Practice 2: 170 ASWB Style Questions

The hallmark cognitive deficit in Alzheimer disease is typically:

A. Language production

B. Attention

C. Memory impairment

D. Motor coordination

Correct Answer: C

The PRIMARY goal during acute crisis intervention is to:

A. Increase insight

B. Resolve childhood conflicts

C. Restore baseline functioning

D. Interpret defenses

Correct Answer: C

A manic episode must last at least:

A. 24 hours

B. 4 days

C. 1 week

D. 2 weeks

Correct Answer: C

Memorize:

Hypomania = 4 days

Mania = 1 week (or hospitalization)

A client with schizophrenia says:

"The FBI monitors my thoughts through the television."

The client is calm, eating regularly, taking medications inconsistently, and denies suicidal or homicidal intent.

What should the social worker do?

A. Arrange involuntary hospitalization

B. Assess the impact of the delusions on functioning and safety

C. Contact law enforcement

D. Warn potential victims

Correct Answer: B

Why:

Psychosis alone ≠ involuntary hospitalization.

The exam repeatedly tests:

dangerousness or grave disability must be established.

A client states:

"I made one mistake at work, so I'm completely incompetent."

This is:

A. Personalization

B. Catastrophizing

C. All-or-nothing thinking

D. Projection

Correct Answer: C

PTSD Timing

Symptoms must persist for at least:

A. 3 days

B. 2 weeks

C. 1 month

D. 6months

Correct Answer: C

Memorize:

A client with significantly low body weight insists they are overweight.

This disturbance in self-perception is MOST characteristic of:

A. Bulimia nervosa

B. Body dysmorphic disorder

C. Anorexia nervosa

D. Avoidant personality disorder

C. Anorexia nervosa

A client develops muscle rigidity, fever, and autonomic instability after starting antipsychotic medication.

This suggests:

A. Tardive dyskinesia

B. Neuroleptic malignant syndrome

C. Serotonin syndrome

D. Akathisia

Correct Answer: B

Memorize:

NMS:

fever

rigidity

autonomic instability

emergency

A social worker encounters a former client at a community event 8 months after termination. The former client asks the social worker on a date.

What should the social worker do?

A. Accept if both feel comfortable

B. Decline because of potential exploitation

C. Consult colleagues before deciding

D. Wait until 2 years after termination

Correct Answer: B

Why:

Even after termination, power imbalance remains.

ASWB usually favors:

avoid dual relationships with exploitation risk.

The exam is less about memorizing timelines and more about protecting vulnerable clients.

A client states that they are taking the medication Fluoxetine . What is the MOSTlikely diagnosis for this client?

A.Anxiety

B.Depression

C.Borderline Personality Disorder

D.Specific Phobia

b-Rationale: Fluoxetine is an SSRI medication. Medications that end in "ine" aremost commonly used to treat depression.

A therapist has been conducting a closed 10-week group for men living with AIDS. After the 3rd session, a group member reports to the leader that they are feeling frustrated and disconnected with other members of the group. They question whether or not they want to continue. The social worker should FIRST:

A. Initiate an individual session with this group member to address their feelings of frustration and disconnect

B. Tell the group member that it isn't possible to leave the group at this time due to the closed nature of the group

C. Encourage the group member to bring this up in the next group session

D. Use the next group session to explore how other group members are feeling and whether anyone relates to how this group member is feeling in order to encourage cohesiveness

C. When working with groups we want to make sure we keep any issues that come up around the group within the group. So in this case, it's important to encourage the client to address their feelings with the group. A would not keep the issue within the group, and B would not be appropriate because a group member has the right to leave a group. D could be done at some point, but not before we give the client an opportunity to share his own feelings with the group.

A 27-year-old client presents for treatment after multiple unstable romantic relationships and repeated episodes of self-harm during interpersonal conflicts. The client reports chronic feelings of emptiness and says:

"I become terrified when people pull away from me."

The client also describes occasional periods lasting 2-3 days of elevated mood, impulsive spending, and decreased sleep following arguments with partners.

Which diagnosis is MOST supported?

A. Bipolar I disorder B. Bipolar II disorder C. Borderline personality disorder D. Cyclothymic disorder

Correct Answer: C

Important distinction:

Bipolar episodes are:

more sustained

episodic

not primarily triggered by interpersonal events

The "2-3 day elevated mood after fights" is emotional reactivity, not true hypomania.

A client has experienced several episodes of severe depression accompanied by auditory hallucinations. During evaluation, the client reports that hallucinations also occurred for approximately one month when mood symptoms were absent.

Which diagnosis is MOST appropriate?

A. Major depressive disorder with psychotic features

B. Bipolar disorder with psychotic features

C. Schizophreniform disorder

D. Schizoaffective disorder

Correct Answer: D

High-yield rule:

The exam LOVES this distinction.

Psychotic symptoms occurring:

independently of mood episodes

strongly suggest schizoaffective disorder.

Memorize:

Mood disorder with psychotic features:

psychosis ONLY during mood episodes

Schizoaffective:

psychosis ALSO occurs alone

An 80-year-old hospitalized client becomes suddenly disoriented overnight, cannot maintain attention during conversation, and alternates between agitation and drowsiness throughout the day.

What is the MOST likely diagnosis?

