Licensure Exam Questions 3

The assistant director has indisputable proof that the director of a large community fund-raising the agency has signed costly noncompetitive contracts with a business in which the executive director has an ownership interest. The activity is unknown to the board of directors, violates agency policy, and may be illegal. The assistant director's first step is to 1. discuss the matter with the director and then notify the chairman of the board. 2. discuss the matter with the director and then notify the district attorney. 3. discuss the matter with other senior staff. 4. consult the agency's outside attorneys.

The best answer is 1. All the alternatives in this question may need to be pursued; however, the first step is to notify the board chair. The board is legally responsible; unless they have conspired with the director, they should be given the first opportunity to redress the situation

A delusional and disorganized 20-year-old homeless woman appears at a community mental health agency. She refuses hospitalization, but does not cut off contact with the worker. What is the social worker's best strategy for helping the woman? 1. Respect her self-determination and ask her what kind of help she would like. 2. Accompany her to a walk-in psychiatric outpatient emergency facility. 3. Tell her family to proceed with an involuntary commitment. 4. Determine if other sheltered environments or supports are available to her.

The best answer is 2. Since the client seems delusional and disorganized, the worker should continue trying to provide help. The best immediate solution is for the worker to accompany her to a walk-in emergency service. The other strategies are not responsive to her immediate need for help or have no referents within the stem of the question

The primary learning emphasis used by a supervisor to improve treatment effectiveness is most likely to be 1. understanding and applying proven treatment theories. 2. working through the worker's feelings about the client. 3. helping the worker deepen, understand, and effectively use the relationship between the clinician and the client. 4. structuring the treatment relationship to conform to the agency's purposes and treatment methodologies.

The best answer is 3. While theory is important, clinical research suggests that the most effective tool for helping clients is the clinical relationship. Indeed, slavish adherence to theories may constrain workers, and no theory is particularly proven. Answer 2 is not responsive to the question, and answer 4 suggests an inappropriate focus on the agency that excludes the client's treatment needs.

Social workers who function in case management positions are usually most directed to enhancing which ofthe personality structures that derive from Freud's theories? 1. Ego. 2. Id. 3. Conscious motivation. 4. Superego.

The correct answer is 1. Case managers ordinarily operate in a supportive role and seek to strengthen the client's self-managing and normative functioning capabilities by maintaining connections between clients and services. Thus, the ego, or the selfs ability to rationally connect with the real world, is the main personality structure that is affected by case management.

Salvador Minuchin and others have written about the families of delinquent boys who live in poor, urban neighborhoods. Parents find it difficult to maintain an emotional connection with these children or to assert parental authority since antisocial activities and peer pressure are powerfiil countervailing influences. The most precise family system concept that contributes to understanding this family phenomenon is 1. disengagement. 2. triangulation. 3. sibling subsystems. 4. boundaries.

The correct answer is 1. Disengagement suggests an emotional disconnect between the child and the parent. It is signified by parental feelings of loss of control or influence over the behavior of their children, and children's lack of responsiveness or concern about their parent's desires.

The study of epidemiology is 1. the study of the relationships among diseases, behavior, and populations. 2. the study of the disease process. 3. an experimental method for evaluating programs. 4. a non experimental method for evaluating programs.

The correct answer is 1. Epidemiology uses statistics to identify the relationships between disease, populations, and environment or behavior.

As women age, the percentage with orgasmic disorders that prevent them from achieving orgasm is 1. likely to decrease. 2. not known. 3. likely to increase. 4. likely to remain the same.

The correct answer is 1. For reasons that are not well understood, women with orgasmic disorders seem to be better able to achieve orgasm as they age.

Formative program evaluations are designed to 1. focus attention on the program development and implementation process, and determine how the program is developing. 2. identify program successes and failures. 3. provide an ongoing assessment of program efficiency and effectiveness. 4. monitor expenditures.

The correct answer is 1. Formative evaluations usually emphasize the program's continuing development process and problems, and highlight the need for changes that inevitably occur in any ongoing program. Summative evaluations are designed to highlight the results of program interventions.

A social worker using a systems perspective assists a couple with two young children who have decided to divorce. All agree that reconciliation is neither possible, nor a goal of treatment. The purpose of the family meetings is to facilitate the divorce, plan for the future, and reach a consensus on shared parenting. After several meetings involving the parents and the children, the couple remains angry with each other but they both show concern about their children. They make little progress. The social worker should probably 1. suggest that the couple and the social worker meet without the children present in time- limited sessions. 2. transfer the case to a social worker more experienced in working with this type of situation. 3. focus on the children, try to build agreement on issues about which the parents are most concerned, and suspend discussion of other issues until the couple is ready. 4. recognize that not all families can be helped to resolve divorce situations amicably.

The correct answer is 1. From a systems perspective, creating a change in the pattern might help the parents change their interactive style. In this case, there seems little point in continuing in the same way until the parents can work together.

In order to fully assess a child's behavior and emotional responses to a social work interview, the social worker must have a complete understanding of 1. normal child development. 2. psychiatric diseases of childhood. 3. the child's health status. 4. the parents' values.

The correct answer is 1. It would be impossible to assess behavior without a clear vision of "normal" development to be expected from a child at each age level.

Which of the following medications can decrease physical energy and libido? 1. Medications such as Lisinoprol and Atenolol designed to lower blood pressure. 2. Steroids used to reduce inflammations and in some auto immune diseases. 3. Aspirin used in pain management. 4. Many over the counter medications available without prescription.

The correct answer is 1. Many blood pressure medications and beta-blockers stimulate drowsiness, reduced libido, and lowered motivation. Clients taking these medications may exhibit symptoms that are similar to a mild depression.

Tom, an impulsive male adolescent, is in treatment at a mental health agency. Perceiving that Tom is depressed and upset, the social worker is concerned that he might harm himself. Which or the following events would concern the social worker most in evaluating the potential for suicide. 1. A recent family conflict. 2. Difficulties with peers and academic work. 3. A recent move to a new neighborhood. 4. A friend's death.

The correct answer is 1. Of the four choices offered, answer 1 is the best. Research evidence suggests that family conflicts and problematic family relationships can have a powerful influence on adolescent suicides. The other stressors mentioned in the stem can be powerful, but are not as potent as family conflicts and are unlikely to stimulate suicide attempts.

A child abuse victims group has divided into factions and become fragmented after meeting for a few months. Group meetings are sometimes tense and argumentative. It is likely that this group is in a stage of development described by Kolodny, Garland, and Jones as 1. power and control. 2. intimacy. 3. differentiation. 4. separation.

The correct answer is 1. Power and control is the second stage of group development, and occurs after a group has begun to prepare for the next stage, intimacy. During this phase of group development, members often form cliques and seek the protection of smaller units within the group. Differentiation occurs as the group becomes more stable, cohesive, and bonded. Separation, the final stage, occurs as members seek outlets beyond the group and may be accompanied by ambivalence and some sadness.

A social worker in a mental health agency is asked to develop risk management procedures for the agency. It is likely that the worker will explore methods through which the agency can 1. identify and minimize risks incurred by clients and workers and develop procedures that will reduce the agency's exposure to liability lawsuits for all forms of injury or malpractice. 2. file more timely requests for insurance reimbursement. 3. improve its procedures for dealing with police emergencies. 4. classify clients according to the kinds of problems they exhibit, and the likelihood that they might hurt themselves or others.

The correct answer is 1. Risk management usually refers to individual or organizational risks that might lead to lawsuits for negligence or malpractice. These risks include all practice-related activities, as well as all other possible vulnerabilities such as personal injury liability or violations of confidentiality.

