Pre Quiz

Page 1 of 23
Course: Trauma-Informed Care

This course has been approved for 6 Continuing Education Units/Contact Hours
Pre-Quiz
To aid and enhance the learning experience please take this pre-quiz.
Quiz Questions
1. A traumatic experience involves some type of a threat to

one’s physical or emotional well-being.
True or False
2. Trauma can disrupt an individual’s self-perception and

identity.
True or False
3. Research has recently uncovered the relationship between

traumatic events and what?
a. Impaired Neurodevelopment
b. Growth Hormone release
c. Spina Bifida
4. What factors must be considered when attempting to understand

trauma?
a. Biological factors
b. Psychological factors
c. Interpersonal factors
d. Community factors
e. Societal factors
f. All of the above
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Page 2 of 23
5. Traumatic experiences complicate a person’s capacity to make

sense of their lives and to create meaningful, consistent
relationships in their families and communities.
True or False
6. How often is a report of childhood abuse made in the United

States?
a. Every second
b. Every hour
c. Every 10 seconds
d. Twice a day
7. Approximately how many women in the U.S. have experienced

rape, physical violence, and/or stalking by an intimate partner?
a. 1 in 3 women
b. 50% of women
c. 1 and 5 women
d. 1 and 10 women
8. Appropriate assessments, screenings and support by service

providers can significantly aid those who have been traumatized.
True or False
9. Trauma is uncommon and only includes events that are

extraordinary or cataclysmic?
True or False
10. The prevalent nature of trauma means that there is a

good chance that a person you are caring for, your
neighbor, friends, family member or even yourself, have
experienced, or is currently suffering from, some type of
trauma at some level.
True or False
11. To be diagnosed with Post-traumatic stress disorder (PTSD)

you must have been exposed to an event that involved or held the
threat of death, violence or serious injury.
True or False

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12. Children with PTSD may reenact traumatic events through

play.
True or False
13. The Substance Abuse and Mental Health Services’ definition

of trauma includes the 3 E’s. What do the 3 E’s stand for?
a. Evidence, Extraordinary, Elapsed

b. Event, Experienced, Effects
c. Esoteric, Effects, Exact
14. What does Self-regulation refer to?
a. A person’s capacity to help others manage impulses.

b. The inability of someone to stop traumatic experiences
from affecting their health.
c. A person’s capacity to control impulses; both to stop
doing something if needed or start doing something if
needed.
15. An example of disrupted self-regulation in a child due to

trauma might be:
a. The inability to control angry outbursts

b. The inability to pay attention in class
c. All the above
16. A single traumatic event that causes extreme emotional or

physical stress is what type of trauma?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
d. Historical/Intergenerational Trauma
17. A tsunami is an example of what type of trauma?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
d. Toxic Trauma

Page 4 of 23
18. Steve is having signs and symptoms of trauma, however, he

hasn’t been a victim of trauma. Steve’s grandparents were
Holocaust survivors and have been significantly traumatized from
the experience. What type of trauma is Steve suffering from?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
19. Chronic trauma is defined as:
a. Multiple traumatic events that occur over a long period

of time.
b. A single traumatic event that causes extreme emotional
or physical stress.
c. Multiple traumatic events that are repetitive, prolonged
and cumulative and involves direct harm, exploitation and
maltreatment of some kind including neglect and abandonment
by primary caregivers or responsible adults.
20. What type of trauma includes repetitive, prolonged and

cumulative trauma such as neglect by primary caregivers at
developmentally vulnerable ages?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
21. Past experiences of trauma having an effect on a current

generation of people is what type of trauma?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
22. Nhan is traumatized because for years he experienced the

ravages of war and witnessed the injury and death of friends and
family. What type of trauma is Nhan suffering from?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma

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23. What is hypermnesia?
a. The inability to remember traumatic events

b. Remembering more and more of a traumatic event as time
passes
c. Short-term memory loss
d. Difficulty paying attention due to a traumatic event
24. Children who have been traumatized may have sensory and
motor function disruptions.
True or False
25. A seemingly small event could be traumatic to one

individual and not another.
True or False
26. Early experiences of childhood have a significant

effect on the development of the brain infrastructure.
True or False
27. In the first few years of life, seven hundred to a thousand

neural connections are forming every _________?
a. Day
b. Minute
c. Hour
d. Second
e. Month
28. What interaction is the most important element in shaping

the development of the brain?
a. Return and Reverse Interaction

b. Serve and Reframe Interaction
c. Serve and Return Interaction

Page 6 of 23
29. What type of stress describes the disruption in brain

architecture and other developing organ systems that occur when
a child is exposed to strong, frequent or prolonged adversity?
a. Traumatic Stress
b. Chronic Stress
c. Complex Stress
d. Toxic Stress
30. Toxic stress can cause a cascade of events such as; a

