Deck 1

Question 1

Jeff shares about the pain of his divorce, triggered by his spouse’s affair with his brother. Jeff was left isolated from his family, feeling no support whatsoever. Other members have similar stories, but Mark’s spouse specifically had an affair with his brother, leaving him feeling he had no support either. The group counselor said, “Mark, you shared your wife is now dating your brother. I wonder if there is any part of Jeff’s story you relate to or that you would like to share about today.” The group counselor has demonstrated:

Active listening
Linking
Summarizing
Blocking

Answer 1

Correct answer: Linking

Explanation: Linking occurs when group leadership assists members in recognizing their similarities. Blocking occurs when leadership prevents unfocused members from being disruptive by redirecting or preventing them from monopolizing discussion. Summarizing occurs when leaders assist members in raising awareness of what occurs and how the group and membership have changed. Active listening is the leader’s attention to language, nonverbal and tone around an individual’s message.

Question 2

Joshua is treated for his Attention Deficit Disorder over the course of several years. At 15, Joshua reports he needs more of his medication to achieve the same results. His physician increases Joshua’s dosage according to Joshua’s reports, and his parents concurred that Joshua seems to be happier. Joshua notices getting a “rush” one day when he doubled his dose, so he began regularly taking the higher dose pursuing the same feeling again and again. His tolerance quickly began to increase, and he began feeling highly agitated when skipping a dose. Joshua’s presentation is consistent with:

Stimulant Abuse
Stimulant Dependence
Stimulant Use Disorder
Simulant Intolerance

Answer 2

Correct answer: Stimulant Use Disorder

Explanation: Joshua is developing Stimulant Use Disorder. While he is prescribed the medication, he has begun to abuse it by taking more than is prescribed and taking it for different uses than what is intended. Withdrawal and tolerance are both symptoms of the disorder, along with his strong desire to take more than was prescribed.

Question 3

Tom and Brenda co-facilitate a group on co-dependency. They observe the membership assuming a variety of roles, working on enabling behaviors, depression, and anger. The majority of their time is spent in observation, with occasional linking member stories or facilitating a specific intervention. The group is engaged in:

Conflict
Cohesion
Dependency
Interdependence

Answer 3

Correct answer: Interdependence

Explanation: Interdependence is also called performing and occurs when members are comfortable with one another and occupy their time with problem-solving and engaging with one another for the group’s primary purpose.

Question 4

Gary smokes angel dust several times per week. He lost access to his children last year, and his family has all but disowned him. Gary has tried to quit many times, but loves the high and finds the cravings too strong to overcome. He has been to prison for things he has done to support his habit, been arrested for DUI, and always returns to using. Overt time, tolerance has developed. Tonight, he sprinkles angel dust on tobacco and smokes to numb his feelings. Soon, he is numb, he cannot easily control the muscles in his mouth, and he struggles to control his body. Gary’s presentation is consistent with:

Phencyclidine Intoxication coded to indicate co-morbidity with Phencyclidine Use Disorder, severe
Phencyclidine Use Disorder, severe
Phencyclidine Intoxication
Phencyclidine Intoxication coded to indicate co-morbidity with Phencyclidine Use Disorder, mild

Answer 4

Correct answer: Phencyclidine Intoxication coded to indicate co-morbidity with Phencyclidine Use Disorder, severe

Explanation: Gary has the following symptoms of a use disorder: unsuccessful efforts to stop use, cravings, using despite inability to fulfill major roles (fatherhood), using despite persistent interpersonal issues (family discord and separation), giving up social or other activities (prison), uses when it is hazardous to do so (DUI), tolerance. His current presentation is acute intoxication. ICD-10-CM coding requires Phencyclidine Intoxication to specify whether there is an associated use disorder, and at what level (mild, moderate, severe). Gary’s presentation is consistent with Phencyclidine Intoxication, accompanying Phencyclidine Use Disorder, severe (6 or more symptoms)

Question 5

When you ask a client if he has had thoughts of killing himself, he changes the subject. What is the best intervention?

You follow the client’s lead, respecting his autonomy
You go on to the next item on your checklist
You continue to assess the client’s suicide risk
You confront the client about his rudeness

Answer 5

Correct answer: You continue to assess the client’s suicide risk

Explanation: Never be afraid to ask about ideations, intention, plans, means.

