ADM Patient Assessment & Clinical Evaluation 3 — Questions and Answers
Question 1: A 28-year-old pregnant woman presents for addiction evaluation. Which screening tool is validated and recommended for substance use during pregnancy?
- 4Ps Plus (Correct answer)
- CAGE
- DAST-10
- MAST
Correct answer: 4Ps Plus
The 4Ps Plus screen (Parents, Partner, Past, Pregnancy) is validated for identifying substance use risk in pregnant women.
Question 2: Which component of the biopsychosocial assessment addresses a patient's trauma history and its relationship to substance use?
- Psychosocial history (Correct answer)
- Physical examination
- Laboratory workup
- Medication reconciliation
Correct answer: Psychosocial history
Trauma history is captured in the psychosocial history component, which explores adverse life events and their connection to substance use initiation and maintenance.
Question 3: During motivational interviewing-based assessment, the clinician notices the patient is ambivalent about stopping cannabis use. The BEST next step is to:
- Explore the patient's pros and cons of use using a decisional balance (Correct answer)
- Prescribe medication for cannabis use disorder immediately
- Refer for inpatient treatment
- Discharge the patient for lack of motivation
Correct answer: Explore the patient's pros and cons of use using a decisional balance
Exploring ambivalence through a decisional balance is a core MI technique that elicits the patient's own reasons for change.
Question 4: Which finding on urine drug screen would suggest benzodiazepine use not disclosed by the patient?
- Positive for oxazepam and temazepam metabolites (Correct answer)
- Positive for morphine
- Positive for amphetamine
- Positive for THC-COOH
Correct answer: Positive for oxazepam and temazepam metabolites
Oxazepam and temazepam are benzodiazepine metabolites that appear in urine; their presence without a prescription suggests undisclosed use.
Question 5: Which co-occurring psychiatric disorder is MOST commonly associated with stimulant use disorder and should be assessed at intake?
- ADHD and mood disorders (Correct answer)
- Obsessive-compulsive disorder
- Specific phobia
- Autism spectrum disorder
Correct answer: ADHD and mood disorders
ADHD and mood disorders, particularly depression and bipolar disorder, are highly prevalent among patients with stimulant use disorder.
Question 6: A patient in early recovery from opioid use disorder endorses persistent anhedonia and sleep disturbance. The clinician should FIRST consider:
- Protracted abstinence syndrome vs. independent depressive disorder (Correct answer)
- Immediate antidepressant initiation
- Resuming opioid therapy
- Discharge from care
Correct answer: Protracted abstinence syndrome vs. independent depressive disorder
Protracted withdrawal symptoms mimic depression; distinguishing them from an independent mood disorder requires observation over time before prescribing.
Question 7: Which validated tool screens specifically for unhealthy alcohol use in primary care settings using only 3 questions?
- AUDIT-C (Correct answer)
- CAGE
- MAST
- SASSI
Correct answer: AUDIT-C
The AUDIT-C is a 3-item condensed version of the full AUDIT that effectively screens for hazardous and harmful alcohol use.
ADM Patient Assessment & Clinical Evaluation 3
A 28-year-old pregnant woman presents for addiction evaluation.
Which screening tool is validated and recommended for substance use during pregnancy?