EXAM 4

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? A. Financial well-being B. Number of dependents C. Payroll contributions D. Health status

The correct answer is A .Means testing is a process used to evaluate a person's financial means, or financial well-being, based on her income, debts, health, number of dependents, etc., and the results are used to determine the person's eligibility to receive a benefit. If a person has the "means" to pay for the services she is seeking, the person will be turned down. Means-tested federal programs and services - including TANF, the Food Stamp Program, and Medicaid - help low-income people by providing cash and noncash benefits. These programs and services are provided to families and individuals whose income falls below defined levels and who meet certain other eligibility criteria established for each program.

: A social worker has been referred a family that fled from violence in their home country. The family consists of a father, mother and two children. A third child was killed by landmines just before the family fled their home. All four members of the family are showing significant stress, and the father has started drinking, although he swears that he did not drink before. The mother was a doctor, but can now only find work as a janitor in a hospital. She complains of nightmares almost nightly and says the children often wake up frightened, but can't say of what. How BEST should the social worker respond to help bridge the cultural gap? A. Use a traditional healer from the family's home culture; help the family to connect with others from their culture who have re-settled before them; encourage each of them to tell their story; assess and treat PTSD and refer to a substance abuse program. B. Connect the family with ethno-cultural community organizations and religious institutions, help the client get involved with community resources and make vocational training referrals. C. Focus on the father's drinking initially, followed by reviewing the family's migration trajectory, use tradition

The correct answer is A. The question asks about how to bridge the cultural gap, and three out of the four elements in this answer do just that. Working with a traditional healer, at least in the beginning, from the family's home culture (if available) can help bridge the cultural divide, by beginning with a framework the family knows and understands. Connecting the family to others who have resettled, especially those who have been here a while and are doing well, can lessen the impact of dealing with a foreign culture. Encouraging the family members to tell their stories can help them process what they have gone through before they emigrated, during the immigration process, and during resettlement. The fourth non-cultural element is nevertheless a very good one as it addresses PTSD and substance abuse issues, which are both pervasive in the clinical presentation.

A social worker helps a client acknowledge the target problem, develop and select problem-solving actions, and resolve anticipated obstacles to accomplishing these actions. The social worker also uses guided practice to prepare the client to carry out actions between sessions. Which type of model is the social worker using? A. Task-centered B. Client-centered C. Gestalt D. Behavioral

The correct answer is A. The question describes key components of the task-centered model, a short-term problem-solving approach that focuses on problems that are explicitly acknowledged by the client. An emphasis is placed on the client's input in developing intervention strategies, not only to develop more effective interventions, but also to promote the client's own problem-solving abilities. Change is brought about primarily through problem-solving actions, or tasks, carried out by the client (and, sometimes, by you or others) between sessions. During sessions, the social worker and the client review problems and tasks, identify and resolve potential obstacles to task accomplishment, plan how the client will implement the tasks, and establish incentives and rationale for the tasks. You may also model task behavior or ask the client to rehearse what he or she is going to do or say, and provide the client with suggestions, coaching, and feedback. Modeling and rehearsal are often achieved using role-playing and/or guided practice.

According to the DSM-5, a personality disorder is an enduring pattern of thinking, feeling and behaving that is relatively stable over time. Which statement about personality disorders is true? A. In rare instances a personality disorder can be diagnosed in children if the maladaptive personality traits appear to be pervasive and persistent. B. A personality disorder cannot be diagnosed in a person who has a mental illness. C. Antisocial personality disorder is diagnosed when an adolescent with Conduct disorder reaches the age of 18. D. A personality disorder can emerge in middle age.

The correct answer is A.Although it is extremely rare, personality disorders can be diagnosed in children if the maladaptive personality traits appear to be pervasive and persistent, according to the DSM-5 (pg. 647).

Psychologist Jeffrey Arnett proposes that there should be an additional life-cycle stage for young adults that should be considered. He calls this stage: A. emerging adulthood. B. extended adolescence. C. transitional adulthood.

The correct answer is A.Arnett (2000) proposed a new stage between adolescence and adulthood (roughly between 18 and 25), calling it emerging adulthood, which has become common over the past half-century in industrialized countries. Instead of leaving home after adolescence and marrying, starting a family, and entering into full-time employment, young adults are pursuing secondary education, marrying, and achieving financial independence at a later age. Young people tend to be dependent on their parents for longer, and they take longer to become full contributing members of their societies. However, when they do make commitments to career and family, they have a tendency to be more mature in their judgment.

A school social worker has been meeting with a 12-year-old girl. She reports that anytime she looks in the mirror she sees an "extremely large whale." The social worker observes that the girl's body is of average size. The girl reports feeling isolated as she misses spending time with her friends but refuses to engage in social events because she hates the way she looks. She becomes anxious about even having to attend school and wishes she could stop obsessing about the way she looks. Based on the information provided, what would be the MOST likely provisional DSM diagnosis? A. Body Dysmorphic Disorder B. Obsessive Compulsive Disorder C. Anorexia Nervosa D. Bulimia Nervosa

The correct answer is A.Based on the information provided in the vignette, there is not sufficient evidence to suggest that this individual may be struggling with either anorexia nervosa or bulimia nervosa. Additionally, body dysmorphic disorder (BDD) is characterized by unwavering beliefs that he or she is ugly based on some imperfection or deformity. Individuals with BDD may also engage in obsessive type behaviors such as constant grooming or looking at his or herself in the mirror. Individuals may also tend to avoid social situations.

An adult client would be MOST likely to give which of the following reasons for leaving group therapy prematurely? A. Scheduling conflicts B. Feeling fearful of intimacy C. Feeling that he "doesn't belong" with the other group members D. Feeling unsure about the group leader's competence

The correct answer is A.Clients who terminate group therapy prematurely usually use a polite social "white lie" (excuse) instead of discussing uncomfortable feelings.

: A social worker determines that a client who has been abusing alcohol for many years needs medical supervision in order to withdraw safely from alcohol and refers him for inpatient care. One of the reasons the social worker decides this is that, the last time the client quit drinking, he developed delirium tremens (DTs). Delirium tremens includes which of the following? A. Autonomic hyperactivity, vivid hallucinations, delusions, and agitation B. Permanent physical damage, with major psychological impairments C. Aphasia, amnesia, and confabulation D. Amnesia, perceptual disturbances, and autonomic hypoactivity

The correct answer is A.Delirium tremens is called alcohol withdrawal delirium in DSM-5 and is one of several alcohol-induced mental disorders. Alcohol withdrawal delirium (delirium tremens) involves prominent disturbances in attention, awareness, and cognition following cessation or reduction of alcohol consumption that are sufficiently severe to warrant clinical attention. Common associated features include autonomic hyperactivity, vivid hallucinations, delusions, and agitation.

An adult exhibits a long-term and persistent pattern of passivity, dependency, and manipulativeness. From a psychoanalytic viewpoint, this person would be described as having: A. an oral character type. B. an anal character type. C. a phallic character type. D. a genital character type.

The correct answer is A.Freud maintained that the id's libido (sexual energy) is centered on a different part of the body during each stage of psychosexual development and that under- or over-gratification of the relevant sexual needs during each developmental stage is associated with fixation at that stage and with a different personality outcome. Freud's theory suggests that fixation at the oral stage produces such personality traits as passivity, dependence, manipulativeness, and envy. Other traits associated with the oral character include gullibility/suspiciousness, optimism/pessimism, and cockiness/self-belittlement. Some theorists suggest that "orally fixated" individuals waver from one pole of a dimension to the other (gullibility to suspiciousness, admiration to envy, manipulativeness to passivity, etc.).

A mother is concerned about her 9-year-old daughter because the girl seems shy. She does well at school but rarely has friends over to play. Mom has encouraged her to get involved in afterschool activities but the girl has been reluctant to choose one. In conceptualizing this case, the social worker draws on his knowledge of child development including Erikson's theory of psychosocial development. Erikson's theory suggests that, in order to avoid feelings of inferiority, this school-age child needs to: A. master important social and academic skills. B. acquire the ability to set goals and carry out plans. C. establish close relationships with other people. D. develop a sense of purpose.

The correct answer is A.In his theory of psychosocial development, Erikson emphasized the role of social factors, and each of his eight stages of development involves a different psychosocial crisis. According to Erikson, school-age children are in the stage of industry vs. inferiority - to avoid feelings of inferiority, these children must master certain social and academic skills.

People with personality disorders often have disturbed attachment styles: insecure-ambivalent, insecure-avoidant and disorganized/disoriented (as opposed to secure attachment). In order, what attachment style would you expect to find in someone with borderline PD, schizoid PD and narcissistic PD? A. Disorganized/disoriented, insecure-avoidant, insecure-ambivalent B. Disorganized/disoriented, insecure-ambivalent, insecure-avoidant C. Insecure-avoidant, disorganized/disoriented, insecure-ambivalent D. Insecure-ambivalent, insecure-avoidant, disorganized/disoriented

The correct answer is A.People with borderline PD oscillate between the need to belong and connect, and their fear and anxiety when forming relationships. They often feel intense loneliness because of their need for a genuine connection, but the fear they feel at wanting that connection causes them to act erratically, driving away potential connection (disorganized/disoriented attachment). People with schizoid PD find relationships to be highly anxiety-producing, so they simply avoid them (insecure-avoidant). People with narcissistic PD are insecure and anxious and are hypersensitive to rejection, and show compulsive attention-seeking behavior (insecure-ambivalent). The shortcut to finding the correct answer is to find the one sure description, that of insecure-avoidant, (listed second in A. and D.) which fits schizoid PD, and then work it out from there.

