Final Mock 1
7 An agency has chosen to use a single subject research protocol to assess their postpartum depression support groups. Which of the following BEST describes why an agency would choose this research model? Score: 1 of 1 A. It has strong external validity B. More than one variable can be measured C. Avoid ethical issues related to creating a control group D. Baseline measures are not required
C RATIONALE: Having a control group means that some individuals are not receiving the treatment. Withholding treatment from some individuals has ethical implications, making (C) the best answer.
21 A new client comes to treatment after losing his job of 15 years. He reports that "nothing in his life is going right," and goes on to note that his marriage is failing, recent investments are not paying off, and that he has "no real friends." In addition to a risk assessment, the social worker should focus on: Score: 0 of 1 A. The client's strengths and resources B. A possible medical issue C. Referring the client for employment assistance D. A referral for couples therapy
A RATIONALE: A is the best answer, because it focuses on the client's strengths. B is not indicated by the client's symptoms or presenting problem. C and D may be helpful, but the social worker should identify the client's strengths and resources so that interventions and treatment decisions can be made appropriately.
32 A social worker is hired by a non-profit foundation to complete a process evaluation on three agencies that received grants from the foundation. Each of the following is an example of a process evaluation question EXCEPT: Score: 0 of 1 A. Was the program more successful with certain groups of people than with others? B. Was the program well managed? C. Was there adequate agency support for the program? D. What specific interventions were put into place by the program?
A RATIONALE: A is the best answer, because it is not a question associated with process evaluation; it is associated with program evaluation.
30 A client is being treated by a social worker. She has a history of relationship problems and suicidal gestures. In the first session, the client tells the social worker how great she thinks the social worker is. What is the MOST important element of a treatment plan for this client? Score: 1 of 1 A. Establishment of clear therapeutic boundaries with the client. B. Short-term cognitive therapy to work with distorted self-image. C. Long-term psychoanalytic therapy to process painful memories of the past. D. Adjunctive group treatment to address relationship problems.
A RATIONALE: A is the best answer, because the client is presenting with several symptoms indicative of Borderline Personality Disorder (relationship problems, suicidal gestures, idealization of the social worker) and boundaries are a key component to engaging in effective treatment with a client with this profile. B, C, and D are not specifically related to treatment with clients with Borderline Personality Disorder.
28 A 55-year-old female client is in therapy with a male social worker for help with her relationships with her grown sons. The social worker perceives that a good working relationship has been established, but in the eighth session, the client announces that she wants a new social worker. She states that the social worker is too young and inexperienced to help with her particular problem. The social worker should FIRST: Score: 1 of 1 A. Encourage the client to discuss her feelings about their relationship. B. Review his professional experience to reassure the client. C. Help the client to differentiate the social worker from her grown sons. D. Offer a list of older social workers and facilitate a referral.
A RATIONALE: A is the best answer, because the social worker should be discussing the client's feelings about the relationship. This would be the place to begin, so A is the best answer. B, C, and D could be done once the issue had been explored more.
18 A newly licensed social worker is providing outreach to a community that recently experienced a major hurricane. The social worker goes door-to-door, asking families if they need mental health services and outlining opportunities to receive these services. At the end of her first week, the social worker realizes that no families have expressed interest in receiving mental health services. The social worker should next: Score: 1 of 1 A. Attend upcoming community events to join with the community and understand their needs. B. Provide informational flyers in community centers to reach people in a less threatening way. C. Terminate the intervention since no one is interested. D. Continue the intervention as planned.
A RATIONALE: A is the best answer. The social worker should recognize that a community that has recently experienced a stressful or traumatic event may not be open to new people or offerings. Joining with the community and understanding their needs will assist the social worker in meeting those needs effectively. B might help but does not do as much to create a relationship between the social worker and the community. The social worker will not know unless s/he gets to know the community better. C is premature, and D continues with an intervention that is not working at this time.
10 A 55 year-old Native American woman seeks treatment following the death of her son. When working with Native American clients, in order to be culturally sensitive and develop a good therapeutic relationship it is important to observe all of the following EXCEPT: Score: 1 of 1 A. Be directive B. Use active listening and reflective responses. C. Avoid interrupting D. Allow for periods of silence
A RATIONALE: Answers B, C, and D are all advised approaches with Native Americans. This leaves A as the only one that should be avoided.
