Test Bank Chapter 13 Co-occurring Psych/Substance Disorders

Chapter 13

1. Greg has recently been given the role of developing a new program at the mental health center. The administration envisions patients getting their physical and mental health needs met at the mental health center. Greg is developing a ________________________________ model of care.

a. Serial treatment

b. Simultaneous/parallel care

c. Coordinated/parallel care

d. Integrated care

@Cognitive domain: Application; Addressing Mental Health Needs; Question type: MC

2. Jillian is called down to the emergency room to assess a patient. Jillian has worked with this patient before, and they have always had a good working relationship. When Jillian walks into the room, she is startled by the changes in the patient since the last time she saw him. The patient is disheveled, talking to himself, and looking wildly around the room. Jillian tells the emergency room staff that the patient has _____________________________ since she last saw him.

a. Adapted

b. Assimilated

c. Suffered an epigenetic crisis

d. Decompensated

@ Cognitive domain: Application; Answer location: Crisis Intervention and Lethality Risk Assessment: Question type: MC

3. The Substance Abuse and Mental Health Services Administration (SAMHSA) has suggested all of the following strategies for engaging and retaining patients in detoxification and recovery except _____________________.

a. Educate the patient on the withdrawal process

b. Confront the patient regarding how their choice to continue misusing substances is affecting their health, family, and opportunity for continued employment

c. Engage patient support systems (family, peer, community)

d. Encourage the patient to maintain a drug-/alcohol-free environment and avoid environments where these substances are present.

@ Cognitive domain: Application; Answer location: Substance Abuse As A Co-Occurring Disorder; Question type: MC

4. John suffers from bipolar disorder and high blood pressure. John goes to the mental health center for medications and therapy to assist him in managing the symptoms of his bipolar disorder. John’s primary care doctor manages his high blood pressure with medications. John sees his doctor at the primary care clinic every 3 months. He attends therapy sessions at the mental health center weekly and sees the psychiatrist every 2 months. This model of care is called _____________________________.

a. Serial treatment

b. Simultaneous parallel care

c. Coordinated/parallel care

d. Integrated care

@ Cognitive domain: Application; Answer location: Addressing Mental Health Needs Question type: MC

5. Emma completed her Masters of Social Work degree. She is excited to start her first job working in a ___________________________. She will be a member of a multidisciplinary team that provides round-the-clock staffing for patients within their own homes. Care is provided 24 hours a day, 7 days a week, 365 days a year. As the newest member on the team, Emma has been scheduled to work Labor Day. While Emma would have liked to have the day off, she has planned some activities she believes her patients will enjoy.

a. Assertive community treatment (ACT) program

b. Residential care facilities

c. Adult foster care and/or group home

d. Intensive outpatient care program

@ Cognitive domain: Application; Answer location: Coordination of Mental Healthcare Services: Question type: MC

6. John has been working with a patient, Theresa, who has had a psychotic break. The patient is currently in an inpatient psychiatric facility. Theresa is becoming more oriented but is still having some auditory hallucinations that are causing her some distress. John meets with the psychiatrist and suggests that Theresa be transferred to the transitional care facility. Theresa would no longer be in a locked unit but will still have support from medical staff. John is practicing the ____________________________ principle.

a. Righting reflex

b. Least restrictive

c. Optimal tendency

d. Epigenesis

@ Cognitive domain: Comprehension; Answer location: Psychiatric Care In Healthcare Settings: Question type: MC

7. The advent of ________________________ in the 1950s led to the deinstitutionalization of many mentally ill patients.

a. Medicaid

b. Medicare

c. Psychotropic medications

d. Electroconvulsive therapy

@ Cognitive domain: Comprehension; Answer location: Psychiatric Care In Healthcare Settings: Question type: MC

8. The rights of the mentally ill include the right to be free from unnecessary restraints and the right to be protected against inappropriate institutionalization or commitment. Each state and/or county must designate an office of ___________________________ to ensure that the recipients of public mental healthcare do not have their rights violated.

