NYC CASEWORKER (NYC HEALTH + HOSPITALS)
EXAM with Questions and Answers/Plus a Rationale
Updated 2026 A+/Instant Download PDF
EXAM COVERAGE
1. Social Work Theory, Psychosocial Assessment, and Clinical Intervention Strategies
2. Healthcare Delivery Systems, Hospital Discharge Planning, and Continuity of Care
3. Child Welfare, Elder Abuse, Mandated Reporting, and Domestic Violence Protocols
4. Crisis Intervention, De-escalation Techniques, and Suicide Risk Management
5. Psychopharmacology, Substance Use Disorders, and Dual Diagnosis Frameworks
6. Legal, Ethical, and Regulatory Standards in Healthcare (HIPAA, Confidentiality, Informed
Consent)
7. Community Resources, Public Benefits, Medicaid/Medicare Eligibility, and Case Management
1. A caseworker at an NYC Health + Hospitals acute care facility is conducting a comprehensive
psychosocial assessment for a newly admitted, unhoused patient presenting with untreated
schizophrenia and chronic homelessness. The patient expresses extreme paranoia regarding
medical staff and refuses to take prescribed antipsychotic medications. Which of the following
approaches represents the most appropriate initial clinical action aligned with trauma-informed
care principles?
A. Request an immediate court order for forced medication administration to stabilize the
patient's psychiatric condition quickly
B. Establish a therapeutic alliance through non-confrontational listening, validate the
patient's fears, and explore small, voluntary steps to address immediate physical comfort
C. Discharge the patient immediately to a local shelter since they refuse psychiatric treatment
, D. Involve security personnel to enforce hospital room restrictions and reduce the patient's
agitation by isolating them
CORRECT ANSWER : B
Rationale: Trauma-informed care prioritizes safety, trust, and collaboration over coercive
measures. Option B builds rapport and reduces paranoia, whereas Option A breaches patient
autonomy prematurely, Option C abandons a vulnerable client, and Option D exacerbates
trauma and escalates agitation.
2. A hospital caseworker is coordinating discharge planning for an elderly patient with severe
cognitive impairment who lives alone and has no identified family support. The medical team
clears the patient for discharge to home, but the caseworker determines the home environment is
unsafe. What is the caseworker's primary professional obligation?
A. Discharge the patient home as cleared by the medical team to free up acute hospital bed
capacity
B. Advocate for a delay in discharge, conduct a multidisciplinary safety review, and explore
higher levels of care such as subacute rehabilitation or adult protective services
intervention
C. Instruct the patient's landlord to provide daily personal care assistance
D. Leave discharge instructions on the kitchen table and close the case file
CORRECT ANSWER : B
Rationale: Safe discharge planning requires ensuring that a patient's post-discharge
environment matches their clinical and functional needs. Option B upholds safety and standard
of care, while Options A, C, and D risk patient abandonment and immediate readmission or
harm.
3. During an intake interview, an adult patient discloses that their partner routinely restricts access
to financial resources, monitors all communications, and has recently threatened physical
violence if the patient attempts to leave the apartment. How should the caseworker classify and
respond to this disclosure?
A. Treat the situation as a standard marital disagreement and offer couples counseling
B. Recognize indicators of severe domestic violence and intimate partner coercion, conduct
a specialized safety assessment, and connect the patient with confidential domestic violence
advocacy resources
C. Report the matter to child protective services immediately regardless of whether children are
involved
, D. Advise the patient to confront the partner directly to resolve the communication barrier
CORRECT ANSWER : B
Rationale: Financial and psychological control combined with threats of violence constitutes
severe intimate partner violence. Option B provides specialized, confidential safety planning,
whereas Option A endangers the victim, Option C misapplies agency mandates, and Option D
increases physical risk.
4. A caseworker receives a referral for a pediatric patient exhibiting unexplained linear burns and
severe withdrawal behaviors. When questioned separately, the parent offers contradictory
explanations for the injuries. Under New York State law, what is the caseworker's legal
mandate?
A. Maintain patient confidentiality and avoid reporting to prevent offending the parent
B. Immediately file a mandated report with the New York State Central Register of Child
Abuse and Maltreatment (SCR) and notify the hospital child protection team
C. Wait for a second physician to confirm the abuse before taking any action
D. Confront the parent aggressively during a family meeting
CORRECT ANSWER : B
Rationale: Caseworkers are mandated reporters under New York State law. Reasonable cause to
suspect child abuse or maltreatment requires an immediate report to the SCR. Options A, C, and
D violate legal mandates and endanger the child.
