IC RC ADC Exam Questions

Page 2 of 40

21.

What is the main problem with dual relationships? 

  • Threats to integrity 

  • Threats to confidentiality 

  • Threats to safety 

  • Threats to professional standing 

Correct answer: Threats to integrity 

A dual relationship is any relationship in which one defined role, such as supervisor or therapist, overlaps with another role in a relationship between the same people, such as friend or mechanic or neighbor. These are sometimes impossible to avoid, particularly in smaller communities. However, it is the responsibility of those involved to ensure that the two relationships do not conflict and pose a problem to the ethical integrity of one role or the other.

Though confidentiality, safety, and professional standing can sometimes be at risk due to a dual relationship, the main problem is more likely to be compromise in the ethics of one or both sets of relationships. 

22.

Which of the following is NOT part of the theoretical basis of motivational interviewing?

  • Psychodynamic theory

  • Rogerian principles

  • Person-centered therapy

Correct answer: Psychodynamic theory

Motivational interviewing is a relatively recent development in the treatment of substance use disorders, and is based on person-centered therapy modalities in conjunction with Rogerian principles of optimism, empathy, and positive attention.

Psychodynamic theory is not an explicit part of the theoretical basis of motivational interviewing.

23.

Would a substitute medication be given when opioid dependence is low?

  • No, as it may bring on dependence

  • Yes, to help prevent dependence

  • Yes, to help taper off dependence

Correct answer: No, as it may bring on dependence

Substitute medications are commonly given to help ease the symptoms of withdrawal in established users. When opioid dependence is low, usually a substitute is not given, as this may increase the risk of dependence on opioids.

24.

Which of the following is TRUE about the influence of family substance abuse on individual behavior?

  • Persons with a family history of substance use are at greater risk

  • Persons with a family history of substance use have the same risk as others

  • Persons with a family history of substance use are at less risk

  • Persons with a family history of substance use tend to use in groups

Correct answer: Persons with a family history of substance use are at greater risk

Persons with a family history of substance use are at greater risk for problematic use themselves. This might be due to genetic/epigenetic factors, environmental circumstances, trauma, social learning about use, and many other factors. Persons with a family history of substance use may or may not prefer to use in groups.

25.

How important are genetic factors to the experience of substance-use problems? 

  • The influence of genetic factors varies by substance used 

  • The influence of genetic factors is constant across substances

  • The influence of genetic factors is negligible across substances 

  • The influence of genetic factors is less important than the influence of social factors 

Correct answer: The influence of genetic factors varies by substance used 

Genetic factors definitely influence various aspects of substance-use problems. The literature suggests that genetics play a role in the formation of substance-use problems and the nature of their course, though this influence varies by substance used. As an example, genetics appear to play different roles in alcohol than in other kinds of substance-use problems. Genetic factors alone will never fully explain a substance-use problem, but social factors are similarly variable across substances in their level of influence. 

26.

Which of the following is the MOST likely to cause instant death?

  • Cocaine

  • Cannabis

  • Alcohol 

Correct answer: Cocaine

Cocaine in whatever form ingested, and by whatever route, can cause immediate death. It is much more likely to do so than cannabis, which is not known to produce immediate death at all, or alcohol, which requires extremely high dosage to result in immediate death.

27.

Should agencies and counselors tailor their environments to avoid transference? 

  • Outside of reasonable steps, this is not possible 

  • Yes, based on client feedback at intake 

  • No, as the experience of transference builds resilience 

  • Yes, with regular updates and audits 

Correct answer: Outside of reasonable steps, this is not possible 

Transference is an unavoidable, highly subjective phenomenon in many cases. It is the system of extra feelings that a client brings to the relationship with the counselor. These feelings may be romantic, hostile, or of another type. It is impossible to prepare for the phenomenon adequately due to its subjectivity, outside of taking reasonable steps such as avoiding the use of sexual or violent content in office decorations. 

The experience of transference is not known to build resilience and, if possible, should be minimized. As a rule, it can be called out openly and addressed to therapeutic benefit. 

28.

Which of the following is TRUE about substance-related sexual dysfunction?

  • It usually remits with the cessation of use

  • It is usually permanent

  • It usually remits after medical detoxification

Correct answer: It usually remits with the cessation of use

Substance-related sexual dysfunction usually remits with the cessation of use. It is generally not permanent or related to medical detoxification.

29.

Which of the following is NOT among the effects usually reported by users of PCP? 

  • Sedation 

  • Hallucinations 

  • Detachment from reality 

  • Fear 

PCP (phencyclidine) is a highly potent drug that can produce a variety of vivid effects in users. These include detachment from reality; distortions of time, space, and body image; intense fear; hallucinations; and sometimes invulnerability and increased physical strength. Users can become highly disoriented, aggressive, and/or suicidal.

Sedation is much less commonly reported as an effect of PCP. 

30.

Which of the following types of supervision would be MOST concerned with the self-care of the supervisee?

  • Supportive

  • Administrative

  • Evaluative

  • Clinical

Correct answer: Supportive

Supportive supervision is most concerned with the impact of the work on the well-being of the supervisee. It is in this type of supervision that therapeutic-style interactions would be most appropriate. 

Administrative supervision involves assistance with organizational management issues and other kinds of administrative support. Evaluative supervision is addressed to giving and receiving feedback about performance and skills. Clinical supervision seeks to build clinical skills in the supervisee.

31.

Which of the following accurately describes the action of alcohol?

