Maine CADC questions well answered to pass, Exams of Nursing

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Maine CADC

The desire and yearning for a specific substance or substances is known as: b. craving The initial stage of crisis intervention involves: c. recognizing the crisis Which of the following is the BEST definition of insight? b. A sudden understanding of self, or realization of how a problem can be solved. MAT refers to: c. The use of medications such as suboxone in the treatment of addiction. Aisha has completed her treatment at an in-patient facility and is ready to be discharged. She has asked her counselor to recommend a therapist to work with her and her husband on an outpatient basis. This process is BEST viewed as an example of: a. a referral.

Referral Transfer of patient care from one physician to another. Consultation meeting for discussion or planning Case Management development of patient care plans to coordinate and provide care for complicated cases in a cost- effective manner. Aftercare Plan is designed to address the specific needs of an individual. Following are some common components of a typical aftercare treatment plan: Ongoing Counseling Sober Living Community Family Therapy 12-Step programs Vocational Rehabilitation Housing Educational Assistance Legal Assistance Mental Health Care Case Management Maintenance Medication Which type of therapy is directive, offering the greatest potential for abuse of power by the counselor? c. Gestalt

Adlerian Therapy Adlerian therapy is a brief, psychoeducational approach that is both humanistic and goal oriented. It emphasizes the individual's strivings for success, connectedness with others, and contributions to society as being hallmarks of mental health. Rational-Emotive Behavior Therapy REBT is an action-oriented approach to managing cognitive, emotional, and behavioral disturbances. Gestalt therapy form of directive insight therapy in which the therapist helps clients to accept all parts of their feelings and subjective experiences, using leading questions and planned experiences such as role-playing Person-Centered Therapy a nondirective insight therapy based on the work of Carl Rogers in which the client does all the talking and the therapist listens The primary purpose of professional credentialing for counselors is to: c. protect public safety by ensuring that counselors meet minimum standards of competency. Which of the following in NOT a CNS depressant? a. Alcohol

b. Xanax c. Nembutal d. Benzedrine DEPRESSANTS drugs (such as alcohol, barbiturates, and opiates) that reduce neural activity and slow body functions Xanax Valium Halcion Librium Ativan Klonopin Amytal Nembutal Seconal Phenobarbital The concept of informed consent requires that before agreeing to accept treatment, clients should know their rights and obligations, therapeutic goals, frees for service and ______. d. the limits of their confidentiality. Attitudes, policies, and practices that are destructive to other cultures, and their members are examples of lack of cultural_____. b. competence Restlessness, nervousness, flushed face, muscle twitching, tachycardia, or cardiac arrhythmia are all signs or symptoms of:

a. caffeine intoxication Of all of the possible substance use disorders, which one is typically not seen in older children or adults? b. Inhalant Use Disorder Needle exchange programs can BEST be described as: b. harm reduction Autonomic hyperactivity, hand tremor, nausea or vomiting, psychomotor agitation, grand mal seizures are all signs or symptoms of: c. sedative, hypnotic, or anxiolytic withdrawal Among other things,__________involves making a client aware of resources in the community, as well as providing information related to substance abuse, HIV/AIDS and other STDs. c. client education Client Education Provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources.

In the United States, the population that experiences the lowest prevalence of alcohol use disorder is: d. Asian Americans and Pacific Islanders Classical and operant conditioning are associated with _________ therapy. b. behavior Eric has admitted being sexually active without using any type of protection against sexually transmitted diseases. His counselor has made an appointment for him to be tested for the HIV virus. He then made arrangements for Eric to be transported to the clinic. Facilitating this appointment is BEST described as: b. case management Studies indicate that counseling is most effective when: a. culture and values are taken into account One basic principle of documentation requires the counselor to: b. describe events in objective terms, using measurable language that can be easily understood The _________ model of addiction explains addiction as a consequence of personal choice.

b. moral Disease model of addiction The disease model assumes that the origins of addiction lie within the individual him/herself. This model adopts a medical viewpoint and suggests that addiction is a disease or an illness that a person has. It believes that: -Addiction does not exist on a continuum - it is either present or it isn't. -Addicted people cannot control their intake of a given substance. Once they consume some of the substance (such as one drink of alcohol) they are powerless to stop themselves having any more and are overtaken by almost irresistible cravings when they cannot have it. -The disease of addiction is irreversible. It cannot be cured and can only be treated by lifelong abstinence. Alcoholics Anonymous (AA) is based on the disease model. Given the popularity of disease models, it is worth examining their advantages and disadvantages in greater detail. Moral Model of Addiction During the eighteenth and early nineteenth centuries, addiction was viewed as a sin. Drug-dependent people were considered morally weak, and addiction was seen as a fault of one's character. Under the influence of this model, users were punished with whippings, public beatings, stocks, fines, and public ridicule being relatively common. (In some British towns, people were made to walk around wearing nothing but beer barrels.) Spiritual direction was also a common treatment. Jail sentences were another form of punishment and at the turn of the century, many more drug users were put in mental hospitals as the jails became full. Social Learning model of addiction

