ADC Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

uncomplicated early withdrawal.: Early withdrawal (tremor, anxiety, sweating) starts within hours and does not include disorientation and fever.

alcoholic hallucinosis.: Hallucinosis usually appears earlier, within the first day or two, with a clear mind and fairly stable vital signs.

delirium tremens.: Correct. Disorientation, hallucinations and autonomic hyperactivity (fever, rapid pulse, sweating) about 2 to 3 days after the last drink indicate delirium tremens, a medical emergency.

a postictal state after a seizure.: Postictal confusion follows a witnessed or suspected seizure and is not accompanied by vivid hallucinations with fever.

Delirium tremens typically begins 2 to 3 days after the last drink and combines confusion, hallucinations and autonomic instability; it needs emergency medical care.

Answer: A

buprenorphine's high receptor affinity and partial agonist effect.: Correct. Buprenorphine binds tightly and displaces fentanyl but activates receptors less, so the net drop in opioid effect precipitates withdrawal.

synergy between buprenorphine and the remaining fentanyl.: Synergy would increase opioid effect and sedation, not produce withdrawal.

buprenorphine acting as a full opioid agonist.: Buprenorphine is a partial agonist; a full agonist would relieve withdrawal, not cause it.

the naloxone component blocking opioid receptors.: Naloxone is poorly absorbed when taken under the tongue; it is added to deter injection and is not the main cause of precipitated withdrawal.

Buprenorphine is a high-affinity partial agonist; taken while a full agonist is still active, it can precipitate withdrawal.

Answer: D

metabolic (dispositional) tolerance.: Metabolic tolerance means the liver breaks alcohol down faster, giving a lower blood level per drink; here the blood level is high.

sensitization.: Sensitization (reverse tolerance) is an increased response to the same dose, the opposite of what is described.

cross-tolerance.: Cross-tolerance describes reduced response to a different but related drug, such as a benzodiazepine; no second drug is involved.

pharmacodynamic tolerance.: Correct. The nervous system has adapted, so the same high blood alcohol level produces less impairment; this is pharmacodynamic (cellular) tolerance.

High blood levels with little impairment point to nervous-system (pharmacodynamic) tolerance; faster breakdown with lower blood levels is metabolic tolerance.

Answer: B

a severe disorder calls for medically managed inpatient care.: Severity does not dictate any single level; this repeats the same error at a higher level.

placement should reflect needs and risks across several dimensions.: Correct. DSM-5-TR severity counts criteria; it does not show withdrawal risk, medical or mental health status, readiness, recovery environment or supports. Placement uses a multidimensional assessment, so a severe diagnosis can still fit outpatient care.

severity ratings should be made only after 12 months of treatment.: Severity is rated from criteria met in the past 12 months, not after treatment; this is not the flaw.

placement must wait until the client reaches the preparation stage.: Readiness is one factor, but placement does not wait for a stage of change.

A DSM-5-TR diagnosis and its severity inform placement but do not determine it; level of care comes from a multidimensional assessment.

Answer: C

1. Criteria present: larger amounts/longer than intended; unsuccessful efforts to cut down; craving; continued use despite interpersonal problems; important activities given up = 5.
2. Public intoxication citation = legal problem, not a criterion.
3. 5 criteria = moderate.

below the diagnostic threshold.: Five criteria are present; tolerance and withdrawal are not required for a diagnosis.

mild.: Mild is 2–3 criteria; this client meets 5.

moderate.: Correct. Larger amounts than intended, unsuccessful efforts to cut down, craving, continued use despite interpersonal problems and activities given up are 5 criteria; DSM-5-TR rates 4–5 as moderate. The citation is a legal problem, which is not a criterion.

severe.: Severe (6 or more) is reached only by counting the legal citation, which is not a DSM-5-TR criterion.

Count only DSM-5-TR criteria: mild 2–3, moderate 4–5, severe 6+. Legal problems are not counted; craving is.

Answer: B

the client is exaggerating use to qualify for treatment.: Unsupported: the negative result has a known technical cause, so it is not evidence against the client's report.

standard opiate immunoassays do not detect fentanyl.: Correct. Opiate immunoassays target morphine-type opiates; fentanyl is a synthetic opioid that needs a fentanyl-specific test.

the specimen must have been diluted before it was collected.: Dilution is possible, but nothing in the stem suggests it, and a technical explanation fits better.

fentanyl leaves the body too quickly to appear in urine.: Fentanyl and its metabolite are detectable in urine with a fentanyl-specific test.

A negative standard opiate screen does not rule out fentanyl; order a fentanyl-specific test when fentanyl use is possible.

Answer: A

"What would be better for you if you drank less?": Correct. An open, evocative question asks the client to voice the benefits of change in their own words (MI: change talk).

"Do you think you drink more than you should?": A closed yes/no question that invites a defensive "no" rather than the client's own reasons.

"Why haven't you been able to cut back yet?": A "why haven't you" question puts the client on the defensive and draws out sustain talk.

