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Quantum Units Education®

Substance Use Disorder Treatment for Persons With Co-Occurring Disorders

1. A 25-year-old male patient has questions regarding addiction. Which of the following educational points should be expressed to the patient?

A. Addiction is an acute brain disease.

B. Addiction is an acute brain disease that has the potential for relapse.

C. Addiction is a chronic brain disease that has the potential for recovery, but not relapse.

D. Addiction is a chronic brain disease that has the potential for both relapse and recovery.


2. A health care professional has questions regarding binge drinking. Which of the following informational points of interest should be communicated to the health care professional?    

A. Binge drinking for men is drinking 2 or more standard alcoholic drinks, on the same occasion on at least 1 day in the past 30 days.

B. Binge drinking for men is drinking 4 or more standard alcoholic drinks, on the same occasion on at least 1 day in the past 30 days.

C. Binge drinking for women is drinking 2 or more standard alcoholic drinks, on the same occasion on at least 1 day in the past 30 days.

D. Binge drinking for women is drinking 4 or more standard alcoholic drinks, on the same occasion on at least 1 day in the past 30 days.


3. Which of the following statements best describes heavy drinking?    

A. Consuming 5 or more drinks per week for women and 12 or more drinks per week for men.

B. Consuming 6 or more drinks per week for women and 14 or more drinks per week for men.

C. Consuming 8 or more drinks per week for women and 15 or more drinks per week for men.

D. Consuming 10 or more drinks per week for women and 18 or more drinks per week for men.


4. How many ounces of pure alcohol does one standard drink contain?    

A. 0.2 ounces

B. 0.4 ounces

C. 0.6 ounces

D. 0.8 ounces


5. Which of the following statements best describes substance misuse?    

A. The misuse of prescription medications.

B. The use of drugs in a manner, situation, amount, or frequency that can cause harm to users or to those around them.

C. The use of alcohol in a manner, situation, amount, or frequency that can cause harm to users or to those around them.

D. The use of any substance in a manner, situation, amount, or frequency that can cause harm to users or to those around them.


6. According to the course, which of the following statements is most accurate?    

A. CODs are equal in severity.

B. CODs, found in individuals over the age of 18, are always equal in severity.

C. CODs, found in individuals under the age of 65, are always equal in severity.

D. CODs are not necessarily equal in severity.


7. According to the course, which of the following best represents a guiding principle in treating clients with CODs?    

A. Do not adopt a multi-problem viewpoint.

B. Address specific real-life problems late in treatment.

C. Plan for the client’s cognitive and functional impairments.

D. Limit treatment options for individuals seeking treatment for chronic drug use.


8. A health care professional has questions regarding the main practice principles of the recovery perspective. Which of the following informational points of interest should be communicated to the health care professional?    

A. The recovery perspective acknowledges that recovery is a short-term process of internal change.

B. Health care professionals should acknowledge that recovery does not take place in stages.

C. Health care professionals should develop a treatment plan that provides for continuity of care over time.

D. Health care professionals should acknowledge that recovery typically occurs in one setting.


9. A health care professional has questions regarding the "no wrong door" policy. Which of the following informational points of interest should be communicated to the health care professional?    

A. The no wrong door policy limits treatment options for those that are homeless.

B. The no wrong door policy is specific to those individuals entering treatment from a primary care facility.

C. The no wrong door policy indicates that effective systems must ensure that an individual needing treatment will be identified and assessed and will receive treatment, either directly or through appropriate referral.

D. The no wrong door policy indicates that effective systems must ensure that an individual needing treatment will be identified and assessed and will receive treatment, exclusively through referral.


10. Which of the following best represents quadrant two of the Four Quadrants Model?      

A. More severe mental disorder/less severe SUD

B. More severe mental disorder/more severe SUD

C. Less severe mental disorder/less severe SUD

D. Less severe mental disorder/more severe SUD


11. Which of the following best represents a SAMHSA practice principles of integrated treatment for CODs?    

A. Do not treat mental illness and SUDs concurrently.

B. Mental illness and SUDs are both treated concurrently to meet the full range of clients’ symptoms equally.

C. Motivational techniques are not integrated into care.

D. Clients should only be offered one treatment format.


12. A health care professional has questions regarding the components of a COD program. Which of the following informational points of interest should be communicated to the health care professional?    