A. Major depressive disorder

B. Alzheimer disease

C. Delirium

D. Persistent depressive disorder

Correct Answer: C

Why:

Key clues:

sudden onset

fluctuating symptoms

impaired attention

altered consciousness

That is classic delirium.

Why this is high yield:

ASWB repeatedly tests:

attention impairment + fluctuating awareness = delirium

Dementia usually:

gradual decline

stable consciousness

slower progression

A client repeatedly checks locks for hours each night and says:

"I know it probably doesn't make sense, but I can't stop thinking someone will break in."

Which feature MOST supports obsessive-compulsive disorder rather than psychosis?

A. Repetitive behaviors

B. Anxiety symptoms

C. Preserved insight

D. Fearfulness

Correct Answer: C

Why:

The client recognizes the thoughts may not make sense.

That means:

insight is preserved.

A 10-year-old child has difficulty understanding social cues, rarely makes eye contact, engages in repetitive hand movements, and becomes intensely distressed when routines change. The child wants friendships but struggles to maintain reciprocal conversations.

Which diagnosis is MOST likely?

A. Social anxiety disorder

B. Oppositional defiant disorder

C. Autism spectrum disorder

D. Avoidant personality disorder

Correct Answer: C

Why this is difficult:

The distractor is social anxiety because:

poor social interaction

discomfort socially

BUT autism requires:

social communication deficits

restricted/repetitive behaviors

Key clues:

repetitive movements

rigidity with routine

reciprocal conversation deficits

A client with a history of major depressive disorder tells a social worker:

"Sometimes I think my old supervisor deserves to suffer for ruining my life. Yesterday I drove past his house and imagined shooting him, but I'd never actually do it."

What should the social worker do FIRST?

A. Notify police immediately

B. Warn the former supervisor

C. Conduct a more thorough assessment of violence risk

D. Terminate therapy due to safety concerns

Correct Answer: C

Why this is the clear ASWB answer:

The client has:

violent thoughts

possible target identification

BUT:

no clear intent

no stated plan

no imminent threat established yet

ASWB almost always wants:

further risk assessment BEFORE breaching confidentiality.

A 7-year-old client tells a school social worker:

"My dad gets mad and hits me with a belt when I'm bad. Please don't tell anyone because I'll get in trouble."

What should the social worker do FIRST?

A. Explain the limits of confidentiality and report

B. Call the child's father

C. Explore the child's feelings about discipline

D. Determine whether marks are present and report

Correct Answer: A

Why this is the clear ASWB answer:

The child has disclosed possible abuse.

The FIRST step with a child:

explain that the social worker cannot keep unsafe secrets.

Then report.

A social worker notices feeling unusually angry and impatient with a client who repeatedly misses appointments. The client reminds the social worker of a former partner.

What should the social worker do FIRST?

A. Transfer the client immediately

B. Confront the client about resistance

C. Seek supervision or consultation

D. Establish stricter attendance policies

Correct Answer: C

Why this is the clear ASWB answer:

The social worker recognizes:

emotional overreaction

personal association

possible countertransference

ASWB consistently favors:

supervision FIRST.

A social worker is asked by a client to attend a family wedding. What should the social worker do?

A. Attend briefly to support the client

B. Attend only if no fee is charged

C. Decline due to boundary issues

D. Attend if the client insists

Answer: C Explanation: Dual relationships can impair objectivity and create boundary violations.

A 15-year-old client reports suicidal thoughts but asks you not to tell anyone. What is the best action?

A. Maintain confidentiality

B. Inform parents immediately

C. Break confidentiality to ensure safety

D. Wait until next session

Answer: CExplanation: Imminent risk of harm overrides confidentiality

A 32-year-old client says, "I can't do this anymore. I bought a gun yesterday and I've been thinking about ending my life tonight." The client refuses to give consent to contact anyone.

What should the social worker do FIRST?

A. Explore childhood trauma

B. Develop a safety plan

C. Break confidentiality and initiate emergency intervention

D. Schedule a follow-up session tomorrow

Answer: C

Explanation: Imminent risk + means + plan = immediate emergency action.

Best reason to terminate therapy?

A. Client misses one session

B. Client has met treatment goals

C. Client requests a new therapist

D. Insurance stops coverage

Answer: B

Explanation: Termination is appropriate when goals are achieved.

A 10-year-old child says, "My mom's boyfriend hits me with a belt when she's not home, and I have bruises." The child begs you not to tell anyone.

What is the BEST action?

A. Respect confidentiality

B. Confront the mother first

C. Report to child protective services

D. Wait for more evidence

Answer: C

Explanation: Suspected child abuse must be reported immediately.

A client reports fatigue, insomnia, poor appetite, and low mood for 3 weeks after job loss. No suicidal ideation.

What is the NEXT best step?

A. Diagnose major depressive disorder

B. Explore psychosocial stressors and functioning

C. Start antidepressant discussion

D. Hospitalize

Answer: B

Explanation: Assessment comes before diagnosis or treatment.

A client refuses medication stating, "My faith healer says I don't need it." The client is stable and not at risk.

What should the social worker do?

A. Insist on medication compliance

B. Respect belief and explore alternatives

C. Terminate services

D. Report noncompliance

Answer: B

Explanation: Respect autonomy and integrate cultural beliefs when no safety risk exists.

A 45-year-old client says, "I sometimes think my family would be better off without me, but I could never actually do it." The client denies plan or intent but reports increasing isolation and recent job loss.