Russell (1976) introduced the idea that dependence is not only chemical but also behavioral and social in nature. It is based more on the user's thoughts about the substance, and what it is like to be 'under the influence' of the drug itself. The key points of the social learning model can be summarised in the following way: -Anyone who engages in an activity that they find pleasurable is at risk of developing a dependence on that activity. -Dependence is a learned behavior that results from conditioning, modeling, and thinking about the substance. -Dependence on an activity/drug or person exists in degrees. The greater the dependence then the greater the negative feelings experienced in the absence of the activity. -Dependence is a normal facet of human behavior. It only becomes a problem when the individual experiences a number of negative consequences as a result of their behavior but continues to do it anyway. -A sense of compulsion, of wanting to engage in a behavior (such as drug use), but knowing that one really shouldn't, is the hallmark of addictive behavior. People talk about a sense of having handed over control to the drug/person/object. In wanting to do something very much but knowing that one shouldn't, behavior becomes erratic. 'Bingeing', ambivalence, secrecy, unreliability, rationalizations, and vows of abstention are common. -Addictive behaviors are only terminated when the individual makes the decision that the costs of continued use are vastly greater than the benefits. Sociocultural model of Addiction This model has become popular in the last 15 years. Unlike other models it focuses on society as a whole and not just on individuals. This model is based on the idea that the type of society in which people live has an impact on their drug use. In particular, this model makes links between inequality and drug use. It suggests that people who belong to groups who are culturally and socially disadvantaged are more likely to experience substance abuse problems. It also recognises that society labels users of certain substances as deviant, thereby creating further problems. Because this model links substance abuse to

the conditions of the wider society, the solution to 'drug problems' revolves around changing the social environment, rather than treating individuals. This involves developing ways to address poverty, poor housing and discrimination. How does solution-focused brief therapy differ from many of the other approaches to counseling? a. Emphasis is placed on the present and future while devaluing the past Case Reviews: d. enable the counselor to assess progress and make any necessary changes in the treatment plan The tendency of the family to try and maintain balance when dealing with a loved one's substance use disorder is called: c. homeostasis Your client expresses growing feelings of rage. He has recurring nightmares in which he attacks random women on the street. If you followed through with what you believed was a duty to warn, under what circumstances would you be least likely to be disciplined? d. If the client discloses the name of a person he plans to harm In his second counseling session, a client reveals to the counselor that he is gay. Having never worked with a member if the special population, the counselors's BEST course of action is to:

b. offer to refer the client to someone with experience with special issues associated with the gay community Determining a client's eligidility and appropriateness for treatment occurs during the _________ process. d. screening Highly structured daily routines, a system of reward and punishment, and frequent group confrontation are characteristics of: b. therapeutic communities Collateral Interviews: c. involve gathering from other persons who are, or have been, associated with the person being assessed A major criticism of the _________ is that the questions are so obvious that this test cannot possibly detect alcoholics who deny having a problem. a. MAST MAST

Developed in 1971, the Michigan Alcohol Screening Test (MAST) is one of the oldest and most accurate alcohol screening tests available. ASI Addictive Severity Index- The ASI is a semi-structured interview designed to address seven potential problem areas in substance-abusing patients: medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status Sassi Substance Abuse Subtle Screening Inventory (SASSI) The SASSI is a brief self-report, easily administered psychological screening measure that is available in separate versions for adults and adolescents. The Adult SASSI-3 helps identify individuals who have a high probability of having a substance dependence disorder with an overall empirically tested accuracy of 93 percent. The Adolescent SASSI-A2 is designed to identify individuals who have a high probability of having a substance use disorder, including both substance abuse and substance dependence, with its decision rules yielding an overall accuracy of 94 percent. POSIT Problem Oriented Screening Instrument for Teenagers (POSIT)- Designed to identify potential problem areas that require further in-depth assessment. POSIT was designed to identify problems and potential treatment or service needs in 10 areas, including substance abuse, mental and physical health, and social relations. Related is the POSIT follow-up questionnaire that was derived from items on POSIT to screen for potential change in 7 out of the 10 problem areas represented on POSIT. The goal of complete abstinence is most consistent with the ______________ model of addiction b. disease

__________ can develop between natural and synthetic opiates, but not between opiates and CNS depressants c. Cross tolerance Appropriate treatment goals must be: a. observable and measurable, in order to facilitate monitoring progress When is confrontation probably least appropriate? a. Prior to establishing rapport with the client The goal of screening is to: b. determine whether a client is appropriate and eligible for a particular treatment service __________ drugs are used to treat mental disorders. b. Psychotropic Jarmal believes that he has everything he will ever need materially and financially, so he has decided to devote his time to music and other creative outlets for self- expression. Jamal's motivation is best accounted for by: c. humanistic theories

