LMSW LICENSING EXAM TEST BANK 2022

LMSW LICENSING EXAM TEST BANK 2022LMSW LICENSING EXAM TEST BANK 2022 1. A 35 year old individual has recently experienced the death of a parent and the loss of a job, and has increased consumption of alcohol. Which of the following areas should be assessed FIRST by the social worker? a. Financial resource availability b. Potential for suicidal behavior c. Need for grief counseling d. Extent of substance abuse Rationale: FIRST, the social worker would act to determine the client’s safety. The only option that addresses the client’s safety is (B). Options A, C, and D may be appropriate later, once the safety of the client has been addressed. 2. The ability to keep personal feelings and needs separate from work relationships BEST represents which social work ethical standard? a. Professional discretion b. Responsibility to the profession c. Professional boundaries d. Responsibility to colleagues Rationale: This requires knowledge of the definition of professional boundaries (C). Since the question asks for the BEST response, the secondary responsibilities in the other options are not correct. 3. A social worker has been treating a client for two months in an agency setting and is experiencing intense sexual attraction toward the client. The social worker’s BEST response is to: a. Consult with an agency supervisor about the case b. Reveal the attraction to the client c. Transfer the client to another agency worker d. Work toward ending the client’s services at the agency Rationale: Consulting with a supervisor (A) is the BEST response because it assists in helping to understand and address the situation. Options B and D are clearly unethical. Transferring the client (C) may be done later but it is unclear if this action is required at this point and there is not enough information in the stem to conclude this. 4. In a routine review of case records at a mental health center, a social work supervisor discovers that case managers routinely refer all Native American clients to either Alcoholics Anonymous or Al-Anon. In discussing this practice with the case managers, the supervisors learns that the referrals are made without obtaining information about the clients’ use or abuse of substances. How can the supervisor effectively address this practice? a. Reprimand case managers providing client services based on stereotyping b. Educate the staff about services provided by Alcoholics Anonymous and Al-Anon c. Provide staff training about culturally competent social work practice d. Allow no referrals to be made without approval from the supervisor Rationale: It is important to provide educational interventions (C) before moving to more restrictive supervisory practices. Options A and D are more restrictive and may be done later, after the provision of base line training first. While staff members may benefit from being educated about AA and Al-Anon (B), it does not address the concern of stereotyping that is occurring. 5. At an intake session, a client requests medication for sleep. Since becoming unemployed the client has used alcohol as a sedative. The client is worried about finances and is afraid of being evicted. The social worker should FIRST: a. Refer the client for evaluation for sleep medication b. Refer the client to public assistance c. Obtain more information about the client’s use of alcohol d. Refer the client to the local unemployment office Rationale: While options A, B, and D may all be appropriate actions for the social worker to take, none would be the first. As part of the assessment process, the social worker needs to FIRST further explore the issue of alcohol use (C). 6. A client with whom a social worker has worked for several years suddenly dies. The social worker is very distressed by the death. During supervision, the supervisor encourages expression and ventilation of feelings. The supervisor is providing: a. Education b. Consultation c. Therapy d. Support Rationale: The correct answer is (D) because ventilation is one of the techniques used in providing support. 7. A school age boy is being beaten almost daily by his father who has a drug and alcohol problem for which he received no treatment. The boy solves his school conflicts by punching and kicking younger children. This behavior is BEST described as: a. Identification with the abuser b. Hostility toward peers c. Conduct disorder, group type d. Passive-aggressive personality disorder Rationale: Basic recall of cycle of abuse concepts and dynamics. Option D is not reasonable given the information in the stem and is not a current personality disorder. He may be hostile towards peers (B) but it is because of his identification with the abuser. Option C and D are not indicated and do not BEST explain his behavior. Option A is the BEST descriptor of what is occurring. 8. Client feedback that indicates a social worker’s interpretation is on target is BEST displayed when the client: a. Argues with the social worker b. Changes the subject c. Expresses anger at the social worker d. Discusses related material Rationale: The effectiveness of a response can be assessed through client reaction. Continuing to stay on target in the discussion (D) indicates a good progression. 9. A social work administrator is responsible for record keeping at a large agency. Which approach is MOST appropriate for maintaining client records? a. Maintain all records for seven years following termination b. Keep records indefinitely to assure their availability c. Seek permission from clients for destruction of their records d. Store records for the number of years required by law Rationale: Social workers are required to follow the laws of the jurisdictions in which they practice. Such statutes vary in their requirements. Hence, the only option that is correct is to maintain files for the length of time required by law (D). Options A, B, and C might not apply in all locations. 10.A school social worker meets with a teenager who is increasingly frustrated and disengaged in school. The student appears to be bright, but unmotivated, and does not submit completed homework assignments. Meetings with the student have not resulted in changes in the teen’s behaviors. What should the social worker do NEXT? a. Consider an alternative educational program for the student b. Arrange for individual tutoring sessions for the teen c. Refer the teen for evaluation by an educational psychologist d. Create a behavioral self-monitoring plan with the student Rationale: Unscored question. The fact that the student is noted as bright, but unmotivated, may indicate a learning problem. Of the choices listed, (C), is the correct answer because the social worker has not been successful in helping the teen, and the problem may be more than behavioral (D). 11.A doctor notifies a hospital social worker that a child with a chronic illness has not kept any appointments in the past year and must be evaluated four times a year. The doctor states that if the child does not come for the appointments, it will be considered medical neglect by the parents. The social worker learns the mother has a physical disability and lives over an hour away from the medical center. The mother asks if the child can be treated at a local medical center instead. What is the MOST appropriate action for the social worker to take? a. Insist that the child go to at least four medical visits per year b. Explore an alternative treatment schedule with the doctor c. Empathize with the mother about the limitations of her physical disability d. Determine if the child can receive health care services near the home Rationale: Goal is to find a feasible way for the child to receive medical treatment. Hence A, B, and C are incorrect because none of them would remove the barriers to the child’s medical treatment. Finding health care services near the child’s home, (D), could potentially remove one of the perceived barriers. 