5. A caseworker is managing the care of a dual-diagnosis patient experiencing acute alcohol
withdrawal symptoms alongside major depressive disorder. The patient expresses passive
suicidal ideation. Which immediate clinical intervention is paramount?
A. Advise the patient that depression will resolve once sobriety is achieved without medical
support
B. Implement rigorous suicide risk precautions, ensure immediate medical detoxification
oversight, and coordinate a formal psychiatric evaluation
C. Discharge the patient with an outpatient self-help pamphlet
D. Reassure the patient that alcohol use is a minor lifestyle choice
CORRECT ANSWER : B
, Rationale: Dual-diagnosis patients with active withdrawal and suicidal ideation require
immediate medical stabilization for detoxification combined with structured psychiatric
evaluation and suicide precautions. Options A, C, and D expose the patient to severe medical
and psychiatric risk.
6. A patient with advanced chronic obstructive pulmonary disease (COPD) lacks decision-making
capacity and has no designated Health Care Proxy. The adult children disagree on whether to
pursue invasive life-support measures. How should the hospital caseworker assist in resolving
this ethical dilemma?
A. Make the unilateral medical decision on behalf of the hospital administration
B. Facilitate an ethics committee consultation, review any documented prior expressions of
the patient's wishes, and convene a family meeting mediated by clinical social work
C. Follow the preference of whichever child yells the loudest in the hallway
D. Discontinue all treatment immediately without consulting anyone
CORRECT ANSWER : B
Rationale: Complex surrogate decision-making disputes require formal ethics consultations,
family mediation, and careful exploration of the patient's substituted judgment or prior wishes.
Options A, C, and D violate healthcare ethics and legal standards.
7. A caseworker is assisting a low-income patient with applying for Medicaid and Supplemental
Nutrition Assistance Program (SNAP) benefits following a catastrophic medical event. The
patient is overwhelmed by the documentation requirements. What is the most effective case
management action?
A. Tell the patient to complete the digital applications independently from home without internet
access
B. Provide structured, step-by-step assistance in gathering identity, residency, and income
verification documents, and submit the applications via the NYC HRA ACCESS HRA
portal
C. Inform the patient that public benefits are unavailable to hospital patients
D. Instruct the patient to wait until their medical debt is sent to collections
CORRECT ANSWER : B
Rationale: Navigating public benefit systems requires active caseworker facilitation, reduction
of administrative barriers, and direct application support. Options A, C, and D fail to provide
necessary safety-net assistance.
EXAM with Questions and Answers/Plus a Rationale
Updated 2026 A+/Instant Download PDF
EXAM COVERAGE
1. Social Work Theory, Psychosocial Assessment, and Clinical Intervention Strategies
2. Healthcare Delivery Systems, Hospital Discharge Planning, and Continuity of Care
3. Child Welfare, Elder Abuse, Mandated Reporting, and Domestic Violence Protocols
4. Crisis Intervention, De-escalation Techniques, and Suicide Risk Management
5. Psychopharmacology, Substance Use Disorders, and Dual Diagnosis Frameworks
6. Legal, Ethical, and Regulatory Standards in Healthcare (HIPAA, Confidentiality, Informed
Consent)
7. Community Resources, Public Benefits, Medicaid/Medicare Eligibility, and Case Management
1. A caseworker at an NYC Health + Hospitals acute care facility is conducting a comprehensive
psychosocial assessment for a newly admitted, unhoused patient presenting with untreated
schizophrenia and chronic homelessness. The patient expresses extreme paranoia regarding
medical staff and refuses to take prescribed antipsychotic medications. Which of the following
approaches represents the most appropriate initial clinical action aligned with trauma-informed
care principles?
A. Request an immediate court order for forced medication administration to stabilize the
patient's psychiatric condition quickly
B. Establish a therapeutic alliance through non-confrontational listening, validate the
patient's fears, and explore small, voluntary steps to address immediate physical comfort
C. Discharge the patient immediately to a local shelter since they refuse psychiatric treatment
, D. Involve security personnel to enforce hospital room restrictions and reduce the patient's
agitation by isolating them
CORRECT ANSWER : B
Rationale: Trauma-informed care prioritizes safety, trust, and collaboration over coercive
measures. Option B builds rapport and reduces paranoia, whereas Option A breaches patient
autonomy prematurely, Option C abandons a vulnerable client, and Option D exacerbates
trauma and escalates agitation.
2. A hospital caseworker is coordinating discharge planning for an elderly patient with severe
cognitive impairment who lives alone and has no identified family support. The medical team
clears the patient for discharge to home, but the caseworker determines the home environment is
unsafe. What is the caseworker's primary professional obligation?
