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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?
A.
B.
C.
D.
2 . Which of the following is true of methadone?
A.
B.
C.
D.
3 . Nonpharmacologic therapies for pain treatment
A.
B.
C.
D.
4 . For which of the following pain conditions are ER/LA opioids indicated?
A.
B.
C.
D.
5 . According to assessment tools, which of the following factors heighten risk for opioid-use disorder?
A.
B.
C.
D.
6 . Name one method by which patients should be encouraged to dispose of unused opioids
A.
B.
C.
D.
7 . Name one way patients should be monitored for adherence to medical direction during long-term opioid therapy?
A.
B.
C.
D.
8 . Which of the following is true of potential drug-drug interactions with opioids?
A.
B.
C.
D.
9 . In which of the following clinical scenarios may a patient be discontinued from opioids without taper and management of withdrawal symptoms?
A.
B.
C.
D.
10 . Which of the following is one indication for take-home naloxone with opioid prescription?
A.
B.
C.
D.
11 . Increased monitoring of patient response is essential during opioid dose initiation, upward titration, rotation, and addition of other central-nervous system depressants because
A.
B.
C.
D.
12 . Urine drug testing as a monitoring measure can tell the clinician which of the following:
A.
B.
C.
D.
13 . Which of the following factors increases a patient’s risk of opioid misuse?
A.
B.
C.
D.
14 . Recommended frequency to check the prescription drug-monitoring database is:
A.
B.
C.
D.
15 . Which of the following influences the amount of dopamine released and the degree of reward experienced by an opioid user?
A.
B.
C.
D.
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?
A.
B.
C.
D.
17 . What two competing needs must the CSA and regulators attempt to balance?
A.
B.
C.
D.
18 . Which attribute of some drugs with legitimate therapeutic uses increases their likelihood of being abused?
A.
B.
C.
D.
19 . The duration of action of ER/LA opioids is typically ______________.
A.
B.
C.
D.
20 . Uncomfortable or unpleasant side effects (aside from constipation) may potentially be reduced by which two approaches?
A.
B.
C.
D.
21 . What drug class has largely replaced barbiturates as treatment for anxiety and muscle spasms?
A.
B.
C.
D.
22 . Which of the following items does not need to be contained in any prescription for a controlled substance?
A.
B.
C.
D.
23 . Which of the following might suggest inappropriate prescribing of controlled substances by a clinician?
A.
B.
C.
D.
24 . The Ryan Haight Act made it illegal to _____________.
A.
B.
C.
D.
25 . Which of the following is not a potential benefit of urine drug screening?
A.
B.
C.
D.
26 . Drugs with the highest risk for subsequent addiction slowly elicit dopamine release in the midbrain.
A.
B.
27 . 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.
A.
B.
28 . Little evidence supports the assertion that long-term use of opioids provides clinically significant pain relief or improves quality of life or functioning.
A.
B.
29 . Roughly what percent of patients reported that they increased their dose of an opioid without talking to the prescribing physician in one study?
A.
B.
C.
D.
30 . When opioid treatment is initiated, it should be viewed by both patient and clinician as _____________________?
A.
B.
C.
D.
31 . Opioid tolerance must be demonstrated before prescribing any strength of _________________.
A.
B.
C.
D.
32 . What level of opioid dose is widely considered a red flag warranting more intense monitoring and/or referral to an interdisciplinary treatment team?
A.
B.
C.
D.
33 . What relatively new development may reduce the incidence of death from accidental overdose of an opioid medication?
A.
B.
C.
D.
34 . 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.
A.
B.
35 . Medication-Assisted Treatment is primarily used for treating
A.
B.
C.
D.
Self-Assessment Answers for Section 3: Reducing Diagnostic Error in Medicine
36 . Approximately what percentage of U.S. adults seeking outpatient care will experience a diagnostic error each year?
A.
B.
C.
D.
37 . The phrase “next frontier in patient safety” has been applied to which topic of current interest in medicine?
A.
B.
C.
D.
38 . A key part of defining “diagnostic error” from a patient-centered perspective is ____________________.