12.A client is referred to a social worker regarding depression that began eight months earlier. The client reports irritability, sleep problems, and loss of appetite. In exploring the onset of the depression, the social worker learns that the client had an abortion nine months ago. What should the social worker do FIRST? a. Complete a comprehensive eating disorder assessment b. Offer relaxation strategies to address sleep problems c. Refer the client to a grief and bereavement group d. Ask about the meaning of the abortion to the client Rationale: The social worker should start with the problem presented by the client, which is depression. In assessing the depression, the worker would ask the client to explain her feelings about the abortion (D). Options A, B, and C may all be done later, but the FIRST action is to determine the meaning of the abortion for the client. 13.An adoption social worker is involved in permanency planning for siblings and wants to place them in the same home. One of the siblings is receiving therapy and has severe behavioral problems that may make adoption difficult. In considering whether the siblings can be placed together, what should the social worker do FIRST? a. Plan for long-term placement based on the children’s preference b. Request a recommendation from the child’s psychologist about placement risks c. Allow the children to remain in foster care until they can be adopted together d. Make the decision to separate the siblings permanently to facilitate adoption Rationale: Unscored question. This question is asking for the FIRST thing to be done in this situation. Obtaining a recommendation from the child’s psychologist about placement risks (B) will allow the social worker information to consider in taking appropriate action. 14.A family services agency has a high number of clients who do not keep appointments. The agency’s social work administrator conducts a client satisfaction survey, which reveals that clients believe the agency is not welcoming to their children. To address the clients’ concerns, the administrator should FIRST: a. Create specialized activities for children b. Evaluate the need to change agency programs c. Obtain consultation to develop an action plan d. Form a committee of clients and staff to identify solutions Rationale: Forming a committee (D) engages the clients and staff in formulating solutions. FIRST engaging those who are directly involved is an important consideration. After forming the committee, options A, B, or C may follow, but would not be done first. 15.During an initial therapy session with a social worker, a client indicates that she wants to disclose certain information but is reluctant to do so because it involves others in her family. In response, the social worker should: a. Explain that the social worker is ethically mandated to maintain confidentiality b. Discuss the issue of confidentiality and the factors that would cause disclosure c. Assure the client that she does not have to share any information until she is ready to do so d. Quickly establish rapport with the client to increase her level of trust Rationale: Client is ready to share but is reluctant about how it might impact others in her family. Discussing confidentiality and factors that would cause disclosure (B) recognizes that there may be times when information needs to be disclosed. This is ethical to do in an initial session and is part of the informed consent process. Option A suggests a blanket statement that does not educate the client about those situations in which disclosure may be necessary. Options C and D are incorrect because both do not address the client concern. 16.A rural social worker has recently been assigned to work with a person convicted of child molestation. The social worker is not knowledgeable or skillful enough in the treatment of sex offenders to provide effective services. What should the social worker do in this situation? a. Conduct a review of the research literature to identify an evidencebased approach b. Consult professional colleagues about the situation and follow their recommendations c. Suspend the client’s treatment until the social worker receives adequate education and training d. Find and use the supervision of an expert in treating sex offenders Rationale: Option A is not correct because simply being able to identify an evidence-based approach is not sufficient to equip the social worker to use the approach. Option B is incorrect because there is no indication that the worker’s professional colleagues have the necessary expert knowledge and skills in this area of practice. Postponing services, (C), is not appropriate. Finding and using supervision of an expert (D) is an appropriate resource that might be available to a rural social worker. 17.Privileged communication is BEST defined as: a. Ethical standards that dictate the social worker cannot reveal client information under any circumstances b. Advance directives, such as living wills and enduring powers of attorney, which protect client wishes and decisions c. The privileges granted the client in communication with the social worker d. Legal rights that, under certain circumstances, protect clients from having their communications revealed in court without their permission Rationale: Item requires recall of the definition for privileged communication as well as reasoning. Privileged communication is a legal concept, therefore D is the correct answer. It is neither an ethical standard (A), nor advanced directive (B). Option C is incorrect because it only states a selected aspect of the definition. 18.Over a period of several months a social worker thoroughly prepares a client for joining a group, including establishment of a contract for three months of participation. After one group session, the client informs the social worker that she will not return to the group. What should the social worker do FIRST? a. Remind the client of her commitment to three months of group participation b. Terminate the client from all services c. Discuss the client’s failure to integrate with the group d. Encourage the client to discuss her reasons for leaving Rationale: Unscored question. The FIRST thing that a social worker should do when a client decides to discontinue therapy is to try to determine the reasons (D). Options A and C seem to blame the client and may do more harm than good. Option B is an extreme reaction as it terminates the client from all services, not just group. 19.Research findings from a study of cancer patients in one hospice agency can be generalized to: a. All hospice patients b. All cancer patients c. The general population d. The population studied Rationale: Research findings from an isolated study of one population in one agency can only be extrapolated to that particular population (D). The variability of both the particular group being studied and the setting for the study makes generalization beyond the target population reliable. 20.A social worker meets with a group of concerned citizens who want to stop youth drinking and driving. At an initial meeting, it is suggested that if the youth can find jobs then they will not drink. Another suggestion is that the parents should become more involved in the youths’ lives. They also want the police department to be more accountable for what happens with the youth. What should the social worker encourage the group to consider FIRST? a. A meeting with the police department to learn about policies and procedures b. Recommending that the licenses of youth who drink and drive be revoked c. A joint meeting with the youth to understand their concerns and issues d. Collection of all the statistics about youth and crime for the town Rationale: Citizens have several competing suggestions for dealing with this problem and need to make effective plans, but these plans will only be effective if they are responsive to the youths. A joint meeting with the youths FIRST (C) is the only option that would help the group develop a meaningful plan. Collecting all crime statistics (D) is not pertinent to the issue of concerns of youth drinking and driving. Both options A and B are premature. 