Certified Alcohol and Drug Counselor Exam Quiz 02

Question 1 of 30

1. Question

A counselor is working with a young, self-identified gay male client who is struggling with methamphetamine addiction. Data indicates that substance use disorders are disproportionately high within the LGBT community. Which of the following approaches would be MOST appropriate for the counselor to adopt initially, aligning with the goals of Healthy People 2030?

Prioritize culturally competent care that acknowledges the unique stressors and experiences of LGBT individuals related to substance use.
Focus primarily on the individual factors contributing to the client's addiction, such as genetics and personal choices.
Assume that the client has access to the same resources and support systems as heterosexual individuals with similar addiction issues.
Refer the client for immediate psychiatric evaluation to address potential co-occurring mental health conditions before addressing the addiction.

Question 2 of 30

2. Question

A client in long-term recovery begins to display a ‘don’t care’ attitude, rejects offers of support, and starts rationalizing their past drinking. According to relapse prevention strategies, what is the MOST appropriate immediate course of action?

Implement a comprehensive relapse prevention plan focusing on trigger identification and coping strategies.
Address underlying family issues that may be contributing to the client's distress.
Encourage increased attendance at aftercare meetings, such as Alcoholics Anonymous.
Consult with a psychiatrist to evaluate the need for medication to manage mood or cravings.

Question 3 of 30

3. Question

During a comprehensive review of a client’s struggles with test anxiety, which strategy would be MOST effective in addressing the root causes and promoting a sense of control and preparedness, aligning with best practices in counseling?

Implementing effective time management techniques, addressing unresolved fears, practicing relaxation techniques, cognitive restructuring, and seeking social support.
Focusing solely on relaxation techniques to calm the client's nerves immediately before the test, without addressing underlying issues.
Advising the client to avoid studying with peers to prevent comparison and competition, which may exacerbate anxiety.
Recommending the client to cram the night before the test to ensure all material is fresh in their mind, despite potential exhaustion.

Question 4 of 30

4. Question

Within the context of Alcoholics Anonymous (AA), what primary purpose does the principle of anonymity serve, aligning with the core values and traditions of the organization?

To protect members from stigma and ensure privacy, fostering a safe environment for recovery.
To ensure the group remains self-reliant and does not seek external financial assistance.
To guarantee that each AA group maintains complete autonomy in its decision-making processes.
To prevent AA from becoming involved in public controversies unrelated to its recovery focus.

Question 5 of 30

5. Question

In the context of family roles within an alcoholic system, as described by Sharon Wegscheider-Cruse, which of the following best characterizes the ‘family hero’?

A child who seeks to bring recognition and success to the family, often overachieving to compensate for the alcoholic parent's behavior.
A child who frequently engages in disruptive behaviors to draw attention away from the alcoholic parent.
A child who actively ignores the family's problems and pretends that everything is normal to maintain a sense of stability.
A child who enables the alcoholic parent by making excuses for their behavior and shielding them from consequences.

Question 6 of 30

6. Question

Considering the criteria outlined in the DSM-5 for substance use disorders and the neurobiological effects of cannabis, how would a counselor differentiate between psychological dependence and physiological addiction in a client with a history of prolonged marijuana use?

Assess the presence and severity of physical withdrawal symptoms, as physiological addiction is characterized by significant physical distress upon cessation, while psychological dependence primarily involves cravings and emotional discomfort.
Focus solely on the client's self-reported cravings and compulsive use patterns, as these are the most reliable indicators of addiction severity regardless of the substance.
Administer a urine drug screen to confirm the presence of THC metabolites, as this is the definitive marker of physiological addiction to marijuana.
Evaluate the client's social and occupational functioning, as impairment in these areas is the primary determinant of addiction severity, irrespective of physical or psychological symptoms.

Question 7 of 30

7. Question

Which of the following statements best encapsulates the common personality characteristics observed in Adult Children of Alcoholics (ACAs), reflecting the impact of their upbringing on their adult behavior and relationships, as often seen in counseling settings?

