Module 7

Question 1

The number of adults with any diagnosable mental disorder within the past year is estimated to be

Answer 1

nearly 1 in 5, or roughly 43 million Americans.

Question 2

how many people have serious functional impairment due to a mental illness

Answer 2

nearly 10 million American adults (1 in 25)

Question 3

factors leading to more frequent incidents of suicide from 1999-2014

Answer 3

the economic recession of the late 2000s and the increase in incidence of substance use

Question 4

median reduction in life expectancy among those with mental illness was

Answer 4

10.1 years

Question 5

The collaborative method is based on

Answer 5

Wagner’s Chronic Care Model and emphasizes behavioral change, use of information systems such as electronic health records, and a team approach, utilizing high-level expertise for illness management and strong community linkages

Question 6

the most common psychiatric disorder in the United States

Answer 6

anxiety

Question 7

anxiety common in

Answer 7

Anxiety most commonly presents in individuals aged 20 to 45 years and is more frequently seen in women

Question 8

anxiety is

Answer 8

an unpleasant state of physical and psychological arousal that interferes with effective psychosocial functioning. Occasional, mild anxiety is a normal fact of life and can be positive; however, severe or chronic anxiety can become debilitating.

Question 9

Anxiety symptoms are typically manifested in several dimensions:

Answer 9

affective,
cognitive,
behavioral,
and somatic.

Question 10

affective component of anxiety

Answer 10

by cognitive thoughts that seek to make sense of or minimize the discomfort. Additional affective symptoms of anxiety are apprehension, fear, irritability, intolerance, frustration, and overreaction or hypersensitivity to personal feelings of shame.

Question 11

anxiety behaviors

Answer 11

Behaviors such as avoidance, distractibility, and restlessness reflect the anxiety or may evolve in response to it. Behavioral symptoms of anxiety may include apathy, compulsions, rigidity, overreactions, preoccupation, and repetitive actions such as hair pulling or nail biting

Question 12

Somatic symptoms of anxiety

Answer 12

range in intensity from a loss of appetite, dry mouth, and fatigue, to diarrhea, sweating, chest pain, hyperventilation, vomiting, and paresthesias.

Question 13

Panic disorder:

Answer 13

the specific worry is focused on the symptoms of panic.

Question 14

Social anxiety disorder (social phobia)

Answer 14

: the worry is about social situations.

Question 15

Obsessive-compulsive disorder:

Answer 15

the worry becomes focused on a specific object or activity.

Question 16

Separation disorder:

Answer 16

the worry is about being away from parents and caregivers.

Question 17

Somatic symptoms disorder:

Answer 17

the worry is focused on physiologic symptoms

Question 18

Body dysmorphic disorder:

Answer 18

the worry is focused on a perceived defect in physical appearance.

Question 19

Post-traumatic stress and acute stress disorder

Answer 19

: the worry is focused on reminders of a traumatic event.

Question 20

The hallmarks of major depression

Answer 20

are sadness and apathy, although symptoms presented in primary care may be fatigue, loss of appetite, and change in sleep

Question 21

The more common patient presentation of depression in primary-care settings

Answer 21

is the person who has moderate to severe feelings of sadness or apathy that he or she may, or may not, attribute to depression. Common presentations also include complaints of unexplained fatigue, insomnia, irritability, anger, anxiety, and hyperactivity. Many deeply depressed persons are unaware of the level of impairment resulting from their illness.

Question 22

two severe symptoms of depression

Answer 22

Slowed thinking and emotional numbness——can contribute to minimal self-awareness of depression

Question 23

Depression belongs to a broad category called

Answer 23

mood (affective) disorders

Question 24

Organic causes of depression

Answer 24

endocrine change, hyperthyroidism, menopause, myxedema, Cushings disease, syphilis

Question 25

Brief psychotic disorder:

Answer 25

occurs without a clear episode of depression; may resolve quickly and be a response to stress.

Question 26

Persistent depressive disorder (dysthymia):

Answer 26

depressive symptoms are milder than those of major depressive disorder but may persist for years.

Question 27

It is well documented that grief is accompanied by

Answer 27

impaired immune function, specifically decreased lymphocyte proliferation and impaired functioning of natural killer cells

Question 28

stages of grieving

Answer 28

* Denial * Anger * Bargaining * Depression * Acceptance

Question 29

Grief consists of three distinct phases:

Answer 29

avoidance, confrontation, and accommodation.

Question 30

The risk factors for a more complicated grief reaction include

Answer 30

(1) sudden and/or violent death, (2) social isolation, (3) individuals who believe that they are in some way responsible for the death (real or imagined), (4) individuals with a history of traumatic losses, and (5) individuals who had an intensely ambivalent or dependent relationship with the deceased.

