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NR546 Week 6 Exam 2024/2025 Questions With Completed & Verified Solution.
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NR546 Week 6 Exam 2024/2025 Questions With Completed & Verified Solution.
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NR546 Week 6Substance Use Disorder - ANS 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? - ANS Adolescence
Common Comorbidities of substance use disorder - ANS Anxiety disorders
depression
bipolar disorder
psychotic illness
borderline personality disorder
antisocial personality disorder
Neurological basis: Genetic factors of SUD - ANS 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` - ANS influence whether genes associated with substance use
disorder are activated
Neurological Basis: Neuroanatomy in SUD - ANS Brain circuits that mediate reward, impulse
control, decision making, learning, and emotions play a role in substance use disorder.
Mesolimbic Dopamine pathway in SUD - ANS 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 - ANS 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 - ANS 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? - ANS Dopamine.
Tolerance - ANS 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 - ANS State of adaption produced with repeated administration of certain drugs so
that physical symptoms occur when the drug is discontinued abruptly.
Addiction - ANS 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 - ANS Physiological and psychological reactions that occur when the use of a
substance is stopped abruptly.
Intoxication - ANS Condition following the ingestion of a substance resulting in changes in level
of consciousness, cognition, perception, judgement, and behavior.
Treatment - ANS 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) - ANS 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 - ANS 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 - ANS Other mental health disorders shar similar
neurobiological characteristics with substance use disorders.
Pharmacological management for Obesity - ANS Phentermine or phentermine/topiramate
Bupropion or bupropion/naltrexone
lorcaserin
zonisamide
Pharmacological management for Anorexia Nervosa - ANS Olanzapine may lead to modest
weight gain
Pharmacological management for Bulimia Nervosa - ANS High dose fluoxetine
Pharmacological Management for Binges Eating Disorders - ANS Lisdexamfetamine
Topiramate
Bupropion
What medication do you avoid in individuals with anorexia nervosa and bulimia nervosa and
why? - ANS Avoid bupropion as it lowers the seizure threshold in these patients putting them at
risk for new onset seizures.
Opioid Use Disorder - ANS Chronic Use of opioids that causes clinically significant distress or
impairment
How do clients present with opioid use disorder? - ANS They experience overwhelming cravings
to use the drugs, dependence, increased tolerance, and withdrawal symptoms when stopped
abruptly.
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