ACAs often exhibit a range of traits including hyper-responsibility or irresponsibility, difficulty with authority, low self-esteem, hypersensitivity, lack of spontaneity, fear of abandonment, reluctance to forgive, addiction to excitement, commitment avoidance, dependency issues, feelings of oddness, a need for external affirmation, emotional extremes, and inconsistent approaches to life, reflecting deep-seated coping mechanisms.
ACAs primarily demonstrate outward aggression and hostility towards others, stemming from unresolved anger towards their parents' substance abuse, leading to frequent conflicts and difficulties in maintaining stable relationships, often requiring anger management interventions.
ACAs typically display an exceptional level of independence and self-reliance, having learned to fend for themselves from a young age, making them highly successful in their careers but emotionally detached in their personal lives, rarely seeking help or support from others.
ACAs are generally characterized by a consistent pattern of seeking out relationships with individuals who mirror their parents' addictive behaviors, perpetuating a cycle of dysfunction and enabling, often requiring intensive therapy to break free from these patterns.

Question 8 of 30

8. Question

In accordance with the Seattle Downtown Emergency Service Center (DESC) recommendations, what is the primary purpose of the Vulnerability Assessment Tool (VAT) when used with homeless individuals?

To provide a comprehensive evaluation across ten domains, including survival skills, basic needs, and mental health, to determine appropriate support and interventions.
To primarily assess the mental health status of homeless individuals, focusing on identifying psychiatric disorders and co-occurring substance use disorders.
To focus solely on the substance use history and current drug preferences of homeless individuals to guide detoxification and treatment planning.
To quickly determine the immediate medical risks and needs of homeless individuals, such as indicated mortality risks and basic medical requirements.

Question 9 of 30

9. Question

According to the Michigan Alcoholism Screening Test (MAST), what score is generally considered suggestive of alcoholism, warranting further evaluation, in accordance with commonly used screening tools in substance use disorder assessments?

Five or more points
Two or fewer points
Fifteen or more points
Zero points

Question 10 of 30

10. Question

A client consistently loses jobs and strains family relationships due to heavy drinking, yet continues to consume alcohol. According to the concepts discussed in the context of substance abuse, which of the following best describes this behavior?

Alcoholism is characterized by continued use despite serious consequences.
Social drinking is defined by occasional consumption in social settings.
Alcohol abuse is indicated by any level of alcohol consumption.
Experimental drinking is marked by infrequent and irregular use.

Question 11 of 30

11. Question

In a long-term study examining the cognitive effects of chronic marijuana use, which of the following potential outcomes is most directly associated with the disruption of the hippocampus by THC, the active ingredient in marijuana, as highlighted by the U.S. Drug Enforcement Administration (DEA)?

Lasting memory impairment due to hippocampal disruption
Increased risk of lung cancer from tar inhalation
Compromised immune system leading to increased infections
Elevated risk of cardiovascular disease due to increased heart rate

Question 12 of 30

12. Question

In accordance with best practices for managing chronic pain in a patient with a documented history of opioid use disorder, which pharmacological approach would be MOST suitable to minimize the risk of relapse while providing effective analgesia, considering guidelines from the Substance Abuse and Mental Health Services Administration (SAMHSA)?

Prescribing methadone due to its long half-life and reduced euphoric effects, which can help manage pain and prevent cravings.
Administering short-acting opioids on an as-needed basis to avoid tolerance and dependence.
Utilizing high doses of codeine to maximize analgesic effects while minimizing the risk of respiratory depression.
Opting for oxycodone in a time-release formulation to provide consistent pain relief throughout the day.

Question 13 of 30

13. Question

A client reports experiencing vivid flashbacks several months after discontinuing hallucinogen use. These flashbacks involve a complete loss of orientation to time and place, and the client describes the original hallucinatory experience as deeply disturbing. According to the information provided, what is the MOST likely impact of these flashbacks on the client’s overall well-being and functioning?

The flashbacks can be decidedly debilitating, significantly impairing the client's ability to function effectively in daily life.
The flashbacks are likely to be mild and transient, causing minimal disruption to the client's daily routine and activities.
The flashbacks will likely enhance the client's creativity and problem-solving abilities, leading to improved cognitive function.
The flashbacks will likely resolve spontaneously within a few weeks, requiring no specific intervention or support.

Question 14 of 30

14. Question

An addiction counselor is experiencing increased critical expressions, feelings of depression, and a tendency to avoid work. According to best practices for counselor well-being and ethical guidelines, which of the following strategies would be MOST effective in preventing burnout, aligning with the core principles of self-care and professional development as emphasized in counselor training programs?