A young woman with a history of drug abuse appears at a mental health clinic for her fourth visit with a clinical social worker. Though calm and lucid at previous interviews, the client is now agitated, anxious, sweating profusely, and her hands are shaking. She seems unable to sit still and moves her legs continuously. She occasionally rises and walks aimlessly around the room. The worker might suspect 1. a possible drug withdrawal syndrome. 2. a pre-psychotic episode. 3. intoxication. 4. a drug overdose.

The correct answer is 1. The client exhibits classic symptoms of drug withdrawal. Intoxication is likely to produce either an exhilarated or depressed state, while a drug overdose is likely to immobilize the person, or even cause them to enter a comatose state.

A child is brought into the hospital. The child's symptoms only manifest themselves while her mother is present, or shortly after the mother leaves. The physical symptoms are puzzling and may require invasive procedures to diagnose. Shortly after admission, it is learned that the mother has brought the child to other hospitals with obscure and difficult to diagnose conditions that were never resolved. The mother seems concerned and is very involved in the treatment, and with the staff treating her daughter. The social worker might suspect 1. Munchausen's syndrome by proxy. 2. malingering. 3. hypochondriasis. 4. child abuse.

The correct answer is 1. The description provides the classic features of Munchausen's by proxy. One explanation for this syndrome is that the mother is seeking attention and sympathy from hospital personnel, and using the childs' manufactured illness to obtain the desired result from staff.

A 40-year-old man recently moved to the community and works at a menial job. He is brought to a psychiatric facility after an altercation at his place of work. He has no identification and when asked about his previous residences, he claims that he does not remember. Following a police check he is identified as a missing person, an executive with serious job difficulties who disappeared a short time ago from his home in a nearby city. When his wife is brought to see him, he does not recognize her. A few weeks later his memory returns. The most likely diagnosis is 1. dissociative amnesia-dissociative fugue disorder 2. amnestic disorder. 3. transient global amnesia. 4. anxiety disorder.

The correct answer is 1. The dissociative fugue disorder is related to stress, and is now a subtype of dissociative amnesia in DSM-5 The onset is always sudden. Unlike amnesia, there is no lapsing in and out of the disorder. Most cases end spontaneously and do not recur, but while it is in process the client does not remember a former life. Usually there is full recovery. Transient global amnesia is a sudden memory loss episode that resolves fairly rapidly and rarely recurs. Its cause is unknown

A researcher seeking to identify a measure of central tendency that is calctdated by identifying the score below which of all scores fall would calculate the 1. median. 2. average. 3. mode. 4. standard deviation.

The correct answer is 1. The median score is located at the midpoint of all scores in n scores. Thus, with 5 scores of3, 5, 8, 11, and 13. The median score is 8.

Ellen is a 14-year-old girl who lives in a single parent household. She comes home from school every day and prepares dinner after completing her homework. She never invites friends to her home as she is afraid that her mother, who abuses alcohol, may embarrass her. Ellen wonders when she will feel comfortable visiting other homes or participating in after-school activities. A social worker using a systems perspective might consider this family 1. a tightly closed system. 2. a system with no boundaries. 3. a child abuse situation. 4. a dystonic family system.

The correct answer is 1. The mother's alcoholism and the daughter's embarrassment conspire to keep the family separate from others, and insulates the family from outside relationships. There is insufficient evidence of child abuse

A school guidance counselor refers to a 15-year-old girl to a clinic for depression and behavioral problems in school. These problems appear to be relatively new. The most likely treatment approach is 1. short-term counseling. 2. group treatment. 3. cognitive therapy. 4. family treatment.

The correct answer is 1. The problems do not appear pervasive and the treatment should not be excessive

A family court judge requests an evaluation of a sexual abuse perpetrator after a conviction. In interviewing the perpetrator, the social worker should 1. remind him of the evaluation's purpose and that the results will be available to the court. 2. suggest that he inform the social worker of any statements that he does not wish revealed to the court. 3. conduct the interview at the court. 4. inform the judge that the social work code of ethics requires the social worker to hold in confidence everything revealed by the client.

The correct answer is 1. The purpose of the evaluation is manifest in the court's request. Since the family is aware of the purpose and know their statements will not be held in confidence, there is no violation of confidentiality. Answer 2 would turn control over to the family and diminish the worker's capacity to provide a balanced evaluation.

Which of the following statements best describes the clinical purpose of note-taking during or after treatment sessions? 1. To maintain professional accountability, to retain the ability to determine response patterns over time, and to ascertain any changes that may occur in the clients behavior and feelings. 2. To verify visits and to maintain accountability to third-party payers. 3. To verify treatment in the event that negligence or malpractice suits are filed. 4. To permit supervisors to evaluate clinical practice and to provide responsive learning- focused assistance to practitioners.

The correct answer is 1. The question asks for the clinical purpose of note-taking. It thus focuses on the reasons that notes might help in the treatment process. Answers 2, 3, and 4 are all correct reasons for clinical recording, though they are not the correct answer for this question

Agencies that provide informed consent to treatment usually inform clients at the start of treatment that 1. clients have a right to confidentiality that is limited by the requirement to report child and elder abuse, and serious threats of harm to others or self 2. there are numerous risks to treatment that the client should accept. 3. the agency may arbitrarily terminate treatment. 4. fees may rise during the course of treatment.

The correct answer is 1. The right to privacy is not absolute and clients should be informed that under certain circumstances the worker is obligated to reveal facts that may be discussed in treatment.

A clinical supervisor in a community mental health center learns that the agency has double-billed Medicare as well as private insurers. The supervisor is deeply upset, but is unsure as to whether it is merely a billing error or deliberate fraud. The best strategy is to 1. inform the executive director of the problem. 2. organize a group of workers and confront the director and the board. 3. notify the appropriate law enforcement agency and suggest an investigation. 4. contact the insurers and indicate that the agency is billing inaccurately.

The correct answer is 1. The worker's first obligation is to observe professional ethical standards. Without evidence proving the double billing is deliberate, the worker's first step is to treat the problem as an inadvertent error and to allow the agency to voluntarily correct the problem. Thus, answer 1 is the correct first response. It gives the agency director ample opportunity to identify the source of the problem, and to make the necessary adjustments. All other choices suggest that the problem is deliberate and there is no possibility of correction within the agency.

A client's wife, from whom he has been separated for a year in what appears to be a bitter and litigious divorce, calls her husband's social worker for information concerning her husband's problems. The social worker's best response is to 1. state that she cannot discuss anything about her cases. 2. indicate that the relationship must remain confidential, but that the social worker would let her husband know at his next appointment that she had called to ask about his situation. 3. ask her to come in for an appointment. 4. suggest that she not interfere, since it could have a detrimental effect on the treatment relationship.

The correct answer is 1. There can be no indication that the husband is a client since this is normally a confidential matter. To say that the social worker will tell the husband confirms he is in treatment

The birth of a first child sometimes creates a crisis mainly because 1. couples can rarely anticipate the many stresses that caring for an infant will impose on their lives and on their marriage 2. marriages are rarely tested in the crucible of adversity before the birth of a child. 3. role stresses emerge as husbands place greater responsibility on their wives. 4. the couple hadn't completed the transition to interdependence that effective parenting requires.

The correct answer is 1. There has been much research on the impact of a new baby upon marriages. Couples tend to focus on the joyous and more fulfilling components of child- rearing, without realizing the degree to which their freedom and personal flexibility will be altered by the responsibilities of parenting. While there is clearly much pleasure to be gained from parenting, it is usually maximized when parents are reconciled with its full impact.

The most critical activity for a hospital social worker while planning post hospital care for a depressed married woman, prior to release from an inpatient psychiatric unit, is to 1. consult with the patient's husband to insure that the patient's follow-up care is understood, and that there is a supportive family available to her. 2. arrange continuing psychiatric follow-up. 3. refer the client for case management. 4. develop a contract with the client.

The correct answer is 1. While all of the activities are likely to be a part of the follow-up plan, the most critical activity is to insure the family will support the treatment program, and help the client to follow up.