A. COD programs should not include psychoeducational classes.

B. COD programs should include an offsite prescribing psychiatrist.

C. COD programs should include offsite double trouble groups.

D. COD programs should include offsite dual recovery mutual-help groups.


13. A 30-year-old female patient has questions regarding 12-Step facilitation (TSF). Which of the following educational points should be expressed to the patient?    

A. TSF is a treatment engagement strategy designed to move female clients toward participation in mutual support as a part of their plan for achieving and sustaining short-term recovery.

B. TSF is a treatment engagement strategy designed to move clients toward participation in mutual support as a part of their plan for achieving and sustaining long-term recovery.

C. TSF is a treatment engagement strategy designed to move clients away from participation in mutual support as a part of their plan for achieving and sustaining long-term recovery.

D. TSF is reserved for male clients.


14. A counselor has questions regarding COD assessments. Which of the following informational points of interest should be communicated to the counselor?    

A. Assessments are not all about getting to know a person.

B. Counselors should acknowledge that there is only one type of treatment approach for CODs.

C. Counselors should be familiar with the diagnostic criteria for common mental disorders.

D. When speaking to a client, counselors should never admit that they do not know something.


15. Which of the following statements is most accurate?    

A. Screening is a simple process of determining whether more in depth assessment is needed.

B. Screening is a complex process of determining whether more in depth assessment is needed, and should not include simple "yes" or "no" questions.

C. The purpose of screening is to identify what kind of problem the person might have.

D. The purpose of screening is always to identify the seriousness of a person's problem.


16. Which of the following best represents a biological SUD area of assessment?    

A. Alcohol on the breath

B. Abnormal laboratory tests

C. Neurological exams

D. Mental status exam results


17. Which of the following best represents a psychological mental disorder area of assessment?    

A. Intoxicated behavior

B. Functional impairment

C. Responses to SUD assessments

D. Self-image and personality


18. A counselor has questions regarding the SBQ-R. Which of the following informational points of interest should be communicated to the counselor?    

A. The SBQ-R should only be used on individuals over the age of 25.

B. The SBQ-R assesses the frequency of sundial ideation over the past 2 months.

C. The SBQ-R includes 8 items.

D. The total SBQ-R score should range from 3 - 18.


19. A counselor has questions regarding the MHSF-III. Which of the following informational points of interest should be communicated to the counselor?    

A. MHSF-III should only be used to diagnose individuals.

B. MHSF-III should only be used to diagnose individuals under the age of 18.

C. The MHSF-III is scored by totaling the “yes” responses, for a maximum score of 17.

D. The MHSF-III is scored by totaling the “no” responses, for a maximum score of 18.


20. According to the course, MDD is marked by which of the following?     

A. MDD is marked by either depressed mood or loss of interest in nearly all previously enjoyed activities; at least one of those symptoms must be present and must persist most of the day, almost every day over a 1-week period.

B. MDD is marked by either depressed mood or loss of interest in nearly all previously enjoyed activities; at least one of those symptoms must be present and must persist most of the day, almost every day over a 2-week period.

C. MDD is marked by both depressed mood and loss of interest in nearly all previously enjoyed activities; both symptoms must be present and must persist most of the day, almost every day over a 1-week period.

D. MDD is marked by both depressed mood and loss of interest in nearly all previously enjoyed activities; both symptoms must be present and must persist most of the day, almost every day over a 2-week period.


21. According to the course, which of the following is a sign/symptom of PDD?    

A. Elevated energy levels

B. Inflated self-esteem

C. Poor appetite

D. Manic episodes


22. Which of the following best represents a diagnostic criteria for bipolar I disorder?    

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.

B. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 2 weeks and present most of the day, nearly every day.

C. A distinct period of abnormally and persistently low or irritable mood and abnormally and persistently decreased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.

D. A distinct period of abnormally and persistently low or irritable mood and abnormally and persistently decreased goal-directed activity or energy, lasting at least 2 week and present most of the day, nearly every day.