Question 31

the use of drugs such as tranquilizers or alcohol with grief, which numb emotions,

Answer 31

should be discouraged

Question 32

substance use disorders

Answer 32

These disorders are considered chronic and relapsing because despite significant negative consequences, the behaviors continue.

Question 33

Targeted treatments, often referred to as medically assisted treatments (MATs) for are now available for

Answer 33

tobacco, alcohol, and opioids

Question 34

Intimate partner violence (IPV)

Answer 34

is defined as a pattern of assaultive and coercive behaviors that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation, and threats perpetrated by someone who is, was, or wishes to be involved in an intimate relationship with an adult or adolescent, and aimed at establishing control by one partner over the other

Question 35

Symptoms or behaviors that may signal abuse include

Answer 35

exacerbation or poor control of chronic illness, sleep disturbances, chronic pain, or frequent unexplained appointment changes

Question 36

Behavioral red flags are

Answer 36

(1) a patient who is reluctant to speak in front of her partner or gives evasive answers and (2) an overly protective or controlling partner. Any patient presenting with multiple complaints or whose symptoms are not consistent with her history should be assessed for violence at least once and reassessed if she fails to respond to therapy appropriately

Question 37

Routine screening for IPV is recommended by the USPSTF for all

Answer 37

women of childbearing age at initial visits and periodically

Question 38

The core features of SUDs include a triad of

Answer 38

behavioral, physiological, and cognitive symptoms.

Question 39

Substance withdrawal is characterized by

Answer 39

functional impairment related to the cessation or reduction of a substance, which is demonstrated in physiological, cognitive, and behavioral symptoms

Question 40

Use is defined as

Answer 40

sporadic or intermittent utilization of alcohol or drugs with no adverse consequences.

Question 41

Abuse is defined as

Answer 41

utilization of drugs or alcohol that causes the user some type of adverse consequence

Question 42

Physical dependence refers to

Answer 42

the physiological effects of withdrawal from rapid dose reduction, abrupt cessation of the drug, or administration of an antagonist.

Question 43

Psychological or behavioral dependence emphasizes

Answer 43

pathological use patterns and substance-seeking activities; it is a subjective need for the substance.

Question 44

the risk of SUD is directly related to

Answer 44

the properties of the drug of choice, such as availability, cost, how quickly the brain perceives the substance, and its ability to produce gratification or pleasure, as well as various environmental factors

Question 45

The highest prevalence rates for substance use occur in persons aged

Answer 45

18 to 24 years

Question 46

is the leading preventable cause of death and disability

Answer 46

Tobacco use

Question 47

remains the primary substance of abuse and dependence

Answer 47

Alcohol

Question 48

correlate overall with illicit substance use.

Answer 48

Male sex, ethnicity, education, employment status, and criminal justice population

Question 49

The most common comorbidities are substance abuse with more than one substance

Answer 49

and mood disorders including bipolar disorder, anxiety disorders, antisocial personality, and schizophrenia

Question 50

The susceptibility variant emphasizes that

Answer 50

genetic factors play an important role in the development of substance dependence, influencing the individual’s vulnerability

Question 51

the exposure construct holds that

Answer 51

chemicals and their actions on the brain are the primary causes of addiction

Question 52

One characteristic that all commonly abused drugs share is

Answer 52

their ability to stimulate reward centers in the brain.

Question 53

All addictive substances/behaviors involve increases in

Answer 53

dopamine levels in the mesolimbic dopamine system, the reward system of the brain.

Question 54

substance use disorders (

Answer 54

those pathological behaviors associated with substance-seeking activities)

Question 55

substance-induced disorders

Answer 55

(intoxication, withdrawal, and mental disorders caused by a medication or a substance).

Question 56

Cannabis Intoxication:

Answer 56

Intoxication typically includes euphoria, alterations in mood and judgment, and changes in sensory perception, cognition, and coordination. Driving and machine-operating skills may be impaired.

Question 57

Cannabis Withdrawal:

Answer 57

Transient symptoms occur on withdrawal, usually within 1 week of stopping after prolonged use, and include irritability, cravings, anxiety, sleep problems, and decreased appetite.

Question 58

Stimulant Intoxication:

Answer 58

Symptoms include euphoria; increased wakefulness; decreased appetite; and increased breathing, heart rate, blood pressure, and body temperature.

Question 59

Stimulant Withdrawal:

Answer 59

Symptoms occur within hours or days of last use and include severe depression, anxiety, fatigue, psychosis, and intense craving for the drug. Experienced heavy users may plan their drug use to include substances that can prevent or minimize withdrawal.