  • It first enhances mood, then depressant effects take over

  • It first acts as a depressant, then mood enhancement occurs

  • It acts as a mood enhancer in small doses

Correct answer: It first enhances mood, then depressant effects take over

Alcohol acts in a bimodal way in any dosage. First it enhances mood, then its effects as a central nervous system depressant take over. The implications for users who already are struggling with mood regulation are potentially significant. 

32.

What is the approximate alcohol content of wine?

  • 12%

  • 5%

  • 10%

  • 30%

Correct answer: 12%

There is a psychological tendency to excuse one's own substance abuse as being less harmful than that of others. It is useful to educate clients on exactly how much alcohol per serving they are consuming, particularly when formulating sobriety strategies. A standard "drink" of wine is about 5 ounces and contains approximately 12% alcohol.

33.

According to Kaufman (1994), what is the most important objective of recovery? 

  • Achieving healthy intimate relationships 

  • Achieving personal safety 

  • Achieving recognition of past trauma 

  • Achieving healthy life balance 

Correct answer: Achieving healthy intimate relationships 

Edward Kaufman, one of the better-known writers in the field of substance use, proposed in 1994 that the most important objective of recovery was achieving healthy relationships. This is partially due to the prophylactic nature of healthy relationships due to substance-use recovery. However, he found exploring the benefits of healthy relationships worthwhile in its own right as an avenue for making substance use obsolete for individuals.

Achieving personal safety, recognizing past trauma, and achieving life balance are all important in recovery, but Kaufman recognized the importance of intimate relationships as the paramount recovery objective. 

34.

Which of the following BEST characterizes the effects of substance use? 

  • All substance use involves physiological and behavioral consequences 

  • All substance use involves physiological consequences 

  • All substance use involves behavioral consequences 

  • All problematic substance use involves physiological consequences 

Correct answer: All substance use involves physiological and behavioral consequences 

Substance use of any kind involves various physiological and behavioral consequences. However, due to the idiosyncracy of drug effects, these consequences are highly variable by user, context, history, and a variety of other factors. This variability exists whether the substance use in question has been deemed problematic or not. 

35.

Which of the following styles is the MOST likely to be successful in initial questions about substance use?

  • Nonjudgmental

  • Confrontational

  • Skeptical

  • Neutral

Correct answer: Nonjudgmental

Nonjudgmental, respectful styles and attitudes are most useful in gaining information from people in initial questions about substance use. This nonjudgmental style is in keeping with motivational interviewing, though it is also good practice in the initial phase of treatment for most disorders. 

One should avoid confrontational and skeptical styles, as these tend to crystallize resistance and create barriers to the therapeutic relationship. The situation will call for more than a simple neutral presentation.

36.

Which of the following MOST accurately reflects the withdrawal effects of cannabis? 

  • Insomnia, irritability, and restlessness among chronic users 

  • Euphoria and relaxation among chronic users 

  • Insomnia, irritability, and restlessness among most users 

  • Euphoria and relaxation among most users 

Correct answer: Insomnia, irritability, and restlessness among chronic users 

Though studies are ongoing, the most vivid withdrawal effects among cannabis users are noted in chronic users. These effects include irritability, insomnia, and restlessness. The research shows they occur in a relatively small number of chronic users and are much less common among users whose use is less chronic. 

Euphoria and relaxation are effects of cannabis more common in the acute phase of intoxication rather than in withdrawal. 

37.

Which of the following is TRUE in the population of those who use substances to clinical levels of dysfunction? 

  • They lack adequate coping skills 

  • They are very experienced users of coping skills 

  • Their coping skills can be robust in all areas but substance use 

Correct answer: They lack adequate coping skills 

A common thread that runs through much of the clinical presentation of users of substances is that, in part, their use of substances is a compensation for their lack of adequate coping skills for dealing with the exigencies of life. This impacts treatment in that such skills must be acquired concurrently with the removal or titration of substances in that patient's life. 

38.

How significant is ethnicity to substance use issues? 

  • Profoundly significant in all cases 

  • Not as important as specific pathology 

  • About as important as specific pathology 

  • Not significant in most cases 

Correct answer: Profoundly significant in all cases 

There is a need for much more research into exactly how such factors as race, ethnicity, gender, and culture affect substance-use treatment and supervision. What research is available suggests that ethnicity alone is a profoundly significant layer in most substance-use treatment and supervision, having an effect on such aspects as defensive styles, symptom manifestations, ways of reaching out for assistance, and so on. There is no necessary conflict of importance between these contextual factors and the specific pathology in question; rather, the contextual factors help form a better overall picture of the individual's situation. 

39.

Which of the following MOST accurately represents the relationship of culture to pathology? 

  • Pathological behaviors are culturally reinforced 

  • Pathological behaviors do not have a direct relationship with culture 

  • Pathological behaviors exist independently of culture 

  • Pathological behaviors are completely derived from culture 

Correct answer: Pathological behaviors are culturally reinforced 

Research is ongoing into the exact relationship between culture and pathology, especially in the context of substance use. What is considered pathological behavior in one culture may be rewarded in another, so we can say that pathological behaviors are reinforced behaviorally within the context of a given culture. For instance, one culture may have a broad tolerance for substance use, while another may have none. Pathology is not derived exclusively from culture, however, and is better understood as growing within a certain cultural environment that affects it. 

40.

How much of client change is due to the therapist's technique?

  • 15%

  • 30%

  • 5%

  • 40%

Correct answer: 15%

Only about 15% of client change is due to the specific technique of the therapist, regardless of modality. Other factors, such as therapeutic rapport, seem more significant according to research.