Maryland Addiction Counselor LCADC
Exam Practice Questions And Correct
Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
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1. A client with opioid use disorder presents in early recovery reporting
cravings, insomnia, and anxiety. Which neurobiological mechanism is
most responsible for these symptoms during withdrawal?
A. Increased serotonin synthesis in the prefrontal cortex
B. Suppression of the limbic reward pathway due to dopamine
depletion
C. Hyperactivation of the cerebellum affecting motor coordination only
D. Excess acetylcholine release in the spinal cord
Correct answer: B
Withdrawal symptoms in opioid use disorder are largely driven by
dysregulation of the brain’s reward circuitry, particularly reduced
dopamine activity in the mesolimbic pathway, which contributes to
craving, dysphoria, and autonomic symptoms.
2. A counselor working under Maryland LCADC regulations is most
directly governed by which source of legal authority?
A. Federal HIPAA guidelines only
, B. NAADAC ethical standards exclusively
C. COMAR regulations established by the Maryland Board of
Professional Counselors and Therapists
D. American Psychological Association practice guidelines
Correct answer: C
LCADC practice in Maryland is regulated through COMAR (Code of
Maryland Regulations), which defines scope of practice, supervision,
and licensure requirements enforced by the state board.
3. A client in substance use treatment frequently minimizes their use and
blames external circumstances for relapse. This pattern is most
consistent with which defense mechanism?
A. Sublimation
B. Projection
C. Rationalization
D. Reaction formation
Correct answer: C
Rationalization involves creating socially acceptable explanations for
behaviors that are otherwise unacceptable, commonly seen in
substance use disorders when individuals justify continued use or
relapse.
4. Which screening tool is most commonly used for rapid identification of
alcohol use disorder severity in clinical settings?
A. MMPI-2
B. AUDIT
C. WAIS-IV
D. Beck Hopelessness Scale
Correct answer: B
The Alcohol Use Disorders Identification Test (AUDIT) is a
standardized screening instrument designed to quickly assess
, hazardous drinking patterns and severity of alcohol-related
problems.
5. A counselor uses motivational interviewing and reflects a client’s
ambivalence without judgment. The primary goal of this technique is
to:
A. Confront denial directly to force insight
B. Increase resistance to change
C. Enhance intrinsic motivation for behavioral change
D. Provide diagnostic labeling for treatment planning
Correct answer: C
Motivational interviewing focuses on strengthening internal
motivation by exploring and resolving ambivalence in a
collaborative, non-confrontational manner.
6. Which substance withdrawal is most likely to present with life-
threatening seizures if untreated?
A. Cannabis
B. Alcohol
C. Nicotine
D. LSD
Correct answer: B
Alcohol withdrawal can progress to severe complications including
seizures and delirium tremens due to neurochemical rebound
hyperexcitability.
7. A client diagnosed with both major depressive disorder and opioid use
disorder is best described as having:
A. Substance-induced mood disorder only
B. Co-occurring disorders
C. Personality disorder
D. Factitious disorder
, Correct answer: B
Co-occurring disorders refer to the simultaneous presence of a
mental health disorder and a substance use disorder requiring
integrated treatment approaches.
8. Which stage of change in the Transtheoretical Model is characterized
by intention to act soon but no current behavioral change?
A. Precontemplation
B. Contemplation
C. Preparation
D. Maintenance
Correct answer: C
Preparation involves planning and readiness to take action in the
near future, often including small initial steps toward change.
9. In group counseling for addiction, which factor is most associated with
therapeutic effectiveness?
A. Therapist dominance in discussion
B. Universalization and peer identification
C. Strict silence among members
D. Avoidance of emotional expression
Correct answer: B
Group cohesion is strengthened when members recognize shared
experiences, reducing isolation and promoting therapeutic
engagement.
10. Which principle is central to maintaining confidentiality in
addiction counseling?