What is the BEST next step?

A. Hospitalize immediately

B. Explore protective factors and assess suicide risk further

C. Develop a safety contract only

D. Focus on cognitive restructuring

Answer: B

Explanation: Passive ideation without intent → assess further before higher-level intervention.

A client reports 2 weeks of sadness, insomnia, fatigue, and guilt after breakup. They are still attending work but with reduced efficiency. No prior episodes.

What is the BEST interpretation?

A. Major depressive disorder

B. Adjustment disorder with depressed mood

C. Persistent depressive disorder

D. Normal grief requiring no diagnosis

Answer: B

Explanation: Time frame + identifiable stressor = adjustment disorder.

A client arrives intoxicated and says, "I want to kill myself tonight. I have pills at home." The client refuses to stay.

What is the FIRST action?

A. Begin psychotherapy intervention

B. Assess trauma history

C. Initiate emergency protection/hospitalization

D. Schedule next session

Answer: C

Explanation: Acute intoxication + suicidal intent = highest risk → emergency action.

A client with generalized anxiety disorder is stable but reports chronic worry affecting sleep. They are already in therapy and not in crisis.

What is the BEST next step?

A. Immediate psychiatric hospitalization

B. Increase therapy frequency and introduce CBT techniques

C. Explore childhood trauma exclusively

D. Discharge due to stability

Answer: B

Explanation: Non-crisis symptom management → evidence-based outpatient intervention.

A 72-year-old client enters therapy after retiring last year. The client says, "I keep thinking I wasted my life. I never did anything meaningful, and now it's too late." The client reports frequent sadness, regrets about past choices, and feeling that life has no purpose. They also note decreased interest in social activities but deny suicidal ideation.

What is the BEST psychosocial stage focus for this client?

A. Identity vs Role Confusion

B. Intimacy vs Isolation

C. Generativity vs Stagnation

D. Integrity vs Despair

Answer: D. Integrity vs Despair

Brief Explanation: In late adulthood, Erikson's final stage involves reviewing one's life. Feelings of fulfillment = integrity; regret and meaninglessness = despair.

A 7-year-old child is in therapy after struggling in school. The teacher reports the child has difficulty understanding that the amount of liquid stays the same when poured into different-shaped containers. The child also tends to focus on one feature of a situation at a time and struggles with perspective-taking.

Which stage of cognitive development is the child MOST likely in, according to Piaget?

A. Sensorimotor

B. Preoperational

C. Concrete operational

D. Formal operational

Answer: C. Concrete operational

Brief Explanation:

Ages ~7-11. Key features include conservation, logical thinking about concrete objects, and reduced egocentrism (though still limited abstract reasoning).

A 38-year-old client who recently lost their job says, "Honestly, I didn't even like that job. It was boring and beneath my skills anyway." However, the client previously reported being devastated and anxious about the job loss.

Which defense mechanism is MOST clearly being used?

A. Projection

B. Rationalization

C. Displacement

D. Reaction formation

Answer: B. Rationalization

Brief Explanation:

The client is reframing a distressing event with socially acceptable explanations to reduce emotional discomfort.

A 29-year-old client recently started an SSRI for depression. After 3 weeks, they report improved mood but say, "I just can't seem to orgasm anymore, and my sex drive is gone."

Which medication class is MOST likely responsible?

A. Benzodiazepines

B. SSRIs

C. Mood stabilizers

D. Antipsychotics

Answer: B. SSRIs

Brief Explanation:

Selective Serotonin Reuptake Inhibitors commonly cause sexual dysfunction (decreased libido, anorgasmia).

A client with bipolar disorder taking lithium reports nausea, diarrhea, coarse tremors, and confusion. The social worker should FIRST recognize this as:

A. Expected initial side effects

B. Lithium toxicity

C. Serotonin syndrome

D. Normal anxiety response

Answer: B. Lithium toxicity

Brief Explanation:

Lithium toxicity signs include GI upset, tremor, confusion, ataxia → medical emergency.

A client is prescribed medication for anxiety and reports feeling "calm but also very sleepy and forgetful." The client is taking the medication daily for 2 months.

Which medication is MOST likely?

A. Buspirone

B. Benzodiazepine

C. SSRI

D. Stimulant

Answer: B. Benzodiazepine

Brief Explanation:

Benzodiazepines commonly cause sedation, cognitive slowing, dependence risk.

A child started medication for ADHD and now has decreased appetite and difficulty sleeping but improved attention in school.

Which medication is MOST likely?

A. Atomoxetine

B. Methylphenidate

C. Risperidone

D. Clonazepam

Answer: B. Methylphenidate

Brief Explanation:

Methylphenidate commonly causes appetite suppression + insomnia.

A client on antidepressants presents with agitation, sweating, diarrhea, tremors, and hyperreflexia after dose increase.

What is the MOST likely diagnosis?

A. Neuroleptic malignant syndrome

B. Serotonin syndrome

C. Panic disorder

D. Anticholinergic toxicity

Answer: B. Serotonin syndrome

Brief Explanation:

Often caused by excess serotonergic meds → agitation, autonomic instability, neuromuscular symptoms.

A 41-year-old client abruptly stops taking a long-term prescribed medication used for anxiety. Two days later, the client presents to the clinic with severe agitation, tremors, sweating, insomnia, and heightened anxiety. The client says, "I thought I didn't need it anymore, but I feel worse than before I started it."

Which medication withdrawal is MOST likely?

A. SSRI discontinuation syndrome

B. Benzodiazepine withdrawal

C. Lithium withdrawal

D. Antipsychotic withdrawal

Answer: B. Benzodiazepine withdrawal

Brief Explanation:

Benzodiazepines withdrawal can cause rebound anxiety, agitation, tremors, insomnia, and in severe cases seizures. Abrupt cessation is dangerous, especially after long-term use.

A 16-year-old adolescent tells the social worker, "Whenever my parents argue, my mom tells me to take her side and talk to my dad for her. I feel stuck in the middle and anxious all the time."

Which family systems concept is MOST clearly illustrated?

A. Enmeshment

B. Triangulation

C. Differentiation of self

D. Disengagement

Answer: B. Triangulation

Brief Explanation:

Triangulation occurs when a third party (child) is pulled into parental conflict to reduce tension between the parents.

A 20-year-old client reports, "My mother gets very upset if I don't tell her everything about my life. She gets offended if I make decisions without her input, and I feel guilty when I try to set boundaries."

Which family systems pattern is MOST consistent?

A. Disengagement

B. Enmeshment

C. Role reversal

D. Family projection process

Answer: B. Enmeshment

Brief Explanation:

Family Systems Theory describes enmeshment as overly blurred boundaries and lack of autonomy, often leading to guilt when independence is attempted.

A 55-year-old client with schizophrenia has been taking an antipsychotic medication for several years. The client now presents with involuntary, repetitive movements of the tongue and lips, including lip smacking and tongue thrusting. The client is unaware of the movements and reports no distress.

Which condition is MOST likely?

A. Acute dystonia

B. Akathisia

C. Tardive dyskinesia

D. Neuroleptic malignant syndrome

Answer: C. Tardive dyskinesia

Brief Explanation:

Antipsychotics long-term use can lead to tardive dyskinesia, characterized by involuntary, repetitive facial and oral movements that may be irreversible.

You are working with a client who has just found out he has terminal lung cancer.He is working on coping with the news of his illness. The client makes statements suchas "If I beat this cancer I promise to be a better husband and father to my family. I will do things differently this time." Which stage of grief is the client most likely in?

A.Anger

B.Depression

C.Denial

D.Bargaining

D-Rationale: Bargaining is the stage in the grief cycle where you begin to make"deals" in order to change the result. This stage is associated with false hope.You might falsely make yourself believe that you can avoid the grief through atype of negotiation to do better.

Which of the following BEST describes the educational aspect of supervision?

A.Monitoring case notes and documentation

B.Helping the supervisee manage workload and stress

C.Working with the supervisee to develop knowledge and skills that are job related

D.Evaluating job performance and ensuring job standards are met

c-Rationale: In supervision, a supervisor should help the supervisee develop knowledge and skills that are needed to perform their job accordingly. This falls under the educational aspect of supervision.

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

B.Determine the risks of the dual relationships and work to protect the client's interests

You have been tasked with evaluating a teen pregnancy prevention program at your agency. You have identified the key stakeholders that include participants, the agency leaders, and the local health administrators. What would be the NEXT step in evaluating the program?

A.Defining the program's goals and outcomes

B.Collecting data to be analyzed

C.Sharing the evidence with identified stakeholders

D.Choosing an appropriate program evaluation design

a-Rationale: The next step in program evaluation after identifying stakeholders is to define the programs goals and outcomes to be evaluated.

A patient (38) who identifies as gay is admitted into the ER. His partner is listed as his emergency contact person. The social worker learns that the hospital staff contacted his mother and father instead of the partner. The social worker should FIRST:

A. Call the partner directly.

B. Tell the patient that his parents were notified.

C. Wait until the family arrives and discuss the mistake that was made.

D. Report the staff member for this violation of information.

B-RATIONALE: It is important to notify the client of the error that was made FIRST.The client has the right to be informed. Next steps cannot be taken until thepatient is notified.

A client who has recently immigrated to the United States from Ecuador seeks therapy to adjust to the new cultures and way of life in his community. To assess the client's level of acculturation, which of the following factors should the social worker take into consideration FIRST?

A. Newly immigrated individuals are often hesitant to challenge cultural traditions in theirnew communities.

B. Newly immigrated individuals are slow to learn new traditions in their new community.

C. Gender differences cause more resistance than acculturation issues.

D. The pace of acculturation may vary from group to group.

d-RATIONALE: How quickly someone experiences acculturation varies and is dependent on a variety of different factors. The other answer options do not givean accurate depiction of a client who is experiencing a new way of life in a new country.

A social worker receives a referral 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 relational strengths.

D. Creating connection through role play of conflicts that arise.

a-RATIONALE: A is the best answer given the age of the children and the tensionstated within the family. At this developmental stage, children want to spendmore time with their friends and experience the need for independence.Establishing roles and boundaries for the family would be a good focus as itlooks at the family unit as a whole and touches on the need for clear expectationsand boundaries for family members.

You notice a student at school is constantly tired and is falling asleep in class. The teacher reports he never turns in homework and has difficulty completing class assignments. When you talk to the student he states he has difficulty sleeping at night because he has to sleep on the couch and is woken up by all the other people livingwith him. He states he lives with his mom, sister, brother, grandma and aunt in a onebedroom apartment. His aunt is currently pregnant. He states they do not have much money and his mom works odd jobs. What should the social worker do to FIRST?

A. Talk with the teacher and ask if the student can sleep in the office if he is tired.

B. Refer the family to a housing agency for more services.

C. See if there is enough money in the school budget to purchase a bed for the family.

D. Set up a meeting with the mother, student and teacher to talk further about the problem.

d-RATIONALE: It is important to FIRST gather more information by conducting a meeting with the teacher and parent to collect more information. The family maybe in need of more support that can be offered by the social worker. Answer A and C do not get to the root of the problem and Answer B may be done AFTERmeeting with the mother.

Which of the following is not a classic indicator that a child is showing signs ofAutism Spectrum Disorder?

A. Lack of response or eye contact when their name is called

B. Delayed speech or communication

C. Sensitivity to touch, light or sound

D. Difficulty toilet training

d-RATIONALE: Difficulty toilet training is not a classic sign of Autism SpectrumDisorder. Lack of eye contact, delayed speech or communication and sensitivity to sensory stimuli are all indicators of ASD.

An 82-year-old woman with moderate dementia-related neurocognitive disorder lives in assisted living. She recently wandered outside at night and became lost before being safely returned. During a care meeting, she states, "I don't want to move to a locked unit. I can still make my own choices." Her daughter, who is her health care proxy, demands immediate placement in a secured memory care unit for safety reasons. The client consistently expresses her preference but has impaired short-term memory and limited understanding of the risks of wandering.

What should the LCSW do FIRST?

A. Support the daughter's request because safety overrides autonomy in dementia cases

B. Assess the client's decision-making capacity regarding the housing decision

C. Arrange immediate transfer to a locked unit to reduce liability risk

D. Tell the client she can no longer exercise self-determination because a health care proxy is activated

Correct Answer: B

Rationale: The LCSW must first assess the client's decision-making capacity related to the specific decision. A dementia diagnosis alone does not eliminate self-determination. Capacity is decision-specific, and clients should retain the greatest level of autonomy possible unless assessment shows they cannot understand or appreciate the consequences of the decision.

A social worker meets with a client who is grieving the death of her mother. The client frequently cries in session and states that life will not be the same without her mother. The client also reports symptoms of depression. The social worker plans to administer a depression inventory at three points. This includes prior to treatment, three weeks into treatment and post treatment. What is the social worker's PRIMARY reason for repeatedly administering the inventory?

A. To assess the need for a medication evaluation.

B. To document the effectiveness of treatment.

C. To justify the client's length of time in treatment.

D. To determine the severity of the loss on the client.

b-RATIONALE: The administration of a depression inventory before, during, andafter treatment allows the social worker to gauge progress toward treatmentgoals. Answer A, C and D would not be the primary reasons for administering ascreener at three points. Screeners or inventories are often used to determineeffectiveness of an intervention.

While many variables affect suicidality among teenagers, which item below has been a particularly powerful predictor:

a. a recent parental divorce

b. a transfer to a new school

c. a history of occasional drug use

d. a change in family economic status

a. a recent parental divorceFamily dynamics and the stability of internal structure are the highest predictors of suicidality.

You have a client who has hypertension and struggles with healthy eating. The client joins a group where he learns about healthy living, including diet and exercise. In this group he learns more about his condition, shares ideas with other members andconnects with others. What type of group is your client most likely in?

A. Educational

B. Growth

C. Support

D. Preventative

a-RATIONALE: This requires knowledge of the different types of social workgroups. Educational groups are designed to teach clients more about a problem or situation. Educational groups give clients an opportunity to learn about a condition, ask questions, discuss fears or concerns and/or improve or cope with a condition.

Billy comes to you after a recent divorce with his wife of 29 years. He has two children who now live with their mother full time. Billy states that he feels regret for being such a bad husband and father. He says he feels very lonely and sad without

being able to see his kids as often. What would be the primary focus of treatment for Billy?

A. Discussing how his behavior has impacted his marriage.

B. Working on skills that can improve Billy's self esteem.

C. Referring Billy to a doctor for potential depression symptoms.

D. Identifying ways in which he can be connected and a part of his children's life.

d-RATIONALE: Billy has stated his loneliness and sadness are a result of not seeing his children as often as he would like. Focusing treatment on connecting with his children and being a part of their life is the only answer option that BEST meets Billy's treatment needs.

Crisis is a normal part of life, and individuals try to maintain equilibrium by using coping mechanisms. Sometimes the usual techniques do not work when a problem is threatening. People in crisis may experience guilt, feelings of anxiety, helplessness, and fear. Which of the following criteria are used to determine whether a situation constitutes a crisis?

A. An individual's view and response to an event

B. How others view and respond to an event

C. Instincts on what is threatening

D. Conditioning as to what defines a crisis

Answer: A - When an individual sees an event as threatening with no way to cope, he or she may find themselves in crisis. This is a state of psychological disequilibrium with a number of indicators. Changes will be observed in energy levels, ability to concentrate, sleeping patterns, and social interaction with friends or relatives.

Clients should only be limited in their access to documentation when the information may cause harm to the individual. Administrators will normally look at the records first to take steps in protecting the confidentiality of other individuals that may be identified.