A community agency has a difficult competitive relationship with another agency in the area. The competition has led to frequent conflicts over city and state grants and has sapped the energies of both boards of directors and executive directors. A new executive director decides that it is time to resolve the conflict and feels that it may be possible to use co-optation as a primary strategy to resolve the conflicts. To implement this principle the director is likely to 1. stimulate increased conflict initially, and then when everyone is fearful of the consequences, indicate an interest in finding common ground. 2. offer the other agency an opportunity to participate in a newly funded program that would add to their capabilities. 3. seek a meeting to mediate differences. 4. offer to resolve differences by agreeing not to compete on grants and contracts.

The correct answer is 2. A cooptation strategy requires the development of a means to align the interests of competitors so that the groups in conflict find it more beneficial to work together than to continue the conflict. Answer 4 could possibly constitute an illegal agreement.

The period of experimenting with choices in values and life style described by Erikson, which usually arises during adolescence as an effort to achieve a stable identity is called 1. a personal crisis. 2. a psychosocial moratorium. 3. ego integrity. 4. a learning experience.

The correct answer is 2. A psychosocial moratorium is described as a stage that begins about age 11, when the approach of adolescence leads to a transition in the relatively fixed values learned as child to the more flexible ethics that characterize adolescence and adulthood. During this period, the youth may experiment with a variety of lifestyle and behavioral choices on the route to fully adult development.

Marcia Minn, a child protective worker, is assigned to work with Jean, a young mother aged 17. She has a 10-month-old girl who has been abused. Jean also has a history of being abused by her partners. When the social worker arrives, the door is answered by a disheveled young man who seems inebriated. From the door, Marcia observes three men drinking beer. When asked Jean's whereabouts, the man is evasive and gives contradictory answers. He invites the worker to enter the apartment. The worker should 1. enter the apartment to view the child and the mother and then leave quickly. 2. exit as quickly as possible and return with an agency or police escort. 3. send Jean a letter and ask her to visit the office. 4. return at a later time when Jean is available.

The correct answer is 2. A social worker should never place herself at risk by entering a home where there is a possibility of danger. While there is no indication ofviolence in this question, the fact that the man's answers are evasive, there is a violent history, and there is alcohol present provides a warning signal. The presence ofan infant who has been abused adds some urgency to the need for a response.

A child welfare worker observes red marks and welts on a 4-year-old Asian child's stomach and thighs. The child has recently been ill. The family are recent emigres and they seem stable and loving. The child seems well cared for. There are no previous referrals for child protection. The worker-should first 1. refer the family for a child protective investigation. 2. explore the possibility of a culturally specific practice that might lead to the symptoms described. 3. recommend ongoing supportive services. 4. do nothing.

The correct answer is 2. An immediate referral to child protection would seem excessive since there are no indications other than the marks at this time. Though child abuse may be a factor, there are culturally specific practices that can produce the welts described. Some Asian groups, for example, believe that rubbing coins on the body of the sick person cures the disease. Answer three is premature, and doing nothing is a poor choice if there is a vulnerable child involved.

Hypochondriasis is best understood as 1. an inability to attain high energy levels. 2. an excessive concern with health, unreasonable fears of disease, or unrealistic beliefs that one is ill. 3. the production of symptoms designed to induce medical professionals to provide care. 4. a device to manipulate others into excusing someone from unpleasant tasks.

The correct answer is 2. Answer 1 is a nonsense answer. Answer 3 might describe Munchausen's syndrome in which the client deliberately fabricates symptoms. Answer 4 resembles malingering, or fabricating illnesses as a method of being excused from unpleasant tasks.

Bill is a participant in an HMO support group for men with heart disease needing to change their lifestyles. He tells group members that he is aggressive in stating his views to family members and in setting rules for his family. As a result, his teen-age children fear him and have withdrawn from him and his wife has become very submissive, though he has never threatened anyone. He says he wants closer relationships with his family. The worker should 1. ask group members if they have similar problems. 2. encourage the group to respond to Bill's concerns. 3. redirect the conversation to health issues. 4. ask Bill to keep the discussion within the group's purposes.

The correct answer is 2. Bill's statement relates to the lifestyle questions for which group is designed. His authoritarian style may illustrate the stressors that affect his. The discussion may also turn to other stressors that affect group members.

Feminist developmental theorists such as Carol Gilligan and Jean Baker Miller note that male psychologists suggest that men get their greatest sense of self-esteem and satisfaction from 1. a feeling of control over their families. 2. achievement in the work sphere. 3. a sense of connection with their wives. 4. caring for their children.

The correct answer is 2. Both Gilligan and Miller identify work as an important element in male identity formation and the development of autonomy.

The most important consideration in choosing a goal with a client is 1. what the agency wants. 2. what the client wants. 3. what the worker wants. 4. what the client's parent wants.

The correct answer is 2. Client self-determination is always an important consideration in providing social work services. The client's wishes almost always transcend or modify other goals

The most reliable form of mental health treatment program evaluation is 1. client self reports 2. schedules and rating sheets prepared by clinicians over time after receiving training. 3. audits of case records performed by skilled researchers. 4. interviews with a client's family and coworkers.

The correct answer is 2. Client self-reports are overly subjective. Audits of case records are likely to be inaccurate since workers tend to selectively record sessions. Interviews with client families and co-workers provide confidentiality problems and are unlikely to provide good information. Formal reporting systems based on structured schedules provide the best alternative among those mentioned.

A mental health center director observes that some support staff and professionals are curt with clients and appear to be disrespectful, unfriendly, and overly hasty. Concerned that clients will view the agency as unfriendly and uncaring, the director decides to take action. However, he is concerned that the problem may be structural rather than simply a few problem employees. In designing a strategy, the director is likely to achieve the best results by 1. working through supervisors, and setting up a series of penalties and rewards for good performance. 2. establishing a broadly based committee that brings together all segments of the agency including clients, and asking them to develop methods for assessing the problem and proposing solutions. 3. hiring a consultant to perform an objective assessment. 4. talking directly with staff who appear to lack the proper attitudes.

The correct answer is 2. If the problem is broadly constructed, then a solution i§ likely to involve all segments of the agency community. Indeed, the broader and more ingrained the problem, the greater the likelihood that strategies that go beyond the agency's existing authority structure will be necessary.

Jim has a history of child molestation. He joins an outpatient sex offender group as a condition of probation. It operates under the sponsorship of the court's mental health service. For several meetings, Jim says nothing. He then claims that he never assaulted a child. The other group members aggressively probe his claims and ask him to describe the conditions of his conviction. Jim becomes very uncomfortable as the aggressive, sometimes mocking questioning continues. The worker's role is to 1. help moderate the group's questioning. 2. allow the group to focus on Jim's claims. 3. help Jim integrate into the group. 4. stop the interaction before it becomes overly aggressive.

The correct answer is 2. In the treatment of pedophiles, the group often confronts the client's denial. In this case the worker should stay silent and allow the group to help Jim focus on his denial and his behavior.

An agency board member calls a senior clinical supervisor and asks her to visit him at his office to discuss a confidential question concerning the executive director's competence, behavior, and performance. The supervisor's best professional response is: 1. "I don't think I should meet with you." 2. "If you have a question, shouldn't it be raised with the board which can then authorize an official evaluation?" 3. "I'd rather discuss it over the phone than at your office." 4. "Why don't you speak with the assistant director about this matter?"

The correct answer is 2. In this situation, the general principle is that staff should not become involved in board disputes with agency management unless the board acts officially and asks for staff assistance through a formal mechanism or structure. A board member who free-lances and involves staff may be acting inappropriately, and should be encouraged to work through existing channels.