A. Sharing client information with family upon request
B. Disclosing information only with written consent or legal mandate
C. Reporting all client statements to supervisors
D. Discussing cases freely in public settings
Exam Practice Questions And Correct
Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
1. A client with opioid use disorder presents in early recovery reporting
cravings, insomnia, and anxiety. Which neurobiological mechanism is
most responsible for these symptoms during withdrawal?
A. Increased serotonin synthesis in the prefrontal cortex
B. Suppression of the limbic reward pathway due to dopamine
depletion
C. Hyperactivation of the cerebellum affecting motor coordination only
D. Excess acetylcholine release in the spinal cord
Correct answer: B
Withdrawal symptoms in opioid use disorder are largely driven by
dysregulation of the brain’s reward circuitry, particularly reduced
dopamine activity in the mesolimbic pathway, which contributes to
craving, dysphoria, and autonomic symptoms.
2. A counselor working under Maryland LCADC regulations is most
directly governed by which source of legal authority?
A. Federal HIPAA guidelines only
, B. NAADAC ethical standards exclusively
C. COMAR regulations established by the Maryland Board of
Professional Counselors and Therapists
D. American Psychological Association practice guidelines
Correct answer: C
LCADC practice in Maryland is regulated through COMAR (Code of
Maryland Regulations), which defines scope of practice, supervision,
and licensure requirements enforced by the state board.
3. A client in substance use treatment frequently minimizes their use and
blames external circumstances for relapse. This pattern is most
consistent with which defense mechanism?
A. Sublimation
B. Projection
C. Rationalization
D. Reaction formation
Correct answer: C
Rationalization involves creating socially acceptable explanations for
behaviors that are otherwise unacceptable, commonly seen in
substance use disorders when individuals justify continued use or
relapse.
4. Which screening tool is most commonly used for rapid identification of
alcohol use disorder severity in clinical settings?
A. MMPI-2
B. AUDIT
C. WAIS-IV
D. Beck Hopelessness Scale
Correct answer: B
The Alcohol Use Disorders Identification Test (AUDIT) is a
standardized screening instrument designed to quickly assess
, hazardous drinking patterns and severity of alcohol-related
problems.
5. A counselor uses motivational interviewing and reflects a client’s
ambivalence without judgment. The primary goal of this technique is
to:
A. Confront denial directly to force insight
B. Increase resistance to change
C. Enhance intrinsic motivation for behavioral change
D. Provide diagnostic labeling for treatment planning
Correct answer: C
Motivational interviewing focuses on strengthening internal
motivation by exploring and resolving ambivalence in a
collaborative, non-confrontational manner.
6. Which substance withdrawal is most likely to present with life-
threatening seizures if untreated?
A. Cannabis
B. Alcohol
C. Nicotine
D. LSD
Correct answer: B
Alcohol withdrawal can progress to severe complications including
seizures and delirium tremens due to neurochemical rebound
hyperexcitability.
7. A client diagnosed with both major depressive disorder and opioid use
disorder is best described as having:
A. Substance-induced mood disorder only
B. Co-occurring disorders
C. Personality disorder
D. Factitious disorder
, Correct answer: B
Co-occurring disorders refer to the simultaneous presence of a
mental health disorder and a substance use disorder requiring
integrated treatment approaches.
8. Which stage of change in the Transtheoretical Model is characterized
by intention to act soon but no current behavioral change?
A. Precontemplation
B. Contemplation
C. Preparation
D. Maintenance
Correct answer: C
Preparation involves planning and readiness to take action in the
near future, often including small initial steps toward change.
9. In group counseling for addiction, which factor is most associated with
therapeutic effectiveness?
A. Therapist dominance in discussion
B. Universalization and peer identification
C. Strict silence among members
D. Avoidance of emotional expression
Correct answer: B
Group cohesion is strengthened when members recognize shared
experiences, reducing isolation and promoting therapeutic
engagement.
10. Which principle is central to maintaining confidentiality in
addiction counseling?
A. Sharing client information with family upon request
B. Disclosing information only with written consent or legal mandate
C. Reporting all client statements to supervisors
D. Discussing cases freely in public settings