The idea that people have an in-born desire to self-actualize is associated with: b. humanistic theory Methadone, Tramadol and Morphine are all _______________________. d. opiates The central focus or "charge" of the twelfth step of Alcoholics Anonymous is: a. service to others A counselor's Personal values: d. are communicated through the therapeutic goals they offer and how they attempt to reach those goals with the client. Nonmaleficence is the ethical principle that means: c. do no harm

__________ interventions have been developed or are being sought to block the effects of abused drugs, reduce cravings for drugs and block the toxic effects of drugs. b. pharmacological The terminology now being used in the DSM-5 for diagnostic categories is: c. Substance Use Disorder Which statement BEST describes the relevance of counselor self-exploration? b. counselors can benefit greatly from being clients themselves, at some point __________ is the term used to describe the mental activities involved in acquired, retaining and using any type of knowledge. c. cognition We have an expert-written solution to this problem! In the DSM-5, for a substance use disorder severity indicator mild, how many criteria must be present? a. 2- In which situation is it acceptable to release confidential information without prior consent from the client?

d. when the client admits to abusing a child Substance _________ is a syndrome that develops temporarily after ingestion of a psychoactive substance c. intoxication Toya is a 35-year-old African American woman who has brought her toddler to the emergency room with her. The baby is lethargic and irritable. The mother states that she doesn't know what is wrong with the baby. The mother seems erratic, herself. The E.R. doctor has called you in to consult on the mother, while he treats the child. In the course of your conversation, you learn that the mother takes valium every day because she "has nerves." She insists that it isn't a problem. Later you learn that the baby apparently found her mother's valium and managed to swallow a couple of pills. The father, an African American male, age 36 arrives and says he thinks his wife is addicted, however, he won't even make eye contact with you. During the interview with the mother, she has insisted she doesn't have a problem. What should you do? b. Talk with the husband about planning an intervention, using other family and friends to assist. Toya is a 35-year-old African American woman who has brought her toddler to the emergency room with her. The baby is lethargic and irritable. The mother states that she doesn't know what is wrong with the baby. The mother seems erratic, herself. The E.R. doctor has called you in to consult on the mother, while he treats the child. In the course of your conversation, you learn that the mother takes valium every day because she "has nerves." She insists that it isn't a problem. Later you learn that the baby apparently found her mother's valium and managed to swallow a couple of pills. The father, an African American male, age 36 arrives and says he thinks his wife is addicted, however, he won't even make eye contact with you. Do you have a responsibility to report the incident involving the child to authorities?

a. Yes, because the child was put in danger because of the mother's addiction. Toya is a 35 year old African American woman who has brought her toddler to the emergency room with her. The baby is lethargic and irritable. The mother states that she doesn't know what is wrong with the baby. The mother seems erratic, herself. The E.R. doctor has called you in to consult on the mother, while he treats the child. In the course of your conversation, you learn that the mother takes valium every day because she "has nerves." She insists that it isn't a problem. Later you learn that the baby apparently found her mother's valium and managed to swallow a couple of pills. The father, an African American male, age 36 arrives and says he thinks his wife is addicted, however he won't even make eye contact with you. The father stated that his wife was an addict and needed help, but he could not seem to make eye contact. What does this suggest? c. Perhaps nothing, since some cultures view direct eye contact as disrespectful. "Referral" means: a. assisting a client to utilize the support systems and community resources available. _________ are a problem associated with consuming alcohol and valium together. a. Synergistic effects __________ is the belief that one's own culture is superior to others. b. Ethnocentrism

"Excessive use of alcohol is a result of personal choice and therefore should be punished." This statement is consistent with the __________ model of addiction. b. moral A common problem for beginning counselors is: b. failing to identify an approach that is appropriate to the client. A counselor wants to record a counseling session with a client so that the counselor could listen to the tape, along with her supervisor, as part of ongoing training. According to ethical best practices, the counselor's plans are: c. ethical, as long as the client granted permission beforehand A major criticism of self-report instruments is that the questions are so obvious that these tests cannot possibly detect alcoholics who deny having a problem. This issue is a dilemma of __________ questions. b. face valid A mental status exam does NOT assess: a. education level b. appearance

c. speech d. thought processes Abstinence is to harm reduction as: c. Alcoholics Anonymous is to needle exchange Appropriate treatment goals must be: d. agreed upon by the client and counselor Arbitrary inferences and selective abstractions are examples of: a. cognitive distortions Arbitrary inference (Cognitive distortions) Arbitrary inference is a classic tenet of cognitive therapy created by Aaron T. Beck in 1979. He defines the act of making an arbitrary inference as the process of drawing a conclusion without sufficient evidence, or without any evidence at all. Selective abstraction (cognitive distortion)

