Free CAC Screening, Assessment and Engagement Questions and Answers — Questions and Answers
Question 1: All of the following are questions on the CAGE questionnaire EXCEPT?
- Have you ever felt the need to cut down on your drinking?
- Have you ever felt annoyed by others criticizing your drinking?
- Have you ever experienced delirium tremens? (Correct answer)
- Have you ever felt guilty about your drinking?
Correct answer: Have you ever experienced delirium tremens?
Delirium tremens are a severe form of alcohol withdrawal which is not included on the CAGE questionnaire. Delirium tremens usually occur three days into withdrawal and can last 2-3 days.
Question 2: According to the DSM-5, which symptom is not included in the criteria for an alcohol use disorder?
- Consuming alcohol in the morning to relieve the shakes (Correct answer)
- A persistent desire or unsuccessful efforts to cut down or control alcohol use
- Recurrent alcohol use in situations in which it is physically hazardous
- Craving, or a strong desire or urge to use alcohol
Correct answer: Consuming alcohol in the morning to relieve the shakes
While consuming alcohol in the morning may be an indicator of withdrawal symptoms, it is not a criteria of an alcohol use disorder. There are eleven criteria in total and are as follows: - Use of substance in larger amounts or longer periods of time than was originally intended. - A desire or unsuccessful attempts to reduce alcohol use.
Question 3: Lee is coming into the clinic for a substance use assessment. He reports using Xanax occasionally, but is unsure if he has a problem. During the course of the assessment, you learn that when he first started taking Xanax he used about one pill at a time. He reports that he is now taking three pills during each use because "one just doesn't do it for me anymore." You also learn that he decided he wanted to stop using Xanax altogether, but that he "keeps going back to it." He denied any other issues related to Xanax. When assessing the severity of Lee's Xanax use, what severity specifier would be most appropriate?
- Mild (Correct answer)
- Moderate
- Severe
- No severity specifier should be given as he does not meet criteria for a substance use disorder
Correct answer: Mild
According to the DSM-5, when 2-3 criteria are indicated, a mild severity specifier is appropriate. Based on the information provided, we can identify that he meets the criteria for two criteria. Needing three pills instead of one to get the same effect indicates tolerance. He also demonstrates a desire to cut down or eliminate use and being unsuccessful which is another criteria.
Question 4: The following substances are all stimulants, except:
- Caffeine
- Methamphetamine
- Adderall
- Xanax (Correct answer)
Correct answer: Xanax
Xanax is a benzodiazepine. Caffeine, Methamphetamine, and Adderall are all classified as stimulants.
Question 5: The CAGE-AID is a screening tool containing four yes/no items. How many questions need to be answered "yes" to be considered a positive screen?
- One (Correct answer)
- Two
- Three
- Four
Correct answer: One
The CAGE-AID is screened positive when at least one question is indicated "yes." The CAGE-AID is screened negative if the answer to all four questions is "no."
Question 6: Angela is attending a substance use assessment in hopes to be admitted to a residential program same day. During her assessment, she completes a drug screening including a breathalyzer and a drug panel. She does not appear significantly intoxicated, but she blows a .38 BAC. What is the next appropriate step?
- Have her complete some physical and cognitive tests to evaluate her capacity to participate in treatment.
- Admit her to the program and notify the nurse to monitor.
- Tell her to come back when her BAC has decreased.
- Refer her to the nearest detox. (Correct answer)
Correct answer: Refer her to the nearest detox.
Withdrawals from alcohol can pose serious risks including death. Referral to detox is appropriate to ensure Angela is safe and receiving appropriate assistance and monitoring.
Question 7: Which of the following drugs would be present on a Urine Drug Screen (UDS) 5 days after use?
- Cocaine
- Marijuana (Correct answer)
- Methamphetamine
- Heroin
Correct answer: Marijuana
The active ingredient in marijuana, THC, is fat soluble whereas the other substances listed are water soluble. Fat cells are harder to burn, therefore can remain in a person&'s system longer.
