TEST BANK FOR CONCEPTS OF
CHEMICAL DEPENDENCY 10TH
EDITION DOWEIKO
1 . The earliest written record of wine-making is found in _______ and dates back to 3,000 B.C.E. a.
Sumeria
b. Rome
c. Egypt
d. Greece
ANSWER:
c POINTS:
1
REFERENCES: A Brief History of Alcohol
2. Evidence suggests that beer made from ingredients other than fermented honey might date back to
a. 3,000 B.C.E.
b. 5,000 B.C.E.
c. 7,000 B.C.E.
d. 9,000 B.C.E.
ANSWER: d
POINTS:
1
REFERENCES: A Brief History of Alcohol
3 . Prohibition in the United States could be described as a ______ social experiment. a. failed
b. successful
c. primitive
d. neutral
ANSWER: a
POINTS:
1
REFERENCES: A Brief History of Alcohol
4 . Presently, ______ percent of the human population is intoxicated at any given moment. a. 0.25
b. 0.5
c. 0.7
d. 1.2
ANSWER:
c POINTS:
1
REFERENCES: Alcohol Today
5. Jamal will have an occasional glass of wine with dinner, does not require daily use of alcohol to function,
has never
had any negative consequences due to his drinking, and does not use alcohol for continuous periods of time.
Jamal would most likely be considered
a. someone with an alcohol addiction.
b. someone with an alcohol abuse problem.
c. a binge drinker.
d. a rare or social drinker.
ANSWER: d
POINTS:
1
REFERENCES: A Working Definition of Rare or Social Drinking
6 . The most popular alcohol-containing beverage in the United States is a.
beer.
b. wine.
c. whiskey.
d. rum.
ANSWER: a
POINTS:
1
REFERENCES: Scope of Alcohol Use in the United States Today
7. In general, peak blood alcohol levels after the ingestion of single alcoholic drink are achieved in
__________
minutes. a. 510
b. 15-25
c. 30-60
d. 70-90
ANSWER:
c POINTS:
1
REFERENCES: 35
8 . Currently, scientists believe that alcohol is a “dirty” compound. This means
a. alcohol shows a preference for a specific receptor site.
b. alcohol decreases the effects of GABA.
c. alcohol gets contaminated during the fermentation process.
d. alcohol alters the action of various neurotransmitters and interferes with the action of messenger
molecules within the neuron.
ANSWER: d
POINTS:
1
REFERENCES: The Pharmacology of Ethyl Alcohol
9 . Which of the following drugs are dangerous to mix with alcohol?
a. Nitroglycerine
b. Barbiturates
c. Opiates
d. All of these answers
ANSWER: d
POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker
10 . According to your text, many historians believe
a. alcohol was the cause of the Protestant reformation in Europe.
b. alcohol was one reason for the expansion of the Roman empire.
c. alcohol may have been one factor in the rise of civilization.
d. the brewing of alcohol resulted in the widespread application of the new science of biochemistry that
emerged during the mid-13th century.
ANSWER:
c POINTS:
1
REFERENCES: Introduction
11. According to sources cited in your text, there is evidence that the consumption of mead can be traced
back
a. to the “stone ages.”
b. 18,000 years.
c. 2,000 years.
d. to the 8th century B.C.E.
ANSWER: a
POINTS: 1
REFERENC
ES: A Brief
History of
Alcohol
12. According to your text, the highest concentration of alcohol that can be achieved from
fermentation is about a. 22 percent.
b. 28 percent.
c. 15 percent.
d. 8 percent.
ANSWER:
c POINTS:
1
REFERENCES: Alcohol Today
13 . Historical evidence suggests that the process of distillation emerged a. in
800 A.D.
b. in 8,000 B.C.E.
c. 800 years ago.
d. 1,800 years ago.
ANSWER: a
POINTS:
1
REFERENCES: A Brief History of Alcohol 14 . One
major consequence of distillation is
a. many of the vitamins and minerals found in the mash prior to distillation are lost.
b. you cannot achieve an alcohol level higher than 30 percent.
c. the flavor is enhanced, but only for products made from certain species of grapes.
d. it is necessary to warm the resulting fluid to body temperature to serve it.
ANSWER: a
POINTS:
1
REFERENCES: How Alcoholic Beverages Are Produced Today
15 . According to your text, all of the following are methods by which alcohol has been introduced into the
body
EXCEPT
a. orally.
b. transdermal administration.
c. as a vapor.
d. intravenously.
