22 Alcohol Effects & Signs of Intoxication Practice Questions & Answers

1. 1. A U.S. standard drink is defined by the amount of pure alcohol in the serving, not by the size of the glass. How much pure alcohol is that?

   • A.About 1.0 fl oz, roughly 23 grams, of pure alcohol
   • B.About 0.6 fl oz, roughly 14 grams, of pure alcohol✓ Answer
   • C.About 0.3 fl oz, roughly 7 grams, of pure alcohol
   • D.About 1.5 fl oz, roughly 35 grams, of pure alcohol

   A standard drink is a fixed quantity of ethanol, about 0.6 fluid ounces or 14 grams, so any serving is counted as its volume multiplied by its alcohol strength rather than as one glass.

   Source: NIAAA standard drink definition — 0.6 fluid ounces (14 grams) of pure ethanolReport a problem with this question

2. 2. Which set lists three servings that each contain about the same amount of pure alcohol, that is, one standard drink?

   • A.12 oz of beer at 5% ABV, 5 oz of table wine at 12% ABV, 1.5 oz of 80-proof spirits✓ Answer
   • B.12 oz of beer at 5% ABV, 12 oz of table wine at 12% ABV, 3.5 oz of 80-proof spirits
   • C.16 oz of beer at 5% ABV, 8 oz of table wine at 12% ABV, 4.5 oz of 80-proof spirits
   • D.8 oz of beer at 5% ABV, 5 oz of table wine at 12% ABV, 3 oz of 80-proof spirits

   Each of the three works out to about 0.6 fl oz of ethanol: 12 oz at 5%, 5 oz at 12% and 1.5 oz at 40% all give the same dose, which is why they are treated as equivalent servings.

   Source: NIAAA standard drink equivalents for beer, table wine and distilled spiritsReport a problem with this question

3. 3. A bartender pours 2 fl oz of 100-proof whiskey over ice. Proof is twice the alcohol by volume. How many standard drinks is that pour?

   • A.About 1.7 standard drinks, because 100-proof means 50% alcohol by volume✓ Answer
   • B.About 1.3 standard drinks, because 100-proof means 40% alcohol content
   • C.About 3.3 standard drinks, because 100-proof means it is pure alcohol
   • D.Exactly 1 standard drink, because it is poured as a single serving

   Proof is twice the alcohol by volume, so 100-proof is 50% ABV. Two fluid ounces at 50% contain 1.0 fl oz of ethanol, and 1.0 divided by 0.6 is about 1.7 standard drinks.

   Source: Proof-to-ABV conversion (proof equals twice the ABV) applied to the NIAAA standard drinkReport a problem with this question

4. 4. A guest orders a 16 fl oz pour of a craft IPA listed at 7.5% ABV. How many standard drinks should the server count it as?

   • A.One standard drink, since a single beer counts as one drink
   • B.About four standard drinks, since IPA is a strong style
   • C.Two standard drinks, since it holds 1.2 fl oz of alcohol✓ Answer
   • D.About 1.3 standard drinks, based on the 16 oz volume alone

   Sixteen ounces at 7.5% ABV contains 1.2 fl oz of ethanol, and 1.2 divided by 0.6 is exactly two standard drinks, which is why a glass of beer cannot be counted as one drink automatically.

   Source: NIAAA standard drink arithmetic — volume times ABV divided by 0.6 fluid ouncesReport a problem with this question

5. 5. A cocktail is built from 2 fl oz of 80-proof vodka and 1 fl oz of a 30% ABV coffee liqueur, then topped with cream. How many standard drinks does it contain?

   • A.About 3 standard drinks, counting the 3 oz of total liquid volume
   • B.About 1.8 standard drinks, adding both spirits in the glass✓ Answer
   • C.About 1.3 standard drinks, counting only the vodka poured
   • D.One standard drink, because it is served in a single glass

   The vodka contributes 0.8 fl oz of ethanol and the liqueur another 0.3, for 1.1 fl oz in one glass; divided by 0.6 that is about 1.8 standard drinks, so every alcoholic ingredient must be counted.