23. According to the course, which of the following is a symptom of PTSD?    

A. Nocturnal enuresis

B. Constipation

C. Memory loss

D. Depression lasting for 1 week


24. A counselor has questions regarding PTSD treatment. Which of the following informational points of interest should be communicated to the counselor?    

A. Provide trauma exploration treatment.

B. Do not provide trauma exploration treatment.

C. Avoid present focused psychoeducation.

D. Only provide present focused psychoeducation to patients over the age of 65.


25. Which of the following may be considered to be a Cluster A PD?    

A. Paranoid PD

B. Histrionic PD

C. Narcissistic PD

D. ASPD


26. Which of the following may be considered to be a Cluster C PD?    

A. Narcissistic PD

B. ASPD

C. BPD

D. Obsessive-compulsive PD


27. A counselor has questions regarding working with a client with BPD. Which of the following informational points of interest should be communicated to the counselor?    

A. Anticipate that client progress will be slow and uneven.

B. Anticipate that client progress will be fast but uneven.

C. Avoid skill development.

D. Avoid skill development with patients over the age 25.


28. Which of the following best represents a diagnostic criteria for ASPD?    

A. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 12 years.

B. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years.

C. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 18 years.

D. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 20 years.


29. Which of the following best represents a diagnostic criteria for GAD?    

A. Excessive depression, occurring more days than not for at least 6 months.

B. Excessive depression, occurring more days than not for at least 12 months.

C. Excessive anxiety and worry, occurring more days than not for at least 6 months.

D. Excessive anxiety and worry, occurring more days than not for at least 12 months.


30. A 34-year-old male patient has questions regarding agoraphobia. Which of the following educational points should be expressed to the patient?     

A. Agoraphobia typically only affects females.

B. Agoraphobia is a panic disorder.

C. Individuals with agoraphobia exhibit a strong fear of being in certain places or situations where escape could be difficult.

D. Individuals with agoraphobia typically prefer to be in crowds and/or public spaces.


31. Which of the following best represents a diagnostic criteria for SAD?    

A. Marked fear or anxiety about one or more individuals.

B. Marked fear or anxiety about one or more individuals in the home environment.

C. Marked fear or anxiety towards social situations regarding school or work.

D. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.


32. According to the course, the term hallucination may refer to which of the following?    

A. Beliefs that are fixed, resistant to change, and are directly contradicted by evidence or otherwise not grounded in reality.

B. Hearing, seeing, tasting, or feeling things that are not there and being unable to recognize that what is being experienced is not real.

C. Illogical use of words.

D. Feelings of being depressed when in a crowd or around people.


33. Which of the following is the best representation of disorganized thinking?    

A. Tangential speech

B. Echolalia

C. Echopraxia

D. Catatonia


34. According to the course, AN is marked by which of the following?    

A. A refusal to maintain body weight below the minimally normal weight for age and height.

B. A refusal to maintain body weight below the minimally normal weight for age and height because of an intense fear of weight loss.

C. A refusal to maintain body weight above the minimally normal weight for age and height because of an intense fear of eating and drinking.

D. A refusal to maintain body weight above the minimally normal weight for age and height because of an intense fear of weight gain.


35. A counselor has questions regarding BED. Which of the following informational points of interest should be communicated to the counselor?    

A. BED involves recurring episodes of eating significantly less food in a short period of time than most people would eat under similar circumstances.

B. BED involves recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances.

C. BED involves recurring episodes of eating significantly more food in a significantly longer period of time than most people would eat under similar circumstances.

D. BED involves one episode per year of eating significantly more food in a significantly longer period of time than most people would eat under similar circumstances.


36. Which of the following substance-induced mental disorders is associated with cannabis?    

A. Bipolar disorder

B. Depressive disorder

C. Psychotic disorder

D. Sleep disorder


37. Which of the following substance-induced mental disorders is associated with opioids?    

A. Bipolar disorder

B. Depressive disorder

C. Psychotic disorder

D. PTSD disorder


38. Which of the following best represents an alcohol withdrawal symptom?    

A. Increased sexual interest

B. Hyporeflexia

C. Marked decrease in blood pressure

D. Mild tachycardia


39. Which of the following best represents an opioid intoxication symptom?    

A. Intense euphoria

B. Mild to low euphoria

C. Anxiety

D. Agitation


40. Which of the following substance may mimic depression during intoxication?     

A. Hallucinogens

B. Inhalants

C. Benzodiazepines

D. PCP


41. A counselor has questions regarding suicide. Which of the following informational points of interest should be communicated to the counselor?     

A. Suicide is not a common risk factor that pertains to CODs.

B. Suicide is not a common risk factor that pertains to male COD patients.

C. It is not necessary for agencies that offer SUD counseling to have a protocol in place that addresses the recognition and treatment (or referral) of people who may be suicidal.

D. Every agency that offers SUD counseling also must have a clear protocol in place that addresses the recognition and treatment (or referral) of people who may be suicidal.


42. A counselor has questions regarding suicide and treatment. Which of the following informational points of interest should be communicated to the counselor?     

A. A counselor should never directly ask a client about his or her desire to die by suicide.

B. A counselor should never directly ask a female client about her desire to die by suicide.

C. Asking a client directly about his or her desire to die by suicide makes self-harm more likely.

D. Asking a client directly about his or her desire to die by suicide does not make self-harm more likely.


43. A 22-year-old female patient has questions regarding trauma. Which of the following educational points should be expressed to the patient?    

A. Typically, trauma only affects females.

B. Typically, trauma only affects females victimized by sexual violence.

C. Trauma may result from exposure to actual or threatened death, serious injury, or sexual violence.

D. Trauma can only occur from actual events.


44. According to the course, how can counselors maintain a recovery perspective?    

A. Acknowledge that recovery refers solely to a change in substance use.

B. Acknowledge that recovery is a short-term process.

C. Avoid "stages of change."

D. Use client empowerment to motivate change.


45. According to the course, which of the following recommendations can help counselors monitoring psychiatric symptoms?    

A. Do not ask clients to bring medications to counseling sessions because they can prove to be a distraction.

B. Ask clients to bring medications to counseling sessions if they are on 2 - 4 medications.

C. Ask clients directly and regularly about the extent of their depression.

D. Do not ask clients directly and regularly about the extent of their depression.


46. Which of the following best represents a focusing process of MI?    

A. A counselor uses strategies to establish rapport and help build a trustful relationship with the client.

B. A counselor helps direct the conversation and process as a whole through agenda setting and identifying a target behavior of change.

C. A counselor helps clients express their motivations or reasons for change.

D. A counselor collaborates with the client to develop a plan for change.


47. A counselor has questions regarding suicide and relapse prevention. Which of the following informational points of interest should be communicated to the counselor?    

A. A lapse may refer to a long-term return to substance use.

B. Lapses signal failure.

C. Lapses signal loss of all treatment progress.

D. Lapses do not signal failure or loss of all treatment progress.


48. According to the course, which of the following best represents an aspect of RPT that may be most useful for improving recovery from CODs?    

A. Promoting abstinence to mood-stabilizing medication.

B. Promoting adherence to mood-stabilizing medication.

C. Avoid family-focused interventions.

D. Avoid discussing substance-refusal skills.


49. A counselor has questions regarding anxiety treatment. Which of the following informational points of interest should be communicated to the counselor?    

A. Integrated treatments are highly recommended.

B. Integrated treatments are not recommended.

C. Health care professionals should work to treat anxiety first then SUDs.

D. Health care professionals should work to treat SUDs first then anxiety.


50. Which of the following best represents linear housing?    

A. Housing that is contingent on initiation of treatment for SUDs or mental disorders.

B. Housing that is contingent on completion of treatment for SUDs or mental disorders.

C. Housing combined with access to services and supports to address the needs of individuals without housing so that they may live independently in the community.

D. Housing combined with limited access to services and supports to address the needs of individuals without housing so that they may live independently in the community.


51. Which of the following statements is most accurate?     

A. The Housing First model provides housing no matter where a person is in recovery from SUDs or mental disorders.

B. The Housing First model only provides housing to individuals who have completed recovery.

C. The Housing First model provides housing for female individuals in recovery.

D. The Housing First model provides housing for male individuals in recovery.


52. A 38-year-old female patient has questions regarding COD programs. Which of the following educational points should be expressed to the patient?    