Question 6

Angela is brought by ambulance to the emergency room. Angela’s sister became concerned when Angela began yelling at people who were not present and called for an ambulance. Angela had no intention of being someplace where her skin would not stop crawling and shadowy figures would not stop speaking to her. Angela is anxious, agitated, her pulse is at 150 bpm, and she has not slept for 2 days. Her sister reports Angela has used “pills” for some time but had no idea what was going on today. The two have been somewhat estranged over the years due to Angela’s drug use. Angela’s presentation is most consistent with:

Sedative, Hypnotic or Anxiolytic Use Disorder, moderate or severe
Sedative, Hypnotic or Anxiolytic Intoxication, coded to indicate co-morbidity with Sedative, Hypnotic or Anxiolytic Use Disorder, moderate or severe
Sedative, Hypnotic or Anxiolytic Withdrawal, coded to indicate co-morbidity with Sedative, Hypnotic or Anxiolytic Use Disorder, mild
Sedative, Hypnotic or Anxiolytic Withdrawal, coded to indicate co-morbidity with Sedative, Hypnotic or Anxiolytic Use Disorder, moderate or severe

Answer 6

Correct answer: Sedative, Hypnotic or Anxiolytic Withdrawal, coded to indicate co-morbidity with Sedative, Hypnotic or Anxiolytic Use Disorder, moderate or severe

Explanation: Angela’s symptoms are consistent with withdrawal from Sedative, Hypnotic or Anxiolytic drugs. The ICD-10-CM requires the diagnosis to indicate co-morbidity with Sedative, Hypnotic or Anxiolytic Use Disorder, moderate to severe.

Question 7

Which is NOT a symptom of Sedative, Hypnotic or Anxiolytic Intoxication?

Sweating or cold chills
Unstable gait, unstable physical coordination
Extreme fatigue
Nystagmus

Answer 7

Correct answer: Sweating or cold chills

Explanation: Sweating or cold chills is not indicative of Sedative, Hypnotic or Anxiolytic Intoxication.

Question 8

The informed consent for treatment document should always contain:

The informed consent for treatment document should always contain:

Answer 8

Correct answer: Information about confidentiality and its exceptions

Explanation: Therapists may consult with a supervisor or other professional therapist in order to provide the best service. In the event that the therapist consults with another therapist, no identifying information such as the patient’s name would be released. Therapists are required by law to release information when the client poses a risk to themselves or others and in cases of abuse to children or older adults. If a therapist receives a court order or subpoena, he or she may be required to release some information. In such a case, the therapist will consult with other professionals and limit the release to only what is necessary by law.

Question 9

When conducting a psychoeducational group, the level of facilitator activity is:

High, with a strong focus on the leader
Moderate, with a strong focus on the group
High, with a strong focus on group involvement
Low, with a strong focus on the leader

Answer 9

Correct answer: High, with a strong focus on the leader

Explanation: In psychoeducational groups, the focus in on the leader and what the leader is presenting. Little attention is given to group process or the specific issues of group membership.

Question 10

Stage two of the comprehensive assessment process, screening, refers to all, EXCEPT:

Brief procedures used to determine the presence of a problem
Identify that there is a need for further evaluation
Determining which treatment program is best for the client
Substantiate that there is reason for concern

Answer 10

Correct answer: Determining which treatment program is best for the client

Explanation: The other three choices are parts of the screening stage of the comprehensive assessment process.

Question 11

An exception to confidentiality includes:

Receiving a judge’s order
Receiving a release of information from an agency
Receiving a subpoena
Receiving a written release of information signed by the client’s attorney

Answer 11

Correct answer: Receiving a judge’s order

Explanation: When a therapist is directed by a judge’s order to respond, the therapist must abide by the law, taking into consideration protection of the client’s confidentiality as best s/he can.

Question 12

In regard to crisis situations, the most useful criterion for evaluating the effectiveness of actions taken between sessions is:

Observed effect of client(s)
Whether client keeps scheduled appointments
Level of cooperation
Level of functioning, compared to pre-crisis level

Answer 12

Correct answer: Level of functioning, compared to pre-crisis level

Explanation: Crisis workers should plan for a follow-up contact with the client after the initial intervention to ensure that the crisis is on its way to being resolved and to evaluate the postcrisis status of the client.

Question 13

John shares during group therapy about his intense issues with insomnia, not sleeping for days at a time, feeling in a haze, and desiring help. Ted shares his past experience with this issue and offers how he used a specific progressive relaxation technique, altered his caffeine intake, drinks chamomile tea and added exercise in the morning and stretching an hour before bed, suggesting John try the same. This is an example of:

Interpersonal learning
Imitative behavior
Direct advice
Instillation of hope

Answer 13

Correct answer: Direct advice

Explanation: Ted provides direct advice to John, suggesting his solution may work for him, as well. It is not interpersonal learning or a new way of relating. It may offer hope, but in the context of group treatment it refers to the modality providing hope for overall treatment. Nor is this imitative behavior in which one member seeks to mimic another who has greater adaptive skills.