21.What is the FIRST thing that social workers should do when attempting to evaluate institutionalized racism in their agencies? a. Analyze the agencies’ policies and procedures b. Discuss the issue of fairness with their supervisors c. Review literature on eliminating discriminatory practices d. Review policies that have been successful in other agencies Rationale: Analyzing policies and procedures (A) is the FIRST action to take initially. After assessing, options B, C, and D may be appropriate. A social worker may conduct research on ways to evaluate agency practices but not on eliminating discrimination (C). It is important to understand agency practices FIRST. 22.In a clinical setting, information gathered from an ecomap is MOST often used to: a. Identify a family’s evolutionary patterns b. Assess family strengths and weaknesses c. Assess intrafamilial communication patterns d. Identify systems that are part of a family’s life Rationale: Basic recall of the uses of an ecomap (D). Other tools are used to determine options A, B, and C. 23.A school social worker working with an adolescent girl is concerned about the girl’s weight loss and withdrawal from her peer group. Upon questioning, the girl expresses fear of gaining weight, and states that she exercises three hours a day and has stopped menstruating. What initial diagnosis should the social worker consider? a. Obsessive-compulsive disorder b. Anxiety disorder c. Bulimia nervosa d. Anorexia nervosa Rationale: Only anorexia nervosa (D) includes all of the conditions described by the client in the stem. Basic recall item. 24.A social worker at a senior health center is working in a government program that provides services to all seniors. What is this approach to the provision of services called? a. Incremental b. Institutionalized c. Preventive d. Residual Rationale: Basic recall of policy definitions. 25.A social worker in a youth recreation program conducts an initial interview with a teenager. The social worker concludes that the presenting problems involve the teen’s need to get a job to meet personal needs. What should the social worker do NEXT? a. Contact the teenager’s parents b. Consult with the supervisor c. Discuss planning with the client d. Provide needed assistance Rationale: Planning should be discussed with the client NEXT (C). Options described in A and B may or may not be done later, option D does not address the presenting problems. 26.A social worker can BEST enhance a family’s ability to understand each other’s views by requesting that they: a. Clarify each family member’s statements b. Identify weaknesses in the other family member’s arguments c. Focus on the identified client d. Remain silent while the other family members are talking Rationale: Option C suggests scapegoating one identified family member. Additionally, there is no indication that there is one identified client. Option B would invite additional conflict and is not the best option. Option D encourages listening skills, but this is no guarantee that members will comprehend what is being stated. The BEST answer is A, as it requires the social worker to restate the family’s viewpoints in an attempt to help everyone understand their meanings. 27.During supervision, a social worker talks about personal feelings of inadequacy that surfaced during sessions with a particular client. The social worker’s reaction describes: a. Resistance b. Countertransference c. Transference d. Projective identification Rationale: All the options except (B), countertransference, describe reactions by the client. Countertransference is the answer because it is the only response that deals with the reactions by the social worker. 28.An agency social worker becomes aware that a co-worker frequently consumes alcohol on their lunch break. When this occurs, the co-worker does not appear intoxicated. This individual is responsible for driving foster children to and from specialized services throughout the day. What is the FIRST action the social worker should take? a. Discuss the drinking directly with the co-worker b. Inform the co-worker’s supervisor of the behavior c. Continue to observe and document the co-worker’s actions d. Consult the state social work regulatory board for direction Rationale: Code of Ethics specifies the area of responsibility to colleagues and suggests that talking with the co-worker (A) is always done FIRST. The next action would be to inform the supervisor (B) but it would not occur first. Option C potentially places clients at risk, while consulting the regulatory board (D) is a step that would be taken later if necessary. 29.The personality disorder that is characterized by a restricted range of emotional experience and expression is: a. Antisocial b. Schizoid c. Histrionic d. Dependent Rationale: Basic recall of knowledge of personality disorders. 30.A nursing home social worker has a client who is elderly and mentally alert. The client declines a medical procedure that most likely will prolong 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 capacity to make the decision b. Explain to the client the treatment choice that has been made c. Allow the client’s family member to make an appropriate choice d. Challenge the adult child’s decision only if it seems to violate ethical principles Rationale: Question addresses the role of self-determination in social work practice. In the absence of a legally appointed guardian, the client’s wishes must be respected (A). 31.A client begins seeing a social worker at the encouragement of family members. Family members are concerned about the client’s well-being after losing a long-term job seven months ago. The client reports being frequently irritable and unable to focus on tasks. The client has also been experiencing nausea, excessive perspiration, and insomnia. The client is MOST likely experiencing which disorder? a. Posttraumatic stress b. Generalized anxiety c. Acute stress d. Dysthymia Rationale: Requires knowledge of how various disorders are defined. Generalized anxiety (B) reflects the client’s behaviors, given the history provided. Options A, C, and D can be ruled out for various reasons – posttraumatic stress (A) is a response to an event beyond normal experience; acute stress (C) refers to an immediate response to a grave threat; symptoms associated with dysthymic disorder (D) must be present for longer than two years. 32.A belief that one’s thoughts alone can result in the accomplishment of certain wishes is: a. Depersonalization b. Magical thinking c. Thought broadcasting d. Looseness of associations Rationale: Basic recall item requiring knowledge of cognitions. 33.Which of the following activities is LEAST effective for the social worker in engaging clients in the beginning phase of treatment? a. Considering options for problem resolution with the client b. Exploring the client’s perceptions of the problem c. Reducing the client’s anxiety by providing support d. Clarifying the services that can be offered to the client Rationale: Options B, C, and D are all aspects of the first steps of engagement and discussion of the services the social worker provides. Option A occurs later in the problem solving process, making it the LEAST effective activity in engagement. 34.A supervisor finds that a social worker has good skills interviewing clients, but has difficulty in clearly presenting case information. What is the FIRST thing that the supervisor should recommend to enhance the social worker’s skills in this area? a. Increase the number of cases the worker presents in supervision b. Record information after each session to help prepare for supervision c. Review the treatment plans of other workers in the agency d. Reduce caseload size and complexity for a training period of three months Rationale: Unscored question. The supervisee’s FIRST task is to ensure that sufficient information is recorded for purposes of presentation (B). Reducing caseload size and complexity (D) will not improve clarity in presentations. Options A and C are steps which could be taken after organizing the information to be presented. 