Deck 13: Co-Occurring Psychiatric and Substance Abuse Disorders in Medical Patient

Question 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

Answer 1

Integrated care

Question 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

Answer 2

Decompensated

Question 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.

Answer 3

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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 9

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

A) Opioids
B) Cannabis
C) Alcohol
D) Amphetamines

Question 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 _____________________________________.
[AU: This is an extremely long question. Can you shorten it?]

A) Civil commitment
B) Voluntary commitment
C) Involuntary commitment
D) Safety plan

Question 11

The rates of methamphetamine and ____________________________ are increasing.

A) Cocaine
B) Marijuana
C) Prescription pain medications (OxyContin, Vicodin)
D) Hallucinogens

Question 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

Question 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

Question 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

Question 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.

Question 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

Question 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

Question 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

Question 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

Question 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

Question 21

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

Question 22

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

Question 23

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

Question 24

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

Question 25

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.

Question 26

In the Four Quadrant Model, both behavioral and physical health risks are considered, and patients are classified into one of four groups.
[AU: Is this the correct capitalization? Seems unnecessary.]

Question 27

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.

Question 28

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

Question 29

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

Question 30

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.

Question 31

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

Question 32

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

Question 33

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.

Question 34

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.