ADM Patient Assessment & Clinical Evaluation 2 — Questions and Answers
Question 1: Which validated tool is used to assess the severity of alcohol withdrawal and guide medical management?
- CIWA-Ar (Correct answer)
- AUDIT-C
- CAGE questionnaire
- PHQ-9
Correct answer: CIWA-Ar
The Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) quantifies withdrawal severity across 10 symptoms to guide medication dosing.
Question 2: A patient reports using opioids daily for 18 months and is now seeking treatment. Which instrument best quantifies opioid withdrawal severity at intake?
- COWS (Correct answer)
- CIWA-Ar
- DAST-10
- CRAFFT
Correct answer: COWS
The Clinical Opiate Withdrawal Scale (COWS) measures 11 objective and subjective signs to score opioid withdrawal severity.
Question 3: During assessment, a 45-year-old patient minimizes alcohol use. Which collateral information source is MOST appropriate to obtain with the patient's consent?
- Family member or close contact (Correct answer)
- Previous employer records
- IRS tax filings
- DMV driving history
Correct answer: Family member or close contact
Collateral history from a family member or close contact, obtained with patient consent, helps corroborate and clarify the extent of substance use.
Question 4: Which lab finding is most specific for heavy chronic alcohol use when assessing a new patient?
- Elevated phosphatidylethanol (PEth) (Correct answer)
- Elevated BUN
- Low serum albumin
- Elevated TSH
Correct answer: Elevated phosphatidylethanol (PEth)
Phosphatidylethanol (PEth) is a direct ethanol metabolite with high specificity for chronic heavy alcohol consumption over the past 3–4 weeks.
Question 5: A clinician performs a functional assessment on a patient with severe alcohol use disorder. Which domain is MOST relevant to include?
- Ability to maintain employment and manage daily activities (Correct answer)
- Preferred recreational hobbies
- Childhood educational history
- Preferred dietary patterns
Correct answer: Ability to maintain employment and manage daily activities
Functional assessment in addiction medicine evaluates the impact of substance use on occupational, social, and daily living activities.
Question 6: Which DSM-5 specifier indicates that a patient no longer meets criteria for a stimulant use disorder but still experiences cravings?
- Early remission (Correct answer)
- Sustained remission
- In a controlled environment
- Partial remission
Correct answer: Early remission
DSM-5 'early remission' applies when no criteria (except craving) have been met for 3–12 months.
Question 7: When assessing polysubstance use, which approach is MOST comprehensive?
- Screen for all substance classes including tobacco, alcohol, illicits, and non-prescribed medications (Correct answer)
- Focus only on the primary substance the patient identifies
- Ask only about substances detected on urine drug screen
- Document only substances used in the past 30 days
Correct answer: Screen for all substance classes including tobacco, alcohol, illicits, and non-prescribed medications
A comprehensive assessment screens across all substance classes because polysubstance use is common and each substance influences treatment planning.
ADM Patient Assessment & Clinical Evaluation 2
Which validated tool is used to assess the severity of alcohol withdrawal and guide medical management?