Strategies for Managing Substance Relapse

17. A patient presents for a follow-up visit and has a dual diagnosis of
substance use disorder and major depressive disorder. Which of

the following best describes this patient’s situation?
A. Relapse
B. Withdrawal
C. Intoxication
D. Lapse
18. Which of the following substances would be most likely to cause
withdrawal symptoms?
A. Alprazolam
B. Diazepam
C. Clonazepam
D. Chlordiazepoxide

Relapse Prevention and Substance Use

19. A patient with familial fatty liver disease and elevated liver enzymes
secondary to alcohol use disorder is admitted for detox. Which of the
following benzodiazepines should not be used?
A. Temazepam
B. Lorazepam
C. Oxazepam
D. Chlordiazepoxide
20. A patient who has been sober for 7 days struggles with cravings and is
fearful of relapse. He reports taking naltrexone daily. What agent
should the PMHNP prescribe to help reduce his cravings?
A. Citalopram
B. Disulfiram
C. Buprenorphine
D. Thiamine
ANSWERS
1. Answer C. Alcohol withdrawal symptoms include emotional lability,
bilateral upper extremity tremor, hypertension, tachycardia, nausea,
sweating, and anxiety. therefore, Alcohol use disorder is characterized by a pattern
of use with significant impairment with two or more Diagnostic and

Hence, Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria
over the previous 12-month period. therefore, Generalized anxiety disorder is
characterized by excessive worrying lasting at least 6 months. Moreover, Delirium
tremens is a severe form of alcohol withdrawal marked by global
confusion, audiovisual hallucinations, fever, hypertension, and
diaphoresis, which occur within 3 to 10 days of the last alcoholic drink.
2. Answer A. Hence, dependence is characterized by the repeated use of a
substance for physical needs leading to increased tolerance and, when
discontinued, results in physical withdrawal symptoms. Hence, Tolerance is a
condition in which repeated administration of the dosage causes a
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decreased effect despite increasingly larger doses, which are required to
obtain the effect observed in the initial dosage. Therefore, addiction is
psychological dependence leading to persistent and increased use of the
substance or behavior and when discontinued causes distress and urges to
resume use despite adverse consequences.Moreover, withdrawal is a substancespecific cluster of signs
and symptoms that occur when reducing or
stopping the consistent use of the substance. APA