1. A social worker notices that a client's depressive symptoms have significantly improved over the
past week after starting antidepressant medication. What should the social worker do NEXT?
A) Begin discharge planning since the client is no longer depressed
B) Schedule follow-up appointments at monthly intervals
C) Immediately assess for suicide risk due to increased energy levels
D) Reduce session frequency to allow client independence
Immediately assess for suicide risk due to increased energy levels - Clients are at greater risk for
suicide when depressive symptoms recently improve because they may now have the energy to act
on suicidal ideation while still experiencing emotional pain
2. A 10-year-old child refuses to attend school, clinging to mother and crying each morning. This
has occurred daily for three weeks. What is the MOST likely diagnosis?
A) Oppositional Defiant Disorder
B) Conduct Disorder
C) Separation Anxiety Disorder
D) Social Anxiety Disorder
Separation Anxiety Disorder - School refusal is a common manifestation of separation anxiety
disorder, which requires symptoms lasting at least four weeks in children and involves excessive
distress when separated from attachment figures
3. A social worker in private practice has a client who has not paid for services for three months
despite multiple reminders. The client is not at risk of harm to self or others. What should the
social worker do FIRST?
A) Terminate services immediately due to nonpayment
B) Review the signed contract regarding payment policies with the client
C) File a claim in small claims court for unpaid fees
D) Continue services pro bono to maintain therapeutic alliance
,Review the signed contract regarding payment policies with the client - Termination for
nonpayment is only appropriate when the contract clearly specifies this consequence and no
imminent threat of harm exists; the social worker should first review the agreement with the client
4. A social worker is subpoenaed to provide client records for a court case. What is the social
worker's MOST appropriate response?
A) Immediately provide all requested records to the court
B) Refuse to provide any records citing confidentiality
C) Request that the subpoena be withdrawn or seek to limit disclosure
D) Provide records only after obtaining verbal permission from the client
Request that the subpoena be withdrawn or seek to limit disclosure - Unlike a court order which
mandates compliance, a subpoena allows the social worker to assert privilege and request
withdrawal or limitation of the request before releasing records
5. A social worker conducting a community needs assessment discovers that a local agency is
consistently denying services to Latino families. What ethical standard is being violated?
A) Informed consent
B) Self-determination
C) Social justice
D) Professional boundaries
Social justice - Social justice as an ethical value requires social workers to pursue change on behalf
of vulnerable and oppressed individuals and groups, including challenging discrimination based on
national origin
6. During an initial session, a client reports hearing voices telling her that she is worthless and
should hurt herself. What should the social worker do FIRST?
A) Explore the content and frequency of the voices
B) Ask about past psychiatric hospitalizations
C) Rule out medical conditions that could cause hallucinations
D) Assess for immediate safety and risk of harm
,Assess for immediate safety and risk of harm - Safety is always the priority; the social worker must
first determine if the client poses an immediate danger to herself or others before proceeding with
further assessment
7. A social worker is using solution-focused therapy with a client who reports feeling stuck in life.
Which question best exemplifies the miracle question technique?
A) Why do you think you feel stuck right now?
B) What would be different tomorrow if your problem disappeared overnight?
C) How did your family of origin contribute to these feelings?
D) On a scale of one to ten, how stuck do you feel?
What would be different tomorrow if your problem disappeared overnight? - The miracle question
asks clients to imagine how their life would be different if their problem was suddenly resolved,
helping identify goals and solutions without focusing on problem etiology
8. A 16-year-old client discloses that she is pregnant and wants an abortion but fears telling her
parents. What should the social worker do FIRST?
A) Inform the parents due to mandatory reporting laws
B) Explore state laws regarding minor consent for reproductive health services
C) Encourage the client to carry the pregnancy to term
D) Schedule an abortion appointment for the client
Explore state laws regarding minor consent for reproductive health services - Many states allow
minors to consent to reproductive health services without parental involvement; the social worker
must first understand applicable state laws before taking action
9. A social worker notices that a colleague appears to be coming to work intoxicated, slurring
speech, and smelling of alcohol. What should the social worker do FIRST?
A) Report the colleague to the licensing board immediately
B) Confront the colleague directly about the observed behaviors
C) Discuss the concerns privately with the colleague before taking further action
D) Ignore the situation unless client safety is compromised
, Discuss the concerns privately with the colleague before taking further action - The NASW Code of
Ethics requires social workers to first address concerns directly with the colleague when possible
before escalating to supervisors, employers, or licensing boards
10. A social worker using strategic family therapy tells a family to continue their problematic
behavior of arguing every night at dinner. This technique is called:
A) Reframing
B) Paradoxical directive
C) Circular questioning
D) Restructuring
Paradoxical directive - Also called prescribing the symptom, this technique instructs clients to
continue maladaptive behaviors to help them gain awareness and voluntary control over the
behavior, often leading to its cessation
11. Which medication requires dietary restriction of foods containing tyramine such as aged
cheeses and red wine?
A) SSRIs like fluoxetine
B) MAOIs like phenelzine (Nardil)
C) Benzodiazepines like alprazolam
D) Antipsychotics like chlorpromazine
MAOIs like phenelzine (Nardil) - MAOIs inhibit monoamine oxidase which breaks down tyramine;
consuming tyramine-rich foods can cause hypertensive crisis, making dietary restrictions essential
for client safety
12. A social worker is documenting a session and writes: Client appeared anxious, made poor eye
contact, reported feeling sad for two weeks. Under which SOAP component would client stating I
feel sad belong?
A) Subjective
B) Objective
C) Assessment
D) Plan
past week after starting antidepressant medication. What should the social worker do NEXT?
A) Begin discharge planning since the client is no longer depressed
B) Schedule follow-up appointments at monthly intervals
C) Immediately assess for suicide risk due to increased energy levels
D) Reduce session frequency to allow client independence
Immediately assess for suicide risk due to increased energy levels - Clients are at greater risk for
suicide when depressive symptoms recently improve because they may now have the energy to act
on suicidal ideation while still experiencing emotional pain
2. A 10-year-old child refuses to attend school, clinging to mother and crying each morning. This
has occurred daily for three weeks. What is the MOST likely diagnosis?
A) Oppositional Defiant Disorder
B) Conduct Disorder
C) Separation Anxiety Disorder
D) Social Anxiety Disorder
Separation Anxiety Disorder - School refusal is a common manifestation of separation anxiety
disorder, which requires symptoms lasting at least four weeks in children and involves excessive
distress when separated from attachment figures
3. A social worker in private practice has a client who has not paid for services for three months
despite multiple reminders. The client is not at risk of harm to self or others. What should the
social worker do FIRST?
A) Terminate services immediately due to nonpayment
B) Review the signed contract regarding payment policies with the client
C) File a claim in small claims court for unpaid fees
D) Continue services pro bono to maintain therapeutic alliance
,Review the signed contract regarding payment policies with the client - Termination for
nonpayment is only appropriate when the contract clearly specifies this consequence and no
imminent threat of harm exists; the social worker should first review the agreement with the client
4. A social worker is subpoenaed to provide client records for a court case. What is the social
worker's MOST appropriate response?
A) Immediately provide all requested records to the court
B) Refuse to provide any records citing confidentiality
C) Request that the subpoena be withdrawn or seek to limit disclosure
D) Provide records only after obtaining verbal permission from the client
Request that the subpoena be withdrawn or seek to limit disclosure - Unlike a court order which
mandates compliance, a subpoena allows the social worker to assert privilege and request
withdrawal or limitation of the request before releasing records
5. A social worker conducting a community needs assessment discovers that a local agency is
consistently denying services to Latino families. What ethical standard is being violated?
A) Informed consent
B) Self-determination
C) Social justice
D) Professional boundaries
Social justice - Social justice as an ethical value requires social workers to pursue change on behalf
of vulnerable and oppressed individuals and groups, including challenging discrimination based on
national origin
6. During an initial session, a client reports hearing voices telling her that she is worthless and
should hurt herself. What should the social worker do FIRST?
A) Explore the content and frequency of the voices
B) Ask about past psychiatric hospitalizations
C) Rule out medical conditions that could cause hallucinations
D) Assess for immediate safety and risk of harm
,Assess for immediate safety and risk of harm - Safety is always the priority; the social worker must
first determine if the client poses an immediate danger to herself or others before proceeding with
further assessment
7. A social worker is using solution-focused therapy with a client who reports feeling stuck in life.
Which question best exemplifies the miracle question technique?
A) Why do you think you feel stuck right now?
B) What would be different tomorrow if your problem disappeared overnight?
C) How did your family of origin contribute to these feelings?
D) On a scale of one to ten, how stuck do you feel?
What would be different tomorrow if your problem disappeared overnight? - The miracle question
asks clients to imagine how their life would be different if their problem was suddenly resolved,
helping identify goals and solutions without focusing on problem etiology
8. A 16-year-old client discloses that she is pregnant and wants an abortion but fears telling her
parents. What should the social worker do FIRST?
A) Inform the parents due to mandatory reporting laws
B) Explore state laws regarding minor consent for reproductive health services
C) Encourage the client to carry the pregnancy to term
D) Schedule an abortion appointment for the client
Explore state laws regarding minor consent for reproductive health services - Many states allow
minors to consent to reproductive health services without parental involvement; the social worker
must first understand applicable state laws before taking action
9. A social worker notices that a colleague appears to be coming to work intoxicated, slurring
speech, and smelling of alcohol. What should the social worker do FIRST?
A) Report the colleague to the licensing board immediately
B) Confront the colleague directly about the observed behaviors
C) Discuss the concerns privately with the colleague before taking further action
D) Ignore the situation unless client safety is compromised
, Discuss the concerns privately with the colleague before taking further action - The NASW Code of
Ethics requires social workers to first address concerns directly with the colleague when possible
before escalating to supervisors, employers, or licensing boards
10. A social worker using strategic family therapy tells a family to continue their problematic
behavior of arguing every night at dinner. This technique is called:
A) Reframing
B) Paradoxical directive
C) Circular questioning
D) Restructuring
Paradoxical directive - Also called prescribing the symptom, this technique instructs clients to
continue maladaptive behaviors to help them gain awareness and voluntary control over the
behavior, often leading to its cessation
11. Which medication requires dietary restriction of foods containing tyramine such as aged
cheeses and red wine?
A) SSRIs like fluoxetine
B) MAOIs like phenelzine (Nardil)
C) Benzodiazepines like alprazolam
D) Antipsychotics like chlorpromazine
MAOIs like phenelzine (Nardil) - MAOIs inhibit monoamine oxidase which breaks down tyramine;
consuming tyramine-rich foods can cause hypertensive crisis, making dietary restrictions essential
for client safety
12. A social worker is documenting a session and writes: Client appeared anxious, made poor eye
contact, reported feeling sad for two weeks. Under which SOAP component would client stating I
feel sad belong?
A) Subjective
B) Objective
C) Assessment
D) Plan
