1.  Compared to the general population, individuals treated for alcohol abuse or dependence are at about _____ times greater risk to eventually die by suicide.
2
4
10
12

2.  If a counselor asks their client 'are you thinking about killing yourself?' this would be considered . . .
Too direct
Direct but appropriate
Countertherapeutic
A and C

3.  Aggressively questioning the client about their thoughts and feelings and demanding assurance of safety when a client cannot provide such assurance are examples of . . .
Countertherapeutic practices
Acting like a suicide interrogator
Data collection techniques
Both A and B

4.  Suggestions to ease the treatment process for suicidal clients include all EXCEPT:
Address suicide discreetly and subtly with the client
Work collaboratively with suicidal clients
Obtain clinical supervision
Acknowledge the limitations of confidentiality

5.  Informing the client of the limits of confidentiality in the event of a suicide risk is . . .
Ill-advised because this may deter the client from disclosing a suicide attempt
Appropriate because clients should not be given a false sense of confidentiality
Evaluated on a case-by-case basis
Unimportant considering the gravity of suicidal issues

6.  Almost all clients who are suicidal . . .
Will try to commit suicide at least once during their lifetime
Want to die
Are ambivalent about living or not living
Both A and C

7.  Which of the following is true about hesitation wounds?
They reflect ambivalence about living and dying
They are uncommon
They are a form of non-suicidal self-injury
None of the above

8.  _____ suicidality is a transient state.
Acute
Severe
Substance abuse-related
Depression-related

9.  According to the authors, suicide contracts . . .
Ensure client safety
Should be used sparingly
Often reduce legal liability
A and C

10.  The intent of the suicidal act and the lethality of the method chosen are often . . .
Misunderstood
Related
Mismatched
Corresponding

11.  Which of the following best describes the relationship between suicidal behavior and treatment outcomes?
Survival indicates proper treatment
A tragic outcome indicates improper treatment
Outcomes are often a poor indicator of treatment quality
A and B

12.  Which of the following is true about substance abuse treatment and suicide?
Substance abuse treatment is an improper way to prevent suicide
Additional services such as mental health evaluations are always needed
Merely receiving substance abuse treatment can decrease the risk of suicide
A and B

13.  Which of the following is NOT mentioned as an indirect warning sign of suicide?
Reckless behavior
Mood changes
Withdrawal from others
All of the above are specifically mentioned as indirect warnings of suicide

14.  Acute alcohol intoxication is present in about _____ percent of suicide attempts and suicides.
5-10
10-20
30-40
50-60

15.  In the event that a suicidal client has poor treatment attendance . . .
It is ok to terminate treatment
It is unethical to terminate treatment
Involuntary treatment should be sought
It is ok to terminate treatment if alternative arrangements are made

16.  The risk of suicide is likely to increase . . .
During treatment transition periods
If treatment is terminated administratively
In clients with a history of suicidal ideation
All of the above

17.  Suicidal ideation ranges from . . .
Fleeting thoughts to persistent thoughts
Unrealistic plans to feasible plans
Non-recurring thoughts to recurring thoughts
All of the above

18.  The major elements of suicide attempts include . . .
Precontemplation and contemplation
Intent and lethality
Preparation and execution
Method and outcome

19.  Hoarding pills would be considered a suicidal . . .
Intention
Preparation
Contemplation
Motivation

20.  Suicidal communication would be a(n)
Suicidal preparation
Indirect warning sign of suicidality
Direct warning sign of suicidality
It depends on what exactly is communicated

21.  Among people who abuse substances, _____ is the most commonly experienced stressful life event.
Break-up of a partner relationship
Experience of trauma
Relapse
Financial crisis

22.  The most potent risk factor for suicide is
Prior history of suicide attempts
Family history of suicide
Severe substance use
Co-occurring mental disorder

23.  Which of the following is a risk factor for suicide?
Sexual orientation
Anorexia nervosa
Chronic pain
All of the above

24.  Which of the following is a known and likely protective factor against suicide?
Religious attendance
Child rearing responsibilities
Employment
All of the above

25.  The most common suicide method is . . .
Overdosing
Cutting/slitting
Use of firearms
Hanging

26.  The most lethal suicide method is . . .
Cutting/slitting
Use of firearms
Hanging
Both B and C

27.  Which of the following is true about reasons for suicide attempts?
Seeking attention is the most common reason for suicide attempts
Reasons for dying are usually attributable to single factors
Inducing guilt is the most common reason for suicide attempts
Reasons for dying are usually attributable to multiple factors

28.  Which of the following is NOT part of the four step process for addressing suicidal thoughts and behaviors in substance abuse treatment?
Gather information
Access supervision
Take responsible action
End the treatment

29.  Screening questions involve . . .
Introducing the topic of suicide only
Introducing the topic of suicide and screening for suicidal thoughts only
Screening for suicidal thoughts and attempts only
Introducing the topic of suicide, screening for suicidal thoughts and attempts

30.  Which of the following statements is true about asking appropriate follow-up questions about suicidal thoughts?
Always ask open-ended questions last.
It is not appropriate to ask about the details of a patient
Open-ended questions can help you avoid
Close-ended questions should be avoided at all times.

31.  A client
An increased risk for suicide
A decreased risk for suicide
Ambivalence about suicide
Hopelessness

32.  When gathering information about suicidal thoughts and behaviors, it is most important to gather information about . . .
Plan/method
Intent
Lethality
All of the above

33.  Judgments about the degree of seriousness of risk should be made . . .
In consultation with a supervisor and/or a treatment team
By a counselor acting alone
During counseling sessions while the patient is present
Before or after counseling sessions while the patient is not present

34.  Which of the following is NOT mentioned as a way to ensure that a client will make use of their safety card?
Personalize the card
Have the patient sign the card
Create a wallet-sized card
Have back-up copies of the card

35.  During inpatient treatment for suicidality, the focus is typically on . . .
Medication management
Disposition planning
Addressing ongoing stressors therapeutically
A and B

36.  Not trivializing suicidal thoughts is a/an _____ component of the gathering information core competency for working with clients who are suicidal in substance abuse treatment settings.
Attitude
Knowledge
Skill
Behavior

37.  Following HIPAA is a skill component of the _____ core competency for working with clients who are suicidal in substance abuse treatment settings.
Awareness of legal issues
Gathering information
Awareness of legal issues
Take responsible action

38.  Which of the following is NOT mentioned as a core competency for working with clients who are suicidal in substance abuse treatment settings?
Cultural competence
Emotional intelligence
Empathy for clients
Awareness of ethical issues

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