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RN Fundamentals Actual and Retake

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1. A young boy is stopped by a police officer and claims that he is a member of the armed forces, though it is obvious that he is not. This assertion by the boy is MOST likely a: A. Comorbid thought B. Dissociation C. Folie à deux D. Delusion - ANSWERSD A delusion is a false, fixed belief despite evidence to the contrary (i.e., believing something that is not true). Comorbid means existing at the same time. Dissociation is a change in memory, perception, or consciousness. Folie à deux is a shared delusion. 2. A social work administrator is having trouble finding a group home manager for a new program scheduled to open in 2 weeks. Further delays in locating staff will delay clients from moving into the program. The administrator temporarily hires her niece, who just graduated with a social work degree, for this position. This action is: A. Ethical because the niece is clearly qualified for the position B. Unethical because this is a conflict of interest C. Ethical because the position is temporary and ensures clients get the services needed D. Unethical because clients will experience staff turnover when a new manager is hired - ANSWERSB Social workers should avoid situations interfering with impartial judgment. Hiring a family member creates a dual relationship and should be avoided.

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1. A young boy is stopped by a police officer and claims that he is a member of the
armed forces, though it is obvious that he is not. This assertion by the boy is MOST
likely a:
A. Comorbid thought
B. Dissociation
C. Folie à deux
D. Delusion - ANSWERSD
A delusion is a false, fixed belief despite evidence to the contrary (i.e., believing
something that is not true). Comorbid means existing at the same time. Dissociation
is a change in memory, perception, or consciousness. Folie à deux is a shared
delusion.

2. A social work administrator is having trouble finding a group home manager for a
new program scheduled to open in 2 weeks. Further delays in locating staff will delay
clients from moving into the program. The administrator temporarily hires her niece,
who just graduated with a social work degree, for this position. This action is:
A. Ethical because the niece is clearly qualified for the position
B. Unethical because this is a conflict of interest
C. Ethical because the position is temporary and ensures clients get the services
needed
D. Unethical because clients will experience staff turnover when a new manager is
hired - ANSWERSB
Social workers should avoid situations interfering with impartial judgment. Hiring a
family member creates a dual relationship and should be avoided.

3. A social worker is interested in seeing the extent to which current clients are
satisfied with a new relapse prevention program. The social worker distributes a
client satisfaction survey to those in the program. The social worker then collects the
surveys and analyzes the results that are presented to a management team in the
agency. The social worker is conducting which type of evaluation?
A. Summative
B. Experimental
C. Quasi-experimental
D. Formative - ANSWERSD
Formative evaluations examine the process of delivering services, whereas
summative evaluations examine the outcomes. Formative evaluations are ongoing
processes that allow for feedback to be implemented during service delivery. These
types of evaluations allow social workers to make changes as needed to help
achieve program goals. Summative evaluations occur at the end of services and
provide an overall description of their effectiveness. Summative evaluation examines
outcomes to determine whether objectives were met.
1. Which of the following is NOT true about motivation to change?
A. Motivation fluctuates from one time to another.

,B. Motivation can be increased by working to remove barriers to change.
C. Motivation is driven by hope or the belief that life can be different.
D. Motivation that is imposed by external forces is more salient than that which is
intrinsic. - ANSWERSD
Motivation is a state of readiness or eagerness to change, which fluctuates from one
time to another. The role of the social worker is to create an atmosphere that is
conducive to change and to increase a client's intrinsic motivation, so that change
arises from within rather than being imposed from without. If a client is driven to
change internally, it is much more likely that the change effort will be sustained. A
technique to increase motivation is to work to remove barriers and instill hope or the
belief that life can be different.

. Evidence-based social work practice can BEST be defined as:
A. Interventions that a social worker has gained training and experience in delivering
B. Treatment that yields the most cost-effective outcomes according to a cost-benefit
analysis
C. Decision making based on the conscientious, explicit, and judicious use of
research knowledge, clinical expertise, social work values, and client wishes
D. Practice evaluations that adhere to scientific principles - ANSWERSC
Evidence-based practice (EBP) combines well-researched interventions with clinical
experience and ethics, as well as client preferences and culture, to guide and inform
the delivery of treatments and services. Social workers, clients, and others must
work together in order to identify what works, for whom, and under what conditions.
This approach ensures that the treatments and services, when used as intended, will
have the most effective outcomes as demonstrated by the research.

3. What are the stages of change in sequential order?
A. Precontemplation, preparation, contemplation, action, maintenance, and relapse
B. Preparation, action, precontemplation, contemplation, maintenance, and relapse
C. Preparation, precontemplation, contemplation, action, maintenance, and relapse
D. Precontemplation, contemplation, preparation, action, maintenance, and relapse -
ANSWERSD
Precontemplation is denial or ignorance of the problem. It is followed by
contemplation in which there is ambivalence about making change. Then comes
preparation or experimenting with small changes. Action moves toward achieving a
goal, whereas maintenance sustains a new behavior and avoids relapse, which can
lead to feelings of frustration and failure.

4. Which of the following is NOT an essential step in ethical problem solving?
A. Identifying the ethical standards that may be compromised
B. Determining whether there is an ethical dilemma
C. Weighing ethical issues in light of social work values and principles
D. Asking a supervisor to monitor practice to identify new ethical issues or dilemmas
- ANSWERSD
A social worker, not his or her supervisor, should monitor practice to identify whether
new issues or dilemmas arise.


The design described is not experimental—which requires a control group and
randomization of assignment—or quasi-experimental, which does not require

,randomization, but has more support for causal inferences than does
preexperimental designs.

8. Which of the following is an example of social stratification?
A. A child is not included in group activities in school because of his or her poor
social skills.
B. Children who are violent need to be segregated from their peers.
C. A child with social deficits is assumed to be delayed in cognition without additional
assessment.
D. Children from affluent households receive a better public education than those
from low-income households. - ANSWERSD
Stratification refers to structured inequality of entire categories of people in society
who have unequal access to social rewards. Stratification applies to individuals
based on ethnic and racial background, social status, and/or other factors.

9. During an intake interview, a client reports that she is extremely depressed and
has self-destructive thoughts. She has had prior suicide attempts, but tells the social
worker not to worry as she won't "do it again." The social worker should FIRST:
A. Tell the client that her decision not to harm herself is a good one
B. Explore with the client what is causing her depression
C. Conduct a safety assessment
D. Refer the client to a psychiatrist for a medication evaluation - ANSWERSC
Despite the client's report that she will not act on her thoughts, she is at risk because
she has had these feelings and has acted on them in the past. The case vignette
does not describe the social worker taking any action yet. A safety assessment will
determine the severity of the depression and whether the client is at risk for a suicide
attempt. It must be done FIRST before any other action is taken.

10. A client with a Social Anxiety Disorder will MOST likely be prescribed which of
the following medications to take on an ongoing basis?
A. Zoloft (sertraline)
B. Mellaril (thioridazine)
C. Thorazine (chlorpromazine)
D. Valium (diazepam) - ANSWERSA The primary medications used to treat social
anxiety disorder are selective serotonin reuptake inhibitors (SSRIs), which were first
developed to treat depression. They have been found to be effective in the treatment
of a wider range of disorders. Zoloft (sertraline) is an SSRI.

Benzodiazepines, such as Valium (diazepam), reduce levels of anxiety. However,
they are habit-forming and sedating, so they are typically prescribed for only short-
term use.

Mellaril (thioridazine) and Thorazine (chlorpromazine) are antipsychotic medications
for the treatment of psychosis.


20. Federal law requires health care facilities that receive Medicare and Medicaid
reimbursements to do all of the following with regard to advance directives EXCEPT:
A. Inform clients of their rights to have advance directives that will allow them to
make decisions regarding their health care

, B. Use a portion of their revenues to assist clients with the costs associated with
creating advance directives
C. Ask clients if they have advance directives and document their responses
D. Provide education about advance directives - ANSWERSB
The Patient Self-Determination Act of 1991 specifies facilities that receive Medicare
and Medicaid inform clients of their rights to make decisions concerning their own
health care, ask and document whether clients have advance directives, and provide
education for staff and the community.

21. In which of the following circumstances is task-centered treatment NOT
recommended?
A. When the client wants to see immediate results or changes in circumstances
B. When the client is anxious to be an active part of the change process
C. When there is a time limited period in which to work with the client
D. When the client is addressing long-standing problems that are complex in nature -
ANSWERSD
A task-centered approach aims to quickly engage clients in the problem-solving
process because it is usually delivered in a time-limited environment. The client is an
active part of the change process and the approach is highly structured to attempt to
achieve immediate results as goals are broken into defined tasks. Termination
begins in the first session. This approach is too brief to address long-standing
problems that are complex.

22. A client is currently taking Clozaril for the treatment of Schizophrenia. The client
is MOST likely going to be required to undergo what medical monitoring due to this
medication use?
A. Weight checks
B. Blood work
C. Dietary restrictions
D. Exercise regimen - ANSWERSB
Clozaril increases the risk of agranulocytosis (low white blood cell count). Monitoring
of the white blood cell count through regular blood work is required.

23. Which of the following inhibits the establishment of a therapeutic relationship?
A. A universalism approach or the acceptance of a standard set of norms or
standards
B. A pluralistic approach that values cultural pluralism
C. Clients examined as being influenced by their environment with problems being
seen as resulting from role ambiguity rather than individual deficits
D. Flexible treatment approaches that take into account the subjective realities of
clients - ANSWERSA
Universalism is based on one acceptable norm or standard for everyone versus
many valid standards that have been developed by clients that they have determined
to be most useful to them.

24. Which of the following is NOT an exception to a social worker's duty to protect
confidentiality?
A. When a client poses a serious risk to self and others
B. When child abuse is suspected
C. When a client has violated criminal laws and has not been properly prosecuted
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