ANSWER: b
POINTS:
1
REFERENCES: The Pharmacology of Ethyl Alcohol
16. As a general rule, the __________ can biotransform alcohol at the rate of one 12-ounce can of beer,
one glass of wine, or one standard drink per hour. a. duodenum
b. pancreas
c. liver
d. glutamate
ANSWER:
c POINTS:
1
REFERENCES: The Biotransformation of Alcohol
17 . All of the following are end products of the alcohol biotransformation process EXCEPT a.
aldehyde dehydrogenase.
b. glucose.
c. carbon dioxide.
d. carbohydrates.
ANSWER: a
POINTS:
1
REFERENCES: The Biotransformation of Alcohol
18 . Which of the following is a good summary of the Mellanby effect, according to your text?
a. A person feels more intoxicated when the alcohol levels are falling, after the neurons have been affected
by the alcohol molecules.
b. A person feels more intoxicated as the blood alcohol level is rising
c. The alcohol ingested causes the body to become stimulated.
d. The alcohol ingested causes the release of opioid peptides in the peripheral regions of the body.
ANSWER: b
POINTS:
1
REFERENCES: The Blood Alcohol Level (BAL)
19 . The sense of euphoria that many drinkers report is the result of
a. the release of opioid peptides in the peripheral regions of the body, which eventually reach the brain’s
pleasure center and accounts for alcohol’s slow onset of action.
b. alcohol’s ability to stimulate the release of alcohol dehydrogenase in the stomach.
c. alcohol’s ability to stimulate the brain’s reward system.
d. the release of glucose by the liver, directly causing the reward cascade in the brain.
ANSWER:
c POINTS:
1
REFERENCES: The Biotransformation of Alcohol
20 . A friend of yours is a rare drinker, perhaps drinking one or two mixed drinks a month when out for
dinner. You know this will
a. increase that person’s risk of a hemorrhagic stroke.
b. improve muscle coordination as the alcohol removes doubts and inhibitions.
c. improve respiration, allowing more oxygenated blood to reach the muscles and brain.
d. improve visual peripheral field perception, allowing the person to see and then anticipate tactics used by
defensive players.
ANSWER:
a POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker
21. The disinhibition effect induced by alcohol is caused by its effects on the activity of the
_________ region of the drinker’s brain.
a. hippocampus
b. reticular activating system (RAS)
c. cortex
d. occipital
ANSWER:
c POINTS:
1
REFERENCES: Subjective Effects of Alcohol on the Individual at Normal Doses in the Social Drinker 22.
According to your text, the alcoholrelated “hangover”
a. is sufficient to cause the drinker’s death.
b. is self-limiting for those drinkers who ingested less than 8 cans of beer or mixed drinks.
c. can be avoided if the drinker ingests food prior to drinking.
d. is generally self-limiting, although very unpleasant.
ANSWER: d
POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker
23. According to your text, which of the following individuals would you normally expect to have the lowest
blood alcohol level?
a. A 160-pound man who consumed 14 standard drinks over a 3 hour span of time
b. A 160-pound man who consumed 8 stand drinks over a 3 hour span of time
c. A 160-pound man who consumed 4 standard drinks over a 3 hour span of time.
d. A 180-pound man who consumed 16 standard drinks over a 3 hour span of time.
ANSWER:
c POINTS:
1
REFERENCES: The Blood Alcohol Level (BAL)
24. Your aunt, who suffers from sleep apnea, likes to have a “wee shot of brandy” before going to bed to
help her sleep better. Based on your textbook, this
a. can suppress or improve the symptoms of sleep apnea.
b. can exacerbate the symptoms of sleep apnea.
c. will have no effect on her sleep apnea symptoms.
d. will have little effect on her sleep apnea if she waits 20 minutes before going to bed.
ANSWER: b
POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker
25 . There are no significant long-term neurocognitive effects from alcohol because
a. it improves blood flow to the cortex of the brain.
b. it decreases endorphin release in the cortex of the brain.
c. it improves blood oxygenation levels and stimulates the production of free radicals in the brain. d. none of
the above.
ANSWER: d
POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker
26 . As a physician on duty in the emergency room, you could expect
a. alcohol ingestion would make drinkers so relaxed that they would suffer fewer head injuries than
nondrinkers in similar automobile accidents.
b. about half of the patients you see who have a traumatic injury will have been drinking immediately prior
to the incident.
c. improved survival rates for drinkers, who would be more likely to be thrown from a vehicle during
an accident.
d. no relationship between the individual’s alcohol use status and his or her having suffered a traumatic
injury of some kind.
ANSWER: b
POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker 27 .
