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1. Women often report that stress, relationships, and __________ often precipitate initial substance use.
A. Trauma
B. Socioeconomics
C. Negative affect
D. Genetics
2. Women have more complications and more severe problems from alcohol use than do men, but these complications and problems develop less rapidly.
A. True
B. False
3. Gender does not appear to predict retention in substance abuse treatment, and women are as likely as men to stay in treatment once it is initiated.
A. True
B. False
4. According to the Substance Abuse and Mental Health Services Administration, ____ percent of females ages 12 and older were classified with substance dependence or abuse in 2004, but only ____ percent received treatment.
A. 9.5; 4.3
B. 8.4; 3.6
C. 7.3; 2.1
D. 6.2; 0.9
5. Which of the following is NOT one of the likely characteristics of women who use alcohol and illicit drugs?
A. They often have great feelings of shame and guilt
B. They are much less likely than men to seek help after relapse
C. They have low levels of self-esteem and self-efficacy
D. The are frequently devalued or disliked by other women
6. Substance abuse treatment for women should:
A. Recognize the role and significance of relationships in women’s lives
B. Address women’s unique health concerns
C. Endorse a developmental and trauma informed perspective
D. All of the above
7. Women who abuse substances have specific health issues and medical needs related to gynecology.
A. True
B. False
8. In a large study of female twins, childhood sexual abuse was associated with a greater likelihood of lifetime alcohol use, alcohol dependence, and:
A. Having the first drink at an early age
B. A greater likelihood of substance abuse relapse after treatment
C. An increased prevalence of polysubstance abuse
D. None of the above
9. Most women with substance use disorders have to contend with economic and social factors as well as individual and family issues to negotiate their recoveries successfully.
A. True
B. False
10. All of the following have been identified as developmental issues that affect substance abuse and its treatment EXCEPT:
A. Changes in physiology
B. Emotional and social development
C. Changes in social roles and expectations
D. Reasoning ability
11. Alcohol problems seem to be ordinary events among the elderly, and estimates of the prevalence of heavy drinking or alcohol abuse range from 8 to 24 percent for this population.
A. True
B. False
12. Women are affected by familial substance abuse as much as men, with a prevalence of alcohol dependence from ________ times higher than women who do not have a parent who abuses substances.
A. 10 to 50
B. 15 to 45
C. 20 to 40
D. 25 to 35
13. Some women continue using alcohol and illicit drugs to have an activity in common with their substance abusing partners or to maintain the relationships.
A. True
B. False
14. One study found a lifetime history of trauma in 55 to 99 percent of women who abused substances, compared with rates of 36 to 51 percent in the general population.
A. True
B. False
15. Which of the following is a true statement about co-occurring substance use and mental disorders?
A. One study of women diagnosed with alcohol abuse indicated that 62.9 percent have lifetime co-occurring mental disorders and 76 percent of women diagnosed with alcohol dependence have co-occurring disorders
B. In comparison to men, women are less likely to have multiple comorbidity (three or more psychiatric diagnoses in addition to substance use disorders).
C. Various literature on co-occurring disorders highlights the role of substance abuse as a means of self-medicating distressing affect
D. All of the above
16. Research indicates that foreign-born Mexican Americans and foreign-born non-Hispanic Caucasians are at significantly higher risk for substance use disorders than are their American-born counterparts.
A. True
B. False
17. Compared with men, women are _____ percent more likely to use a prescription drug that can be abused.
A. 32
B. 36
C. 42
D. 48
18. Data from 2006-2007 shows that among pregnant women ages 15 to 44 years, 5 percent reported using illicit drugs in the past month.
A. True
B. False
19. The primary sources of treatment referrals for women with substance abuse issues are social service agencies and healthcare professionals.
A. True
B. False
20. While the primary substance of abuse reported on admission of Caucasian and American-Indian/Alaska-Native women is alcohol, Asian-and Pacific-American women reported ______________ most often.
A. Cocaine
B. Methamphetamine
C. Narcotics
D. None of the Above
21. When working with women in substance abuse treatment, administrators need to develop and incorporate policies and procedures that support family involvement from the onset.
A. True
B. False
22. By and large, women who have substance use disorders have poorer quality of life than men when it comes to health-related issues.
A. True
B. False
23. According to the Centers for Disease Control, women from ethnically diverse backgrounds who have substance abuse disorders possess greater risks for developing hypertension, HIV/AIDS, and:
A. Kidney disease
B. High blood pressure
C. Anemia
D. All of the above
24. The World Health Organization reports that alcohol is one of the ____ most significant risk factors for diseases, with more than ____ percent of alcohol-related diseases being a chronic condition.
A. 3; 50
B. 4; 45
C. 5; 60
D. 6; 65
25. In women, moderate drinking is considered to be no more than two drinks per day, compared with no more than three drinks per day for men.
A. True
B. False
26. Which of the following is a correct statement about alcohol and breast cancer?
A. Studies from around the world show that for each drink of alcohol consumed daily, women increased their risk of breast cancer by 11 percent
B. Women who drink alcohol have elevated cortisol and progesterone levels, which may be contributors to the development of breast cancer in this population
C. Postmenopausal women have an increased risk of breast cancer if they currently drink alcohol
D. All of the above
27. Women who are alcohol dependent exhibit deterioration in planning, visuospatial ability, working memory:
A. Voluntary movement
B. Balance and Posture
C. Muscle control
D. Psychomotor speed
28. Hormonal changes across the menstrual cycle have the greatest effect on stimulant drugs, particularly cocaine and amphetamine.
A. True
B. False
29. One study found that women who consumed five or more drinks per week were three times as likely to deliver a stillborn baby compared with those who have fewer than one drink per week.
A. True
B. False
30. Fetuses exposed to opioids may experience neonatal abstinence syndrome (NAS) at birth, which is characterized by each of the following EXCEPT:
A. Jitteriness and discomfort
B. Central nervous system irritability
C. Gastrointestinal problems
D. Respiratory distress
31. Which of the following is NOT a true statement about tobacco and pregnancy?
A. Women who smoke tobacco increase their chances of ectopic pregnancy, spontaneous abortion, and preterm delivery
B. Infants born to women who smoke are more likely to have lower birth weights and have an increased risk of SIDS
C. Children of parents who smoke heavily can be affected adversely in their auditory, language, and cognitive performance
D. Studies have drawn an association between maternal smoking during pregnancy and failure to meet developmental milestones
32. Almost one out of four newly diagnosed cases of HIV in the United States is a woman, and approximately ____ percent of these newly diagnosed women with HIV also have Hepatitis C.
A. 10
B. 20
C. 30
D. 40
33. The purpose of screening is to gather the detailed information needed for a treatment plan that meets the individual needs of the woman.
A. True
B. False
34. One study indicated that clients with more than a high school education are more apt to disclose the use of drugs or alcohol during pregnancy.
A. True
B. False
35. The ________ is an effective screening instrument for women that consists of 10 questions that are highly correlated with hazardous or harmful alcohol consumption.
A. AUDIT
B. TCUDS II
C. CAGE
D. MAST
36. Women who smoked in the month before pregnancy are six times more likely to be currently using either drugs or alcohol or both while pregnant.
A. True
B. False
37. Questioning past or present mental disorder symptoms that may indicate the need for a full mental health assessment is known as:
A. Symptom evaluation
B. Symptom testing
C. Symptom screening
D. None of the Above
38. Initial questions about trauma should be specific and the counselor should control the level of disclosure.
A. True
B. False
39. Women in substance abuse treatment need to be routinely screened for depressive symptoms, eating disorders, and:
A. Past trauma
B. Anxiety disorders
C. Psychosocial histories
D. None of the above
40. Discussing the challenges that the client has faced throughout her life and how she has managed them is included in which category of biopsychosocial and cultural history?
A. Mental health and treatment history
B. Sociocultural history
C. Interpersonal and family history
D. Strengths and coping strategies
41. The Addiction Severity Index is an assessment tool that can be distributed in several languages including French, German, Russian, and Chinese.
A. True
B. False
42. Women have identified multiple factors as barriers to entering or engaging in treatment and they exist on several levels including:
A. Intrapersonal factors including health problems, psychological issues, cognitive functioning, motivational status, and treatment readiness
B. Sociocultural factors including cultural differences; the role of stigma, bias, and racism; societal attitudes; disparity in health services; attitudes of healthcare providers toward women; and others
C. Structural characteristics including treatment policies and procedures, program design, and treatment restrictions
D. All of the above
43. From 2004 to 2006 the number one reason that women aged 18 to 49 who needed substance abuse treatment failed to receive it was that they were not ready to stop using.
A. True
B. False
44. Research indicates that the co-occurrence of a substance use disorder and involvement in the child welfare system ranges from:
A. 50 to 80 percent
B. 40 to 70 percent
C. 30 to 60 percent
D. 20 to 50 percent
45. The three major components of outreach services include each of the following EXCEPT:
A. Identifying a woman’s most urgent concerns and addressing those first
B. Providing comprehensive case management
C. Empathizing with the woman’s fears and resistances, while assisting her in following through on commitments
D. Assisting the woman in negotiating the human service system
46. Women assigned to intensive case management had significantly higher levels of substance abuse treatment initiation, ___________, and retention in comparison to women who received only screening and referral.
A. Engagement
B. Adherence
C. Commitment
D. All of the above
47. Life skills needed in substance abuse treatment include money management and coping skills training.
A. True
B. False
48. Brief interventions using motivational interviewing seem to be more effective for women who are primarily dependent on illicit drugs rather than alcohol.
A. True
B. False
49. Which of the following correctly describes intensive outpatient treatment (IOP)?
A. These services are the most common and widely available for women seeking treatment
B. Intensive outpatient treatment is recommended for women have multiple and complex needs and require stabilization
C. IOP provides a higher treatment level than traditional outpatient programs but does not require structured residential living
D. None of the above
50. The effectiveness of residential treatment appears to rely on the client profile at the time of the admission as the key element of success.
A. True
B. False
51. Medically managed acute inpatient treatment usually lasts between:
A. 2 and 4 days
B. 3 and 5 days
C. 4 and 6 days
D. 5 and 7 days
52. Information about substance use among Hispanics/Latinas indicates that:
A. Mexican–American women show higher rates of abstinence than Cuban and Puerto Rican women and exhibit the lowest rates of frequent heavy drinking of all Hispanic/Latina subgroups
B. Young Mexican-American and Puerto Rican women drink less alcohol than immigrant women of their subgroups
C. Hispanic/Latina women admitted to substance abuse treatment were more likely to report cocaine as their primary substance of abuse
D. While Puerto Rican and Cuban-American women reported more opiate use, Mexican-American women reported more methamphetamine use
53. Studies show that ___________appears to affect substance abuse among Hispanic populations more than any other factor.
A. Acculturation
B. Socioeconomics
C. Gender Socialization
D. Age
54. Since the 1990s the total substance abuse admissions among African Americans has been steadily increasing.
A. True
B. False
55. African-American women are 10 times more likely than Caucasian women to have positive drug screens, but this difference may be directly related to a disproportionate testing percentage.
A. True
B. False
56. Regardless of the approach used with African American women, treatment should evolve around the premise that ___________________ are essential elements to healing and recovery.
A. Ancestry and culture
B. Values and experiences
C. Spirituality and rituals
D. Family and community
57. In comparison to other ethnic groups, Asian and Pacific Americans have the lowest percentage of current drinking history and of past year alcohol dependence or abuse.
A. True
B. False
58. The primary substance of abuse among Asian and Pacific American women entering treatment is:
A. Alcohol
B. Methamphetamine
C. Opiates
D. Cocaine
59. Preliminary research with Asian Americans in community-based substance abuse treatment found no overall group differences in treatment retention and outcomes.
A. True
B. False
60. Among women of all races aged 35 to 44, 4.9 per 100,000 died of alcohol-related disease, but among American-Indian and Alaska-Native women in this age range the alcohol-related death rate is:
A. 52.7 per 100,000
B. 61.8 per 100,000
C. 67.2 per 100,000
D. 73.6 per 100,000
61. American-Indian women are disproportionately affected by childhood sexual abuse, physical abuse, and:
A. Violent crimes
B. Emotional trauma
C. Poverty and unemployment
D. None of the above
62. The most critical feature for treatment of American-Indian and Alaska-Native women is that programs be comprehensive and family-based.
A. True
B. False
63. Each of the following accurately describes research on substance abuse among lesbian and bisexual women EXCEPT:
A. Studies in the 1970s and 1980s revealed high rates of alcohol use and abuse among lesbians, yet most surveys were conducted at bars
B. Studies suggest that lesbian women-in comparison to heterosexual women-are more likely to use and abuse alcohol, less likely to decrease their use of alcohol with age, and more likely to report alcohol-related problems
C. Researchers report that women with female sexual partners had at least two symptoms of dysfunctional drug use and were more likely to display serious impairment in comparison to heterosexual women
D. In a study conducted in urban primary care sites, bisexual women were about twice as likely as heterosexual women to report having used illicit drugs in the past month
64. Limited available data suggests that patterns of substance use among lesbian women of color are more similar to those of their Caucasian lesbian counterparts than to those of their heterosexual racial and ethnic counterparts.
A. True
B. False
65. Approximately ____ percent of all prescriptions and _____ percent of all benzodiazepine prescriptions are prescribed to elderly individuals.
A. 20; 30
B. 30; 40
C. 40; 50
D. 50; 60
66. Program development advice for treating older women with substance abuse issues includes:
A. Introduce coping strategies, including relaxation methods, to enhance feelings of self-efficacy in handling life stressors
B. Incorporate counseling services that address issues of grief along with substance abuse treatment as needed
C. Provide education on the physiological impact of alcohol and drug intake among older women
D. Create access to treatment through non-traditional delivery such as home-based or mobile community services
67. Using a non-direct individualized approach can help capitalize on each woman’s life experiences and give meaning to her recovery.
A. True
B. False
68. While rural and urban areas experience similar drug-use problems, the consequences may be greater in rural areas because of:
A. Limited access to health care and treatment
B. Social isolation
C. Lack of community support
D. Stress and anxiety
69. Research shows that among incarcerated prisoners:
A. Women in state prisons are more likely than men to be sentenced for drug offenses
B. Females were more likely than males to have used methamphetamines in the month before their offense
C. An estimated 52 percent of females in comparison to 44 percent of males incarcerated in local jails were dependent on or abusing drugs
D. All of the above
70. Despite assumptions to the contrary, gender is not likely to predict retention in substance abuse treatment.
A. True
B. False
71. Clinical experience has shown that women who abuse substances benefit more from ___________ therapies than other types of therapeutic approaches.
A. Behavioral
B. Collaborative
C. Motivational
D. Supportive
72. Across studies, women have identified several counselor characteristics they believe contribute to treatment success including confidence and faith in their abilities, projection of acceptance and care, and:
A. A compassionate problem solving agenda
B. A non-authoritarian attitude and approach
C. Empathic communication skills
D. An open and tolerant mind
73. The three major themes in relational theory are interpersonal experiences, family patterns, and the need for autonomy.
A. True
B. False
74. Sexual concerns that women report during early substance abuse recovery include:
A. Confusion about sexual identity
B. Fear of sex while abstinent
C. Sexual violence
D. All of the above
75. Mother–child relationships are understood to be the model for the child’s future relationships, so these relationships are very important in recovery from substance use disorders.
A. True
B. False
76. Which of the following is NOT one of the factors that may affect the parenting of a woman who has experienced trauma?
A. Extent of trauma history
B. Who the abuser was
C. A woman’s parenting role models
D. Current support system
77. Alcohol and drug use by trauma survivors can be adaptive at first because substances may help survivor’s dissociate from the trauma.
A. True
B. False
78. Which of the following correctly describes violence and women?
A. One out of every four women has been forcibly raped at some time in her life, and women are as likely to be raped as adults as they are as minors
B. Between 15 and 30 percent of women will be abused by male partners during their lifetime
C. A history of intrafamilial violence may be the most influential risk factor for a woman’s abuse of substances
D. Women are injured as a result of domestic violence about 10 times more frequently than men
79. Benzodiazepines are commonly used to treat anxiety and are often prescribed to women in substance abuse treatment because of their safety.
A. True
B. False
80. When working with women who are experiencing the effects of trauma and substance abuse, the counselor should:
A. Identify which is the primary problem and which is secondary
B. Focus on the client’s current crisis and stabilizing her affect
C. Delay working on trauma symptoms until the client has been abstinent for a predetermined amount of time
D. All of the above
81. While women with PTSD appear to possess more psychological risk factors associated with relapse than men, women maybe more likely to engage in treatment, thereby offsetting the higher risks for relapse
A. True
B. False
82. The Women Embracing Life and Living (WELL) Project was developed to integrate treatment services for women with co-occurring substance use and mental disorders who have histories of:
A. Abandonment issues
B. Emotional abuse
C. Incarceration
D. Violence
83. Case management considerations in trauma-informed services include counselor readiness, staff training and supervision, and continual self assessment of strengths and limitations.
A. True
B. False
84. The stages of recovery from trauma include safety,______________________, and reconnection.
A. Establishing expectations and boundaries
B. Developing trust and joy
C. Remembrance and mourning
D. None of the above
85. Stage three reconnection groups should be structured and formal in order to ensure client safety.
A. True
B. False
86. Which of the following is a true statement about trauma-specific curricula?
A. Seeking Safety is a 12-week program that integrates psychoeducational and expressive activities for individuals with trauma-related and substance use problems
B. TARGET assists in replacing stress responses with a positive approach to personal and relational empowerment
C. Helping Women Recover is a cognitive, behavioral, and interpersonal therapy model for substance use disorders and PTSD
D. SDPT includes survivor empowerment, power support, and techniques for self-soothing, boundary maintenance, and problem solving
87. Depression usually precedes alcohol abuse in men, whereas alcohol dependence usually comes first among women.
A. True
B. False
88. Antidepressant and mood-regulating medications are appropriate for women in treatment for co-occurring substance use disorders and depression.
A. True
B. False
89. Research focusing on women with substance use and eating disorders indicates that:
A. 12 percent of women seeking treatment for either anorexia nervosa or bulimia nervosa had a lifetime drug use disorder
B. Overall, research indicates that substance abuse is accompanied more often by anorexiathan bulimia
C. Nearly one third of women with a history of bulimia also have a history of alcohol abuse
D. Both A and C above
90. Interpersonal therapy has been affective for women with bulimia in reducing the frequency of binge/purge cycles and improving body image, mood, and social functioning.
A. True
B. False
91. Since the mid 1980s, research and experience about tobacco use during substance abuse treatment has shown that :
A. Any attempt to stop smoking could put the recovering person at an increased risk for relapse
B. People will quit naturally if they so desire, and are often more likely to stop smoking if allowed to make the decision on their own
C. Nicotine cessation interventions in substance abuse treatment are associated with an increase in long-term abstinence of alcohol and illicit drugs.
D. All of the above
92. For women, relapse is prevalent during the continuing care process, especially when there is little compliance or support from family to follow aftercare plans.
A. True
B. False
93. Substance abuse relapse is more likely to be determined by ____________________ than by the client’s gender.
A. Client characteristics
B. Length of time in treatment
C. Availability of support system
D. None of the above
94. Women are less likely than men to be affected by the same relapse risks across multiple relapse episodes.
A. True
B. False
95. Women For Sobriety is a self-help program designed specifically for women who are dependent on illicit drugs.
A. True
B. False
96. When hiring people in recovery as mentors, case managers, counselors, and board members, characteristics to consider include significant time in recovery and:
A. Ability to handle the expected range of tasks
B. Considerable training in issues related to recovery in specific treatment areas
C. Communication and problem solving skills
D. Both A and B above
97. The primary characteristic of a healing environment is _____________.
A. Compassion
B. Experience
C. Safety
D. Consistency
98. Training for substance abuse counselors who specialize in treating women should include information on women's substance use and abuse along with the physiological effects that are unique to women.
A. True
B. False
99. Sympathethic traumatization occurs when counselors develop symptoms of depression, such as sleep disturbances, loss of appetite, or loss of pleasure.
A. True
B. False
100. Which of the following is NOT one of the strategies for organizational change recommended by the authors?
A. Staff members should be helped to identify their biases and assumptions
B. Administrators need to model respectful relationships with clients and staff
C. Advocacy for the program’s philosophy of treatment should be general and flexible
D. The program environment should reflect the diverse cultures of the staff and clients
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