Selective abstraction is a type of cognitive bias or cognitive distortion in which a detail is taken out of context and believed whilst everything else in the context is ignored. It commonly appears in Aaron T. Beck's work in cognitive therapy. Beneficence is the ethical principle that means: a. help Client education on HIV and other sexually transmitted diseases: d. is important information to incorporate in the treatment process of every client Completing necessary documentation for admission to a particular treatment program occurs during the __________ process. a. intake Concise and accurate reporting is necessary in order to: b. ensure continuity of client care Counselor self-disclosure is BEST limited to: b. ideas and emotional reactions in the counseling session

Drowsiness or coma, slurred speech, impairment in attention or memory are all signs or symptoms of: d. opioid intoxication Generally, the Tarasoff requirement has been interpreted as: d. a duty to warn the intended victim and/or the police In his second counseling session, a client reveals to the counselor that he is HIV positive. The counselor's best course of action is to: d. discuss the client's case with a clinical supervisor in order to meet the needs of the client In which situation is it NOT acceptable to release confidential information without prior consent from the client? b. if law enforcement officials request information in writing Jackie is recently discharged from the Air Force. His counselor suspects that he has PTSD, due to his experiences during active duty in Afghanistan. The counselor contacted the Veteran's Administration and located a clinic in the area with special groups for Vets with PTSD. The counselor then made arrangements for Jackie to be attend these groups while he is still in primary treatment for substance abuse. The counselor's actions are BEST described as: b. case management

Methadone maintenance programs can BEST be described as: b. harm reduction focused Niko ia a client who has been gaining weight steadily since entering treatment. When confronted about his constant snacking and lack of activity, he told his counselor that he needed to heat this way in order to keep his mind off of his drug of choice. He felt that he deserved to indulge since he was giving up the primary source of satisfaction he had used for years. The counselor would rightly conclude that the ego defense mechanism of _________ is at work here. d. rationalization Reaction formation (defense mechanism)

• Preventing unacceptable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors. EX: Jane hates nursing. She attended nursing school to please her parents. During career day, she speaks to prospective students about the excellence of nursing as a career. Denial psychoanalytic defense mechanism by which people refuse to believe or even to perceive painful realities. Projection psychoanalytic defense mechanism by which people disguise their own threatening impulses by attributing them to others

Rationalization psychoanalytic defense mechanism that offers self-justifying explanations in place of the real, more threatening, unconscious reasons for one's actions. One basic principle of documentation requires the counselor to: b. record material in a manner that allows a new counselor to understand the general progress of any client Rajish is avoiding social situations which involve drinking or drugs. He is worried that others may encourage him to drink. The counselor suggests that they act-out such a situation in order to develop responses if such a situation arises. This counseling technique is: d. role play "I" messages An "I" message or "I" statement is a style of communication that focuses on the feelings or beliefs of the speaker rather than thoughts and characteristics that the speaker attributes to the listener. Cognitive Restructuring (CR) CR is an internal process through which individuals can deliberately adjust how they perceive an action or experience. Empty chair technique

A role-playing intervention often used in Gestalt psychotherapy in which clients play conflicting parts. This typically consists of clients engaging in an imaginary dialogue between different sides of themselves. Role playing A learning technique in which two or more people act out characterizations of other people or other communication styles. Rates of opioid use are higher in __________ than in ____________. a. males; females Reinforcement and punishment are associated with _________ Therapy. b. Behavior Some researchers have concluded that no one pattern of dysfunctional substance abuse exists. They also conclude that there is more than one personality type that happens to be more prone to addiction than some others. This multivariate is MOST consistent with the: b. biopsychosocial model Studies have linked substance abuse among African Americans to three factors: economic deprivation, stress and __________. b. racism

The concept of informed consent requires that before agreeing to accept treatment, clients should know __________, their rights and obligations, fees for service, and limits of confidentiality. d. the goals of therapy The cultural philosophy of "noninterference" is associated with alcohol-related problems among: a. Native Americans The DSM-5 includes criteria sets specific to intoxication for each substance category except for __________. d. tobacco The first step of Alcoholics Anonymous requires: a. an admission that one's life is unmanageable The 1st step of AA: We admitted we were powerless over alcohol/addiction - that our lives had become unmanageable. The 2nd step of AA:

Came to believe that a Power greater than ourselves could restore us to sanity. The 3rd step of AA: Made a decision to turn our will and our lives over to the care of God as we understood Him. The 4th step of AA: Made a searching and fearless moral inventory of ourselves. The 5th step of AA: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. The 6th step of AA: Were entirely ready to have God remove all these defects of character. The 7th step of AA: Humbly asked Him to remove our shortcomings. The 8th step of AA: Made a list of all persons we had harmed, and became willing to make amends to them all. The 9th step of AA: