Chemical Dependency Counselor License Exam Screening and Assessment 4 — Questions and Answers
Question 1: A counselor administers the PHQ-9 during an intake assessment. This instrument is designed to screen for:
- Alcohol use disorder severity
- Major depressive disorder symptoms (Correct answer)
- Post-traumatic stress disorder
- Cognitive impairment due to substance use
Correct answer: Major depressive disorder symptoms
The PHQ-9 (Patient Health Questionnaire-9) is a validated 9-item tool for screening and measuring the severity of depression.
Question 2: During assessment, a client reports using heroin daily for three years and experiencing muscle aches, sweating, and anxiety when they stop using. These withdrawal symptoms are MOST consistent with:
- Stimulant use disorder
- Opioid use disorder with physiological dependence (Correct answer)
- Sedative-hypnotic use disorder
- Cannabis use disorder
Correct answer: Opioid use disorder with physiological dependence
Opioid withdrawal classically presents with myalgia, diaphoresis, anxiety, lacrimation, and GI symptoms when use is abruptly discontinued.
Question 3: Which of the following best describes 'trauma-informed assessment' in a chemical dependency context?
- Assessing only clients who self-report a history of trauma before asking substance use questions
- Integrating awareness of trauma's prevalence and impact into assessment practices without re-traumatizing the client (Correct answer)
- Administering a trauma-specific instrument before all other screening tools
- Excluding clients with active PTSD from substance use assessments until stabilized
Correct answer: Integrating awareness of trauma's prevalence and impact into assessment practices without re-traumatizing the client
Trauma-informed assessment recognizes that trauma is widespread, integrates this awareness into all interactions, and prioritizes client safety and empowerment.
Question 4: When a client presents with both a substance use disorder and a mental health disorder, the assessment process should:
- Focus exclusively on the substance use disorder since it is primary
- Address the mental health disorder first and defer substance use assessment
- Assess both disorders simultaneously using an integrated approach (Correct answer)
- Refer the client to separate providers for each disorder before assessing
Correct answer: Assess both disorders simultaneously using an integrated approach
Co-occurring disorders require integrated assessment of both conditions simultaneously, as each can affect the other and both must be addressed in treatment.
Question 5: The term 'tolerance' as assessed in a substance use evaluation refers to:
- A client's ability to manage stress without using substances
- The need for markedly increased amounts of a substance to achieve the desired effect (Correct answer)
- The degree to which a client accepts their diagnosis
- Physical symptoms that appear during abstinence from substances
Correct answer: The need for markedly increased amounts of a substance to achieve the desired effect
Tolerance is a DSM-5 criterion for substance use disorder defined as needing more of a substance to get the same effect, or diminished effect with the same amount.
Question 6: A counselor conducting a mental status examination during assessment would evaluate which of the following domains?
- Insurance eligibility and prior authorization status
- Appearance, orientation, mood, affect, cognition, and thought content (Correct answer)
- Urine drug screen results and blood alcohol concentration
- Family genogram and multigenerational substance use patterns
Correct answer: Appearance, orientation, mood, affect, cognition, and thought content
A mental status examination systematically evaluates appearance, behavior, speech, mood, affect, thought process, thought content, perception, cognition, insight, and judgment.
Question 7: Which ethical principle requires a counselor to obtain voluntary, informed consent before conducting a substance use assessment?
- Beneficence
- Nonmaleficence
- Autonomy (Correct answer)
- Justice
Correct answer: Autonomy
Autonomy is the ethical principle that supports the client's right to make informed decisions, which is operationalized through informed consent procedures.