A. Women with CODs cannot be served in mixed-gender COD programs.

B. Women, over the age of 18, with CODs cannot be served in mixed-gender COD programs.

C. Women, under the age of 65, with CODs cannot be served in mixed-gender COD programs.

D. Women with CODs can be served in mixed-gender COD programs.


53. A counselor has questions regarding adapting treatment services to women’s needs. Which of the following informational points of interest should be communicated to the counselor?    

A. Use confrontational, strengths-based, trauma-informed treatment approaches.

B. Use nonconfrontational, strengths-based, trauma-informed treatment approaches.

C. Female clients should only work with female counselors.

D. Female clients, over the age of 18, should only work with female counselors.


54. A 28-year-old pregnant female patient has questions regarding MAT. Which of the following educational points should be expressed to the patient?    

A. Pregnant women are not typically considered for MAT.

B. Pregnant women should not take methadone for any reason.

C. Pregnant women should be considered for transmucosal buprenorphine treatment.

D. Neonatal abstinence syndrome is not associated with buprenorphine in any way.


55. A 34-year-old female patient has questions regarding PPD. Which of the following educational points should be expressed to the patient?    

A. PPD is considered the same as postpartum “blues.”

B. PPD refers to postpartum “blues” that occur within 8 weeks after delivery.

C. PPD refers to MDD in which the most recent depressive episode has an onset either during pregnancy or within 4 weeks after delivery.

D. PPD refers to MDD in which the most recent depressive episode has an onset either during pregnancy or within 8 weeks after delivery.


56. Which of the following statements regarding co-occurring–capable (COC) programs is most accurate?    

A. COC programs are treatment programs that mainly focus on mental disorders but can also treat patients with SUDs.

B. COC programs are treatment programs that mainly focus on mental disorders but can also treat female patients with SUDs.

C. COC programs are SUD treatment programs that mainly focus on SUDs but can also treat patients with subthreshold or diagnosable but stable mental disorders.

D. COC programs are SUD treatment programs that mainly focus on male patients with SUDs but can also treat patients with subthreshold or diagnosable but stable mental disorders.


57. Which of the following best represents one of the nine essential features of ACT?    

A. Services are provided in clinic offices.

B. Holistic approaches are reserved for individuals over the age of 45.

C. Focus on utilizing referrals to other professionals.

D. Focus on helping to support long-term rather than acute recovery.


58. Which of the following best represents a recommendation for extending ACT and ICM in SUD treatment settings?    

A. Use ACT and ICM for clients who do not require considerable supervision and support.

B. Use ACT and ICM for clients who require considerable supervision and support.

C. Do not extend and/or modify ACT or ICM.

D. Extend and/or modify ACT and ICM for all individuals over the age of 25.


59. A 40-year-old male patient has questions regarding TC treatment settings. Which of the following educational points should be expressed to the patient?    

A. Residential TC treatment duration is typically 6 to 12 months.

B. Residential TC treatment duration is typically 24 months.

C. Residential TC treatment duration for male patients is typically 12 to 18 months.

D. Residential TC treatment duration for male patients is typically 24 months.


60. How can health care professionals create an MTC program for clients with CODs?     

A. Decrease flexibility

B. Increase intensity

C. Increase individualization

D. Reduce individualization


61. Which of the following best represents a recommended treatment/service from the MTC model?    

A. Provide a highly structured daily regimen.

B. Avoid highly structured daily regimens.

C. Do not allow peers to "help" one another.

D. Limit individual interactions.


62. Which of the following best represents a recommendation for continuing care following discharge from residential treatment?     

