CWCM PRE-SERVICE EXAM STUDY GUIDE UPDATED 2025/2026
QUESTIONS AND VERIFIED ANSWERS RATED A+
This maltreatment also would apply when a parent/caregiver is
present but has a history of or is currently exhibiting signs of
unmanaged mental health, delusional behavior, immaturity,
developmental delays, or other limitations that have resulted in
harm, or pose a threat of harm, to a child.
Internal njury - ---Answers---An internal injury is an injury
caused by a willful act by a caregiver to the organs occupying the
thoracic (chest), cranium or abdominal cavities that is not visible
from the outside. Internal injuries may be accompanied by other
external injuries. A person so injured may be pale, cold,
perspiring freely; have an anxious expression; seem semi-
comatose; or exhibit other symptoms, such as lethargy,
disorientation, blood in bowel movements or urine, and/or loss of
consciousness
Brain/spinal cord damage, hemorrhage, lacerate spleen or
organs, stab or gunshot wounds
Intimate partner violence threatens child - ---Answers---
includes the dynamics of establishing power, control or coercion
perpetrated by one intimate partner over another that includes
actions that have caused, or could cause, the child's physical,
mental or emotional health to be significantly impaired. The
volatility and lethality of this dynamic are differentiated from
other types of family or household violence or aggression, and
requires a specific assessment.
,Medical neglect - ---Answers---failure to provide or the failure
to allow needed care as recommended by a health care
practitioner for a physical injury, illness, medical condition,
mental health condition, or impairment, or the failure to seek
timely and appropriate medical/mental health care for a serious
health/mental health problem that a reasonable person would
have recognized as requiring professional medical/mental health
attention
Mental injury - ---Answers---injury to the intellectual or
psychological capacity of a child as evidenced by a discernible
and substantial impairment in the ability to function within the
normal range of performance and behavior, or when a child
exhibits symptoms of serious emotional problems when
emotional or other abuse, abandonment, or neglect is suspected.
Examples: A parent alienating a child from another parent,
resulting in substantial impairment to the child • A parent making
an older child wear a diaper and drink from a bottle (act like a
baby) after bedwetting • A parent shaving a young girl's head as
punishment for talking to a boy. The girl is ridiculed at school and
then breaks down crying daily before going to school.
Physical injury - ---Answers---willfully inflicted physical injury
to a child that results in temporary or permanent disfigurement,
temporary or permanent loss or impairment of a bodily part or
function, or is an action that is likely to cause a physical injury, a
threat to a child's safety or a real, plausible and significant threat
to the child's physical, mental or emotional health
Sexual battery - ---Answers---conduct involving the oral, anal
or vaginal penetration by, or union with, the sexual organ of a
child; the forcing or allowing a child to perform oral, anal or
, vaginal penetration on another person; or the anal or vaginal
penetration of another person by any object. This includes digital
penetration, oral sex (cunnilingus, fellatio), coitus, and copulation
Sexual molestation - ---Answers---the intentional touching of
the genitals or intimate parts, including the breasts, genital area,
groin, inner thighs, and buttocks, or the clothing covering them,
of either the child or the perpetrator, except that this does not
include: • Any act which may reasonably be construed to be a
normal caregiver responsibility, interaction with, or affection for
a child; or • Any act intended for a valid medical purpose
Sexual exploitation - ---Answers---any other sexual act
intentionally perpetrated in the presence of a child, if such
exposure or sexual act is for the purpose of sexual arousal or
gratification, aggression, degradation, or other similar purpose.
Substance exposed newborn - ---Answers---occurs when a
child is exposed to a controlled substance or alcohol prenatally -
established by: • A test, administered at birth, which indicates
that the child's blood, urine or meconium contained any amount
of alcohol or a controlled substance or metabolites of such
substances, the presence of which was not the result of medical
treatment administered to the mother or the newborn infant; • A
diagnosis of Neonatal Abstinence Syndrome or Fetal Alcohol
Spectrum Disorder as a result of maternal use of a controlled
substance or alcohol; or • Knowledge or suspicion by medical
personnel or hospital staff that an infant was exposed to a
controlled substance or alcohol prenatally based on
physiological or neurobehavioral abnormalities (e.g., seizures,
muscle tightness, rapid breathing), and/or the mother's reported
use of controlled substances or alcohol prenatally when such
use would likely result in neonatal toxicology or withdrawal.