35.In developing a therapy group in an adult psychiatric setting, which of the following criteria will be MOST important? a. Diagnosis b. Family status c. Level of functioning d. Intellectual capacity Rationale: In an adult psychiatric setting, one would expect a wide range of diagnoses, family statuses, levels of functioning and intellectual capacities. Of those, the MOST important for successful group functioning is the participants’ level of functioning (C). 36.A 22 year old patient is currently in residential treatment because of her developmental disability. She reports to the social worker that her uncle sexually abuses her while on home visits and she doesn’t want him to do this anymore. The social worker’s FIRST response should be to: a. Investigate the validity of the client’s allegations b. Help the client report the abuse to the appropriate authorities c. Contact the client’s parents and inform them of the situation d. Require that all visits take place at the client’s residential treatment facility Rationale: Helping the client report the abuse (B) promotes client selfdetermination and addresses the alleged abuse. The social worker does not have the client’s consent to contact the parents (C). Option D does not support the client’s issue of abuse or self-determination. It is not the role of the social worker to investigate the allegations (A). 37.A social work student is providing therapy during a field placement at a community mental health center. A client reports the urge to overdose on a bottle of medication to escape emotional pain. The student has no experience working with clients who are suicidal. What is the BEST action for the social work student to take? a. Explore the reasons for the client’s pain b. Contract with the client for safety c. Bring the supervisor into the session d. Inquire about access to the medication Rationale: Test item is attempting to assess whether the respondent knows the BEST step to be taken. In situations where a social worker requires expert information that he or she lacks, it is always prudent to first seek the supervisor’s guidance. This case involves suicidal ideation and the social worker is a student. The urgency of the matter, coupled with the fact that the field supervisor is at the first level of authority, indicates that C is correct. 38.The systems approach in social work practice is MOST accurately described as a: a. Framework for analyzing problems b. Way in which clients can alter their environment c. Pattern of interactions among role actors d. Set of principles for family intervention Rationale: The systems approach is not limited to family intervention applications (D) or to ways in which clients can change their environment (B). The pattern of interactions (C) is only a section of the systems approach. It provides a way of looking at a client’s situation (A), which is the correct answer. 39.A social worker has been treating an adolescent for one year but has met with the parents only briefly at the time of intake. The social worker has been appointed to a local committee and has learned that the client’s mother is also on the committee. It would be most appropriate for the social worker to FIRST: a. Resign from the committee b. Transfer the adolescent to another social worker c. Inform the adolescent about the situation d. Avoid talking to the mother in the committee meetings Rationale: Question is asking what the social worker should do FIRST. The answer is (C) because the adolescent is the client; speaking with the client FIRST would yield the best indicators of what action might be necessary. Even if the mother were the client, resigning from the committee (A) is not a plausible FIRST step. Option B is not an appropriate first step because the adolescent has been a client for a year and an immediate transfer to another social worker could have negative consequences. Avoiding talking to the mother in the committee meeting (D) would not be a necessary first step. 40.A Navajo couple bring their sick child to a health clinic close to the reservation. The non-Navajo physician and clinic supervisor criticize the family for first taking the child to a traditional Navajo healer. This behavior is BEST understood in what context? a. Concerns about medical neglect b. Institutional discrimination c. Concerns about parental mental health issues d. Staff burnout Rationale: The behavior of the physician and supervisor reflect the discriminatory attitudes that can occur at the institutional level (B). The stem contains no indication that the parents have been neglectful (A) or that their mental health status is in question (C). Staff burnout (D) may or may not be present, but this is not the BEST understanding of the reaction. 41.What type of schizophrenia is marked by psychomotor disturbance involving stupor, negativism, rigidity, excitement, or posturing? a. Catatonic b. Paranoid c. Disorganized d. Hebephrenic Rationale: Recall item that requires knowledge of schizophrenia. 42.A social worker plans to refer a client for services at a substance abuse rehabilitation center. What is the FIRST step the social worker should take in the referral process? a. Set up a face-to-face meeting with a social worker from the rehabilitation center b. Write a referral report that presents the services previously provided to the client c. Discuss with the client the resources and services available at the rehabilitation center d. Arrange for the client to take a tour of the new facility and speak with a current client Rationale: Discussing available resources and services (C) is the FIRST step because it supports the concept of self-determination. This allows the client to decide whether or not to enter the rehabilitation center. 43.Which of the following interventions BEST addresses the treatment of a family life cycle crisis? a. Discussing origins of presenting problem b. Enabling family members to solve immediate problems c. Working through the crisis while preparing the family for ongoing changes d. Working with the parents to reestablish family roles Rationale: Before work can begin on A, B, and D, the social worker needs to help the family resolve the crisis (C). Option C addresses life cycle issues and prepares the family to manage future problems. Options B only focuses on the current issue. Option A and D could occur in treatment, but not in the immediate crisis situation. 44.A social worker who advocates for legislative change can BEST build credibility with legislators by: a. Engaging in direct confrontation b. Applying political pressure c. Avoiding agency affiliation d. Participating as a team player Rationale: Participating as a team player (D), will BEST provide the social worker with an opportunity to build relationships with legislators through providing useful information and other needed resources. Options A, B, and C do not accomplish this as well. 45.Which of the following conditions is NOT a cause of dementia in the elderly? a. Dehydration b. Korsikoff’s disease c. Cerebral vascular accident d. Osteoporosis Rationale: Item requires knowledge that osteoporosis is not directly linked to dementia. 