IC RC ADC Exam Questions

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81.

Which of the following stages of change is characterized by consolidating gains?

  • Maintenance

  • Relapse

  • Contemplation

  • Action

Correct answer: Maintenance

Maintenance, the last of the recognized stages of change, is the one in which many in recovery spend that recovery if it is successful: adapting to a new way of life and avoiding relapse.

Precontemplation is the first stage in the stages-of-change model. It describes the situation that exists before the client realizes they have a problem, but while those around the client are aware of a problem. Contemplation is the next stage, involving a high degree of ambivalence about whether change is necessary or desirable. Preparation, the next stage, involves the client making the first steps toward change without really changing anything. The Action stage follows, in which concrete steps are taken. Maintenance follows, in which gains are consolidated. Relapse can happen at any stage and is technically a return to an earlier stage of change.

82.

How do substance-using clients compare with clients of other types?

  • Substance-using clients tend to have more problems with suicide, serious medical conditions, and other consequences 

  • Substance-using clients tend to have fewer problems with suicide, serious medical conditions, and other consequences 

  • Substance-using clients tend to have about the same number of problems with suicide, serious medical conditions, and other consequences 

  • Substance-using clients cannot be reliably compared with other clients due to the nature of substance use as a brain disease 

Correct answer: Substance-using clients tend to have more suicidal thoughts or attempts, serious medical conditions, and other consequences 

One of the factors contributing to the historical reliance on substance-use providers to serve patients with substance-use issues has been that users tend to have more problems with suicide, serious medical conditions, and other consequences than other clients these providers might serve. Serving substance-using clients means engaging on some level with most of their complicated history and presentation and helping them maneuver through the consequences while doing the hard work of treating the substance-use issues themselves. 

Substance use is a complicated brain disease, but this does not preclude it from being compared with other types of mental illness. 

83.

Is it appropriate for friends to provide supervision to friends?

  • Yes, with proper attention to boundaries

  • No, under no circumstances

  • Yes, with the approval of the licensing authority

  • No, unless a special addendum is made to supervision agreements

Correct answer: Yes, with proper attention to boundaries

Though not the ideal situation, it is often the case that coworkers or those who already know each other in the field form a supervisory relationship. It is natural that friendship may exist before supervision begins. 

With careful attention to the boundaries involved, this situation is not unethical. It is not a matter for state licensing authorities or special addenda.

84.

From a self-medication perspective, which of the following is MOST often used to mitigate social awkwardness?

  • Alcohol

  • Opioids

  • Cocaine

Correct answer: Alcohol

The self-medication hypothesis suggests that substances are self-prescribed to manage certain intolerable affective states. Social awkwardness is often managed with alcohol, and it is often provided in social settings for that explicit purpose. This is not advocacy of use for any purpose, but alcohol seems to suit this need better than opioids or cocaine from the position of a person who might use it to govern their own affect. 

Opioids and cocaine are used less often than alcohol to manage social awkwardness and more often used to manage other affective states, such as depression.

85.

Of the following, how is alcohol classified? 

  • A CNS depressant 

  • A CNS stimulant 

  • A hallucinogen 

  • A sedative

Correct answer: A CNS depressant 

Alcohol is technically classified as a CNS (Central Nervous System) depressant. It impairs motor coordination and judgment, and its effects include changes to respiration, cognition, sensorium, and other aspects of human function.

Alcohol is not considered a CNS stimulant. Stimulants include such items as cocaine and amphetamines that contribute to overall arousal. Hallucinogens include such drugs as LSD and peyote that radically alter sensorium. Sedatives include such drugs as Xanax and Ativan that in many ways mimic the effects of alcohol. 

86.

Which of the following is the BEST way to deal with countertransference? 

  • Separate client issues from counselor issues 

  • Ignore it, as it usually subsides 

  • Discuss it openly with the client 

  • Report it to a supervisor 

Correct answer: Separate client issues from counselor issues 

Countertransference takes place when a counselor has feelings toward a client that are "borrowed" from another relationship or circumstance in the counselor's past. It can be positive or negative. For example, a counselor may begin to have romantic feelings for a client based on issues of their own. In these circumstances, the best course of action is to do the work necessary to separate the client's issues from the counselor's issues; in other words, the counselor's responsibility is to work out these feelings in themselves. 

It is most likely unnecessary to discuss these feelings with the client if they can be adequately resolved, but ignoring the feelings will not make them go away. It may be helpful to report and discuss the issue with a supervisor, but in the end, the responsibility lies with the counselor. 

87.

Do most people who drink develop an alcohol problem at some point in their life?

  • No

  • Yes

  • Yes, though it is usually short-term

Correct answer: No

Most people who consume alcohol do so without developing a recognized alcohol problem at any time in their life. Overall lifetime prevalence of alcohol use problems is around 29%.

88.

Which of the following BEST describes the "pink cloud" of recovery?

  • The recovery period before everyday stress catches up

  • The recovery period where one is still feeling drug's effects

  • The recovery period where one is using antidepressants

Correct answer: The recovery period before everyday stress catches up

The "pink cloud" is the recovery phenomenon characterized by a honeymoon period in which the psychological gains of recovery are being experienced without the full onset of everyday stresses and challenges. This may instill false hope in an individual that their recovery is complete, when it has really only begun. 

It does not refer to lingering drug effects or the use of antidepressants.

89.

Which population is MOST appropriate for treatment plans involving moderation in drinking?

  • Those with less severe problems

  • Those with more severe problems

  • Those who have failed to be abstinent

  • Those who are in physical danger due to use

Correct answer: Those with less severe problems

The more severe a person's problems with drinking, the more likely they are to have problems with controlling their drinking. If a person has a less severe problem, they are far more able to work with a treatment plan that involves moderation rather than abstinence.

