Practice Questions

A local developer plans to tear down a series of shops that have been an important part of a local community. Community members are angry and feel that their voices are not being heard. Which of the following actions would be the MOST appropriate step for the community to take?

A. Protest outside of the construction site.

B. Alert local legislators that the community does not agree with the construction.

C. Hold a community meeting and invite the developer to discuss concerns with the project.

D. Collect donations from community members to obtain legal counsel to oppose the project.

C. When facing resistance from a stakeholder it is important that you try and work with the “oppressors”. Inviting the developer to the meeting will allow the community to directly share their concerns.

The owner of a condo building has been contacted by his tenants due to electricity and utilities being cut off. The tenants are upset because the condo manager has not answered any calls, texts or emails. One of the tenants contacts their local community agency who assigns them a case manager. The case manager becomes the “middle man” between the building manager and the tenants and tries to resolve the disagreement. What is the role of the case manager in this case?

A. Enabler.

B. Advocate.

C. Mediator.

D. Broker.

C. The mediator is the role of the person trying to mediate conflict between two parties. The mediator may be referred to as the “middle man” and should stay neutral in the discussions.

Which of the following is the MOST important benefit of community participation in social work practice?

A. It puts the decision-making power partly or fully with the community members.

B. It shows politicians that individuals want to get involved and need change in their communities. C. It informs community members about the work that needs to be done to make a change.

D. It helps manage workload to be divided up amongst community members.

A. The most important benefit of involving community members is giving them the voice and power to become involved in issues that are most important to them.

Members of a local apartment building are concerned about rising crime rates, drug problems, and racial profiling in their neighborhood. A social worker has been assigned by a community agency to work with this group. In order to best meet the needs of this community the social worker should FIRST:

A. Tell community members about strategies that have worked well in other apartment complexes.

B. Work with the citizens to prioritize their concerns.

C. Contact local legislators to make them aware of the problems.

D. Identify an individual who would like to lead the effort to mobilize neighbors.

B. The first step in working with a community is to work alongside community members. The other steps can be done later in the community organizing process.

A social service agency hires a social worker to evaluate the effectiveness of a program the agency implemented 6 months ago. The program works with adolescents age 12-17 who are at risk of becoming involved in the juvenile justice system. What should the social worker do FIRST in evaluating the effectiveness of this program?

A. Set goals and objectives for treatment.

B. Determine who the target population is.

C. Share outcome results and recommendations.

D. Identify what measures were used to determine progress towards goals.

D. First you need to identify what measures were used to determine program goals. A and B have already been done prior to the evaluation. C would be done after measures are determined.

A social worker begins working with a community that has experienced high levels of crime. She has identified several problems in the community through conversations and meetings with community leaders. One of the leaders is putting pressure on the group to start “making things better” so the neighborhood can be safer. What should the social worker do NEXT? A. Mobilize citizens who are concerned to vote on a strategic plan.

B. Set goals with community leaders around reducing crime.

C. Put together an action plan that works to reduce crime.

D. Ask local police officers to set up a neighborhood watch.

B. This is the third step in the community organizing process. The social worker has already integrated into the community and identified the problem. The next step is to set goals.

Which of the following statements is TRUE about the relationship between the ethical and legal actions of social workers?

A. All legal behaviors are ethical.

B. All illegal behaviors are unethical. C. Some behaviors are legal but unethical.

D. A behavior that is illegal can never be ethical.

C. Some behaviors are legal but unethical. Most unethical behaviors are legal. This includes taking gifts from clients, breaking confidentiality, and engaging in dual relationships. While these are unethical you most likely are not breaking the law when engaging in this act.

A social worker in private practice designs a standard intake form for clients to complete. The form asks for demographic information including age, gender, marital status, sexual orientation, education, and criminal history, and drug and alcohol use. This form is: A. Ethical because this is information that the therapist will need to use.

B. Ethical since all of this information will be kept confidential.

C. Unethical since this information may not be needed for treatment.

D. Unethical unless the social worker makes it clear that the client has the choice as to whether to complete it.

C. This intake form is unethical. We cannot ask for information that is not needed for treatment purposes. Asking criminal history, drug and alcohol use and sexual orientation may not be needed for treatment.

You are working in a child welfare agency. One of your clients states that she has started a GoFundMe page to help raise money for her family to furnish their house. She asks you to share the page with friends and family in hopes to raise more money. The social worker shares the link on Facebook and writes “Please support my client in raising money for the family during this time of need.” The actions of this social worker are?

A. Ethical as the social worker is working to help the client obtain resources.

B. Unethical because this poses a conflict of interest when the social worker brings family and friends into the situation.

C. Unethical because the therapist is violating confidentiality by posting on social media.

D. Ethical because the client asked you to do this on her behalf.

C. A social worker should not post identifying information about a client on social media. This is unethical and breaks confidentiality.

A clinical social worker has been reported by a client to the licensing board for unethical conduct. The colleagues know this charge is not true and want to support the colleague. What should the colleagues do?

A. The colleagues should let the board investigate independently.

B. The colleagues should discuss the matter with the client.

C. The colleagues should defend the professional by providing information to the board.

D. Tell the colleagues clients she needs to take a leave of absence.

C. It is in the Code of Ethics that social workers have an obligation to their coworkers. In this case, the social workers should notify the board about the information they have in support of the coworker

You are volunteering to work on a crisis hotline. You receive an anonymous call and the caller discloses his wife has made threatening comments and he is worried she may have a plan to commit suicide. As you are taking down the information you realize that this man’s wife is your client. Ethically speaking, what is the best course of action?

A. Hang up. Taking the call would be a conflict of interest.

B. Suggest ways the caller can help protect the safety of his wife.

C. Tell the caller you are his wife's therapist and ask to speak to the wife directly.

D. Continue the call and collect information about the wife so you can bring it up in your next therapy session.

B. Answers C, and D would violate the ethical principle of confidentiality. Answer A is not appropriate as we would never hang up on a client in crisis. B is the most appropriate answer

Lisa has knowledge that a colleague is teaching parenting skills during a group for parents at her agency. This is not a field of expertise, and the colleague’s instruction is based on personal parenting experiences. She has not been trained to conduct this group. Lisa has tried to discuss this issue with the fellow clinical social worker but has not been successful. What ethical standard is the colleague violating?

A. Respect.

B. Competence.

C. Authority.

D. Professionalism.

B. The social worker is performing a therapy that she does not have proper training in. The value of competence is being compromised because the colleague is not competent in this area of practice.

A social work supervisor completes an observation of a supervisee. The supervisor is alarmed at many of the techniques used in the session. The supervisee has made judgemental, offensive, and inappropriate comments to the client. The supervisor decides that it is necessary to terminate this employee, to protect the needs and safety of the client. The actions of the supervisor are:

A. Unethical because performance reviews and supportive feedback should be provided. Social work supervisees should be given the chance to work on agreed-upon areas.

B. Unethical because a social work supervisee cannot be terminated without the approval of an Agency Director or Human Resources.

C. Ethical because the supervisor was working in the best interests of the client. Client safety is the most important factor considered.

D. Ethical because the supervisor acted in a way that was fair to both the needs of the client and the supervisee.

A. As stated in the Code of Ethics, supervisors must provide evaluations that are fair to the supervisee. Terminating this employee without giving them the opportunity to improve their actions through ongoing feedback and support is unethical.

Which of the following would be unethical for a supervisor to do in a relationship with a supervisee?

A. Ask the supervisee to pay for supervision services.

B. Provide support when the client is overwhelmed or experiencing burnout.

C. Examine case notes from a supervisee’s sessions.

D. Assuming “best intent” when signing off on a supervisee’s hours.

D. Answer choices A, B, and C are all ethical actions that can be taken by a supervisor. We need to verify that a student has completed the hours they say they have performed. The supervisor could face disciplinary action from the board if it is found out the student falsified supervision hour information. Ask the supervisee to keep a log of their hours and also keep a log of supervision sessions conducted for your own records.

A social work supervisor is made aware that one of his supervisees is considering becoming romantically engaged with a client. The supervisee suggests that this is a relationship they want to pursue. They state that they no longer think serving this client is ethical. What is the FIRST action the supervisor should take?

A. Alert the supervisee that this is an action that is reportable to the licensing board.

B. Work to get the client transferred to another therapist.

C. Discuss the ethical violations that are present in becoming involved with a client.

D. Tell the supervisee that the decision to engage with the client is not a good one.

C. This is a FIRST question that requires determining what the starting point is when addressing the situation. It is unethical for the supervisee to provide services to a client and engage in a romantic relationship with them. However, as the supervisor, the first step to take is to discuss the ethical violations with the supervisee so the best course of action can be taken.

A mother of three small children has sought help with parenting skills. The clinical social worker will gather family history, using this to help set goals for the client. It is important not to set these too high or beyond reach. The mother is educated on a positive view of human nature with the focus on controlling one's own fate instead of becoming a victim to it. This intervention is part of what kind of therapy?

A. Life skills training

B. Cognitive-behavioral therapy

C. Interactive peer modeling

D. Empowerment

D. An empowerment model places emphasis on the client controlling the outcomes of their life. It also includes goal setting and meeting the client where they are at.

The Jacobs family has decided to incorporate the services of a clinical social worker due to intense conflict between parents and children. During the first session, the Jacobs take turns discussing their issues while the social worker listens intently. There is no focus on what is wrong, but rather on the complex interplay of risks and strengths. This type of assessment is known as what?

A. Strength-based assessment

B. Family-centered assessment

C. Conflict resolution assessment

D. All of the above

A. A strengths-based assessment is used to determine where the strengths or assets of a client lie. The focus should be placed on strong areas rather than problems of weaknesses.

You have a client that comes in for an intake and discusses in great detail her past history. She was neglected as an infant and was in and out of several foster homes. The client states that she does not feel she has many close friends and cannot form intimate relationships. The social worker explores her past more deeply, specifically the relationship of her caregivers at birth. What therapy model is the client using?

A. Attachment Theory

B. Cognitive Behavior Theory

C. Psychodynamic Theory

D. Strengths-Based Approach

A. Attachment theory looks at the bond or connection between a child and their caregiver early on in life and how these early interactions affect relationships later on in life.

What is the main difference between Cognitive Behavior Theory and Dialectical Behavior Therapy?

A. CBT is used to treat anxiety and DBT is used to treat depression.

B. DBT is based on CBT, with a greater focus on emotional and social aspects including accepting pain, managing emotions, and accepting that experiences are real.

C. CBT focuses more on inner thoughts and DBT focuses more on outward behaviors.

D. They are the same therapy and can be used interchangeably

B. This is a recall question. DBT and CBT share many similarities but DBT has a greater focus on emotional and social aspects including accepting pain, managing emotions, and accepting that experiences are real. DBT may be used for clients experiencing extreme emotional shifts.

A short-term, problem-solving approach is used with your client who is trying to find a job. The initial phase is centered on setting up initial tasks. The middle phase consists of evaluating the outcomes of tasks and identifying obstacles to achieve said outcomes. Lastly, comes the termination phase which emphasizes what the client has learned or accomplished. Which of the following problem-solving approaches is described above?

A. Psychoanalytic approach

B. Cognitive-behavioral approach

C. Solution-focused therapy

D. Self-centered approach

C. Solution-focused therapy is brief and is focused on helping the client use problem solving to get to a desired solution or outcome.

You are seeing a client with anxiety. The client is discussing that she ran into a friend on the street and the friend did not acknowledge her or say hello back. The client states “I must have done something wrong” and looks visibly distressed. You label this as an automatic thought and help the client reframe their thinking. What type of therapy model are you using?

A. Cognitive Behavior Therapy

B. Psychodynamic Therapy

C. Problem Solving Therapy

D. Dialectical Behavior Therapy

A. In CBT automatic and negative thoughts are addressed and techniques are introduced to help the client reframe and address negative or unhealthy thought patterns

A client comes in and expresses she has guilt and remorse for giving her child up for adoption when she was 15 years old. The client expresses that this remorse has been eating away at her for years. The social worker gets out of a chair and has the client express her thoughts as if her birth daughter is in the room. What type of therapy model is being used?

A. Gestalt Therapy

B. Client-Centered Therapy

C. Cognitive Behavior Therapy

D. Person in environment model

A. In Gestalt Therapy, the client is encouraged to engage in role-playing and be present in the “here and now”. The empty chair technique is often used in this therapy

A school social worker meets with the parents of a 13-year-old boy who has an IQ of 70. The social worker works directly with the son in his special education classroom. The parents report that their son has been smoking marijuana given to him by the brother of a classmate who is 19. What should the social worker do FIRST?
A. Suggest that the parents provide closer supervision of their son.
B. Explain to the parents that a report must be made to CPS.
C. Encourage the parents to confront the neighbor.
D. Recommend that the parents speak with the principal and report the incident.

B. Safety FIRST. An adult is giving a minor marijuana and you have enough information to report.

A social worker supervisor at CPS becomes aware that agency crisis workers are not offering in-home assessments as outlined in the agency policy. The supervisor should FIRST:
A. Ask the clients how they feel about the agency policy.
B. Assess the staff members’ perspectives on the agency’s policy.
C. Report the findings to the Executive Director.
D. Adjust the policy to better match the actual practices being carried out by the
employees

B. In order to collect more information about why agency policy is not being followed the supervisor should FIRST assess the perspectives of the staff members regarding this policy. Changes cannot be made to a policy without first understanding the employee's perspectives or feedback about the policy

A director of a Non-Profit has problems retaining staff. Staff are suffering from severe burn-out and attendance is at an all-time low. Many staff quit after being at the agency for a short time. What should the director do to BEST meet the needs of the employees?
A. Give bonuses to staff who have been at the agency the longest.
B. Change the sick leave policy to allow more time off for employees.
C. Hire more employees to replace the workers who have left.
D. Change the overall policies prescribed by the agency regarding benefits, employee recognition, and wages.

D. Staff turnover and retention may indicate that there are structural problems and poor morale at an agency. To best address, these areas the director should try to enact change that will do the greatest amount of good for the entirety of the organization. This may include analyzing employee recognition, wages, and benefits to promote positive change.

An Executive Director at a community-based agency observes that staff
members seem to have problems working with clients from diverse cultural backgrounds. This includes a low retention rate and poor satisfaction surveys from clients. The director interviews several staff who mention they feel that they are unprepared to work with these clients. The director determines that something needs to be done so that the clients can be better served. What would be the BEST course of action for the director to take?
A. Hold performance review meetings for the staff members who are having trouble with cultural competency.
B. Ask supervisors to provide training to new hires.
C. Revise current onboarding and training protocols and educate all staff in culturally competent practices.
D. Revise interviewing questions to ensure staff are only hired if they can demonstrate cultural competence.

C. Since the problem is structural, in order to ensure training is reached by the maximum number of people, all staff should be trained in culturally competent practices.

You have been working with a client for 6 weeks. The client has recently lost his job and has problems in his marriage. The client struggles with opioid addiction. The client wants to quit opioids completely and get his life back on track. You talk to him about several detox program with follow up rehab options. The client says he wants to quit cold turkey and is not open to structured rehab. What should you do NEXT to ensure his success in achieving sobriety?
A. Refer the client to a 12 step Narcotics Anonymous program
B. Educate the client on the cycle of addiction and brainstorm ways to minimize opioid use
C. Encourage the client to speak with a physician prior to quitting opioids
D. Identify triggers for use and discuss a plan to taper the opioid use safely

C.
The safety of the client needs to be considered first. Due to the potential dangerous nature of opioid withdrawal, the client should speak with their physician FIRST. Social workers should never give medical advice or encourage clients to taper opioid use without supervision of a medical professional

A social worker recognizes that their office has scheduled an intake appointment for a person that they had an intimate relationship with 15 years ago. What should the social worker do?
A. Since the time passed is more than 10 years, the clinician can proceed in working with the client
B. The social worker can treat the client but must make note in the file that there was a previous relationship
C. The constitutes a conflict of interest and the social worker should discuss with the client if they feel comfortable starting a therapeutic relationship
D. The social worker should inform the office that the client should be assigned to work with a different social worker due to conflict of interest

D.
This question requires knowledge of the NASW Code of Ethics. A social worker should not begin a therapeutic relationship with anyone they had prior intimate of sexual relationships with. According to NASW Code of Ethics - Section 1.09 (c) Social Workers should not engage in sexual activities or sexual contact with former clients because of the potential for harm to client

You are a social worker at an urban high school. You have been tasked to design a program that will focus on decreasing truancy for English Language Learners. The truancy rate amongst English Language Learners is 15%, the highest of any population. You have talked with students, parents, staff and the administrator regarding this problem. What would be the NEXT step the social worker would take in designing a program for this population?
A. Pilot truancy program that will focus on supporting and providing resources to English Language Learners.
B. Research program that have been effective in a similar demographic population
C. Partner with local community action agencies to provide referrals for additional support
D. Write a grant proposal to secure funding for a large-scale truancy prevention program

B
The requires knowledge of the steps included in program development. After identifying the problem and conduction a needs assessment by collecting information from stakeholders, the next step is to research programs that have been conducted with similar populations

You are working at a hospital on a Pediatric Intensive Care Unit. You are called in to speak with a family regarding the decision to consent for a medical procedure for their son. If the medical procedure is not performed, he will die or suffer irreversible brain damage. The family refuses any medical intervention due to religious beliefs. What should the social worker do?
A. Document the decision and respect the parent's right to refuse the procedure.
B. Consult with the hospital's legal counsel and report the incident to determine it next steps are needed to overrule the parent's decision under religious exemption laws.
C. Discuss with the family the option of hospice care to support the end of life needs of the child
D. The social worker should discuss further with the family about how their religious beliefs are interfering with the quality of life for their child.

B.
Many states have laws that protect the medical rights of children. Social workers are mandated reporters and have to protect vulnerable children from medical neglect. When professionals identify a child who faces danger of death or disability because of their parents' decisions, actions or inactions, they are obligated by professional standards and mandated by state law to report the situation to the proper authorities

A social worker is told by their supervisor to carry out a job function that the social worker does not agree with. The social worker feels the supervisor is asking them to act in an unethical manner. What would be the BEST response from the social worker?
A. Obtain feedback from colleagues to see if the social worker's assessment is valid
B. Speak to the supervisor about concerns
C. Meet with the agency director to make him or her aware of the disagreement
D. Respect the supervisor's position and comply the the directive

B
This requires knowledge of the Code of Ethics and the obligation social workers have to their colleagues. If a social worker has a problem with a colleague, the social worker should go directly to the colleague and share their concerns FIRST

A client begins seeing a social worker after being referred by a family member. The client reports that his family is concerned because he has not been actively engaged with is family and friends. The client reports that he often feel tired and has no energy to go to family events. The client says he is embarrassed to admit but these symptoms have been occurring for the last 5 years. When asking about additional symptoms the client states he has difficulty at work because his mind is "all over the place." What is the MOST likely diagnosis for this client?
A. Generalized Anxiety Disorder
B. Major Depressive Disorder
C. Persistent Depressive Disorder
D. Compounded Stress

C.
Persistent depressive disorder ( PDD) is a mild to moderate chronic depression that occurs on most days for a period of 2 years or more. The client expresses symptoms of depression including lack of energy, loss of interest in engaging with others and poor concentration. These symptoms have occurred for over 5 years signaling Persistent Depressive Disorder

A doctor is required to obtain written permission to perform an autopsy on a client that has passed away due to an unknown cause. The doctor asks the social worker to obtain the family's consent to proceed with the autopsy. The family refuses and becomes upset and angered by the request. What should the social worker do NEXT?
A. Help the family deal with their reactions to the loss
B. Ask if the family's cultural beliefs prohibit an autopsy
C. Acknowledge the family's right to make the decision
D. Explore further support the family will need to make a decision

C.
As stated in the Code of Ethics, clients have a right to self determination. The right to self determination and the autonomy of the decision should be respected. The family does not have to move forward with an autopsy and this should be acknowledged by the social worker

You are seeing a client who has been referred for clinical services by her Primary Care Physician. The referral states the client has had headaches, muscle weaknesses and disrupted sleep. The referral states the client is experiencing PTSD symptoms, but does not give any more details. During the intake session, it is MOST important for the clinician to focus on:
A. What the trauma was that prompted the PTSD diagnosis
B. The severity of the health symptoms and the need for medical intervention
C. Active listening and rapport building with the client
D. Structured questions to collect demographic information including the client's presenting problem

C.
This client has been referred for clinical services and has been given a PTSD diagnosis. When working with clients with traumatic pasts, it is important to know that rapport and trust is essential to healing. The clinician should focus on active listening and rapport building as a first step for engaging the client given the referral information

A 56 year old man seeking therapy after being terminated from the job he held for 30 years. He says that he has been traumatized since being fired and cannot properly function. He tells the social worker he is experiencing nightmares, feels nauseous and visualizes the termination in his head repeatedly. He states that he feels like a loser and does not think he will gain employment again due to his age. What should the social worker do FIRST when responding to her client?
A. refer to a doctor for medical evaluation
B. Acknowledge his feelings of loss and sadness
C. Assure the client that he cannot be discriminated against due to age
D. Ask the client how this event is affecting his overall functioning

B
This client is experiencing trauma from the loss of his employment he held for most of his life. While there are many symptoms the client is experiencing, it is important to first validate his emotions. This is important for building rapport and showing support for the client

What should a social worker do when they find out a dual relationship with a client may exist?
A. Dual relationships are unethical so the social worker must terminate services
B. Determine the risks of the dual relationships and work to protect the client's interests
C. Let the client know you will have to refer them to another social worker
D. Discuss with the client whether or not they would like to continue services with the therapist and respect self determination

B
The social work Code of Ethics states that if a dual relationship is exploitative, whether is begins before, during, or after a professional relationship, it should be avoided. This is why the social worker should determine what risks are present in the dual relationship and make a decision that is in the best interest of the client. Respecting the client's right to self determination may not be in the best interest of the client

An 82 year old client meets with you for a therapy appointment and reports that she is having trouble coming up with the money to pay for her sessions. When the social worker inquires about this, she reports that her grown son has been "investing" her money for the past 6 months, but she no longer has access to any of her bank accounts. She states her son says she no longer has any money to pay for care. What should the social worker do NEXT?
A. Inform the client that an elder abuse report must be filed
B. Inform the client that you will see them on a pro bono/reduced fee basis
C. Call 911 and report the financial abuse to the authorities.
D. Contact a financial advisor to discuss the situation further.

A.
This is an example of potential financial exploitation of an elderly client. Financial exploitation occurs when a person misuses or takes the assets of a vulnerable adult for his/her own personal benefit. While we do not have evidence to confirm financial exploitation is occurring, the behaviors of the son warrant a report to Adult Protective Services. Calling 911 would not be warranted as the client is not in immediate danger. Social workers cannot contact a financial advisor without consent from the client. Answer choice B may be discussed at a later point in time but not until the concerns regarding the son's management of money have been addressed.

You are working with an 18 year old college freshmen who has just learned she is HIV positive. The client is distraught over the news. She is tearful, overwhelmed and having difficulty expressing her emotions. She state she is mortified and does not want anyone to find out her status including her partner. What is the FIRST thing the social worker should do?
A. Provide psychoeducation on the symptoms of HIV and treatment option that are available
B. Explore more about why she doesn't want her family to know about her HIV status.
C. The client is in crisis. Empathetic listening techniques should be used to support the client
D. The safety of both the client and her partner must be addressed first due to the nature of the HIV diagnosis.

C
This client is presenting with symptoms of being in crisis as a result of the medical news she has be received. Social workers do NOT have a duty to warn when working with HIV clients as this information is protected under HIPAA. The social worker should provide support and empathy FIRST

A 15 year old client has been meeting with a social worker due to a diagnosis of major depression and social anxiety. The client is wheelchair bound and has been having difficulty managing the limitations of getting around her school. The teen suggests that her disability causes her to be an outcast and that her peers look at her and gossip about her in the hallways. What would be the MOST appropriate response from the social worker?
A. Educate the client on her rights under the Americans with Disabilities Act (ADA) so she can advocate for herself.
B. Assist the client in processing these emotions and help the client prioritize what issue she would like to focus on in treatment
C. Report the behavior to the principle as the student may be experiencing bullying
D. Provide the school staff with psychoeducation on the client's condition and how the school can provide appropriate accommodations

B
Although the client is a minor, it is important to meet them where they are at and respect their right to self-determination. Given that the client has identified a variety of different stressors and has been diagnosed with major depression and social anxiety, it is important to prioritize the issue(s) she would like to focus on in treatment

A social worker is working in a community mental health setting with a client who has previously met with several other social workers in the agency. After the second session, the client calls and leaves a message with the receptionist stating he wants to discontinue services. What should the social worker do?
A. Wait for the client to reconnect with services if requested.
B. Ask the client to schedule a session to discuss the decision.
C. Contact the client to explore referral options for continued treatment.
D. Discuss the issue with the clinical supervisor.

B
The social worker needs to collect more information on why the client wants to discontinue services. This would be best done by scheduling a meeting to discuss this decision. Answer A is not an appropriate response. C may be done at a later time but not until a meeting is set. Seeking supervision does not handle the client's problem and is not necessary at this time.

A nursing home social worker is assessing a client who is oriented and alert. The client has terminal cancer. The client declines a medical procedure that most likely will prolong his life. An adult child tries to persuade the social worker to change the client's mind about the decision. The social worker should:
A. Respect the client's right to make the decision regarding the procedure.
B. Explain to the client the treatment choice that has been made by the child.
C. Allow the client's family member to make an appropriate choice.
D. Allow the child to assist the father in making the decision unless it violates the Code of Ethics.

A
When working with adult clients we need to respect the right to self-determination. Even though the procedure could prolong the client's life we respect self-determination and let the client make the medical decision on their own accord. The opinion of the child is not relevant in this question.

A new social worker at a Head Start program has been assigned to work with an African American woman and her two young children. The social worker is a white female from a rural town who has never worked with an African American client. The social worker feels unsure of her abilities to connect and provide services to this client. In order to build cultural competence, the social worker should FIRST?
A. Explore her own self-identity and how her beliefs may affect the therapeutic relationship.
B. Obtain literature on best practices for working with diverse clients.
C. Identify cultural norms that may help her connect with the client.
D. Ask the social work supervisor to co-treat the family.

A
Cultural competence is the ability to comprehend, interact, and communicate with individuals regardless of their cultural background. Cultural competency starts with an awareness of one's own cultural views. The social worker needs to explore her self-identity to determine where areas of need may lie.

The classic features of depression include all of the following EXCEPT?
A. Significant weight loss or weight gain.
B. Fatigue or loss of energy reported on most days.
C. Longer periods of deep sleep with inability to regain energy when waking.
D. Loss of interest in activities that were previously pleasurable.

C
Longer periods of deep sleep with the inability to regain energy MAY be a symptom of depression. However, it is not a classic feature because some people may experience sleep disturbances that cause hypersomnia (excessive tiredness) OR insomnia (difficulty sleeping). The other answer choices are "classic" depression symptoms included in DSM 5 diagnostic criteria.

A 13-year-old male is referred to the social worker by a teacher. The student struggles with personal hygiene, getting to school on time, rarely turns in homework, and is constantly falling asleep. What should the social worker assess for FIRST?
A. Child abuse
B. Child neglect
C. Substance abuse
D. Level of motivation

B
Signs of child neglect may include: Consistently poor hygiene, poor sleep habits, lack of appropriate clothing for weather or season, frequently unsupervised, left alone or allowed to play in unsafe situations, and lack of needed medical or dental care. The stated signs indicate an assessment for neglect is needed.

A family who has just immigrated to the United States from Mexico comes to the hospital for medical care for their son. He repeatedly has stomach pains and headaches and they are worried something more serious may be going on. In the intake with the parents, the social worker determines that they have previously tried taking the son to a local spiritual healer but he still continues to get sick. What would be the BEST course of action for the social worker to take?
A. Report the family to CPS for medical neglect.
B. Explain to the family that it is not acceptable in the US to go to spiritual healers.
C. Acknowledge the family's concerns and explain to them what will happen next at their visit.
D. Refer the family to a support group for children with medical needs.

C
It is important to respect the client's cultural background. Acknowledging their concern and explaining what will happen next is the BEST response. There is no indication that medical neglect is occurring. Answer B is inappropriate and places personal assumptions on the client. Referring the client to a support group is not needed at this time.

Which of the following is the MOST important benefit of community participation in social work practice?
A. It puts the decision-making power partly or fully with the community members.
B. It shows politicians that individuals want to get involved and need change in their communities.
C. It informs community members about the work that needs to be done to create change.
D. It helps manage workload to be divided up amongst community members.

A
When community members are involved in the decisions of their community, they will be empowered to make lasting changes. When working in communities it is essential that social workers work WITH community members and respect their involvement in the decision-making process.

An adult client with little support from family and friends is being discharged from an inpatient rehabilitation program. Which of the following social work activities will BEST contribute to the client's successful reentry into the community?
A. Establishing permanent housing resources for the client.
B. Ensuring that discharge is the appropriate step for the client.
C. Collaborating with community agencies.
D. Helping the client obtain financial resources.

C
This question is asking for the best way to help the client re-enter into the community. Because the question states that the client does not have strong family ties and is being discharged from an inpatient rehabilitation program, it will be important to connect the client to community agencies to provide additional support.

You are volunteering to work on a crisis hotline. You receive an anonymous call and the caller discloses his wife has made threatening comments and he is worried she may have a plan to commit suicide. As you are taking down the information you realize that this man's wife is your client. Ethically speaking, what is the best course of action?
A. Hang up. Taking the call would be a conflict of interest.
B. Suggest ways the caller can help protect the safety of his wife.
C. Tell the caller you are his wife's therapist and ask to speak to the wife directly.
D. Continue the call and collect information about the wife so you can bring it up in your next therapy session.

B
Answers C and D would violate the ethical principle of confidentiality. Answer A is not appropriate as we would never hang up on a client in crisis. B is the most appropriate answer as it provides safety planning support for the client.

During an initial intake, a client reports that she is depressed and has suicidal thoughts. When the social worker inquires further, the client says, "Everything is fine; please don't worry." The social worker should FIRST
A. Tell the client that her decision not to harm herself is a good one. B. Explore with the client what is causing her depression.
C. Conduct a safety assessment.
D. Refer the client to a psychiatrist for a medication evaluation.

C. If a client makes remarks that suggest suicidality, we must conduct a safety assessment FIRST.

A social worker enters a home for a routine home visit. When he arrives, the father is drunk and shoves one of the children to the ground. What should the social worker do FIRST:
A. Intervene to try and de-escalate the father.
B. Make a CPS call to report abuse or neglect.
C. Take the children out of the home to ensure safety.
D. Call 911 for immediate assistance

D. If active abuse or violence is taking place, calling 911 is the first step to take. Intervening may cause more harm.

A social worker is facilitating a psychotherapy group for individuals who are in recovery from substance abuse. After the group, a client mentions that she has been having thoughts of using and is struggling to stay sober. In order to meet this client's needs, the social worker should:
A. Suggest the client leave the group to attend individual therapy.
B. Encourage the client to discuss her struggles with the group in the next session.
C. Contact the client's sponsor and report the behavior.
D. Call 911 to report the client.

B. In a group setting, participants should be encouraged to bring up any feelings or issues directly to the group. This helps with the support aspect as others may also be feeling the same way.

A client abruptly stops coming to therapy without notifying the social worker. Several weeks later, she appears announced at the office demanding a copy of her records. The social worker does not believe that the information in the record could cause harm to the client but denies access because the client did not provide any reason for the abrupt termination and did not notify the practice that she would not continue with treatment. The actions of the social worker are:
A. Unethical because the client should have access to his or her record under these circumstances.
B. Ethical because the reason for the release must be disclosed to the social worker.
C. Ethical because the client terminated without notice.
D. Unethical because the client is always able to access his or her record under any circumstances.

A. If a client requests access to his/ her records and the clinician does not feel releasing the information would cause harm, the records must be released.

A patient who is described as "oriented times four" (or "oriented x4") is able to demonstrate awareness of which of the following four features:
A. Name, date, city, and season.
B. Age, current year, location, and situation.
C. Name, gender, ethnicity, and marital status.
D. Person, place, time, and situation.

D. Person, place, time, and situation are general questions asked to determine if the client is oriented (Oriented Times 4). This is often done in a mini-mental status exam.

What primary condition is treated by monoamine oxidase inhibitors (MAOIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs)?
A. Attention deficit disorders.
B. Eating disorders.
C. Sleep disorders.
D. Depressive disorders.

D. MAOIs, SSRIs, and SNRIs are the major medications used to treat depression.

A 10-year-old child would like to start earning an allowance for completing chores around the house. During several attempts to do these chores, she is scolded and told she is doing them wrong. According to Erikson's stages, she may experience doubts in her abilities due to a crisis in which of the following stages?
A. Industry versus inferiority.
B. Initiative versus guilt.
C. Autonomy versus shame/doubt.
D. Generativity versus stagnation.

A. In the industry vs. inferiority phases, children want to feel competent and take on more responsibility. When they successfully take on these responsibilities they will continue to engage but if they do not gain or feel competent their self-esteem will be hurt and they will not engage in new responsibilities

. A 13-year-old boy is able to stay home alone because he is aware of dangers, can cook for himself, and problem-solves when needed. This child has reached which stage of cognitive development according to Piaget?
A. Sensorimotor.
B. Formal operations.
C. Concrete operations.
D. Preoperational.

B. In the formal operations phase, adolescents can think abstractly, make logical decisions and care for their needs.

3. Jenny continues to have problems in her relationships. In her adult life, she has not been able to hold a relationship for more than 3 months. She is in what stage of development?
A. Trust vs. mistrust.
B. Industry vs. Inferiority.
C. Generativity vs. Stagnation.
D. Intimacy vs. Isolation.

D. Jenny is in the intimacy vs isolation stage because she continues to have difficulty forming and keeping intimate connections.

A 4-year-old child and her sister are playing "doctor" with their stuffed animals. The sister states that one of the animals has gotten sick and needs to go to the hospital. The 4-year-old begins to get very upset and flees to the mother crying She states " my bear is sick and won't get better." What is the name of this concept and which cognitive stage is it associated with?
A. Animism; Pre-operational.
B. Magical thinking; Pre-operational.
C. Object Permanence; Concrete- operational.
D. Egocentrism; Concrete- operational.

A. Animism is part of Piaget's theory of cognitive development. Animism Is the belief that inanimate objects (such as toys and teddy bears) have human feelings and intentions

A fight breaks out at school. There is a big crowd of students watching the fight. The principal comes in and breaks up the fight and must decide what to do next. The school rules have a zero-tolerance policy and require students to be suspended if they engage in physical altercations. Ultimately, the principal follows the school rules and suspends the students. What stage of Kohlberg's Moral Theory of Development does this represent?
A. Stage 1: Obedience (Pre-Conventional).
B. Stage 2: Reward (Pre-Conventional).
C. Stage 3: Interpersonal (Conventional).
D. Stage 4: Authority (Conventional)

D. In Stage 4 of Kohlberg's Theory of Moral Development, the person is focused on keeping order by following rules, laws, and procedures that are in place.

According to Freud, which of the following is an example of how a person would behave if their id went unchecked?
A. They see a cake and want to eat it so they go ahead and eat the entire cake.
B. They see a cake and want to eat it but wait a few hours to have a piece.
C. They see a cake and want to eat it so they walk away and do not have a piece.
D. They see a cake and want to eat it but offer it to a friend instead.

A. According to Freud's psychoanalytic theory, the id is the primitive and instinctual part of the mind that contains sexual and aggressive drives and hidden memories. The id works on the pleasure principle and acts on impulses and desires

Jane, a preschooler, insists on dressing herself each morning for school, even though she generally selects mismatching outfits, misses buttons, and wears her shoes on the wrong feet. When her mother tries to dress Jane or fix her outfit, Jane brushes her mother off and insists on doing it herself. What stage of psychosocial development best describes Jane's behavior?
A. Trust vs. Mistrust.
B. Autonomy vs. Shame and Doubt.
C. Industry vs. Inferiority.
D. Identity vs. Role Confusion.

B. Jane is in the autonomy vs. stage and doubt phase. She is showing the need to be independent and make her own decisions by insisting to dress without help from the mother.

A 38-year-old woman quits her high-paying marketing job to focus on her children and become a school counselor. What stage would Erikson consider this to be:
A. Integrity vs. Despair.
B. Autonomy vs. Shame and Doubt.
C. Generativity vs. Stagnation.
D. Identity vs. Role Confusion.

C. In the generativity vs. stagnation phase, people are looking for ways to make a difference in the world by caring for others as well as creating and accomplishing things that make the world a better place. She quits her high-paying job to focus on her children and become a counselor which shows she is trying to have a deeper purpose in her life and the lives of others.

An 11 year old child becomes very involved in clubs at her school. The child's mother becomes very concerned because the girl is not wanting to spend as much time with the mother and chooses activities with friends over family activities. According to Freud, what is the most likely stage the child is in?
A. Industry vs. inferiority stage
B. Latency stage
C. Self actualization stage
D. Early onset puberty

B. Latency stage

A social worker is collecting information for family therapy. The family consists of a mother, father and two children ages 14 and 8. The parents report they want the family to spend "quality time" together, but whenever they try, everyone ends up fighting. The 14 year daughter looks visibly annoyed and states her parents treat her like a baby. The 8-year-old says he wants to play with kids in the neighborhood and go to his friends' houses but his parents say family time at home is more important. The social worker should focus treatment on:
A. Helping the family establish appropriate roles and boundaries.
B. Developmental levels and communication strategies for each child. C. Facilitating activity-based family interactions to build on the strengths the family presents with.
D. Connecting the family in meaningful ways through role play

A. Helping the family establish appropriate roles and boundaries.

A social worker is working on a crisis hotline. She receives a phone call from a parent of a 14-year-old female. The parent reports that she doesn't know what to do because her daughter has locked herself in her room and refuses to come out. The mother mentions that the client has previously attempted suicide by swallowing a bottle of pills and struggles with anxiety and depression, for which she sees a therapist. What should the social worker do NEXT?
A. Create a safety plan with the mother.
B. Instruct the mother to call 911.
C. Ask the mother to call the daughter's therapist to discuss the situation.
D. Instruct the mother to find a way to get into the daughter's room.

B. This is a question where an assessment of safety is needed. Due to the severity of the situation, calling 911 to assist the mother is the BEST option.

A same-sex couple meets for an intake with an adoption social worker. They state that it has been their life goal to have a child but have been met with discrimination through the process. The couple states they are ready to move forward with adoption but don't know where to start. What should the social worker do FIRST?
A. Help the clients explore legal ways to fight the discriminatory practices against them.
B. Suggest the clients explore foster care as an option as they may have more luck adopting as a same-sex couple.
C. Educate the clients on same-sex adoption and the barriers they may face.
D. Understand the needs of the client so that the correct information regarding same-sex adoption and agency policy can be shared with the couple.

D. This is a FIRST question. The social worker must know the policies regarding same-sex adoption before giving any information to the couple. Same-sex adoption laws can vary from state to state.

. A social worker is working at a group home for adults with developmental disabilities. In a weekly individual session, a client states that they don't like going to group anymore. When the social worker inquires further the client states that at night one of the residents comes into her room and touches her inappropriately. What is the MOST appropriate action for the social worker to take?
A. Call 911.
B. Conduct a mediation between the client and the resident.
C. Call the client's parents and report the situation.
D. Document the statement and immediately contact the agency supervisor to discuss the next steps.

D. In order to address this situation, the social worker must document the disclosure and contact the agency supervisor so that steps to protect the resident can be taken. This does not require calling 911 as it is not an immediate safety danger.

A social worker is working at a nonprofit organization. The agency is working to examine its 5-year strategic plan. What would be the FIRST step the agency would take in this process?
A. Work with the Board of Directors to examine the budget models for the next 5 years.
B. Evaluate staff satisfaction including promotion and retention rates. C. Conduct a SWOT analysis to determine areas of growth.
D. Reevaluate the agency's mission statement to ensure the strategic plan aligns with the agency's mission.

D. When looking at strategic plans, the long-term goals of the agency need to be considered. In order to best do this, the mission statement needs to be examined and reevaluated.

. A social worker in a home-based community agency is working with an 83-year-old client who lives alone. During a monthly home visit, the social worker notices the client has lost a significant amount of weight. When looking in the refrigerator the client has no fresh food and the food is expired. The trash can is overflowing and has a strong odor. The client reports he doesn't remember the last time he went to the grocery store and that no one in his family cares about him. What should the worker do NEXT?
A. Make a report to Adult Protective Services.
B. Ask the client why he feels as if no one cares about him.
C. Offer to take the man to the grocery store to get food.
D. Refer the client to Meals on Wheels.

A. This is a safety assessment question. There is overwhelming evidence that the client may have difficulties caring for himself. A report to adult protective services is warranted.

You are a school social worker at an urban elementary school. You are contacted by teachers because a 10-year-old, fourth-grade male, is having difficulty in classes. The teachers report that the student is failing to turn in homework and has become disengaged in class. The teachers have spoken with the parents who also report they are concerned because the student struggles at home with written assignments and refuses to engage in work. When the social worker speaks to the student he states " I hate school, it is just so hard." What would be the MOST appropriate step for the social worker to take? A. Connect the student with a peer mentor to help with his work.
B. Refer the student to the school psychologist for further assessment.
C. Discuss with the parents the option of retaining the student to recoup academic skills.
D. Speak with the principal about the next steps for the student.

B. Social workers cannot conduct psychological testing in school settings. The evidence in the question suggests that the student may be having learning difficulties that require an assessment from the school psychologist.

A family who has just immigrated to the United States from Mexico comes to the hospital for medical care for their son. He repeatedly has stomach pains and headaches and they are worried something more serious may be going on. In the intake with the parents, the social worker determines that they have previously tried taking the son to a local spiritual healer but he still continues to get sick. What would be the BEST course of action for the social worker to take?
A. Report the family to CPS for medical neglect.
B. Explain to the family that it is not acceptable in the US to go to spiritual healers.
C. Acknowledge the family's concerns and explain to them what will happen next at their visit.
D. Refer the family to a support group for children with medical needs

C. This question suggests that the family is worried about their son's medical problems. There is no sign that the child is in danger. To best meet the client where they are at, the social worker must acknowledge their concerns and explain to them what they can expect in the hospital setting.

You are completing an intake with a parent who has been referred to your agency by their child's school. During the initial session, the client states she has no social support network, and has been physically abused by the spouse in the past. The mom states she is overwhelmed and does not know what to do. The social worker should FIRST help the mother to: A. Help her work with the child's school to get services for the child.
B. Develop a safety plan so she can ensure safety if abuse occurs in the future.
C. Refer the mother to a support group for domestic violence.
D. Encourage the mother to report.

B. This is a FIRST question. In order to best assist the mother, a safety plan should be developed due to her stating that abuse has occurred in the past and that she has no social support. The other steps may be conducted at a later time.

A social worker in a community mental health agency has been working with a 17-year-old client for 2 years. The client has been recently diagnosed with schizophrenia and often has auditory hallucinations. The client states that her father watches her take showers and it makes her feel uncomfortable. After speaking to the client about the details of the incident, what should the social worker do NEXT?
A. Encourage the client to express her discomfort to her father.
B. Contact the client's doctor to review current medications.
C. Call the father with the client and confront him about his behavior.
D. Explain to the client that you have to make a CPS call and encourage her to make the call with you.

D. A call to CPS is warranted. Due to the child's age (17), she may want to make the call with you which may be empowering for the client. However, she can make the choice whether to be included in the call or not.

You are working in an outpatient setting with a client who has been seeing you for anxiety and depression. The client had previously been hospitalized due to suicidal ideations several months prior. During the session the client states that he is feeling "great" and feels he no longer needs therapy. He states he also needs to leave the session early because he needs to stop by his friend's house because he is giving him his dog as a present. What should the social worker do NEXT?
A. Ask the client if he has any thoughts of hurting himself or a plan to self-harm.
B. Respect the right to self-determination and let the client terminate services.
C. Process the feelings around termination with the client.
D. Initiate an involuntary hospitalization for the client as his behavior is unsafe.

A. This client is presenting with more energy after being previously hospitalized due to suicidal ideations. Increased energy and giving away of belongings may be an indicator that the client has a plan for suicide. The social worker should clarify with the client and ask if he has thoughts of hurting himself.

Which of the following is NOT an example of elder self-neglect?
A. A client states they have no one who cares if they are alive or dead and has stopped going to events at the senior home
B. A client continuously misses medical appointments with her doctor
C. A client reports that he has run out of money after spending it all on online shopping
D. A client reports that their caretaker is mean to them and yells at them constantly

D. This is not an example of elder self-neglect. This is an example of elder abuse. Self-neglect is when an elderly person cannot take care of their basic needs.

A CPS social worker receives a report of alleged child abuse from a teacher. When entering the information into the system, the social worker sees that this family has had an open CPS case in the past. The social worker interviews the child's parents, who are both age 17. The child is interviewed at school and mentions that the parents leave him alone all night and he gets scared. Which factor should carry the MOST weight in the social worker's assessment of abuse?
A. The parent's marital status
B. The age of the child
C. The history of previously reported abuse
D. The underage status of the child's parents

C. This question requires knowledge of the cycle of abuse. The history of previously reported abuse carries the most weight as it may be likely to happen again.

You are working with a client in private practice. The client is 14 years old and has been seeing you to work on interpersonal relationships and emotional regulation. When discussing problems with a peer at school the client states, " I hate that kid, I am going to kill him." When the therapist inquires further, the client states he doesn't actually intend to harm the classmate. What should the social worker do NEXT?
A. Tell the client you will have to warn the classmate about his threat
B. Document the interaction and monitor for further substantiated threats
C. Encourage the parents to take the client to the psychiatric ER for admission
D. Tell the client that you must tell his parents about the threat

B. There is a statement of harm to others, however, the client states he does not intend to harm the classmate. The social worker should document the interaction and monitor for patterns of substantiated threats in the future.

A man has been having difficulties at work. When the wife inquires further about these problems he gets upset and accuses her of having issues at work. The husband is MOST likely using the defense mechanism of:
A. Reaction formation.
B. Projection.
C. Conversion.
D. Displacement.

B. Projection is a defense mechanism that involves taking our own unacceptable qualities or feelings and ascribing them to other people. The husband who is having issues at work projects his feelings onto the wife by accusing her of having work issues

Jessica was an aggressive child in elementary school who frequently got into trouble. In high school, she joined the track team and no longer displays aggression or gets into trouble at school. Jessica is MOST likely using the defense mechanism of:
A. Reaction formation.
B. Sublimation.
C. Intellectualization.
D. Displacement.

B. Sublimation is a defense mechanism where a person channels unacceptable feelings, desires, and impulses into more positive, socially approved activities.

Eric is very dependent on his mom. She does many things for him including washing, and ironing his clothes, and making him dinner. When asked about this by a friend, Eric becomes defensive and says his friend is a "momma's boy". Eric is MOST likely using the defense mechanism of:
A. Projection.
B. Denial.
C. Intellectualization.
D. Displacement

A. Projection is a defense mechanism that involves taking our own unacceptable qualities or feelings and ascribing them to other people. Eric calls his friend a "momma's boy" although he is the one whose mother is washing and ironing his clothes and cleaning for him. He is projecting this image onto his friend.

What is an example of regression?
A. Someone who has experienced trauma begins to act out towards his family through aggression.
B. Someone who has been physically assaulted is not able to recount the attack in her therapy session.
C. Someone who did not get the job they wanted begins crying and pouting and cannot be consoled.
D. Someone who was embezzling money claims he was set up and denies having been involved.

C. Regression is a defense mechanism in which a person handles a perceived threat by reverting to an immature behavior or earlier stage of development, generally a time when they felt safe and secure. In this case, crying and pouting over not getting a job is a regression back to a younger developmental stage.

A CEO of a major corporation was bullied as a child. He was frequently manipulated and made fun of by his peers. In the workplace, he laughs at his employees in meetings and pressures them into completing tasks for him. This is an example of what?
A. Displacement.
B. Identification with Aggressor.
C. Reaction Formation.
D. Introjection.

B. Identification with the aggressor is a defense mechanism where a person takes on or adopts the characteristics, traits, or behaviors of someone who has been aggressive or hostile towards them. This defense mechanism helps the victim protect themselves from the threats faced by the aggressor

Anna's husband dies, and she continues to set a place for him at the dinner table. This is an example of:
A. Dissociation.
B. Denial.
C. Repression.
D. Redirection.

B. Denial is a defense mechanism where a person blocks external events or circumstances from your mind so that you don't have to deal with the emotional impact. In denial, there is no acknowledgment that an event occurred. In this case, the wife leaves a plate for her husband, indicating that she has not accepted or acknowledged his death.

A social worker meets with a couple who reports that things have been very
tense in the home. They are often yelling at one another and are not able to
communicate in a healthy manner. During the assessment, the wife reports that
she has been on Oxycontin since she broke her hip last winter. When the social
worker asks follow-up questions, the wife admits that she is still taking the
medication but is using it at twice the recommended dose. She claims that when
she returns to the prescribed dose she feels anxious and physically ill. What
should the social worker do FIRST?
A. Explore how the wife’s medication use is affecting the couple’s relationship
B. Tell the husband to monitor his wife's Oxycontin intake
C. Complete a comprehensive assessment of the couple’s communication
D. Refer the wife for a substance abuse assessment

D. This question suggests that the wife is abusing prescribed substances. The FIRST step when someone is actively abusing drugs or alcohol is to refer them to a substance abuse program.

A client comes in stating that he has been using a substance. When the social
worker inquires further the client states that he has been awake for 30 hours after
partying at a music festival. The client also states he was having the time of his
life and feels euphoric. What substance is the client most likely using?
A. Alcohol
B. Heroin
C. Cocaine
D. Hallucinogens

C. Side effects of cocaine include euphoria, feeling larger than life and lack of sleep.

Substance Dependence is defined by having which of the following two
symptoms:
A.  Physical and mental symptoms
B.  Tolerance and Withdrawal
C.  Sobriety and Relapse
D. Medical diagnosis of addiction and abuse

B. Both symptoms of tolerance and withdrawal need to be present to be diagnosed with substance dependence.

A client has just finished up a big project at work that she has been working on
for the past six months. In order to “decompress” she spends the weekend
drinking and staying out all night on Friday and Saturday. Come Sunday, she is
physically ill, with symptoms that include vomiting and headache. She still feels
tired on Monday but is able to get through the workday with caffeine. What is the
following scenario an example of?
A. Substance Abuse Withdrawal
B.  Relapse
C.  Substance Abuse
D.  Substance Dependence

C. The client appears to be abusing alcohol and experiencing negative
symptoms associated with overuse. However, she is able to go to work and can function in her personal life which signals substance abuse

A client you are treating comes in experiencing withdrawal from their
substance of choice. The client complains of headaches, anxiety, and nausea.
The client's hands are shaking and he is having trouble concentrating. What is
the most likely substance your client is withdrawing from?
A. Alcohol
B. Opioids
C. Marijuana
D. Heroin

A. Alcohol withdrawal includes headache, nausea, vomiting, tremors, and symptoms of anxiety

One of your clients has been in a rehab program and no longer meets the
criteria for Substance Use Disorder. The client still has cravings for alcohol but
has been clean for 6 months. What criteria would the client meet?
A. Early Full Remission
B. Severe Full Remission
C. Sustained Full Remission
D. Remission

A. Early full remission is when the person no longer meets the criteria for substance use disorder for more than 3 months but less than 12 months

A community mental health social worker receives a referral to assess and treat a
transgender client suffering from severe gender dysphoria. The social worker has
no experience with transgender clients but wants to help the client. In order to
BEST support this client, the social worker should:
A. Seek guidance from an expert immediately.
B. Help the client secure a referral to another social worker that specializes in LGBT
clients.
C. Discuss the issue of lack of knowledge with the client directly.
D. Attend an LGBT workshop prior to working with the client.