46.A social worker at a correctional facility is providing a treatment group for substance abusers who are at the prison. A prison classification committee has selected 12 group participants of various racial and ethnic backgrounds. During the first three weeks of group, the social worker notices that very few inmates seem willing to speak. Which statement MOST likely explains the members’ reluctance to talk in the group? a. Inmates tend to exhibit much denial about substance abuse problems b. Racial tensions in prison populations inhibit communication in treatment situations c. Inmates often have an adversarial view of non-inmates which can hamper disclosure d. Self-disclosure in group treatment contradicts behavioral expectations of prison culture Rationale: In a prison culture, the environmental influence does not promote participant self-disclosure (D). Option B focuses on racial tension as one possible explanation, but does not take into account the early stages of the group process and prison culture. There is not enough information in the stem to determine that option C is correct. Option A is an assumption that is stereotypical of prison inmates. 47.A client who experienced severe neglect by his biological parents during infancy is brought to a social work agency for evaluation. According to records, the client lived with several foster families before being adopted at the age of five. Despite receiving consistent nurturance from his adoptive family, the client has failed to bond with them. Upon initial assessment, a social worker notes that the client’s inhibitions and ambivalence toward others could indicate the presence of: a. Rett’s disorder b. Selective mutism c. Separation anxiety disorder d. Reactive attachment disorder Rationale: Basic recall of the indicators of reactive attachment disorder. Options A, B, and C could be reasonable but the stem points more directly to reactive attachment disorder (D). 48.A social worker is contacted by a client whose initial complaint is depression. The client reports symptoms of insomnia, headaches, inability to eat, vomiting, and neck aches. The FIRST action the social worker should take in this situation is to: a. Obtain a detailed social history on the client b. Probe for a substance abuse problem c. Engage the client in establishing goals d. Ask the client to seek medical consultation Rationale: The realm of symptoms indicates a potential medical issue, which indicates the FIRST action to take (D). Option C may be a step further along in the process, while obtaining a social history (A) and assessing for a substance abuse problem (B) may be done later. It is important to FIRST rule out medical issues. 49.A social worker is providing court mandated services to a child of a divorcing couple. The court has granted the father sole custody. The child’s mother demands the social worker share the child’s records with her. What should the social worker do in response to the request? a. Schedule a session with both parents b. Disclose all records to the biological mother c. Provide the limitations of disclosure in writing d. Encourage the mother to talk with the father Rationale: Given that it is court mandated, the social worker needs to provide the limitations of disclosure in writing (C). This protects confidentiality of the child and addresses the mother’s request. Scheduling a session with both parents (A) would not be done right away, and does not respond to the request. Disclosing all records to the biological mother (B) may potentially violate a court order. Encouraging the parents to talk (D) may promote further conflict and is not appropriate. 50.A social worker who is part of an interdisciplinary team is collaborating in a patient’s care in a mental health facility. The social worker disagrees with the other team members about the appropriate time for discharge of the patient. What should the social worker do? a. Withdraw from the team after providing an explanation b. Contact the patient’s family about the team’s decision c. Focus on shared values and skills to resolve the conflict d. Support the majority vote after voicing concerns Rationale: Unscored question. The social worker is part of an interdisciplinary team and each member has a specific role in the provision of services to the patient; therefore, C is the correct answer in attempting to resolve conflict in the best interests of the client. Withdrawing from the team after providing an explanation (A) or supporting the majority vote after voicing concerns (D) does not resolve the problem or the disagreement about the timing of the patient’s discharge. Contacting the patient’s family about the team’s decision (B) would be appropriate only if patient consent is given. 51.A social worker is working in a mental health agency with a client who has met with several other social workers in the agency. After the third session, the client calls and leaves a message stating an intention to discontinue. What should the social worker do? a. Wait for the client to reconnect with services if desired b. Ask the client to schedule a session to discuss the decision c. Contact the client to explore referral options d. Refer the client’s case to the agency’s clinical supervisor Rationale: The appropriate action is to determine why the client intends to discontinue (B). To wait until the client reconnects (A), without having any sense about the reason for discontinuation, may not be safe. To contact the client to explore referral options would only perpetuate what appears to be a cycle (C). Option D can be ruled out because referring to a clinical supervisor might not be necessary. 52.A community-based mental health clinic has just added a computer program that social work staff will be using for client data. The MOST important benefit of this system for the agency is to: a. Increase the security of client files b. Improve client satisfaction with the social worker c. Save time for the staff when completing assessments d. Standardize information gathered about the clients Rationale: Because the goal of improved services should be the guiding principle of an agency, the MOST important benefit of a computer program would be to standardize information that could in turn be used in evaluations of service (D). The benefits described in options A, B, and C are positive outcomes, but not the MOST important benefit. 53.A social worker studying parent-child interactions observes that an eightmonth old baby prefers his father over all other caregivers and makes intentional efforts to be near him. This behavior is BEST described as a reflection of: a. Object permanence b. Concrete operations c. Maternal deprivation d. Secure attachment Rationale: Recall item of normative child development. Secure attachment (D) is the only term that fits the scenario. Object permanence (A) applies to absent people or objects. Concrete operations (B) occurs with children older than the eight-month old baby and maternal deprivation (C) is incorrect because there is no mention of the mother in the stem. 54.A Caucasian social worker meets a new Latino client for an initial assessment in an outpatient clinic. The social worker notes that the client appears very anxious, defensive, and somewhat hostile. After some discussion, it appears that the cultural differences may be interfering with the client’s ability to develop rapport with the social worker. What should the social worker do? a. Assure the client of the social worker’s knowledge of Latino values b. Refute the client’s negative perceptions about Caucasians c. Offer to transfer the client to a minority social worker d. Discuss and acknowledge the client’s concerns Rationale: Options A and B are likely to make the situation worse. While a transfer may be necessary at some point (C) given the circumstances presented in the stem, acknowledgement and discussion of concerns (D) is the most appropriate way to address the situation. 55.A mother in an intact family seeks help for her child at a child guidance clinic but informs the social worker that she does not want her husband to know that she has applied. The social worker should FIRST: a. Respect the client’s wishes and continue to work with her on that basis b. Explain to the client that the entire family should be seen c. Explore the husband’s feelings about the service d. Explore the client’s reasons for not wanting her husband involved Rationale: The social worker should engage the client in a discussion about her feelings regarding the child’s father FIRST (D). This will help the social worker develop an understanding of the familial patterns so that work with the mother and the child will be more effective. Options A, B, and C may be reasonable steps to do later, but not before FIRST exploring the client’s reasons for excluding the husband’s involvement. 