According to your text, why do people consume alcohol?
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: Why Do People Consume Alcohol?
28. E xplain what is meant when alcohol is described as a “dirty”
compound.
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: The Pharmacology of Ethyl Alcohol
29. What are some of the factors that may affect the blood alcohol level
(BAL)?
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: The Blood Alcohol Level (BAL)
30. Describe the symptoms and treatments for hangovers. What is believed
to be the basic causal factor(s) of a hangover? ANSWER:
No answer provided.
POINTS:
1
REFERENCES: Medical Complications of Alcohol Use for the Social Drinker
31. D escribe the characteristics of a rare, or social, drinker.
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: A Working Definition of Rare or Social Drinking
1 . What percentage of adults in the western world will use a benzodiazepine each year? a. 1-2
percent
b. 5-8 percent
c. 10-15 percent
d. 20-22 percent
ANSWER:
c POINTS:
1
REFERENCES: Introduction
2 . It is impossible to overdose on a benzodiazepine.
a. True
b. False
ANSWER:
False
POINTS:
1
REFERENCES: Subjective Effects of Benzodiazepines at Normal Dosage Levels
3. Benzodiazepines are rarely injected into muscle tissue due to their erratic absorption. One
exception to this is when a patient is experiencing a. a heart attack.
b. an overdose of heroin.
c. delirium tremors.
d. a seizure.
ANSWER: d
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines 4 .
Benzodiazepines enhance the effects of
a. serotonin.
b. GABA.
c. dopamine.
d. metabolites.
ANSWER: b
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
5 . The medical community collectively uses benzodiazepines for the long-term treatment of anxiety. a. True
b. False
ANSWER:
False
POINTS:
1
REFERENCES: Side-Effects of the Benzodiazepines When Used At Normal Dosage Levels
6. The Royal College of Psychiatrists in Great Britain recommends that benzodiazepines be used for no long
than
____________ continuously. a. 4
weeks
b. 8 weeks
c. 6 months
d. 12 months
ANSWER: a
POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines
7. A common form of benzodiazepine abuse is when they are mixed with _______ to produce a sense of
euphoria.
a. anabolic steroids
b. barbiturates
c. methadone
d. marijuana
ANSWER:
c POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines 8 .
Benzodiazepine can interfere with
a. sexual function.
b. sleep.
c. memory.
d. all of these answers.
ANSWER: d
POINTS:
1
REFERENCES: Side-Effects of the Benzodiazepines When Used At Normal Dosage Levels
9. It is potentially dangerous to mix benzodiazepines with many prescription and over-the-counter drugs
or herbal supplements. a. True
b. False
ANSWER:
True
POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines 10 .
Which hypnotic drug works by binding with the melatonin receptor in the brain? a. Zolpidem
b. Buspirone
c. Ramelteon
d. Rohypnol
ANSWER:
c POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs)
11 . All of the following describe benzodiazepines EXCEPT
a. they have a large therapeutic window.
b. all are proven to assist in seizure control.
c. they require GABA molecules to be at receptor site to be effective.
d. they are occasionally used as adjunct to treatment of anxiety.
ANSWER: b
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
12 . The benzodiazepines are said to
a. artificially simulate the effects of GABA at the receptor site.
b. block the effects of GABA at the receptor.
c. make the receptor site more sensitive to GABA molecules.
d. activate production of more GABA molecules.
ANSWER:
c POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
13 . The variations in chemical structure between different benzodiazepines
a. affects the duration of effect.
b. affects their binding site within the brain.
c. determines the production costs for that specific benzodiazepine.
d. eliminates or facilitates the process of lipid binding for that chemical.
ANSWER: a
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
14 . Benzodiazepine over-sedation usually is
a. not commonly encountered when the person starts to take one of these medications.
b. commonly encountered when the person starts to take one of these medications.
c. a measure of the individual’s vulnerability to the development of physical addiction to one of these
compounds.
d. a sure sign of cross tolerance to other CNS depressants such as alcohol orantihistamines.
ANSWER:
a POINTS:
1
REFERENCES: Subjective Effects of Benzodiazepines at Normal Dosage Levels
15. To date, researchers have identified _______ subtypes of the GABA receptor, and the exact function
of each __________.
a. more than 20; is still being explored
b. more than 20; has been identified
c. between 12 and 15; has been genetically isolated
d. less than 20; is still being explored
ANSWER: a
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
16 . The benzodiazepines are thought to exert their primary effect in the
a. GABAf receptor site.
b. GABAa receptor site.
c. GABAc receptors in the descending fibers of the mesocortical system.
d. GABAb receptor sites in the optic lobe.