A theoretical framework that helps professionals understand the level at which a person understands, accepts, and integrates ethics, laws, and rights are known as 1. punishment and obedience orientation. 2. Kohlberg's theory of moral development. 3. naive instrumental hedonism. 4. Rawls theory of justice.

The correct answer is 2. Kohlberg's framework describes levels of moral development. In part age related, the highest levels of moral development are usually implanted through examples and models provided by individuals with higher levels of development.

Live supervision differs from other forms of supervision in that 1. die supervisory relationship is closer and more intimate. 2. guidance can be provided during the clinical interview. 3. it requires special training. 4. it allows the supervisor to act as a co-therapist.

The correct answer is 2. Live supervision involves observation during the session with a means for communicating directly with the worker during the treatment session.

Marie is a client at a family agency. At 34, she is a single parent with three children and limited education. Her youngest child, David, is 15-years-old, living at home and on probation due to a drug conviction. Marie will be evicted from her public housing apartment if David reoffends. Due to changes in welfare law, Marie has only a few months to seek employment or training before payments are reduced. She is unclear about the requirements or what is expected of her. She has never worked and though she expresses willingness, it is clear that she is fearful and apprehensive about her ability to find work and hold a job. She requests help with her welfare and employment situation. What should her social worker do first to help Marie? 1. Arrange for a job training or supported-work program in which Marie can succeed. 2. Help Marie understand what she must do in the next few months, and assist her in making employment or training arrangements. 3. Ask to see David and work with him to insure that he does not cause the family to be evicted. 4. Arrange an appointment with the welfare department for Marie.

The correct answer is 2. Marie is confused about what she needs to do and the first thing the worker must do is clarify the issues. After the client understands what is needed a plan can be constructed to help Marie. Answer 1 is incorrect because it is premature. Answer 3 is not responsive to Marie's service request at this time. Answer 4 is plausible, but a referral may simply pass the buck without providing any concrete assistance, and might also preempt the possibility of offering other assistance.

An elderly resident living in supported housing complains to her social worker that another resident, with whom she is normally friendly is ignoring her and does not call her as often as she used to. She is angry with the friend, though the friend says that she is as attentive as she has always been. The resident also complains that her children do not visit of call frequently, and she is upset and deeply hurt by their neglect. What defense mechanism is probably involved in this case? 1. Reaction formation. 2. Projection. 3. Hallucination. 4. Delusion.

The correct answer is 2. Projection is an immature defense in which incompatible thoughte or feelings are externalized and attributed to others. The woman seems to be projecting the anger she feels toward her children on another person. She accuses her friend ofignormg her -the same behavior that she attributes to her children.

A family service agency receives a request for assistance from a woman with three young children under 10-years-old. At the first interview she states that her husband with whom she had an excellent relationship, was killed in an automobile accident a few days earlier. She seems somewhat disoriented and exhibits acute anxiety, breaking into tears as she discusses her feelings. The worker should first 1. seek to help her adjust to the new situation and assist her in acclimating herself to living alone. 2. address her current situation and emotional state as an acute grief reaction. 3. ask her how she is helping the children adjust. 4. suggest she join a group.

The correct answer is 2. Since the loss occurred only a few days earlier, it is reasonable to assume that the client's distress reflects a normal grief reaction precipitated by her loss. None of the other answers in this question reflect a realistic approach at this time.

A behavior or symptom that is ego dystonic is one which the client experiences as 1. comfortable and useful. 2. uncomfortable and burdensome. 3. one that can be easily denied. 4. one that can be easily changed.

The correct answer is 2. Symptoms that are ego dystonic are experienced as sources of discomfort for the client. Symptoms that are ego dyntonic are often seen as integral and useful.

A social worker starts a home based business selling food supplements. Her supervisor soon learns that the worker is mailing brochures to clients and co-workers and is personally soliciting orders from staff and from clients. The supervisor should 1. do nothing. 2. inform the staff member that there are ethical prohibitions on using her professional position to advance her private business interests. 3. suggest that she ask the board for permission to market her products. 4. require her to relinquish her business interests if she wishes to continue working at the agency.

The correct answer is 2. The NASW code of ethics requires social workers to separate their personal business interests from their social work activities.

Latin Americans tend to accept help from experts who 1. sound knowledgeable and work for institutions. 2. speak Spanish, are knowledgeable about the area of concern and have a positive reputation within the community. 3. are Anglo and seem confident about the problem and its possible solutions. 4. have a reputation for knowledge about a subject, and is also a relative or friend of the person in need.

The correct answer is 2. The ability to speak the language and personal reputation are important features of credibility in close ethnic communities

Neighborhood changes have altered the ethnic and linguistic population of the community served by a mental health agency. Forty percent of the clients are now Asian and many do not speak English. Treatment problems result from the marked inability of many staff to communicate easily with clients. Increasing the number of multilingual clinicians is not immediately feasible. Seeking the best alternative solution, the agency should 1. request English-speaking relatives to accompany clients to interviews. 2. hire and train translators conversant with mental health issues. 3. hire secretaries and other support staff who can double as translators. 4. restrict access to those the agency can best serve.

The correct answer is 2. The best solution avoids confusing clients and embarrassing them by asking friends, children, or other relatives to translate sensitive mental health information. Clearly, the most desirable solution is to hire bilingual and bicultural clinicians, but these are not immediately available. Thus, a professionally trained translator is appropriate. Asking secretaries and support staff is less appealing since translating is not their primary task. It can be problematic for clients to confront a clerk at the front desk and then have the same person sit in on an interview. Answer 4, restricting access to service based on language, is clearly unethical and inappropriate and would quickly be discerned as a discriminatory policy.

A senior manager discovers that flaws in the computerized record management system are causing security lapses that compromise client confidentiality. Unauthorized persons can view records. The first action that the manager should take is to 1. find out who has been accessing files and fire those who have violated agency policy. 2. shut down the system and implement temporary procedures, to assure that only authorized staff to have access to confidential files. 3. notify the agency attorneys. 4. notify clients of the problems.

The correct answer is 2. The first principal management must follow is to stop the leakage of information immediately. Other measures may be taken later, but the first step is to take control of the problem.

A social worker is asked to testify in court in a child custody case and is told by the plaintiff's attorney that she will ask questions designed to qualify her as an expert witness. If she is successful in qualifying as an expert witness, it is likely that she will be asked to 1. describe the child's relationship to the social worker. 2. offer opinions on the child's behavior, personality, or current or proposed custody arrangements. 3. provide confidential information that she would otherwise not be allowed to reveal. 4. testify privately in the judge's chambers.

The correct answer is 2. The major reason for qualifying an expert witness is to allow professional opinions as testimony. Other witnesses can only testify about what they have seen or heard directly.

When social workers establish a professional helping relationship that respects the dignity of the individual, their behavior, attitudes and intervention with individuals 1. will be the same for every client. 2. individualizes each situation presented by clients by determining the client's perception of the problem, and the client's perception of their needs. 3. encourages clients to pursue their own strategies for resolving their problems, even if they are likely to create additional problems for the client. 4. is calculated to maintain professional distance.

The correct answer is 2. The social worker's focus is on establishing a helping relationship that respects the client's dignity. This can best be accomplished by understanding how clients experience their problems, and by individualizing interventions. A social worker would not normally encourage clients to solve their problems using ineffective means. Professional distance is not responsive to the stem of the question.

A 40-year-old man on neuroleptic medication for the past four months begins to exhibit involuntary rapid and jerky movements with his tongue and jaw. Over a period of five weeks, the symptoms grow progressively worse and more pronounced. Suspecting that these symptoms are related to the medication regimen, a social worker would 1. rely on the client's psychiatrist to review the client's medication. 2. notify the psychiatrist that the client is exhibiting symptoms that suggest tardive dyskinesia. 3. suggest that the medications be increased. 4. suggest that the medications be decreased.

The correct answer is 2. The symptoms are serious enough to warrant a medication review by a psychiatrist. Tardive's dyskinesia is a fairly common reaction among patients using neuroleptic medication. The social worker's role is to quickly bring the condition to the psychiatrist's attention.

A social worker accepts a couple for treatment. On one occasion the husband privately reveals that he maintains a dual life and is involved in numerous high risk, unprotected homosexual liaisons. The social worker is concerned about both the health risks and about the fact that she has been placed in the uncomfortable position of withholding important information from the wife. In addressing this problem, which principle has the highest priority? 1. A social worker has a duty to warn someone deliberately placed in danger by another. 2. A social worker has a duty to maintain confidentiality. 3. A family comes to a social work intervention with the expectation that the social worker will be helpful, and will be responsive to their concerns. 4. Helping families remain together is a primary goal of treatment.

The correct answer is 2. There are not any good answers here. It could be argued that the social worker has at least as strong an obligation to warn the wife. However, this is a couple's treatment situation and there is an obligation to both parties. One solution might be to give the husband an opportunity to discuss this matter with his wife in a protected clinical situation.

A social worker in a small town accepts Jane S. for treatment and shortly afterwards learns that she is involved in a bitter and divisive divorce action involving Sara B., another client. Jane S. has been conducting an affair with Sara B.'s husband and she is likely to be called as a witness in a custody dispute that is part of the divorce action. The social worker realizes that she too may be called to testify. What principle should guide the worker's actions? 1 Both clients are equal and the worker should treat each as a separate situation that requires its own clinical strategy. 2. If the worker believes there is a clear conflict of interest, she should terminate one or the clients and refer her elsewhere, after fully discussing the issue with her. 3. The worker should bring both clients together to determine their motivation for involving her in this awkward situation. 4. The worker should seek clinical supervision on managing this unusual situation.

The correct answer is 2. There is little doubt that a potential conflict of the type described is inimical to good practice. Moreover, the social work code of ethics is quite specific about the need to assess potential conflicts and act aggressively to limit them. In this case the social worker should probably terminate one of the clients.

Piaget identified one barrier to the development of logical thinking as a child's tendency to concentrate on only one detail of an object or situation and ignore all other aspects. This barrier is called 1. egocentrism. 2. centration. 3. conservation. 4. classification.

The correct answer is 2. This is a definitional question.

TANF refers to 1. a new psychotropic medication. 2. Temporary Assistance to Needy Families which limits the duration of welfare benefits. 3. AFDC. 4. a Medicare Program.

The correct answer is 2. This is a definitional question.

A social worker hotline supervisor receives a call from an inexperienced volunteer at 2 am. The volunteer describes a call from a man who is contemplating suicide by driving his car off a bridge. The social worker should tell the volunteer to 1. keep him talking on the telephone until a specific arrangement can be made with a therapist later in the morning. 2. keep him on the phone and get a crisis worker to him immediately. 3. tell him no one is available and to call back in a few hours. 4. tell him to go to a mental health agency in the morning.

The correct answer is 2. This is an emergency situation that cannot wait until morning. The best strategy is to keep him on the phone, and get help to him quickly.

A social work clinician finds that his mind wanders during sessions with clients. As a result, he occasionally misses significant information and misinterprets client concerns. Several clients have noticed his lack of attention and expressed dismay that he doesn't seem to listen to them. How should the worker address this problem? 1. Take a vacation as he obviously needs some rest. 2. Discuss the problem with a supervisor to assess the problem. 3. Have a confidential discussion with colleagues. 4. Consider another profession.

The correct answer is 2. While fatigue may be a factor, the worker needs to obtain some help before the problem seriously impinges on his clinical capabilities. Discussion with the supervisor may lead to a better understanding of what is affecting the worker, and can offer some direction. The worker may need a change in workload, more client variety, or some other change that can help reinvigorate interest and capability.

A child diagnosed as autistic is difficult to treat, however, certain treatment models have proved effective. The most likely choice of method will be 1. long-term psychotherapy. 2. play groups. 3. behavioral treatment. 4. cognitive therapy.

The correct answer is 3. Behavioral treatment is commonly chosen as the treatment of choice. Autistic children do not respond as well to methods requiring the use of relationship, or verbal methods.

The social worker's perceptions of the client's problems should be well-formed 1. during the first interview. 2. as the client progresses, with the ability to be flexible and change his or her opinion as more facets of the problem are revealed. 3. within the first two or three contacts. 4. after each interview.

The correct answer is 3. Current practice, particularly in managed care settings, requires that assessments are completed rapidly. A worker should have a fairly clear idea of a client s problems within three visits.

Down's syndrome is a medical condition associated with 1. ocular degeneration. 2. physical disability. 3. mental retardation. 4. drug and alcohol use.

The correct answer is 3. Down syndrome is medical condition associated with mental retardation.

When performing a program evaluation requested by a funding agency, and designed to measure the success of a program in reaching program goals, it is best to have the study performed 1. by a knowledgeable staff member involved in the program. 2. by a knowledgeable management staff member. 3. by an outside program evaluation organization or independent consultant. 4. without the knowledge of the program's management.

The correct answer is 3. For a study to have credibility with funding agencies, it must be independently performed by a qualified outside professional evaluator.

An 83-year-old client with diminished mental capacity lives in a supported housing program. His married daughter often visits, and with his permission confers frequently with the elder service agency about his affairs. He informs his social worker that he has been offered an opportunity to make a substantial investment in a new company that guarantees his investment will triple m value within six months. He seems confused when responding to the worker's questions. When she probes, his answers seem irrelevant. The worker fears that his impaired judgement may allow someone to exploit him and that he is a victim of a fraudulent scheme. She calls his daughter and tells her about the conversation. Is the decision correct? Choose the best response. 1. No, it is a violation of confidentiality. There is no justification for her to call, as it is not part of the contract. 2. No, the daughter may have a conflict of interest and may use the information to take control of his resources. 3. Yes, the social worker knows that this client's judgement is impaired. The knowledge that the elderly are often victimized by financial scams justifies efforts to protect him. 4. Yes, old people need special protection and the worker is morally justified in discussing her concerns with the daughter.

The correct answer is 3. If the worker suspects impaired judgement, she is obligated under the NASW code of ethics to take suitable action to protect the client. Since the daughter appears to be the closest relative who is concerned about the client, she would be the appropriate person to inform. Answer 4 is not correct, since the generalization that all older people need special protection is untrue.

A worker in an HMO is threatened and struck by a client who failed to comply with medication instructions. Since many of the HMO's clients are seriously ill or have a history of violent behavior the director decides to develop new procedures designed to protect workers and minimize exposure to violent outbursts. The best course is to 1. hire guards to provide a visible deterrent. 2. institute a better medication monitoring procedure. 3. appoint a staff committee to develop comprehensive short, and long-term recommendations for physical safety, including policies and procedures. 4. install a new alarm system with "panic" buttons in every office.

The correct answer is 3. It is perhaps the least intuitive. It is the most general answer and could easily subsume all the other responses. It is important that when violence occurs the preventive actions that are taken must respond to staffs perceived needs for a safe environment. Hence, action should respond to the staff perceptions of what is important.

A social worker is empowering a client when 1. solving a problem for a client. 2. linking a client with resources that they need to improve their lives. 3. facilitating the client's ability to independently solve problems. 4. agreeing to a client's request for a specific service.

The correct answer is 3. It is the only response that focuses on improving the client's capacity to improve his or her own life. This is the definition of empowerment.

An agency administrator is responding to a request for proposals to operate a managed care child mental health project. In assessing the project and preparing to develop a proposal, the first thing she should do is 1. identify potential managed care network linkages. 2. develop a demographic profile of the target population, and identify the areas within the agency's catchment areas. 3. review the application guidelines to determine if the agency is qualified to bid on the project and has the necessary qualifications to operate the program. 4. discuss the project with agency supervisors to win support for a large and complex project that will require managerial attention.

The correct answer is 3. It makes little sense to work on a proposal until there is certainty that the organization is, or can become, a qualified bidder. The other activities listed in answers 1,2, and 4 would normally proceed from a determination of eligibility.

A social worker employed in a residential youth services agency learns that a fellow employee has multiple convictions for sexual molestation of young children. The agency is unaware of his history, though he was asked pre-employment questions about previous convictions. Sexual offenses automatically disqualify applicants for employment in the agency. The social worker's professional and ethical obligation is best met by 1. saying and doing nothing. 2. urging the employee to reveal his history to management. 3. immediately notify the responsible agency manager of the situation. 4. notify the man's probation officer.

The correct answer is 3. It responds to the ethical expectation that social workers share responsibility for maintaining a safe environment. Since many sexual offenders do reoffend, and the employee lied on his application, it is not appropriate to maintain silence. Moreover, many offenders seek to associate with vulnerable children since this eases their predation. Talking to the employee would seem neither safe nor appropriate and might place the worker at greater risk. Answer 4 has no referent within the question. There is no indication that the employee is on probation.

A social worker receives notice that a former client has filed a complaint and requested a hearing with the social work ethics board. The client claims that the worker revealed confidential information to his employer, and that this has damaged him with his company. The worker has never spoken with the employer, and does not believe that any confidential information was ever revealed. The social worker should 1. call the client and ask why he believes that the information was revealed. 2. call the company and ask them for background information. 3. respond to the ethics board's instructions and questions. 4. write a letter to the client asking for more information.

The correct answer is 3. It would be inappropriate to call the client since this might be seen as an attempt to influence or coerce him. Once the complaint is filed, the worker's best course is to follow through with the process.

A medical social worker interviews a young married woman, J., who was brought into the emergency room the night before with head injuries, a broken jaw, and upper-body contusions and abrasions. She will remain in the hospital several more days for tests. J. explains that she fell asleep at the wheel and crashed. Her husband is present throughout the interview and seems determined to remain. He nods and encourages her as she tells the story. J. seems intimidated by her husband's presence. The social worker fears that J. is not being truthful and that the injuries might have resulted from domestic abuse. The most prudent course of action is to 1. continue the interview and record only the facts that J. is prepared to reveal. 2. ask the husband to leave the room to permit a confidential discussion. 3. gracefully terminate the interview and return when the husband is not present. 4. file a domestic violence report with the police department.

The correct answer is 3. Many abused women will not reveal abuse while the husband is present, as they are intimidated and frightened. Asking the husband to leave might precipitate an argument with the husband, and could place the woman at risk. Answer 4 is unlikely because there is insufficient cause, and the wife may not cooperate in any event. Answer 3 causes no conflict and does not arouse the husband's anger.

A 25-year-old immigrant from Rwanda informs her social worker that she has recurrent nightmares during which the massacre of her family is reenacted. She thinks about these events frequently and is often immobilized and unable to work. Yet, she cannot discuss these events and maintains her distance from others. She has few close relationships. It is likely that she suffers from 1. numbed affect. 2. amnesia. 3. post traumatic stress disorder. 4. organic brain disorder.

The correct answer is 3. The behaviors that are described in the stem; nightmares, numbed affect, continuing recurrent thoughts ofterrible events, inability to discuss the events, and distance from others, are the classic features ofPTSD.

A researcher seeking to identify a measure of central tendency that is calculated by averaging a set of scores would calculate the 1. median. 2. standard deviation. 3. mean. 4. mode.

The correct answer is 3. The mean is the average score. It is arrived at by adding the total of all scores and dividing that total by the number of scores in the sample.

Most clinicians who treat clients with alcohol dependency emphasize a treatment goal of 1. controlled drinking. 2. gradually lengthening periods of sobriety. 3. total abstinence. 4. substituting benign medications for alcohol.

The correct answer is 3. The most consistent research finding in the treatment of alcohol dependence is that the best results are usually obtained through complete abstinence.

A social worker is ordinarily not permitted to terminate a client when 1. services are no longer required. 2. clients fail to pay fees in a fee-for-service setting. 3. a client is disrespectful. 4. the worker is leaving the setting.

The correct answer is 3. The question can be misread because it is asked in the negative. All of the conditions in answers 1,2, and 4 are acceptable reasons for terminating. In the case of nonpayment, the worker should try and arrange an appropriate alternative. It is not acceptable to terminate a client because they display an objectionable attitude.

Bill W. is an influential senior clinician at a large mental health center and is a member of the selection committee assigned to recommend candidates for assistant director. The leading candidate is an experienced and dynamic woman who has a 4-month-old child. Bill argues that the candidate's child-rearing responsibilities will interfere with her demanding job obligations, and recommends that she not be hired. The committee should 1. accept Bill's recommendation and hire another candidate. 2. ask the woman how she plans to meet her child-rearing obligations, and make a recommendation based on her responses. 3. reject Bill's analysis on legal and ethical grounds. 4. recommend her, with reservations, and allow the Board to work out the details.

The correct answer is 3. The selection committee should not make assumptions about &e candidate's life, or ask her to meet criteria they wouldn't expect of a male candidate Such behavior would be clearly discriminatory, unethical, and patronizing. They could make the agency vulnerable to a sex discrimination lawsuit.

A family seeks counseling help to address their reactions to the sudden accidental death of one of their children. The social worker's genuine concern and over involvement with the family is noticed by the supervisor. The supervisor should 1. commend the social worker for being so dedicated to his work. 2. arrange.for an immediate transfer of social work services for this family to a more experienced social worker. 3. involve the social worker in assessing the effect of subjective reactions on the quality of his work and on his clients. 4. explore the social worker's inner conflicts regarding the nature of this tragedy.

The correct answer is 3. The supervisor's role is to address the social workers' learning and practice needs. In this situation, the supervisor may help the worker identify his over-involvement and understand the consequences of practice, but the supervisory role does not ordinarily spill over into working with inner conflicts.

According to DSM-5, anorexia nervosa and bulimia are categorized as 1. digestive disorders. 2. chronic anxiety problems. 3. feeding and eating disorders. 4. psychiatric anomalies.

The correct answer is 3. This is a fact question and simply calls for the DSM-5 classification of feeding and eating disorders.

A hospital social worker is called to the emergency room to counsel a family that has just lost their 8-month-old daughter to sudden infant death syndrome (SIDS), During the interview, the social worker learns that this is the third child who died in this manner. In each case SIDS was diagnosed. The mother is currently pregnant with another child. How should the worker respond to this tragic situation? 1. Help the family to find a counselor to help them deal with their loss. 2. Suggest a genetic evaluation. 3. Suggest counseling but also notify the child protection agency and recommend an investigation. 4. Suggest the use of a sleep apnea monitor for the next child.

The correct answer is 3. While all the answers are somewhat correct, recent research provides evidence that multiple SIDS deaths may occur as a result of actions of family members. By acknowledging the family's grief and suggesting counseling, the worker responds to the family's situation, however, the safety of the next child must also occupy the attention of the social worker. A recommendation to the child protection agency is in order.

A tenant group decides to conduct a rent strike in order to force a landlord to make needed repairs to their apartments. According to Rothman's model of community organization this strategy is an example of 1. locality development. 2. social planning. 3. a task centered group. 4. social action.

The correct answer is 4. A contest or confrontative strategy is within a social action framework. Locality development involves the creation of a community social infrastructure and must normally precede social action. Social planning is usually accomplished after detailed analysis. Social planning involves the preparation of alternative community futures involving the participation of various community constituencies, and reliance on a consensus.

Which of the following characteristics are not usually found in alcoholic families? 1. Poor communication patterns. 2. Rigidified roles. 3. Denial as a major defense. 4. Enmeshment between parents.

The correct answer is 4. Alcoholism within the family is unlikely to stimulate over- involvement among family members. It is far more likely to induce emotional separation as well as poor communication, denial, and lack of flexibility in role functioning.

The research concept of reliability is established by 1. testing to insure that the experiment or test measures what it is designed to measure. 2. a scientific research design. 3. a chi square test. 4. replicating results over many trials.

The correct answer is 4. Answer 1 refers to validity. Answer 2 is a characteristic of all good program evaluations. Answer 3 is a statistical measure. Answer 4, reliability, asserts that the results of tests are replicable across administrations.

A social worker in the hospital geriatric unit meets with Mary, the daughter of an 84-year-old Alzheimer's patient. Mary, who is 62-years-old and diabetic, is hesitant about placing her father in a residential setting. However, she recognizes that she cannot provide the increased care and supervision her father needs. His memory is severely impaired. He is occasionally incontinent, wanders, gets lost, and needs constant supervision. The social worker's main role in this situation is to 1. convince Mary to place her father in an appropriate facility. 2. explore Mary's understanding of her situation and help focus her attention on the real problems that she must confront. 3. arrange visits to residential programs to reassure Mary that her father will be well cared for. 4. act as a resource by helping Mary understand all the various alternatives that are available to her and her father. Facilitate whatever choice she makes.

The correct answer is 4. Answer 1 suggests a more active and prescriptive role than a social worker might normally accept. Answer 2 is largely redundant since the stem of the question notes that Mary already has a realistic picture of her situation. Answer 3 is premature since Mary is still in the process of clarifying the choices available to her. The social worker's best strategy is to help Mary work through a variety of strategies, while facilitating those with which she is most comfortable.

A client receives a high Beck Depression Inventory score. What should the social worker first do to help this client? 1. Discuss the score with the client at the next session. 2. Administer another inventory as soon as practicable. 3. Document clients' status in clinical notes to measure progress over time. 4. Assess safety issues as soon as possible.

The correct answer is 4. Any serious indicator of severe depression requires an early assessment of the client's potential for suicide.

A school social worker provides family information, referral and support services, for children with a variety of learning disabilities. Aaron, a sensitive, intelligent, affectionate first grade boy, presents learning and behavioral problems since his mother died after a long struggle with cancer. He is, at times, very aggressive and violent with other children, and needs constant supervision and attention. He and his father seem mutually dependent and enmeshed, and neither seems able to deal with their grief. The father is caring and well intentioned, but he is not yet able to fully cooperate with the school in helping Aaron. In this case the social worker should 1. engage the services of the child protective agency• 2. suggest that Aaron be transferred to a special school for children with emotional difficulties. 3. suggest that the father spend more time with Aaron. 4. help the father find services that can help him deal with his grief.

The correct answer is 4. At first glance, it might appear that the best answer is 2-a transfer to a special school. However, Aaron's difficulties seem to be related to the recent death of his mother and a special program may not be necessary. For Aaron to deal with his grief, his father must be helped to process his own loss. Then his attachment to Aaron can assume a more positive form that allows him to help Aaron also deal with his loss. This is not a child protective situation as there is no abuse. Instructing the father to spend more time is likely to exacerbate Aaron's problems in school when he is away from his father, without helping either to address their grief

An experienced foster care social worker feels that his supervisor is urging him to more clinically unsound case decisions. After raising his concerns with the supervisor and finding him unresponsive, the next step the worker should take is to 1. ask the agency director to overrule the supervisor. 2. file a grievance with the NASW ethics board. 3. conform to the supervisor's suggestions, since he is more experienced. 4. ask for a case conference to present both the supervisor's and his own recommendations.

The correct answer is 4. Before publicly challenging the supervisor, the worker should carefiilly present his ideas, and seek verification through the case conference process.

A Visiting Nurse Association social worker visits a Cambodian family whose young child has cerebral palsy. The worker found that the child is kept in a darkened room and though fed and bathed, is isolated from the family, and denied any action. The grandfather wants the child removed from the family. The social worker should first 1. try to relate to the whole family, including the grandfather, to determine more about their values. 2. suggest that the mother ask her father to live elsewhere. 3. call the Cambodian community agencies and the Buddhist priest. 4. report the situation to the child protective service agency.

The correct answer is 4. Despite the shame associated with having a child that the family considers defective, no cultural practice that would normally be considered child abuse is exempt from local laws to protect children.

A social worker using the technique of partialization is engaging in a therapeutic technique that 1. divides problems into appropriate categories and establishes timetables for dealing with them in logical order. 2. takes a major problem and divides it into its components. 3. helps a client understand that parts of her life are positive. 4. helps a client divide interrelated problems into more manageable components. Assists the client in identifying issues that need immediate attention.

The correct answer is 4. It is an accepted definition of the term. Partialization of a client a problem allows an overwhelming large problem to be divided into smaller more manageable components, on which the client can focus.

Mohammed and Samar A. seek help from a family agency. They are recent immigrants to the U.S. from Egypt. Though traditional in their views, they are making an adequate adjustment. Both Mr. and Mrs. A. are employed and they will shortly open their own business. In a first interview they emotionally complain that their daughter, Suhar, aged 15, is going out with boys. Not only do they strongly disapprove of the freedom that American teens have, but they do not want Suhar to go out unescorted by family members. The parents want the social worker to help them control Suhar's behavior. Suhar says she loves and respects her family, but that she needs more freedom. The social worker's strategy should initially focus on 1. helping the parents conform to and respect new cultural conditions. 2. helping Suhar conform with her parent's wishes. 3. reassuring the parents about Suhar's behavior. 4. sustaining the parent's relationship with Suhar and helping to mediate and negotiate their contradictory concerns.

The correct answer is 4. It is important for the social worker to focus on the family. Their daughter is adapting to a new and different culture that her parents are slow to accept. If Suhar is too aggressive in pursuing her independence, there could be serious consequences. Many Middle East cultures firmly believe that the family's honor is bound up with the behavior of its female members. Overtly sexual or rebellious behavior can place daughters at risk of serious harm. Indeed, honor killings of women are common and the worker may not be able to evaluate the risk. The social worker must help the family adapt while remaining sensitive to the culture and customs that guide them, as well as to the potential for violence against the daughter.

John, a member of a short-term parenting group reveals that he has just been diagnosed with prostate cancer and will undergo surgery in a few weeks. He is anxious about the disease and the surgical procedure since it may result in permanent incontinence or impotence. He welcomes the opportunity to discuss this with the group, and they respond sympathetically and with emotional support. The group leader's best course in this situation is to 1. rapidly move the group onto its assigned work by reminding them of the purpose of the meeting. 2. gently encourage John to seek emotional support from a group designed for that purpose. 3. suggest that the group end the meeting early since everyone is upset by John's illness. 4. allow the group to provide support to the member for as long as necessary, even if this means that the group's agenda may not be fully addressed.

The correct answer is 4. The group's purpose is largely supportive and instrumental with clear short-term goals. When a group member is experiencing a crisis, the group will be temporarily deflected from its stated purposes and should provide support to a member. To do otherwise, would not be supported by the group, and could lead to serious stresses within the group.

When facilitating a client, group or community's ability to make decisions and progress toward problem solving, a social worker is acting in the role of 1. a teacher. 2. A broker. 3. a social change agent. 4. an enabler.

The correct answer is 4. The key is the idea of facilitation which places the worker in the role of enabler

A social worker is assigned to work with a Latino single parent family. The 29-year-old mother has difficulty controlling her 10 and 12-year-old children. The problem began when the grandmother, who resides with them, became ill and unable to help care for the children. The children are unruly and occasionally truant. The social worker's first objective is to 1. decide if the children are abused or neglected. 2. meet with teachers and the mother and arrange after-school activities for the children. 3. ask the mother if she wants to go to court with the children, and have the judge try to help her by declaring the children in need of supervision. 4. form a relationship with the mother and help empower her to manage her relationships with the children, and her parenting responsibilities.

The correct answer is 4. The question implies that the ill grandmother has provided a stable backdrop for the family and that her illness has shifted more responsibility to the daughter, both for child care and for the grandmother. She needs assistance in becoming an effective parent. The other responses are extreme interventions or judgements given the facts of the case

A gay couple comes to the clinic to address problems in their relationship. Bob is an activist and is becoming more visible on the gay political scene, while Joe is a teacher in a local high school and is very worried about publicizing his sexual orientation. Because of their difference in openness about their sexual orientation, they have begun to develop distinctly different social worlds. The first thing that the social worker would most likely do is 1. ask questions about Joe's relationships with the boys in his school. 2. find out how long they've been together. 3. find out if they are having "safe sex". 4. explore how each person feels about this situation.

The correct answer is 4. The question that should be addressed by the social worker is the one that the couple has brought to the session. The worker's role initially is to clarify the problem with the clients and then proceed from there.

When an elderly person enters a nursing home, there is a period of adjustment. Some residents characteristically withdraw, while others are more gregarious. When a client withdraws in the first weeks of residence, the social worker's first task is usually to I. encourage staff to draw the person into floor routines 2. discuss the resident's hesitation about participation in activities. 3. encourage the family to visit more often. 4. help the person become involved with programs and activities.

The correct answer is 4. The social worker's role is to facilitate entry into the community and to help minimize the client's problems with adjusting to the new environment. Engagement in the activities of the residence is the best strategy of those offered.

A social worker in a mental health agency is working with a client who constantly complains about her husband's compulsive gambling and the financial deprivation she experiences. He owes money and has been threatened. Her discussions and complaints always emphasize her husband's irresponsible behavior. She seems too distracted by his gambling to focus on her own needs and feelings. The social worker would 1. suggest a referral to Gamblers Anonymous in order to alleviate his gambling and her distress. 2. ask that the husband come in to see the social worker. 3. suggest that the wife consider separation as his behavior is unlikely to change. 4. determine with the woman how to refocus treatment so that she can discuss her own feelings and concerns.

The correct answer is 4. The social worker's role is to help the primary client. Any movement toward change should reflect the client's determination as to how she can best alter the situation. While separation or referral maybe indicated, this should derive from the client's understanding of how to best resolve the situation.

While being transferred to a new foster home by a public social services worker, a 14-year-old boy who seems very depressed mentions that he is thinking of suicide. He discusses how he will kill himself. What should the worker do first? 1. Respect the confidentiality of the relationship. 2. Call the client's family after telling him that this is a required procedure. 3. Refer the client to the agency psychiatrist for an appointment later in the week after consulting with the supervisor. 4. Stay with the boy and accompany him to a psychiatric emergency facility.

The correct answer is 4. The suicidal ideation combined with a plan, signals that the boy may be a danger to himself. While the family should be notified, it is not necessarily the first thing a worker would do with a child in placement. A suicide possibility should be treated as an emergency and not referred for later action to a psychiatrist

A 26-year-old man has always lived with his parents. Though employed, he makes a low salary, and his current job is likely to be of limited duration. He has some health problems including a stomach ulcer that requires careful attention to diet. He informs his social worker that he wants to move so that he can be more independent. He asks the social worker for help in meeting his goal. The worker should first 1. give him information about available apartments. 2. help him see the ways in which he is still dependent on his family. 3. suggest to the client that the worker talk with his family to prepare them for this move'. 4. explore his intentions and his plans more specifically.

The correct answer is 4. There are many factors that need exploration. While it is desirable to end his parental dependence, his ulcer and marginal employment suggest a need for some planning and concrete assistance. Careful coaching and exploration are needed to determine his goals, and to plan a smooth transition to independent living

Without client consent, a social worker should not reveal confidential client information when 1. it is necessary to prevent serious harm. 2. it is necessary to prevent foreseeable injury. 3. it is necessary to prevent imminent threats or danger. 4. it is necessary to secure third party payment.

The correct answer is 4. Third party payment is never sufficient reason to violate the canons of client confidentiality. Answers 1-3 are supported by public policy, judicial precedent, and law as reasonable causes for breaching confidentiality.

Marie and Tony are about to be married. They see a social worker to resolve relationship and communication problems that concern Marie more than Tony. After several sessions, the social worker comes to the conclusion that Tony has an unacknowledged alcohol problem. After coming to this understanding, the social worker should 1. meet with Tony privately, confront him with the problem and offer him a referral for treatment. 2. meet with Mary privately and form an alliance to address Tony's drinking. 3. say nothing about the alcohol problem since this was not the reason they came into treatment. 4. encourage discussion of Tony's alcohol abuse at the first appropriate moment during a joint counseling session.

The correct answer is 4. This is a treatment question that frequently arises. Though the agreement between the clinician and the couple is to work on communication issues, one partner's alcoholism is a serious impediment to the marital relationship that is likely to grow worse over time. The clinician should permit the issue to come to the surface, and then seek to motivate the client to seek help.

A social worker employed on an HMO pediatric team confers with a parent who, for religious reasons, has refused to approve a medical procedure that may save his child's life. The medical staff is certain the child will be severely disabled or die without medical intervention. The social worker should 1. respect and support the parent's perspective. 2. point out how grief-stricken and guilty the parent will feel if the child dies. 3. call a meeting with medical professionals to try and influence the parent. 4. recommend consultation with legal counsel and support medical intervention if the parent continues to deny approval for medical care.

The correct answer is 4. While a social worker does not wish to compel a parent to do something that they oppose, the courts have ruled that a life threatening illness may require overruling a parent's wishes. The social worker should support legal intervention to provide the necessary care.

A homeless man with a history of alcohol abuse and with no family connections appears at a hospital outpatient clinic on a bitterly cold night. He is confused and distraught. Though ill and coughing, he is not suicidal and is not hostile. The social worker fears, however, if he does not receive medical help, then his physical and mental condition will deteriorate. He does not wish to accept hospitalization, but seems willing to continue to talk with the social worker. What is the social worker's best strategy for helping him? 1. Respect self-determination and tell him to return when he wants some help. 2. Encourage him to stay overnight in a bed at the outpatient clinic and meet later to develop a long term plan. 3. Find his family and convince them to commit him. 4. Determine if other sheltered environments or supports are available to him.

There is no good answer, but the best answer is 2. A few states have amended laws to make it easier to hold people involuntarily, but in this case, the social worker's best strategy is to rely on persuasion.

A social worker at a maternal-child health clinic interviews 19-year-old Carla. She is five months pregnant and has a history of drug abuse and destructive relationships with violent men. Carla claims that she is drug-free. However, she has missed visits and usually comes to the clinic for prenatal care only when the health outreach worker finds her. She seems unable to accept the need for prenatal care. Carla is vague about where she is living. She has a bruise on her arm, a disheveled appearance, and she has been absent from the employment training program she attends. The social worker is concerned about Carla and her baby. In working with Carla, the worker should 1. focus on finding ways to obtain Carla's cooperation in using prenatal care. 2. file a child abuse report against Carla. 3. find out where Carla is living and who she is with. 4. help Carla accept the possibility that she will need to place her baby with a foster family until a permanent adoption is arranged.

he best answer is 1. The immediate issue facing the social worker is to address Carla's health and social service needs. If Carla is using drugs, it may provide a reason for other measures to compel Carla to accept treatment. However, until that issue is clarified, the social worker should try to obtain voluntary compliance. While at a later point it may be necessary to arrange placement, that issue is secondary to a healthy pregnancy.