a. Recipients’ rights

b. Public affairs

c. County health

d. Auditor

@ Cognitive domain: Knowledge; Answer location: Facilitating Transfers to Psychiatric Facilities; Question type: MC

9. The most common drug(s) used and abused in our society is ______________.

a. Opioids

b. Cannabis

c. Alcohol

d. Amphetamines

@ Cognitive domain: Knowledge; Answer location: Substance Abuse As A Co-Occurring Disorder Question type: MC

10. Mary meets with her patient Tina. Tina is tearful and states that she is “tired of it all.” Tina has been undergoing chemotherapy and is almost done with her treatment for lymphoma. Mary asks Tina to elaborate on what she means. Tina states, “Well, I am just so tired of treatments, and getting sick has made me realize that even if I get better now, I’m just going to get sick from something else some other time. I’m such a burden to my family and friends. I find myself constantly thinking everyone would be better if I was not around.” Mary asks Tina if she has wished she were dead or had thoughts of killing herself. Tina nods her head slowly and says, “Yes, I have had the thought at times.” Mary knows from Tina’s history that Tina did make a suicide attempt in the past, and Tina has expressed regret for that action. Mary asks Tina if she has a plan to commit suicide and Tina says, “No, I know I would not actually act on it. It caused so many problems when I did that in the past.” Mary expresses her concern for Tina and asks Tina if she would be willing to be assessed by a psychiatrist. Tina agrees, and an appointment is set up for 2 days later. In the meantime, Tina’s family has agreed to stay with her, and Mary and Tina complete a _____________________________________.

a. Civil commitment

b. Voluntary commitment

c. Involuntary commitment

d. Safety plan

@ Cognitive domain: Application; Answer location: Crisis Intervention and Lethality Risk Assessment: Question type: MC

11. The rates of methamphetamine and ____________________________ are increasing.

a. Cocaine

b. Marijuana

c. Prescription pain medications (OxyContin, Vicodin)

d. Hallucinogens

@ Cognitive domain: Knowledge; Answer location: Substance Abuse As A Co-Occurring Disorder Question type: MC

12. Audrey reviews her daily patient census and notices that there is a patient who has schizophrenia and has just been diagnosed with testicular cancer. His having these ________________________ disorders causes Audrey be concerned and thus to prioritize this patient.

a. Co-occurring

b. Divergent

c. Complimentary

d. Similar

@ Cognitive domain: Knowledge Answer location: Psychiatric Care In Healthcare Settings: Question type: MC

13. Amanda works in a mental health center. She has been asked to see a new patient for an evaluation. As Amanda looks through the patient’s medical chart, she notes the patient has been seen at several other mental health centers in the state. This is the ______________________ model of care.

a. Serial treatment

b. Simultaneous/parallel care

c. Coordinated/parallel care

d. Integrated care

@ Cognitive domain: Application; Answer location: Addressing Mental Health Needs: Question type: MC

14. Overall, the suicide rate for ______________________________ is the highest among all racial, ethnic, or age groups.

a. Non-Hispanic whites

b. Non-Hispanic blacks

c. Asians/Pacific Islanders

d. American Indians/Alaska Natives

@ Cognitive domain: Knowledge; Answer location: Crisis Intervention and Lethality Risk Assessment: Question type: MC

15. Chemical or mechanical restraints should be used ___________________________.

a. As a convenience

b. To punish patients

c. As a last resort

d. To keep psychotic patients from wandering off the unit.