15 A couple starts seeing a social worker after the death of their two children in a car accident. The social worker's supervisor notices that the social worker is spending many hours on the phone with the couple and is seeing them more often than her other clients. The supervisor should: Score: 1 of 1 A. Work with the social worker to assess if the level of intervention is necessary. B. Advise the social worker that her behavior is unethical. C. Transfer the clients immediately to a different social worker. D. Have the social worker tell the clients that they can't contact her after hours.
A RATIONALE: The best place to start would be A. This is an example of the supervisor recognizing that the social worker's boundaries may be compromised, so the best response would be to discuss it with the social worker.
2 A family comes in with high expectations of their 10-year-old child. The child excels in school and the teacher states that he has never had an infraction although he appears to be unhappy and has a hard time socially. The parents are likely using what kind of parenting style? Score: 1 of 1 A. Authoritarian B. Authoritative C. Permissive D. Uninvolved
A RATIONALE: The clues in the stem are that the child excels and hasn't had an infraction but seem unhappy and has a hard time socially. This is the description of a child raised in an Authoritarian home. Children raised with Authoritative parenting styles are the best adjusted. Both Permissive and Uninvolved children display behavioral problems and generally have lower school performance.
6 A social worker is conducting a study on the effectiveness of group therapy in decreasing depression in teenagers recently diagnosed with diabetes. Which of the follow refers to the extent to which the results of a study can be generalized to other situations and people? Score: 1 of 1 A. External Validity B. Internal Validity C. Reliability D. Statistical Significance
A RATIONALE: This is a factual recall question; B, C, and D would all be described differently.
14 A social worker receives a referral from parents regarding their 9 year-old daughter. A social history reveals symptoms consistent with a diagnosis of Major Depressive Disorder. What should the social worker do FIRST? Score: 1 of 1 A. Determine if the child has had a recent physical examination to rule out possible physical causes for her symptoms B. Under the diagnosis of Major Depressive Disorder, refer the child to a psychiatrist for medication. C. Have the parents fill out a questionnaire to confirm the diagnosis of Major Depressive Disorder. D. Begin cognitive behavioral therapy with the child to decrease symptoms.
A RATIONALE: While B, C and D may all be appropriate at some time in the near future, option A is the best choice as medical conditions should always be ruled out before giving a diagnosis.
22 A social worker at a local community mental health agency started a group for adults who grew up in the Foster care system. Each week fewer group members show up. In order to keep the group strong and ensure reasonable attendance, the social worker should: Score: 1 of 1 A. Talk to the group members to assess why attendance is dwindling and have them assist with the group structure and future topics. B. Cancel the group since it is not needed. C. Change the day and time of the group to hopefully make it more convenient. D. Have a different social worker take over the group.
A RATIONALE: You would start by asking group members why they haven't been attending the group. B, C, and D are possible responses once you ask the members about their experiences.
3 A woman has been going to therapy for the past two months. Whenever the therapist brings up emotional material the woman dismisses it and says she isn't interested in talking about those subjects. She talks a lot about her day to day life and says she thinks she is ready to terminate. What should the therapist do next: Score: 1 of 1 A. The client seems like she is doing fine and feels she is ready to terminate so the therapist should start the termination process. B. The therapist should address the client's resistance in discussing the emotional material. C. The therapist should give the client two more sessions to see if she still feels ready for termination. D. The therapist should inform the client that she needs to talk about this material or else the therapy sessions will be over.
B RATIONALE: A client expressing disinterest in discussing emotional material is likely a sign of resistance.
12 A gay couple who say they are both in long-term recovery for cocaine addictions request couples' therapy. The couple reports frequent arguments and an increased sense of distance in their relationship. The social worker should FIRST: Score: 1 of 1 A. Teach the couple communication skills. B. Assess for a drug relapse in either partner. C. Assign the couple intimacy exercises as homework. D. Teach the couple anger management skills.
B RATIONALE: B is the best answer, because a decrease in intimacy and an increase in arguments may be signs that one partner has relapsed, putting stress on the relationship. This needs to be assessed first. A, C, and D can be done later.
