ARKANSAS ADDICTION COUNSELOR
CERTIFICATION REAL EXAM QUUESTIONS
WITH CORRECT ANSWERS AND RATIONALES
LATEST 2026-2027 UPDATE
Domain I: Clinical Evaluation (Screening, Intake, & Assessment)
1. A client presents for their initial intake with slurred speech and
the odor of alcohol on their breath. What is the counselor's
PRIORITY action?
A. Complete the intake paperwork as scheduled.
B. Confront the client about their dishonesty.
C. Conduct a breathalyzer test and assess for medical emergency.
D. Administer the ASAM criteria to determine level of care.
Correct Answer: C
Rationale: Safety is the primary concern. A client under the influence
may be experiencing a medical emergency (e.g., overdose, withdrawal).
The counselor must assess the client's immediate medical stability (often
via breathalyzer/clinical observation) before proceeding with any
paperwork or psychosocial assessment.
2. Which of the following screening tools is specifically designed to
identify alcohol misuse and is widely used in clinical settings?
A. DAST-10
B. MAST
C. SASSI-3
D. ASAM PPC-2R
Correct Answer: B
Rationale: The Michigan Alcoholism Screening Test (MAST) is a
screening tool specifically for alcohol. The DAST screens for drugs, the
SASSI is a comprehensive substance abuse screening instrument, and
the ASAM PPC is a placement criteria tool, not a screening tool.
,3. During a biopsychosocial assessment, a client reports a family
history of addiction. This information is MOST relevant to which
domain?
A. Psychological
B. Social
C. Biological/Genetic
D. Spiritual
Correct Answer: C
Rationale: Family history of addiction is a significant biological/genetic
risk factor. While it has social implications, the genetic predisposition to
substance use disorders is classified under the biological domain.
4. A client is referred for an assessment but is actively hallucinating.
The counselor should FIRST:
A. Ask the client to describe the hallucinations in detail for the
assessment.
B. Suspend the assessment and refer for a psychiatric evaluation.
C. Inform the client that they cannot be admitted until they are sober.
D. Administer the SASSI-3 to rule out malingering.
Correct Answer: B
Rationale: Active hallucinations indicate a severe psychiatric or medical
emergency (e.g., delirium tremens, psychosis). The assessment cannot
proceed safely; the client requires immediate medical/psychiatric
stabilization. This falls under the counselor's duty to refer for emergency
services.
5. What is the primary purpose of the ASAM Criteria (PPC-2R) in
the assessment phase?
A. To diagnose the specific substance used by the client.
B. To determine the client's motivation for change.
C. To match the client to the appropriate level of care (e.g., outpatient,
residential).
D. To assess the client's spiritual beliefs regarding recovery.
Correct Answer: C
Rationale: The ASAM Criteria is a multidimensional assessment tool
used to place clients into the appropriate level of care based on six
, dimensions (e.g., intoxication/withdrawal, biomedical conditions,
emotional/behavioral conditions).
6. A client refuses to sign the release of information form but wants
you to call their spouse. What should you do?
A. Call the spouse to encourage the client's treatment engagement.
B. Document the refusal and explain that you cannot share information
without a signed release.
C. Call the spouse but limit the conversation to general updates.
D. Call the spouse and inform them of the client's refusal.
Correct Answer: B
Rationale: Confidentiality is governed by 42 CFR Part 2 and HIPAA.
Without a signed release, the counselor is legally and ethically
prohibited from sharing any information with a third party, including the
spouse. The counselor must explain the policy and document the refusal.
7. A client reports they have been using "Oxys" for the past three
years. What should the counselor ask to clarify the assessment?
A. "Are you using anything else to manage withdrawal?"
B. "Is that OxyContin or Oxycodone, and are you taking it as
prescribed?"
C. "Why did you start using OxyContin?"
D. "Does your family know about this?"
Correct Answer: B
Rationale: "Oxys" is slang. The counselor needs to clarify the specific
substance (brand vs. generic) and the route of
administration/prescription status to complete an accurate diagnostic
assessment and assess for potential polysubstance use (e.g., fentanyl
contamination).