B. The client should be referred to a social worker who specializes in gender dysphoria.
This falls under the Code of Ethics principle of competency. Social workers should
provide referrals to a more specialized professional if a client requires expertise outside
their scope of practice.

You are a school social worker working with a 15-year-old male client. The client
has recently started wearing makeup and experimenting with wearing different
styles of clothing, including dresses and heels. The client comes into session
with a bruise under his right eye. When you ask the client what happened he
shrugs his shoulders and states “ My dad doesn’t agree with my lifestyle
choices”. What would be the BEST response from the social worker?
A. Acknowledge the statement made by the client and make a CPS report.
B. Ask the client for contact information for the father so an accurate CPS report can be
made.
C. Make a safety plan with the client to ensure he is safe from his father in the future.
D. Discuss ways the client can manage and navigate his difficult family relationships.

A. This situation requires a call to CPS due to potential abuse. LGBTQ adolescents are
more likely to experience abuse. The social worker should also acknowledge the
statement and support the teenager through this experience.

You are working with a 45-year-old man presenting for symptoms of depression. In
the initial assessment, the client states that he is gay. As part of the assessment,
he describes his past, including an internal battle to come out to and connect
with his family members. The client states that he and his partner of ten years
just went through a “messy” break up and now he is feeling lost and is unable to
cope with the grief. What should the social worker do FIRST?
A. Conduct a risk assessment for suicide.
B. Explore with the client how the breakup has affected his overall mood.
C. Acknowledge that the breakup can cause symptoms of grief and sadness.
D. Ask the client if he has discussed these symptoms with his doctor.

A. This client has had a life change happen that is causing him distress ( breakup from
his partner of ten years). This combined with his statements of feeling lost and unable to
cope warrant the social worker to conduct a risk assessment for suicide FIRST.

A 30-year-old female was admitted to the hospital following a suicide attempt
by swallowing a bottle of pills. An interview is completed that reveals that the
client had been sexually abused for several years by her father when she was a
minor. In completing the social history, the social worker should NEXT:
A. Ask for a sexual history of the client.
B. Obtain confirmation of this abuse from other family members through collateral
information.
C. Determine how the abuse contributes to the client’s presenting problem.
D. Acknowledge the abuse but understand it happened in the past and carries little
weight in overall functioning

C. The disclosure of abuse may be contributing to the client’s current problems
or play a role in overall functioning. The social worker should determine if and
how this past abuse is affecting the client’s present functioning.

A parent brings a four-year-old child to a family services agency because the
child is having fantasies of being chased by a giant and a tiger. The parents
report the child is having nightmares and aggressive behavior in their sleep.
What should the social worker do FIRST?
A. Ask the child to describe the fantasies in more detail.
B. Complete a comprehensive Biopsychosocial assessment.
C. Refer the child for play therapy.
D. Tell the parent the child is developing normally and this behavior is within normal
development limits.

B. In order to collect more information the social worker should complete a
biopsychosocial assessment. We cannot affirm to the parents that this is part of
normal development until we have more information. A referral may be made at a
later point once more information is collected. Asking the child to describe the
fantasies in more detail may not be age-appropriate or may cause distress to the
child.

A clinician is meeting with a 55-year-old client who she has been treating for
the past 5 weeks. The client presents with violent, aggressive, and delusional
thinking for which he is being treated. The man states that his neighbor has been
listening in on his cell phone conversations. The client becomes enraged and
states he is going to give this neighbor what he has coming for him. What would
be the FIRST step the social worker should take?
A. Tell the client his anger towards the neighbor is warranted and suggest healthy
coping mechanisms
B. Conduct a risk assessment to better assess the client’s statements
C. Encourage the client to speak with the police regarding his concerns
D. Ask the client to sign a No Harm contract

B. This statement requires knowledge of safety and risk assessments. This client has
made a statement that may suggest harm to someone. A risk assessment needs to be
conducted to determine the level of potential harm.

You are working with a client in private practice. The client is 14 years old and
has been seeing you to work on interpersonal relationships and emotional
regulation. When discussing problems with a peer at school the client states, “ I
hate that kid, I am going to kill him.” When the therapist inquires further, the
client states he doesn’t actually intend to harm the classmate. What should the
social worker do NEXT?
A. Tell the client you will have to warn the classmate about his threat
B. Document the interaction and monitor for further substantiated threats
C. Encourage the parents to take the client to the psychiatric ER for admission
D. Ask the client to speak to his parents so that the behavior can be closely monitored
for further threats

B. In this question the adolescent makes a statement that suggests he has a thought to
potentially harm a classmate. However, after further assessment the client states he
does not actually have a plan or intent to harm this student. This does not constitute a
duty to warn. However, the social worker should NEXT document the statement and
closely monitor for further parents of behavior.

A 16-year-old tells her school social worker that her stepfather has sexually
molested her and her 10-year-old sister over one year prior. The social worker
knows the family's problems include the stepfather's unemployment, alcoholism,
and occasional outbursts of anger at the children. The client is occasionally
truant from school, is often in trouble at school, and has intermittent involvement
with drugs. What would be the BEST response from the social worker?
A. Make a sexual abuse report to the local child protective agency.
B. Talk with the sister to confirm the sister's disclosure.
C. Talk to the child's mother and her teachers to discuss the concerns with the student’s
behavior and drug use.
D. Request a family evaluation to work on family communication and dynamics.

A. There is no time limitation on when abuse can be reported. The 16-year-old disclosed that she and her sister have been molested which must be reported to CPS.

A social worker is working with a 38-year-old divorced male who sees his
children every weekend. During a therapy session, he tells the clinician that he
suspects his ex-wife may be beating the children as a way to punish them. The
SW should FIRST:
A. Explore the client's feelings about the ex-wife’s style of punishment.
B. Ask if the client has contacted child protective services.
C. Arrange a session with the clients' ex-wife to gather more information.
D. Ask the father to follow up and ask more questions about the children’s time with
their mother.

B. The FIRST step the social worker should take is asking the client if he has reported his suspicions to CPS. If he believes that his children are in danger he can report these concerns to CPS. The social worker can make the call WITH the client but cannot make the call on his behalf.

You are working with a teenage mother who has very little support from her
family. She suggests that she will not have her baby vaccinated as she feels it will
only harm her baby more. The baby cannot start daycare until she receives
proper vaccinations. What is the obligation on the part of the social worker?
A. The social worker should encourage the client to get the child vaccinated as it will be
needed for daycare.
B. The social worker should report the situation to child protective services for
suspected medical neglect.
C. The social worker should respect the client’s right to self-determination and respect
her wishes to not vaccinate her child.
D. The social worker should seek consultation from a supervisor to discuss the issue
further.

C. The client has a right to determine if she will get her child vaccinated. The social worker should respect this right to self-determination as there is no indication of harm or danger to the child.

In the DSM-5, which of the following is NOT incorporated into Autism Spectrum Disorder?
A.  Asperger’s Disorder
B.  Pervasive Developmental Disorder Not Otherwise Specified
C.  Childhood Disintegrative Disorder
D.  Mental Retardation

D - Mental Retardation is no longer a diagnosis used in the DSM ( it is now referred to as Intellectual Disability). The other diagnoses ( Aspergers, Pervasive Developmental Disorder NOS and Childhood Disintegrative Disorder have now all fall under the umbrella of Autism Spectrum Disorder.