17 A 12-year-old African-American boy has been meeting with a social worker for 2 months for feelings of depression. He recently discovered that one of his ancestors was a slave who led a rebellion during the Civil War. He previously felt ashamed of his background, but in sessions, starts speaking about his ancestor as being a "brave leader." In terms of racial identity development, the client's experience could be best described as: Score: 0 of 1 A. Conformity B. Dissonance C. Resistance D. Introversion
B RATIONALE: B is the best answer, because according to a minority identity development model, the stage of dissonance includes a period in which the individual moves from feeling shame about their identity to feelings of pride. In the stage associated with A, the individual prefers the dominant culture and devalues their own background; in the stage associated with C, the individual rejects the dominant culture and has a sense of appreciation for their own culture; in the stage associated with D, the individual moves toward feeling that the dominant culture is not all bad and that there are individual differences.
33 A client with a history of interpersonal problems with co-workers has recently been fired for getting into repeated arguments with colleagues and supervisors. The client arrives at the next session late and becomes very angry when the social worker inquires about the client being late. The client yells, "Why are you monitoring my every move? Can't you just trust me and leave me alone?" The social worker should interpret the client's behavior as: Score: 1 of 1 A. Resulting from a feeling of judgment by the social worker. B. Displaying problems that occur in workplace relationships. C. Indicating a need for medication to stabilize the behavior. D. Signaling a desire to terminate treatment.
B RATIONALE: B is the best answer, because it is MOST likely that the client is exhibiting behavior that is typical in another area of the client's life; since the question references problems in the workplace, this is probable. A, C, and D are not supported by information in the stem.
19 A 50-year-old woman in the commercial real-estate business is referred to her EAP due to interpersonal conflicts with female co-workers. During the assessment, the social worker learns that the woman frequently minimizes her colleagues concerns regarding sexism and sexual harassment in the workplace and during work functions. The woman says, "They need to get over it. This is just part of the business. They're being too sensitive." The social worker should view this response as: Score: 1 of 1 A. Expected, given the employment setting and cultural standards. B. An internalization of the sexism the client has experienced during her career. C. Evidence of a personality disorder. D. An indication that long-term therapy is needed.
B RATIONALE: B is the best answer, because the client's behavior indicates she has internalized the sexism she has experienced over time. A is not a good answer, because, while it may be true, it does not identify the process through which this has occurred as well as B does. C is not indicated by the client's statements or behavior. D may be true, but is not clear from the information provided in the question stem.
23 A social worker is attending a neighborhood block party. While speaking with her neighbor, the neighbor discloses that she was so frustrated with her child the other day that she hit her with a belt. While the neighbor is not a client of the social worker, the social worker should first: Score: 1 of 1 A. Make a suspected child abuse report B. Report the incident according to state law. C. Refer the neighbor to a different social worker so there is no dual relationship. D. Contact the school to discuss the child.
B RATIONALE: In some states, social workers are mandated reporters 24/7, while in others, they are only mandated reporters while in their professional capacity. A would not be correct, since the law may not require this. B is the best answer, because it allows the social worker to do whatever is legally required. The social worker could do C if the neighbor asked for assistance. D would violate the neighbors trust.
20 A 45-year-old man meets with a social worker for an initial appointment. He reports that his wife is an alcoholic and becomes verbally abusive when she is intoxicated. He indicates that his wife refuses to go to treatment, insisting that they can resolve this problem on their own. The therapist should FIRST: Score: 1 of 1 A. Provide the man with psychoeducation around substance abuse and the stages of change. B. Explore the man's issues and work collaboratively to develop treatment goals. C. Explore the man's commitment to the relationship. D. Help the man identify the reasons behind his wife's behavior.
B RATIONALE: The best answer is B. A, C, and D could be options later in treatment after a treatment plan focusing on the man has been established.
11 A client with a history of severe depression reports hypersomnolence and decreased appetite. The client reports having discontinued his prescribed medication because he didn't think he needed it anymore. The social worker should FIRST: Score: 0 of 1 A. Question the client as to the other reasons for discontinuing the medication B. Instruct the client to resume the medication C. Encourage to the client to speak to his psychiatrist D. Discuss alternative treatment options
C RATIONALE: Because the increase in symptoms is likely to be directly related to the discontinuation of medication, the client should be encouraged to go back to his psychiatrist. It would be outside of the social worker's scope of practice to instruct the client to resume medication. While questioning the client about the reasons for discontinuing medication and discussing alternative treatment options may be appropriate interventions at some point, the social worker should FIRST encourage the client to speak to his doctor regarding his increase in neurovegetative symptoms.