56.A school social worker has written parental authorization to provide treatment to a teenager with academic problems. The teen reveals being distracted by an intimate relationship with a classmate, which is noted in the record. After several sessions, the parents, who are unaware of the relationship, submit a written request for a copy of the teen’s record. What should the social worker do FIRST? a. Provide a complete copy of the record b. Send carefully selected parts of the record c. Follow appropriate jurisdictional regulations d. Offer to read portions of the record to the parents Rationale: Unscored question. The FIRST thing for this social worker is to follow appropriate jurisdictional regulations (C). These regulations will guide the social worker in what type of information can be released to the teen’s parents. 57.At what age does separation anxiety occur? a. 24 months b. 18 months c. 12 months d. 9 months Rationale: Item requires basic recall of ages when separation anxiety normally occurs. 58.Both the general public and decision makers have very little awareness of a community problem brought to the attention of a social worker. What strategy can BEST facilitate the development of policies or programs to correct the problem? a. Conducting extensive client satisfaction surveys b. Conducting empowerment training for key players c. Using multiple forms of media communication d. Circulating a petition in the neighborhood Rationale: Using multiple media communication techniques (C) BEST addresses the concern regarding community awareness. While conducting satisfaction surveys (A) and empowerment training (B) may be steps later in the development of policies or programs, neither focuses on the specific concern. Circulating a petition (D) does not educate the general public or decision makers. 59.An acute care hospital social worker is asked by a doctor to see a patient who was admitted after ingesting a large quantity of laundry detergent. The patient is alert and oriented and states he was trying to kill himself. His affect is flat and he makes little eye contact. He states that he is discouraged that he did not succeed in the suicide attempt. What should the social worker do FIRST? a. Request a psychiatric evaluation b. Request a psychological evaluation c. Refer the patient for psychopharmacology evaluation d. Offer therapy to help the patient develop ways to cope with depression Rationale: Unscored question. A suicide attempt has been made and acknowledged by the patient, who also says that he is discouraged that he did not succeed. A psychiatric evaluation is necessary (A) to determine the appropriate intervention, which may be medication. 60.The FIRST task of a multidisciplinary team is to: a. Discuss, clarify, and commit to an overall purpose b. Identify how each team member will communicate with others c. Agree on the roles and functions of each team member d. Define how work tasks will be achieved Rationale: A multidisciplinary team features those with a variety of backgrounds coming together for a common purpose. A team without a common purpose will not function, having no reason to exist. Before deciding how communication will occur (B), what roles team members will play (C) and how tasks will be accomplished (D), an overall purpose FIRST must be discussed and committed to by team members (A). 61.A nursing home social worker has arranged for a resident to return home after receiving rehabilitative services. The social worker has made arrangements for home health care and an in-home meal supplier to provide services to the client. After the resident’s discharge, what should the social worker do? a. Put the resident’s file in closed records so that it doesn’t get confused for an open case b. Call the resident in one to two weeks and ask how the services are working out c. In one to two weeks, call the home health care agency to see how services are working out d. Call the resident’s family and inquire how the discharge is working out Rationale: The social worker’s responsibility is to the resident and not with the home health agency (C) or the resident’s family (D). Additionally, unless there has been consent given, the social worker cannot contact either. Option A implies that responsibility to the client ends when the resident leaves the facility, and it does not. Contacting the resident in follow up (B) is the most appropriate action. 62.A 13 year old adolescent meets with a social worker because of poor hygiene, sleeping in class, and stealing food from the cafeteria. What should the social worker assess for FIRST? a. Conduct disorder b. Child neglect c. Substance abuse d. Adolescent rebellion Rationale: Item test s basic knowledge of indicators of neglect. A social worker would assess for child neglect FIRST (B), insuring the client’s safety. Poor personal hygiene, sleeping in class, and stealing food are not classic symptoms of conduct disorder (A) or adolescent rebellion (D). C is possible but would not be assessed FIRST and does not address level of safety. 63.A gay or lesbian adolescent faces the greatest need of treatment and the MOST stress during which of the following stages? a. Becoming involved in an intimate same-sex relationship b. ‘coming out’ and acknowledging gay feelings c. Experimenting with gay identity d. Experiencing the sense of being different Rationale: Item requires basic knowledge of the stages of gay identity development. 64.A nonprofit social work agency is preparing to develop its strategic plan for the upcoming five years. What is the FIRST step in the process? a. Complete an assessment of the internal environment, including the agency’s recruitment and retention history b. Coordinate a meeting of the board of directors to develop a long-range financial plan for capital expenditures c. Conduct an assessment of the external environment, including strengths, weaknesses, threats, and opportunities d. Reevaluate the mission and vision statements to be sure that they reflect the agency’s most highly regarded values Rationale: Important element in the stem is the idea of what is done FIRST. Although options A, B, and C pertain to steps the worker might take in long-term planning, the most appropriate FIRST step is to reevaluate the mission and vision statements (D). Long-term organizational planning appropriately beings with the mission statement. All subsequent decision making would flow from the mission or vision for the agency. 65.A young man comes to a social worker very upset because he is unhappy in his marriage and wants to end it. His religion, which is important to him, prohibits divorces. He states that he does not know why he is so unhappy and that he feels guilty about wanting to end the marriage. His wife does not want him to leave. She has the support of his family and their church. The social worker’s INITIAL action should be to: a. Explore the history of the marital relationship with the client b. Schedule a joint appointment with the couple c. Refer him for pastoral counseling d. Explore the client’s support network Rationale: The social worker’s FIRST action should be to assess the client and his marital history, given his stated concerns (A). Other actions may be taken later, as noted in options B, C, and D. 66.In clarifying expectations in the social worker/client relationship, which of the following factors is MOST important for the client and social worker to establish? a. A time and place to meet b. The extent of the client’s problem c. Roles and responsibilities d. Mutual respect Rationale: In order to understand what is expected in a social worker/client relationship, roles and responsibilities must be clarified at the onset. Option A would occur as part of the contract, while (B) is part of the problem-solving process. Mutual respect (D) is an outcome when the social worker/client relationship exhibits professionalism. Therefore, roles and responsibilities (C) is the correct response. 