ASAM QUESTION BANK QUESTIONS
WITH CORRECT ANSWERS
1.4A432-year-
old4woman4is4being4evaluated4for4alcoholism.4This4is4her4first4time4in4treatment.4She4has4
a415-
year4history4of4alcohol4dependence.4Which4of4the4following4is4the4most4appropriate4medi
cation?4-4ans-✔✔Naltrexone
2.4A414-year-
old4boy4comes4to4the4office4for4an4annual4examination.4During4the4interview,4he4tells4his4
physician4that4he4has4switched4from4smoking4cigarettes4to4using4smokeless4tobacco4bec
ause4he4does4not4want4to4get4lung4cancer.4The4physician4should4tell4the4patient4that4he4i
s4now4at4increased4risk4for4cancer4of4which4of4the4following?4-4ans-✔✔Esophageal
3.4A432-year-
old4woman4comes4to4the4office4seeking4assistance4with4smoking4cessation.4She4has4sm
oked4two4packs4of4cigarettes4daily4for4the4past4eight4years.4She4has4attempted4to4quit4twi
ce4before4but4was4unable4to4overcome4the4withdrawal4symptoms.4She4is4using4a4nicotin
e4transdermal4system4to4assist4her4in4smoking4cessation.4Which4of4the4following4is4a4sid
e4effect4she4should4still4expect4to4experience4during4her4withdrawal4of4nicotine?4-4ans-
✔✔Impaired4reaction4time
4.4A442-year-
old4physician4who4specializes4in4ear,4nose,4and4throat4conditions4is4being4interviewed4for
4a4position4by4a4hospital.4She4has4active4licenses4in4Arizona,4Idaho,4and4Missouri4(her4la
st4place4of4residence4for4seven4years).4The4training4listed4on4her4CV4received4has4been4
verified4by4a4primary4source.4The4National4Data4Bank4contains4no4adverse4records.4Whi
ch4of4the4following4is4troublesome4to4require?4-4ans-✔✔Polygraph4test
5.4A445-year-
old4injection4drug4user4was4started4on4methadone4maintenance4one4month4prior4to4his4c
urrent4hospitalization4for4pneumonia.4On4a4routine4inpatient4electrocardiogram,4he4has4a4
prolonged4QT4interval.4In4addition4to4his4methadone4dose,4which4of4the4following4factors4
increases4his4risk4for4developing4an4arrhythmia?4-4ans-✔✔Hypokalemia
6.4A430-year-
old4woman4began4taking4alprazolam40.254mg4four4times4daily4two4weeks4ago4for4general
,ized4anxiety4disorder4(GAD).4She4now4has4increased4sedation4as4treatment4continues.4F
or4this4patient,4select4the4most4appropriate4term:4-4ans-✔✔Sensitization
7.4A445-year-
old4woman4who4has4been4taking4alprazolam40.54mg4four4times4daily4for4GAD4ruminates4
about4the4next4dose4beginning4two4hours4after4the4last4dose.4For4this4patient,4select4the4
most4appropriate4term:4-4ans-✔✔Pseudowithdrawal
8.4A445-year-
old4man4took4alprazolam4for4GAD4for4one4year.4He4was4weaned4off4the4medication4over4
a4three-
month4period.4Two4weeks4after4complete4cessation,4he4notices4increased4worry.4For4this
4patient,4select4the4most4appropriate4term:4-4ans-
✔✔Symptom4recurrence4(not4true4withdrawal)
9.4A445-year-
old4man4was4placed4on4alprazolam40.254mg4three4times4daily4for4GAD4and4treatment4wa
s4successful.4He4was4tapered4off4of4the4medication4over4three4months.4One4week4after4c
omplete4cessation,4he4is4tormented4by4anxiety4and4is4sleeping4only4two4hours4per4night.4
For4this4patient,4select4the4most4appropriate4term:4-4ans-
✔✔Rebound4(not4true4withdrawal)
10.4A436-year-old4man4who4has4a420-
year4history4of4smoking4cigarettes4comes4to4the4office4for4counseling4about4smoking4ces
sation.4He4has4heard4that4"light"4cigarettes4may4be4safer4and4less4addictive4and4asks4wh
ether4they4could4help4him4stop4smoking.4Which4of4the4following4statements4about4light4ci
garettes4is4supported4by4scientific4evidence?
4A:4Smokers4adjust4their4current4nicotine4level4by4adjusting4puffing4habits4-4ans-
✔✔Smokers4adjust4their4current4nicotine4level4by4adjusting4puffing4habits
11.4A450-year-
old4man4with4alcohol4dependency4is4hospitalized4with4signs4of4acute4withdrawal.4Which4
of4the4following4drugs4should4be4administered4to4prevent4Wernicke's4encephalopathy4in4t
his4patient?4-4ans-✔✔thiamine
12.4A425-year-
old4man4is4brought4to4the4emergency4department4by4his4partner4because4of4a4two-
day4history4of4agitation.4The4patient4says4he4left4his4work4early4because4his4boss4was4sp
ying4on4him.4His4speech4is4pressured.4He4says4he4has4been4taking4medication4for4the4pa
st4three4months.4His4partner4reports4that4the4patient4had4been4taking4more4than4the4pres
cribed4dose4because4he4was4preparing4for4a4college4examination.4Which4of4the4following
4medications4is4the4most4likely4cause4of4his4symptoms?4-4ans-✔✔methylphenidate
13.4A445-year-
old4man4has4jaundice4caused4by4chronic4alcohol4abuse.4His4physician4spends4several4m
inutes4asking4him4about4his4drinking4habits4and4encourages4him4to4consider4stopping4dri
,nking.4The4patient4is4not4ready4to4contemplate4stopping4at4that4visit,4but4the4physician4bri
ngs4up4the4topic4in4a4nonthreatening4manner4at4subsequent4visits4until4the4patient4decide
s4to4take4some4action4to4stop4drinking.4The4physician4then4offers4the4patient4several4choi
ces4for4accomplishing4that4goal.4This4framework4of4brief4interventions4to4promote4healthf
ul4behavior4is4known4as4which4of4the4following?4-4ans-✔✔motivational4interviewing
14.4A417-year-
old4boy4comes4to4the4office4for4a4sports4physical4examination.4When4asked4about4his4dru
g4and4alcohol4use,4he4discloses4that4he4recently4started4smoking4marijuana.4Which4of4th
e4following4is4the4most4likely4source4from4which4he4obtained4the4marijuana?4-4ans-
✔✔Friends
15.4A4retired4physician4works4eight4hours4per4week4at4a4private4general4medicine4clinic4i
n4a4rural4community.4The4practice4serves4primarily4economically4stable,4Medicare-
eligible4patients.4Recently,4the4physician4learned4and4implemented4a4new4diagnostic4test
4with4a4sensitivity4of491%4and4specificity4of494%4to4diagnose4a4disease.4However,4one4of4
the4physician's4patients4believes4he4has4been4incorrectly4diagnosed4as4a4result4of4this4te
st4and4retains4a4lawyer4to4file4a4suit4against4the4physician.4The4successful4court4argumen
t4against4the4use4of4the4test4by4the4physician4is4most4likely4based4on4which4of4the4followi
ng?4-4ans-✔✔Cases4in4the4population4per4year4(prevalence)
16.4Which4of4the4following4disorders4would4most4likely4benefit4from4treatment4with4canna
binoid4type414(CB1)4receptor4antagonists?4-4ans-
✔✔Obesity(ref4:4Trends4Neurosci.420064Feb414;4Links4Involvement4of4the4endocannabin
oid4system4in4drug4addiction.4Maldonado4R,4Valverde4O,4Berrendero4F.46:Gadde4KM.4En
docannabinoid4receptor4antagonists4and4other4emerging4pharma-
cological4strategies4for4weight4reduction.4Curr4Drug4Targets4Cardiovasc4Haematol4Disor
d.420054Dec;5(6):549-56.)
17.4A4patient4comes4to4the4emergency4department4because4he4is4"hearing4colors4and4s
melling4sounds."4He4reports4taking4an4unknown4substance4at4a4party4several4hours4ago.4
Vital4signs4show4increased4pulse4rate4and4blood4pressure.4The4patient4is4quite4agitated4a
nd4wants4these4effects4to4go4away.4Which4of4the4following4drugs4is4most4likely4to4cause4t
hese4effects?4-4ans-✔✔Lysergic4acid4diethylamide4(LSD)
18.4Which4of4the4following4neurotransmitters4is4most4closely4associated4with4the4function
4of4the4brain4reward4circuitry?4-4ans-✔✔Dopamine
19.4A419-year-
old4college4student4is4brought4to4the4emergency4department4after4using4drugs4for4the4firs
t4time.4He4says4he4initially4felt4as4if4he4was4"melting4through4the4floor,"4but4now4feels4as4if
4he4is4"floating4through4alternate4realities."4The4experience4lasts4about4one-
half4hour.4Which4of4the4following4substances4is4the4most4likely4cause4of4his4symptoms?4-
4ans-
✔✔Salvia(ref:4Lange4JE,4Reed4MB,4Croff4JM,4et4al:4College4student4use4of4Salvia4divinor
um.4Drug4Alcohol4Depend42008;94:263-266.)
, 20.4Which4of4the4following4problems4with4alcohol4is4likely4to4be4most4common4among4pat
ients4admitted4in4outpatient4settings?4-4ans-✔✔at-risk4drinking
21.4A425-year-
old4woman4who4has4just4given4birth4is4concerned4that4her4child4has4inherited4a4predispos
ition4for4smoking.4She4and4the4child's4father4have4recently4quit4smoking,4but4many4of4thei
r4first-4and4second-
degree4family4members4smoke.4The4risk4that4this4child4will4smoke4based4on4genetic4fact
ors4alone4is4closest4to4what4percentage?4-4ans-✔✔60%
(ref:4Reference:4Sullivan4PF,4Kendler4KS:4The4genetic4epidemiology4of4smoking.4Nicotin
e4Tob4Res41999;14Suppl42:4S51-S57.)
22.4A423-year-
old4man4is4currently4undergoing4treatment4for4heroin4dependence.4He4reports4that4his4he
roin4dealer4gave4him4a4small4supply4while4he4was4experiencing4withdrawal4symptoms.4T
he4patient4will4most4likely4perceive4heroin4as4which4of4the4following?4-4ans-
✔✔negative4reinforcement4(ref:4Molecular4Neuropharmacology,4Nestler,4et4al.420014p.43
56)
23.4A425-year-
old4man4is4abusing4a4drug4of4choice4daily4and4at4relatively4consistent4amounts.4Which4of4
the4following4drugs4is4he4most4likely4using?4-4ans-
✔✔heroin4(ref:4Molecular4Neuropharmacology,4Nestler,4et4al.420014p.4361)
24.4A448-year-
old4man4comes4for4consultation4after4seeing4light4trails4behind4moving4objects4and4havin
g4the4feeling4that4he4could4"smell4colors"4around4him.4These4symptoms4first4occurred4on
e4day4after4he4began4lifting4weights4to4relieve4work-
related4stress.4He4says4that4he4has4used4lysergic4acid4diethylamide4(LSD),4cocaine,4gam
ma-
hydroxybutyrate4(GHB),4kava4kava,4and4toluene4in4the4past.4Which4of4the4following4drug
s4is4most4likely4responsible?4-4ans-
✔✔LSD4(ref:4Weaver4MF,4Schnoll4SH.4Hallucinogens4and4club4drugs.4In4M.4Galanter4&4
H.4D.4Klebert4(Eds.),4Textbook4of4Substance4Abuse4Treatment,44th4Ed.,4Washington,4D.
C.:4American4Psychiatric4Press,4pp4191-200,42008)
25.4A448-year-
old4man4comes4for4consultation4after4seeing4light4trails4behind4moving4objects4and4havin
g4the4feeling4that4he4could4"smell4colors"4around4him.4These4symptoms4first4occurred4on
e4day4after4he4began4lifting4weights4to4relieve4work-
related4stress.4He4says4that4he4has4used4lysergic4acid4diethylamide4(LSD),4cocaine,4gam
ma-
hydroxybutyrate4(GHB),4kava4kava,4and4toluene4in4the4past.4Within4which4of4the4followin
g4time4frames4did4this4patient4most4likely4use4this4drug?4-4ans-
✔✔one4year4(same4ref4as423)
WITH CORRECT ANSWERS
1.4A432-year-
old4woman4is4being4evaluated4for4alcoholism.4This4is4her4first4time4in4treatment.4She4has4
a415-
year4history4of4alcohol4dependence.4Which4of4the4following4is4the4most4appropriate4medi
cation?4-4ans-✔✔Naltrexone
2.4A414-year-
old4boy4comes4to4the4office4for4an4annual4examination.4During4the4interview,4he4tells4his4
physician4that4he4has4switched4from4smoking4cigarettes4to4using4smokeless4tobacco4bec
ause4he4does4not4want4to4get4lung4cancer.4The4physician4should4tell4the4patient4that4he4i
s4now4at4increased4risk4for4cancer4of4which4of4the4following?4-4ans-✔✔Esophageal
3.4A432-year-
old4woman4comes4to4the4office4seeking4assistance4with4smoking4cessation.4She4has4sm
oked4two4packs4of4cigarettes4daily4for4the4past4eight4years.4She4has4attempted4to4quit4twi
ce4before4but4was4unable4to4overcome4the4withdrawal4symptoms.4She4is4using4a4nicotin
e4transdermal4system4to4assist4her4in4smoking4cessation.4Which4of4the4following4is4a4sid
e4effect4she4should4still4expect4to4experience4during4her4withdrawal4of4nicotine?4-4ans-
✔✔Impaired4reaction4time
4.4A442-year-
old4physician4who4specializes4in4ear,4nose,4and4throat4conditions4is4being4interviewed4for
4a4position4by4a4hospital.4She4has4active4licenses4in4Arizona,4Idaho,4and4Missouri4(her4la
st4place4of4residence4for4seven4years).4The4training4listed4on4her4CV4received4has4been4
verified4by4a4primary4source.4The4National4Data4Bank4contains4no4adverse4records.4Whi
ch4of4the4following4is4troublesome4to4require?4-4ans-✔✔Polygraph4test
5.4A445-year-
old4injection4drug4user4was4started4on4methadone4maintenance4one4month4prior4to4his4c
urrent4hospitalization4for4pneumonia.4On4a4routine4inpatient4electrocardiogram,4he4has4a4
prolonged4QT4interval.4In4addition4to4his4methadone4dose,4which4of4the4following4factors4
increases4his4risk4for4developing4an4arrhythmia?4-4ans-✔✔Hypokalemia
6.4A430-year-
old4woman4began4taking4alprazolam40.254mg4four4times4daily4two4weeks4ago4for4general
,ized4anxiety4disorder4(GAD).4She4now4has4increased4sedation4as4treatment4continues.4F
or4this4patient,4select4the4most4appropriate4term:4-4ans-✔✔Sensitization
7.4A445-year-
old4woman4who4has4been4taking4alprazolam40.54mg4four4times4daily4for4GAD4ruminates4
about4the4next4dose4beginning4two4hours4after4the4last4dose.4For4this4patient,4select4the4
most4appropriate4term:4-4ans-✔✔Pseudowithdrawal
8.4A445-year-
old4man4took4alprazolam4for4GAD4for4one4year.4He4was4weaned4off4the4medication4over4
a4three-
month4period.4Two4weeks4after4complete4cessation,4he4notices4increased4worry.4For4this
4patient,4select4the4most4appropriate4term:4-4ans-
✔✔Symptom4recurrence4(not4true4withdrawal)
9.4A445-year-
old4man4was4placed4on4alprazolam40.254mg4three4times4daily4for4GAD4and4treatment4wa
s4successful.4He4was4tapered4off4of4the4medication4over4three4months.4One4week4after4c
omplete4cessation,4he4is4tormented4by4anxiety4and4is4sleeping4only4two4hours4per4night.4
For4this4patient,4select4the4most4appropriate4term:4-4ans-
✔✔Rebound4(not4true4withdrawal)
10.4A436-year-old4man4who4has4a420-
year4history4of4smoking4cigarettes4comes4to4the4office4for4counseling4about4smoking4ces
sation.4He4has4heard4that4"light"4cigarettes4may4be4safer4and4less4addictive4and4asks4wh
ether4they4could4help4him4stop4smoking.4Which4of4the4following4statements4about4light4ci
garettes4is4supported4by4scientific4evidence?
4A:4Smokers4adjust4their4current4nicotine4level4by4adjusting4puffing4habits4-4ans-
✔✔Smokers4adjust4their4current4nicotine4level4by4adjusting4puffing4habits
11.4A450-year-
old4man4with4alcohol4dependency4is4hospitalized4with4signs4of4acute4withdrawal.4Which4
of4the4following4drugs4should4be4administered4to4prevent4Wernicke's4encephalopathy4in4t
his4patient?4-4ans-✔✔thiamine
12.4A425-year-
old4man4is4brought4to4the4emergency4department4by4his4partner4because4of4a4two-
day4history4of4agitation.4The4patient4says4he4left4his4work4early4because4his4boss4was4sp
ying4on4him.4His4speech4is4pressured.4He4says4he4has4been4taking4medication4for4the4pa
st4three4months.4His4partner4reports4that4the4patient4had4been4taking4more4than4the4pres
cribed4dose4because4he4was4preparing4for4a4college4examination.4Which4of4the4following
4medications4is4the4most4likely4cause4of4his4symptoms?4-4ans-✔✔methylphenidate
13.4A445-year-
old4man4has4jaundice4caused4by4chronic4alcohol4abuse.4His4physician4spends4several4m
inutes4asking4him4about4his4drinking4habits4and4encourages4him4to4consider4stopping4dri
,nking.4The4patient4is4not4ready4to4contemplate4stopping4at4that4visit,4but4the4physician4bri
ngs4up4the4topic4in4a4nonthreatening4manner4at4subsequent4visits4until4the4patient4decide
s4to4take4some4action4to4stop4drinking.4The4physician4then4offers4the4patient4several4choi
ces4for4accomplishing4that4goal.4This4framework4of4brief4interventions4to4promote4healthf
ul4behavior4is4known4as4which4of4the4following?4-4ans-✔✔motivational4interviewing
14.4A417-year-
old4boy4comes4to4the4office4for4a4sports4physical4examination.4When4asked4about4his4dru
g4and4alcohol4use,4he4discloses4that4he4recently4started4smoking4marijuana.4Which4of4th
e4following4is4the4most4likely4source4from4which4he4obtained4the4marijuana?4-4ans-
✔✔Friends
15.4A4retired4physician4works4eight4hours4per4week4at4a4private4general4medicine4clinic4i
n4a4rural4community.4The4practice4serves4primarily4economically4stable,4Medicare-
eligible4patients.4Recently,4the4physician4learned4and4implemented4a4new4diagnostic4test
4with4a4sensitivity4of491%4and4specificity4of494%4to4diagnose4a4disease.4However,4one4of4
the4physician's4patients4believes4he4has4been4incorrectly4diagnosed4as4a4result4of4this4te
st4and4retains4a4lawyer4to4file4a4suit4against4the4physician.4The4successful4court4argumen
t4against4the4use4of4the4test4by4the4physician4is4most4likely4based4on4which4of4the4followi
ng?4-4ans-✔✔Cases4in4the4population4per4year4(prevalence)
16.4Which4of4the4following4disorders4would4most4likely4benefit4from4treatment4with4canna
binoid4type414(CB1)4receptor4antagonists?4-4ans-
✔✔Obesity(ref4:4Trends4Neurosci.420064Feb414;4Links4Involvement4of4the4endocannabin
oid4system4in4drug4addiction.4Maldonado4R,4Valverde4O,4Berrendero4F.46:Gadde4KM.4En
docannabinoid4receptor4antagonists4and4other4emerging4pharma-
cological4strategies4for4weight4reduction.4Curr4Drug4Targets4Cardiovasc4Haematol4Disor
d.420054Dec;5(6):549-56.)
17.4A4patient4comes4to4the4emergency4department4because4he4is4"hearing4colors4and4s
melling4sounds."4He4reports4taking4an4unknown4substance4at4a4party4several4hours4ago.4
Vital4signs4show4increased4pulse4rate4and4blood4pressure.4The4patient4is4quite4agitated4a
nd4wants4these4effects4to4go4away.4Which4of4the4following4drugs4is4most4likely4to4cause4t
hese4effects?4-4ans-✔✔Lysergic4acid4diethylamide4(LSD)
18.4Which4of4the4following4neurotransmitters4is4most4closely4associated4with4the4function
4of4the4brain4reward4circuitry?4-4ans-✔✔Dopamine
19.4A419-year-
old4college4student4is4brought4to4the4emergency4department4after4using4drugs4for4the4firs
t4time.4He4says4he4initially4felt4as4if4he4was4"melting4through4the4floor,"4but4now4feels4as4if
4he4is4"floating4through4alternate4realities."4The4experience4lasts4about4one-
half4hour.4Which4of4the4following4substances4is4the4most4likely4cause4of4his4symptoms?4-
4ans-
✔✔Salvia(ref:4Lange4JE,4Reed4MB,4Croff4JM,4et4al:4College4student4use4of4Salvia4divinor
um.4Drug4Alcohol4Depend42008;94:263-266.)
, 20.4Which4of4the4following4problems4with4alcohol4is4likely4to4be4most4common4among4pat
ients4admitted4in4outpatient4settings?4-4ans-✔✔at-risk4drinking
21.4A425-year-
old4woman4who4has4just4given4birth4is4concerned4that4her4child4has4inherited4a4predispos
ition4for4smoking.4She4and4the4child's4father4have4recently4quit4smoking,4but4many4of4thei
r4first-4and4second-
degree4family4members4smoke.4The4risk4that4this4child4will4smoke4based4on4genetic4fact
ors4alone4is4closest4to4what4percentage?4-4ans-✔✔60%
(ref:4Reference:4Sullivan4PF,4Kendler4KS:4The4genetic4epidemiology4of4smoking.4Nicotin
e4Tob4Res41999;14Suppl42:4S51-S57.)
22.4A423-year-
old4man4is4currently4undergoing4treatment4for4heroin4dependence.4He4reports4that4his4he
roin4dealer4gave4him4a4small4supply4while4he4was4experiencing4withdrawal4symptoms.4T
he4patient4will4most4likely4perceive4heroin4as4which4of4the4following?4-4ans-
✔✔negative4reinforcement4(ref:4Molecular4Neuropharmacology,4Nestler,4et4al.420014p.43
56)
23.4A425-year-
old4man4is4abusing4a4drug4of4choice4daily4and4at4relatively4consistent4amounts.4Which4of4
the4following4drugs4is4he4most4likely4using?4-4ans-
✔✔heroin4(ref:4Molecular4Neuropharmacology,4Nestler,4et4al.420014p.4361)
24.4A448-year-
old4man4comes4for4consultation4after4seeing4light4trails4behind4moving4objects4and4havin
g4the4feeling4that4he4could4"smell4colors"4around4him.4These4symptoms4first4occurred4on
e4day4after4he4began4lifting4weights4to4relieve4work-
related4stress.4He4says4that4he4has4used4lysergic4acid4diethylamide4(LSD),4cocaine,4gam
ma-
hydroxybutyrate4(GHB),4kava4kava,4and4toluene4in4the4past.4Which4of4the4following4drug
s4is4most4likely4responsible?4-4ans-
✔✔LSD4(ref:4Weaver4MF,4Schnoll4SH.4Hallucinogens4and4club4drugs.4In4M.4Galanter4&4
H.4D.4Klebert4(Eds.),4Textbook4of4Substance4Abuse4Treatment,44th4Ed.,4Washington,4D.
C.:4American4Psychiatric4Press,4pp4191-200,42008)
25.4A448-year-
old4man4comes4for4consultation4after4seeing4light4trails4behind4moving4objects4and4havin
g4the4feeling4that4he4could4"smell4colors"4around4him.4These4symptoms4first4occurred4on
e4day4after4he4began4lifting4weights4to4relieve4work-
related4stress.4He4says4that4he4has4used4lysergic4acid4diethylamide4(LSD),4cocaine,4gam
ma-
hydroxybutyrate4(GHB),4kava4kava,4and4toluene4in4the4past.4Within4which4of4the4followin
g4time4frames4did4this4patient4most4likely4use4this4drug?4-4ans-
✔✔one4year4(same4ref4as423)