Ensuring a rich and supportive personal life, avoiding work overload, ensuring adequate treatment planning time, continuing education, and utilizing consultation resources.
Increasing client caseload to feel more productive and valuable, minimizing personal time to focus on professional growth, and avoiding consultation to maintain autonomy.
Focusing solely on professional development, attending mandatory training sessions without personal reflection, and limiting personal interactions to avoid emotional drain.
Prioritizing administrative tasks over client interaction, reducing treatment planning time to see more clients, and avoiding continuing education to minimize workload.

Question 15 of 30

15. Question

In the context of counseling for addiction, which of the following best encapsulates the key components that define a behavioral addiction, distinguishing it from a typical behavior or habit?

Obsession/preoccupation with the behavior, continued engagement despite serious negative consequences, and compulsive/out-of-control behavior.
Engaging in the behavior to relieve stress, experiencing pleasure from the behavior, and feeling a sense of accomplishment afterward.
Repeatedly performing the behavior, experiencing mild withdrawal symptoms when the behavior is stopped, and having a strong desire to continue.
Occasional engagement in the behavior, awareness of potential negative consequences, and attempts to moderate or control the behavior.

Question 16 of 30

16. Question

According to the Seattle Downtown Emergency Service Center (DESC), which of the following domains is assessed by the Vulnerability Assessment Tool (VAT) when working with homeless individuals?

Survival skills
Financial literacy
Employment history
Family relationships

Question 17 of 30

17. Question

According to the ‘Opponent Process Theory’ regarding substance use disorders, what critical change signifies the transition from recreational drug use to compulsive drug-seeking behavior, often necessitating increased frequency and dosage?

The 'hedonic set point' is breached, where aversive 'B-Processes' outweigh positive 'A-Processes'.
The user experiences a sudden increase in the intensity of the positive 'A-Processes'.
Tolerance to the drug decreases, leading to enhanced sensitivity and pleasure.
The user consciously decides to increase drug use to experience novel effects.

Question 18 of 30

18. Question

According to Kirkpatrick’s research, what is a key benefit of all-female groups in substance abuse treatment for women?

They minimize the impact of sex-typed nurturing roles, allowing for more open exploration of issues.
They encourage competition among participants, fostering a drive for recovery.
They provide a platform for women to assert dominance and challenge traditional gender roles.
They replicate the dynamics of mixed-gender relationships, preparing women for real-world interactions.

Question 19 of 30

19. Question

In the context of substance use counseling, a client reports consistent marijuana use over several years and expresses difficulty stopping despite acknowledging negative impacts on their personal life. According to current understanding and research, how would a counselor best characterize the potential for physiological addiction in this scenario, considering guidelines outlined in the DSM-5 and relevant state regulations?

Rarely, as marijuana use is more commonly associated with psychological dependence rather than severe physiological addiction.
Absolutely, given the client's history of prolonged use and reported difficulty stopping, physiological addiction is highly probable.
Frequently, as consistent marijuana use invariably leads to significant physiological dependence and withdrawal symptoms.
Never, because marijuana lacks the chemical properties necessary to induce physiological changes leading to addiction.

Question 20 of 30

20. Question

A counselor is working with a client whose family exhibits codependent behaviors related to a parent’s substance abuse. The counselor chooses to frame these behaviors as ‘normal’ responses to an unhealthy family system, focusing on identifying and addressing the client’s arrested developmental stages. Which treatment approach is the counselor utilizing?

Developmental-symbiotic model
Cognitive behavioral therapy
Disease model
Family systems therapy

Question 21 of 30

21. Question

A counselor working with a family affected by substance abuse notices they feel unusually anxious when the client, a young adult, expresses a desire to attend a recovery program different from the one the family researched and approved. According to family systems theory, what boundary issue is MOST likely contributing to the counselor’s anxiety in this situation?

Enmeshed boundaries, where the counselor's anxiety reflects the family's difficulty in allowing individual autonomy.
Disengaged boundaries, where the counselor's anxiety stems from the family's lack of involvement in the client's recovery process.
Clear boundaries, where the counselor's anxiety is a normal reaction to the client's resistance to treatment.
Rigid boundaries, where the counselor's anxiety is caused by the family's inflexible rules regarding treatment options.

Question 22 of 30

22. Question

A counselor is working with a family affected by substance abuse and chooses to utilize the ‘developmental-symbiotic model’ in their approach. What primary focus differentiates this model from the ‘disease model’ in addressing codependency within the family?

