Substance Abuse Assessment and Treatment, Exams of Nursing

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What are withdrawal symptoms, characterized by severe flu-like symptoms (nausea, vomiting, runny nose, watery eyes, chills, abdominal cramps, anorexia, weakness, tremors, sweating, etc.), MOST characteristic? a. Opioid withdrawal b. Hallucinogenic withdrawal c. Barbiturate withdrawal d. Benzodiazepine withdrawal - Correct Answer-Opioid withdrawal Genetic factors make up roughly what proportion of the risk for addiction? a. Less than one-tenth b. One-quarter c. One-half d. Three-quarters - Correct Answer-One-half What is the adolescent tendency to impulsivity and risk taking due to primarily? a. Poor parenting b. Prior abuse c. Neurological immaturity d. Influences of puberty - Correct Answer-Neurological immaturity What are depressant drugs (e.g., alcohol, opiates, barbiturates, and benzodiazepines) typically used to cope with? a. Excitement b. Fatigue c. Stress d. Boredom - Correct Answer-Stress Past which point is benzodiazepine treatment of anxiety NOT effective? a. Six weeks b. Four months c. One year d. Eighteen months - Correct Answer-four months At low doses, what does alcohol act as physiologically? a. Stimulant b. Psychedelic c. Depressant d. Hallucinogenic - Correct Answer-Stimulant

Among the following, what is the MOST harmful drug a mother can abuse during pregnancy? a. Heroin b. Lysergic Acid (LSD) c. Alcohol d. Methamphetamine - Correct Answer-alcohol Theorists posit that stimulant abuse often occurs to compensate for deficiencies in all of the following neurotransmitters EXCEPT a. norepinephrine. b. acetylcholine. c. serotonin. d. dopamine. - Correct Answer-acetylcholine What is the euphoria experienced when under the influence of cocaine caused by? a. A cascade-effect of endorphins b. A sudden release of adrenalin c. Increased basal metabolic rate d. A buildup of neurotransmitters - Correct Answer-A buildup of neurotransmitters What kind of drug does the term nootropic refer to? a. Memory enhancing b. Mood stabilizing c. Hallucinogenic d. Psychedelic - Correct Answer-Hallucinogenic Psychedelic Which of the following is NOT a stage in the development of alcoholism? a. Dependent drinking b. Morning drinking c. Social drinking d. Heavy drinking - Correct Answer-Morning drinking In the lifecycle of heroin addiction, what is the stage known as disjunction characterized by? a. Entrance into the addiction subculture b. Episodic binge use of heroin in social settings c. Serial treatment, abstinence and relapses d. Crime, arrests, imprisonment, and serial treatment - Correct Answer-Crime, arrests, imprisonment, and serial treatment Which of the following is NOT a typical stage in the development of cocaine addiction? a. Compulsive use b. Experimental use c. Isolated use d. Dysfunctional use - Correct Answer-Isolated use

Social control theorists suggest that deviance results from which TWO of the following? a. Poor socioeconomic conditions b. Weak societal ties with the individual c. Weak familial ties with the individual d. Confining societal expectations - Correct Answer-Weak familial ties with the individual Weak societal ties with the individual Withdrawal symptoms from anabolic steroids most closely resemble those of which drug? a. Marijuana b. Heroin c. Amphetamines d. Cocaine - Correct Answer-cocaine Which is the MOST correct statement regarding individuals voluntarily entering treatment for substance? a. They are committed to change. b. They are fully ready to change. c. They are at varying stages of change readiness. d. They are primarily in need of encouragement. - Correct Answer-They are at varying stages of change readiness What is ambivalence about substance abuse treatment symptomatic? a. Resistance b. Denial c. Uncertainty d. Confrontation - Correct Answer-Uncertainty What is the primary goal of screening a client with a known substance abuse disorder? a. Get rid of those clients with serious problems b. Determine a best initial treatment course c. Discover any dual diagnoses d. Evaluate the likely length of treatment needed - Correct Answer-Determine a best initial treatment course In screening clients, what does a cutoff score refer to? a. A criteria-based score beyond which a client must be turned away b. The threshold above which a more thorough assessment is indicated c. A score that is incomplete, having been cut off prematurely d. The final score that supersedes any other screening score obtained - Correct Answer-The threshold above which a more thorough assessment is indicated What is the suicide risk for individuals treated for alcohol abuse or dependence? a. About the same as for the general population b. Two times as high as among the general population