67.A social worker has been leading a therapy group for two months. Some of the group members begin to challenge the social worker as the leader of the group. What should the social worker do? a. Remain consistent in the manner of leading the group b. Use self-disclosure to change the power balance c. Seek support from the other group members d. Assert authority to manage the group Rationale: Unscored question. While conflict is a normal aspect of groups, it should be managed. In this case, the social worker must remain consistent in the manner of leading the group (A). This will allow the group to deal with the issues. Requesting support from other group members (C) or asserting authority in managing the group (D) can be destructive to the group’s interaction. There is nothing in the stem to support using self-disclosure (B). 68.A social worker is working with a client who is in the midst of a very difficult divorce and custody battle. The social worker is contacted by the client’s spouse’s attorney, who is obtaining a subpoena to request records of the social worker’s work with the client. The social worker should: a. Release all requested records b. Tell the client to sign a release of information form c. Provide only verbal information as needed d. Refuse to release records until ordered by the court Rationale: Options A and C are clear violations of confidentiality. Option B is incorrect because to simply tell the client to take an action would not be informed consent. However, sometimes the client’s right to confidentiality may be restricted by courts of law. In jurisdictions where privileged communication is recognized, the communication cannot be introduced into court without the consent of the person making the communication. Refusing to release records until ordered by the court to do so is the best response (D). 69.A social worker is asked to evaluate a 10 year old child who was reported to be talking with peers about explicit sexual activity and singing a song about incest. After ruling out direct sexual abuse to the child, the social worker should NEXT: a. Assess other exposures to sexually explicit material b. Assess the child’s level of impulse control c. Consider a diagnosis of conduct disorder d. Educate the child about appropriate talk with peers Rationale: Assessing additional exposure (A) is the NEXT reasonable action to take. While direct sexual abuse may not be occurring, these are indicators that the child is being exposed to either direct or indirect sexual activity. These are no symptoms of conduct disorder (C) or poor impulse control (B). Educating the child (D) would be appropriate later as it is an intervention that may occur after assessment. 70.High school teachers report to the school social worker that a student has been verbally intimidating other students. The student is also reported as lying about completing homework and is frequently absent. What should the social worker do FIRST to assess the situation? a. Make a referral to the local mental health center b. Involve the parents in exploring the student’s problems c. Meet with the student to discuss the teachers’ concerns d. Ask the teachers to document their concerns Rationale: The question asks what the social worker would do FIRST. In this context, the social worker can do little until a clear understanding of the problem has been arrived at through a meeting with the student (C). Options A, B, and D may occur, but only after (C) is done. 71.A social worker is interviewing a client in a community mental health clinic. The client first completes a computer assessment and then is interviewed by the social worker. Although the interview findings reveal the client has mild anxiety symptoms, the computer assessment indicates high levels of depression. What should the social worker do? a. Use only the computer assessment to develop a treatment plan b. Consider the interview assessment to be more accurate c. Consider both the interview and computer assessment in treatment planning d. Have the client retake the computer assessment to check for reliability Rationale: Unscored question. In developing treatment plans, all available information should be considered (C). 72.A 40 year old man comes home after work to find that his wife of 15 years has moved out. She has removed all of the furniture and taken their two children. In the initial interview, the client tells the social worker that he fears that he will never see his family again. He cries easily and states that he feels confused. The MOST likely diagnosis for this client is: a. Dysthymic disorder b. Posttraumatic stress disorder c. Adjustment disorder with depressed mood d. Major depressive episode with anxious mood. Rationale: The client’s’ behavior and the emotional impact of the recent event combine to indicate that he is experiencing adjustment disorder with depressed mood (C). The symptoms have not existed long enough to support dysthymic disorder (A), and the event itself, while emotionally powerful, does not rise to the severity of events associated with PTSD (B). Option D is not a diagnosis. This is a recall question. 73.A social worker is working with an involuntary client whose children have been removed from the home for abuse and neglect. To increase the likelihood of the children’s return to the home, the worker should FIRST focus on: a. Improving the children’s behavior b. Confronting the parent c. Emphasizing cooperation d. Meeting the parent’s needs Rationale: Determining and meeting the needs of the parent (D) should be the FIRST focus in this intervention. Option A suggests that the children’s behavior is problematic and there is nothing in the stem to indicate that. Because the client is involuntary, confrontation is inherent (B) and has already likely occurred. Emphasizing cooperation (C) may be an action that would occur later. 74.Faking mental or physical illness in an effort to avoid an unpleasant consequence or to obtain a desirable result can BEST be defined as: a. Malingering b. Sociopathy c. Factitious disorder d. Schizotypal disorder Rationale: Basic recall that requires knowledge of the definition of malingering. 75.A social worker is asked to analyze new social welfare policies that will affect the community. The FIRST step in completing the policy analysis is to: a. Examine the likely impact of the policies on the community b. Research the historical problems that led to the policies c. Organize a grassroots coalition to discuss reaction to the policies d. Look into legal precedents that could potentially nullify the policies Rationale: Item requires understanding of the basic steps in policy analysis. FIRST, the social worker must understand the historical background of the policy (B) before moving to the analysis stage. Options A, C, and D are steps to take later in the process. 76.Under what condition may a social worker share a client’s case record without the client’s permission? a. The social worker receives a request from the lawyer for the record b. The client’s medical insurance company requests copies of the case record c. The social worker’s agency supervisor requests copies of case notes for supervision d. The social worker seeks consultation from a colleague at another agency Rationale: Unscored question. A client must consent to having their case records shared when requested by an attorney (A), when requested by an insurance company (B) and when consultation is sought from a colleague at another agency (D). Options A, B, and D are breaches of confidentiality. A request from the social worker’s supervisor is the only instance of these options (C) where permission is not required. 