Comprehensive Practice Exam #1
At what age did Piaget hypothesize that children develop representation?
2 to 3 years
A client comes in for counseling because he feels tremendous guilt over some crimes he committed years ago when he was 20 years old. He served time in prison for these crimes and has been out for 2 years now. What should the social worker do FIRST?
Ask the client what crimes he committed
A conflict between trust and mistrust is MOST likely to be apparent in which of the following?
A 6-month-old who is fearful of a new babysitter.
Which of the following children is MOST likely to have been sexually abused?
A 7-year-old who frequently masturbates at school
he management philosophy of an agency reflects a "Theory Y" approach. Consequently, one would expect to find which of the following in the agency?
A high degree of self-direction on the part of staff
A client, age 22, recently graduated from college and landed a job at a company in her hometown. She lived at home while in school and has just moved into her own apartment. She's feeling anxious and worried that she'll fail at her job; she's already made a couple of mistakes that her supervisor chalked up to inexperience. The client worries that she might just be bad at her job. Her parents call her almost every day wanting updates on her life, and she's feeling like they don't want her to grow up. She's their only child, and they often say they miss having her at home. The client says she feels like crying all the time and doesn't know if she can cope with being an adult. This information suggests that the client is MOST likely experiencing which of the following?
A maturational crisis
Which of the following BEST describes the collaborative care model?
A model that involves the addition of behavioral (mental) health or allied health care professionals to provide auxiliary services in a primary care setting
Which of the following is a TRUE statement regarding participation in a research study?
A social worker who is providing therapeutic services to a client and who is collecting and analyzing data on that client's progress is not required to obtain consent.
Which of the following is NOT a strategy that is typically effective for establishing rapport?
A warm-up period, or small-talk before asking the client why he came in
A social worker engaged in macro practice helps bring together several groups in his community to discuss relevant issues and work toward achieving a goal. What strategy has he used?
Coalition building
The social worker has been seeing a young man for several weeks before he admits he thinks he is addicted to alcohol, even though he has been only drinking for a year. In assessing his situation, the social worker will want to advise him about the levels of substance abuse treatment that are available to him in the community. His insurance tells him that he does not qualify for inpatient treatment. If he does not need medical detox, but is not certain that he can get clean on his own, what are his options?
AA and partial hospitalization
When is a referral considered complete?
When social worker has followed up to find out what the client's experience with the referral resource was like Feedback
A social worker has started working with a Mexican American family. After meeting with the family three times at her office, she visits their home to complete her assessment. The mother has prepared a meal and asks the social worker to eat with the family. What is the BEST way for the social worker to respond?
Accept the invitation to share the meal
Which of the following is not a foundational principle of trauma-informed care practice?
Accountability
A social worker's 43-year-old client discloses that he is attracted to his 8-year-old niece and has been having sexual fantasies about her. The social worker is shocked and deeply disturbed when she hears this, so much so that her reaction (i.e., body language that conveys shock and revulsion) is clearly visible to the client. What should the social worker do about her reaction?
Acknowledge it and emphasize that it was a reaction to the client's disclosure and not to the client as a person
A client has completed her treatment goals and is ready to terminate treatment. During her final session with the social worker, the client abruptly says that she has other problems she wants to work on. What should the social worker do FIRST?
Acknowledge the anxiety that normally accompanies termination
A social worker is meeting for the first time with a new client, a Gulf War I veteran who uses a wheelchair. He has paraplegia. In making the appointment over the phone, the client said that he wanted to work on feelings of depression and improve his relationships, but he didn't mention his disability at all. What should the social worker do with regard to raising the topic of the client's disability?
Acknowledge the client's disability and ask him if he thinks it plays any role in his presenting problem
In a cross-cultural counseling situation, the social worker should do which of the following to facilitate the development of rapport?
Acknowledge the cultural difference to the client
Linda has developed anxiety and depression after her husband left her a month ago. She complains of being "sick to her stomach" all of the time and having to sleep "a lot." What is the most likely diagnosis for Linda?
Adjustment disorder
A social worker has been working for several months with a 25-year-old woman who has mild intellectual disability and lives in a group home in the community. The social worker learns that the woman's physician has committed her to a psychiatric facility over the weekend. The next day, the social worker attends a team meeting at the psychiatric facility concerning the woman's admission. What should be the social worker's priority at this meeting?
Advocate on behalf of his client
client reports to his case manager that he is having trouble with Social Security regarding his disability benefits. He says that they are threatening to cut his benefits because he is now able to work due to being on anti-depressants, after years of severe, disabling chronic depression. How should the case manager proceed?
Advocating on behalf of the client
Of the following factors, which is associated with a lower risk of osteoporosis following menopause overall?
African American race
Which substance presents the highest risk of mortality during withdrawal?
Alcohol
Which of the following combinations of drugs, taken at the same time, is considered the MOST lethal?
Alcohol and barbiturates
Which of the following is NOT included as an alcohol-related disorder in the DSM-5?
Alcohol dependence
A social worker is conducting the first interview with a client who recently divorced her husband. When the social worker mentions the divorce, the client becomes uncomfortable and begins talking about the problems she is having with her school-aged son. What is the social worker's BEST course of action?
Allow the client to continue talking about her son if she is not ready yet to talk about her divorce
A court-ordered client shows up to meet with a social worker. He tells the social worker he does not want to participate in treatment and refuses to sign informed consent. What is the BEST response by the social worker?
Allow the client to refuse treatment
Ted and Alice come to therapy for marital problems. Ted feels that Alice disrespects him because she won't always do what he wants her to do. Alice says that she has a right to make her own decisions and that Ted should take her opinions more into account. They end up fighting about even little things, like who puts away the dishes. How would a strategic therapist view their communication style?
An unhealthy symmetrical relationship
A client who is extremely thin admits that she binge-eats and then over-exercises to compensate for it. What is the most likely diagnosis?
Anorexia nervosa
As described in the DSM-5, the characteristic symptoms of substance use disorder can be categorized in terms of which of the following?
Impaired control, social impairment, risky use, and pharmacological criteria.
A female social worker discovers that her new client, a 35-year-old man, has difficulty trusting women. What should the social worker do FIRST?