QUESTIONS AND VERIFIED ANSWERS RATED A+
This maltreatment also would apply when a parent/caregiver is
present but has a history of or is currently exhibiting signs of
unmanaged mental health, delusional behavior, immaturity,
developmental delays, or other limitations that have resulted in
harm, or pose a threat of harm, to a child.
Internal njury - ---Answers---An internal injury is an injury
caused by a willful act by a caregiver to the organs occupying the
thoracic (chest), cranium or abdominal cavities that is not visible
from the outside. Internal injuries may be accompanied by other
external injuries. A person so injured may be pale, cold,
perspiring freely; have an anxious expression; seem semi-
comatose; or exhibit other symptoms, such as lethargy,
disorientation, blood in bowel movements or urine, and/or loss of
consciousness
Brain/spinal cord damage, hemorrhage, lacerate spleen or
organs, stab or gunshot wounds
Intimate partner violence threatens child - ---Answers---
includes the dynamics of establishing power, control or coercion
perpetrated by one intimate partner over another that includes
actions that have caused, or could cause, the child's physical,
mental or emotional health to be significantly impaired. The
volatility and lethality of this dynamic are differentiated from
other types of family or household violence or aggression, and
requires a specific assessment.
,Medical neglect - ---Answers---failure to provide or the failure
to allow needed care as recommended by a health care
practitioner for a physical injury, illness, medical condition,
mental health condition, or impairment, or the failure to seek
timely and appropriate medical/mental health care for a serious
health/mental health problem that a reasonable person would
have recognized as requiring professional medical/mental health
attention
Mental injury - ---Answers---injury to the intellectual or
psychological capacity of a child as evidenced by a discernible
and substantial impairment in the ability to function within the
normal range of performance and behavior, or when a child
exhibits symptoms of serious emotional problems when
emotional or other abuse, abandonment, or neglect is suspected.
Examples: A parent alienating a child from another parent,
resulting in substantial impairment to the child • A parent making
an older child wear a diaper and drink from a bottle (act like a
baby) after bedwetting • A parent shaving a young girl's head as
punishment for talking to a boy. The girl is ridiculed at school and
then breaks down crying daily before going to school.
Physical injury - ---Answers---willfully inflicted physical injury
to a child that results in temporary or permanent disfigurement,
temporary or permanent loss or impairment of a bodily part or
function, or is an action that is likely to cause a physical injury, a
threat to a child's safety or a real, plausible and significant threat
to the child's physical, mental or emotional health
Sexual battery - ---Answers---conduct involving the oral, anal
or vaginal penetration by, or union with, the sexual organ of a
child; the forcing or allowing a child to perform oral, anal or
, vaginal penetration on another person; or the anal or vaginal
penetration of another person by any object. This includes digital
penetration, oral sex (cunnilingus, fellatio), coitus, and copulation
Sexual molestation - ---Answers---the intentional touching of
the genitals or intimate parts, including the breasts, genital area,
groin, inner thighs, and buttocks, or the clothing covering them,
of either the child or the perpetrator, except that this does not
include: • Any act which may reasonably be construed to be a
normal caregiver responsibility, interaction with, or affection for
a child; or • Any act intended for a valid medical purpose
Sexual exploitation - ---Answers---any other sexual act
intentionally perpetrated in the presence of a child, if such
exposure or sexual act is for the purpose of sexual arousal or
gratification, aggression, degradation, or other similar purpose.
Substance exposed newborn - ---Answers---occurs when a
child is exposed to a controlled substance or alcohol prenatally -
established by: • A test, administered at birth, which indicates
that the child's blood, urine or meconium contained any amount
of alcohol or a controlled substance or metabolites of such
substances, the presence of which was not the result of medical
treatment administered to the mother or the newborn infant; • A
diagnosis of Neonatal Abstinence Syndrome or Fetal Alcohol
Spectrum Disorder as a result of maternal use of a controlled
substance or alcohol; or • Knowledge or suspicion by medical
personnel or hospital staff that an infant was exposed to a
controlled substance or alcohol prenatally based on
physiological or neurobehavioral abnormalities (e.g., seizures,
muscle tightness, rapid breathing), and/or the mother's reported
use of controlled substances or alcohol prenatally when such
use would likely result in neonatal toxicology or withdrawal.