c. Five times as high as among the general population d. Ten times as high as among the general population - Correct Answer-Ten times as high as among the general population Which one of the following MOST properly defines screening and assessment? a. Screening evaluates a problem; assessment diagnoses it. b. Screening identifies a problem; assessment treats it c. Screening looks for a problem; assessment defines it. d. Screening reveals a problem; assessment resolves it. - Correct Answer-Screening looks for a problem; assessment defines it. When does assessment of a client with co-occurring disorders occur? a. Following an initial screening b. During the process of intake c. Upon confirmation of diagnosis d. Regularly over time - Correct Answer-Regularly over time Which is the gold standard assessment tool for co-occurring disorders? a. The Addiction Severity Index (ASI) b. The Minnesota Multiphasic Personality Inventory (MMPI) c. The Mental Status Exam (MSE) d. None of the above - Correct Answer-None of the above During assessment, what does the term collateral contacts refer to? a. Contacts with family b. Contacts with friends c. Contacts with treatment providers d. All of the above - Correct Answer-All of the above Contacts with family, friends and with treatment providers Which of the following is NOT included in basic intake information? a. Feelings about institutional treatment (treatment readiness, etc.) b. Background (family, legal, employment, etc.) c. Substance use (first use, current drugs, treatment, etc.) d. Mental health (diagnoses, hospitalizations, treatment, etc.) - Correct Answer-Feelings about institutional treatment (treatment readiness, etc.) Which of the following instruments is used to screen for substance abuse in individuals who frequently distort or misrepresent the truth? a. MAST b. SASSI c. SBIRT d. ASI - Correct Answer-SASSI Which of the following is NOT a key informational outcome of screening and assessment?

a. Measures of client treatment compliance b. Essential consents and authorizations c. Substance abuse disorder severity d. Client strengths and available supports - Correct Answer-Measures of client treatment compliance Which of the following is NOT a key goal and purposes of assessment? a. Identifying the optimum form of intervention for the presenting problem b. Identifying the resources available for successful problem resolution c. Whether or not a substance or alcohol problem exists d. Extent and severity of the substance or alcohol abuse problem - Correct Answer- Whether or not a substance or alcohol problem exists What must treatment planning discussions with clients be like? a. Appropriate to client age and developmental level b. Sensitive to issues of race, ethnicity, and culture c. Free of technical jargon and obscure acronyms d. All of the above - Correct Answer-All of the above Appropriate to client age and developmental level Sensitive to issues of race, ethnicity, and culture Free of technical jargon and obscure acronyms Why should data and findings from the assessment be presented to the client and his or her significant others? a. The client is paying for the service. b. Staff need to justify what they are doing. c. Client understanding affects treatment. d. Client problems need to be aired openly. - Correct Answer-Client understanding affects treatment. What does the treatment term matching refer to? a. Selecting resources by client needs and preferences b. Pairing clients into supportive treatment dyads c. Sequencing treatment modalities for maximum benefit d. Reciprocal communication to ensure client support - Correct Answer-Selecting resources by client needs and preferences Which of the following does NOT address patient placement criteria (PPC)? a. Substance abuse admission criteria b. Continuing stay criteria c. Outcome measurement criteria d. Discharge or transfer criteria - Correct Answer-Outcome measurement criteria What is a client's readiness for treatment strongly associated? a. Duration of time abusing a drug of choice b. The perception of needing help in change

c. Number of deteriorative health changes encountered d. Increased cost of the primary drug of choice - Correct Answer-The perception of needing help in change What does the term treatment sequencing refer to? a. The order of medications administration b. Movement through the levels of care c. Using credentialed staff before non-credentialed staff d. Prioritizing client needs in the treatment process - Correct Answer-Prioritizing client needs in the treatment process How is Maslow's Hierarchy of Needs BEST described? a. A fundamental ranking of essential needs b. The way a client selects a drug of choice c. A scale for determining treatment readiness d. A model of the processes involved in change - Correct Answer-A fundamental ranking of essential needs Which of the following levels was NOT proposed by Abraham Maslow in his Hierarchy of Needs? a. Basic needs b. Safety needs c. Recreational needs d. Esteem needs - Correct Answer-Recreational needs Information gathering and assessment can be biased if a clinician a. uses very general questions. b. uses open-ended leading questions. c. uses professional jargon. d. uses all of the above. - Correct Answer-uses all of the above What does the Biopsychosocial Model suggest that problems have? a. Both mental and physical aspects and origins b. An underlying medical or physical etiology c. Sociocultural and biological causative factors d. Numerous causal factors that are interconnected - Correct Answer-Numerous causal factors that are interconnected What is the Chemical Use, Abuse, and Dependence (CUAD) Scale BEST known for? a. Its use in substance abuse screening and assessment b. Its utility in assessing substance abuse in mentally ill clients c. Its ability to producing a Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis of substance abuse disorder d. Its brevity and the minimal administration training required - Correct Answer-Its utility in assessing substance abuse in mentally ill clients What is the Symptom Checklist- 90 - R (SCL- 90 - R) used for?

