Self-Assessment Answers for Section 1: Prescriber Education for Opioid Analgesics
1 . When evaluating patients for treatment with extended-release/long-acting (ER/LA) opioid analgesics, which is an important risk to consider? 2 . Which of the following is true of methadone? 3 . Nonpharmacologic therapies for pain treatment: 4 . For which of the following pain conditions are ER/LA opioids indicated? 5 . According to assessment tools, which of the following factors heighten risk for opioid-use disorder? 6 . Name one method by which patients should be encouraged to dispose of unused opioids: 7 . Name one way patients should be monitored for adherence to medical direction during long-term opioid therapy: 8 . Which of the following is true of potential drug-drug interactions with opioids? 9 . In which of the following clinical scenarios may a patient be discontinued from opioids without taper and management of withdrawal symptoms? 10 . Which of the following is one indication for take-home naloxone with opioid prescription? 11 . Increased monitoring of patient response is essential during opioid dose initiation, upward titration, rotation, and addition of other central-nervous system depressants because: 12 . Urine drug testing as a monitoring measure can tell the clinician which of the following: 13 . Which of the following factors increases a patient’s risk of opioid misuse? 14 . Recommended frequency to check the prescription drug-monitoring database is: 15 . Which of the following influences the amount of dopamine released and the degree of reward experienced by an opioid user?
Self-Assessment Answers for Section 2: Evidence-Based Guidance on Responsible Prescribing, Effective Management, and Harm Reduction
16 . In the United States, approximately how many non-medical users of pain relievers, tranquilizers, stimulants, and sedatives got their prescription drugs from a friend or relative for free? 17 . What two competing needs must the CSA and regulators attempt to balance? 18 . Which of the following factors might be used to determine into which schedule a drug or other substance should be placed? 19 . Into how many classes does the CSA assign drugs or other substances? 20 . Which attribute of some drugs with legitimate therapeutic uses increases their likelihood of being abused? 21 . Heroin, LSD, MDMA, and cannabis are currently listed in which CSA schedule? 22 . Drugs in which schedule are deemed to have a high potential for abuse or dependence but also have a currently accepted medical use in the US? 23 . The duration of action of ER/LA opioids is typically ______________. 24 . Uncomfortable or unpleasant side effects (aside from constipation) may potentially be reduced by which two approaches? 25 . What drug class has largely replaced barbiturates as treatment for anxiety and muscle spasms? 26 . Any person who handles or intends to handle controlled substances must obtain what? 27 . If a physician is filling in for another physician in another state as part of a locum tenens arrangement, the substitute physician can legally prescribe controlled substances as long as he or she is legitimately registered with the DEA in his or her home state. 28 . In an emergency, a prescriber may phone or electronically submit a prescription for a Schedule II drug to a pharmacy but must follow up with a written prescription within 7 days. 29 . Which of the following items does not need to be contained in any prescription for a controlled substance? 30 . Which of the following might suggest inappropriate prescribing of controlled substances by a clinician? 31 . The Ryan Haight Act made it illegal to _________________. 32 . Which of the following is not a potential benefit of urine drug screening? 33 . How frequently are the data in most prescription drug monitoring programs updated? 34 . Drugs with the highest risk for subsequent addiction slowly elicit dopamine release in the midbrain. 35 . Although initially thought to be less prone to induce tolerance and dependence than barbiturates, benzodiazepines are now recognized to be just as liable to diversion and abuse. 36 . Little evidence supports the assertion that long-term use of opioids provides clinically significant pain relief or improves quality of life or functioning. 37 . Roughly what percent of patients reported that they increased their dose of an opioid without talking to the prescribing physician in one study? 38 . When opioid treatment is initiated, it should be viewed by both patient and clinician as _____________________. 39 . Opioid tolerance must be demonstrated before prescribing any strength of _________________. 40 . What level of opioid dose is widely considered a red flag warranting more intense monitoring and/or referral to an interdisciplinary treatment team? 41 . What relatively new development may reduce the incidence of death from accidental overdose of an opioid medication? 42 . For patients at the end of life, optimal pain management may mean lower doses of an analgesic, and higher levels of pain, in order to allow the patient mental alertness sufficient for interactions with loved ones. 43 . Medication-Assisted Treatment is primarily used for treating: 44 . Which of the following is NOT a practice that clinicians can use to minimize diversion of controlled substances? 45 . Acamprosate is a medication that can be used in the treatment of _________________.
