methadone Clinics - ANSWER-✅incorporate psychosocial interventions and require
daily attendance for the first several months. Good option for a client that has the
flexibility to attend meetings.
Use of methadone in MAT for opioid use disorder helps extend client survival rates.
When the client stops methadone, they have the likelihood of relapsing, even 10
years after starting treatment.
Antoine is a 34-year-old who has been abusing prescription oxycodone. He is
employed but is on probation at work for increased absenteeism. He desires MAT
but is concerned about his roommates stealing his medication to get high.
prescribe the proper medication:
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