weakened immune system, disruption in the the hormone systems of
the body, and the way DNA is read and transcribed.
True or False
31. What type of stress can cause disparities in language

skills?
a. Traumatic Stress
b. Toxic Stress
c. Complex Stress
d. Historical Trauma
32. A relatively stable state of equilibrium, or a tendency

toward such a state, between the different but interdependent
elements or groups of elements of an organism is called what?
a. Equilibrium
b. Homogenous
c. Homeostasis
33. What part of the nervous system is responsible for

stimulating skeletal muscles?
a. Autonomic nervous system

b. Sympathetic nervous system
c. Somatic nervous system
34. What division of the nervous system controls the body’s

“Fight”, “Flight”, “Freeze”, “Submit” responses?
a. Sympathetic division
b. Parasympathetic division
c. Peripheral nervous system

Page 7 of 23
35. What division of the nervous system forms the body’s “rest
and digest” response when the body is relaxed, resting or
feeding?
36. When there is some type of stimuli that causes fear or

stress, what mechanism is activated in the body?
a. Sympathetic Parenchyma Axis

b Amygdala-Hypothalamic-Pituitary-Adrenal Axis
c. Parasympathetic division
d. Peripheral nervous system
37. What part of the brain forms and stores memories that have
been associated with emotional events?
a. Prefrontal Cortex
b. Cerebellum
c. Hypothalamus
d. Amygdala
38. Which glands are responsible for secreting norepinephrine?
a. Pituitary glands
b. Pineal gland
c. Adrenal glands
d. Thyroid and Parathyroid glands
39. Which hormone makes stored glucose immediately available to

our organs?
a. Epinephrine
b. Testosterone
c. Norepinephrine
d. Cortisol

Page 8 of 23
40. What is the term used when our body’s are in a state of
“Fight”, “Flight”, “Freeze” or “Submit”.
a. Hyper-alert
b. Hyperarousal
c. Hypervigilant
d. Hyperactive
41. One of the most important and significant ways to be

Trauma-informed is to have an understanding of the signs
and symptoms of trauma as well as an understanding of the
reactions and responses to trauma by a victim.
True or False
42. An immediate emotional reaction to trauma may include:
a. Numbness
b. Detachment
c. Anxiety
d. Fear
e. Guilt
f. All of the above
43. Which is NOT an example of a delayed emotional reaction to

trauma?
a. Mood swings
b. Shame
c. Depression
d. Irritability
e. Redefining life’s meaning
44. Immediately following trauma an individual may have what

type of physical reactions?
a. Uncontrollable shaking
b. Increased heart rate
c. Increased blood pressure
d. Shivering
e. Nausea
f. All of the above

Page 9 of 23
45. What domain of trauma reactions deals with our thoughts

concerning the traumatic event?
a. Existential Domain
b. Spiritual Domain
c. Cognitive Domain
d. Behavioral Domain
46. What domain of trauma reactions deals with thoughts about

the meaning of life?
a. Existential/Spiritual Domain
b. Cognitive Domain
c. Behavioral Domain
47. After a traumatic event Bob is argumentative and having

difficulty expressing himself. What domain of trauma reactions
is his behavior related to?
b. Spiritual Domain
c. Cognitive Domain
48. After a traumatic event Jane asks herself, “Why me. Why did
this happen to me?” What domain of trauma reaction is this
related to?
b. Spiritual Domain
c. Cognitive Domain
49. Which of the following are positive reactions to traumatic

events?
a. Reestablishing priorities
b. Redefining meaning and importance of life
c. Silencing yourself
d. Working extra hours

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50. Which of the following is an example of reworking life’s

assumption to accommodate trauma?
a. Taking a self-defense course

b. Drinking alcohol
c. Working more hours at work
d. Ignoring the traumatic event
51. Delayed physical reactions to trauma include which of the

following?
a. Sleep disturbances
b. Somatization
c. Appetite changes
d. Anxiety
52. What is the term used for the unconscious process by

which psychological distress is expressed as physical
symptoms such as back, neck or stomach pain?
a. Somatization
b. Allodynia
c. Hyperalgesia
d. Alimentary
e. Supination
53. Delayed cognitive reactions to trauma include which of the

following?
a. Intrusive memories
b. Reactivation of previous traumatic events
c. Self-blame
d. Difficulty making decisions
e. All of the above
54. Magical thinking is a belief that certain behaviors,

