Instructions:

* Read the article on page 95.

* Take the test, recording your answers in the test answers section (Section B) of the CE enrollment form. Each question has only one correct answer.

* Complete registration information (Section A) and course evaluation (Section C).

* Mail completed test with registration fee to: Lippincott Professional Development, CE Group, 74 Brick Blvd., Bldg., 4 Suite 206, Brick, NJ 08723.

* Within 4-6 weeks after your CE enrollment form is received, you will be notified of your test results.

* If you pass, you will receive a certificate of earned contact hours and answer key. If you fail, you have the option of taking the test again at no additional cost.

* A passing score for this test is 14 correct answers.

* Need CE STAT? Visit http://www.nursingcenter.com for immediate results, other CE activities, and your personalized CE planner tool.

* No Internet access? Call 800-787-8985 for other rush service options.

* Questions? Contact Lippincott Professional Development: 800-787-8985

Registration Deadline: March 5, 2021

Provider Accreditation:

Lippincott Professional Development (LPD) will award 1.5 contact hours for this continuing nursing education activity. This activity has been assigned 0.5 pharmacology credits.

LPD is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LWW is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida #50-1223.

Disclosure: The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

This article has been approved by the Orthopaedic Nurses Certification Board for Category B credit toward recertification as an ONC.

Payment and Discounts:

* The registration fee for this test is $7.50 for NAON members and $15.00 for nonmembers.

* If you take two or more tests in any nursing journal published by LWW and send in your CE enrollment forms together, you may deduct $0.95 from the price of each test.

* We offer special discounts. Send in 6 tests together and the least expensive one is free; send in 12 tests and the 2 least expensive ones are free, etc. We also offer institutional bulk discounts for multiple tests. Call 800- 787-8985 for more information.

CE TEST QUESTIONS

GENERAL PURPOSE: To provide information on the opioid epidemic and a population health approach to address it.

LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:

1. Summarize the current status of the opioid epidemic.

2. Recognize the trends over the last 30 to 40 years that may have contributed to the opioid epidemic and a population health approach to address it.

1. The 13% increase in drug overdose deaths in the United States between 2016 and 2017 is primarily attributable to the use of synthetic opioids, particularly illicit

a. hydrocodone.

b. fentanyl.

c. oxycodone.

2. The state with the highest age-adjusted drug overdose death rate in 2016 was

a. West Virginia.

b. New York.

c. South Dakota.

3. The death rate from opioid overdose is higher for

a. persons aged 14 to 21 years.

b. "middle class" Americans.

c. males.

4. Seventy-nine percent of individuals who overdose on opioids are

a. non-Hispanic white.

b. non-Hispanic Black.

c. Hispanic.

5. As noted in the article, persons who have which condition are 3 times more likely to use opioids?

a. a mental health condition, like anxiety and depression

b. chronic kidney failure or chronic heart failure

c. obesity and/or malnutrition

6. Examining death rates from opioid overdose, economists have found that the hardest hit group includes those who

a. have college degrees and "white collar" jobs.

b. live in regions where manufacturing and construction jobs have been decreasing.

c. live in inner-city areas in large metropolitan centers.

7. In the 2017 study by Brummett et al., up to what percentage of patients developed new, persistent opioid use after major or minor surgical procedures?

a. 2.4%

b. 4.9%

c. 6.5%

8. The roots of the current opioid epidemic date back to a one-paragraph, non-evidence-based letter that appeared in 1980 in the

a. New York Times.

b. Wall Street Journal.

c. New England Journal of Medicine.

9. A book targeting doctors that erroneously claimed, "there is no evidence that addiction is a significant issue when persons are given opioids for pain control," was published in 2000 by the

a. Joint Commission.

b. Centers for Disease Control and Prevention (CDC).

c. Surgeon General's office.

10. A 2012 study by Fenton et al. concluded that higher patient satisfaction was associated with all of the followingexcept

a. greater inpatient use.

b. decreased mortality.

c. higher prescription drug expenditures.

11. The United States consumes what percentage of the world's hydrocodone?

a. 80%

b. 90%

c. 100%

12. One of the 2 most frequently diverted opioids is

a. hydromorphone.

b. methadone.

c. oxycodone.

13. Data from the CDC (2017) reported that most people who abuse prescription opioids get them from

a. an illicit drug dealer.

b. a friend or relative.

c. a physician.

14. A 2015 CDC report found that people who are addicted to prescription opioids are 40 times more likely to be addicted to

a. heroin.

b. marijuana.

c. cocaine.

15. Compared to fentanyl that is 100 times more potent than morphine, how much more potent is carfentanil?

a. 500 times

b. 1,000 times

c. 10,000 times

16. Carfentanil can be deadly if a person consumes a dose the size of

a. a grain of salt.

b. a pumpkin seed.

c. a marble.

17. In the gradualism treatment approach for persons with opioid-related substance use disorder (ORSUD), for the active drug user not seeking care, interventions may include

a. screening for co-morbidities associated with opioid addiction.

b. counseling and therapy, including motivational interviewing.

c. syringe exchange and safer injection education.

18. Much of the primary prevention of ORSUD involves

a. early recognition, prevention of high-risk behavior for subsets of the population who are at a higher risk for ORSUD.

b. public education, such as raising awareness of the risks of opioids and ORSUD.

c. education of care providers about the signs of tolerance, dependence, and addiction.

19. A key midstream strategy for addressing the opioid epidemic is the

a. establishment of Prescription Drug Monitoring Programs.

b. treatment of ORSUD as a chronic disease.

c. safe prescribing of opioids.

20. As noted in the article, what is key in helping persons with ORSUD achieve the highest level of health possible?

a. replacing negative attitudes with evidence-based interventions

b. ensuring the availability of medication-assisted treatment to low-income persons

c. educating high school- and college-aged persons about the inherent risks of opioid use