@ Cognitive domain: Application; Answer location: Facilitating Transfers to Psychiatric Facilities: Question type: MC

16. Managing the detoxification process for a patient is a form of ___________________ because it reduces the individual’s discomfort of withdrawal.

a. Palliative care

b. Hospice care

c. Boundary spanning

d. Adjustment-to-illness counseling

@ Cognitive domain: Comprehension; Answer location: Substance Abuse As A Co-Occurring Disorder; Practice: Question type: MC

17. The co-occurrence of ________________________ is as high as 1 in 20 in hospitalized patients.

a. Mood disorders

b. Substance-abuse disorders

c. Delirium/dementia

d. Anxiety disorders

@ Cognitive domain: Comprehension; Answer location: Psychiatric Care In Healthcare Settings Question type: MC

18. _________________ is the acronym for four simple questions regarding alcohol abuse that can be incorporated easily into a biopsychosocial assessment.

a. STOP

b. QUIT

c. CAGE

d. AAPD

@ Cognitive domain: Knowledge; Answer location: Substance Abuse As A Co-Occurring Disorder; Question type: MC

19. All of the following might complete a petition for commitment except _________________.

a. A family member

b. The patient

c. Police officer

d. A social worker

@ Cognitive domain: Analysis; Answer location: Facilitating Transfers to Psychiatric Facilities; Question type: MC

20. Psychiatric patients in acute care beds are most likely to _______________________.

a. Have a co-attending psychiatrist

b. Receive antidepressant medications

c. Leave the hospital against medical advice (AMA)

d. Not obtain needed diagnostic testing

@ Cognitive domain: Comprehension; Answer location: Psychiatric Care In Healthcare Settings: Question type: MC

True False:

1. Approximately one in four hospital admissions involves a mental illness and/or substance abuse disorder.

a. True

b. False

@ Cognitive domain: Knowledge; Answer location: Psychiatric Care In Healthcare Settings; Question type: TF

2. Only psychologists or neuropsychologists can administer standardized screening tools like the Brief Symptom Inventory (BSI).

a. True

b. False

@ Cognitive domain: Comprehension; Answer location: Screening and Identification of Patients with Co-occurring Disorders; Question type: TF

3. Women are four times more likely than men to commit suicide.

a. True

b. False

@ Cognitive domain: Knowledge; Answer location: Crisis Intervention and Lethality Risk Assessment; Question type: TF

4. Intermittent suicidal ideation is much riskier than persistent suicidal ideation because it is harder to know when a person may be having these thoughts.

a. True

b. False

@ Cognitive domain: Analysis; Answer location: Crisis Intervention and Lethality Risk Assessment; Question type: TF

5. Social workers can break confidentiality in the case they have a duty to warn an individual who has been threatened with harm by their client.

a. True

b. False

a. @ Cognitive domain: Application; Answer location: Crisis Intervention and Lethality Risk Assessment; Question type: TF

6. In the Four Quadrant Model, both behavioral and physical health risks are considered, and patients are classified into one of four groups.

a. True

b. False

@ Cognitive domain: Comprehension; Answer location: Integrating care; Question type: TF

7. When working with a patient whose behavior has become anxious, agitated, and aggressive, the social worker should always make sure his or her own exit from the examination room is not blocked but that the patient’s exit is blocked.

a. True

b. False

@ Cognitive domain: Application; Answer location: Facilitating Transfer to Psychiatric Facilities; Question type: TF

8. Withdrawing suddenly from certain substances, including alcohol, can be life threatening.

a. True

b. False

@ Cognitive domain: Comprehension; Answer location; Substance Abuse As A co-Occurring Disorder. Question type: TF

9. Criteria for involuntary commitment are the same in all 50 states.

a. True

b. False

@ Cognitive domain: Knowledge; Answer location: Facilitating Transfers to Psychiatric Facilities ; Question type: TF

10. @ Cognitive domain: Answer location: ; Question type: TF

Short Answer/Essay 3-5

1. The initial period of an involuntary commitment is _________________________. This allows for the evaluation and stabilization of the patient by the mental health team. If additional hospitalization is necessary, the case will be presented to a judge, who may or may not decide to extend the commitment.