8. To establish a therapeutic alliance during the intake session, the
counselor should prioritize:
A. Strict adherence to agency policy.
B. Empathy, active listening, and a non-judgmental stance.
C. Confrontational questioning to break through denial.
D. Completing all paperwork in the first 15 minutes.
CERTIFICATION REAL EXAM QUUESTIONS
WITH CORRECT ANSWERS AND RATIONALES
LATEST 2026-2027 UPDATE
Domain I: Clinical Evaluation (Screening, Intake, & Assessment)
1. A client presents for their initial intake with slurred speech and
the odor of alcohol on their breath. What is the counselor's
PRIORITY action?
A. Complete the intake paperwork as scheduled.
B. Confront the client about their dishonesty.
C. Conduct a breathalyzer test and assess for medical emergency.
D. Administer the ASAM criteria to determine level of care.
Correct Answer: C
Rationale: Safety is the primary concern. A client under the influence
may be experiencing a medical emergency (e.g., overdose, withdrawal).
The counselor must assess the client's immediate medical stability (often
via breathalyzer/clinical observation) before proceeding with any
paperwork or psychosocial assessment.
2. Which of the following screening tools is specifically designed to
identify alcohol misuse and is widely used in clinical settings?
A. DAST-10
B. MAST
C. SASSI-3
D. ASAM PPC-2R
Correct Answer: B
Rationale: The Michigan Alcoholism Screening Test (MAST) is a
screening tool specifically for alcohol. The DAST screens for drugs, the
SASSI is a comprehensive substance abuse screening instrument, and
the ASAM PPC is a placement criteria tool, not a screening tool.
,3. During a biopsychosocial assessment, a client reports a family
history of addiction. This information is MOST relevant to which
domain?
A. Psychological
B. Social
C. Biological/Genetic
D. Spiritual
Correct Answer: C
Rationale: Family history of addiction is a significant biological/genetic
risk factor. While it has social implications, the genetic predisposition to
substance use disorders is classified under the biological domain.
4. A client is referred for an assessment but is actively hallucinating.
The counselor should FIRST:
A. Ask the client to describe the hallucinations in detail for the
assessment.
B. Suspend the assessment and refer for a psychiatric evaluation.
C. Inform the client that they cannot be admitted until they are sober.
D. Administer the SASSI-3 to rule out malingering.
Correct Answer: B
Rationale: Active hallucinations indicate a severe psychiatric or medical
emergency (e.g., delirium tremens, psychosis). The assessment cannot
proceed safely; the client requires immediate medical/psychiatric
stabilization. This falls under the counselor's duty to refer for emergency
services.
5. What is the primary purpose of the ASAM Criteria (PPC-2R) in
the assessment phase?
A. To diagnose the specific substance used by the client.
B. To determine the client's motivation for change.
C. To match the client to the appropriate level of care (e.g., outpatient,
residential).
D. To assess the client's spiritual beliefs regarding recovery.
Correct Answer: C
Rationale: The ASAM Criteria is a multidimensional assessment tool
used to place clients into the appropriate level of care based on six
, dimensions (e.g., intoxication/withdrawal, biomedical conditions,
emotional/behavioral conditions).
6. A client refuses to sign the release of information form but wants
you to call their spouse. What should you do?
A. Call the spouse to encourage the client's treatment engagement.
B. Document the refusal and explain that you cannot share information
without a signed release.
C. Call the spouse but limit the conversation to general updates.
D. Call the spouse and inform them of the client's refusal.
Correct Answer: B
Rationale: Confidentiality is governed by 42 CFR Part 2 and HIPAA.
Without a signed release, the counselor is legally and ethically
prohibited from sharing any information with a third party, including the
spouse. The counselor must explain the policy and document the refusal.
7. A client reports they have been using "Oxys" for the past three
years. What should the counselor ask to clarify the assessment?
A. "Are you using anything else to manage withdrawal?"
B. "Is that OxyContin or Oxycodone, and are you taking it as
prescribed?"
C. "Why did you start using OxyContin?"
D. "Does your family know about this?"
Correct Answer: B
Rationale: "Oxys" is slang. The counselor needs to clarify the specific
substance (brand vs. generic) and the route of
administration/prescription status to complete an accurate diagnostic
assessment and assess for potential polysubstance use (e.g., fentanyl
contamination).
8. To establish a therapeutic alliance during the intake session, the
counselor should prioritize:
A. Strict adherence to agency policy.
B. Empathy, active listening, and a non-judgmental stance.
C. Confrontational questioning to break through denial.
D. Completing all paperwork in the first 15 minutes.