A social worker has a bad home visit where the clients were uncooperative and kept arguing with one another. Within the documentation, the social worker used derogatory language about the clients. When the case came up for review, this information was discovered by administration. What course of action should be taken?

a. The social worker needs anger management counseling

b. The social worker should be suspended without pay

c. The social worker would be advised to review the NASW Code of Ethics

d. The social worker should allow the clients to view the documentation

c. The social worker would be advised to review the NASW Code of Ethics

Which statement BEST reflects the principle of self-determination in social work practice?

A. Clients have the right to make decisions unless those decisions create serious, foreseeable harm

B. Clients may make any decision regardless of risk

C. Family wishes should take priority when clients have cognitive impairment

D. Social workers should prioritize safety over autonomy in all cases

Correct Answer: A

A client tells their social worker, "Don't tell my parents I'm pregnant." The client is 17 years old and legally able to consent to reproductive health treatment in her state. What should the LCSW do?

A. Inform the parents because the client is a minor

B. Encourage the client to tell her parents but maintain confidentiality

C. Contact child protective services

D. Refuse services until parental consent is obtained

Correct Answer: B

During a session, a child discloses physical abuse by a parent and begs the social worker not to tell anyone because "I'll get in trouble." What is the BEST response by the social worker?

A. Respect the child's wishes to preserve therapeutic trust

B. Explain the limits of confidentiality and make a mandated report

C. Encourage the child to tell another trusted adult first

D. Wait to gather more evidence before taking action

Correct Answer: B

A client is prescribed Lithium for bipolar disorder. Which symptom should the LCSW recognize as a possible sign of lithium toxicity?

A. Weight gain

B. Fine tremor

C. Severe diarrhea and confusion

D. Dry mouth

Correct Answer: C

Why: Mild tremor and weight gain can happen normally with lithium, but severe GI symptoms, confusion, ataxia, and coarse tremors suggest toxicity.

Which defense mechanism is demonstrated when a client who is angry at their boss goes home and yells at their child?

A. Projection

B. Displacement

C. Rationalization

D. Regression

Correct Answer: B

Displacement = redirecting emotions to a safer target

Projection = attributing your feelings to others

Regression = reverting to earlier behavior

Rationalization = making excuses

According to Jean Piaget, during which stage do children develop object permanence?

A. Preoperational

B. Concrete operational

C. Sensorimotor

D. Formal operational

C. Sensorimotor

Sensorimotor (birth-2) = object permanence

Preoperational = egocentrism

Concrete operational = logical thinking

Formal operational = abstract reasoning

A client says, "Everyone at work hates me," despite no evidence. Which cognitive distortion is this?

A. Catastrophizing

B. Mind reading

C. Minimization

D. Personalization

Correct Answer: B

Mind reading = assuming others' thoughts

Catastrophizing = expecting disaster

Personalization = blaming self for unrelated events

Minimization = downplaying significance

Which neurotransmitter is MOST associated with Parkinson's disease?

A. Serotonin

B. Dopamine

C. Acetylcholine

D. GABA

Correct Answer: B

Parkinson's = ↓ dopamine

Depression often linked with serotonin/norepinephrine

Anxiety linked with GABA dysregulation

Which attachment style is MOST associated with inconsistent caregiving in childhood?

A. Secure

B. Avoidant

C. Disorganized

D. Ambivalent/anxious

D. Ambivalent/anxious

In group therapy, what term describes when members begin challenging each other and conflict emerges?

A. Performing

B. Norming

C. Storming

D. Forming

Correct Answer: C

A client taking an SSRI suddenly develops agitation, fever, tremor, sweating, and confusion after starting another serotonergic medication. What condition should the social worker suspect?

A. Neuroleptic malignant syndrome

B. Serotonin syndrome

C. Lithium toxicity

D. Hypertensive crisis

Correct Answer: B

A social worker is providing supervision to a recent graduate working toward clinical licensure. The supervisee reports completing several client contact hours that the supervisor cannot independently verify. The supervisor is under pressure to sign the documentation quickly because the supervisee's application deadline is approaching. What should the supervisor do?

A. Sign the documentation if the supervisee has generally been trustworthy

B. Delay signing until documentation of hours can be verified

C. Sign the hours but note concerns in the supervision file

D. Ask another supervisor to review the hours

Correct Answer: B

A client is referred to treatment by family members due to concerns about possible substance use. During the initial session, the client states, "I don't think I need therapy, and I only came to get my family off my back." What should the social worker do FIRST?

A. Explore the client's perception of the referral concerns

B. Explain the negative effects of substance abuse

C. Assess the client's readiness for change

D. Obtain a detailed substance use history

Correct Answer: A

A social worker in a rural community realizes that a newly assigned client attends the same church and their children participate in the same school activities. What should the social worker do FIRST?

A. Immediately transfer the client to avoid a dual relationship

B. Discuss potential risks and boundaries with the client

C. Continue treatment without addressing the overlap

D. Consult with the church leadership regarding ethical concerns

Correct Answer: B

Parents bring their 4-year-old son to therapy because he frequently touches his genitals at home and occasionally in public settings. The parents are worried he may have been sexually abused. The child has no behavioral changes, trauma symptoms, or medical complaints. What should the social worker do FIRST?

A. Provide education about developmentally expected behavior

B. Report suspected abuse to child protective services

C. Refer the child for a forensic interview

D. Conduct trauma-focused therapy with the child

Correct Answer: A

During an intake appointment, a client appears confused while reviewing consent paperwork. The client later explains that English is not their primary language and they do not fully understand several sections of the forms. What should the social worker do?

A. Continue because the client signed the paperwork voluntarily

B. Obtain interpretation or translated materials before proceeding

C. Summarize only the most important parts of the consent form

D. Ask a family member to explain the documents to the client

Correct Answer: B

A social worker is developing services for unaccompanied immigrant minors entering a community program. Which action should the social worker take FIRST to best address the clients' needs?

A. Identify evidence-based interventions for immigrant youth

B. Assess available agency funding and staffing resources

C. Meet with the minors to identify perceived needs and barriers

D. Coordinate with local schools and medical providers

Correct Answer: C

Parents of a child recently diagnosed with autism spectrum disorder spend the session discussing research studies, treatment statistics, and expert opinions while avoiding discussion of their emotions about the diagnosis. Which defense mechanism is MOST evident?

A. Rationalization

B. Sublimation

C. Intellectualization

D. Projection

Correct Answer: C

A client consistently seeks reassurance from others before making decisions and reports feeling helpless when alone. The client states, "I usually just agree with people because I don't want them to leave me." Which diagnosis is MOST consistent with these symptoms?

A. Avoidant personality disorder

B. Borderline personality disorder

C. Dependent personality disorder

D. Histrionic personality disorder

C. Dependent personality disorder

A 16-year-old client reports struggling with questions about identity, peer acceptance, and sexual orientation. According to Erik Erikson, which developmental conflict is the client MOST likely experiencing?

A. Intimacy vs. isolation

B. Identity vs. role confusion

C. Industry vs. inferiority

D. Trust vs. mistrust

Correct Answer: B

A client seeks services after losing employment unexpectedly. Since the job loss, the client reports difficulty sleeping, increased anxiety, and inability to concentrate on daily tasks. Which statement BEST describes a crisis situation?

A. Crisis situations always require hospitalization

B. Crisis occurs when coping abilities are become overwhelmed

C. Crisis intervention focuses primarily on long-term insight

D. Crisis prevents clients from participating in decision-making

B. Crisis occurs when coping abilities are become overwhelmed

A same-sex couple seeks information about adoption after experiencing discrimination from several agencies. Before assisting the couple with the adoption process, what should the social worker do FIRST?

A. Explore legal action related to discriminatory experiences

B. Identify current adoption laws and policies affecting the couple

C. Encourage the couple to pursue foster parenting instead

D. Refer the couple to an advocacy organization

B. Identify current adoption laws and policies affecting the couple

A client who was court ordered to attend substance use treatment tells the social worker, "I don't have a problem. I'm only here because the judge made me come." According to the stages of change model, which stage is the client MOST likely in?

A. Preparation

B. Action

C. Maintenance

D. Precontemplation

Correct Answer: D

teenager recently disclosed questioning their sexual orientation and reports feeling confused about what this means personally. Which step in the coming out process typically occurs FIRST?

A. Disclosing sexual orientation to family and friends

B. Beginning a same-sex romantic relationship

C. Self-recognition and acceptance of sexual orientation

D. Participating in LGBTQ+ support groups

Correct Answer: C

A social worker is in the termination phase of treatment with a client who has successfully met treatment goals. Which task would LEAST likely occur during termination?

A. Reviewing progress made during treatment

B. Linking the client with additional supports if needed

C. Revising the treatment goals

D. Processing feelings about ending services

Correct Answer: C

Parents bring their 7-year-old child for evaluation due to frequent angry outbursts at home and school. The child has been irritable nearly every day for over a year and has repeated behavioral outbursts several times each week. What is the MOST likely diagnosis?

A. Attention-deficit/hyperactivity disorder

B. Disruptive mood dysregulation disorder

C. Bipolar disorder

D. Oppositional defiant disorder

Correct Answer: B

Rationale: Disruptive Mood Dysregulation Disorder is characterized by chronic irritability and severe recurrent temper outbursts occurring for at least 12 months in multiple settings.

A social worker is providing court-ordered services to a child involved in a custody dispute. The child's father currently has sole legal custody. The child's mother contacts the social worker requesting copies of the child's treatment records. What should the social worker do FIRST?

A. Release only limited information to the mother

B. Explain the limits of access to records and document the request

C. Encourage the mother to obtain records from the father

D. Provide the records because the mother is the child's parent

Correct Answer: B

Rationale: The social worker should clarify legal limitations regarding confidentiality and custody rights while documenting the interaction. A parent without legal custody may not have rights to access records.

A client in private practice has not paid for therapy services in over 2 months despite repeated discussions and a payment agreement. The client is not at risk of harm to self or others. What is the MOST appropriate action for the social worker?

A. Continue providing free services indefinitely

B. Refer the balance to collections while continuing treatment

C. Terminate services after appropriate notice and referrals

D. Provide only crisis sessions until payment is made

Correct Answer: C

Rationale: Ethical termination may occur for nonpayment when the client is not in danger and the social worker provides reasonable notice, referrals, and continuity planning.

A family presents to treatment appearing highly cooperative and emotionally close. However, family members avoid discussing conflict and consistently deny tension despite evidence of significant dysfunction. Which family dynamic is MOST likely present?