including avoidant behavior, will protect against future trauma.
True or False

Page 11 of 23
55. Using drugs or alcohol to cope with a traumatic event

relates to which domain of traumatic reactions?
b. Spiritual Domain
c. Cognitive Domain
56. What does ACE stand for?
a. Adversity Community Exam

b. Adverse Childhood Experiences
c. Attitude Competency Exponent
57. The ACE study showed that adverse childhood experiences are
linked to every major chronic illness and social problem that
the United States grapples with.
True or False
58. ACE scores are calculated based on experiences after 18

years of age.
True or False
59. Adverse childhood experiences include:
a. Divorce
b. Neglect
c. Family member incarcerated
d. Family member with mental illness
e. All of the above
60. As ACE scores increase, the rates of chronic diseases

decrease.
True or False
61. ACE scores are not a good predictor that someone will
attempt suicide sometime in their life.
True or False

Page 12 of 23
62. The ACE study had how many participants?

a. 10,000
b. 2500
c. Over 17,000
d. 200
63. As the number of research study participants increases the

margin of error decreases.
True or False
64. Which two doctors conducted the ACE study?
a. Dr. Who and Dr. Doolittle

b. Dr. Felitti and Dr. Anda
c. Dr. Watts and Dr. Lewis
d. Dr. Weiner and Dr. Linn
65. The participants of the ACE study were mostly poor and
uneducated.
True or False
66. In healthcare and human services settings emotional and

psychological trauma often goes unnoticed, ignored or
unaddressed.
True or False
67. Trauma-Informed Care seeks to understand the whole life

context of a person and not just their symptoms or complaints.
True or False
68. Which question conveys care and compassion?
a. What happened to you?

b. What’s wrong with you?
69. Which question can be shaming and blaming as well as bring

up feelings of guilt and can ultimately thwart relationships?
a. What happened to you?

b. What’s wrong with you?

Page 13 of 23
70. In order to meet the unique needs of those who have

experienced trauma, programs, healthcare systems and services
need to proactively respond compassionately and empathetically
to a trauma survivor.
True or False
71. Generally speaking, being Trauma-Informed is a philosophy

that includes what two elements?
a. Awareness and Understanding of trauma

b. Awareness and Development of trauma services
c. Developing and incorporating trauma-specific services
72. At the minimum, what do Trauma-Informed services aim to do?
a. To do no harm or anything that is re-traumatizing

b. To cure an individual from their trauma
c. To refer victims to trauma-specific services
73. What are the four key assumptions of Trauma-Informed Care?
a. Realize
b. Refer
c. Respond
d. Recognize
e. Ratify
f. Rectify
g. Resist Re-traumatization
74. To be Trauma-Informed, every member of an organization must

be aware about trauma and its effects.
True or False
75. Dietary staff in an organization do not need to be aware

about how trauma impacts the lives of individuals.
True or False

Page 14 of 23
76. It is critical to provide a safe environment and that

is done by helping patients to recognize how they view
safety.
True or False
77. Which principle of Trauma-Informed Care is related to

establishing safe, authentic, transparent and positive
relationships?
a. Trustworthiness and Transparency

b. Safety
c. Collaboration and Mutuality
d. Supporting Control, Choice and Autonomy
78. Utilizing the stories and lived experiences of those who

have experienced trauma is related to which principle of Trauma-
Informed Care?

b. Safety
c. Peer Support
d. Collaboration and Mutuality
79. Promoting democracy across departments and programs is

related to which principle of Trauma-Informed Care?

b. Safety
c. Peer Support
80. The feeling of powerlessness is so central to trauma victims

that helping them regain a sense of control over their daily
lives and build competencies that will strengthen their sense of
autonomy is a must.
True or False

Page 15 of 23
81. Expanding the trauma victim’s resources and networks of

support so there is less reliance on professional services is
related to which principle of Trauma-Informed Care?

b. Peer Support
c. Collaboration and Mutuality
d. Supporting Control, Choice, Autonomy
82. Respecting diversity, providing opportunities for patients,

clients or consumers to engage in cultural rituals, and using
interventions respectful of and specific to cultural backgrounds
is related to which principle of Trauma-Informed Care?
a. Cultural, Historical, Gender Issues

b. Safety
c. Peer Support
83. Which principle of Trauma-Informed Care focuses on strength

and resiliency?

b. Safety
c. Peer Support
84. Which principle of Trauma-Informed Care focuses on

leveling power differences?

b. Safety
c. Peer Support
85. Trauma-Informed Care involves looking to the future to

help patients envision what they want so they may rise
above the pain of trauma.
True or False