A. Clients should be engaged in continuing care services for a minimum of 1 to 2 weeks following discharge.

B. Clients should be engaged in continuing care services for a minimum of 3 to 6 weeks following discharge.

C. Clients should be engaged in continuing care services for a minimum of 1 to 2 months following discharge.

D. Clients should be engaged in continuing care services for a minimum of 3 to 6 months following discharge.


63. Which of the following best represents a service provision for a traditional mental health setting?    

A. Population-based

B. Community-based

C. Family-based

D. Individualized/case-based


64. Which of the following best represents a focus of treatment for an integrated mental health-primary care setting?    

A. Concrete, skills-oriented, and symptom-based

B. Exploratory discussions

C. Interpersonal therapy

D. Psychodynamic therapy


65. Which of the following medications is approved for treatment-resistant major depression?    

A. Esketamine nasal spray

B. Prozac nasal spray

C. Zoloft nasal spray

D. Ativan nasal spray


66. According to the course, which of the following medication classes is associated with teeth grinding?    

A. SSRI

B. SNRI

C. TCA

D. MAOI


67. According to the course, which of the following medication classes is associated with an irregular heart rhythm?    

A. SSRI

B. SNRI

C. TCA

D. MAOI


68.  A 40-year-old male patient has questions regarding serotonin syndrome. Which of the following educational points should be expressed to the patient?    

A. Serotonin syndrome is caused by benzodiazepines.

B. Serotonin syndrome can occur if a person takes too much of a prescribed SSRI or SNRI.

C. Serotonin syndrome only affects individuals over the age of 65.

D. Serotonin syndrome typically only leads to constipation and/or GI disturbances.


69. Which of the following statements is most accurate?    

A. Taking benzodiazepines with opioids markedly increases the risk of overdose.

B. Taking benzodiazepines with opioids only markedly increases the risk of overdose in individuals under the age of 18.

C. Taking benzodiazepines with opioids does not increases the risk of overdose.

D. Taking benzodiazepines with opioids does not increases the risk of overdose in individuals over the age of 18.


70. A 68-year-old male patient has questions regarding benzodiazepines. Which of the following educational points should be expressed to the patient?    

A. Individuals over the age of 65 should not take benzodiazepines.

B. Older adults taking benzodiazepines are at an increased risk of falls.

C. Benzodiazepines are not associated with memory loss.

D. Benzodiazepines are not associated with dependence.


71. A health care professional has questions regarding lithium. Which of the following informational points of interest should be communicated to the health care professional?    

A. Lithium should not be used to treat mania associated with bipolar disorder.

B. Lithium is a MAOI.

C. Lithium is a mood stabilizer.

D. Lithium does not need to be frequently monitored.


72. Which of the following medication classes is most associated with tardive dyskinesia?    

A. First-generation antipsychotics

B. Mood stabilizers

C. TCA

D. MAOI


73. Which of the following medications is approved by the FDA to treat bulimia nervosa?    

A. Zoloft

B. Prozac

C. Paxil

D. Ativan


74. According to the course, which of the following is the recommended approach to managing OUD?     

A. Cognitive behavioral therapy

B. Psychosocial treatment, with the use of support groups

C. Pharmacotherapy in outpatient settings

D. Pharmacotherapy, with or without adjunctive psychosocial treatment


75. Which of the following medications is FDA approved for AUD?    

A. Acamprosate

B. Methadone

C. Buprenorphine

D. Naloxone


76. Which of the following medications can rapidly reverse opioid overdose and prevent fatality?    

A. Methadone

B. Buprenorphine

C. Naltrexone

D. Naloxone


77. A newly employed health care manager has questions regarding turnover. Which of the following informational points of interest should be communicated to the health care professional manager?    

A. Turnover in the behavioral health field is low.

B. Turnover in the behavioral health field can be high.

C. Turnover does not typically have negative effects.

D. Turnover cannot be prevented.


78. Which of the following best represents a recommendation to reduce staff turnover in programs for clients with CODs?    

A. Do not hire staff members who have experience treating SUDs.

B. Do not hire staff members who have experience treating mental disorders.

C. Hire staff members who are critically minded and can think independently.

D. Do not conduct exit interviews with departing employees.


79. Which of the following best represents an intermediate competency for treating people with CODs?    

A. De-escalating the emotional state of a client who is agitated

B. Integrated assessment of treatment needs

C. Manage a crisis involving a client

D. Coordinate care with a mental health counselor


80. Which of the following best represents an advanced competency for treatment of people with CODs?    

A. De-escalating the emotional state of a client who is agitated

B. Coordinate care with a mental health counselor

C. Use integrated treatment planning

D. Apply knowledge of psychotropic medications


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