Concerns in Substance Use Disorders
1. A 61-year-old married woman who has been sober from alcohol use
disorder for 25 years relapsed 3 weeks ago. She reports drinking 1.5 L
of vodka and half a liter of scotch daily. On exam she is emotionally
labile ranging from irritable to crying, slurring her words, and exhibits
a bilateral upper extremity fine tremor. Vitals: blood pressure 150/100,
heart rate 110, respiratory rate 18, SpO2
98% room air. She reports
feeling nauseous, sweating, and moderately anxious. What is the
primary concern for this patient?
A. Alcohol use disorder
B. Generalized anxiety disorder
C. Alcohol withdrawal
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D. Delirium tremens
Concerns in Substance Use Disorders
2. A patient who has required increasing amounts of medication to
achieve the desired effect and develops withdrawal symptoms when
dosing is delayed is said to be:
A. Dependent
B. Tolerant
C. Addicted
D. In withdrawal
3. A patient is complaining of chronic back pain and requests a refill of his
oxycodone prescription because the pain is so bad he becomes
suicidal. As a result, his primary care provider referred him to the
PMHNP. The patient states he can tell if he is late taking his next dose
by even 1 hour as he becomes very anxious, restless, irritable, and
begins sweating. He states that he is so worried about having pain
attacks that much of his day is spent waiting to take the next dose.
When he runs out of his medication between visits he buys some from
his friend. Which of the following best describes the patient’s
condition?
A. Dependence
B. Addiction
C. Tolerance
D. Withdrawal
4. A 30-year-old male who was started on sertraline for generalized anxiety
disorder was also started on lorazepam 1 mg for sleep during the first 2
weeks as he was adjusting to the medication. At the 2-week follow-up
visit his psychiatrist increased the sertraline, but the dose of lorazepam
does not seem to be helping with sleep and the patient is requesting a
higher dose. Which of the following best describes the patient’s
condition?
A. Dependence
B. Addiction
C. Tolerance
D. Withdrawal APA