Question 8: Joseph comes into your office for an intake assessment required by his Probation Officer. Joseph is reluctant to discuss his opiate use. However, he is compliant because he knows that the results of the intake would be reported to his PO. He shared that he is on probation as a result of being arrested for stealing. Joseph explained that he was stealing to support his heroin use and has continued to use since his arrest. Joseph began using Oxycodone recreationally at age 17 which progressed to daily use soon after. Joseph began using heroin approximately 8 months later due to the cost difference. Joseph has used to avoid withdrawal symptoms. He recently began to share needles and noted that he is aware of the health risk that this behavior poses. Joseph's family began distancing themselves from him when he continued using heroin after being arrested. With the information provided, how would you diagnose Joseph?
- Opiate Use Disorder, Severe
- Opiate Use Disorder, Mild
- Opiate Use Disorder, Moderate (Correct answer)
- Opiate Use Disorder
Correct answer: Opiate Use Disorder, Moderate
"The summary above falls into the moderate level of the DSM-V for Opiate Use Disorder. The severity rating scale is as follows: Mild: 2-3 Symptoms Moderate: 4-5 Symptoms Severe: 6 or more Symptoms - Symptoms identified in the summary were as follows. Joseph had continued use despite persistent social and interpersonal issues (discord with family). Joseph continued to use in physically dangerous situations (sharing needles). Joseph has developed a tolerance which led to him using larger amounts over time. Lastly, he has experienced withdrawal and uses to avoid symptoms. "
Question 9: Susan was referred for an Alcohol Assessment by her Primary Care Physician. She scored a 17 on the AUDIT assessment. Which risk zone and action recommendation would be the most appropriate?
- Zone I; Brief education
- Zone II; Brief intervention
- Zone III; Brief education or referral for specialized treatment (Correct answer)
- Zone IV; Referral to a specialist for treatment
Correct answer: Zone III; Brief education or referral for specialized treatment
AUDIT scores ranging from 13-19 for a Woman fall into Zone III with the recommendation of simple advice plus brief counseling and continued monitoring. When scoring the AUDIT, the gender of the client will aide in determining the recommendation. Zone recommendations are as follows: Zone I: Brief education, Zone II: Brief intervention, Zone III: Brief intervention or referral to specialized treatment, Zone IV: Referral to specialized treatment
Question 10: Which option correctly represents the Stages of Change Model?
- Pre-contemplation, contemplation, preparation, action and maintenance (Correct answer)
- Pre-contemplation, contemplation, action and relapse
- Contemplation, preparation, action and maintenance
- Contemplation, preparation, action, maintenance and relapse
Correct answer: Pre-contemplation, contemplation, preparation, action and maintenance
The Stages of Change Model was developed by Prochaska and DiClemente in the 1970&'s to allow professionals to gauge a client&'s readiness for change to aide in treatment planning.
Question 11: A 67 year old female, Mary, attends an intake assessment with you on Monday. You diagnosis her with Alcohol Use Disorder, Severe and Bipolar I. You gave her a treatment schedule to engage her in group sessions along with a referral for a doctor on staff to assess for medications. Mary lives alone and has limited mobility due to severe arthritis. Mary misses her group session on Wednesday. As her primary clinician, you call her to follow up regarding her absence. While on the phone, it becomes apparent that she is inebriated and she reported falling down stairs and is struggling to get up. You encourage her to call 911, however she refuses. Which would be the best course of action to present to your supervisor?
- Call her son so he can go check on her.
- Talk to her about the incident when she comes in for group and discuss the danger she put herself in.
- Document the call; process the call if she brings is up with you.
- Call 911 for a wellness check. (Correct answer)
Correct answer: Call 911 for a wellness check.
The best option to discuss with your supervisor would be to call for a Wellness Check. Her apparent intoxication, limited mobility, living alone and her self-report of falling with a difficulty of getting up poses a concern for her safety. Therefore, you have an ethical responsibility to break confidentiality to ensure her safety. Consulting with your supervisor or colleague allows you the opportunity to receive feedback regarding your plan of action.
Free CAC Screening, Assessment and Engagement Questions and Answers
All of the following are questions on the CAGE questionnaire EXCEPT?