CARN Addiction Assessment & Diagnosis 4 — Questions and Answers
Question 1: In the context of addiction assessment, 'telescoping' refers to which phenomenon?
- Gradual dose escalation over time
- Women progressing more rapidly from first use to dependence than men (Correct answer)
- Alternating periods of use and abstinence
- Reduction in withdrawal severity with each detox episode
Correct answer: Women progressing more rapidly from first use to dependence than men
Telescoping describes the accelerated progression from initiation of substance use to dependence observed in women compared to men.
Question 2: A nurse assessing a patient's readiness to change asks, 'On a scale of 0-10, how important is it for you to change your drinking?' This technique is called:
- Decisional balancing
- Importance and confidence rulers (Correct answer)
- Reflective listening
- Affirmation
Correct answer: Importance and confidence rulers
Importance and confidence rulers are motivational interviewing tools that use scaling questions to elicit and explore ambivalence about change.
Question 3: Which condition must be ruled out when a patient presents with auditory hallucinations and agitation in the context of cocaine use cessation?
- Stimulant-induced psychotic disorder (Correct answer)
- Alcohol withdrawal delirium
- Primary schizophrenia
- Cannabis-induced anxiety disorder
Correct answer: Stimulant-induced psychotic disorder
Stimulant-induced psychotic disorder can occur during or shortly after cessation of cocaine and must be distinguished from primary psychotic disorders.
Question 4: The ASI (Addiction Severity Index) assesses problem severity across how many life domains?
- 4
- 5
- 7 (Correct answer)
- 9
Correct answer: 7
The ASI evaluates seven domains: medical, employment/support, alcohol, drug, legal, family/social, and psychiatric status.
Question 5: Which physical finding is most consistent with chronic intravenous drug use during a physical assessment?
- Jaundice and asterixis
- Track marks and thrombosed veins (Correct answer)
- Rhinorrhea and nasal septum perforation
- Hypertension and tachycardia
Correct answer: Track marks and thrombosed veins
Track marks (venipuncture scars) and thrombosed or sclerosed veins are characteristic physical findings of chronic IV drug use.
Question 6: Which DSM-5 severity specifier applies when a patient meets 6 or more criteria for substance use disorder?
- Mild
- Moderate
- Severe (Correct answer)
- Extreme
Correct answer: Severe
DSM-5 specifies severe SUD when 6 or more of the 11 diagnostic criteria are present within a 12-month period.
Question 7: A co-occurring disorder assessment reveals that a patient's depression preceded their alcohol use by five years. This temporal relationship most suggests:
- Alcohol-induced depressive disorder
- Independent co-occurring major depressive disorder (Correct answer)
- Adjustment disorder with depressed mood
- Dysthymia triggered by alcohol
Correct answer: Independent co-occurring major depressive disorder
When a psychiatric disorder clearly predates substance use by years, it is more likely an independent primary disorder rather than substance-induced.
CARN Addiction Assessment & Diagnosis 4
In the context of addiction assessment, 'telescoping' refers to which phenomenon?