ANSWER: b
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
17 . Persons taking diazepam have been found to have a 500% increased chance of a. optic
neuritis.
b. shortened reaction time.
c. motor vehicle accidents.
d. increased visual perception in dim light situations.
ANSWER:
c POINTS:
1
REFERENCES: Side-Effects of the Benzodiazepines When Used At Normal Dosage Levels 18. A friend
started taking a prescribed benzodiazepine for anxiety and begins to demonstrate symptoms of
depression and suicidal thinking. Which of the following statements is most true?
a. His benzodiazepine use might have “unmasked” a hypomanic state.
b. These symptoms possibly could reflect a rare side effect of this class of medications.
c. He has developed a tolerance for this medication and its effects.
d. These symptoms are a common side effect with this class of medications.
ANSWER: b
POINTS:
1
REFERENCES: Subjective Effects of Benzodiazepines at Normal Dosage Levels
19. The brain constantly attempts to adjust to environmental demands through a number of
compensatory mechanisms, including
a. maintenance of consistent blood supplies to all parts of the amygdala.
b. maintenance of neurotransmitter site responsiveness for NMDA.
c. neural-definitation.
d. neuroadaptation.
ANSWER: d
POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines
20 . The benzodiazepine withdrawal syndrome
a. is uncomfortable but tolerable and not dangerous.
b. holds the potential to be life threatening.
c. usually can be carried out in 6-12 days, at most.
d. does not usually involve the use of a gradual “taper” from the patient’s prior dose.
ANSWER: b
POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines 21. When used
at normal doses, which of the following is NOT a potential side effect of the benzodiazepines?
a. Enhanced neurocognitive function
b. Anterograde amnesia
c. Paradoxical rage reactions
d. Over-sedation
ANSWER: a
POINTS:
1
REFERENCES: Side-Effects of the Benzodiazepines When Used At Normal Dosage Levels 22 .
Benzodiazepines have been found to ____________ in some users.
a. increase stage 1 and 2 sleep when started
b. decrease stage 1 and 2 sleep when started
c. cause rebound insomnia when discontinued
d. increase REM sleep time
ANSWER:
c POINTS:
1
REFERENCES: Side-Effects of the Benzodiazepines When Used At Normal Dosage Levels
23 . Alcohol abusers will most commonly use a benzodiazepine to
a. enjoy the effects of alcohol for a longer period of time as they grow older.
b. mitigate withdrawal effects from alcohol during the workday.
c. treat muscle sprains.
d. distract themselves from boring, routine tasks such as long distance driving.
ANSWER:
b
POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines 24 .
According to your text, flunitrazepam (Rohypnol ®) is about
a. 10 times as potent as diazepam.
b. half as potent as diazepam unless mixed with alcohol.
c. three times as potent as diazepam.
d. 100 times as potent as diazepam.
ANSWER: a
POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs)
25 . The patient who is prescribed buspirone should not expect to
a. have dietary restrictions recommended while he or she is on this medication.
b. experience the peak effects in 2-5 hours.
c. be able to dose just once daily.
d. have to take a dose 3-4 times a day.
ANSWER:
c POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs)
26 . Zaleplon appears to
a. decrease sleep latency but does not significantly interfere with REM sleep.
b. increases sleep latency and does not lengthen the total duration of time spent asleep.
c. has no effect on sleep latency but reduces REM sleep time.
d. decreases sleep latency but causes “fragmentation” of sleep cycles.
ANSWER: a
POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs)
27 . The peak effects of zaleplon appear
a. in the last 3 hours of the night’s sleep.
b. in the first 4 hours after ingestion.
c. in the increased time spent asleep.
d. during REM sleep.
ANSWER: b
POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs)
28. Describe the nature of the debate regarding the longterm efficacy of
benzodiazepines as anxiolytics.
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: The Pharmacology of the Benzodiazepines
29. D iscuss the relationship between benzodiazepines and suicide
attempts.
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: Subjective Effects of Benzodiazepines at Normal Dosage Levels 30. What are
some of the longterm consequences of chronic benzodiazepine use?
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: Neuroadaptation to, Abuse of, and Addiction to, the Benzodiazepines 31 . Describe
the serotonin syndrome, one of the more serious adverse effects of buspirone.
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs) 32 . Describe
some of the more common side effects of the newer hypnotics.
ANSWER:
No answer provided.
POINTS:
1
REFERENCES: The Benzodiazepine Receptor Antagonists (Z-Compounds or BRAs)