25 A social worker in a community mental health agency meets with a 14-year-old boy and his parents after 3 months of treatment. The family first presented for treatment because the boy was experiencing feelings of anxiety and had several panic attacks. The goal of the session is to review the client's progress and reevaluate the treatment plan. All of the following are examples of objective data EXCEPT: Score: 1 of 1 A. The number of panic attacks the client reports in the past 2 weeks B. The client's score on the Beck Anxiety Inventory C. The client's ability to express feelings to the social worker D. The parents' report on how often the child avoids anxiety-provoking situations
C RATIONALE: C is the best answer, because it represents subjective data (information from the client's point of view gathered through an interview). A, B, and D are all examples of objective data: observable and measurable data.
26 A 41-year-old woman has been in therapy for two years for anxiety attacks and depression. She is no longer taking medication and is currently symptom free. During recent therapy sessions she frequently laughs and enjoys herself. Which of the following actions should the social worker take? Score: 1 of 1 A. Interpret the client's behavior as a flight into good health. B. Confront the client regarding avoidance of underlying issues. C. Develop a termination plan with the client to maintain progress made. D. Identify precipitating events leading to the new symptom development.
C RATIONALE: C is the best answer, because the client's presenting problems have been resolved and the client is doing well without the aid of medication both of which indicate a readiness for termination. A does not make sense because the client has been in treatment for 2 years; a flight into good health is typically seen at the initiation of treatment. B and D are not supported by the information in the stem.
13 A married couple meet with a social worker in private practice for an initial session. Afterwards, the wife calls the social worker and states, "I have something I want to talk to you about, but my husband can't find out." The social worker's MOST appropriate response would be to: Score: 1 of 1 A. Reassure the wife that what she says will be kept confidential. B. Recommend that both husband and wife meet individually before the next couple's session. C. Advise the wife of the therapist's "no secrets" policy and suggest disclosure at a future couple's session. D. Refer the husband and wife to separate individual therapists.
C RATIONALE: Redirecting the wife to reserve the disclosure for the marital session is the best answer, because it will preserve the therapist's ability to treat the couple effectively. A would potentially jeopardize the couple's treatment by creating a situation in which the social worker and wife are keeping secrets from the husband. B does not make sense since couple's treatment has already been initiated. Recommending that the couple see individual therapists may be missing the point, as the couple has presented for marital therapy, not individual therapy, and keeping secrets may be part of the couple's problem.
9 A social worker in a community agency receives a referral for her friend's preschool-age son. The social worker should: Score: 1 of 1 A. Involve the friend in a comprehensive assessment and treatment plan B. Conduct an initial assessment and make treatment recommendations C. Refer the son to a different therapist D. Treat the son after getting consultation regarding confidentiality and boundaries
C RATIONALE: Social workers should avoid dual relationships with clients. In this case, the son would be at risk of not receiving the best treatment, as the social worker may have preconceived notions about the son or may treat him differently due to the social worker's relationship with the mother. Avoiding dual relationships ensures the client's safety and ability to receive appropriate treatment.
5 A clinical social worker is evaluating a friendly, 5-year-old child who has difficulty making friends in school. He is very verbal, but has a hard time answering questions about his feelings. He is eager to talk about all the different types of reptiles and knows all about them. What should be the social worker's next step: Score: 0 of 1 A. Diagnose him with Autism Spectrum Disorder. B. Use play therapy to try to connect with him on different topics. C. Refer him to a social skills group. D. Suggest that he is transferred to a different school.
C RATIONALE: The best option is C. While there are signs of Austism Spectrum Disorder, there is not enough to make a formal diagnosis. B suggests the social worker direct the play, which you wouldn't do in the initial phase of treatment. The main issue is his inability to make friends and talk about his feelings, so a social skills group is clearly indicated. There is no reason to have him transfer to another school.
4 An unlicensed social worker is meeting with an older woman for their first therapy session. The older woman reminds the social worker a lot of her mother who she does not have a good relationship with. The social worker finds herself becoming easily frustrated with the older woman and is having a hard time remaining calm. What should the social worker do first: Score: 0 of 1 A. She should bring up the situation with the client and explain why she is becoming agitated. B. Since it is only the first session, she should transfer her to another therapist. C. She should talk to a supervisor about her countertransference issues. D. She should journal about her feelings after the sessions.
C RATIONALE: The experience the social worker is having is a countertransference reaction. When you put the answers in order, the first thing to do would be to talk to a supervisor; this could lead to her doing D or B. A would not be appropriate in the initial phase of treatment, as it makes the social workers issues the focus.