: Regarding the physical changes that accompany growing older, which is the following is true? A. Physical activity can help prevent the frailty that may come with old age. B. By age 75, the majority of adults have experienced notable hearing loss. C. Older adults need less sleep than younger adults. D. Diabetes is the most common chronic health condition among adults over age 65.

The correct answer is A.Regular physical activity in late adulthood is associated with many benefits including a lowered risk of coronary heart disease, colon cancer, diabetes, high blood pressure, and osteoporosis; a reduced risk of falling; less anxiety and depression; a greater ability to maintain joint strength and mobility; and better cognitive functioning. In addition, maintaining lean muscle helps to prevent frailty and disability.

A client is taking medication to control the symptoms of a mental disorder. Because of the potential side effect of a serious blood disorder, she is required to have a blood test every week. The client is MOST likely taking which of the following medications? A. Clozaril B. Chlorpromazine C. Clonazepam D. Celexa

The correct answer is A.The atypical (second-generation) antipsychotic clozapine (Clozaril) was introduced in the United States in 1990. In clinical trials, this medication was found to be more effective than conventional (first-generation) antipsychotic medications in individuals with treatment-resistant schizophrenia (schizophrenia that had not responded to other drugs) and the risk of tardive dyskinesia was lower. However, because of the potential side effect of a serious blood disorder - agranulocytosis (loss of the white blood cells that fight infection) - individuals who are on clozapine must have a blood test every one or two weeks.

A new client comes to see the social worker. He is very quiet and sallow looking. He states that he has tried therapy a lot of times, but it has never worked. When the social worker asks why he thinks this is, he says, "they just never get me. I doubt if you will either." What is the best response? A. Tell the client that it is possible that he will have a similar experience here. B. Tell the client that the social worker feels sure that they can work things out here. C. Ask the client what it is about him that leads to this happening over and over again. D. Reassure the client that they can work together to have a different outcom

The correct answer is A.The social worker should try to meet the client where he is at, which in this case is to reflect the client's hopelessness honestly. Of course, there is more discussion to follow, and the social should ask what happened in the client's previous experiences that have disappointed him, etc

The establishment of a new behavior is most rapid when reinforcement is applied on a continuous schedule. Maintenance of the behavior is maximized when the behavior is reinforced on an intermittent schedule. The best procedure is to first use a continuous schedule of reinforcement and once the behavior is well established, to then change to an intermittent one. The process of reducing the proportion of reinforcements is referred to as _______? A. thinning B. fading C. positive reinforcement D. punishment

The correct answer is A.Thinning is the process of reducing the proportion of reinforcements in operant conditioning.

A gay man presents for individual therapy shortly after coming out to his pastor. The client has attended this church for five years and had a good connection with his pastor, but now the pastor avoids him. The client adds that he feels alienated at his church now and that this experience is making him question his faith. In addressing the presenting problem in this case, what should the social worker do FIRST? A. Offer the client referral to a local church where he will find acceptance and be more comfortable B. Discuss with the client the pros and cons of disclosing his sexual orientation C. Further assess the client's religious needs and explore his beliefs with him D. Encourage the client to break away from his church and find support elsewhere

The correct answer is A.This client appears to have a strong faith in religion which has been challenged by his recent experience. It would be beneficial for him to know that religious support is available to him. There are churches, such as the Fellowship United Methodist Church, that are accepting of a gay congregation. In general, when working with gay, lesbian, bisexual, or transgender (GLBT) clients, social workers should be aware o

A social worker is meeting with a mother, father, and their 4-year-old daughter. During the interview, the girl sits on the floor a few feet away from her parents and flicks her hands repeatedly. What DSM-5 diagnosis is MOST indicated for this girl? A. Stereotypic movement disorder B. Autism spectrum disorder C. Social (pragmatic) communication disorder

The correct answer is A.This is the best answer because the only obvious symptom described is the child's repetitive hand movements. Stereotypic movement disorder is characterized by repetitive, seemingly driven, and apparently purposeless motor behavior (e.g., hand waving, body rocking, head banging, self-biting) that interferes with social, academic, or other activities and may result in self-injury. The repetitive motor behavior is not attributable to the physiological effects of a substance or neurological condition and is not better explained by another neurodevelopmental or other mental disorder.

A middle-class 35-year-old Caucasian social worker is meeting with an Asian family for the first time. The family had moved from the Philippines 5 years ago and speaks moderate English. The mother expresses feeling distressed over the thought of her eldest son beginning and moving to college in the fall. The social worker concludes that this anxiety comes from a Filipino cultural belief that children should remain close to the nuclear family in order to assist with finances and take care of their parents until old age. Did the social worker make a mistake in assessing this family? A. Yes, the social worker may be applying preconceived notions or stereotypes about the Filipino culture to this family B. No, the social worker is most likely correct and is taking the steps to maintain a cross-cultural perspective C. Yes, the social worker may have misunderstood due to a language barrier and a translator should be contacted D. Yes, the social worker is wrong in thinking that the Filipino cultural belief is to have children stay close to home for finances, as it is typically because children are expected to live at home until they are married.

The correct answer is A.When engaging in cross-cultural communication it is important to remain self-aware about any preconceptions or stereotypes you may have. Before assessing a situation, it would be imperative to learn the family's narrative from their point of view.

The geographic region that is served by a social agency is known as the agency's: A. mission statement. B. catchment area. C. functional community. D. claimed domain.

The correct answer is B.A catchment area is the geographic region that an agency serves (i.e., all the agency's potential clients located in that region).

A person's ability to self-regulate their own emotional states depends in large degree on: A. genetic susceptibilities. B. early attachment experiences. C. upbringing. D. self-soothing and calming capabilities.

The correct answer is B.A person's ability to self-regulate their own emotional states depends in large degree on their early attachment experiences. Children learn to recognize and manage their internal states when they are reflected, and adequately responded to, by an empathic and attuned caregiver. If the caregiver is overly focused on their own needs rather than those of the child, or are indifferent or abusive to them, the child will not get the mirroring that helps them learn how to regulate their own emotional states.

A child living in the United States is exposed to both English and a second language between the ages of six months and 3 years and, as result, becomes fluent in both languages. If the child had not been exposed to the second language until after the age of 4 or 5, she would have had more trouble acquiring the second language. This provides evidence for: A. the concept of critical periods. B. the concept of sensitive periods. C. the theory of information processing. D. the notion of imprinting.

The correct answer is B.Although some authors use the terms "critical period" and "sensitive period" interchangeably, they actually mean two different things. A critical period refers to a time when, if certain developmental events don't happen, later aspects of development will not occur. A sensitive period refers to an optimal period rather than a necessary period. The situation described in this question suggests there is a sensitive period for dual language learning.

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 FIRST? A. Use of alcohol B. Suicide potential C. Medical history D. Level of anxiety

The correct answer is B.Because the client has reported symptoms of severe depression, the social worker should promptly assess, through direct questioning, whether the client has ever thought about hurting herself.

A 25-year-old client recently immigrated to the United States from Southeast Asia. In working with this client, which of the following will be MOST important? A. Providing counseling to accelerate his acculturation process B. Connecting him to community programs for immigrants and refugees that offer resources C. Helping him deal effectively with discrimination, racism, and xenophobia

The correct answer is B.Because we have no details about this client's situation, we should answer the question by applying basic knowledge about working effectively with clients who are immigrants or refugees. Clients who are recent immigrants or refugees usually have few social contacts, may need help with the basic necessities of life, and usually benefit from being connected to programs that provide culturally relevant services and resources. For example, the client may benefit from being connected to a program that offers interpreters, language classes, and other assistance with learning about American culture, as well as contact with other immigrants and individuals who share his cultural background.

Epigenetic changes to inherited genes has been gaining traction as a way of explaining why some people develop mental illness, while others, with the same inheritance, do not. Which of these is not an epigenetic factor? A. Chemical exposure B. Inheritance C. Maternal stress D. Abuse

The correct answer is B.By definition, epigenetics are things that change the expression of genes, not the actual inherited genetic code itself.

The cultural humility (Ortega and Faller, 2011) perspective is one that: A. acknowledges that what is appropriate in one culture may not be so in another culture. B. reminds the social worker to maintain a stance of humility and normalizes not knowing in regards to their knowledge of other cultures. C. encourages social workers to take into account an individual's multiple identities particularly as it relates to their expression of their culture.

The correct answer is B.Cultural humility focuses on self-humility rather than achieving a state of knowledge or awareness. It normalizes not being an expert and rather to instill a sense of curiosity and a view that the client is an expert in his own life.

A social worker has been conducting research on the effectiveness of a new treatment program for veterans suffering from post-traumatic stress disorder (PTSD). Which of the following questions would best guide the research study? A. Do veterans enjoy participating in the program? B. Do veterans experience improvement in their PTSD symptoms as a result of participating in the program? C. How many American veterans suffer from PTSD? D. Are veterans suffering from PTSD more likely to experience housing insecurity?

The correct answer is B.Determining whether veterans experienced improvement as a result of the program is a specific and measurable research question that could lead to the identification of evidence-based practice recommendations. The other answer choices are not related to the social workers research goals.

In terms of emotional development, a key task in middle childhood is the development of "emotional competence," which is BEST described as the ability to: A. regulate negative emotions in appropriate ways. B. experience, express, and understand emotions. C. read other peoples emotions and express empathy.

The correct answer is B.Emotional competence refers to the ability to experience, express, and understand emotions. An "emotionally competent" person is aware of and recognizes his/her own emotions and regulates their expression ("experiencing" emotions); expresses his/her emotions in ways that are socially appropriate to the situation ("expressing" emotions); and is able to read other people's emotions and respond to them appropriately and understands that people have different emotional styles ("understanding" emotions).

Based on the initial evaluation of a 15-year-old boy, a social worker believes that the nature and number of his symptoms suggest a DSM-5 diagnosis of attention-deficit/hyperactivity disorder (ADHD), predominantly inattentive presentation. Before assigning the diagnosis, the social worker will want to confirm that some symptoms were present before the boy was _____ years of age and that he exhibits them in at least _____ settings. A. 7; two B. 12; two C. 6; three D. 10; three

The correct answer is B.For a diagnosis of ADHD, the DSM-5 requires that "several inattentive or hyperactive-impulsive symptoms were present prior to age 12" (p. 60) and that symptoms are present in at least two settings.

A social worker involved in an episode of macro change has analyzed the problem, developed a working hypothesis about the causes of the problem, created a working hypothesis of intervention, and selected an approach to change (s/he has decided to use a program approach). Their NEXT major step is MOST likely to be which of the following? A. Conducting a needs assessment B. Building support for the program C. Identifying what resources they need D. Identifying objectives and activities and creating an action plan

The correct answer is B.In sequence, the major steps taken in an episode of macro change include the following: a) analyze the problem, population, and arena; b) develop a working hypothesis of etiology about the problem; c) develop a working hypothesis of intervention; d) select an approach to change (policy, program, project, practice, or personnel); e) build support for the change; f) estimate the probability of success; g) decide whether to pursue the change effort; h) select strategies and related tactics to get the change approved by decision-makers and others; i) plan the intervention; j) prepare to implement the intervention; k) monitor the intervention; and, l) evaluate the effectiveness of the intervention.

The management philosophy of an agency reflects a Theory Y approach. Consequently, one would expect to find which of the following in the agency? A. Highly formalized communication channels B. A high degree of self-direction on the part of staff C. The use of pay and bonuses as the primary mechanisms of reward D. Promotion and selection based on technical competence

The correct answer is B.McGregor (1960) identified two opposite approaches to management - Theory X and Theory Y - and suggested that a manager's view of his or her role depends on his or her assumptions about employee characteristics: Theory Y transfers decision-making power to lower-level workers and assumes that management's task is to recognize workers' higher-order (e.g., self-actualizing) needs and to design organizations that allow them to achieve these needs. Theory Y managers view work as being "as natural as play" and assume that employees are capable of self-control and self-direction. Theory X, by contrast, is a much more domineering style of management. Theory X managers believe that employees dislike work and avoid it whenever possible, and, as a result, they must be directed and controlled.

A gay couple, Bob and Joseph, come in to therapy to discuss whether they want to go through the process of surrogacy in order to be able to become parents. The social worker notices that Bob seems to be dominant over Joseph, in that Joseph tends to yield to Bob even when he has a different opinion. How would a social worker using an MRI approach describe this relationship? A. A symmetrical feedback loop B. Complementary communication C. Pursuer-distancer D. A non-egalitarian relationship

The correct answer is B.Mental Research Institute (MRI) theory would see this type of relationship as complementary. In a healthy complementary style of relationship, the pattern of one persons behavior fits the other, or one person tends to take the supportive role to the more dominant partner. In an unhealthy complementary relationship one person dominates and controls the other and the other responds by being passive and victimized.

A client reports experiencing a great deal of stress at work that is affecting him at home. He and his wife are expecting their second child and their first child is a toddler. The client wants to learn relaxation techniques so that he can prevent a build up of stress during the day and be more available to help his wife with things at home. Which of the following factors, if true about this client, is MOST likely to have a negative effect on his response to the stress in his life? A. His self-efficacy beliefs are high. B. He has an external locus of control. C. He sometimes engages emotion-focused coping and problem-focused coping at the same time.

The correct answer is B.People's responses to stress are typically determined by certain moderating factors, including their social resources and personal characteristics. Here, you're looking for something that would have a negative impact on this client's response to the stress in his life. Individuals are better able to tolerate and cope with stress when they have an internal locus of control - i.e., when they believe they have a degree of control over the causes or consequences of stress.

The client is a 20-year-old immigrant from Turkey who came to the U.S. with his family when he was 16. The client says he's becoming more like his American friends and is uneasy about that. He wants to fit in but doesn't want to lose his own customs and values. He acts one way when he's with his family and another way when he's with his friends. He asks the social worker what she thinks about that. Based on her familiarity with contemporary models of acculturation, the social worker is MOST likely to tell the client that efforts to function well within both one's culture of origin and the mainstream culture: A. may produce overwhelming levels of stress. B. may be associated with better adaptation. C. often produce confusion and identity crises. D. lead to social isolation.

The correct answer is B.Some experts have suggested that the best possible outcome of acculturation is the ability to function well in both one's culture of origin and the dominant (mainstream) culture. In order to become "biculturally competent," immigrants need knowledge of the new culture's beliefs and values, a positive attitude toward both cultures, the belief that they can live happily and successfully in both groups without compromising their sense of cultural identity, supportive and reliable social networks in both groups, a broad range of culturally and situationally appropriate behaviors and roles, and communication competency.

A client who has been taking antipsychotic medication for years begins experiencing tightness in his jaw and involuntary arm and tongue movements. If the client has developed tardive dyskinesia (TD), what medication could be used to alleviate its symptoms? A. Haldol B. Clonazepam C. Prozac D. Clozaril

The correct answer is B.Tardive dyskinesia (TD) is a medication-induced movement disorder that can develop in individuals who have been taking an antipsychotic drug (especially a typical, or traditional, antipsychotic) for a long period of time. Its symptoms include involuntary, rhythmic movements of the jaw, lips, tongue, limbs, and trunk. TD is the most serious of the extrapyramidal side effects associated with antipsychotic drugs and must be addressed immediately by a qualified medical professional. Treatments for TD include taking the patient off the medication and may also include giving the patient clonazepam (a benzodiazepine).

The "nature-nurture" debate is over the relative contributions of genetic and environmental factors to human development. Currently most experts agree that: A. both play a role, but culture is the key variable affecting development. B. both are important and have a reciprocal influence on development. C. nurture is stronger than nature.

The correct answer is B.The "nature-nurture debate" is concerned with the degree to which hereditary (biological) and environmental factors are responsible for diversity in the development of human characteristics and behavior. Historically, maturationists have maintained that development is a biological process that occurs automatically in predictable, sequential stages over time, while learning theorists have maintained that human development and behavior are primarily the result of environmental factors. Currently, most experts believe that many human characteristics are the result of an interaction between nature (biology) and nurture (the environment); this view is represented by interactionist theories, including those set forth by Freud, Piaget, and Kohlberg. There remains a lack of consensus about the relative contributions of nature and nurture, however.

The social worker has been seeing a woman for about a year, who has several severe, life-threatening conditions. She is in constant pain, with only occasional relief from medication. She has been told several times that she has only months to live, but has always rallied back. One day, she comes in and tells the social worker that she has had enough, and that she has decided to stop taking all of her medications, except pain pills. The social worker points out that the medications seem to be what have been keeping her alive these past few years. The client acknowledges this, and states, "I don't want to live any longer. I'm done." How should the social worker respond? A. The client plans to attempt suicide and the social worker must intervene. B. The client is exercising her right to make a decision and the social worker should support her in that decision. C. The social worker should call the Psych. Emergency Team and ask them to institute an involuntary hold on the client. D. The social worker should strongly encourage the client to talk with her doctor about what will happen if she goes off her medication.

The correct answer is B.The client is exercising her right to determine what is best for her and the social worker should support her decision. This client is fully aware of the implications of her decision to go off of her medication, and has decided to face her inevitable death on her own terms.

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: A. observe and become aware of thoughts, feelings, behaviors and behavioral urges. B. observe without judgment, describe by separating the experience from reality, and participate by being fully present in the moment non-judgmentally. C. being able to inform the wise mind from the logical and emotional minds. D. interpersonal effectiveness, emotional regulation, and distress tolerance.

The correct answer is B.The core skills of mindfulness as delineated by DBT are observation, description and participation without self-consciousness and judgment. The final skills, not listed in the answer, are one-mindfulness (focusing on only one thing at a time) and effectiveness in doing what works.

The DSM-5 requires that which of the following be ruled out as the cause of an individual's symptoms before assigning a diagnosis of a sexual dysfunction? A. Other mental disorders, physiological/medical factors, and partner factors B. A nonsexual mental disorder, severe relationship distress, and the effects of a substance, medication, or other medical condition C. A nonsexual mental disorder, the effects of a substance/medication, and a lack of information about sexuality D. Other mental disorder/condition, the effects of a substance/medication, and psychosocial factors

The correct answer is B.The following is included as a diagnostic criterion for a DSM-5 diagnosis of erectile disorder, premature ejaculation, and other sexual dysfunctions: "The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition" (APA, 2

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? A. Social B. Psychological C. Personality D. Biophysical

The correct answer is B.The multidimensional framework used by most social workers emphasizes the biophysical, psychological, and social dimensions. The psychological dimension is concerned with psychological functions that influence a person's ability to satisfy his or her needs over the lifespan. It consists of early emotional bonding; basic temperament; cognitive development and information processing; communication; personality, identity, and self-concept; emotions and attitudes; social regulation; and moral development; and incorporates both psychological strengths (protective factors), and psychological hazards (risks)

The social worker is working with two different clients - one client immigrated from China one year ago and the other client is 5th generation Asian-American. What would not be expected of the latter? A. The 5th generation Asian-American family would expect the social work not to be formal and directive with them. B. The 5th generation Asian-American family would be very concerned with maintaining linkage to historical values. C. The 5th generation Asian-American family would respond better to a structured approach than an unstructured one. D. The 5th generation Asian-American family would not have acculturation issues.

The correct answer is B.The question is asking what would most likely not be seen in the client whose family has been in the US for 5 generations, and who we can assume is likely to be fully assimilated. After 5 generations, it is not a certainty that the Asian-American family would be overly concerned with maintaining linkage to historical values. One would expect this from the recent immigrants, however.

A social worker has been working in individual therapy with a client for three weeks. 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 should the social worker do FIRST? A. Explore what precipitated these feelings B. Mobilize the client's support system C. Recruit the client's family members to monitor him D. Find out whether the client's home environment is safe

The correct answer is B.The social worker should first complete a suicide assessment of the client (e.g., find out if he has a suicide plan), but this action is not listed among the answers. Therefore, "B" is not a perfect answer, but it is the best one offered. Both legally and ethically, the social worker is required to take reasonable steps to prevent a suicidal client from harming himself. The proper steps depend on the degree of risk currently posed by the client and his willingness and ability to follow your recommendations. With many clients who have expressed suicidal ideation, mobilizing their support system is a reasonable intervention (e.g., you may suggest that the client temporarily stay with friends or relatives, arrange to see the client more often, and/or have the client telephone you on a daily basis). Family members or close friends can offer the client support during the crisis and be a source of logistical help by monitoring the client and/or removing weapons or other means of suicide from the client's home. Note that if the social worker determines that the risk of suicide is high enough, they don't need the client's permission to contact his family members or other close support people - if it is determined that a breach of confidentiality is needed in order to prevent the client from committing suicide, then the social worker can disclose whatever confidential information is needed for the purpose of achieving that goal.

The social worker is seeing Dave, who has bi-polar disorder. Dave has a long history of manic episodes that have, at times, gotten him in trouble with the law. He is currently stable on his medications and is able to hold down a full-time job as a bus driver for the local transit district. What is the social worker's role as far as managing a client's medication? A. The social worker has no role in medication management. B. The social worker should monitor the client's medication compliance. C. The social worker should monitor the client's medication compliance, and report any problems to the prescribing physician. D. The social worker can recognize when there are problems with medication, such as side-effects and help the client manage them.

The correct answer is B.There is growing recognition that social workers play a vital role in medication management. While a psychiatrist may only see a client once every few months or so, the typical social worker is seeing the client at least once a week. The social worker is in a better position to monitor compliance and to spot problems such as side-effects. Of course, the social worker is not allowed to give advice about how to deal with side-effects, but can play an active role in facilitating communication between the client and the prescribing physician.

Refugees experience stress before, during, and after their migration experience. Before leaving their home country, they may have experienced severe stress, such as inability to meet their (and their children's) physical needs, persecution, violence, or war. Culturally-competent treatment takes into account that: A. the social worker may misunderstand subtle cultural cues. B. culture can influence every aspect of illness and adaptation and what may be considered a strength in one cultural context may be perceived as undesirable in another cultural context. C. help seeking behavior is influenced by cultural factors. D. the social worker should try to use English speaking youth in the family to serve as ad hoc communicators if language barriers exist.

The correct answer is B.This answer provides the most encompassing, accurate statement.

The social worker is employed in an agency with a large immigrant population. She is most familiar with immigrants from Latin American countries. Lately, she has taken on a female client who immigrated from the middle east and is Muslim. The client complains of depression and anxiety, and feels alienated from Allah since moving to the United States. The social worker has researched Islamic culture and its views on mental health, and knows that there is an emphasis in Islam of the value and cohesion of the community. She runs a group for people with depression and anxiety and recommends that the client attend. The client agrees, and never returns. Which of the following BEST represents the error the social worker made? A. The social worker should have inquired as to whether this client would feel comfortable in a mixed-gender group. B. The social worker did not take into account that some Muslims, although comfortable with groups within their own culture, may feel uncomfortable in group settings with people from different cultures. C. The social worker should have assessed the place that Islam has in the life of this client. D. The social worker should have realized that her suggestion wo

The correct answer is B.This client may not feel comfortable in a group setting with people from diverse cultures. And, it is unclear if the group is mixed-gender, but if it is, it may not be appropriate for this particular client due to her religious background, although different branches of Islam approach the issue of how men and women relate in differing ways.

: A social worker meets with a client whose friend died recently from an opportunistic illness that developed during the late stage of HIV disease. The client has HIV disease and has not been taking his medication regularly since his friend died. The client's behavior MOST likely indicates which of the following? A. Displacement B. Grieving C. Suicidality D. Denial

The correct answer is B.This is the best answer because you know that this client has recently lost a friend. For some people, the grieving process includes self-destructive (non-suicidal) behavior.

A client says, "I don't want to get so wrapped up in my relationship with my boyfriend that I lose my ability to make my own decisions." The social worker responds by saying, "Your independence is important to you." What skill has the social worker used? A. Interpretation B. Paraphrase C. Accent response D. Seeking concreteness

The correct answer is B.This response is basically a more concise version of what the client has just said. A paraphrase restates the essence of a client's message - it is a selective restatement of the main idea that resembles the client's statement but is not identical to it. Particularly when they are used with responses that highlight the client's feelings (such as empathic responses), paraphrases are effective for encouraging the client to continue expressing herself. They are also useful for bringing focus to an idea or a situation that the client should consider.

A social worker is beginning family therapy with an American Indian family, including the husband, the wife, the children, and the husband's father, who lives with them. The social worker notices that the wife keeps referring to her father-in-law as "he," rather than using his name. The social worker starts to wonder why. The social worker's BEST course of action is to: A. ask the father-in-law his name. B. ask the family about their habits regarding names and relationships. C. accept the wife's language as a cultural norm. D. invite the adult family members to start using first names in therapy sessions.

The correct answer is B.This would help the social worker to discover the family's rules in a respectful manner.

A boy is able to tell that dogs are mammals and therefore related to cats. He also knows cats are related to horses, and concludes that dogs are related to horses as well. How would Piaget describe this process? A. Deductive reasoning B. Transitivity C. Concrete operational D. Formal operations

The correct answer is B.Transitivity is the ability to recognize relationships among various things in a serial order, in other words, the understanding that if A is related to B, and B is related to C, then A must be related to C.

A couple comes to see a social worker for grief counseling. They discuss an incident that occurred over a year ago where they lost both of their children and suffered their own physical injuries. They explain that they are religious and have been supported by their church in this time of loss, but have been feeling guilty recently for questioning God's reason for taking their sons. How BEST would the social worker respond empathically to this family? A. Employ a future focused therapy strategy to help the couple move forward from the loss B. Utilize a double-sided reflection to express how hard it must be to struggle with not only losing their sons, but also questioning their faith C. Reassure the couple that God has a plan for everything and although they may be confused about what it is now it will become clearer with time D. Suggest they consider switching to a different church

The correct answer is B.When responding empathically it is recommended to utilize reflection. A double-sided reflection is a great technique to help summarize ambivalent feelings that a client or clients may be struggling with. In this situation the couple is struggling with the loss of their sons as well as the questioning of their faith.

An 11-month-old baby becomes very upset when his mother leaves the room for a few minutes. This MOST likely reflects which of the following? A. Autism spectrum disorder B. An insecure/avoidant attachment pattern C. Separation anxiety D. Reactive attachment disorder

The correct answer is C. "Separation anxiety" refers to distress displayed by babies when they are separated from their primary or customary caregivers. It usually begins at about 6 to 8 months of age, peaks at about age 14 to 18 months, and then gradually declines. Unlike separation anxiety disorder, separation anxiety, when it occurs during this developmental period, is considered normal. It reflects a child's increasing cognitive skills and growing emotional and social bonds with his or her primary caregiver.

A client reports that she's having "a lot of problems" with food, including "episodes of overeating." She states that she's been on numerous diets over the years, and even when she achieves her desired weight, she always gains it back. She says that she's been evaluated for medical problems, such as hypothyroidism, but all of the tests have been negative. When determining if the client's symptoms meet the criteria for binge-eating disorder or, instead, bulimia nervosa, the social worker should keep in mind that: A. binges are more severe in binge eating disorder than in bulimia nervosa. B. a disturbance in body image is not characteristic of bulimia nervosa. C. compensatory behavior to prevent weight gain is not a requirement for binge-eating disorder. D. a sense of lacking control over eating during binges is not characteristic of binge-eating disorder.

The correct answer is C. Compensatory behavior is a diagnostic criterion for bulimia nervosa but not for binge-eating disorder and, therefore, differentiates the two disorders. In the DSM-5, a diagnosis of binge-eating disorder requires recurrent episodes of binge eating that involve a sense of lack of control over eating, the presence of at least three characteristic symptoms (e.g., eating more rapidly than usual, eating until feeling uncomfortably full, eating alone due to feeling embarrassed about the amount of food consumed), and the presence of marked distress about binge eating; for the diagnosis, binges must occur, on average, at least once a week for three months. A diagnosis of bulimia nervosa, in contrast, requires recurrent episodes of binge eating that are accompanied by a sense of a lack of control, inappropriate compensatory behavior to prevent weight gain (e.g., self-induced vomiting, misuse of laxatives, fasting, excessive exercise), and self-evaluation that is unduly influenced by body shape and weight; for the diagnosis, binge eating and compensatory behaviors must occur, on average, at least once a week for three months.

Social policy emerges from governments, voluntary organizations and the will of the people. The policy that is instituted determines how resources are distributed. The differences between collectivism and individualism can be described in what ways? A. Collectivistic philosophy aligns with the idea that society collectively decides how best to address social problems, while individualism assumes individuals will rise in function to a level to meet their own needs. B. The idea that some individual choice must be limited to better serve the good of society has its roots in individualism, while collectivism is based on societal norms and customary values. C. Social policy influenced by individualism seeks to remove restrictions on personal freedom while the collectivist philosophy predicates that individual choice will necessarily be limited by the needs of the whole. D. Individualism is based in Social Darwinism that assumes that the wealthy are more fit for survival, while collectivism assumes that disparities in resources are purely determined by chance.

The correct answer is C. These are accurate descriptions of individualistic and collectivistic philosophies.

Problem drug use among adolescents is MOST linked with: A. peer pressure. B. lack of information/education. C. alienation. D. early experimentation with drugs.

The correct answer is C. This question is about "problem drug use," not merely experimentation with drugs. Although "just say no" and educational programs are probably the most popular types of anti-drug programs aimed at children and adolescents, the research suggests that their success is destined to be limited because they are based on the wrong assumptions regarding the causes of problem drug use. Based on their longitudinal study, J. Shedler and J. Block (Adolescent Drug Use and Psychological Health, American Psychologist, May 1990, 612-630) conclude that problem drug users exhibit a coherent syndrome, often as early as age 7, that is characterized by alienation, impulsivity, and subjective distress and that these symptoms clearly precede the onset of drug use.

Researchers interested in the relationship between basic temperament and personality later in life have found that: A. temperament and personality are both products of the social environment. B. temperament is inherited and will change only if social-environmental conditions are extreme. C. the impact of temperament on personality depends on the fit between temperament and characteristics of the social environment. D. temperament in early childhood is not predictive of later personality development.

The correct answer is C. This question requires familiarity with the "goodness-of-fit" model (Thomas & Chess, 1977). Thomas and Chess proposed that most babies can be categorized as having either an "easy," "difficult," or "slow-to-warm-up" temperament and that many children categorized as "difficult" or "easy" at age 3 were rated, respectively, as poorly- or well-adjusted as young adults. However, the relationship between early temperament and later adjustment was not perfect, and, based on this finding, Thomas and Chess developed a "goodness-of-fit model" which predicts that it is the degree of match between parents' behaviors and the child's temperament that contributes to the child's outcomes.

Kohlberg's (1963) Heinz dilemma poses a story where a man's wife is dying of cancer and he cannot get the money to buy the medication she needs. He breaks into the pharmacy to steal the drug to save his wife's life. Kohlberg was interested in what children would say about social conventions in this dilemma in terms of: A. Right and wrong B. Moral development C. Post-conventional moral development D. Abstract thinking

The correct answer is C. Post-conventional moral development goes beyond convention or what other people think, or the legalistic consequences of a behavior, to a higher, universal ethical principle of conduct. The focus is on doing the right thing, regardless of the personal consequences.

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. She is terrified that her boss will fire her. When she talks to her parents, the calls often end in awful fights. She then worries that her parents will abandon her. 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. Antisocial personality disorder B. Conduct disorder C. Borderline personality disorder D. Intermittent explosive disorder

The correct answer is C.All four disorders are associated with either episodic or chronic displays of uncontrolled anger or aggression. Among the potential symptoms of borderline personality disorder (BPD) are recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior; these commonly occur in response to perceived or actual abandonment by another person. Identity disturbance, emotional outbursts, and frantic efforts to avoid abandonment are hallmarks of BPD that this client exhibits.

Early onset persistent bilateral otitis media with effusion has been linked to which of the following? A. Stuttering B. Intellectual disability C. Specific learning disorder D. Autism spectrum disorder

The correct answer is C.Bilateral otitis media with effusion is a severe form of middle ear infection involving inflammation of the left and the right middle ear with fluid leakage. Middle-ear infections in early childhood, especially severe infections resulting in hearing loss, have been associated with attention deficits and the development of specific learning disorder later in childhood.

Teratogens is defined as any agent that can cause an abnormality following fetal exposure during pregnancy. Common teratogens include alcohol, nicotine, legal and illegal drugs and lack of folic acid. Which of the following is NOT a teratogen? A. Infection B. Radiation C. Genetics D. Air pollution

The correct answer is C.By definition, a teratogen is an agent that the mother is exposed to during pregnancy, therefore genetics does not meet that definition. However, the effect of a particular teratogenic agent can be dependent on the genetic susceptibilities of the mother and/or fetus.

The social worker is part of a team that assesses children that are victims of sexual abuse. The area where the clinic is situated covers a very mixed, multi-cultural urban setting. When interviewing a Chinese-American child, the social worker should keep in mind that in comparison to the European-American child the former is more likely to: A. show greater deference to authority. B. focus on details about their own experience and less on information regarding others. C. feel loyal to a familial abuser and unwilling to disclose information. D. feel less allegiance to the abuser and therefore more willing to disclose information.

The correct answer is C.Chinese-American children tend to be more compliant to authority figures than European-American children and therefore would tend to be more obedient to the perpetrator if s/he is a family member.

A social worker is working in individual therapy with a client who is known to use alcohol and several other drugs. The client arrives at a session one day exhibiting manic-like symptoms. These symptoms indicate that the client is MOST likely experiencing which of the following? A. Hallucinogen intoxication B. Alcohol withdrawal C. Inhalant intoxication D. Inhalant withdrawal

The correct answer is C.Euphoria is one of the signs that develops in association with inhalant intoxication. Among the various behavioral and psychological changes produced by inhalant intoxication are belligerence, assaultiveness, and impaired judgment.

The social worker is seeing an 82 year-old man who complains that he is noticing some problems with his memory. He wonders if there is anything that he can do to help him continue functioning and reduce his memory loss as he grows older. Based on her familiarity with research on geriatrics, the social worker would be MOST likely to tell the client which of the following? A. Research has shown that there is nothing that can be done about memory loss. B. The man should consult a nutritionist for supplements and dietary advice to help improve his memory. C. Physical exercise has been shown to the most important thing that one can do to preserve brain function. D. Memory loss is inevitable as one ages.

The correct answer is C.Exercise has been shown to be the most important thing one can do to improve brain function at any age. It not only gets blood moving through the body, but also pumps blood to the brain regions responsible for thinking and memory. Researchers have found that the most active people have a larger total brain volume compared to those who reported lower amounts of physical activity.

As described in the DSM-5, the five core symptoms of the schizophrenia spectrum disorders are: A. delusions, hallucinations, negative symptoms, impaired cognition, and disorganized speech. B. disorganized thinking, delusions, hallucinations, negative symptoms, and depersonalization or derealization. C. hallucinations, negative symptoms, grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking. D. grossly disorganized or abnormal motor behavior, hallucinations, negative symptoms, affective instability, and delusions.

The correct answer is C.Hallucinations, negative symptoms (e.g., diminished emotional expression, avolition), grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking are the five core symptoms of schizophrenia and other schizophrenia spectrum disorders.

The client is a young woman who is a recent immigrant from El Salvador. The client discovered a week ago that her mother, who is still in El Salvador, is seriously ill. Two days after getting this news, the client began crying, trembling, and shouting uncontrollably while at the grocery store. The client's behavior is MOST likely attributable to which of the following? A. Panic disorder B. Uncomplicated bereavement C. A cultural syndrome

The correct answer is C.In the DSM-5, "cultural concepts of distress" are defined as the "ways that cultural groups experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions" (p. 758). Three types of cultural concepts are described: "Cultural syndromes" are clusters of symptoms and attributions that co-occur among individuals from a particular culture and are recognized by members of that culture as coherent patterns of experience; "cultural idioms of distress" are used by members of different cultures to express distress and provide shared ways for talking about personal and social concerns; and "cultural explanations" refer to the explanatory models that members of a culture use to explain the meaning and causes of symptoms, illness, and distress. The DSM-5's Glossary of Cultural Concepts of Distress describes a number of different cultural syndromes, including "ataque de nervios." This syndrome is recognized by the members of certain Latino cultures and is characterized by intense emotional upset (acute anxiety, anger, or grief), screaming or shouting uncontrollably, attacks of crying, trembling, verbal and physical aggression, heat in the chest rising into the head, and an overall sense of being out of control. Some attacks may also include dissociative experiences, seizure-like or fainting episodes, and suicidal gestures. These attacks often occur as a direct result of a stressful event involving the family.

What is the primary purpose of using self-directed strategies (i.e., self-instruction, self-monitoring, or self-reinforcement) in treatments for attention-deficit/hyperactivity disorder (ADHD)? A. To enable clients to track their own improvement over the course of treatment B. To assist clients to record psychosocial phenomena that affect their symptoms C. To help clients gain more control over their own behavior and rely less on support from others D. To obtain information needed to complete rating scales during assessment

The correct answer is C.In treatments for ADHD, self-directed strategies - including self-instruction, self-monitoring, and self-reinforcement - can be used to help clients gain more control over their own behavior and academic performance, while relying less on support from parents, teachers, and peers. Self-reinforcement, for example, involves teaching children to track and assess their own behavior and academic performance and provide appropriate feedback to themselves.

The social worker works at a clinic for disturbed children. She notes that many of the children are inappropriate verbally. If a child gets stuck on an idea and continually repeats it, it is known as: A. echolalia. B. echopraxia. C. perseveration. D. apraxia.

The correct answer is C.Perseveration means the repetition of a particular word or phrase, as if the client is stuck and cant move on to another word or idea. In general perseveration is a persistence in doing something beyond an appropriate point.

The core component of the DSM-5 diagnosis of gender dysphoria is which of the following? A. A persistent preference for cross-gender roles B. A strong desire to be treated as the opposite gender C. Incongruence between assigned and experienced/expressed gender D. Cross-gender identification

The correct answer is C.The DSM-IV-TR diagnosis of gender identity disorder is no longer used in the DSM-5. Gender dysphoria has been added to DSM-5 with modified criteria as compared to gender identity disorder. Incongruence between assigned and experienced/expressed gender is identified as a core component of gender dysphoria. Note that there is separate diagnostic criteria for children and adolescents/adults.

A child is extremely preoccupied with his principal caregiver (his mother), displays fear in response to the presence of strangers, and acts subdued in new social situations. This child is MOST likely in which age group? A. 1 to 3 months B. 4 to 8 months C. 8 to 18 months D. 24 to 36 months

The correct answer is C.The behavior described is characteristic of stranger anxiety, which involves crying, withdrawal, and other fearful responses to strangers. Most infants begin to exhibit stranger anxiety at about 8 to 10 months of age. Stranger anxiety continues until about age 2 and then diminishes. Stranger anxiety is considered to be a part of normal development, but its absence is not necessarily an indication of abnormal development.

: John is court-ordered for therapy after abusing his girlfriend on a public street. He arrives 10 minutes late for the first session and sits sullenly. The social worker tries to start a conversation with him. What is the best way for the social worker to break through John's resistance and get a conversation started? A. Tell John that they can just sit quietly for the entire session if that's what he wants. B. Tell John that unless they can get started she will have to refer him back to the court. C. Acknowledge John's lack of desire to be in treatment and go from there. D. End the session early and tell John that if he wants to talk, come back next week at the same time.

The correct answer is C.The best way to join with John is to state what is obvious (that John doesn't want to be there) and let him know that the social worker can identify with his situation. The social worker should try to meet the client where he is at: in this case, the client is angry and resentful at being made to attend therapy.

A social worker who specializes in child development has decided to start a therapy group for adolescents. Which of the following client factors is MOST important to consider in selecting members for this group? A. Age B. Gender C. Developmental leve

The correct answer is C.The key is that this group is for adolescents. Most authorities agree that group members should be at a similar developmental level so that they will be dealing with the same issues. This is a particularly important issue for adolescent group members because adolescents of the same chronological age may not be at the same developmental level.

The client is a 25-year-old transgender person who recently started hormone therapy. The client has sought help because he has been feeling very anxious lately. What should be the social worker's FIRST step in approaching this case? A. Assess the client's understanding of hormone therapy and provide him literature about this medical treatment and its potential side effects. B. Discuss the client's feelings about undergoing hormone therapy and normalize his anxiety symptoms under the circumstances. C. Clarify the source of the presenting problem by consulting with the client's doctor. D. Assess the intensity of the client's symptoms of anxiety and provide coping skills that he can use immediately.

The correct answer is C.The question doesn't offer much information about the client. You do know, however, that he recently started hormone therapy (hormonal gender reassignment) and now feels anxious. These facts suggest that the social worker's priority at this time would be to consult with the client's physician in order to find out if the medical treatment may be causing his anxiety symptoms.

A client reports that her 4-year-old son was found showing his genitals to a classmate at his preschool. The client is not upset by this but she is curious about what it means. What should the social worker do FIRST? A. Remind the mother of the limitations to confidentiality and file a child abuse report. B. Provide education about sexual behavior in children. C. Elicit more information to determine if this is normal sexual exploration. D. Refer the child to a pediatrician.

The correct answer is C.The social worker's first action should get more information about the boy's sexual play. Generally, "typical" sexual exploration and play by children is infrequent, spontaneous, and voluntary on the part of both children and involves children who know each other well and are of about the same age and size. Conversely, sexual play by children can signal a problem (e.g., perhaps that one of the children has been sexually abused) when it includes behavior that is well beyond the child's developmental stage; causes anxiety, anger, or other strong emotions in one or both children; involves threats, force, or aggression; and/or involves children of very different ages (e.g., a 4 year old and a 10 year old) (NCTSN, 2009).

The client is a 12-year-old boy who has been diagnosed with a tic disorder. His parents are concerned and ask the social worker how they can help their son control his symptoms. They ask her whether stress plays any part in their son's tic disorder. What should the social worker tell them? A. There is no relationship between tic disorders and stress. B. Stressful events tend to attenuate (lessen) the symptoms of a tic disorder. C. Stressful events can exacerbate (worsen) the symptoms of a tic disorder. D. Prolonged stress often precedes the development of a tic disorder.

The correct answer is C.The tics associated with tic disorders - i.e., Tourette's disorder, persistent (chronic) motor or vocal tic disorder, and provisional tic disorder - can be exacerbated during stressful events. According to the DSM-5, tics are worsened by anxiety, excitement, and exhaustion: "Stressful/exciting events (e.g., taking a test, participating in exciting activities) often make tics worse" (p. 83). The DSM-5 also says that tics can be attenuated (lessened) while the individual is engaged in a calm, focused activity, such as doing schoolwork or performing a task at work.

A social worker practices mindfulness therapy, and is seeing several clients who seem to be benefiting from it. Mindfulness based therapy involves which two basic components? A. Teaching people to respond to stressors reflectively rather than reflexively; self-regulation B. Openness; acceptance C. Self-regulation of attention; an accepting orientation toward the present moment characterized by curiosity and acceptance D. Experiencing the present moment in a non-judgmental way; effectively counteracting the effects of external stressors

The correct answer is C.The two components of mindfulness therapy are 1) a non-judgmental awareness of one's physical, mental and environmental state and 2) an open, curious and accepting attitude towards where one is in the moment.

: A client is extremely thin, fears becoming fat, has a distorted perception of his body shape, and has been engaging in binge-eating and purging behavior. What DSM-5 diagnosis is indicated for this client? A. Avoidant/restrictive food intake disorder B. Binge-eating disorder C. Anorexia nervosa, binge-eating/purging type D. Bulimia nervosa

The correct answer is C.This client appears to meet the diagnostic criteria for anorexia nervosa. In the DSM-5, the essential features of anorexia nervosa are a restriction of energy intake that leads to a significantly low body weight for the person's age, gender, developmental trajectory, and physical health; an intense fear of gaining weight or becoming fat or behavior that interferes with weight gain; and a disturbance in the way the person experiences his body weight or shape or a persistent lack of recognition of the seriousness of his low body weight. Although binge-eating and purging behavior (which this client engages in) are more commonly associated with bulimia nervosa, some people with anorexia binge eat and/or purge. As such, the DSM-5 distinguishes between two subtypes of anorexia: Anorexia nervosa, binge-eating/purging type is diagnosed when, during the last three months, the person has engaged in recurrent episodes of binge eating or purging behavior (e.g., self-induced vomiting, misuse of laxatives). In contrast, with the "restricting type," weight loss is achieved through dieting, fasting, and/or excessive exercise and there is an absence of recurrent binge eating or purging behavior during the last three months.

A client reports that her 81-year-old father, a widower, has been having difficultly dressing himself 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? A. Arrange to see the client's father and perform a mental status exam. B. Recommend that the client take her father to a physician for physical examination and lab tests. C. Discuss safety issues and options with the client, such as preventing her father from driving by taking away his car keys.

The correct answer is C.While individuals with mild or major neurocognitive disorder (which this man appears to have) should be encouraged to remain as active and independent as possible, it's also very important to address their safety and the safety of others. This appears to be the priority here given what the client has described. Once the person is at least moderately impaired (like this man), he should be prevented from driving at all costs (e.g., take away his car keys, immobilize his car). After this safety issue has been addressed, the social worker can make recommendations to the client concerning assessments for her father, in particular, evaluations by a doctor.

A 20-year-old man is diagnosed with schizophrenia and is hospitalized. After a month, he is considered to be sufficiently stabilized on medication to return home to his parents' house. According to the concept of homeostasis, which of the following is LEAST likely to happen when the man returns to his family? A. His parents will separate. B. A younger child in the family will develop behavioral symptoms. C. Family rules will change to allow the family to support the man. D. A previously functional family member will develop psychiatric symptoms.

The correct answer is C.You are asked to pick the event that is least likely to happen. Homeostasis is a self-regulating process that maintains equilibrium in an organism or system - i.e., it is the tendency of a system to react toward restoring the "status quo" when change occurs. The concept of homeostasis would predict the opposite of what "C" says: Rather than changing its rules to support the recovered family member, the family would be expected to behave in ways that restore the family to its familiar balance - i.e., a family that includes a "sick member."

Norman has terminal cancer, and has, after many trials, decided not to continue with chemotherapy. He says that he is tired, and just wants to die a good death. His family has reluctantly agreed that perhaps, enough is enough. For Norman to be able to die a good death, what is the most critical component? A. Choosing whether to die at home or at hospice B. Being able to die in his sleep C. Having his family with him when he dies D. Open communication

The correct answer is D. Open communication between Norman, his family, and his medical providers/caregivers is the most important component of being able to have a good death.

The policy of deinstitutionalization has been a contributing factor to homelessness among people with mental illness. The policy of deinstitutionalization in the 1960s and 1970s was heavily influenced by which developments? A. The signing of the Mental Health Systems Act by Jimmy Carter to fund more community health centers B. Lobotomies and electroshock falling out of favor with the public C. The development of anti-psychotics and budget cuts D. The development of anti-psychotics and the creation of Medicaid and Medicare

The correct answer is D. The development of anti-psychotics such as chlorpromazine and later clozapine meant that many patients in state hospitals could function outside the hospital system. Secondly, federal funding such as Medicaid and Medicare would not pay for treatment at mental hospitals, but would pay for treatment at community mental health centers. Another factor that had a strong influence on public thinking about mental hospitals was the movie One Flew Over the Cuckoo's Nest that portrayed abuses of mental patients in hospital care.

The client is a low-income, African American woman who reports having frequent severe headaches. The client, age 30, never went to college because she wanted to work to help her mom pay the bills. She now works two jobs but has great difficulty making ends meet. She has come to the social worker's agency because she's hoping that she qualifies for some kind of temporary financial assistance. The social worker discovers that the client has not seen a medical doctor about her headaches. According to research, which of the following is LEAST likely to be impacting this client's health and/or health-care utilization? A. Her low SES because there's a good chance that she doesn't have health insurance B. Her low SES because higher levels of stress associated with lower levels of income tend to increase vulnerability to illness C. Her race because access to health care is generally better for whites than for non-whites D. Her gender because women are less likely than men to seek and use health care

The correct answer is D. This question is worded in a confusing way (you may see a few "confusing" questions on the exam, too). When you see a confusing question, try to reword it so that it makes more sense to you. Translated, this question is asking, "According to research, which of the following contains a FALSE statement about factors that affect people's health and/or health-care utilization?" With this "translation" in mind, you can then look at each answer and ask yourself, "Is this statement true or false?" The only clearly false statement is the one in Answer Choice D. Women are more likely than men to seek and use health care. Women are also more effective in using coping mechanisms and social support before, during, and after an illness. Men often don't prioritize their health or health care unless they are very ill and are more likely to use alcohol, drugs, and tobacco in response to stress.

The social worker is a case manager at an agency that provides services for a predominantly low-income clientele. She finds that many clients evidence a personality disorder, as well as mental illness. Which statement is most true? A. For a personality disorder to be diagnosed in an individual under 18, the symptoms must have been present for at least 2 years. B. Personality disorder symptoms are usually ego-dystonic. C. There is no difference in prevalence rates for personality disorders across gender. D. Traits of a personality disorder that appear in childhood may change through adult life.

The correct answer is D.According to the DSM-5, traits of a personality disorder that appear in childhood may change through adult life.

Leroy, a 22-year-old white male, was diagnosed as having schizotypal personality disorder when he was 15. He has always been fascinated by aliens and believes that he was abducted when he was 10 and returned to the planet changed. Lately, Leroy has started hearing broadcasts from the aliens telling him to prepare for another trip. A month ago, he dropped out of community college and got fired from his job for not showing up on time, and being sloppy in his work. These indicates could show: A. Leroy is having a psychotic break. B. Leroy has developed delusional disorder. C. Leroy has developed a medical disorder that is affecting his ability to function. D. Leroy's schizotypal diagnosis was pre-morbid to schizophrenia.

The correct answer is D.Although not all of the Cluster A personality disorders (Paranoid PD, Schizoid PD and Schizotypal PD) progress into more serious mental disorders such as schizophrenia, they are thought to be potentially pre-morbid (personality traits that are a precursor to mental illness). What has changed in Leroy's case that leads us to consider that he may now be developing schizophrenia (schizophreniform disorder if less that 6 months) is the presence of positive symptoms of schizophrenia (hallucinations) as well as negative symptoms (amotivation as evidenced by his not going to work) and possibly cognitive symptoms (sloppiness).

An 11 year old with autism spectrum disorder is irritable and has been behaving aggressively. A physician is LEAST likely to prescribe which of the following medications to manage these symptoms? A. Risperidone B. Fluoxetine C. Clomipramine D. Carbamazepine

The correct answer is D.Carbamazepine (Tegretol) is an anticonvulsant used to treat epilepsy that has also been found effective for some patients with bipolar I disorder. Individuals with bipolar I disorder who cycle rapidly (change from mania to depression and back again over the course of hours or days, rather than months) seem to respond particularly well to carbamazepine. The anticonvulsant divalproex sodium (Depakote) has also been approved by the FDA for bipolar I disorder. Clinical trials have shown it to be as effective at controlling manic symptoms as lithium; it is effective for both rapid-cycling and non-rapid-cycling bipolar I disorders.

The social worker asks the parent to briefly leave the playroom, and the child begins to cry and call for the parent. The child is demonstrating object permanence, which is generally acquired as a function of: A. continuous development. B. Piaget's cognitive theory. C. memory development. D. discontinuous development.

The correct answer is D.Discontinuous development tends to takes place in unique stages and occurs at specific times or ages. The change is a result of learning processes that tend to coalesce at fairly predictable times in the course of normal child development. Awareness of object permanence tends to develop toward the end of infancy, according to Piaget's cognitive theory.

A 14-year-old boy is being seen by the school social worker for repeated angry outbursts at school. He is persistently irritable and negative, constantly argues with adults, has a history of behavioral referrals, and recently changed schools after being expelled for threatening a teacher. The boy is failing in school, and his parents are thinking of sending him to a wilderness camp where he can "get some sense knocked into him." The MOST likely DSM-5 diagnosis for this boy is which of the following? A. Intermittent explosive disorder B. Oppositional defiant disorder C. Bipolar II disorder D. Disruptive mood dysregulation disorder

The correct answer is D.Disruptive mood dysregulation disorder involves severe, recurrent temper outbursts with a persistent irritable and angry mood between outbursts on most days.

Most infants speak their first word between the ages of 10 and 15 months. Studies investigating language development have shown that children's first words often refer to: A. objects that are related to eating. B. objects that the child can hold. C. stationary objects that are static and invariable. D. dynamic objects that move or change.

The correct answer is D.First words are most often nominals, or labels for objects, people, or events, although action words, modifiers, and personal-social words (e.g., please) also occur. Nominals are most likely to refer to dynamic objects (dog, car) or objects the child uses (spoon). For many children, the very first word is either "mama" or "dada."

A 9-year-old boy has been referred for evaluation because he is careless, engages in risk-taking behavior, and is not achieving up to his potential at school. When meeting with the boy, the social worker observes that he has trouble staying focused but seems bright and is very engaging. Based on this information, what diagnosis is MOST indicated for this boy? A. Specific learning disorder B. Conduct disorder C. Oppositional defiant disorder D. Attention-deficit/hyperactivity disorder

The correct answer is D.First, this boy is "careless" and has trouble focusing - ADHD is characterized by a persistent pattern of hyperactivity/impulsivity and/or inattention. Second, the boy engages in risk-taking behavior - because of their high levels of impulsivity, some children with ADHD engage in potentially dangerous behaviors and have frequent accidents. Third, the boy is not achieving his potential at school - the academic achievement of children with ADHD is usually impaired. Fourth, the boy is bright - although children with ADHD tend to score lower on IQ tests than their peers, there is great variability in their IQ, and some are in the above-average or gifted range. And last, he is engaging - this is not a feature of ADHD but nor is it inconsistent with the disorder since a child with ADHD would be apt to enter easily into conversations with others and might be quite charming (when he is not interrupting others).

Grandiosity is NOT a characteristic symptom of which of the following disorders? A. Bipolar I disorder B. Narcissistic personality disorder C. Schizoaffective disorder D. Schizoid personality disorder

The correct answer is D.Grandiosity involves an exaggerated sense of self-importance. It is characteristic of three of the four disorders listed in the answers to this question. Schizoid personality disorder is characterized by restricted emotional experience and expression. Although people with this disorder may seem self-absorbed, they don't exhibit grandiosity.

Jane, 40, has been coming to therapy for over a year working on self-esteem issues. One day, she comes in weeping and tells the social worker that John, her husband of 10 years, has started acting strangely. He was banned from the grocery store for telling the clerk that she was a fat pig, and told the manager that he can throw himself in front of a bus and die. She noticed that, for the last month, John has acted depressed, but is unwilling to talk about it. She reports that they have always had a wonderful, open relationship where they could talk about anything. She also states that he has been bingeing on snacks and cookies, and she guesses he has gained at least 5 pounds and seems completely unconcerned about it, whereas before, he was a fitness geek. The social worker asks Jane if John seems to be exhibiting any memory symptoms, but Janes says she doesn't think so. What is the most likely diagnosis for John? A. Early onset Alzheimer's B. Bi-polar disorder C. Major depressive disorder D. Frontotemporal dementia

The correct answer is D.John is showing some of the classic early signs of frontotemporal dementia (FTD). Early signs of frontotemporal dementia include apathy, change in personality or mood, lack of inhibition or social tact, obsessive behavior and weight gain due to dramatic overeating. FTD typically strikes between the ages of 45 and 65. FTD used to be thought of as rare, but now some estimates put it as the cause of up to 50% of dementia cases in people under 65. People tend to live about an average of eight years after diagnosis.

The client is a 19-year-old has been mandated to get therapy as a part of his probation. Over the course of the last year, he broke into several neighbor's houses, and also stole a car. He was accused of sexual assault by a girl at school, but the incident was never prosecuted. The social worker finds him to lack remorse for his actions, to show no empathy for his victims, and to generally project a fearless, callous attitude. She decides to give him a diagnosis of antisocial personality disorder. Recent studies indicate that people with antisocial personality disorder: A. always come from an abusive home. B. have a genetic predisposition. C. demonstrate increased activity in the prefrontal cortex that overstimulates their brain, interfering with the ability to feel empathy and remorse. D. often show brain abnormalities in the regions of the brain important for understanding other's emotions

The correct answer is D.People with antisocial personality disorder often show brain abnormalities in the regions of the brain important for understanding other people's emotions. They tend to show thinning of the cortex and reduced cortical surface area in parts of the brain responsible for thinking, motivation and controlling emotions. It is unknown why they have these abnormalities, but causes could include genetics, mistreatment as children, head trauma, or, most likely, a combination of factors.

The DSM-5 diagnosis of social (pragmatic) communication disorder is characterized by: A. intense anxiety about social situations in which the individual may be exposed to scrutiny by others. B. a disturbance in the normal fluency and time patterning of speech. C. deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, and activities. D. difficulties in the social use of verbal and nonverbal communication

The correct answer is D.Social (pragmatic) communication disorder is a neurodevelopmental disorder in the DSM-5 that is characterized by persistent difficulties in the social use of verbal and nonverbal communication. The difficulties limit effective communication, social participation, social relationships, academic achievement, or work performance and are demonstrated by deficits in using communication for social purposes in a way that's appropriate for the social context; impairment of the ability to adjust communication to match the context or the listener's needs; difficulties following rules for conversation and storytelling; and difficulties in understanding what is not explicitly stated and nonliteral or ambiguous meanings of language.

A child of Belizean immigrants is being interviewed by the social worker for possible inclusion into a psychoeducational group. Compared to a US native, the Belizean child is more likely to characterize themselves in ways that: A. are relationship and authority oriented. B. describe themselves according to their unique characteristics. C. provide more detailed descriptions of events. D. emphasize their social role and relationship to others.

The correct answer is D.The Belizean child is more apt to emphasize their social role and relationship to others. They may describe themselves as being a good student, or being one of five children, for example, versus U.S.-born children, who are apt to describe themselves according to their unique characteristics (I like the color green, or I like to watch a lot of TV).

The DSM-5 roughly categorizes mental disorders as _____________ and _______________. A. psychotic; non-psychotic B. developmental; induced C. serious; non-serious D. internalizing; externalizing

The correct answer is D.The DSM-5 introduction (pg. 13) notes that disorders are roughly clustered disorders by internalizing and externalizing types. Internalizing disorders include depressive, anxiety and somatic disorders, and externalizing disorders include disorders with prominent impulsive and/or disruptive conduct, and substance abuse.

: 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? A. Projection and sublimation B. Intellectualization and denial C. Repression and rationalization D. Introjection and denial

The correct answer is D.The correct answer is the one that includes two defense mechanisms that are both considered to be "primitive." Primitive defense mechanisms are first learned in early childhood. The more primitive a defense mechanism, the less effectively it works over the long-term. Because more primitive defense mechanisms are usually effective in the short-term, however, they are preferred by many people, particularly children. Adults who don't learn more effective ways of coping with stress or trauma also tend to use primitive defense mechanisms. According to many authors, introjection is the most primitive defense mechanism. It ignores interpersonal boundaries and involves attributing the thoughts or feelings of someone else to oneself in order to have more control over those thoughts or feelings. Denial is also a primitive defense mechanism. It is characteristic of early childhood development and is related to a child's faith in the magical power of thoughts and words.

The diathesis-stress theory proposes that some mental disorders are the result of genetic predisposition combined with: A. prenatal stress. B. a person's interpretation of stressful events. C. exposure to high stress during a critical period. D.

The correct answer is D.The diathesis-stress theory (a.k.a. stress-diathesis theory) proposes that schizophrenia and some other mental disorders are the result of genetic predisposition combined with stressful situations in the environment.

The client is a woman whose husband died two weeks ago. She has been brought in by her sister who is helping out during this time and feels worried about her sister's well-being. The client's sister is also concerned about her 10-year-old nephew who has been unwilling to talk about his father's death. She wonders what to expect from him as he grieves and how she can help him. In providing information on this topic, the social worker would be correct in telling the sister which of the following? A. Given his age, the boy probably believes that death is temporary and is waiting for his dad to come back. B. Given his age, the boy may be blaming himself for his fathers death. C. Given his age, its best to avoid encouraging the boy to talk about his feelings if he seems unaffected by the loss. D. Given his age, the boy probably understands the finality of death and may be worried about his own death.

The correct answer is D.The nephew is a 10 year-old. By age 10, children understand the finality of death, and some worry about their own death after a parent dies.

The social worker is working with a Chinese-American family who are dealing with difficulties the youngest boy, 8 years-old, is having in school. They have two other children, teenage girls. The social worker does most of the sessions with all of the family present, but occasionally meets with the parents and the children individually or in sub-systems. During a session with the three children, the teenage girls complain about how much work they have to do around the house. They state that they are always responsible for getting dinner on the table and the clean-up afterwards, as well as the laundry for everyone. They are both straight A students, but say they have no time to see friends because of the housework plus homework. This is: A. unusual, because most Chinese American families would focus their children on getting good grades above all else. B. normal, as it is more important for the Chinese American child to care for their family than to put an emphasis on grades or relationships. C. the norm for Chinese American families but inappropriate for teenagers who are trying to assimilate into the larger society in order to be successful and culturally competent. D. the norm in Chines

The correct answer is D.The norm in Chinese American families is for adolescents to be responsible for many family functions as their duty to the family. They are also expected to work hard at being successful in school and other endeavors as well.

A client is a member of the sandwich generation. In other words: A. the client is a grandparent raising his or her grandchildren. B. the client and his or her siblings disagree on the best way to meet their elderly parents needs. C. the client is a middle-aged woman who has been forced into the job market by circumstances of divorce or widowhood. D. the client is a middle-aged adult who is caring for an elderly parent while also supporting his or her own children.

The correct answer is D.The term "sandwich generation" is used to describe a generation of people who care for their aging parents while also supporting their own children.

A 19 year-old is in her first year of college studying political science. She is holding down a work-study job, and works at a coffee shop on the weekends. She has always had trouble with her weight, and begins binge-eating, gaining 50 pounds in the first two semesters. She seeks help from the college counseling office. What is the social worker's assessment? A. This is a situational crisis. B. The girl is experiencing an identity moratorium. C. She is experiencing role overload. D. This is a maturational crisis.

The correct answer is D.This is the most reasonable choice based on the information the client has shared. With a maturational crisis, the crisis origin is embedded in maturational processes - i.e., the person struggles with a transition from one life stage (or role) to another. Although people generally experience an increase in anxiety during transition states, a crisis is not inevitable. Whether or not a transition state activates an emotional crisis depends on several factors, one of which seems to be operating in this case: The probability of crisis is higher when a person does not, or cannot, prepare for one of these changes.

When using the DSM-5, a social worker or other clinician would code which of the following when a client has symptoms that do not meet the diagnostic criteria for a specific disorder and the clinician does not want to specify the reason why? A. Disorder not otherwise specified B. Disorder provisional C. Other specified disorder D. Unspecified disorder

The correct answer is D.When using the DSM-5, diagnostic uncertainty about a client's diagnosis is indicated by coding one of the following: Other specified disorder is coded when the clinician wants to indicate the reason why the client's symptoms do not meet the criteria for a specific diagnosis (e.g., "other specified depressive disorder, recurrent brief depression"); and unspecified disorder is coded when the clinician does not want to indicate the reason why the client's symptoms do not meet the criteria for a specific diagnosis (e.g., unspecified depressive disorder).

Memory loss among patients suffering from Alzheimer's disease is believed to be caused by a deterioration of neurons that secrete: A. GABA. B. serotonin. C. dopamine. D. acetylcholine.

The correct answer is D.You may have been aware that acetylcholine is associated with motor functions. It has also been linked to memory processes. Alzheimer's disease is associated with deterioration of ACh-secreting neurons in the brain.