ASWB Licensed Master Social Worker (LMSW) Exam — Questions and Answers

Question 1: A BSW working with a refugee family notices the children appear malnourished and the parents seem overwhelmed. What is the FIRST step the social worker should take?

Consult with a supervisor before taking any action
Conduct a comprehensive needs assessment with the family
Arrange emergency food assistance and connect the family to resources (Correct answer)
Report suspected neglect to child protective services immediately

Correct answer: Arrange emergency food assistance and connect the family to resources

Addressing the immediate safety need of food insecurity is the priority before conducting a full assessment or reporting, since the situation appears to reflect poverty rather than neglect.

Question 2: A client of a social worker lately displayed signs of dread and distraction. The social worker believes the client may be a victim of domestic abuse because of other facts the client has provided and the fact that the client frequently has bruises on her arms. The social worker ought to

each out to the domestic abuse hotline
suggest couples therapy
make an unofficial recognition of her assumption in her notes but wait patiently for the client to disclose such information
encourage disclosure so that interventions can quickly be put into place (Correct answer)

Correct answer: encourage disclosure so that interventions can quickly be put into place

When a social worker suspects domestic abuse based on observed signs and client information, their primary ethical responsibility is to address the potential danger. Encouraging disclosure creates an opportunity for the client to share their experience, which is the crucial first step in assessing the situation, ensuring safety, and implementing appropriate interventions and support. Waiting for disclosure or making unofficial notes delays necessary action and potentially leaves the client at further risk.

Question 3: Paul resides in a sizable apartment building. He makes an effort to avoid interacting with other residents in the unit. He leads a solitary life and has no pals. He makes no effort to improve the situation. Which of the following personality disorders does Paul have?

avoidant personality disorder (Correct answer)
depression
autism
antisocial personality disorder

Correct answer: avoidant personality disorder

Paul's behavior, characterized by actively avoiding social interaction, leading a solitary life, having no friends, and making no effort to change this, is highly indicative of Avoidant Personality Disorder. Individuals with this disorder experience intense social anxiety, feelings of inadequacy, and hypersensitivity to negative evaluation, leading them to withdraw from social situations despite a desire for connection. Depression is a mood disorder, antisocial personality disorder involves a disregard for others' rights, and autism is a neurodevelopmental disorder, none of which fully match Paul's specific pattern of social avoidance driven by fear.

Question 4: In family systems theory, the term 'triangulation' refers to:

A third person being pulled into a two-person conflict to reduce tension (Correct answer)
Three-generational trauma patterns
A technique for joining with resistant family members
Mapping family relationships on a genogram

Correct answer: A third person being pulled into a two-person conflict to reduce tension

Triangulation occurs when a dyad under stress draws in a third party to manage anxiety and stabilize the relationship.

Question 5: The most prevalent type of unethical behavior that social workers have documented is the following:

Conflict of interest
Not having a client's consent
Dual relationship
Confidentiality breach (Correct answer)

Correct answer: Confidentiality breach

Confidentiality breach is consistently identified as one of the most frequent ethical violations encountered by social workers. This is because social workers are entrusted with highly sensitive client information, and any unauthorized disclosure, whether intentional or accidental, can have significant negative impacts on clients and the therapeutic relationship. Upholding confidentiality is a cornerstone of ethical social work practice.

Question 6: A youth group is being led by a social worker. One of the group members phones the social worker because she is quite unhappy about something she said in the group being revealed to others in her school by another group member. The social worker's BEST course of action in this circumstance is to:

Terminate the group member who disclosed the information in order to create a “safe” environment for the other participants
Develop a confidentiality agreement to be signed by all members at the next group session
Individually contact the group member who disclosed the information to discuss the concern
Suggest that the upset group member bring up her concern at the next group session (Correct answer)

Correct answer: Suggest that the upset group member bring up her concern at the next group session

In group therapy, it is generally most therapeutic to address issues directly within the group setting. Encouraging the upset member to voice her concern at the next session empowers her, models healthy communication, and allows the group to collectively reinforce confidentiality norms. This approach strengthens group cohesion and facilitates learning, rather than singling out individuals or imposing rules unilaterally.

Question 7: The 21-question Bricklin Perceptual Scales (BPS) are used to assess depression in people aged 13 and older.

False (Correct answer)
True

Correct answer: False

This statement is false. The Bricklin Perceptual Scales (BPS) are not used to assess depression. They are a forensic assessment tool primarily designed to evaluate parental capacity and child custody issues, focusing on a parent's perceptions of their child and their parenting abilities. Common depression scales include the Beck Depression Inventory (BDI) or the Hamilton Depression Rating Scale (HDRS).

