CAADE Crisis Intervention 3 — Questions and Answers
Question 1: When conducting a mental status exam during a crisis with a client who is intoxicated, the counselor should prioritize assessing:
- Intelligence and abstract reasoning ability
- Orientation, safety risk, and level of consciousness (Correct answer)
- Insight into the nature of addiction
- Long-term memory and executive functioning
Correct answer: Orientation, safety risk, and level of consciousness
With an intoxicated client, orientation, consciousness level, and immediate safety risk are the critical clinical priorities during mental status evaluation.
Question 2: A client calls a crisis hotline and says 'I have nothing left to live for.' The counselor's FIRST action should be to:
- Ask the client to confirm their address for emergency dispatch
- Engage empathically and assess for suicidal ideation (Correct answer)
- Immediately transfer the call to emergency services
- Remind the client of their reasons to stay sober
Correct answer: Engage empathically and assess for suicidal ideation
The first step is to engage empathically and conduct a suicidal ideation assessment before determining the appropriate level of response.
Question 3: Which of the following is a key difference between a crisis and an emergency in substance abuse counseling?
- A crisis requires hospitalization while an emergency does not
- An emergency involves immediate physical danger while a crisis is primarily psychological (Correct answer)
- A crisis always involves suicidal ideation while an emergency involves overdose only
- Emergencies are managed by counselors while crises require medical staff
Correct answer: An emergency involves immediate physical danger while a crisis is primarily psychological
An emergency involves acute physical threat requiring immediate medical intervention, while a crisis is primarily a psychological state of overwhelm.
Question 4: A client with a history of methamphetamine use presents with paranoia and believes others are trying to harm them. The counselor suspects stimulant-induced psychosis. The BEST immediate intervention is:
- Engaging in logical debate to correct the client's distorted beliefs
- Providing a calm, low-stimulation environment and ensuring safety (Correct answer)
- Encouraging the client to call family members immediately
- Reviewing the client's relapse prevention plan
Correct answer: Providing a calm, low-stimulation environment and ensuring safety
Stimulant-induced psychosis requires reducing environmental stimulation and ensuring physical safety until the acute episode resolves.
Question 5: In crisis intervention, 'psychological first aid' primarily involves:
- Conducting a formal psychological assessment battery
- Providing immediate comfort, safety, and connection to support (Correct answer)
- Prescribing medications to reduce acute anxiety symptoms
- Processing traumatic memories through evidence-based therapy
Correct answer: Providing immediate comfort, safety, and connection to support
Psychological first aid focuses on immediate stabilization by providing safety, calm, connection, hope, and access to needed resources.
Question 6: A client in benzodiazepine withdrawal crisis may experience which life-threatening symptom that requires immediate medical referral?
- Hypersomnia and fatigue
- Grand mal seizures (Correct answer)
- Mild irritability and mood swings
- Increased appetite and weight gain
Correct answer: Grand mal seizures
Benzodiazepine withdrawal can cause life-threatening grand mal seizures, making it a medical emergency requiring immediate referral.
Question 7: When creating a safety plan with a client at risk for self-harm, which element is considered MOST critical?
- Identifying a list of pleasant activities to distract the client
- Restricting access to lethal means such as firearms and medications (Correct answer)
- Scheduling the next counseling appointment within two weeks
- Having the client sign a no-suicide contract
Correct answer: Restricting access to lethal means such as firearms and medications
Means restriction — reducing access to lethal methods — has the strongest empirical evidence for preventing suicide attempts and deaths.
CAADE Crisis Intervention 3
When conducting a mental status exam during a crisis with a client who is intoxicated, the counselor should prioritize assessing: