ASAM QUESTION BANK QUESTIONS
WITH CORRECT ANSWERS
1.6A632-year-
old6woman6is6being6evaluated6for6alcoholism.6This6is6her6first6time6in6treatment.6She6has6
a615-
year6history6of6alcohol6dependence.6Which6of6the6following6is6the6most6appropriate6medi
cation?6-6ans-✔✔Naltrexone
2.6A614-year-
old6boy6comes6to6the6office6for6an6annual6examination.6During6the6interview,6he6tells6his6
physician6that6he6has6switched6from6smoking6cigarettes6to6using6smokeless6tobacco6bec
ause6he6does6not6want6to6get6lung6cancer.6The6physician6should6tell6the6patient6that6he6i
s6now6at6increased6risk6for6cancer6of6which6of6the6following?6-6ans-✔✔Esophageal
3.6A632-year-
old6woman6comes6to6the6office6seeking6assistance6with6smoking6cessation.6She6has6sm
oked6two6packs6of6cigarettes6daily6for6the6past6eight6years.6She6has6attempted6to6quit6twi
ce6before6but6was6unable6to6overcome6the6withdrawal6symptoms.6She6is6using6a6nicotin
e6transdermal6system6to6assist6her6in6smoking6cessation.6Which6of6the6following6is6a6sid
e6effect6she6should6still6expect6to6experience6during6her6withdrawal6of6nicotine?6-6ans-
✔✔Impaired6reaction6time
4.6A642-year-
old6physician6who6specializes6in6ear,6nose,6and6throat6conditions6is6being6interviewed6for
6a6position6by6a6hospital.6She6has6active6licenses6in6Arizona,6Idaho,6and6Missouri6(her6la
st6place6of6residence6for6seven6years).6The6training6listed6on6her6CV6received6has6been6
verified6by6a6primary6source.6The6National6Data6Bank6contains6no6adverse6records.6Whi
ch6of6the6following6is6troublesome6to6require?6-6ans-✔✔Polygraph6test
5.6A645-year-
old6injection6drug6user6was6started6on6methadone6maintenance6one6month6prior6to6his6c
urrent6hospitalization6for6pneumonia.6On6a6routine6inpatient6electrocardiogram,6he6has6a6
prolonged6QT6interval.6In6addition6to6his6methadone6dose,6which6of6the6following6factors6
increases6his6risk6for6developing6an6arrhythmia?6-6ans-✔✔Hypokalemia
6.6A630-year-
old6woman6began6taking6alprazolam60.256mg6four6times6daily6two6weeks6ago6for6general
ized6anxiety6disorder6(GAD).6She6now6has6increased6sedation6as6treatment6continues.6F
or6this6patient,6select6the6most6appropriate6term:6-6ans-✔✔Sensitization
,7.6A645-year-
old6woman6who6has6been6taking6alprazolam60.56mg6four6times6daily6for6GAD6ruminates6
about6the6next6dose6beginning6two6hours6after6the6last6dose.6For6this6patient,6select6the6
most6appropriate6term:6-6ans-✔✔Pseudowithdrawal
8.6A645-year-
old6man6took6alprazolam6for6GAD6for6one6year.6He6was6weaned6off6the6medication6over6
a6three-
month6period.6Two6weeks6after6complete6cessation,6he6notices6increased6worry.6For6this
6patient,6select6the6most6appropriate6term:6-6ans-
✔✔Symptom6recurrence6(not6true6withdrawal)
9.6A645-year-
old6man6was6placed6on6alprazolam60.256mg6three6times6daily6for6GAD6and6treatment6wa
s6successful.6He6was6tapered6off6of6the6medication6over6three6months.6One6week6after6c
omplete6cessation,6he6is6tormented6by6anxiety6and6is6sleeping6only6two6hours6per6night.6
For6this6patient,6select6the6most6appropriate6term:6-6ans-
✔✔Rebound6(not6true6withdrawal)
10.6A636-year-old6man6who6has6a620-
year6history6of6smoking6cigarettes6comes6to6the6office6for6counseling6about6smoking6ces
sation.6He6has6heard6that6"light"6cigarettes6may6be6safer6and6less6addictive6and6asks6wh
ether6they6could6help6him6stop6smoking.6Which6of6the6following6statements6about6light6ci
garettes6is6supported6by6scientific6evidence?
6A:6Smokers6adjust6their6current6nicotine6level6by6adjusting6puffing6habits6-6ans-
✔✔Smokers6adjust6their6current6nicotine6level6by6adjusting6puffing6habits
11.6A650-year-
old6man6with6alcohol6dependency6is6hospitalized6with6signs6of6acute6withdrawal.6Which6
of6the6following6drugs6should6be6administered6to6prevent6Wernicke's6encephalopathy6in6t
his6patient?6-6ans-✔✔thiamine
12.6A625-year-
old6man6is6brought6to6the6emergency6department6by6his6partner6because6of6a6two-
day6history6of6agitation.6The6patient6says6he6left6his6work6early6because6his6boss6was6sp
ying6on6him.6His6speech6is6pressured.6He6says6he6has6been6taking6medication6for6the6pa
st6three6months.6His6partner6reports6that6the6patient6had6been6taking6more6than6the6pres
cribed6dose6because6he6was6preparing6for6a6college6examination.6Which6of6the6following
6medications6is6the6most6likely6cause6of6his6symptoms?6-6ans-✔✔methylphenidate
13.6A645-year-
old6man6has6jaundice6caused6by6chronic6alcohol6abuse.6His6physician6spends6several6m
inutes6asking6him6about6his6drinking6habits6and6encourages6him6to6consider6stopping6dri
nking.6The6patient6is6not6ready6to6contemplate6stopping6at6that6visit,6but6the6physician6bri
ngs6up6the6topic6in6a6nonthreatening6manner6at6subsequent6visits6until6the6patient6decide
,s6to6take6some6action6to6stop6drinking.6The6physician6then6offers6the6patient6several6choi
ces6for6accomplishing6that6goal.6This6framework6of6brief6interventions6to6promote6healthf
ul6behavior6is6known6as6which6of6the6following?6-6ans-✔✔motivational6interviewing
14.6A617-year-
old6boy6comes6to6the6office6for6a6sports6physical6examination.6When6asked6about6his6dru
g6and6alcohol6use,6he6discloses6that6he6recently6started6smoking6marijuana.6Which6of6th
e6following6is6the6most6likely6source6from6which6he6obtained6the6marijuana?6-6ans-
✔✔Friends
15.6A6retired6physician6works6eight6hours6per6week6at6a6private6general6medicine6clinic6i
n6a6rural6community.6The6practice6serves6primarily6economically6stable,6Medicare-
eligible6patients.6Recently,6the6physician6learned6and6implemented6a6new6diagnostic6test
6with6a6sensitivity6of691%6and6specificity6of694%6to6diagnose6a6disease.6However,6one6of6
the6physician's6patients6believes6he6has6been6incorrectly6diagnosed6as6a6result6of6this6te
st6and6retains6a6lawyer6to6file6a6suit6against6the6physician.6The6successful6court6argumen
t6against6the6use6of6the6test6by6the6physician6is6most6likely6based6on6which6of6the6followi
ng?6-6ans-✔✔Cases6in6the6population6per6year6(prevalence)
16.6Which6of6the6following6disorders6would6most6likely6benefit6from6treatment6with6canna
binoid6type616(CB1)6receptor6antagonists?6-6ans-
✔✔Obesity(ref6:6Trends6Neurosci.620066Feb614;6Links6Involvement6of6the6endocannabin
oid6system6in6drug6addiction.6Maldonado6R,6Valverde6O,6Berrendero6F.66:Gadde6KM.6En
docannabinoid6receptor6antagonists6and6other6emerging6pharma-
cological6strategies6for6weight6reduction.6Curr6Drug6Targets6Cardiovasc6Haematol6Disor
d.620056Dec;5(6):549-56.)
17.6A6patient6comes6to6the6emergency6department6because6he6is6"hearing6colors6and6s
melling6sounds."6He6reports6taking6an6unknown6substance6at6a6party6several6hours6ago.6
Vital6signs6show6increased6pulse6rate6and6blood6pressure.6The6patient6is6quite6agitated6a
nd6wants6these6effects6to6go6away.6Which6of6the6following6drugs6is6most6likely6to6cause6t
hese6effects?6-6ans-✔✔Lysergic6acid6diethylamide6(LSD)
18.6Which6of6the6following6neurotransmitters6is6most6closely6associated6with6the6function
6of6the6brain6reward6circuitry?6-6ans-✔✔Dopamine
19.6A619-year-
old6college6student6is6brought6to6the6emergency6department6after6using6drugs6for6the6firs
t6time.6He6says6he6initially6felt6as6if6he6was6"melting6through6the6floor,"6but6now6feels6as6if
6he6is6"floating6through6alternate6realities."6The6experience6lasts6about6one-
half6hour.6Which6of6the6following6substances6is6the6most6likely6cause6of6his6symptoms?6-
6ans-
✔✔Salvia(ref:6Lange6JE,6Reed6MB,6Croff6JM,6et6al:6College6student6use6of6Salvia6divinor
um.6Drug6Alcohol6Depend62008;94:263-266.)
, 20.6Which6of6the6following6problems6with6alcohol6is6likely6to6be6most6common6among6pat
ients6admitted6in6outpatient6settings?6-6ans-✔✔at-risk6drinking
21.6A625-year-
old6woman6who6has6just6given6birth6is6concerned6that6her6child6has6inherited6a6predispos
ition6for6smoking.6She6and6the6child's6father6have6recently6quit6smoking,6but6many6of6thei
r6first-6and6second-
degree6family6members6smoke.6The6risk6that6this6child6will6smoke6based6on6genetic6fact
ors6alone6is6closest6to6what6percentage?6-6ans-✔✔60%
(ref:6Reference:6Sullivan6PF,6Kendler6KS:6The6genetic6epidemiology6of6smoking.6Nicotin
e6Tob6Res61999;16Suppl62:6S51-S57.)
22.6A623-year-
old6man6is6currently6undergoing6treatment6for6heroin6dependence.6He6reports6that6his6he
roin6dealer6gave6him6a6small6supply6while6he6was6experiencing6withdrawal6symptoms.6T
he6patient6will6most6likely6perceive6heroin6as6which6of6the6following?6-6ans-
✔✔negative6reinforcement6(ref:6Molecular6Neuropharmacology,6Nestler,6et6al.620016p.63
56)
23.6A625-year-
old6man6is6abusing6a6drug6of6choice6daily6and6at6relatively6consistent6amounts.6Which6of6
the6following6drugs6is6he6most6likely6using?6-6ans-
✔✔heroin6(ref:6Molecular6Neuropharmacology,6Nestler,6et6al.620016p.6361)
24.6A648-year-
old6man6comes6for6consultation6after6seeing6light6trails6behind6moving6objects6and6havin
g6the6feeling6that6he6could6"smell6colors"6around6him.6These6symptoms6first6occurred6on
e6day6after6he6began6lifting6weights6to6relieve6work-
related6stress.6He6says6that6he6has6used6lysergic6acid6diethylamide6(LSD),6cocaine,6gam
ma-
hydroxybutyrate6(GHB),6kava6kava,6and6toluene6in6the6past.6Which6of6the6following6drug
s6is6most6likely6responsible?6-6ans-
✔✔LSD6(ref:6Weaver6MF,6Schnoll6SH.6Hallucinogens6and6club6drugs.6In6M.6Galanter6&6
H.6D.6Klebert6(Eds.),6Textbook6of6Substance6Abuse6Treatment,64th6Ed.,6Washington,6D.
C.:6American6Psychiatric6Press,6pp6191-200,62008)
25.6A648-year-
old6man6comes6for6consultation6after6seeing6light6trails6behind6moving6objects6and6havin
g6the6feeling6that6he6could6"smell6colors"6around6him.6These6symptoms6first6occurred6on
e6day6after6he6began6lifting6weights6to6relieve6work-
related6stress.6He6says6that6he6has6used6lysergic6acid6diethylamide6(LSD),6cocaine,6gam
ma-
hydroxybutyrate6(GHB),6kava6kava,6and6toluene6in6the6past.6Within6which6of6the6followin
g6time6frames6did6this6patient6most6likely6use6this6drug?6-6ans-
✔✔one6year6(same6ref6as623)
WITH CORRECT ANSWERS
1.6A632-year-
old6woman6is6being6evaluated6for6alcoholism.6This6is6her6first6time6in6treatment.6She6has6
a615-
year6history6of6alcohol6dependence.6Which6of6the6following6is6the6most6appropriate6medi
cation?6-6ans-✔✔Naltrexone
2.6A614-year-
old6boy6comes6to6the6office6for6an6annual6examination.6During6the6interview,6he6tells6his6
physician6that6he6has6switched6from6smoking6cigarettes6to6using6smokeless6tobacco6bec
ause6he6does6not6want6to6get6lung6cancer.6The6physician6should6tell6the6patient6that6he6i
s6now6at6increased6risk6for6cancer6of6which6of6the6following?6-6ans-✔✔Esophageal
3.6A632-year-
old6woman6comes6to6the6office6seeking6assistance6with6smoking6cessation.6She6has6sm
oked6two6packs6of6cigarettes6daily6for6the6past6eight6years.6She6has6attempted6to6quit6twi
ce6before6but6was6unable6to6overcome6the6withdrawal6symptoms.6She6is6using6a6nicotin
e6transdermal6system6to6assist6her6in6smoking6cessation.6Which6of6the6following6is6a6sid
e6effect6she6should6still6expect6to6experience6during6her6withdrawal6of6nicotine?6-6ans-
✔✔Impaired6reaction6time
4.6A642-year-
old6physician6who6specializes6in6ear,6nose,6and6throat6conditions6is6being6interviewed6for
6a6position6by6a6hospital.6She6has6active6licenses6in6Arizona,6Idaho,6and6Missouri6(her6la
st6place6of6residence6for6seven6years).6The6training6listed6on6her6CV6received6has6been6
verified6by6a6primary6source.6The6National6Data6Bank6contains6no6adverse6records.6Whi
ch6of6the6following6is6troublesome6to6require?6-6ans-✔✔Polygraph6test
5.6A645-year-
old6injection6drug6user6was6started6on6methadone6maintenance6one6month6prior6to6his6c
urrent6hospitalization6for6pneumonia.6On6a6routine6inpatient6electrocardiogram,6he6has6a6
prolonged6QT6interval.6In6addition6to6his6methadone6dose,6which6of6the6following6factors6
increases6his6risk6for6developing6an6arrhythmia?6-6ans-✔✔Hypokalemia
6.6A630-year-
old6woman6began6taking6alprazolam60.256mg6four6times6daily6two6weeks6ago6for6general
ized6anxiety6disorder6(GAD).6She6now6has6increased6sedation6as6treatment6continues.6F
or6this6patient,6select6the6most6appropriate6term:6-6ans-✔✔Sensitization
,7.6A645-year-
old6woman6who6has6been6taking6alprazolam60.56mg6four6times6daily6for6GAD6ruminates6
about6the6next6dose6beginning6two6hours6after6the6last6dose.6For6this6patient,6select6the6
most6appropriate6term:6-6ans-✔✔Pseudowithdrawal
8.6A645-year-
old6man6took6alprazolam6for6GAD6for6one6year.6He6was6weaned6off6the6medication6over6
a6three-
month6period.6Two6weeks6after6complete6cessation,6he6notices6increased6worry.6For6this
6patient,6select6the6most6appropriate6term:6-6ans-
✔✔Symptom6recurrence6(not6true6withdrawal)
9.6A645-year-
old6man6was6placed6on6alprazolam60.256mg6three6times6daily6for6GAD6and6treatment6wa
s6successful.6He6was6tapered6off6of6the6medication6over6three6months.6One6week6after6c
omplete6cessation,6he6is6tormented6by6anxiety6and6is6sleeping6only6two6hours6per6night.6
For6this6patient,6select6the6most6appropriate6term:6-6ans-
✔✔Rebound6(not6true6withdrawal)
10.6A636-year-old6man6who6has6a620-
year6history6of6smoking6cigarettes6comes6to6the6office6for6counseling6about6smoking6ces
sation.6He6has6heard6that6"light"6cigarettes6may6be6safer6and6less6addictive6and6asks6wh
ether6they6could6help6him6stop6smoking.6Which6of6the6following6statements6about6light6ci
garettes6is6supported6by6scientific6evidence?
6A:6Smokers6adjust6their6current6nicotine6level6by6adjusting6puffing6habits6-6ans-
✔✔Smokers6adjust6their6current6nicotine6level6by6adjusting6puffing6habits
11.6A650-year-
old6man6with6alcohol6dependency6is6hospitalized6with6signs6of6acute6withdrawal.6Which6
of6the6following6drugs6should6be6administered6to6prevent6Wernicke's6encephalopathy6in6t
his6patient?6-6ans-✔✔thiamine
12.6A625-year-
old6man6is6brought6to6the6emergency6department6by6his6partner6because6of6a6two-
day6history6of6agitation.6The6patient6says6he6left6his6work6early6because6his6boss6was6sp
ying6on6him.6His6speech6is6pressured.6He6says6he6has6been6taking6medication6for6the6pa
st6three6months.6His6partner6reports6that6the6patient6had6been6taking6more6than6the6pres
cribed6dose6because6he6was6preparing6for6a6college6examination.6Which6of6the6following
6medications6is6the6most6likely6cause6of6his6symptoms?6-6ans-✔✔methylphenidate
13.6A645-year-
old6man6has6jaundice6caused6by6chronic6alcohol6abuse.6His6physician6spends6several6m
inutes6asking6him6about6his6drinking6habits6and6encourages6him6to6consider6stopping6dri
nking.6The6patient6is6not6ready6to6contemplate6stopping6at6that6visit,6but6the6physician6bri
ngs6up6the6topic6in6a6nonthreatening6manner6at6subsequent6visits6until6the6patient6decide
,s6to6take6some6action6to6stop6drinking.6The6physician6then6offers6the6patient6several6choi
ces6for6accomplishing6that6goal.6This6framework6of6brief6interventions6to6promote6healthf
ul6behavior6is6known6as6which6of6the6following?6-6ans-✔✔motivational6interviewing
14.6A617-year-
old6boy6comes6to6the6office6for6a6sports6physical6examination.6When6asked6about6his6dru
g6and6alcohol6use,6he6discloses6that6he6recently6started6smoking6marijuana.6Which6of6th
e6following6is6the6most6likely6source6from6which6he6obtained6the6marijuana?6-6ans-
✔✔Friends
15.6A6retired6physician6works6eight6hours6per6week6at6a6private6general6medicine6clinic6i
n6a6rural6community.6The6practice6serves6primarily6economically6stable,6Medicare-
eligible6patients.6Recently,6the6physician6learned6and6implemented6a6new6diagnostic6test
6with6a6sensitivity6of691%6and6specificity6of694%6to6diagnose6a6disease.6However,6one6of6
the6physician's6patients6believes6he6has6been6incorrectly6diagnosed6as6a6result6of6this6te
st6and6retains6a6lawyer6to6file6a6suit6against6the6physician.6The6successful6court6argumen
t6against6the6use6of6the6test6by6the6physician6is6most6likely6based6on6which6of6the6followi
ng?6-6ans-✔✔Cases6in6the6population6per6year6(prevalence)
16.6Which6of6the6following6disorders6would6most6likely6benefit6from6treatment6with6canna
binoid6type616(CB1)6receptor6antagonists?6-6ans-
✔✔Obesity(ref6:6Trends6Neurosci.620066Feb614;6Links6Involvement6of6the6endocannabin
oid6system6in6drug6addiction.6Maldonado6R,6Valverde6O,6Berrendero6F.66:Gadde6KM.6En
docannabinoid6receptor6antagonists6and6other6emerging6pharma-
cological6strategies6for6weight6reduction.6Curr6Drug6Targets6Cardiovasc6Haematol6Disor
d.620056Dec;5(6):549-56.)