   Source: NIAAA standard drink arithmetic applied to cocktails with more than one spiritReport a problem with this question

6. 6. Alcohol does not have to be digested before the body can use it. Where does most of a drink's alcohol pass into the bloodstream?

   • A.Mostly through the liver, which releases it into the blood
   • B.Mostly through the stomach lining, and less through the intestine
   • C.Mostly through the small intestine, and less through the stomach✓ Answer
   • D.Mostly through the large intestine, after digestion has finished

   Ethanol is a small molecule that crosses membranes directly, so roughly a fifth is taken up through the stomach and most of the rest through the small intestine, whose surface area is far greater.

   Source: NIAAA overview of alcohol absorption; responsible beverage service training on how alcohol enters the bloodReport a problem with this question

7. 7. A guest finishes their last drink at closing and looks only mildly affected. Why can that same guest be clearly more impaired twenty minutes later?

   • A.Because the liver stops working on alcohol once a guest stops drinking
   • B.Because the cool night air outside raises the blood alcohol reading
   • C.Because blood alcohol usually peaks 30 to 90 minutes after the last drink✓ Answer
   • D.Because standing and walking releases alcohol stored in the muscles

   Absorption keeps going after the last drink is served, so blood alcohol typically peaks half an hour to an hour and a half later and a guest can become more impaired after service has stopped.

   Source: Responsible beverage service training on delayed peak blood alcohol after the last drinkReport a problem with this question

8. 8. A guest eats a full meal just before starting to drink. What does that food actually do?

   • A.It helps the liver break the alcohol down faster during the meal
   • B.It slows alcohol's passage into the intestine, so the peak is lower✓ Answer
   • C.It stops blood alcohol from rising while the guest keeps eating
   • D.It absorbs much of the alcohol so that little of it reaches the blood

   Food slows the stomach's emptying, so alcohol reaches the small intestine more gradually and blood alcohol rises more slowly to a lower peak; the same total dose is still absorbed in the end.

   Source: NIAAA and responsible beverage service training on food, gastric emptying and peak blood alcoholReport a problem with this question

9. 9. Why does sparkling wine, or a spirit topped with soda, tend to raise blood alcohol faster than the same alcohol in a still drink?

   • A.The bubbles carry alcohol straight into the lungs and then the blood
   • B.The carbon dioxide makes the liver hold off on processing alcohol
   • C.The carbonation raises the alcohol content of the drink in the glass
   • D.The carbonation speeds the stomach's emptying into the intestine✓ Answer

   Carbon dioxide speeds gastric emptying, so the alcohol reaches the large absorbing surface of the small intestine sooner and the blood alcohol curve climbs more steeply.

   Source: Responsible beverage service training on carbonation and the speed of absorptionReport a problem with this question

10. 10. Most alcohol is broken down by the liver. What becomes of the small share that is not metabolized?

    • A.It is filtered out by the kidneys and changed into a harmless sugar
    • B.It stays in the blood until a night of sleep makes it disappear
    • C.It leaves unchanged in breath, urine and sweat, so breath tests work✓ Answer
    • D.It is stored in fat tissue and released slowly over the following days

    The liver handles about nine tenths of the ethanol; the remaining tenth leaves the body chemically unchanged in breath, urine and sweat, and that unchanged fraction in the breath is what a breath test measures.

    Source: NIAAA alcohol metabolism — liver metabolism with a small unchanged fraction leaving in breath, urine and sweatReport a problem with this question

11. 11. About how fast does a healthy adult liver clear alcohol, and can a server do anything to speed that up?

    • A.Roughly three standard drinks per hour for a well practiced drinker
    • B.Roughly one standard drink per hour, unless the guest is drinking water
    • C.Roughly one standard drink every ten minutes once digestion starts
    • D.Roughly one standard drink per hour, and no food or drink speeds it✓ Answer

    Elimination runs at a nearly constant rate of about one standard drink an hour and does not speed up when more alcohol arrives, so anything served alongside the drinks leaves that rate untouched.