24 A social worker at a day treatment facility for teens with mood disorders is asked to provide crisis intervention following the suicide of a program participant. The social worker should FIRST: Score: 1 of 1 A. Refrain from sharing information due to confidentiality. B. Contact the residents' parents to inform them of the situation. C. Facilitate a group session to discuss the incident with the other participants. D. Have individual meetings with each participant to discuss the incident.
C RATIONALE: You would want to host a group meeting to ensure that all members hear the same information at the same time so C is the best thing to do first. You could then do B and D. While you would want to be sensitive to issues of confidentiality, you would not have to refrain from sharing any information as it affects the whole community.
16 A social worker in a community clinic meets with a woman who presents with issues related to her job. She discusses a recent incident in which she was gone from work for several days without notifying her boss or coworkers, although she has no memory of this. The client has found a pamphlet and tickets from a Broadway show in her home, although she states that she's never been to New York. The client is describing which of the following conditions? Score: 1 of 1 A. Depersonalization B. Derealization C. Delirium D. Dissociation
D RATIONALE: D is the best answer, because engaging in activities with no consciousness or memory of the activities is a form of dissociation; A, B and C describe different phenomena.
8 A social worker is part of an evaluation team assessing the effectiveness of a neighborhood outreach program targeting families with children ages 0-5. The social worker is in charge of collecting qualitative data. Which of the following is the BEST example of a qualitative measure? Score: 1 of 1 A. Looking at the way variables such as age and income level impact the utilization of client services. B. Tracking the number of clients served in a year through a specific program C. Comparing the number of clients using a new service compared to an old service D. Interviewing clients about their level of satisfaction with the changes in program delivery
D RATIONALE: D is the best answer, because it involves gathering information directly from program participants. A, B, and C are all examples of quantitative data.
31 A client who is gay tells his social worker that he wants to have a baby. He reports that his plan is to contact an adoption agency to begin the process. What should the social worker do FIRST: Score: 1 of 1 A. Assess the client's ability to manage the potential negative response from family members. B. Refer the client to a parenting class for single fathers. C. Assess the client's understanding of the steps needed to adopt a child. D. Explore the client's desire to become a parent.
D RATIONALE: D is the best answer, because it starts where the client is and takes a nonjudgmental stance. A does not make sense, since the stem does not indicate that his family is involved or that they would be unsupportive. B might be helpful later, but not before D. C is somewhat judgmental and assumes that the client has not thought through or researched the decision.
29 A 53-year-old man comes to a social work agency for help regarding a loss of interest in sexual relations with his wife of 20 years. In the intake interview, the client further describes decreased energy, achiness all over his body and depressed mood. The social worker should FIRST: Score: 1 of 1 A. Evaluate the client for sexual dysfunction. B. Assess the client for depression. C. Refer for a psychiatric evaluation. D. Refer for a physical evaluation.
D RATIONALE: D is the best answer, because the client is describing physical symptoms and depressed mood; the social worker needs to rule out a medical cause for the client's problems before moving forward. A, B, and C could be done after a medical issue was ruled out.
27 A 30-year-old man meets with a social worker for the first time and describes himself as a failure. He recently lost his job and his girlfriend of two years broke up with him. He feels hopeless about his life and is beginning to believe his family's criticism and rejection of him are justified. As the interview progresses, his discouragement and feelings of worthlessness become more apparent. The social worker should FIRST: Score: 1 of 1 A. Refer the client to a psychiatrist for a medication evaluation. B. Help the client identify why his relationship with his girlfriend ended. C. Schedule a family session. D. Ask the client if he's had any thoughts about hurting himself.
D RATIONALE: Hopelessness and feeling like a failure are both risk signs for suicide. D would be the place to start. Once that was ruled out, A, B, and C could be considered.
A 10-year-old boy is placed with a foster family that has different religious beliefs than the child. The foster parents want the foster child to follow their religious practices. What is the social worker's BEST course of action in this situation? Score: 1 of 1 A. Tell the family to follow the child's religion. B. Instruct the child to follow the family's religion. C. Tell the child not to practice any religion to avoid conflict. D. Identify alternate placement for the child.
D RATIONALE: The best option here is D. All the other options go against honoring the diversity of the people. Some people may not pick this because they think that another option would not be available, but if it is an option on the exam then it is available.