A.
B.
C.
D.
39 . Before initiating any treatment for a patient’s health problem, a clinician must _______________________.
A.
B.
C.
D.
40 . Which of the following is a potential challenge to the performance of an accurate patient medical history?
A.
B.
C.
D.
41 . Which of the following phases in the “brain-to-brain loop model” of diagnostic testing is least susceptible to error?
A.
B.
C.
D.
42 . What type of diagnostic testing is growing rapidly and, thus, posing a challenge for clinicians?
A.
B.
C.
D.
43 . Which of the following is not a potential source of error when using medical imaging technology?
A.
B.
C.
D.
44 . Which of the following is a model for more closely involving pathologists and radiologists in the diagnostic process?
A.
B.
C.
D.
45 . A potential limitation of using an empiric treatment strategy is that _____________________.
A.
B.
C.
D.
46 . The current understanding of clinical reasoning is based on which theory of decision making?
A.
B.
C.
D.
47 . Which of the following is an example of a situation involving slow system 2 cognitive processing?
A.
B.
C.
D.
48 . What is the formal name for the universal tendency to believe that we know more than we actually do?
A.
B.
C.
D.
49 . Which type of cognitive processing typically performs best in highly reliable and predictable environments?
A.
B.
C.
D.
50 . What can be the result of a diagnostic process in which the outcomes of the decision-making process are unknown?
A.
B.
C.
D.
51 . Because of fatigue, a radiologist misses identifying a suspicious spot on a lung x-ray. When the attending physician reviews the x-ray, she notices the irregularity and consults with the radiologist, who recognizes his mistake. No harm occurred to the patient. What is the proper label for this kind of situation?
A.
B.
C.
D.
52 . Over-diagnosis is considered a form of diagnostic error.
A.
B.
53 . Which of the following is not a recommended motivation for instituting a system for measuring diagnostic error?
A.
B.
C.
D.
54 . Which of the following is not a method for estimating the incidence of diagnostic errors?
A.
B.
C.
D.
55 . __________________ was reported to reduce hospitalization time and costs, improve service provision, and enhance patient satisfaction, staff motivation, and team innovation in the United Kingdom’s National Health Service.
A.
B.
C.
D.
56 . Which group is considered to be at the center of the diagnostic process?
A.
B.
C.
D.
57 . _____________ can ensure communication and care coordination among diagnostic team members, monitor a patient over time to see if the patient’s course is consistent with a working diagnosis, and identify potential diagnostic errors.
A.
B.
C.
D.
58 . Accountable Care Organizations (ACOs) were created to address delivery system fragmentation and to align incentives to improve communication and collaboration among health care professionals.
A.
B.
59 . Morbidity and mortality conferences bring health care professionals from different disciplines together to consider the diagnosis and treatment of specific patients.
A.
B.
60 . A survey of low-income patients faced with major medical decisions found that ____ wanted to be very involved in the decision-making process.
A.
B.
C.
D.
61 . An identified problem with electronic health records is that _______________.
A.
B.
C.
D.
62 . Evidence shows that disclosing medical or diagnostic errors to patients and their families _______________________________.
A.
B.
C.
D.
63 . The phrase “heuristic failure” means _______________________.
A.
B.
C.
D.
64 . Which statement best describes the current state of diagnostic decision support tools?
A.
B.
C.
D.
65 . What fundamental change is recommended to increase the utility of health IT systems as they relate to improving diagnosis?
A.
B.
C.
D.
66 . What does “mHealth” stand for?
A.
B.
C.
D.
67 . What is one barrier to the use of postmortem examinations as a way of obtaining more accurate information about diagnostic errors?
A.
B.
C.
D.
68 . Which of the following is not a characteristic of effective feedback interventions to reduce diagnostic errors?
A.
B.
C.
D.
69 . Which statement is most true about the relationship between fee-for-service (FFS) reimbursement systems and efforts to improve diagnoses?
A.
B.
C.
D.
70 . What system has been proposed as a way to provide injured patients with expedited compensation decisions for certain types of medical errors?
A.
B.
C.
D.
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