a. An in-depth assessment of physiological health b. An in-depth assessment of psychological health c. Tracking client progress or treatment outcomes d. Both B and C - Correct Answer-Both B and C An in-depth assessment of physiological and psychological health What is the COPES scale used for? a. Helping clients learn how to cope with transitions b. Exploring client readiness for treatment c. Assessing client support systems and resources d. Assessing community-based treatment programs - Correct Answer-Assessing community-based treatment programs What does the TSR assessment instrument measure? a. Therapeutic intensity and problem severity b. Solution-oriented therapeutic resistance c. Nature and intensity of treatment services d. Topic-specific remedial outcomes - Correct Answer-Nature and intensity of treatment services What does the BIRP progress note acronym stand for? a. Behavior, Interview, Reaction, Purpose b. Behavior, Integrate, Review, Propose c. Behavior, Intervention, Response, Plan d. Behavior, Intervene, Revise, Program - Correct Answer-Behavior, Intervention, Response, Plan What does the CHEAP progress note acronym stand for? a. Chief complaint, History, Evaluation, Action, and Plan b. Chief complaint, History, Exam, Assessment, and Plan c. Chief complaint, History, Evidence, Attention, and Plan d. Chief complaint, History, Evaluation, Axes, and Plan - Correct Answer-Chief complaint, History, Exam, Assessment, and Plan The mnemonic SIGECAPS evaluates which psychological state? a. Depression b. Anxiety c. Paranoia d. Mania - Correct Answer-depression What do the acronyms CART and CHART refer to? a. Treatment interventions b. Diagnostic assessments c. Progress note formats d. Assessments for symptoms - Correct Answer-Progress note formats What does the term client matching refer to? a. Tailoring resources and services to the client needs

b. Obtaining a sponsor for mutual-help program enrollment c. Finding a treatment buddy during a residential stay d. Picking the proper level of service intensity - Correct Answer-Tailoring resources and services to the client needs The statement "Clients must always hit bottom to be ready for treatment" is a. absolutely true. b. partly true. c. absolutely false. d. partly false. - Correct Answer-absolutely false How is client motivation for treatment BEST maintained? a. Declarations of serious consequences b. Fear of failure and the results that follow c. Reminders of what brought them to treatment d. Devil's advocate statements that they'll never make it - Correct Answer-Reminders of what brought them to treatment What does client resistance to treatment MOST likely indicate? a. The client is being pressured to change too quickly. b. The client simply doesn't care to overcome the problem. c. The client has been coerced into treatment. d. The client is embarrassed about past relapses. - Correct Answer-The client simply doesn't care to overcome the problem. What is the factor that contributes MOST meaningfully to client treatment retention? a. Program location and transportation support b. The therapeutic alliance c. Family insistence on treatment d. Court orders for treatment - Correct Answer-The therapeutic alliance Which of the following treatment episodes is associated with better outcomes? a. Longer episodes are superior to shorter episodes. b. Shorter episodes are superior to longer episodes. c. The length of the treatment episode is not relevant. d. Completion of any length episode is most important. - Correct Answer-Completion of any length episode is most important. What should the position of treatment programs toward twelve-step programs be? a. Clients should not be discouraged from twelve-step programs. b. Clients should be encouraged to participate in twelve-step programs. c. Twelve-step programs are a helpful social tool but have no other impact. d. Twelve-step programs are an integral part of overall client success. - Correct Answer- Twelve-step programs are an integral part of overall client success.

Which statement BEST reflects the nature of mutual-help groups such as twelve-step programs? a. These programs vary greatly and should be carefully chosen. b. These programs are generally very much the same. c. These programs are only for substance abusers. d. These programs are primarily religious in nature and orientation. - Correct Answer- These programs vary greatly and should be carefully chosen. How is the proper role for mental health medications in individuals with co-occurring disorders BEST described? a. There is no place for mental health medications in the treatment of clients with a substance abuse problem. b. Clients with a substance abuse disorder and a co-occurring mental health disorder can benefit from medications. c. Clients with a substance abuse disorder and a co-occurring mental health disorder can take mental health medications without any concern. d. Clients with a substance abuse disorder and a co-occurring mental health disorder will always benefit from long-term pharmacotherapy. - Correct Answer-Clients with a substance abuse disorder and a co-occurring mental health disorder can benefit from medications What is the purpose of open-ended heterogeneous groups? a. To allow flexibility in new member assignments b. To keep difficult clients away from each other c. To put clients together with similar issues d. To meet the needs of clients with special problems - Correct Answer-To allow flexibility in new member assignments What is the purpose of client-specific groups? a. To meet unique client needs b. To facilitate the counseling process c. Both A and B d. Neither A or B - Correct Answer-To meet unique client needs To facilitate the counseling process Both A and B Clients that should never be assigned to the same group include all of the following EXCEPT a. abuse perpetrators and victims. b. neighbors and relatives. c. schizophrenia and antisocial disordered. d. opioid and amphetamine abusers. - Correct Answer-opioid and amphetamine abusers.

During the initial treatment phase, how many therapeutic contact hours per week does the American Society of Addiction Medicine (ASAM) require for intensive outpatient treatment (IOT) participants? a. Three hours b. Five hours c. Seven hours d. Nine hours - Correct Answer-Nine hours Optimal group size in a typical treatment group involves how many members? a. Eight to fifteen members b. Six to Twelve members c. Five to ten members d. Four to eight members - Correct Answer-Eight to fifteen members Which of the following medications is NOT commonly used in the treatment of alcohol abuse? a. Disulfiram b. Buprenorphine c. Acamprosate d. Naltrexone - Correct Answer-Buprenorphine Which of the following medications is NOT commonly used in the treatment of opioid abuse? a. Luminal b. Methadone c. Buprenorphine d. Levo-alpha acetyl methadol - Correct Answer-Luminal The American Society of Addiction Medicine (ASAM) recommends patients with co- occurring disorders be placed in a specialty addiction and mental health treatment program at which level of mental illness severity? a. no co-occurring disorder b. mild to low co-occurring severity c. moderate co-occurring severity d.high co-occurring severity - Correct Answer-high co-occurring severity What are the most common biological samples used for treatment program drug testing? a. hair and sweat b. blood and saliva c. urine and breath d. none of the above - Correct Answer-urine and breath Which one of the following is not an established twelve-step program? a. Narcotics Anonymous b. Cocaine Anonymous

c. Hallucinogens Anonymous d. Alcoholics Anonymous - Correct Answer-Hallucinogens Anonymous What is the ADS scale used to measure? a. Alcohol dependence b. Anomalous drug use c. Readiness for treatment d. Substance use minimization - Correct Answer-Alcohol dependence What is the CIDI instrument used to measure? a. Psychiatric disorders b. Substance use disorders c. Both A and B d. Neither A nor B - Correct Answer-Both A and B Which of the following is NOT measured by the DIS schedule? a. Substance use disorders b. Alcohol use disorders c. Psychiatric disorders d. Physical health disorders - Correct Answer-Physical health disorders For which of the following setting is the MINI designed? a. Clinical trials b. Treatment outcome assessments c. epidemiological studies d. all of the above - Correct Answer-Clinical trials b. Treatment outcome assessments c. epidemiological studies d. all of the above Psychiatric Research Interview for Substance and Mental Disorders (PRISM) evaluates for which of the following distinct personality disorders? a. Paranoid and obsessive-compulsive b. Antisocial and borderline c. Histrionic and narcissistic d. Avoidant and dependent - Correct Answer-Antisocial and borderline How is the term genogram BEST defined? a. a diagram of fx relationships b. a genetic predisposition to addiction c. a pictogram of intergenerational addiction d. a phenotype of predisposing alcoholism - Correct Answer-a diagram of fx relationships How is the CRAFT program or approach BEST described? a. a consensus approach to motivating a client into treatment

b. a confrontational approach to motivating a client into tx c. a community or family approach to motivating a client into tx d. a conscious raising approach to motivating a client into tx - Correct Answer-a community or family approach to motivating a client into tx What are fx education groups primarily designed to do? a. provide fx and couples therapy b. resolve situations of domestic abuse c. teach anger management and coping d. educate families about addiction - Correct Answer-educate families about addiction What is the difference between a lapse and a relapse? a. Insignificant, as they are interchangeable terms b. a single use episode versus prolonged use c. using a drug of choice versus polydrug use d. prolonged drug use versus a single episode - Correct Answer-a single use episode versus prolonged use