A. Enmeshment

B. Mystification

C. Pseudo-mutuality

D. Disengagement

Correct Answer: C

Rationale: Pseudo-mutuality describes a family pattern in which members maintain the appearance of harmony and closeness while suppressing genuine conflict and emotional differences.

What is the PRIMARY clinical purpose of maintaining accurate and current client records?

A. Protecting the agency from liability claims

B. Monitoring client progress and guiding treatment planning

C. Supporting supervision and staff evaluation

D. Assisting with insurance reimbursement

Correct Answer: B

Rationale: Although records may serve administrative and legal functions, their primary clinical purpose is to support continuity of care, monitor progress, and inform treatment decisions.

A social worker is subpoenaed to testify in court regarding a client involved in a criminal proceeding. Which statement BEST reflects the social worker's ethical and legal responsibility?

A. Social work privilege always prevents disclosure of confidential information

B. A judge may require disclosure despite confidentiality protections

C. The NASW Code of Ethics prohibits testimony in legal proceedings

D. Agency confidentiality policies override court orders

B. A judge may require disclosure despite confidentiality protections

A client with schizophrenia intermittently stops taking prescribed medication and reports occasional hallucinations. Following a conflict with a partner, the client is asked to leave the home. The client refuses hospitalization and states a desire to live independently. The client denies suicidal or homicidal ideation. What should the social worker do FIRST?

A. Respect the client's right to refuse treatment while continuing engagement

B. Initiate involuntary hospitalization procedures

C. Insist the client resume medication immediately

D. Encourage the partner to temporarily supervise the client

Correct Answer: A

Rationale: Clients generally retain the right to refuse treatment unless they pose an imminent danger to themselves or others. Maintaining engagement and the therapeutic relationship is the least restrictive and most appropriate intervention.

An older adult reports feeling increasingly fearful because an adult child with a substance use disorder repeatedly demands money and has recently threatened physical harm. What should the social worker do FIRST?

A. Encourage the client to avoid answering phone calls

B. Arrange a joint meeting with the adult child

C. Assess the client's immediate safety concerns and discuss contacting law enforcement

D. Recommend family therapy to improve communication

Correct Answer: C

Rationale: Safety is the priority. Threats of violence require assessment of danger and discussion of protective actions, including contacting police if necessary.

A client diagnosed with obsessive-compulsive disorder reports spending hours repeating routines and checking behaviors each day. Which functional impairment is MOST likely?

A. Limited awareness of symptoms

B. Difficulty completing tasks efficiently at work or school

C. Lack of anxiety related to compulsive behaviors

D. Increased ability to manage stress

Correct Answer: B

Rationale: Obsessions and compulsions are time-consuming and commonly interfere with occupational, academic, and social functioning.

During couples therapy, the social worker consistently validates one partner's perspective while minimizing the concerns of the other partner. This situation BEST illustrates:

A. Countertransference

B. Triangulation

C. Splitting

D. Resistance

Correct Answer: B

Rationale: Triangulation occurs when a therapist becomes aligned with one member of a relationship system, disrupting neutrality and potentially reinforcing conflict.

A client reports feeling depressed "most days" for several years, with low energy, poor self-esteem, and hopelessness. Symptoms have persisted continuously for over 2 years without a manic episode. Which diagnosis is MOST consistent with this presentation?

A. Cyclothymic disorder

B. Major depressive disorder with psychotic features

C. Persistent depressive disorder

D. Adjustment disorder with depressed mood

Correct Answer: C

Rationale: Persistent Depressive Disorder (formerly dysthymia) involves chronic depressive symptoms lasting at least 2 years in adults.

Clients in a mental health group are encouraged by the group leader to interact and socialize with one another outside of scheduled sessions. The group is MOST likely:

A. Psychoanalytic group

B. Behavioral group

C. Supportive group

D. Transactional analysis group

C. Supportive group

Which statement BEST reflects the concept of empathy in social work practice?

A. Acknowledging the client's statements

B. Accepting the client without judgment

C. Understanding the client's internal experience

D. Agreeing with the client's perspective

C. Understanding the client's internal experience

A man from your neighborhood asks you to provide therapy for his adolescent son. You frequently interact with the father in social settings and share mutual friends. What is the BEST course of action?

A. Accept the case after reviewing confidentiality boundaries

B. See the son for an initial assessment and then decide

C. Refer the son to another qualified provider

D. Accept the case if the father agrees

C. Refer the son to another qualified provider

You practice in a small rural community. A local school requests that you evaluate a child for ADHD. What is the MOST appropriate initial step?

A. Explain that you will need consent from the child's parents

B. Conduct the evaluation immediately

C. Consult with the school before proceeding

D. Decline the request

A. Explain that you will need consent from the child's parents

A child cries when told to take a shower, and parents remove the demand. When the child stops crying, the parents allow him to avoid bathing. This is an example of:

A. Positive reinforcement

B. Negative reinforcement

C. Punishment

D. Modeling

B. Negative reinforcement

Rationale: Negative reinforcement strengthens behavior by removing an unpleasant stimulus (crying results in escape from shower).

The PRIMARY purpose of case management services is to:

A. Improve overall psychological functioning

B. Provide emotional support

C. Coordinate needed services and resources

D. Diagnose client conditions

Correct Answer: C

Rationale: Case management focuses on linking, coordinating, and accessing services.