a. 72 hours

@ Cognitive domain; Knowledge; Answer location: Facilitating Transfer to Psychiatric facilities; Question type: FIB

2. Alcohol use during pregnancy can lead to _____________________________, leaving a child with lifelong disabilities.

a. Fetal alcohol syndrome

@ Cognitive domain; Knowledge; Answer location; Substance Abuse As A Co-Occurring Disorder; Question type: FIB

3. As part of the assessment process, social workers conduct a thorough risk assessment of __________________ (or potential for a client to inflict self-harm).

a. Lethality

@ Cognitive domain; Comprehension; Answer location; Crisis Intervention and Lethality Risk Assessment; Question type: FIB

4. There are 11 levels of mental healthcare services. Social workers need to be knowledgeable about what services are available at each level of care in order to match each patient with the appropriate level of care for their needs. List the 11 levels of care and give a brief description of the services available at each level.

a. Prevention and education – Educates and encourages participants to avoid certain harmful activities or to engage in positive activities that promote their emotional and social functioning.

b. Early Intervention – Recognizes warning signs for potential problems and takes early action to reduce the factors that put the individual or family at risk. Services to families with children with a diagnosed developmental delay to include speech, behavioral, cognitive, or other therapies.

c. Outpatient services – Mental health services provided in a clinical setting that are not residential in nature. Those served are able to use therapeutic relationships to maintain clinical stability and independent functioning. Can involve individual, family, and group treatment modalities.

d. Crisis intervention – Services that allow for immediate response to a situation involving imminent danger to ensure the safety of the individual involved.

e. Intensive outpatient care – Highly structured programs for psychiatric or substance abuse treatment that involves programming most of the day, allowing the patient to return home in the evening.

f. Acute care hospitalization/emergency room care – Provision of psychiatric and substance abuse intervention at acute care facilities or in the emergency room. Can be problematic if services are not covered by insurance and are inadequately developed to fully meet the patient’s needs. May involve assessment, stabilization, and transfer to a more appropriate agency.

g. Inpatient Psychiatric Facility – Services offered in a hospital setting. The inpatient setting may be a psychiatric unit in an acute care hospital or a designated psychiatric hospital.

h. Residential Care Facilities – Short-term recovery-oriented service for individuals who have been part of treatment and seek to reenter mainstream. Services for those who need structure, support, and reinforcement in a therapeutic milieu to reverse the course of behavioral deterioration.

i. Adult Foster Care and Group Home – Homes in the community that provide long-term care for a small group of patients with similar conditions. Provides a community-based, milieu therapy and residential-care approach that includes 24-hour supervision and transportation to services.

j. Assertive Community Treatment (ACT) – A multidisciplinary, round-the-clock staffing approach for patients within the comfort of their own home and community. The ACT team provides these necessary services 24 hours a day, 7 days a week, 356 days a year.

k. Support and Advocacy – Interrelated services and resources that provide individuals with emotional, informational, and material sustenance. A structured ongoing series of meetings among people who share common issues and who give encouragement, information, and emotional sustenance to one another. Often led by patients and family members as part of a self-help approach.

@Cognitive domain: Application; Answer locations: ;Coordination of Mental Healthcare Services Question type: ESS

5. Audrey is a social worker who is assigned to the medical/surgical service. This unit houses psychiatric patients when the psychiatric unit is full. Describe Audrey’s role and at least four functions/tasks of this role.

a. Educating other team members about these conditions in a general way as to the specific needs and concerns of individual patients; b. Screening and identification of patients with co-occurring disorders; c. Ensuring that mental health needs are addressed; d. Providing crisis intervention and lethality risk assessment; e. Facilitating involuntary and voluntary transfers to psychiatric units; f. Support, education, and assurance that patient rights are protected, and g. Coordination of mental and physical healthcare services.

@Cognitive domain: Analysis; Answer location: The Social Work Role In Behavioral Healthcare; Question type: ESS