Those who have severe problems, who have failed to be abstinent before, and who are in physical danger from the consequences of their use would be poor choices for moderation strategies.

90.

What is the BEST way to know you are successful in giving feedback to a client about their use? 

  • When the client expresses concern and asks you for input 

  • When the client manifests anger and resentment 

  • When the client begins to relate their current life stressors

  • When the client begins to recount past trauma

Correct answer: When the client expresses concern and asks you for input 

Though it is always welcome when clients trust their counselor enough to relate their current life stressors and/or past trauma, this is not concrete evidence that the client has taken your clinical feedback about substance use to heart. A far better indicator of insight and desire to change is when the client expresses concern and asks for your input about their problem, as this shows they are thinking critically about their situation.

Expressing anger and resentment toward the counselor is not unexpected, but it is not necessarily a sign of clinical success. 

91.

What is a Key Results Indicator (KRA) in supervision?

  • A necessary milestone 

  • A learning objective 

  • An assessment of supervision 

  • A quality review process 

Correct answer: A necessary milestone 

A Key Results Indicator (KRA) in the supervisory context is a specific milestone or set of milestones deemed necessary to call a supervisory arrangement successful. These should be measurable outcomes reviewed by both parties and agreed to in order to ensure that the supervisory arrangement has delivered on its mandate to all parties concerned. It is a deeper matter than a learning objective, as some learning objectives may not be absolutely necessary to call supervision a success. Though quality is reviewed through the process, it is less an assessment of the quality of supervisee work than a marker of supervisee success. 

92.

Which of the following is NOT a benzodiazepine?

  • Lithium

  • Xanax

  • Librium

  • Ativan

Correct answer: Lithium

Lithium carbonate is a salt that is used to treat bipolar disorder. It is not a benzodiazepine, and its use must be carefully monitored. 

Xanax, Librium, and Ativan are all benzodiazepines.

93.

What phase of addiction are medical assessments of addiction MOST likely to identify?

  • Late phase

  • Early phase

  • Relapse

Correct answer: Late phase

By the time the physical effects of addiction are apparent, it is quite often late in the addiction process. This is after the substance has had time to damage organ systems and compromise the individual in other ways that are idiosyncratic to the particular substance and the individual client's ancillary behaviors. 

Medical assessments are not as effective at identifying early phase addiction or any kind of relapse.

94.

In general, to what do those experiencing the Abstinence Violation Effect attribute their slip?

  • Personal failure

  • A preventable mistake

  • Drug tolerance

  • The social environment

Correct answer: Personal failure

The Abstinence Violation Effect occurs when, after a slip, a patient catastrophizes and imagines that their treatment has failed altogether. They tend to attribute these slips to personal failure and not to preventable mistakes, drug tolerance, or the influence of the social environment.

95.

When evaluating supervisees, why is it important to be wary of client assessments of their performance? 

  • Client assessments tend to measure client mood on a given day 

  • Client assessments are not reliable 

  • Client assessments are not valid 

  • Client assessments are not designed with supervision in mind 

Correct answer: Client assessments tend to measure client mood on a given day 

In practice, though one should be interested in clients' perception of a supervisee counselor's work, measuring supervisee performance on this basis is problematic. Even though a given instrument may be simple, reliable, and valid—meaning it has been determined as a good instrument overall with the purpose of supervisee performance improvement in mind—it is still highly likely that the only thing being measured is the client's mood on a given day. Such performance review indices should therefore be used cautiously, if at all. 

96.

Which of the following is NOT a way buprenorphine is ingested?

  • Inhaled

  • Taken sublingually

  • Injected

Correct answer: Inhaled

Buprenorphine, an opioid agonist, can be injected or administered sublingually. It is not inhaled.

97.

Which of the following is TRUE according to the disease model of addiction?

  • Persons with addictions can fully manage their disease

  • Persons with addictions are helpless with respect to their addiction

  • Persons with addictions can manage their disease except for the occasion of relapse

Correct answer: Persons with addictions can fully manage their disease 

There is much misunderstanding regarding the disease model of addiction. 

One of the main misunderstandings is the belief that clients cannot manage their disease effectively, and this is untrue. In the disease model, persons with addictions are not helpless with respect to their addiction, and can fully manage it in or out of occasions of relapse.

98.

Which of the following ACCURATELY describes "kindling" in cocaine use? 

  • Reverse tolerance 

  • Increased tolerance 

  • Reduced tolerance 

  • Negation of tolerance 

Correct answer: Reverse tolerance 

"Kindling" refers to a kind of reverse tolerance in which a user of a stimulant drug such as cocaine may experience a seizure even though the same or a comparable dose taken previously had not had this effect.

The other answers do not accurately describe this phenomenon. 

99.

Which of the following is TRUE about Antabuse?

  • It is neither psychoactive nor addictive

  • It is psychoactive but not addictive

  • It is psychoactive and addictive

Correct answer: It is neither psychoactive nor addictive

Disulfiram (Antabuse), used to treat alcohol abuse and dependence, is neither psychoactive nor addictive. It blocks enzymes used in the metabolism of alcohol.

100.

What effect, if any, does pharmacological treatment for psychiatric disorders have on substance use disorders?

  • It improves outcomes

  • It worsens outcomes

  • It has no effect

Correct answer: It improves outcomes

Generally speaking, when persons with substance use disorders are being treated for another psychiatric disorder, and they successfully undergo this pharmacological treatment, their outcomes tend to improve. Substance use disorders and other psychiatric disorders are to be seen as part of the same overall picture of client mental health; what is done to treat one will inevitably affect the other.