Substance Abuse and Chemical Dependency Education for TN Prescribers

~ Exam ~

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This test has 25 questions.

All questions must be answered before the test can be graded.

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1. According to this text, approximately how many male dental patients abuse alcohol?
  a. 1:5
  b. 1:20
  c. 1:50
  d. 1:100
2. Drug and or alcohol abuse can best be defined as:
  a. The use of any drug that deviates from approved medical or social patterns

  b. Physical or psychological reliance on an exogenous substance
  c. Chronic, progressive and compulsive use of a substance
  d. Unlawful and improper
3. Considering a patient who has alcoholic liver disease (ALD) the dentist should:
  a. Expect prolonged bleeding times
  b. Expect delayed wound healing
  c. Consult the patient’s physician prior to invasive treatment
  d. All of the above
4. According to the 2015 NSDUH: The illicit drug use estimate for 2015 continues to be driven primarily by marijuana use and the misuse of prescription pain relievers.

  a. True
  b. False
5. Extraoral signs of inhalant abuse include:
  a. stained teeth
  b. sores or burns around mouth and/or nose
  c. paint stains around mouth and/or nose
  d. B and C
6. The brain’s reward system only responds to exogenous stimuli.
  a. True
  b. False
7. Intraoral signs of methamphetamine use include:
  a. Severe and extensive carious lesions
  b. Xerostomia
  c. Dental attrition
  d. All of the above
8. Drugs, which slow nervous system activity, include:
  a. Alcohol, codeine, nicotine and methamphetamine
  b. Nitrous Oxide, alcohol and crack cocaine
  c. Adderall, PCP and LSD
  d. Benzodiazepines, barbiturates and alcohol
9. A narcotic abuser in withdrawal (within 24 hours to 10 days after their last drug use) is likely to exhibit which of the following signs and symptoms:
  a. Drug seeking behavior
  b. Runny nose, abdominal cramps, and weight loss
  c. Increased attention to detail
  d. A and B.
10. The recent increase in inhalant use may be attributed to:
  a. Availability in the home
  b. Readily available information related to use such as Internet resources
  c. Obscure signs and symptoms
  d. All of the above
11. If you suspect your patient is under the influence of cocaine or methamphetamine, you should:
  a. Alert police
  b. Refuse to treat the patient
  c. Defer care for at least 24 hours after patient reports last use of drug
  d. None of the above
12. The most widely used stimulant is:
  a. Nicotine
  b. Amphetamines
  c. Cocaine
  d. Caffeine
13. Individuals abuse hallucinogens because:
  a. They often desire to repeat the experience
  b. They experience physical need for the drug
  c. They are readily available and inexpensive
  d. They cannot be detected in the system after 24 hours
14. The oral health team member’s greatest challenge is to motivate the patient in the stage of contemplation into the next stage of change.
  a. True
  b. False
15. Intraoral signs/symptoms of marijuana use include(s):
  a. Goldish green staining of teeth
  b. Benign migratory glossitis (geographic tongue)
  c. Halitosis
  d. A and C
16. Screening for drug and alcohol problems:
  a. Is not appropriate in the dental office
  b. Is completed only at the request of the patient
  c. Conducted during routine dental visits
  d. None of the above
17. If chemically dependent/addicted patients are not ready to change their behavior you should:
  a. Call the police immediately and have the patient arrested
  b. Restate your concern for their health and modify dental treatment accordingly
  c. Dismiss the patient from your practice
  d. Arrange for a psychiatrist to visit during the dental exam
18. The use of local anesthetics is contraindicated when treating:
  a. Individuals under the influence of Cocaine
  b. Recovering alcoholics
  c. Former marijuana users
  d. None of the above
19. You should modify dental treatment for patients recovering from chemical dependency by doing all of the following except:

  a. Consult with patient’s substance abuse counselor regarding pain control
  b. Use non-alcohol containing mouth rinse
  c. Criticize the patient about former drug abuse and addiction
  d. Discuss potential drug interactions or pain control methods
20. Primary goals for the dental practitioner when treating chemically dependent patients are:
  a. Diagnosis of chemical dependency and coordinating treatment
  b. Diagnosis of chemical dependency and distribution of clean needles

  c. Providing quality dental care, preventing complications, and helping patients avoid relapse

  d. A and C.
21. Included in the nine steps for prescribing controlled substances are:
  a. Start with a diagnosis supported by history and physical findings.
  b. Make sure you are not dealing with a drug seeking patient.
  c. Obtain informed consent from a patient before prescribing a drug known to cause dependency problems.
  d. A and C.
  e. All of the above.

22. In 2015 TN had the second highest per capita prescription rate for opioids in the US.

  a. True.
  b. False.
23. Providers must continually monitor the patient for signs of abuse, misuse or diversion. A UDT (or a comparable oral fluids screen or test) should be done twice a year at a minimum.

  a. True.
  b. False.
24. Key principles prior to initiating opioid therapy include:
  a. Chronic pain can be treated by the use of controlled substances through telemedicine.
  b. The provider does not need to discuss birth control plans to prevent unintended pregnancy with women of child bearing age who are prescribed opioids.

  c. Reasonable non-opioid treatments should be tried before opioids are initiated.
  d. A patient who has been prescribed opioids by a previous provider should always continue opioid treatment.
25. Benzodiazepines should be generally avoided in combination with chronic opioid therapy.

  a. True.
  b. False.