Ask the client if he thinks her gender might affect their work together
A hospital social worker meets with a man whose wife was diagnosed with cancer a month ago. The man has been told that his wife's prognosis is very poor. He came to the hospital emergency room tonight complaining of acute pain. The doctors treated his pain with medication and then referred him to the social worker because he couldn't stop crying. The social worker believes that the man is experiencing grief. Specifically, the man is MOST likely experiencing which of the following?
Anticipatory grief
The social worker is assigned to case manage a family in which the 3-year-old has just received a diagnosis of autism spectrum disorder. What referral would be most appropriate in this case?
Applied behavioral analysis treatment
The client is a divorced woman with one young child. Her husband deserted her over a year ago. The client was employed as an assistant buyer for a small manufacturing company, but she lost her job two months ago when the company went bankrupt. Since that time, she has stayed home with her son. She reports being a little depressed and very anxious about her failure to find a new job because she is the sole source of support for her son. She has come in to get advice on how to handle her stress because she's concerned that she might become a bad mother. What would be the BEST way for the social worker to help this client manage her stress?
Arrange for her to join a support group for single mothers so that she can share her fears, reduce her isolation, and do some practical networking
: During an interview, a client who has HIV disease experiences a referential delusion and displays flat affect. The client has a history of moderate to heavy substance use and has been using alcohol on a regular basis for several weeks. He is estranged from his family due to his HIV diagnosis. What should the social worker do FIRST?
Arrange for the client to be stabilized on psychiatric medication
A social worker is referred a client who has no health insurance and very little money. The client reports that she has been in therapy before and that it was not a good experience; she adds, however, that she's willing to give it another try to save her marriage. The client is listless and withdrawn. She reports that she's been having a lot of physical pain lately but hasn't been able to get to a doctor. The social worker and client negotiate a low fee that the client can afford to pay. What should the social worker do FIRST in this case?
Assist the client in arranging to undergo a physical exam at a free or low-cost medical clinic
The client is a teenage boy who has been experimenting with drugs and sexual behavior. The boy was recently found with a rope tied around his neck in his closet, passed out. The rope itself was not tied to anything, simply wrapped around his neck. Based on this information, the social worker's primary impression would be which of the following?
Autoerotic asphyxia
A social worker is meeting for the first time with a client shortly after the client broke up with his girlfriend of three years. The client blames himself for the break-up, saying that he has trouble expressing himself to loved ones. The social worker observes that the client seems passive, and he comes off as needy in the interview. To establish rapport with the client, it is MOST important for the social worker to do which of the following?
Be aware of her personal biases
to clarify the emotional distance or closeness between family members, a social worker could use which of the following techniques?
Sculpting
Federal programs such as Food Stamps, Supplemental Security Income (SSI), and payments for adoption assistance and foster care are examples of ________________ programs.
selective eligibility
The social worker makes a home visit on her client, who is 82 years old, diabetic, and blind. She lives with her 70-year-old husband and her 50-year-old son, who is on disability due to mental illness. She finds out that her other son, who is psychotic and off of his medication, smashed her computer last night and got into a physical fight with her husband. They say that they are never going to allow him to visit again. What should the social worker do?
Call the police and make a report
The client is a 25-year-old man with severe schizophrenia who has not been responding to the traditional antipsychotic medication he has been taking. Under the circumstances, his psychiatrist is MOST likely to recommend which of the following medications?
Clozaril
In the first interview, a client reports feeling unhappy and discouraged about his future, not eating well, and having difficulty falling asleep at night. He has stopped contacting friends and often misses work when he feels too upset to get out of bed. The social worker suspects that the client may be self-destructive. Given that this is the first interview, how should the social worker proceed with her assessment?
Conduct a structured inquiry to collect information as a basis for determining an appropriate plan to protect the client from hurting himself
Which condition is NOT associated with an increased incidence of heart disease?
Conduct disorder
A divorced middle-aged client had been juggling work responsibilities with efforts to care for his elderly mother, but he then placed his mom in a nursing home three months ago. In a session with his social worker, the client says, "I should visit my mom more often, but I get so busy with work. I feel bad about that because I know she's lonely and won't be around much longer." In response to this, the social worker says, "You've said several times in our sessions that you think you should spend more time with your mom, but you're not doing it. I can't help but wonder whether the feelings you've described having about moving your mom to the nursing home are making it difficult for you to visit her there. What do you think about that?" What technique has the social worker used?
Confrontation
Conrad is an African American teenager who has always been labeled by his teachers as performing below expectations. Although clearly intelligent, Conrad tends to clown around in class and talk back to the teachers, and he often fails to do his homework. He has recently been arrested for shoplifting at a local supermarket. How would John Ogbu's cultural-ecological theory explain Conrad's behavior?
Conrad's behavior is influenced both by how society at large treats African Americans and by how African Americans have developed oppositional coping strategies to deal with bias and discrimination.
A social worker is hired to create new services for an agency that serves people with severe mental illness. What is the best way to get buy-in from the staff that is already working there?
Create an outline for how the new service will work and ask for staff input
A social worker is invited to serve on the board of a large charitable organization in her community. She knows that a client who has been in services with her for six months has been serving on that board for many years. From an ethical standpoint, what should the social worker do?
Decline the position and don't tell the client about the offer
Which statement most accurately reflects Peter Lewinsohn's theory of depression?
Depressed people receive a low rate of positive reinforcement due to environmental stressors and lack of personal skills.
A middle-aged man comes to a community mental health clinic and is displaying slurred speech, unsteady gait, and impaired attention. A social worker who meets with him smells alcohol on his breath, and when she questions him about this, he admits to drinking "now and then" but denies being intoxicated at the time of the interview. Of the following findings about this man, which one is LEAST likely to contribute to a decision that he should be referred for acute hospital care (inpatient detoxification)?
Despite clear evidence to the contrary, he has denied being intoxicated during the interview.
A social worker has received a subpoena. What is the first step the social worker should take?
Determine if the subpoena is legally valid
A client reports that her 81-year-old father, a widower, has been having difficultly dressing appropriately and no longer cleans his apartment. He was recently ticketed by the police for driving the wrong way on a one-way street. The next day, he drove to his local market and got lost on the way home. The client says she is worried that her father has Alzheimer's disease. After acknowledging the client's feelings about this, what should the social worker do FIRST?
Discuss safety issues and options with the client, such as preventing her father from driving by taking away his car keys
The client is a divorced mother with a 16-year-old daughter. The client has managed to provide her child with a nice home in a safe neighborhood. She seeks advice because she's concerned about her daughter's "rebelliousness." When the social worker questions the client, he discovers that the girl has stayed out past her curfew a few times, talks back to her mother, gets very good grades at school, and has many close friends. What is the social worker's BEST course of action?
Discuss the fact that the girl's "rebellion" may be developmentally appropriate
Jellinek's formulation of alcohol addiction is based on which of the following models?
Disease
A young child is using one- or two-word responses, uses only present-tense verbs, and has limited language comprehension. At what stage of language production is this child in?
Early production
A social worker is working with a couple. The couple's child recently received a diagnosis of a learning disorder that they know nothing about. The couple has sought services for parenting skills and to learn more about this diagnosis to better help their child. What role would be best for the social worker to use in working with this couple?
Educator
A social worker suspects a colleague of violating ethical guidelines. To be consistent with the provisions of NASW's Code of Ethics, the social worker should do which of the following?
Either handle the situation informally or contact the state licensing board or a professional ethics committee, depending on which course of action he or she believes is appropriate
Which of the following is most difficult to identify in a preschool-age child?
Emotional abuse
A social worker is working in family therapy with two parents and their teenage children, a girl, age 16, and a boy, age 15. The presenting problem was frequent arguing in the family, and the focus of treatment has been on identifying and altering the family's maladaptive communication patterns. After the family has been in treatment for six weeks, the father suddenly admits to the social worker that he drinks heavily. He manages to go to work and functions fairly well at his job, but he always drinks at night when he gets home, usually enough to become intoxicated. He says that he drinks at home because he can't stand all the fighting. Under these circumstances, what should the social worker do?
Establish a therapeutic contract for abstinence with the family
The client is a 35-year-old man who was laid off from his job at a supermarket, where he was a manager. The client reports that there are no jobs available in his community and his money is running out fast. Although he's receiving unemployment insurance, he's barely getting by because he has to help his sister, who is a single mom with a low-paying job. A social worker who relies on an ecological approach would assume that this client's problems result from which of the following?
Exchanges between the client and his environment
A social worker is working in individual therapy with an American Indian client who has suffered from symptoms of depression since the death of her grandfather. How should the social worker address the role of religious and spiritual values in this case?
Explore and reinforce the therapeutic significance of religious and spiritual events for the client
An 85-year-old man has become incoherent, incontinent, and unable to care for himself. His daughters have been caring for him, but his problems have become so great that they are now overwhelmed and unable to meet his needs on their own. A doctor recommends that the man be moved to a nursing home. A day later, in a meeting with a social worker, the daughters agreed to visit several nursing homes that week to determine where they want their father to live. A week later, the social worker finds out that the daughters haven't called or visited any nursing homes. What should the social worker do?
Explore the daughters' feelings
A social worker is meeting for the first time with a young single mother who has been referred for services by her doctor. The client begins her verbal report by telling the social worker that her children are too active and demanding of her attention. The client then complains about needing to see a social worker because she's too busy already with other responsibilities, like motherhood, housekeeping, and a part-time job. The client appears anxious and overwhelmed, but not depressed. What should the social worker do?
Express to the client that it must be tiring and frustrating to have so many responsibilities
A 17-year-old girl lost her mother in a car accident 3 months ago. Which of the following would she be most unlikely to exhibit?
Feeling like she is responsible for her mother's death
A client who is a single mother of three young children has sought assistance because she's having difficulty finding work to support her family. She has few job skills and is running out of money. The client is recently divorced, and her ex-husband has left the state. He has not been sending child support payments. The client would like help applying for TANF and wonders if she's eligible for this assistance. The social worker explains that the program uses a means test to determine eligibility. Means eligibility depends primarily on which of the following?
Financial well-being
A social worker has been working in individual therapy with a client for three weeks. He lives alone and attends a day treatment center during the day. During the current session, the client says that he has been feeling depressed, hopeless, and stuck, and as though nothing will ever improve. He expresses suicidal ideation. To manage the risk for suicide in this case, what would be the LEAST likely thing the social worker would do?
Find out whether the client's home environment is safe
Don has had a very successful career as a trumpet player in a major orchestra. He has played for over 40 years and is now planning to retire in a few months. What would be the most important thing for him to have a successful retirement?
Finding a sense of meaning
A social worker is meeting with a 21-year-old Korean American woman who immigrated to the U.S. four years ago with her family. In the interview, the client reports that she suffers from aches and pains and occasional insomnia. She doesn't describe any other symptoms or disclose information about her personal life or family. She says she has come in only because her doctor told her to. What should the social worker do?
Focus on the problem brought in by the client and help her develop her own goals for therapy.
An African American teenage girl is four months pregnant and living with her mother and 3 siblings. The father is involved with gangs and wants nothing to do with the baby. The absence of a father in the home is least likely to have what effect on the children?
Girls will have trouble bonding with their own children
The mother of a 35-year-old single man brings her son in to see a social worker. She tells the social worker that her son was diagnosed with major depressive disorder by a psychiatrist. The social worker begins working in individual therapy with the man. The mother then calls the social worker and asks to be included on an ongoing, weekly basis in therapy sessions with her son. What should the social worker do?
Give the mother appropriate referrals
The social worker has been referred a client who has been diagnosed with borderline personality disorder (BPD). She is a heroin addict and has relapsed numerous times after extensive treatment efforts. She also recently lost her housing subsidy due to her behavioral issues; she is living out of her car and making money as a prostitute. The client is extremely angry at her father, who she says abandoned her to be raised by a psychotic mother. The father had been providing some financial support to her, but he recently stopped sending money. She calls him a monster and says that she hates him and his wife for not offering to let her live with them and for cutting her off. What should the social worker focus on FIRST?
Harm reduction and case management
A 36-year-old client was referred by his physician because of alcohol abuse. The social worker observes that the client acts very tough but seems insecure. He becomes hostile when asked about his childhood, and, although he briefly mentions that he saw violence at home as a child, he refuses to elaborate. He denies that he has a drinking problem and blames his repeated failures at work on his bosses. The client is married but refuses to let the social worker speak to his wife. Based on this information, what should the social worker MOST suspect is true about this client?
He abuses his wife.
A gay client tells a social worker that he has sought therapy because he is afraid to disclose his sexual orientation to his family and doesn't know what to do. In addressing the presenting problem in this case, what should the social worker do FIRST?
Help the client compare the potential consequences of coming out to those of continuing to hide his homosexuality
An 78-year-old woman reports that she's been feeling unsettled and disconnected. She moved to an independent-living senior apartment about five years ago after her husband died. She retired 10 years ago and has been active in her community since then tutoring children and volunteering at the local library. She reports slowing down a bit during the past year because of worsening physical pain associated with her arthritis. The research suggests that which of the following factors MOST increases this woman's risk for depression?
Her medical disorder and its effects
A new administrator at a community agency finds that there is high conflict and low morale among the staff. Which of the following approaches is MOST likely to be effective for resolving these problems?
Hold a staff meeting as soon as possible
What are some of the most common issues displayed by foster children?
Hygiene, food, sleep, anxiety
The client is a slightly overweight 30-year-old man who was referred by his doctor. The client's presenting complaint is his recent weight gain. In the first interview, he appears despondent about his appearance and expresses guilt about "destroying" himself by becoming too fat. He says he's been "a loser" for years and blames himself. The doctor has told both the client and the social worker that there is nothing medically wrong with the client. What should the social worker do FIRST?
Identify and reframe the client's negative self-statements
A client reports that he is being discriminated against at his job because of a physical disability. From what the client describes, the social worker believes that this allegation is true. As this client's advocate, what should the social worker do NEXT?
Identify what steps the client wishes to take
A family of four comes in for therapy after they discover that the two children (ages 9 and 13) have been caught stealing from the neighbors. The social worker uses Satir's communications approach. What would not be involved in the assessment of these clients?
Identifying the current family schema
he results of a Rorschach test would be MOST useful for which of the following purposes?
Identifying thinking patterns
What does "registration" mean in the context of a mental status exam?
Immediate memory
A social worker involved in policy management relies on a model that emphasizes efforts to engage community members as much as possible in the development and implementation of local programs. He and his colleagues are concerned with facilitating problem-solving in their community. They avoid making decisions on behalf of the community. The social worker is MOST likely using which of the following approaches to public management?
Inclusive
the stages of the management strategy known as "management by objectives" (MBO) are BEST described by which of the following terms?
Inputs, activities, outputs
The unavailability of preventive health services in minority communities, a lack of quality health care in close proximity to these communities, and the delivery of substandard health care services to members of these communities are best attributed to which of the following?
Institutional racism
During a therapy session, a teenage boy says, "My dad left my mom six months ago and we never see him anymore." A few minutes later, the boy says, "I've been feeling like there's something wrong with me lately; like I'm a bad person." After hearing these two statements, the social worker says, "I'm wondering if the reason you've been feeling like you're a bad person is that maybe you believe you caused your dad to leave." What technique has the social worker used?
Interpretation
A client's father dies from complications related to an untreated ulcer. The client, who doesn't have an ulcer, begins experiencing medical symptoms similar to those his father had. Which of the following defense mechanisms describes this situation?
Introjection
A woman with a personality disorder is released from a psychiatric hospital. As part of her ongoing treatment, she will see a social worker for outpatient individual psychotherapy. To prepare for his first session with this woman, the social worker reviews the woman's clinical record and sees that a previous therapist noted that the woman tends to rely on primitive defense mechanisms. Therefore, the social worker can expect that this woman might rely on which of the following defense mechanisms?
Introjection and denial
A social worker's new client is a 40-year-old man who was referred by his physician following thorough physical evaluations. The client complained to his doctor of headaches and fatigue, and the doctor ruled out relevant medical conditions and substance use as causes of these symptoms. When the client meets with the social worker, he tells her immediately that his physician thinks he might be depressed. What should the social worker do FIRST in assessing this client?
Invite the client to share his ideas about his problem
A social worker begins to work in case management with a client who is from a culture that differs from her own. The social worker knows relatively little about the client's culture and acknowledges this to him in the first meeting. What should the social worker do NEXT?
Invite the client to tell her something about his culture
an individual with schizoid personality disorder is MOST likely to display which of the following?
Isolation
The symptoms of shaken baby syndrome include which of the following?
Lethargy, crying, vomiting, loss of appetite, seizures
Which of the following is not a principle of life course theory?
Life span
An existential therapist emphasizes which of the following?
Listening to the client's own account of her experiences
A client in need of case management services immigrated to the United States from Mexico two years ago. He is uncomfortable speaking English and asks the social worker to provide her services in Spanish. The social worker speaks some Spanish but recognizes that her Spanish-language skills may be insufficient for interacting effectively with this client. What should the social worker do?
Make an appropriate referral
A 30-year-old woman is an inpatient at a psychiatric facility, admitted for evaluation and treatment after attempting suicide during an episode of major depression. As a member of the treatment team, a social worker performs a biopsychosocial assessment of the patient during which she discloses many different concerns. To determine the targets of treatment for this patient, the social worker should do which of the following?
Meet with the treatment team to review the assessment findings and the patient's priorities
At what age is a youth most likely to be affected by peer pressure?
Middle school
A social worker provides outreach services after a major flood in the community where he lives and works. Soon after the community has recovered, he considers publicizing in the local media the services he provided during this public emergency as a way of promoting his private practice. To behave in an ethical manner, what should the social worker do?
Not publicize his work
In individuals diagnosed with borderline personality disorder, which ego function is MOST likely to be disturbed?
Object relations
A client who has been experiencing chronic pain reports that her physician has prescribed an opioid analgesic. The client then says that she doesn't want to take the drug because her brother is a former drug addict and she, herself, has had problems with alcohol in the past. What is the social worker's BEST course of action?
Offer to discuss the issue with the client's physician
Which ethnic group has the lowest rate of teen pregnancies?
Pacific Islanders
A social worker finds that she is having sexual thoughts about a client she has been working with for five months. From an ethical standpoint, what should the social worker do?
Seek consultation with a colleague to determine how best to handle this situation
The social worker is seeing a family of 5. The presenting problem is that the children don't listen to the parents. The social worker sees that there is genuine affection in the family but also notes that the parents tend to give unclear directives and the children simply ignore them most of the time. What kind of parenting style do the parents have in this family?
Permissive
A 19 year old who lives with his parents has sought therapy for help getting his life "on track" following a series of job losses and interpersonal failures. The social worker discovers that the client tends to passively resist doing what authority figures ask him to do, to a point where his supervisor at work has threatened to fire him and his parents have asked him to move out. During last week's session, the social worker raised the issue of the client's characteristic response to authority, and he changed the subject without acknowledging what she said. The social worker raises the issue again in the current session, and the client just sits there, silently. What is the social worker's BEST course of action?
Point out the pattern of behavior and help the client explore its effects
A client reports being very angry at a noisy neighbor and wanting revenge. The client is known to have a short temper and has been physically aggressive in the past. What should the social worker do during this interview to address the client's potential for violent behavior?
Pose questions to determine the client's intentions
A social worker who is interviewing a 4-year-old girl who was molested by a neighbor should be aware of which of the following?
Preschoolers are more vulnerable to suggestion than older children.
What is a legal right that prevents confidential information from being disclosed in a court or other legal proceeding without the permission of the person?
Privilege
The client is a middle-aged Hispanic man with a wife and two kids. He seems very anxious in the first interview and reports that he just lost his job. What environmental factors should be emphasized at intake?
Socioeconomic and interpersonal relationships
To understand what influences their clients' development and behavior, social workers often use a multidimensional framework that includes three main dimensions. Which dimension is concerned with social regulation and early attachment?
Psychological
A social worker's new client is a 45-year-old woman who has been divorced for 10 years. The presenting problem concerns her 21-year-old daughter who lives with her. The daughter is supposed to pay rent and help with household chores but rarely does. The client admits that she often gives her daughter "pocket money." She also says that she's worried her daughter uses drugs because she goes out at night with friends and sometimes doesn't come home until the next morning. After acknowledging what the client has shared to this point, what should the social worker do NEXT?
Question and observe the client to gain an understanding of how she perceives and handles the presenting problem
A 30-year-old man loves to go out with his friends to find gay men that they can beat up on. Recently, they were responsible for putting a young man in the hospital with life-threatening injuries. He is known around town as a ladies man, because he is sexually promiscuous with women and a big spender. Secretly, however, the man enjoys watching male on male porno films. What defense mechanism explains this man's behavior?
Reaction formation
A client diagnosed with obsessive-compulsive disorder is MOST likely to rely heavily on which of the following defense mechanisms?
Reaction formation, isolation of affect, undoing
During a meeting with a social worker, a client discloses that he is taking his wife's medication for depression. He explains that he feels better when he does so and has been taking the medication for over a year. When asked what kind of medication he takes, the client says, "It's Prozac, but sometimes I also take my wife's Xanax." The client is also on Clonidine, which was prescribed by his physician for high blood pressure. Regarding the client's medication use, what is the BEST action for the social worker to take?
Refer the client to a psychiatrist
The client is a middle-aged married man with an episodic drinking problem. He says that he can go for weeks without a drink and that he has not had any alcohol for nearly three weeks. The client's wife is supportive of him and describes him as a good husband and father, in spite of his drinking. The client has, however, had many job difficulties as a result of excessive drinking. What is the BEST way for the social worker to arrange treatment for this case?
Refer the client to an intensive outpatient program
A physician refers a terminally ill woman to a social worker. The physician says that the woman would like help writing her will, and the woman confirms that this is what she wants. What should the social worker do?
Refer the woman to an attorney
An attorney phones a social worker and requests that she send him a copy of one of her client's records. What should the social worker do FIRST?
Refuse to release the records
A social worker has been working with a family that includes the parents and two children. The focus of intervention has been on communication difficulties between the parents and children. During a session, the social worker learns that the teenage daughter has been beating up her 7-year-old brother on a frequent basis. What should the social worker do FIRST?
Remind the family about the limitations to their right of confidentiality and file a child abuse report
Which of the following behavioral techniques involves the application of negative punishment that involves removing a specific positive reinforcer each time a negative behavior is performed?
Response cost
The client is a 24-year-old woman who gave birth to a premature boy four months ago. She reports getting little prenatal care while pregnant with her son and smoking cigarettes during her pregnancy. Her son weighed about 4 pounds when he was born and had fairly low Apgar scores. He remained in the hospital for two months but now lives at home with the client and her boyfriend. The client is feeling anxious about motherhood because her first child, who was fussy but seemed healthy, died at age 5 months. This information suggests that the new baby is MOST at risk for which of the following?
SIDS
A social worker has been working in short-term individual therapy with a client for four sessions. The client has not made any progress yet. What is the social worker's BEST course of action?
Schedule a case consultation
A high school senior is brought in for evaluation by his mother, who is concerned because the boy more recently is hearing voices and has withdrawn from his friends and family. He has no other symptoms. What is the MOST likely diagnosis for this boy?
Schizophreniform disorder
A social worker is working with a client who has a history of lying and conning people. The client tends to flatter the social worker and ask her for special favors such as deferring his fee and extending his sessions. The social worker feels as though the client is always testing her, and lately she's been finding it harder to maintain the limits she set with him at the beginning of therapy. Last week, the social worker allowed the client an extra 15 minutes at the end of his session because he'd arrived late. To handle this situation properly, what should the social worker do?
Seek consultation with someone who can be objective
Which of the following principles is MOST associated with living wills?
Self-determination
A 70-year-old man is concerned because he doesn't feel much desire to have sex with his wife. The man married his wife a year ago after being a widower for 25 years. The man's physician has determined that the man is healthy and he's not on any medications. When assessing this case, it would be useful to know that which of the following has been found to be a very good predictor of sexual activity in late adulthood, especially for men?
Sexual activity earlier in life
A social worker is assessing a 4-year-old who was brought in by her parents following a recommendation by the pediatrician. The parents are worried that their child is developing too slowly. Which of the following findings, if true about this child, would reflect something that is considered developmentally appropriate for a 4-year-old?
She still engages in magical thinking.
A social worker is providing case management services to a 27-year-old woman who lost her cashier job a month ago and is running out of money and afraid that she'll lose her apartment soon because of unpaid bills. The client has few job skills and has always had trouble supporting herself, but things have gotten even harder because she's been caring for her older sister who has cancer. The client says she feels helpless and unprepared to deal with the emotional blow she'll suffer if her sister dies. She's not sure if her sister is receiving good medical care but doesn't know where to turn for help. She says there are "road blocks" everywhere. In light of all of this information, what should the social worker do FIRST?
Show his competence through a concrete demonstration of helping
Which statement best represents the NASW's stance on political action by social workers?
Social workers should engage in social and political action to ensure that all people have access to the resources they require to meet their basic human needs.
social worker discovers that a former client has filed a complaint against him with the state board. The board contacts the social worker asking for his records on this client. What should the social worker do?
Submit the records
A woman has been taking care of her 77-year-old father ever since he had a stroke several months ago. Recently, the father's cognitive functioning has declined significantly and his medical needs have become too great for his daughter to meet. The man's physician gives them the name of a complete care nursing facility in their community. The daughter is distraught about the prospect of leaving her father in the care of strangers and insists that she wants to continue caring for him at home. She has been referred to the social worker by her father's physician. Which of the following actions should the social worker take to address the problem described in this case?
Suggest that the woman tour the facility
Although the targets for treatment depend on the particular child's symptoms, there are certain goals that are common to the psychological treatment of most children who have been physically or sexually abused or neglected. Which of the following is NOT
Teach the child strategies for getting support from unsupportive family members
The social worker sees a new client who reveals that she is a prostitute. The social worker feels a strong sense of revulsion at this information. What is the best course of action for the social worker to take?
Tell the client that he feels that she would benefit from seeing a colleague of his and make a referral
Which of these assessment measures can be given as a self-test for alcoholism?
The 20 questions
john is a 50-year-old man who came to therapy for help with his depression. He reports that most days of the week he feels hopeless and empty. He is sleeping a great deal more than usual, but feeling less rested. His job is in jeopardy if he doesn't get it together soon, he says. What testing instrument could the social worker use that would be most useful for monitoring John's progress during the course of therapy?
The Beck's Depression Inventory II (BDI-II)
The presence of extinction for an operant behavior means which of the following?
The behavior has ceased.
The social worker is doing case management for a client who has bipolar 1 disorder. He was recently released from the hospital after a severe episode of depression. What should the social worker be MOST aware of?
The client may have a manic episode in response to the antidepressants he is prescribed.
A 42-year-old woman has been referred to a social worker's agency by a therapist who treated the client for depression about a year ago. The therapist has provided the client's record. The client recently lost her husband in a car accident. She is having difficulty managing her feelings about this and has withdrawn from her family and friends. She doesn't say much when responding to the social worker's initial questions. What would be the reason why the social worker would NOT perform an intake dialogue with this client?
The client turns out to be in crisis.
A social worker is preparing to use a single-subject design to evaluate changes in her client's behavior. In this situation, the dependent variable is which of the following?
The client's behavior
What is the model minority myth?
The cultural expectation that Asian Americans are smarter, more self-reliant, and harder working than other groups.
If the social worker was assessing a family using an intergenerational family therapy perspective, what would he mean if he said that they have an undifferentiated family mass?
The family members have difficulty distinguishing their thoughts and feelings from those of other family members.
A social worker is providing group-based social skills training to a group of adolescents. In his effort to maximize the effectiveness of this training, the social worker should be MOST concerned about which of the following?
The group members' active involvement
Why is six to eight weeks considered the optimal time-frame for crisis intervention?
The life-span of a crisis is about that long
A young heterosexual couple seeks therapy because they fight too much. They are on the verge of ending their relationship because they can't communicate well. They say, "It's like we're two different species when we try to talk about things." Based on his knowledge of research on communication style and gender, the social worker would be MOST likely to suspect which of the following is true about this couple's communication?
The man prefers talking about activities, while the woman prefers talking about feelings.
young Native American man has had a first psychotic break. He lives on the reservation near his family but is hospitalized and getting ready for discharge, being somewhat stabilized by medication. Who should the social worker include in the discharge planning session?
The man, his parents, and his grandparents
Erikson identifies identity formation as the key psychosocial task during adolescence. At age 17 or 18, this task begins to be replaced by which of the following?
The need to develop interpersonal closeness and solidarity
A social work professor has designed a research project regarding the impact of various factors on how students interact with each other during group assignments. He is requiring all his students to participate and has them sign an informed consent document. One student objects to being included in the project and the professor gives him a failing grade because of it. Which of the following statements is MOST true?
The professor should have given the student an alternate assignment to be graded on a similar scale to participation in the research.
The client is a 28-year-old female who has sought services for depression. She discloses that she's been taking sleeping pills every night for months and thinks she might be addicted to them. The social worker encourages the client to stop taking the sleeping pills because she thinks doing so might help her feel better during the day. The client stops taking the pills without seeking medical advice or support, and she experiences a seizure. Which of the following is the MOST significant ethical issue presented in this situation?
The social worker gave advice on a matter that is outside her scope of competence.
A family has been referred by their pediatrician because the 9-month-old daughter is underweight and doesn't eat adequately. The pediatrician has ruled out a medical condition that could account for the problem, and the child has been diagnosed with nonorganic failure to thrive. Given this diagnosis, which of the following is the social worker LEAST likely to find when he evaluates this family?
There are unsanitary living conditions and high levels of lead in the home.
The social worker is trying to diagnose a new client who meets the criterion for a major depressive episode, but has had the symptoms for three years. What criterion must be completely ruled out for a client to be diagnosed with persistent depressive disorder (PDD)?
There has never been a hypomanic or manic episode
A client's symptoms are markedly diminished during sleep. Based on this fact alone, which of the following is the MOST likely diagnosis for this client?
Tic disorder
When asked by the social worker why he has come in, a client says he has low self-esteem and a lack of direction in his life and wants that to change. In the first interview with this man, which of the following should be the social worker's primary objective?
To establish rapport
A social worker is working in couples therapy with a couple who has been fighting a lot. The clients primarily use you-statements instead of I-statements when communicating with each other. What would be the primary purpose of using the empty chair technique with this couple?
To help each partner get a better perspective of the other
A social worker begins working with a family on behavioral problems involving the children. Instead of exploring the family's problems in detail, the social worker asks, "When is this problem not a problem?" What is the purpose of this intervention?
To identify exceptions as a resource for positive change
Why do social workers perform self-assessments?
To monitor their professional strengths and weaknesses
The Brief Symptom Inventory (BSI) would be MOST useful for which of the following purposes?
Tracking a client's progress during the course of therapy
During the initial interview, a client reports a loss of appetite, sleep difficulty, and spells of sadness and weeping. What should the social worker assess SECOND?
Use of substances
A social worker whose private practice is located in an urban setting has many clients who are poor and live in impoverished parts of the city. Some of her clients fail to show up for their appointments or show up late. Which of the following is the MOST likely reason for this?
Value differences that impede trust and/or effective treatment
Which of the following alcohol-related diseases is the MOST serious or life threatening?
Wernicke-Korsakoff syndrome
Benjamin, an 11-year-old, is brought to therapy by his parents because he has been depressed. They say he's always been kind of moody but he's been getting worse lately. When the social worker meets with Benjamin alone, he describes himself as a loser and just worthless. If the social worker used a narrative perspective, she would try to externalize the problem. Which of these statements accomplishes that?
What does Worthlessness want from you?
The client is brought in by his wife because he has been confused and acting strange. He recently went to the store for some milk and was caught for attempting to steal a barbecue tool set, even though he doesn't own a barbecue. When should a social worker suspect frontotemporal neurocognitive disorder over Alzheimer's?
When the age of onset is relatively early
Which of the following is a false statement regarding HIPAA?
While it may be a good idea, HIPAA does not require passwords that protect client information to be changed on a regular basis.
A social worker begins individual therapy with a woman whose husband abuses her. The client left her home to stay with a relative for a while, but her husband found out where she was and convinced her to come home. The client tells the social worker that she wants to "try again and make things work" with her husband. She admits that she worries about him "snapping" again but adds that he has "been good" since she returned home. When questioned by the social worker, the client says she's come in because she's been having trouble sleeping at night; her doctor prescribed medication to help her sleep and suggested she try therapy. What should the social worker do FIRST in this case?
Work with the client to develop a safety plan that she can use right away if she is threatened
Each year, an agency starts its budget process from scratch and must justify every financial request it makes. What type of budget is being used?
Zero-based
The client is a 36-year-old single woman who reports feeling bored at her job and at a "dead-end" socially. She completed two years of college and sometimes thinks about re-enrolling to complete her degree but "never gets around to it." She says she's in a rut she can't get out of. The social worker decides to use a brief therapy model with this client. The assumptions of this model in
a client lacks resources for change and a social worker's key role is to provide skills and knowledge to facilitate change.
Martha and John have a son named Mike. John and Mike have always been close, and Martha, who values her independence, has not minded how much time the boys spend together doing "boy" things, like hunting and fishing, while she pursues her hobbies. When John gets sick from cancer and can't do things with Mike, Mike becomes depressed. Martha feels burdened by John's needs and Mike's depression and doesn't know how to respond, so she becomes anxious. An extended family systems social worker might view this as:
a disruption of the stable triangle
The social worker is assessing a family that is asking for help for their anorexic daughter. The family consists of the parents, the daughter (10 years old), and two young brothers (5 and 3 year old). The focus of assessment in structural family therapy can be said to move from ____________ perspective to ____________ perspective.
a linear; an interactional
While assessing a client who immigrated to the United States from India three years ago, a social worker identifies the client's degree of acculturation into the mainstream culture in this country. According to contemporary models, "acculturation" is BEST defined as:
a process of adopting the traits of the dominant culture with or without abandoning the traits of one's native culture.
A family has been having a great deal of trouble with their two older teens because they have been experimenting with drugs. If a social worker uses strategic therapy, the ultimate aim is to create:
second-order change through first-order change.
A boy who matures sexually early for his age is more likely to experience ____________, and a girl who matures sexually early for her age is more likely to experience ____________.
aggressive behavior and depression; negative health outcomes
Children born with congenital heart disease are much more likely to survive than in previous decades, and can even have a life expectancy that may be comparable to that of the general population. Despite their long-term survival prognosis, these children may still show evidence of certain problems, including:
an increased risk for autism, learning challenges, and problems with attention and executive function skills.
With regard to the confidentiality of disclosures made by participants in group therapy, the social worker leading the group should ___________________.
seek an agreement from participants to maintain one another's confidentiality
he personnel policies of a social agency usually address all of the following EXCEPT:
assignment of day-to-day work activities.
ordinarily, termination should be discussed for the first time with a client:
at the beginning of treatment.
A child has just entered Kohlberg's "conventional morality" level of moral development. She is MOST likely to follow rules in order to:
avoid disapproval or dislike by others.
The client is a 12-year-old girl who was injured in an accident one year ago. The girl was paralyzed from the waist down and now uses a wheelchair. Many of the students at her school have been teasing and isolating her in the classroom and on the playground. The focus of the social worker's intervention plan should be on:
helping the client adapt to and cope with her disability.
Based on something he reads in a client's employment records, a social worker discovers that he and the client attend the same church. From an ethical standpoint, the social worker's BEST course of action is to ________________.
seek consultation
A client has cancer and has been told by his doctors that his prognosis is poor. The client asks his wife to help him plan their annual family reunion, which will take place a few months after his chemotherapy treatment is scheduled to end. Even when she resists helping him, he informs her he's prayed to God and knows he'll still be here to celebrate. According to Kubler-Ross's theory of death and dying (1969), the client's behavior is MOST characteristic of:
bargaining.
Indirect assessment of suicide entails evaluating a client in terms of the demographic, clinical, and psychological risk factors that have been consistently linked with a high risk for suicide. Factors that have been associated with an elevated risk for suicide include all of the following EXCEPT:
being married.
Of the psychiatric disorders, genetic factors have been most consistently linked to:
bipolar disorders.
Social workers often deal with clients that have not only mental health problems but multiple physical problems as well. In geriatric clients, mental health issues are often overlooked by medical doctors because older patients often have so many physical complaints that mask emotional issues. It is not true that:
cognitive abilities such as vocabulary decline with age.
The geographic region that is served by a social agency is known as the agency's:
catchment area.
You have been lobbying representatives in the legislature to provide more funding for childhood mental health screenings for children of at-risk families. This is an example of:
cause advocacy.
The social worker is seeing a Native American man. The man speaks often of his clan and refers to his relationship with his brothers. When the social worker tries to clarify how many brothers the man has, the answer is unclear. This exemplifies that in Native American culture:
roles are determined by relationships, not necessarily by blood.
Advantages to group supervision include all of the following EXCEPT _______________.
conformity to group thinking
A social worker is given two days to prepare and submit a report to the court about a client's progress. The social worker's supervisor needs to review the client's record before the report can be sent to the court. Both the social worker and supervisor have a full caseload of already-scheduled appointments with clients. The social worker's BEST course of action is to:
request an extension.
A social worker is conducting an intake interview with an individual who has come to his agency requesting services. The main purpose of the intake interview is to:
determine eligibility.
During a session, a client describes a recent blind date he had with a woman whom he found to be very unattractive. He tells the social worker that he left the woman in the restaurant and went home after telling her he was just running out to his car to get his phone. The client, who sought help because he was experiencing work-related stress, tends to be arrogant and has told similar stories several times during his sessions. To display positive regard in this situation, the social worker MUST ______________________.
discuss this behavior objectively
lawrence Shulman coined the phrase ____________ communication to describe any disclosure by a client of important or difficult information just as a session is about to end.
doorknob
Many precontact Native American societies were:
egalitarian.
A social worker is beginning to see many Muslim immigrants in his practice. It is important for him to recognize the role of religion and spirituality in his clients' lives. In general, Muslims use their religious practices as coping mechanisms for dealing with mental health issues. It would be important for the social worker to understand that Muslims particularly value:
faith, prayer, the practice of charity, fasting, and pilgrimage.
A social worker's client becomes verbally aggressive toward the social worker during a session. In response, the social worker offers no resistance and acknowledges to the client that she has legitimate reasons for being angry. The technique that the social worker is using is called:
fogging.
Online telemental health services is NOT appropriate for __________________.
high-risk individuals
Immigrants face many stressors before, during, and after resettlement. The immigration process can involve separation from family members, physical stressors, exposure to unfamiliar customs and physical environments, and possibly trauma. The stresses involved in immigration can exacerbate or cause mental health and family difficulties. Immigrant families most often seek mental health treatment for:
intergenerational acculturative conflicts.
he social worker provides support services for a clinic that sees a lot of children whose mothers used alcohol when pregnant. Protective factors for a child who was exposed to alcohol in utero do not include:
low alcohol consumption during pregnancy.
Clients with severe mental illness are seen daily at a center that provides individual therapy, medication management, case management, recreational opportunities, and group therapy. They spend the entire day there and are fed a hot meal at lunch time. This kind of setting is often referred to as:
milieu therapy.
A social worker has been working with a couple for a few weeks when she discovers that there is spousal abuse in the relationship. In terms of reporting this, the social worker should:
not make a report since there is no reporting mandate.
Diana is a 34-year-old client who has been diagnosed as having borderline personality disorder. She has a great deal of trouble regulating her emotions and is constantly in turmoil in her personal relationships. The social worker is recommending that she enroll in a clinic that specializes in Dialectical Behavior Therapy for help in learning to manage her out-of-control emotions and interpersonal difficulties. In Dialectical Behavior Therapy (DBT), the core skills of mindfulness are to be able to:
observe without judgment, describe by separating the experience from reality, and to participate by being fully present in the moment non-judgmentally.
A formal evaluation by a specific group of one's fellow professionals to determine general competence or specific actions is known as:
peer review.
A social worker is conducting a study to determine if a solution-focused approach to treatment has a demonstrable effect on the treatment of test anxiety. The social worker recruits a number of university students who have scored a 4 or above on a Likert scale on a questionnaire about test anxiety. The participants are placed in a group where they either receive solution-focused interventions or see a counselor who simply provides a warm, supportive environment. The social worker is using a:
placebo control group.
A social worker is working with a child that has a facial tic. One of the best known treatments for tic disorder is "habit reversal training." This intervention consists of:
predicting a tic and replacing it with a competing response
The diathesis-stress model proposes that the reasons people develop psychological disorders is because of the interaction of ____________ and ____________.
predisposition; stress
A key component of empathy is:
reflecting the client's feelings.
Jane is a 56-year-old woman who is seeking therapy to help her deal with going through menopause. She has noticed many physical changes, such as hair loss, weight gain, and vaginal dryness. In general, however, postmenopausal women do NOT report that:
the ability to have an orgasm increases with age.
Under the Indian Child Welfare Act, adoptions involving Native American children require a release from ___________________.
the birth parents and the tribe
A social worker is asked to provide case management services to a girl who has developmental disabilities. She meets with the family that includes a father, mother, and 18-year-old daughter. The parents would like to help her move into an apartment with another girl, while still providing substantial support to her. A comprehensive plan of care for this client would describe:
the client's needs, strategies, timeframes, and goals.
The primary element in determining "vicarious liability" is ____________________.
the disparity in training and experience
In the Native American family, the person responsible for raising ethical, culturally aware children is typically ______________.
the grandmother
It would be MOST appropriate for a social worker to refer a client for psychological testing when:
the other means used to assess the client have failed to clarify her level of functioning
While the id operates through a mechanism known as the pleasure principle, the ego operates through:
the reality principle.
A social worker is providing case management services to a client who has been diagnosed with cancer. The client reports that she feels ignored by her doctor who tends to brush off her questions and has provided her with little information about her illness, treatment alternatives, or what side effects she can expect. When she has pressed him for information, he has told her to talk to the nurses at the hospital or do an Internet search for information. After exploring this problem in some depth and then trying unsuccessfully to negotiate with the doctor, the social worker determines that case advocacy is called for and the client agrees. The social worker's FIRST step in advocating on behalf of this client should be which of the following?
to make a direct appeal on her behalf
Which of the following describes an important goal Title XX of the Social Security Act Amendments of 1974?
to provide social services to low-income people in a more economical way
While having dinner at a local restaurant, a social worker discusses one of his clients with a friend. His friend is also a social worker. Although he doesn't mention the client's name, he describes the client's problems in detail. As it turns out, the friend knows the client and is able to identify her through the social worker's description. In this case, the social worker's behavior is _______________.
unethical
A social worker meets with a 30-year-old client who recently divorced her husband. The couple has two children who are living with the client and see their father every other weekend. The client reports feeling exhausted now that she has to care for the children by herself. In assessing this situation, the social worker should be aware that, according to research, in the initial period following divorce, a custodial mother is MOST likely to:
use more authoritarian but less consistent punishment.
Case management is a means for improving client's ____________ and ____________.
well-being; autonomy
