Exam MCCQE Topic 1 Question 205 Discussion
Actual exam question for Medical Council of Canada's MCCQE exam
Question #: 205
Topic #: 1
Question #: 205
Topic #: 1
A 55-year-old man presents to the Emergency Department with intractable nausea and vomiting. He is diaphoretic, tremulous and tachycardic. In a private conversation with his spouse, you learn that for the last several weeks, he has been drinking 1.2 L of vodka daily. On questioning, he says that since he retired, he has been drinking socially and plans to continue doing so. With respect to his alcohol use, which one of the following best describes the patient's current stage of change?
Suggested Answer: A Vote an answer
This patient is in the precontemplation stage because he does not recognize his alcohol use as a problem and has no intention to change his drinking behavior. Despite evidence of harm-heavy daily intake (1.2 L vodka
/day) and current symptoms compatible with alcohol withdrawal/autonomic hyperactivity (tremor, diaphoresis, tachycardia, nausea/vomiting)-he frames his drinking as "social" and explicitly states he plans to continue. In the transtheoretical model, precontemplation describes individuals who are unaware, unwilling, or resistant to change within the foreseeable future. Contemplation would involve ambivalence and acknowledgement of a potential problem; preparation includes intention and planning to change soon; action involves active behavior change; maintenance refers to sustaining change over time. MCCQE objectives emphasize identifying readiness to change to guide counseling: in precontemplation, the clinician focuses on building rapport, providing clear, nonjudgmental feedback about risks, exploring discrepancies between goals and behavior, and using motivational interviewing to enhance insight rather than pushing immediate abstinence plans.
/day) and current symptoms compatible with alcohol withdrawal/autonomic hyperactivity (tremor, diaphoresis, tachycardia, nausea/vomiting)-he frames his drinking as "social" and explicitly states he plans to continue. In the transtheoretical model, precontemplation describes individuals who are unaware, unwilling, or resistant to change within the foreseeable future. Contemplation would involve ambivalence and acknowledgement of a potential problem; preparation includes intention and planning to change soon; action involves active behavior change; maintenance refers to sustaining change over time. MCCQE objectives emphasize identifying readiness to change to guide counseling: in precontemplation, the clinician focuses on building rapport, providing clear, nonjudgmental feedback about risks, exploring discrepancies between goals and behavior, and using motivational interviewing to enhance insight rather than pushing immediate abstinence plans.
by Edison at Oct 01, 2026, 03:05 AM
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