Question 8: A BSW's client, who has been making progress, suddenly misses three consecutive appointments without contact. The BEST initial response is to:

Reach out proactively to check on the client's wellbeing and re-engage (Correct answer)
Wait for the client to re-initiate contact on their own terms
Report the client's non-attendance to their referring agency immediately
Close the case due to non-engagement and document accordingly

Correct answer: Reach out proactively to check on the client's wellbeing and re-engage

Proactive outreach demonstrates concern for the client and is an evidence-based practice to re-engage clients who disengage from services.

Question 9: Which stage of Prochaska and DiClemente's Transtheoretical Model is characterized by a client who acknowledges a problem but is not yet committed to change?

Contemplation (Correct answer)
Precontemplation
Preparation
Action

Correct answer: Contemplation

In the contemplation stage, individuals are aware of a problem and begin considering change but have not committed to action.

Question 10: A social worker is conducting a biopsychosocial assessment of a client who recently immigrated from another country. The client is reluctant to discuss family matters. What is the MOST culturally competent approach?

Refer the client to a clinician from the same cultural background
Explore the client's cultural norms around privacy and family disclosure (Correct answer)
Ask a family member to speak on the client's behalf
Proceed with standardized intake questions regardless of discomfort

Correct answer: Explore the client's cultural norms around privacy and family disclosure

Exploring cultural norms around privacy respects the client's background and informs how the assessment is conducted.

Question 11: Schizophrenia frequently strikes young adults, often in conjunction with grave work- or social-related dysfunction. The diagnosis is based on observed behaviors and self-revealed encounters. No diagnostic or therapeutic procedures exist to confirm the existence of this illness. What symptoms have been identified?

Restlessness, talkative, sadness, crying
Violent outbursts, anger episodes, night terrors
Alter-ego, neurological problems, weight gain
Hallucinations, disorganized speech, paranoia, social isolation (Correct answer)

Correct answer: Hallucinations, disorganized speech, paranoia, social isolation

It's important to note that the course of schizophrenia can vary widely from person to person. Some individuals experience only one or a few episodes of symptoms, while others have chronic symptoms. Early intervention and appropriate treatment, which typically involve antipsychotic medications and psychosocial therapies, can help manage symptoms and improve overall functioning. A holistic treatment approach that addresses medication management, therapy, family support, and lifestyle factors is often beneficial.

Question 12: Benjamin is only permitted to play video games for 15 minutes a day, but one day he stays up for an additional 30. His parents do nothing and let him play the game for as long as he likes without any consequences; instead, they give him praise for reaching level 10. What kind of parenting approach do Benjamin's parents employ?

Indulgent (Correct answer)
Authoritative
Mixed modeling
Neglecting

Correct answer: Indulgent

Benjamin's parents exhibit an indulgent parenting style, characterized by high responsiveness and low demandingness. They set few limits or consequences, allowing Benjamin to disregard rules without repercussions and even praising him for it. This approach prioritizes the child's desires over discipline and structure.

Question 13: When you first meet with Frank, a client whose mother recently passed away following a protracted illness, he self-reports, "I really feel horrible this week." The BEST way for you to reply to a statement of primary empathy would be to express the following:

None of the above
"It's pretty obvious, by the way you're saying that, that you're feeling miserable right now."
"I'm sorry you're not feeling good right now. With your mother's death and all the things you've had to face, perhaps you're a little let down."
"It seems like lately, you've had a lot of disturbing things to deal with, so let's talk about what might have happened this week that was particularly difficult for you, Frank." (Correct answer)

Correct answer: "It seems like lately, you've had a lot of disturbing things to deal with, so let's talk about what might have happened this week that was particularly difficult for you, Frank."

Primary empathy involves reflecting both the client's feelings and the content of their message, demonstrating understanding and validation. Option B acknowledges Frank's stated feeling of 'horrible' and connects it to his recent difficult experiences, such as his mother's death. It then invites him to elaborate, which validates his emotional state and encourages further exploration in a supportive and non-judgmental manner.

Question 14: A family that has recently immigrated from Afghanistan requests your case management services so that they can be connected to resources that can help them with some basic requirements. The family's lone speaker of both English and Dari, which is only used by her parents, is the 15-year-old daughter. You accept the referral even though you can only comprehend and speak English.

