Chemical Dependency Counselor CCDC Exam Risk Assessment & Management 2 — Questions and Answers
Question 1: A client with alcohol use disorder reports drinking a fifth of liquor daily for 10 years. Which withdrawal complication poses the greatest life-threatening risk?
- Insomnia
- Delirium tremens (Correct answer)
- Mild tremors
- Nausea
Correct answer: Delirium tremens
Delirium tremens is a severe alcohol withdrawal syndrome that can be fatal without medical management.
Question 2: When using the AUDIT-C screening tool, a score indicating hazardous alcohol use in women is typically:
- 1 or above
- 3 or above (Correct answer)
- 5 or above
- 7 or above
Correct answer: 3 or above
A score of 3 or above on the AUDIT-C is the threshold for identifying hazardous alcohol use in women.
Question 3: Which factor in a client's history most significantly elevates risk for opioid overdose upon release from incarceration?
- Prior treatment history
- Reduced opioid tolerance after abstinence (Correct answer)
- Family history of addiction
- Current mental health diagnosis
Correct answer: Reduced opioid tolerance after abstinence
Tolerance drops rapidly during incarceration, so returning to prior use levels dramatically increases overdose risk.
Question 4: A counselor uses the Clinical Opiate Withdrawal Scale (COWS). A score of 25 indicates:
- Mild withdrawal
- Moderate withdrawal
- Moderately severe withdrawal
- Severe withdrawal (Correct answer)
Correct answer: Severe withdrawal
COWS scores of 25 and above indicate severe opioid withdrawal requiring immediate medical attention.
Question 5: What is the primary purpose of the Columbia Suicide Severity Rating Scale (C-SSRS) in a chemical dependency setting?
- Measure depression symptoms
- Stratify suicide risk by ideation and behavior (Correct answer)
- Screen for psychosis
- Assess withdrawal severity
Correct answer: Stratify suicide risk by ideation and behavior
The C-SSRS classifies the intensity and nature of suicidal ideation and behavior to guide clinical decision-making.
Question 6: A client discloses they have been sharing needles. Beyond bloodborne disease risk, what immediate safety concern should the counselor prioritize?
- Poor vein health
- Risk of accidental overdose from unknown substances (Correct answer)
- Social stigma
- Legal consequences
Correct answer: Risk of accidental overdose from unknown substances
Shared needles also transfer residual substances, creating unpredictable overdose risk from unknown concentrations or adulterants.
Question 7: In the context of risk management, which documentation practice best protects both the client and the counselor?
- Documenting only positive client progress
- Recording all risk assessments, safety plans, and clinical rationale contemporaneously (Correct answer)
- Summarizing risk discussions in monthly notes
- Keeping risk information in a separate informal log
Correct answer: Recording all risk assessments, safety plans, and clinical rationale contemporaneously
Contemporaneous, thorough documentation of risk assessments and rationale is the standard of care and provides legal protection.
Chemical Dependency Counselor CCDC Exam Risk Assessment & Management 2
A client with alcohol use disorder reports drinking a fifth of liquor daily for 10 years.
Which withdrawal complication poses the greatest life-threatening risk?