LCAS North Carolina Exam Prep 2026:
300 Practice Questions with Answers |
Licensed Clinical Addiction Specialist
Question 1
A client presents with alcohol use disorder and reports
drinking daily to cope with work stress. Which
intervention is most appropriate initially?
A. Prescribing anti-anxiety medication without
assessment
B. Confronting the client aggressively about drinking
habits
C. Motivational interviewing to enhance readiness for
change
D. Ignoring the drinking behavior to build rapport
Answer: C. Motivational interviewing to enhance
readiness for change
Rationale: Motivational interviewing (MI) is an
evidence-based, client-centered approach designed to
enhance intrinsic motivation and resolve ambivalence
about change. It is the preferred initial intervention for
clients who may not be fully ready to commit to
,abstinence, as it respects autonomy and builds therapeutic
rapport without confrontation .
Question 2
According to the DSM-5, which symptom is not required
for a diagnosis of substance use disorder?
A. Craving
B. Tolerance
C. Withdrawal
D. Presence of co-occurring depression
Answer: D. Presence of co-occurring depression
Rationale: Co-occurring depression is a separate
condition that may accompany a substance use disorder,
but it is not one of the 11 diagnostic criteria for SUD in
the DSM-5. The criteria include craving, tolerance,
withdrawal, loss of control, and continued use despite
negative consequences .
Question 3
A client reports relapsing after six months of abstinence.
Which response aligns with relapse prevention best
practices?
,A. Label the client as “noncompliant” and discharge them
B. Explore triggers and coping strategies collaboratively
C. Advise complete avoidance of all social situations
D. Ignore the relapse to avoid discouraging the client
Answer: B. Explore triggers and coping strategies
collaboratively
Rationale: In relapse prevention models, relapse is
viewed as a learning opportunity rather than a failure. The
most effective response is to help the client identify the
triggers that led to the relapse and strengthen their coping
strategies for the future. Punitive or avoidant responses
are not therapeutic .
Question 4
During an intake, a client expresses suicidal ideation.
What is the LCAS’s first action?
A. Ask the client to schedule another appointment
B. Document the ideation but take no immediate action
C. Conduct a safety assessment and follow protocol for
crisis intervention
D. Reassure the client and end the session early
Answer: C. Conduct a safety assessment and follow
protocol for crisis intervention
, Rationale: Suicidal ideation requires immediate attention.
The LCAS must conduct a thorough risk assessment
(including plan, intent, and means) and follow established
crisis protocols, which may include creating a safety plan,
contacting emergency services, or arranging for an
immediate psychiatric evaluation. Safety is always the
first priority .
Question 5
Which of the following best describes the
Transtheoretical Model (Stages of Change)?
A. Pre-contemplation, contemplation, preparation, action,
maintenance
B. Denial, anger, bargaining, depression, acceptance
C. Trust, autonomy, initiative, industry, identity
D. Forming, storming, norming, performing, adjourning
Answer: A. Pre-contemplation, contemplation,
preparation, action, maintenance
Rationale: The Transtheoretical Model, developed by
Prochaska and DiClemente, identifies these five stages
that individuals cycle through during behavior change.
This model is fundamental to addiction treatment and
helps clinicians match interventions to the client's
readiness for change .
300 Practice Questions with Answers |
Licensed Clinical Addiction Specialist
Question 1
A client presents with alcohol use disorder and reports
drinking daily to cope with work stress. Which
intervention is most appropriate initially?
A. Prescribing anti-anxiety medication without
assessment
B. Confronting the client aggressively about drinking
habits
C. Motivational interviewing to enhance readiness for
change
D. Ignoring the drinking behavior to build rapport
Answer: C. Motivational interviewing to enhance
readiness for change
Rationale: Motivational interviewing (MI) is an
evidence-based, client-centered approach designed to
enhance intrinsic motivation and resolve ambivalence
about change. It is the preferred initial intervention for
clients who may not be fully ready to commit to
,abstinence, as it respects autonomy and builds therapeutic
rapport without confrontation .
Question 2
According to the DSM-5, which symptom is not required
for a diagnosis of substance use disorder?
A. Craving
B. Tolerance
C. Withdrawal
D. Presence of co-occurring depression
Answer: D. Presence of co-occurring depression
Rationale: Co-occurring depression is a separate
condition that may accompany a substance use disorder,
but it is not one of the 11 diagnostic criteria for SUD in
the DSM-5. The criteria include craving, tolerance,
withdrawal, loss of control, and continued use despite
negative consequences .
Question 3
A client reports relapsing after six months of abstinence.
Which response aligns with relapse prevention best
practices?
,A. Label the client as “noncompliant” and discharge them
B. Explore triggers and coping strategies collaboratively
C. Advise complete avoidance of all social situations
D. Ignore the relapse to avoid discouraging the client
Answer: B. Explore triggers and coping strategies
collaboratively
Rationale: In relapse prevention models, relapse is
viewed as a learning opportunity rather than a failure. The
most effective response is to help the client identify the
triggers that led to the relapse and strengthen their coping
strategies for the future. Punitive or avoidant responses
are not therapeutic .
Question 4
During an intake, a client expresses suicidal ideation.
What is the LCAS’s first action?
A. Ask the client to schedule another appointment
B. Document the ideation but take no immediate action
C. Conduct a safety assessment and follow protocol for
crisis intervention
D. Reassure the client and end the session early
Answer: C. Conduct a safety assessment and follow
protocol for crisis intervention
, Rationale: Suicidal ideation requires immediate attention.
The LCAS must conduct a thorough risk assessment
(including plan, intent, and means) and follow established
crisis protocols, which may include creating a safety plan,
contacting emergency services, or arranging for an
immediate psychiatric evaluation. Safety is always the
first priority .
Question 5
Which of the following best describes the
Transtheoretical Model (Stages of Change)?
A. Pre-contemplation, contemplation, preparation, action,
maintenance
B. Denial, anger, bargaining, depression, acceptance
C. Trust, autonomy, initiative, industry, identity
D. Forming, storming, norming, performing, adjourning
Answer: A. Pre-contemplation, contemplation,
preparation, action, maintenance
Rationale: The Transtheoretical Model, developed by
Prochaska and DiClemente, identifies these five stages
that individuals cycle through during behavior change.
This model is fundamental to addiction treatment and
helps clinicians match interventions to the client's
readiness for change .
