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Course 6TBI - ToolKit for TBI - Guide 2 - Quiz 2

 

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1)
We are now moving on to the quiz for Study Guide 2 of Course 6 TBI, sponsored ONLINE for APPROVED CE Credit by CEU By Net, LLC. This is the second section (Study Guide) of this sponsored CE course. Each Study Guide has a quiz. When you have passed this second quiz, you will move on to Study Guide 3. The course material in Study Guides 2 and 3 is authored, edited, and published by a group of nationally recognized experts. Which choice below is NOT one of the authors/publishers of this course material?
 
Author Carolyn Lemsky, PhD, C Psych ABPP-CN
Mountain Plains Addiction Technology Transfer Center
Mid-America Addiction Technology Transfer Center
Editors Patricia Stilen, MSW and Thomasine Heitkamp, LCSW
European and Canadian Metal Workers Union
 
2)
The introduction to this Study Guide 2 emphasizes . . .
 
that SUD treatment for TBI survivors requires a different approach than for those without TBI.
the need for special accommodations in the delivery of behavioral health treatment when serving persons with brain injuries. vs. serving those without TBI.
the negative impact of continued use of alcohol and drugs on persons with a brain injury vs.continued use by those without a TBI.
all of the above.
 
3)
In most settings, at least one out of ____ people presenting for treatment of a substance use disorder is also living with the effects of brain injury.
 
10
3
5
20
2
 
4)
Anoxic injuries associated with non-fatal overdose and substance-related brain injury are two common causes of injury to the brain.
 
True False
 
5)
Which of the statements below is not accurate?
 
Approximately one in five American adults have sustained a traumatic brain injury (TBI) severe enough to result in some loss of consciousness.
Most injuries resulting in some loss of consciousness are moderate and need inpatient treatment.
Having one or more brain injuries with loss of consciousness is associated with a significantly greater risk for behavioral health problems, including problematic substance use.
Childhood TBI increases the risk for behavioral health problems, including problematic substance use beginning in adolescence.
 
6)
The presence of a Traumatic Brain Injury should not impact the treatment process for SUD. Modification of the standard SUD treatment approach is not necessary for most clients living with both SUD and TBI.
 
True False
 
7)
In people seeking services for substance use disorders, there is a high incidence of cognitive impairment due to TBI. Which statement about TBI and recovery is not true?
 
Lack of oxygen to the brain -- associated with a non-fatal overdose of a drug -- is a common cause of injury to the brain.
The cognitive impact of an overdose will vary, depending on how long the oxygen supply was interrupted and the type of drug and the pattern of use.
Some substance-related changes in brain function will return to normal with abstinence. Some are lasting.
The toxic effect of alcohol and other drugs on persons with a previous TBI requires no special considerations in the treatment process.
SUD treatment of persons with TBI is complicated and requires coordination among mental health and brain injury experts.
 
8)
Alexa's Story describes how the emotional, behavioral, and cognitive damage caused by a Traumatic Brain injury—such as an accident or fall—may not be immediately apparent, and can cause destructive use of alcohol and drugs much later.
 
True False
 
9)
Moving to BRAIN BASICS—Cerebral Cortex: The brain’s cortex is the grey matter or outer layer of brain tissue. What is not true pertaining to the Cerebral Cortex?
 
The Cerebral Cortex is responsible for our most complex cognitive functions. The frontal and prefrontal cortical areas are responsible for conscious thought and reasoning.
The frontal and prefrontal cortical areas are designed to have a “top down” effect on emotions, allowing us to understand and think about what we feel and to plan action.
Our most complex behaviors are the result of interrelated circuits which connect areas of the brain.
The Cerebral Cortex operates independently and does not need to maintain connection with the other areas of the brain to operate effectively..
Interconnections between the Cerebral Cortex and the other areas of the brain are essential for effective brain functioning.
 
10)
An acquired brain injury (ABI) is
 
a change in brain function or structure that results from a mechanical force (a blow or jolt). TBI may be caused by the head being struck by an object, the head striking an object, acceleration/deceleration, such as whiplash or being shaken, a foreign body penetrating the skull, such as a gunshot wound or skull fragment, or forces from an explosion or blast.
any injury to the brain that occurs after birth that disrupts some aspect of brain functioning and is not the result of a progressive disease such as dementia and is not congenital.
 
11)
Measuring the severity of TBI: What is true?
 
It is usually true that the length of time a person is unconscious or experiencing confusion and disorientation after an injury is directly related to the severity of the TBI.
A mild TBI can sometimes result in an abnormal MRI or CT Scan.
A moderate TBI results in loss of consciousness from 30 minutes to 24 hours
Severe TBI results in post-traumatic amnesia or confusion for greater than 45 days.
All but the fourth option.
 
12)
The prefrontal cortex regulates Executive Functioning, and the limbic system is responsible for focusing attention and regulating emotion and behavior. Therefore, damage to the CONNECTION between these two parts of the brain will likely result in noticeable COGNITIVE symptoms.
 
True False
 
13)
When connections between the prefrontal cortex and the limbic system are damaged (not working well), our judgment about 'the right thing to do' is faulty, and we have trouble reading others’ nonverbal behavior and controlling our strong emotions.
 
True False
 
14)
The implications of alcohol and drug use by clients who have previously been diagnosed with a TBI are significant. What is not accurate about substance use and previous TBI?
 
Substance abuse following a TBI can lead to additional damage to a brain that has not had time to heal following the previous TBI.
It is possible that changes in brain function due to a previous TBI may cause some drugs to have a more powerful effect, increasing the chance of an overdose.
People with TBI are not more prone to drug overdose than others, because their previous brain injury has made them ultra-cautious.
The opioid epidemic has resulted in an increasing number of non-fatal overdoses that can potentially result in lasting changes in cognition and behavior.
All but the third option are true
 
15)
Moving to Toxic Effects of Substance Use: Which statement below is true?
 
Beginning substance use while the brain is developing can have long-term consequences.
it appears that the toxic effects of alcohol and other drugs are more dramatic in people who have had a history of TBI.
The time for the brain to recover from an overdose is unrelated to previous overdoses.
The negative impact of substance use on the brain depends on the substance used and the amount and duration of use.
All but the third option is true.
 
16)
Alcohol use is associated with brain atrophy and lasting learning and memory problems.
 
True False
 
17)
A broad summary of the research of CANNABIS indicates ____________.
 
some evidence for atrophy in the Hippocampus (memory system)
cognitive changes - Memory Executive Functioning.
an impact on the developing brain
all of the above
none of the above
 
18)
Based on broad research of the use of METHAMPHETOMINE, what damage occurs with use of that drug?
 
damage to memory and executive functioning
inability to suppress habitual behaviors
insensitivity to punishment and normal pleasures
All of the above
 
19)
Based on broad research of the use of COCAINE, what changes occur?
 
brain atrophy
changes in limbic (emotional) and Hippocampus (memory system)
Insensitivity to normal pleasures
Increased sensitivity to pain
All of the above.
 
20)
Based on broad research of the use of OPIOIDS, what effects are found?
 
Weakened connections between the frontal lobe and limbic system of the brain
brain atrophy
changes in limbic (emotional) and Hippocampus (memory system).areas of the brain
insensitivity to normal pleasures and increased sensitivity to pain.
All of the above.
 
21)
Moving to the diagram 'SYMPTOMS ASSOCIATED WITH BRAIN INJURY': Assume that you are assessing a behavioral health client who presents with the following array of symptoms: • Inability to process information efficiently • Memory impairment • Impaired attention and concentration • Difficulty multitasking • Impaired self-monitoring (insight and awareness) • Inability to problem-solve and develop new solutions • QUESTION: An individual with these symptoms is likely to have WHICH CATEGORY OF BRAIN INJURY ACCORDING TO THIS DIAGRAM?
 
MOTOR AND SENSORY EFFECTS
MIXED DISABILITY
COGNITIVE IMPAIRMENT
EMOTION AND BEHAVIORAL DYSREGULATION
UNDETERMINED
 
22)
Assume that you are assessing a behavioral health client who presents with the following array of symptoms: • concurrent mental health issues (e.g., anxiety). • behavioral problems (e.g., anger, irritability, socially inappropriate behavior). • Impulsivity. • Difficulty learning from experience. QUESTION: An individual with these symptoms is likely to have WHICH CATEGORY OF BRAIN INJURY ACCORDING TO THIS DIAGRAM?
 
COGNITIVE IMPAIRMENT
MOTOR AND SENSORY EFFECTS
MIXED DISABILITY
EMOTION AND BEHAVIORAL DYSREGULATION
UNDETERMINDED
 
23)
How TBI Affects Treatment: People living with brain injury often have a significant gap between what they intend to do and what they can do, so that intentions in the office are difficult to carry out in the real world.
 
True False
 
24)
The emotional and behavioral impact of damaged connections between sections of the brain can affect participation in treatment. Which statement below is not accurate?:
 
Many individuals with TBI find sensory and emotional inputs more difficult to manage, resulting in mood and behavior changes. These changes are often described as “a change in personality.”
People living with brain injury often have a bigger gap between what they intend to do and what they can do, because of damaged connections in the brain..
Overriding the automatic substance abusing behaviors requires a well-connected brain and strong executive functioning. Addiction is an example of when the reward system is led astray,
The neural reward system is not affected by TBI and addiction, and is not a factor in treatment.
The conscious-control systems may have less influence over behavior -- allowing impulsivity.
 
25)
Signs of difficulty associated with impaired functioning of the prefrontal cortex include: 1. Poor follow-through with goals and intended behavior. 2. Failure to learn through experience. 3. Difficulty setting realistic goals. 4. Trouble recognizing how their behavior affects outcomes.
 
True False
 
26)
TBI and substances including opioids interfer with the process of reading and responding to social cues, emotional regulation, and developing rapport with a therapist or working in group settings.
 
True False
 
27)
Regarding Recovery from a TBI: Which statement is not accurate?
 
How well a person recovers from TBI is related, in part, to the severity of the head injury.
Neurons begin to return to a more normal state, and new connections form between undamaged neurons.
There is a great deal of variation from person to person.
Recovery tends to be slow in the beginning and then gradually accelerates.
Improvements can continue to happen for many years after a TBI, but once a plateau has begun, progress requires re-learning and practice and is very gradual.
 
28)
Risk Factors for Greater Disability After TBI: Which below is not accurate?
 
Multiple mild concussions or injuries resulting from falls, domestic violence, or sports can result in lasting changes in functioning—even though the individual may experience few symptoms.
Pre-injury mental health problems - such as depression, anxiety, and substance use disorders - may face difficult and protracted periods of recovery
When PTSD occurs with a brain injury, there is a much greater risk of lasting problems, due to changes in emotional regulation as well as cognitive changes.
Sustaining an injury in childhood during vulnerable periods of brain development will be immediately apparent.
Injuries sustained as the result of physical violence often have poorer outcomes.
 

 

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