17.6A6patient6comes6to6the6emergency6department6because6he6is6"hearing6colors6and6s
melling6sounds."6He6reports6taking6an6unknown6substance6at6a6party6several6hours6ago.6
Vital6signs6show6increased6pulse6rate6and6blood6pressure.6The6patient6is6quite6agitated6a
nd6wants6these6effects6to6go6away.6Which6of6the6following6drugs6is6most6likely6to6cause6t
hese6effects?6-6ans-✔✔Lysergic6acid6diethylamide6(LSD)
18.6Which6of6the6following6neurotransmitters6is6most6closely6associated6with6the6function
6of6the6brain6reward6circuitry?6-6ans-✔✔Dopamine
19.6A619-year-
old6college6student6is6brought6to6the6emergency6department6after6using6drugs6for6the6firs
t6time.6He6says6he6initially6felt6as6if6he6was6"melting6through6the6floor,"6but6now6feels6as6if
6he6is6"floating6through6alternate6realities."6The6experience6lasts6about6one-
half6hour.6Which6of6the6following6substances6is6the6most6likely6cause6of6his6symptoms?6-
6ans-
✔✔Salvia(ref:6Lange6JE,6Reed6MB,6Croff6JM,6et6al:6College6student6use6of6Salvia6divinor
um.6Drug6Alcohol6Depend62008;94:263-266.)
, 20.6Which6of6the6following6problems6with6alcohol6is6likely6to6be6most6common6among6pat
ients6admitted6in6outpatient6settings?6-6ans-✔✔at-risk6drinking
21.6A625-year-
old6woman6who6has6just6given6birth6is6concerned6that6her6child6has6inherited6a6predispos
ition6for6smoking.6She6and6the6child's6father6have6recently6quit6smoking,6but6many6of6thei
r6first-6and6second-
degree6family6members6smoke.6The6risk6that6this6child6will6smoke6based6on6genetic6fact
ors6alone6is6closest6to6what6percentage?6-6ans-✔✔60%
(ref:6Reference:6Sullivan6PF,6Kendler6KS:6The6genetic6epidemiology6of6smoking.6Nicotin
e6Tob6Res61999;16Suppl62:6S51-S57.)
22.6A623-year-
old6man6is6currently6undergoing6treatment6for6heroin6dependence.6He6reports6that6his6he
roin6dealer6gave6him6a6small6supply6while6he6was6experiencing6withdrawal6symptoms.6T
he6patient6will6most6likely6perceive6heroin6as6which6of6the6following?6-6ans-
✔✔negative6reinforcement6(ref:6Molecular6Neuropharmacology,6Nestler,6et6al.620016p.63
56)
23.6A625-year-
old6man6is6abusing6a6drug6of6choice6daily6and6at6relatively6consistent6amounts.6Which6of6
the6following6drugs6is6he6most6likely6using?6-6ans-
✔✔heroin6(ref:6Molecular6Neuropharmacology,6Nestler,6et6al.620016p.6361)
24.6A648-year-
old6man6comes6for6consultation6after6seeing6light6trails6behind6moving6objects6and6havin
g6the6feeling6that6he6could6"smell6colors"6around6him.6These6symptoms6first6occurred6on
e6day6after6he6began6lifting6weights6to6relieve6work-
related6stress.6He6says6that6he6has6used6lysergic6acid6diethylamide6(LSD),6cocaine,6gam
ma-
hydroxybutyrate6(GHB),6kava6kava,6and6toluene6in6the6past.6Which6of6the6following6drug
s6is6most6likely6responsible?6-6ans-
✔✔LSD6(ref:6Weaver6MF,6Schnoll6SH.6Hallucinogens6and6club6drugs.6In6M.6Galanter6&6
H.6D.6Klebert6(Eds.),6Textbook6of6Substance6Abuse6Treatment,64th6Ed.,6Washington,6D.
C.:6American6Psychiatric6Press,6pp6191-200,62008)
25.6A648-year-
old6man6comes6for6consultation6after6seeing6light6trails6behind6moving6objects6and6havin
g6the6feeling6that6he6could6"smell6colors"6around6him.6These6symptoms6first6occurred6on
e6day6after6he6began6lifting6weights6to6relieve6work-
related6stress.6He6says6that6he6has6used6lysergic6acid6diethylamide6(LSD),6cocaine,6gam
ma-
hydroxybutyrate6(GHB),6kava6kava,6and6toluene6in6the6past.6Within6which6of6the6followin
g6time6frames6did6this6patient6most6likely6use6this6drug?6-6ans-
✔✔one6year6(same6ref6as623)