77.Working with clients to assist them in understanding how their past experience influences their present actions is using which general model of practice? a. Client-centered b. Systems c. Psychosocial d. Red Rationale: Psychosocial method (C) is the only model that uses past experiences as a means of understanding present action. Option A does not involve the social worker’s assistance in interpretation. Option B focuses only on the environment as it currently affects the client. Option D does not concern itself with the impact of the past on the present. 78.In the course of individual therapy with a social worker, a client exhibits clinging, demanding, and intrusive behaviors. The social worker experiences a strong desire to withdraw. The social worker’s response is an example of: a. Reaction formation b. Projection c. Transference d. Countertransference Rationale: Basic recall item. Countertransference (D) is the only option that deals with the social worker’s emotions. Options A, B, and C focus on the client’s reactions. Options A and B are defense mechanisms. 79.What is the normal life crisis that children must resolve during middle childhood? a. Industry versus inferiority b. Intimacy versus isolation c. Initiative versus guilt d. Trust versus mistrust Rationale: Recall question requires knowledge of Ericksonian theory describing the stages of development. Option A is correct, because industry versus inferiority occurs between the ages of six and 12. 80.What is involved in the planning phase of the problem-solving process in social work practice? a. Detailed exploration of the historical origin and development of the problem b. Identification of goals and potential solutions of the problem c. A series of interviews accompanied by the use of psychosocial instruments d. Assignment of multi-axial diagnosis Rationale: In the planning stage, the social worker should work with the client to identify goals and solutions, Option B. This is a recall item of the problem solving process. 81.A social worker conducts intake interviews at a substance abuse treatment program and has an interview scheduled with a person who has a cognitive disability. To be effective, the social worker should: a. First have the person complete an MMPI b. Find a setting with minimal distractions c. Try to complete the intake in one session d. Have a friend accompany the client Rationale: Unscored question. Cognitive disabilities can affect a person’s ability to process and retain information. Reducing distractions enhances a person’s ability to perform these functions (B), and would help the interview process. 82.In working with a family in which father-daughter incest has occurred, the MOST important requirement for positive change within the family is the: a. Father’s acceptance of responsibility for the incestuous behavior b. Mother’s recognition that the incestuous relationship exists c. Daugther’s ability to confront the father d. Daugther’s ability to report further abuse if it occurs Rationale: While options C and D would represent strengths for the daughter, it is not reflective of positive change for the family, which is what the question asks. Option B would be a positive, but would not be the MOST important requirement for the family to positively change. For the family to move forward, the major focus needs to be on the perpetrator and his accepting responsibility for his actions (A). 83.During an initial interview with a social worker, a woman client reports that since her marriage one and a half years ago, she has had no desire for a sexual relationship with her husband. She engages in sex only when pressured by him and dissociates during intercourse. She also has been having recurring violent nightmares and sucidial thoughts. The BEST course of action for the social worker is to: a. Refer the client and her husband for sex therapy b. Refer the client to an inpatient psychiatric unit c. Request a neurological evaluation for the client d. Evaluate for a history of sexual abuse as a child Rationale: There is no reason to substantiate a referral to inpatient (B) as the client is displaying no symptoms necessitating that. There are no symptoms in the stem that suggest a neurological issue (C). Evaluating past history (D) is the BEST action to take before making choices about what would be appropriate. Options A, B, and C are reasonable after an evaluation has occurred. 84.A client asks a social worker about an ‘anonymous’ HIV test. The social worker explains that an anonymous test option is: a. The assignment of a code to the client by the public health department without the use of names b. An assignment of a code to a master list of names so positive results can be reported to the health department c. Rarely used, because by law all HIV positive cases must be reported to communicable disease officials d. Confidential, as only the insurance company, and if positive, sexual partners will be informed Rationale: Unscored basic recall question that requires understanding of anonymity. 85.Lithium would MOST likely be prescribed for what type of disorder? a. Sleep b. Anxiety c. Bipolar mood d. Dissociative Rationale: Basic recall question that requires discrimination of the various types of disorders. 86.When a social worker discovers that a client has been lying, the MOST helpful course of action is to: a. Determine what is motivating the client’s dishonesty b. Confront the client immediately with evidence of the dishonesty c. Ignore the behavior for the present and focus on where the client is at d. Interpret to the client the underlying meaning of the lie Rationale: Understanding the motivation of the client (A) will assist with treatment. Option C avoids the behavior. Options B and D are actions that could later be taken, but FIRST it is necessary to understand the motivation, before moving to intervention. 87.A client telephones to inform her social worker that she is depressed and wants to kill herself. The social worker’s FIRST response to this information is to: a. Advise the client to call 911 b. Suggest that the client go to the nearest emergency room c. Inquire if the client has formulated a plan d. Ascertain whether the client is alone Rationale: Give the scenario described, the social worker needs to FIRST determine the presence of a suicide plan as an indicator of intent (C). Option A is a dangerous action to take because the social worker would have lost all contact with a client who is verbalizing a desire to kill herself. Option B is also dangerous , in that the social worker would lose all contact with the client when she hangs up the telephone. If the client does not have a plan, then exploring (D) may make sense. 88.A social worker is planning an intervention with a client. The social worker should FIRST assess the client’s: a. Economic situation b. Community support system c. View of the problem d. Diagnosis Rationale: The social worker should start with where the client is, and assess his or her view of the situation FIRST (C). Options A, B, and D are factors that may need to be addressed later as they may impact the intervention. 89.After three treatment sessions in a crisis center setting with an adult victim of a recent sexual assault, the issue of incest in the client’s childhood surfaces. What is the MOST appropriate action for the social worker to take? a. Shift focus of treatment to address the incest issues b. Defer the incest issues until the client has resolved the sexual assault c. Focus on the sexual assault and address the incest as it relates to the assault d. Refer the client to an incest survivors’ group for support Rationale: It is important to work on the identified problem as well as being sensitive to the role of incest as it relates to the assault (C). Options A and D may be appropriate for a later session. Deferring the problem (B) avoids an important part of the treatment