Question 14

Vanessa keeps seeing pictures of her husband dying in the car wreck that killed him after being hit by a drunk driver. She thinks this means she is going crazy. She is also having sleep disturbance, irritability with her children, and difficulty making choices. The most appropriate intervention is:

Provide therapy for traumatic grief
Ask a physician to prescribe antipsychotics
Hospitalize her for psychosis
Put her children in a foster home

Answer 14

Correct answer: Provide therapy for traumatic grief

Explanation: It is possible that Vanessa may be experiencing Acute Stress Disorder or PTSD.

Question 15

A collaborative process through which the counselor and client develop desired treatment outcomes and identify the strategies for achieving them is:

Relapse Prevention Planning
Short Term Goal Setting
Long Term Goal Setting
Treatment Planning

Answer 15

Correct answer: Treatment Planning

Question 16

In a treatment program, a treatment plan must be in place within:

Two weeks
One month
Fifteen working days
One week

Answer 16

Correct answer: One week

Explanation: In a treatment program, a treatment plan must be in place within one week. Most clients sign an initial treatment plan during the intake and orientation to the program. This TX plan is superseded by a more comprehensive TX plan formulated over a week of groups and personal interaction with the Counselor.

Question 17

Alcoholics Anonymous is classified as:

Psychoeducational
Group focused
Self-help
Psychotherapy

Answer 17

Correct answer: Self-help

Explanation: Alcoholics Anonymous is a self-help group, not led by a professional or para-professional as in psychotherapy or a psychoeducational group.

Question 18

During Orientation to a program, which individual is NOT involved?

The Client’s family
The Client’s Counselor
The Client’s Probation Officer
The Client’s Significant other

Answer 18

Correct answer: The Client’s Probation Officer

Explanation: During Orientation to a program, all of these individuals are involved except any probation officer. The client’s immediate family and significant other needs to be involved if at all possible. Most recovering individuals are coming from a place of social isolation. The more social support is present and involved in the transition for the client the better.

Question 19

Due to its short half-life, which requires a divided dosing?

Prozac
Elavil
Paxil
Wellbutrin

Answer 19

Correct answer: Wellbutrin

Explanation: WELLBUTRIN is clinically proven to effectively treat depression with a low risk of sexual side effects. However, because of its short half-life, a divided dosing is necessary. Divided doses is the term used when they want to specify a max dose per 24 hours, as maybe when a total dose given all at once might not be safe (toxicity, perhaps) or because its half-life is so short that there won’t be an effective blood level over the course of the day and it has to stay on board all day and all night.

Question 20

Providing therapy to clients who have a different cultural background than the therapist:

Requires that the therapist obtains additional training to work with diverse clients
Requires that the therapist should only see clients from his/her culture
Means that it is okay to see these clients if you enjoy working with them
Means that the therapist should not treat anybody as different

Answer 20

Correct answer: Requires that the therapist obtains additional training to work with diverse clients

Explanation: It is imperative that therapists update their training and skills to ensure ethical treatment of culturally diverse clients.

Question 21

Katherine is a substance abuse counselor in an outpatient program. Her client, Donovan, is dependent on methamphetamine and told Katherine that he deals drugs to others to support his habit. Which is the CORRECT ethical choice for Katherine:

Legally and ethically, Katherine cannot divulge client information that was told to her in confidence.
To fulfill her obligation to her community, Katherine must disclose Donovan’s drug dealing with law enforcement.
Katherine should tell the program’s lawyer what Donovan is doing and let him advise her about what she should do.
Katherine should decline to provide services to Donovan unless he agrees to stop drug dealing.

Answer 21

Correct answer: Legally and ethically, Katherine cannot divulge client information that was told to her in confidence.

Explanation: Communications between the client and the therapist are privileged, meaning that they cannot be disclosed to any other person without the client’s consent.

Question 22

What is the sponsor’s responsibility when it comes to recommending hospitalization?

Sponsors should recommend hospitalization if the person’s health has clearly declined to the point of danger
A sponsor can engage a helpful intervention
Hospitalization can be a helpful part of recovery, and as such, a sponsor can play a key role with staff
Hospitalization is not part of a 12-step program, and a sponsor is no substitution for a physician; hospitalization does not lessen the responsibility of a sponsor

Answer 22

Correct answer: Hospitalization is not part of a 12-step program, and a sponsor is no substitution for a physician; hospitalization does not lessen the responsibility of a sponsor

Explanation: Hospitalization is not part of 12-step programs, always remaining forever non-professional. Common sense is to prevail. If anyone believes someone is in medical crisis, they should take the steps they believe need to be taken, but not as a result of the program.

Question 23

Which is NOT an MAO inhibitor?