    Source: Responsible beverage service training on liver metabolism at roughly one standard drink per hourReport a problem with this question

12. 12. A guest who has been drinking asks for strong coffee, a walk in the cold air and a cold shower to sober up. What do those actually do?

    • A.They cut blood alcohol by about half within roughly fifteen minutes
    • B.They push the alcohol out through the skin and shorten the effect
    • C.They speed the liver up so the alcohol is gone in half the time
    • D.They may leave the guest feeling more awake while impairment is unchanged✓ Answer

    Caffeine, cold and exercise act on alertness, not on the alcohol already in the blood, so they produce a guest who is wide awake and just as impaired; only the passage of time lowers blood alcohol.

    Source: NIAAA and responsible beverage service training on sobering-up mythsReport a problem with this question

13. 13. After several rounds a guest orders a large meal and a pitcher of water and switches from whiskey to beer. What happens to their blood alcohol?

    • A.It stops rising because beer is absorbed far more slowly
    • B.It drops quickly once the food and the water are taken in
    • C.It still falls only with time, while the beers add to it✓ Answer
    • D.It falls because eating late restarts the liver's work

    The body responds to ethanol itself, not to the kind of drink, so switching to beer changes nothing if the standard drink count is the same, and food or water taken afterward cannot remove alcohol already absorbed.

    Source: Responsible beverage service training on beverage-type myths and elimination only over timeReport a problem with this question

14. 14. A guest showing clear signs of impairment intends to drive and asks staff to sober them up first. What is accurate about what staff can do?

    • A.Fresh air and a walk around the lot will clear off enough alcohol
    • B.Water and a rest in a quiet booth will bring the guest back down
    • C.A ride home is the only help, since nothing served lowers the alcohol✓ Answer
    • D.A big meal and an hour of coffee will make the guest safe to drive

    Because only time lowers blood alcohol, no food, drink or fresh air makes an impaired guest fit to drive; the workable responses are a ride, a sober companion or management, never a claim that the guest has been sobered up.

    Source: Responsible beverage service training on intervention when an impaired guest intends to driveReport a problem with this question

15. 15. Two guests of the same sex drink three standard drinks in the same hour, but one is much smaller and carries more body fat. Why does that guest reach a higher blood alcohol?

    • A.A smaller body has less water to dilute the same amount of alcohol✓ Answer
    • B.A smaller body sends more of the alcohol to the brain than to the liver
    • C.A smaller liver produces a stronger form of alcohol during digestion
    • D.A high body fat share soaks up alcohol and returns it to the blood

    Ethanol spreads through the water in the body, and muscle holds water while fat does not, so a smaller or fatter person dilutes the same dose in a smaller volume and reaches a higher concentration.

    Source: Responsible beverage service training on body size and composition; NIAAA on distribution of alcohol in body waterReport a problem with this question

16. 16. On average a woman reaches a higher blood alcohol than a man of the same weight after the same drinks. What explains that?

    • A.A heart rate that carries alcohol to the brain more efficiently
    • B.A liver function that clears alcohol at half the usual hourly rate
    • C.A digestion that holds the drink in the stomach much longer than usual
    • D.A lower share of body water and less alcohol broken down in the stomach✓ Answer

    Women average a smaller proportion of body water, so the same dose is diluted less, and they also break down less alcohol in the stomach wall before it reaches the blood, which raises the resulting concentration.

    Source: Responsible beverage service training on sex differences in body water and gastric breakdown of alcoholReport a problem with this question

17. 17. Why does a guest who takes shots and orders a fresh drink before finishing the last one become far more impaired than one drinking slowly and steadily?

    • A.Rapid drinking shuts the liver down until the following morning
    • B.Alcohol arrives faster than the liver clears it, so it builds up✓ Answer
    • C.Fast drinking irritates the stomach, doubling how much is absorbed
    • D.Shots hold a stronger form of alcohol than the same spirit sipped

    Elimination is fixed near one standard drink an hour, so when drinks arrive faster than that the unmetabolized alcohol adds up in the blood and the concentration climbs far higher than with a slow, even pace.