Page 16 of 23
86. Which domain of Trauma-Informed Care focuses on implementing

and sustaining programs and services?
a. Governance and Leadership

b. Policy
c. Physical Environment
d. Engagement and Involvement
e. Cross Sector Collaboration
87. Which domain of Trauma-Informed Care focuses on

developing openness, transparency, and shared spaces?
a. Screening, Assessment, Treatment

b. Physical Environment
c. Progress Monitoring and Quality Assurance
d. Financing
e. Evaluation

developing protocols?
a. Cross Sector Collaboration

b. Screening, Assessment, Treatment
c. Training and Development
d. Progress Monitoring and Quality Assurance
e. Policy

involving victims of trauma and their families to help
develop Trauma-Informed services?
a. Physical Environment
b. Engagement and Involvement
c. Cross Sector Collaboration
d. Screening, Assessment, Treatment
e. Training and Development

Page 17 of 23

quality, tracking, and monitoring of trauma-informed
principles?

e. Financing
91. Conducting trauma screening involves: Understanding

that patients or clients may be uncomfortable answering
questions because of distrust.
True or False
92. During an assessment it is important to note that many

times people have unexplained complaints such as pain that
could be associated with past traumatic experiences.
True or False
93. Assessments involve clearly communicating the right for

an individual not to answer questions.
True or False
94. What type of tool is a brief, focused inquiry to

determine whether an individual has experienced specific
traumatic events?
a. Assessment tool
b. Trauma tool
c. ACE test
d. Screening tool
95. Which domain of Trauma-Informed Care evaluates the

implementation and effectiveness of trauma-informed care
services and programs?
a. Screening, Assessment, Treatment

b. Training and Development
c. Safety
d. Financing
e. Evaluation

Page 18 of 23
96. Caring, appropriate and empathic responses to those who

share about their past traumatic experiences can be beneficial
and healing to the victim.
True or False
97. The way we respond to a patient, client, co-worker or friend

about their past trauma has a huge bearing and influence on how
they heal from past trauma.
True or False
98. Inappropriate responses to trauma disclosures can hinder the

healing process of the trauma victim.
True or False
99. It is best to refer those who want to talk about trauma

to a mental health specialist.
True or False
100. "I'm sorry you were hurt in that way,” is an

appropriate response to a trauma disclosure.
True or False
101. Feelings of powerlessness, distrust and betrayal are common

to those who have suffered trauma.
True or False
102. Presuming that every person in a treatment setting has

been exposed to traumatic experiences is called what type of
precautions?
a. Standard Precautions
b. Contact Precautions
c. Trauma Precautions
d. Universal Precautions

Page 19 of 23
103. It is important to give a trauma victim choices and also

avoid acts or statements that are overly controlling and
authoritative.
True or False
104. It is acceptable to inform the patient you are available to

help in the future even if you won’t be available.
True or False
105. Recognizing adaptive behaviors and coping mechanisms serve

a purpose and should not be explored but should be judged.
True or False
106. One of the most important tasks you have to accomplish

in helping a trauma victim is to manage your own trauma and
stress.
True or False
107. A trauma-informed setting shouldn't account for compassion

fatigue.
True or False
108. _________ is the capacity to understand someone else's

state of mind.
a. Empathy
b. Compassion
c. Sympathy
d. Felicity
e. Empirical
109. Which of the following are symptoms of compassion fatigue?
a. Apathy
b. Hope
c. Intrusive thoughts
d. Anger
e. Anxiety

Page 20 of 23
110. What step(s) can you take to help combat compassion

fatigue?
a. Maintain a healthy work/life balance

b. Eat healthy
c. Exercise
d. Maintain a good support system
e. Try not to feel emotions
f. Develop healthy boundaries
g. Start drinking alcohol
111. What step(s) can you take to help combat compassion

fatigue?
a. Maintain a healthy work/life balance

b. Eat healthy
c. Exercise
d. Maintain a good support system
e. Try not to feel emotions
f. Develop healthy boundaries
g. Start drinking alcohol
112. Research has recently uncovered the relationship between

traumatic events and what?
a. Impaired Neurodevelopment
b. Growth Hormone release
c. Spina Bifida
113. What factors must be considered when attempting to

understand trauma?
a. Biological factors
b. Psychological factors
c. Interpersonal factors
d. Community factors
e. Societal factors
f. All of the above
114. A tsunami is an example of what type of trauma?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
d. Toxic Trauma

Page 21 of 23
115. Steve is having signs and symptoms of trauma, however, he

hasn’t been a victim of trauma. Steve’s grandparents were
Holocaust survivors and have been significantly traumatized from
the experience. What type of trauma is Steve suffering from?
a. Acute Trauma
b. Complex Trauma
c. Chronic Trauma
116. What part of the nervous system is responsible for

stimulating skeletal muscles?
a. Autonomic nervous system

b. Sympathetic nervous system
c. Somatic nervous system
117. What division of the nervous system controls the body’s

“Fight”, “Flight”, “Freeze”, “Submit” responses?
118. What division of the nervous system forms the body’s “rest
and digest” response when the body is relaxed, resting or
feeding?
119. Which is NOT an example of a delayed emotional reaction to

trauma?
a. Mood swings
b. Shame
c. Depression
d. Irritability
e. Redefining life’s meaning

Page 22 of 23
120. Immediately following trauma an individual may have what

type of physical reactions?
a. Uncontrollable shaking
b. Increased heart rate
c. Increased blood pressure
d. Shivering
e. Nausea
f. All of the above
121. What domain of trauma reactions deals with our thoughts

concerning the traumatic event?
a. Existential Domain
b. Spiritual Domain
c. Cognitive Domain
122. What domain of trauma reactions deals with thoughts about

the meaning of life?
b. Spiritual Domain
c. Cognitive Domain

involving victims of trauma and their families to help
develop Trauma-Informed services?
a. Physical Environment
b. Engagement and Involvement
c. Cross Sector Collaboration
d. Screening, Assessment, Treatment
e. Training and Development

quality, tracking, and monitoring of trauma-informed
principles.

e. Financing

Page 23 of 23
125. Conducting trauma screening involves: Understanding

that patients or clients may be uncomfortable answering
questions because of distrust.
True or False
126. During an assessment it is important to note that many

times people have unexplained complaints such as pain that
could be associated with past traumatic experiences.
True or False
127. Assessments involve clearly communicating the right

for an individual not to answer questions.
True or False
128. Feelings of powerlessness, distrust and betrayal are common

to among those who have suffered trauma.
True or False
129. Presuming that every person in a treatment setting has

been exposed to traumatic experiences is called what type of
precautions?
a. Standard Precautions
b. Contact Precautions
c. Trauma Precautions
d. Universal Precautions
130. What type of tool is a brief, focused inquiry to

determine whether an individual has experienced specific
traumatic events.
a. Assessment tool
b. Trauma tool
c. ACE test
d. Screening tool

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Page 1 of 23

Course: Trauma-Informed Care

1. A traumatic experience involves some type of a threat to

2. Trauma can disrupt an individual’s self-perception and

3. Research has recently uncovered the relationship between

4. What factors must be considered when attempting to understand

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

5. Traumatic experiences complicate a person’s capacity to make

6. How often is a report of childhood abuse made in the United

7. Approximately how many women in the U.S. have experienced

8. Appropriate assessments, screenings and support by service

9. Trauma is uncommon and only includes events that are

10. The prevalent nature of trauma means that there is a

11. To be diagnosed with Post-traumatic stress disorder (PTSD)

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

12. Children with PTSD may reenact traumatic events through

13. The Substance Abuse and Mental Health Services’ definition

a. Evidence, Extraordinary, Elapsed

14. What does Self-regulation refer to?

a. A person’s capacity to help others manage impulses.

15. An example of disrupted self-regulation in a child due to

a. The inability to control angry outbursts

16. A single traumatic event that causes extreme emotional or

17. A tsunami is an example of what type of trauma?

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

18. Steve is having signs and symptoms of trauma, however, he

19. Chronic trauma is defined as:

a. Multiple traumatic events that occur over a long period

20. What type of trauma includes repetitive, prolonged and

21. Past experiences of trauma having an effect on a current

22. Nhan is traumatized because for years he experienced the

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

23. What is hypermnesia?

a. The inability to remember traumatic events

25. A seemingly small event could be traumatic to one

26. Early experiences of childhood have a significant

27. In the first few years of life, seven hundred to a thousand

28. What interaction is the most important element in shaping

a. Return and Reverse Interaction

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

29. What type of stress describes the disruption in brain

30. Toxic stress can cause a cascade of events such as; a

31. What type of stress can cause disparities in language

32. A relatively stable state of equilibrium, or a tendency

33. What part of the nervous system is responsible for

a. Autonomic nervous system

34. What division of the nervous system controls the body’s

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

36. When there is some type of stimuli that causes fear or

a. Sympathetic Parenchyma Axis

38. Which glands are responsible for secreting norepinephrine?

39. Which hormone makes stored glucose immediately available to

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved

41. One of the most important and significant ways to be

42. An immediate emotional reaction to trauma may include:

43. Which is NOT an example of a delayed emotional reaction to

44. Immediately following trauma an individual may have what

ClickPlayCEU.com is a division of Cosine Health Strategies, LLC ©. All Rights Reserved