Question 60

Tobacco Withdrawal:

Answer 60

Cessation of daily tobacco use produces symptoms within 24 hours. Withdrawal symptoms include intense cravings, depressed mood, sleep problems, impaired concentration, anxiety, increased appetite, and irritability.

Question 61

Phencyclidine or Other Hallucinogen Intoxication:

Answer 61

Several behavioral symptoms occur shortly after use of phencyclidine, including hallucinations, delusions, paranoia, and a sense of being outside one’s body. For other hallucinogens, symptoms include rapid mood swings and inability to think rationally, communicate with others, or recognize reality. Physical symptoms include increased heart rate, body temperature, and blood pressure; dizziness, loss of appetite, tremors, pupil enlargement.

Question 62

Inhalant Intoxication:

Answer 62

Intoxication can include confusion, nausea, slurred speech, lack of coordination, euphoria, dizziness and lightheaded, drowsiness, lack of inhibition, delusions or hallucinations, and headache.

Question 63

Opioid Intoxication:

Answer 63

Intoxication typically includes a sudden change in behavior, which can include euphoria, drowsiness, confusion, nausea, and slowed breathing. Constipation is a commonly recognized side effect of opioid use.

Question 64

Opioid Withdrawal:

Answer 64

Withdrawal symptoms include muscle and bone pain, sleep disturbances, nausea and diarrhea, and intense cravings.

Question 65

Sedative, Hypnotic, or Anxiolytic Intoxication:

Answer 65

Symptoms include slurred speech, confusion, trouble concentrating, dry mouth, decreased blood pressure and breathing rate, dizziness and light-headedness, headache, and slowed movements and thinking.

Question 66

Sedative, Hypnotic, or Anxiolytic Withdrawal:

Answer 66

Symptoms may include seizures; shakiness; trouble sleeping; agitation; increased heart rate, blood pressure, and body temperature accompanied by sweating; hyperreflexia, and intense cravings.

Question 67

Caffeine Intoxication:

Answer 67

Symptoms include increased alertness and muscle movements, increased urination, sleeplessness, increased heart rate, and sweating.

Question 68

Caffeine Withdrawal:

Answer 68

Suddenly stopping or reducing daily caffeine use may cause withdrawal symptoms within 12–24 hours, which may include fatigue, headache, and insomnia.

Question 69

is now the leading cause of accidental death in the United States

Answer 69

Drug overdose

Question 70

Particular populations at risk for prescription opioid abuse include

Answer 70

women, adolescents and young adults, and older adults.

Question 71

AUD is a

Answer 71

chronic relapsing progressive brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using. Alcohol use disorder includes (1) alcohol abuse and (2) alcohol dependence. It is also classified as mild, moderate, and severe. It is characterized by a problematic pattern of alcohol use, leading to clinically significant impairment or distress, as manifested by multiple psychosocial, behavioral, or physiological features

Question 72

A blood alcohol level of 0.05 causes

Answer 72

disruptions in thinking, judgment, and inhibition.

Question 73

A blood alcohol level of 0.1 produces

Answer 73

obvious intoxication.

Question 74

A blood alcohol level of 0.2 results in

Answer 74

depression of motor functioning and emotional/behavioral dysfunction.

Question 75

A blood alcohol level of 0.3 produces

Answer 75

stupor and confusion

Question 76

Blood alcohol levels of 0.4 and higher produce

Answer 76

coma.

Question 77

low-risk drinking

Answer 77

for men as less than drinks per day and no more than 14 drinks per week, and for all women and men aged 65 and older no more than 3 drinks per day and no more than 7 drinks per week.

Question 78

At-risk drinking is

Answer 78

consuming volumes greater than these guidelines.

Question 79

Harmful drinking, on the other hand, occurs when alcohol is

Answer 79

causing physical, psychological, or social harm exhibited by zero to two dependence criteria and zero to one abuse criteria, according to this agency

Question 80

pharm tx for AUD

Answer 80

Pharmacological therapy of withdrawal includes intermediate- or long-acting benzodiazepines such as lorazepam, oxazepam, diazepam, or chlordiazepoxide. Carbamazepine has also been shown to be effective in mild to moderate symptoms of withdrawal and has the added advantage to decrease craving. In addition, adjunctive medications include antipsychotic medications such as haloperidol, which is used in patients with significant hallucinations and agitation.

Question 81

the average daily caffeine U.S. consumption over the past 10 years has remained stable at

Answer 81

300 mg per person per day.

Question 82

The first goal of treatment for substance abuse should be

Answer 82

the restoration of the physical, psychological, and social well-being of the person and family