    Source: Responsible beverage service training on rate of consumption and accumulation of alcoholReport a problem with this question

18. 18. A guest at the end of a long shift looks tired and mentions taking an over-the-counter antihistamine before arriving. How should the server read the situation?

    • A.Being tired burns alcohol faster, so the impairment will fade sooner
    • B.The antihistamine slows absorption, so fewer cues will show tonight
    • C.Fatigue and the medicine add to the alcohol, so cues can outrun the count✓ Answer
    • D.Fatigue and medication offset each other, so the risk is normal

    Many antihistamines are sedating and fatigue lowers tolerance for the same dose, so their effects add to alcohol's; the guest can show impairment out of proportion to the drinks counted, and service should stop.

    Source: Responsible beverage service training on alcohol combined with sedating medication and fatigueReport a problem with this question

19. 19. Early in the evening a guest becomes louder, more talkative and unusually outgoing. Alcohol is a central nervous system depressant, so how does that fit?

    • A.The lively behavior comes from the sugar in the drinks, not the alcohol
    • B.Alcohol depresses inhibition first, which can look stimulating✓ Answer
    • C.Alcohol is a depressant only when it is mixed with other drugs
    • D.Alcohol acts as a stimulant in small amounts and a depressant later

    Alcohol never stimulates the nervous system; the first thing it depresses is inhibition and judgment, and a person with the brakes off gets louder and friendlier, which is easily mistaken for stimulation.

    Source: Responsible beverage service training on alcohol as a central nervous system depressantReport a problem with this question

20. 20. Which sequence best describes the usual order in which impairment becomes visible to a server?

    • A.Poor judgment first, then quiet withdrawal, then sharper reaction times
    • B.Lowered inhibition first, then poor judgment, then slurring and swaying✓ Answer
    • C.Slurred speech first, then poor coordination, then loss of inhibition
    • D.Loss of balance first, then slow speech, then louder and faster ordering

    Alcohol takes away inhibition and judgment before it takes away reaction time, coordination, speech and balance, so the visible cues appear in that order and a server can act at the early end.

    Source: Responsible beverage service training on the behavioral progression of impairmentReport a problem with this question

21. 21. Why does an experienced server judge a guest against how that same guest looked on arrival rather than against the other guests at the bar?

    • A.Impairment shows as a change in the same person over time✓ Answer
    • B.Guests at a table always drink at about the same speed
    • C.The loudest guest in the room is the most impaired one there
    • D.Comparing one guest with another estimates blood alcohol well

    People differ enormously in size, tolerance and normal manner, so another guest is a useless yardstick; only the difference from this guest's own baseline, watched over time, shows that alcohol is taking effect.

    Source: Responsible beverage service training on establishing a baseline and observing change over timeReport a problem with this question

22. 22. Why do responsible-service programs teach servers to keep a drink tally AND watch behavior, instead of relying on just one of them?

    • A.Counting on its own works because equal counts give equal blood alcohol
    • B.Tolerance can hide cues, and equal counts affect bodies differently✓ Answer
    • C.A tally by itself proves a guest is fine as long as it stays low
    • D.Behavior on its own is enough when the guest is a familiar regular

    Tolerance is an adaptation to the felt effects, so a practiced drinker can be badly impaired with few visible cues, while the same count produces very different concentrations in different bodies; each method covers the other's blind spot.

    Source: Responsible beverage service training on combining drink counting with behavioral observationReport a problem with this question

Practice questions based on federal law (the national 21 minimum purchase age), NIAAA and NHTSA responsible-beverage-service guidance, and the principles common to state seller/server training programs. Alcohol law is set by each state: legal hours of sale, the minimum age to serve, which IDs are acceptable, whether dram shop liability exists, and all penalties differ — and many states require one specific approved course. Not affiliated with ServSafe®, TIPS®, or any training provider. Always check your state's alcohol beverage control agency and your employer's house policy. NIAAA Alcohol Policy Information System →