Question 1

You work in a hospital with a chemical dependency unit. A new patient in the emergency room shows signs of paranoid schizophrenia, but a toxicology screen indicates he took cocaine. He is sent to your unit, and one week later, he still seems to show signs of paranoid schizophrenia but you are not a doctor). What do you do?

Accepted Answer

A)   Schedule the patient for an assessment with you and an evaluation by a mental health professional to determine if a co- occurrence exists.
B)   Recognize that the patient has a co-occurrence of mental illness and cocaine abuse, and assess for the best treatment approach.
C)   Send the patient to the psychiatric ward for evaluation.
D)   Ask the patient how often he uses cocaine. A

Question 2

A man received a spinal cord injury three years ago in a driving accident while he was intoxicated. He says he did not have a drinking problem then, but he drinks more often and more heavily now. He also thinks he is clinically depressed. He lives alone, is on disability, and has difficulty going out. What do you recommend?

Accepted Answer

A)   Sequential treatment utilizing family support, mutual-help support, and mental health resources
B)   Integrated treatment utilizing community transportation resources, mental health resources, education for independent living, and mutual-help support
C)   Long-term treatment in a community alcohol treatment center
D)   Treatment at a rehabilitation hospital B

Question 3

A woman with a traumatic brain injury starts smoking marijuana regularly. What might occur?

Accepted Answer

A)   Recovery will be slow but almost guaranteed, since medical marijuana is indicated for TBI.
B)   Problems of balance, walking, and speaking might be alleviated, but the TBI will still be there.
C)   Marijuana use is contraindicated for patients with TBI. She could be endangering her recovery or exacerbating the TBI.
D)   Marijuana use is recommended for patients with TBI. She could better control spasticity and enhance her balance and coordination. C

Question 4

The order in which co-occurrences of mental disorders and substance use disorders appear .

Accepted Answer

A)   does not matter
B)   can affect assessment and treatment
C)   is simple to identify
D)   does not affect assessment or treatment

Question 5

Suppose you work in a local psychiatric hospital. A woman is admitted for the fourth time this year for experiencing acute psychotic episodes. According to her partner, she has complied with her medication regimen. What do you do?

Accepted Answer

A)   Ask about her alcohol use, since her psychosis might be triggered by its use.
B)   Ask about her alcohol use or drug use outside of the prescribed medication, since her psychosis might be triggered by their use.
C)   Have her medication regimen reviewed, because it obviously needs to be adjusted.
D)   Remember that a side effect of her medication when used with alcohol is acute psychosis.

Question 6

You and a mental health professional simultaneously treat a client with co-occurring bipolar disorder and alcoholism. Together you coordinate services and approaches to treatment. This is an example of .

Accepted Answer

A)   co-occurrence management
B)   parallel treatment
C)   sequential treatment
D)   tandem case management

Question 7

What eight similarities between mental illness and substance abuse exist according to Minkoff? Name at least five elements that treatment programs should including according to ASAM.

Accepted Answer

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Question 8

Substance use disorders dependence and abuse) are classified as disorders in the DSM-IV.

Accepted Answer

A)   Axis I
B)   Axis II
C)   psychotic
D)   anxiety

Question 9

A teen diagnosed with a learning disability and ADHD is a user of marijuana and tobacco. She is having trouble socializing with other students in school. What might you recommend?

Accepted Answer

A)   Cognitive-based therapy to increase self-esteem
B)   That the student attend a school specifically for students with LDs
C)   Treatment in a facility that mimics the school environment in noise levels
D)   Treatment that helps develop life skills, self-esteem, and self- advocacy

Question 10

A new client is brought in by a group care facility manager. He is 22 years old, his IQ is 70, and he was recently mugged by patrons of a bar in which he was drinking. He never appears intoxicated, but he frequents the bar almost every night. Your assessment indicates that the client misuses alcohol. What do you recommend?

Accepted Answer

A)   That the group care facility manager provide regular and repeated psychoeducational interventions on the consequences of alcoholism
B)   Regular and repeated psychoeducational interventions on the consequences of substance abuse at your chemical dependence facility
C)   That the group care facility manager provide better oversight
D)   Self-regulatory training and skills training as goals of normalization and inclusion, leading the client to make better informed choices about use

Question 11

You are assessing a client with mental illness for substance use disorders. Time is limited. What screening tool do you use?

Accepted Answer

A)   Interviews
B)   MAST
C)   CAGE
D)   DAST

Question 12

A deaf man comes to your chemical dependency facility and indicates that he requires treatment for alcoholism. Your facility does not have access to sign language interpreters. What might you do?

Accepted Answer

A)   Learn ASL as quickly as possible
B)   Refer to SAISD's national directory for the closest service provider so he can be properly assessed, diagnosed, and treated
C)   Refer him to a local mutual-help group that is conducted in ASL
D)   Have him attend an online AA meeting conducted in ASL

Question 13

A disabled individual is .

Accepted Answer

A)   someone with an impairment
B)   someone with an emotional impairment that limits major life activities
C)   not at high risk for alcohol or drug abuse
D)   potentially at-risk for a co-occurring substance use disorder

Question 14

The general alleviation of dysphoria theory states that .

Accepted Answer

A)   individuals with mental illness discover that the actions of substances relieve or change a range of painful affect states
B)   genetic factors interact with early life events and environmental stressors, making people with mental illness vulnerable to the effects of substances
C)   people with severe mental illness begin using substances to feel better eg, escape isolation, boredom, loneliness, or despair, and improve peer relations) 
D)   mental illnesses precede substance use disorders rather than the other way around

Question 15

Is a substance use disorder a disability? Discuss the ADA and your own opinion.

Accepted Answer

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Question 16

Why is it important for chemical dependency prevention and treatment specialists to have a knowledge of co-occurrence of substance use disorders and other disabilities? Why is important for them to know the individual who has the disability?

Accepted Answer

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Question 17

During an assessment for alcoholism, you learn that a youth has type 2 diabetes and self-injects insulin twice daily. She does not perceive that drinking alcohol could affect control of her diabetes. What might you recommend?

Accepted Answer

A)   That she receive information about the added risks alcohol use may pose for her in order to avoid medical emergencies, whether she is alcoholic or not
B)   That she attend a psychoeducational program about how alcohol and insulin interact, whether she is alcoholic or not
C)   Statistically she is not at risk for alcoholism, so she does not need to be concerned about how alcohol would affect her ability to manage her diabetes.
D)   She has a possible mental illness, since she does not perceive the effect of alcohol on her diabetes, and needs a mental health evaluation

Question 18

What is a dual diagnosis? Discuss the general outcomes for individuals with dual diagnoses. Discuss more specific problems for professionals treating such clients.

Accepted Answer

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Question 19

Under ADA employment provisions, those who use illegal drugs .

Accepted Answer

A)   are specifically included in the definition of "a qualified individual with a disability"
B)   are specifically excluded from the definition of "a qualified individual with a disability"
C)   have a disability that allows them to receive federal funds for employment retraining upon successful completion of a treatment program
D)   cannot enter federally funded treatment programs unless they are employed

Question 20

Physical disabilities are a concern when assessing and treating people who use drugs and alcohol. What are the effects of alcohol in people with heart disease, diabetes, and epilepsy? Discuss the potential for prescription drug abuse in people with chronic pain.

Accepted Answer

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Exam 13: Substance Use Disorders and Co-Occurring Disabilities