Self-Assessment Answers for Section 3: Suicide Assessment & Prevention
46 . In 2017, what was the rank of suicide as a cause of death in the United States? 47 . About how much higher is the suicide rate among Veterans as compared to the non-Veteran population? 48 . The three levels of strategies for suicide prevention are _________, _________, and ____________. 49 . What is the name of the conceptual model that frames suicide risk as a balance between protective factors and risk factors at different levels? 50 . Which of the following is a tenet of the Patient-Centered Care model for suicide prevention? 51 . What is one of the advantages of adopting a Patient-Centered Care model of suicide prevention? 52 . Which of the following is a true statement about suicide risk? 53 . Which of the following is a true statement about suicide risk in Veteran and non-Veteran populations? 54 . Which of the following is a direct warning sign of acute suicide risk? 55 . Which of the following is true about asking patients about suicide or suicidal thinking? 56 . When attempting to elicit suicidal ideation from a patient, it is best if clinicians ________________? 57 . What would be an appropriate course of action for a patient determined to be at an intermediate level of acute suicide risk? 58 . Which non-pharmacological treatment modality has been shown to reduce the risk of suicide attempts by helping patients identify and change problematic thinking and behavioral patterns? 59 . Which non-pharmacological treatment modality focuses on helping patients cope with stressful life experiences by actively working on difficulties? 60 . Which pharmacological therapy has been shown to improve acute suicidal symptoms for up to a week after only a single dose? 61 . Which pharmacological therapy has been shown to reduce suicidal behaviors in patients with schizophrenia or schizoaffective disorder? 62 . What post-acute care modality has been shown to reduce the rate of suicide death following a psychiatric hospitalization for suicidal ideation/attempt? 63 . Which therapeutic modality may allow treatment for suicidal thoughts and behaviors regardless of geographic location or access to traditional care facilities? 64 . Which kind of suicide-prevention initiative has not been found to improve population-level suicide rates, either in the general U.S. population or among Veterans? 65 . In an effort to dispel stigma and foster a culture of support throughout the Department of Defense, which policy has been put into place?
Self-Assessment Answers for Section 4: Preventing Clinician Burnout
66 . What is the prevalence of burnout among physicians as in the United States when assessed using a rigorous definition of burnout? 67 . The estimated prevalence of suicidal ideation among physicians is approximately ____________? 68 . The prevalence of suicide is significantly higher among what subpopulation of physicians, compared to the general population? 69 . Which of the following statements most accurately describes an important aspect of burnout among physicians? 70 . Which component of physician workload has been shown to be particularly taxing and associated with higher levels of burnout? 71 . According to one study, for every hour physicians spend in face-to-face time with patients, how many hours do they spend using electronic health records or doing desk work? 72 . Roughly what percentage of patients could be classified as “difficult” and, hence, contribute to physician stress and emotional exhaustion? 73 . Although income levels are not associated with burnout, what aspect of physician compensation does appear to increase the risk of burnout? 74 . Which of the following is an example of systems-level intervention to help reduce physician burnout? 75 . What was the goal of the AMA’s Joy in Medicine Recognition Program? 76 . Which of the following is a component of the Patient-Centered Medical Home model that could help reduce burnout? 77 . Which type of technology has been the focus of literature about the relationship of physician burnout and technology? 78 . What occurred in 2009 that spurred the adoption of electronic health records across the country? 79 . How much time do primary care physicians typically spend using electronic health records? 80 . Which of the following is an example of an artificial-intelligence-based tool to facilitate better provider/patient encounters? 81 . What is one proposed solution to the problem posed by the increasing time demands of electronic health records? 82 . What individual-based practice has been shown to be an independent predictor of lower risk of burnout and higher quality of life among medical students? 83 . What is the name of an intervention consisting of group trainings for doctors about using patient-centered approaches with the aim of improving the doctor-patient relationship? 84 . _______________ is an example of a discussion-group intervention aimed at reducing symptoms of burnout among internal medicine physicians. 85 . A web-based Cognitive Behavioral Therapy program has been shown to _________________?