Elavil
Marplan
Parnate
Nardil

Answer 23

Correct answer: Elavil

Explanation: Elavil (amitriptyline) belongs to a class of similar drugs called tricyclic antidepressants. Elavil is prescribed to treat depression, bulimia (an Eating Disorder characterized by bingeing and purging), chronic pain from a variety of conditions including fibromyalgia, reduce the incidence of chronic headache or migraine, ulcers, uncontrollable hiccups, primary (childhood onset) insomnia, and to control the involuntary crying and laughing experienced by individuals with multiple sclerosis

Question 24

The first stage in group process may be referred to as:

Performing
Conflict
Cohesion
Dependency

Answer 24

Correct answer: Dependency

Explanation: The initial stage of a group is often referred to as “forming” or dependency. In this stage, the therapist might observe a dependency on the therapist for direction as members are uncertain of themselves and look to leadership for direction. Conflict is sometimes called storming, which may be overt or covert. Cohesion is a time when the group develops an identity and feels relaxed with one another and has a sense of cohesion. Performing is the time in which the primary work of the group begins. Members take on constructive roles and address personal issues.

Question 25

When a therapist steps out of the clinical role, there is:

No problem as long as the client is not harmed
No problem as long as the therapist is aware of the client’s dynamics
A legal problem
A potential boundary violation

Answer 25

Correct answer: A potential boundary violation

Explanation: A potential boundary violation can occur when the therapist steps out of his/her clinical role.

Question 26

Greg attends a fraternity party and is introduced to amphetamines. He joins in and finds himself feeling outside himself, his heart pounding in his ears, nauseated, agitated by feeling like everything is suddenly in slow motion. Greg begins to sweat, followed by chills. The diagnosis most consistent with Greg’s presentation is:

Amphetamine intoxication
Amphetamine poisoning
Stimulant Use Disorder
Amphetamine experimentation

Answer 26

Correct answer: Amphetamine intoxication

Explanation: Greg’s presentation is most consistent with Amphetamine intoxication, which also may include tachycardia, dilated pupils, altered blood pressure, vomiting, appearance of weight loss, psychomotor retardation or of agitation, respiratory depression, chest pain, confusion, hallucination, seizure, and coma.

Question 27

Renee is a 21-year-old college student who started drinking over the past year. She loves to party with her social crowd. However, her grades have dropped, her boyfriend left her after she took her clothes off in a bar on a dare one night, and her sister no longer speaks to her after Renee drove drunk, damaging the sister’s car. Renee does not experience tolerance or withdrawal though she is developing an ulcer. The most consistent diagnostic impression for Renee is:

Alcohol Abuse
Alcohol Use Disorder, mild
Alcohol Use Disorder, moderate
Developmental Alcohol Behavior

Answer 27

Correct answer: Alcohol Use Disorder, moderate

Explanation: Renee’s presentation is consistent with Alcohol Use Disorder. The DSM-5 no longer delineates between abuse and dependency or considers legal standing a specific criterion.

Question 28

Jerry began drinking at age 13 when his 19-year-old uncle moved into the house. By age 15, Jerry was smoking pot daily, and by age 17 he is using stimulants several times per week. Jerry has several arrests related to intoxication and possession. Jerry is now 27, is separated from his wife, has two children with two different women, and continues using alcohol, smoking pot daily, and using stimulants. He shows up at your office and says, “I can’t live this way anymore! I have to change but don’t know how to live sober. Please help me find options to finally put all this stuff down and start living life for real.” Jerry’s diagnosis is consistent with:

Suicidality, Polysubstance Use Disorder
Polysubstance Use Disorder
Alcohol Dependence, Cannabis Use, Stimulant Use
Alcohol Use Disorder, Cannabis Use Disorder, Stimulant Use Disorder

Answer 28

Correct answer: Alcohol Use Disorder, Cannabis Use Disorder, Stimulant Use Disorder

Explanation: Polysubstance is a concept the DSM 5 no longer uses. Instead, each substance-related diagnosis is given. In this case, Jerry has Alcohol Use Disorder, Cannabis Use Disorder, and Stimulant Use Disorder.

Question 29

In the practice of Addictions Counseling, the systematic approach to the screening and assessment process in which the counselor identifies and evaluates the individual’s presenting issues and identifies his/or her treatment and referral needs is known as:

Treatment Planning
Clinical Review
Clinical Evaluation
Clinical Process

Answer 29

Correct answer: Clinical Evaluation

Question 30

Rob smoked for over 40 years but stopped smoking about 6 months ago. He continues to have strong cravings, but has managed to not give in to his urges and remains abstinent. Rob’s presentation is most consistent with:

Tobacco Use Disorder, in sustained remission
Tobacco Fixation
Tobacco Withdrawal
Tobacco Use Disorder, in early remission

Answer 30

Correct answer: Tobacco Use Disorder, in early remission

Explanation: Rob’s presentation is most consistent with Tobacco Use Disorder, in early remission, which is inclusive of a lack of symptoms, with the possible exception of cravings.