"How many drinks do you usually have on a weekend night?": Useful for assessment, but it gathers facts rather than motivation for change.

Open questions about the benefits of change evoke change talk; closed and "why not" questions tend to evoke defense.

Answer: D

Talk with the member privately after group and ask them to share less.: A private talk may help later, but it ignores what is happening in the room and misses the chance to use group process.

Let the member continue, since interrupting could damage the member's trust.: Allowing one member to dominate harms the whole group; skilled blocking can be done without shaming.

Tell the member in front of the group that the stories take too much time.: This blocks the behavior but in a shaming, confrontational way that can hurt the member and the group's sense of safety.

Gently interrupt, acknowledge the member, and invite others to respond.: Correct. Blocking with respect and then linking to other members redistributes participation and turns the problem into group process.

Leaders block monopolizing respectfully in the moment and link members so the whole group stays involved.

Answer: B

precontemplation stage.: The client already recognizes a problem and is weighing change; precontemplation means the person does not yet see a need to change.

contemplation stage.: Correct. The client sees a reason to quit but is torn and has no plan or commitment to change, the ambivalence that defines contemplation; attending a required program is not the same as changing the behavior.

preparation stage.: Preparation requires an intention to act soon and a plan or small steps toward change; this client has not committed to stopping.

action stage.: Mandated program attendance is not action; the action stage means the client has changed the substance use itself, and this client still drinks every weekend.

Stage is judged by the client's readiness to change the substance use, not by treatment attendance; open ambivalence with no commitment is contemplation.

Answer: A

Stay with the client and start emergency procedures: Correct. The client has stated a plan, means, intent and a time, which means imminent risk. The counselor keeps the client safe and starts emergency procedures right away.

Develop a written safety plan before the client leaves: Safety planning fits lower-risk situations; with imminent intent the client should not leave on a plan alone.

Ask the client to sign a no-suicide contract: No-suicide contracts are not evidence-based and do not reduce imminent risk.

Ask the client's partner to remove the pills from the home: Restricting means helps, but it does not provide the emergency evaluation this level of risk needs.

A stated plan, means, intent and timeline signal imminent risk: do not leave the client alone, and follow emergency procedures per agency policy.

Answer: A

decline to release it without client consent or a court order.: Correct. Part 2 permits the initial abuse report, but the original treatment records stay protected, including for proceedings arising from the report.

release the record, because the abuse-reporting exception applies.: The exception covers the report itself, not the program's SUD records.

release only the notes that mention the abuse disclosure.: Those notes are still part of the protected record.

release the record, because the disclosure ended confidentiality.: A disclosure of abuse does not waive Part 2 protection for the rest of the record.

Report suspected abuse as required by applicable law; release the Part 2 record itself only with consent or a court order.

Answer: A

Respond through counsel that consent or a Part 2 court order is required.: Correct. Under 42 CFR 2.61 a subpoena alone does not authorize disclosure of Part 2 records; the program withholds them but answers the subpoena properly rather than ignoring it.

Release the records, because a subpoena is a binding legal order.: Part 2 restrictions apply even when the requester has a subpoena.

Release only a summary listing the client's attendance dates.: Attendance dates are themselves protected patient-identifying information.

Disregard the subpoena, because Part 2 records can never be used in court.: A court order meeting Part 2 standards can authorize use, and a subpoena should get a timely response, not be ignored.

Subpoena alone = no disclosure; Part 2 records need the client's consent or a Part 2 court order (plus a subpoena to compel it).

Answer: C

Get verbal consent from the client's partner before answering.: Consent is not required in a bona fide medical emergency, and delaying care to seek it is unsafe.

Give the paramedics a copy of the client's full treatment record.: The exception is limited to what is necessary for the emergency, not the whole record.

Share the information needed for treatment, then document the disclosure right away.: Correct. Part 2 permits disclosure to medical personnel, to the extent necessary, in a bona fide emergency when consent cannot be obtained; the program records the disclosure immediately afterward.

Decline to answer until the client can sign a written consent.: Misapplies Part 2; the emergency exception exists for exactly this situation.

Part 2 medical emergency: disclose only what medical personnel need, then immediately record who received it, who disclosed it, the date and time, and the nature of the emergency.

Answer: C

"Yes, I'm in recovery. Let me tell you how I finally got sober.": Telling the counselor's own story shifts the session to the counselor and suggests that the counselor's path is the model for the client.

"I'm in recovery too, so I know exactly how you feel.": Assumes the two experiences are the same and closes off the client's own account.

"Yes, I'm in recovery. What made you want to ask me that?": Correct. A brief, honest answer avoids seeming evasive, and turning back to the client keeps the focus on the client's concern (often whether the counselor can understand them).

"Agency policy doesn't allow me to answer personal questions.": Hides behind policy, ignores the meaning of the question and can damage rapport early in treatment.

Self-disclosure is used only for the client's benefit: keep it brief and honest, then return the focus to the client.