Addressing arrested developmental growth and reframing codependent behaviors as normal responses to abnormal circumstances.
Emphasizing the chronic and relapsing nature of codependency as a parallel illness to substance abuse.
Identifying specific genetic predispositions that contribute to codependent behaviors within the family.
Implementing strict behavioral contracts to enforce boundaries and prevent enabling behaviors.

Question 23 of 30

23. Question

In a scenario where a client presents with severe mental illness, heavy substance use, and requires daily medication monitoring, which case management approach would be MOST appropriate according to established best practices?

Assertive Community Treatment (ACT)
Broker/Generalist Model
Strengths-Based Perspective
Clinical/Rehabilitation Model

Question 24 of 30

24. Question

A counselor in a substance abuse treatment facility overhears a coworker making disparaging and discriminatory remarks about a client’s sexual orientation. According to the NAADAC Code of Ethics, what is the counselor’s most appropriate course of action?

Report the coworker to the proper agency administrators for investigation.
Ignore the information, as it is hearsay and could be inaccurate.
Confront the coworker directly and attempt to resolve the issue informally.
Discuss the situation with other colleagues to gather more information before taking action.

Question 25 of 30

25. Question

A client in recovery from alcohol use disorder expresses a strong urge to drink after a stressful day at work. According to Marlatt and Gordon’s relapse prevention model, what would be the MOST effective initial intervention?

Implement a cognitive-behavioral strategy to modify the client's learned habits related to stress and drinking.
Immediately refer the client for chemical-aversion therapy to reduce the physiological cravings.
Advise the client to rely solely on willpower and avoid situations that trigger cravings.
Encourage the client to accept the urge as an inevitable part of the disease and wait for it to pass.

Question 26 of 30

26. Question

Which of the following represents a significant milestone in the historical evolution of addiction treatment approaches in the United States during the 19th century?

The establishment of the American Association for the Study and Cure of Inebriety in 1870, marking the emergence of a professional body dedicated to addressing addiction.
The introduction of methadone maintenance therapy as a primary treatment modality for opioid addiction.
The widespread adoption of the disease model of addiction, leading to the decriminalization of substance use disorders.
The passage of the Harrison Narcotics Tax Act of 1914, which criminalized the non-medical use of opiates and cocaine.

Question 27 of 30

27. Question

A client undergoing treatment for cocaine dependence expresses confusion about how the drug caused such intense euphoria. Which of the following best explains the primary neurochemical mechanism responsible for the euphoric effects of cocaine, directly contributing to its addictive nature, as understood within the context of substance use disorders and relevant to counseling strategies under 42 CFR Part 2?

The prolonged presence of dopamine in the brain when reabsorption is prevented by cocaine
The increased production of serotonin, leading to mood elevation and a sense of well-being
The adrenalin rush experienced when natural epinephrine is released by cocaine
The stimulation of endorphin release, creating a sense of pleasure and pain relief

Question 28 of 30

28. Question

A new client presents with increased energy, excessive talkativeness, and dilated pupils. During the initial assessment, the client admits to feeling ‘on top of the world’ lately. Based on these observations, which substance is the client most likely using?

Cocaine, due to its stimulant effects on the central nervous system.
Heroin, due to its initial euphoric effects followed by sedation.
Alcohol, due to its disinhibiting effects at lower doses.
Benzodiazepines, due to their calming and muscle-relaxing properties.

Question 29 of 30

29. Question

A client reports that initial experiences with substance use were highly pleasurable, but now primarily uses to avoid the intense discomfort and dysphoria experienced during periods of abstinence. According to the opponent process theory, what is the MOST accurate explanation for this transition from recreational to compulsive drug use?

The client is attempting to counteract increasingly intense withdrawal symptoms (B-processes) that outweigh the diminishing pleasurable effects (A-processes) of the drug, leading to compulsive use to maintain a sense of equilibrium.
The client's continued use is primarily driven by the persistent activation of neurological reward pathways, resulting in an inability to experience pleasure from natural reinforcers.
The client has developed a strong psychological dependence on the substance, characterized by an overwhelming craving and a belief that the drug is necessary for survival.
The client's brain has undergone irreversible structural changes, resulting in a permanent impairment of impulse control and decision-making abilities.

Question 30 of 30

30. Question

Which of the following neurotransmitters is an endogenous agonist at cannabinoid receptors, influencing motor coordination and short-term memory, and is also indirectly affected by THC?

Anandamide
Dopamine
Serotonin
Norepinephrine