A. Discharge the patient home as cleared by the medical team to free up acute hospital bed
capacity
B. Advocate for a delay in discharge, conduct a multidisciplinary safety review, and explore
higher levels of care such as subacute rehabilitation or adult protective services
intervention
C. Instruct the patient's landlord to provide daily personal care assistance
D. Leave discharge instructions on the kitchen table and close the case file
CORRECT ANSWER : B
Rationale: Safe discharge planning requires ensuring that a patient's post-discharge
environment matches their clinical and functional needs. Option B upholds safety and standard
of care, while Options A, C, and D risk patient abandonment and immediate readmission or
harm.
3. During an intake interview, an adult patient discloses that their partner routinely restricts access
to financial resources, monitors all communications, and has recently threatened physical
violence if the patient attempts to leave the apartment. How should the caseworker classify and
respond to this disclosure?
A. Treat the situation as a standard marital disagreement and offer couples counseling
B. Recognize indicators of severe domestic violence and intimate partner coercion, conduct
a specialized safety assessment, and connect the patient with confidential domestic violence
advocacy resources
C. Report the matter to child protective services immediately regardless of whether children are
involved
, D. Advise the patient to confront the partner directly to resolve the communication barrier
CORRECT ANSWER : B
Rationale: Financial and psychological control combined with threats of violence constitutes
severe intimate partner violence. Option B provides specialized, confidential safety planning,
whereas Option A endangers the victim, Option C misapplies agency mandates, and Option D
increases physical risk.
4. A caseworker receives a referral for a pediatric patient exhibiting unexplained linear burns and
severe withdrawal behaviors. When questioned separately, the parent offers contradictory
explanations for the injuries. Under New York State law, what is the caseworker's legal
mandate?
A. Maintain patient confidentiality and avoid reporting to prevent offending the parent
B. Immediately file a mandated report with the New York State Central Register of Child
Abuse and Maltreatment (SCR) and notify the hospital child protection team
C. Wait for a second physician to confirm the abuse before taking any action
D. Confront the parent aggressively during a family meeting
CORRECT ANSWER : B
Rationale: Caseworkers are mandated reporters under New York State law. Reasonable cause to
suspect child abuse or maltreatment requires an immediate report to the SCR. Options A, C, and
D violate legal mandates and endanger the child.
5. A caseworker is managing the care of a dual-diagnosis patient experiencing acute alcohol
withdrawal symptoms alongside major depressive disorder. The patient expresses passive
suicidal ideation. Which immediate clinical intervention is paramount?
A. Advise the patient that depression will resolve once sobriety is achieved without medical
support
B. Implement rigorous suicide risk precautions, ensure immediate medical detoxification
oversight, and coordinate a formal psychiatric evaluation
C. Discharge the patient with an outpatient self-help pamphlet
D. Reassure the patient that alcohol use is a minor lifestyle choice
CORRECT ANSWER : B
, Rationale: Dual-diagnosis patients with active withdrawal and suicidal ideation require
immediate medical stabilization for detoxification combined with structured psychiatric
evaluation and suicide precautions. Options A, C, and D expose the patient to severe medical
and psychiatric risk.
6. A patient with advanced chronic obstructive pulmonary disease (COPD) lacks decision-making
capacity and has no designated Health Care Proxy. The adult children disagree on whether to
pursue invasive life-support measures. How should the hospital caseworker assist in resolving
this ethical dilemma?
A. Make the unilateral medical decision on behalf of the hospital administration
B. Facilitate an ethics committee consultation, review any documented prior expressions of
the patient's wishes, and convene a family meeting mediated by clinical social work
C. Follow the preference of whichever child yells the loudest in the hallway
D. Discontinue all treatment immediately without consulting anyone
CORRECT ANSWER : B
Rationale: Complex surrogate decision-making disputes require formal ethics consultations,
family mediation, and careful exploration of the patient's substituted judgment or prior wishes.
Options A, C, and D violate healthcare ethics and legal standards.
7. A caseworker is assisting a low-income patient with applying for Medicaid and Supplemental
Nutrition Assistance Program (SNAP) benefits following a catastrophic medical event. The
patient is overwhelmed by the documentation requirements. What is the most effective case
management action?
A. Tell the patient to complete the digital applications independently from home without internet
access
B. Provide structured, step-by-step assistance in gathering identity, residency, and income
verification documents, and submit the applications via the NYC HRA ACCESS HRA
portal
C. Inform the patient that public benefits are unavailable to hospital patients
D. Instruct the patient to wait until their medical debt is sent to collections
CORRECT ANSWER : B
Rationale: Navigating public benefit systems requires active caseworker facilitation, reduction
of administrative barriers, and direct application support. Options A, C, and D fail to provide
necessary safety-net assistance.