Ethical because the daughter will be available to translate for/to the parents
None of the above
Unethical because you cannot speak to or understand all family members (Correct answer)
Unethical because you have not determined if the daughter is willing to translate

Correct answer: Unethical because you cannot speak to or understand all family members

It is unethical for a social worker to rely on a minor child to translate for their parents, especially in sensitive professional contexts. This practice places an undue burden on the child, compromises confidentiality, and can lead to misinterpretations or incomplete communication, preventing the social worker from fully understanding the parents' needs and providing effective, culturally competent services. Professional interpreters should always be used to ensure accurate and confidential communication.

Question 15: A social worker learns that a client is undocumented and fears deportation. The social worker's obligation regarding confidentiality is to:

Maintain confidentiality unless a specific legal exception applies (Correct answer)
Encourage the client to self-report to authorities to reduce legal risk
Report the client's status to immigration authorities as required by law
Disclose the information to other agency staff for safety planning

Correct answer: Maintain confidentiality unless a specific legal exception applies

Immigration status is protected information; social workers maintain confidentiality unless a legally recognized exception—not a general duty to report—applies.

Question 16: How many Americans use at least one prescription?

70% (Correct answer)
90%
50%
40%

Correct answer: 70%

According to various national health surveys and statistics, a substantial majority of the American population uses at least one prescription medication. The figure of 70% accurately reflects the widespread prevalence of prescription drug use in the United States for managing various health conditions. This highlights a significant aspect of public health.

Question 17: A client is prescribed an antidepressant and asks the social worker if it will 'fix' their depression. The BEST response is to:

Discourage medication reliance and emphasize therapy alone
Defer entirely to the prescriber and avoid the topic
Reassure the client that medication will resolve their symptoms
Explain that medication may help manage symptoms while therapy addresses underlying issues (Correct answer)

Correct answer: Explain that medication may help manage symptoms while therapy addresses underlying issues

Integrated psychoeducation about the complementary roles of medication and therapy supports informed decision-making and collaborative care.

Question 18: A social worker is ending treatment with a client who has made significant progress. Which termination task is MOST important clinically?

Reducing session frequency gradually over six months
Scheduling a follow-up appointment six months later
Reviewing progress, identifying relapse warning signs, and consolidating coping skills for independence (Correct answer)
Providing a referral to another clinician as a precaution

Correct answer: Reviewing progress, identifying relapse warning signs, and consolidating coping skills for independence

Effective termination consolidates gains, prepares the client for independence, and includes relapse prevention planning.

Question 19: You're meeting with a middle-aged married couple to talk about their regular disagreements. The husband claims that his wife's short fuse and ongoing irritability is the cause of their problems during the session. You should say in response:

"What have you done to make her angry?"
"Let's talk later about your wife's temper, but right now I want to hear from your wife about what she thinks the problem is."
"Please tell me more about your wife's temper." (Correct answer)
"What have you done so far to make the situation better?"

Correct answer: "Please tell me more about your wife's temper."

When a client blames another, the social worker's role is to explore the client's perspective without immediately challenging or validating the blame. Asking 'Please tell me more about your wife's temper' allows the husband to elaborate on his perceptions and feelings, providing valuable information about his experience of the problem. This approach encourages further communication and understanding of the dynamic without taking sides.

Question 20: A social worker uses a genogram in assessment. Genograms are MOST useful for:

Assessing the client's social support network in the community
Mapping multi-generational family relationships and patterns (Correct answer)
Identifying the client's strengths and resilience factors
Measuring a client's cognitive functioning and IQ

Correct answer: Mapping multi-generational family relationships and patterns

A genogram is a graphic tool used to map family structure, relationships, and patterns across at least three generations.

Question 21: Is there ever a situation where you should withhold a client's information from them?

Not unless a court order for such restriction is in place
None of the above
Yes, in some circumstances (Correct answer)
No, a client should have access in all circumstances

Correct answer: Yes, in some circumstances

While clients generally have a right to access their information, social workers may ethically and legally withhold certain details in specific, limited circumstances. This includes situations where disclosure could cause substantial harm to the client or another person, or when the information contains confidential details about a third party. These exceptions prioritize safety and confidentiality while upholding the client's right to information.

Question 22: Cultural humility in social work practice PRIMARILY involves:

Maintaining an ongoing, self-reflective stance about one's own cultural biases (Correct answer)
Applying cultural generalizations to guide client assessment
Becoming an expert in every culture served by the agency
Matching clients with workers who share the same cultural background

Correct answer: Maintaining an ongoing, self-reflective stance about one's own cultural biases

Cultural humility emphasizes lifelong learning and critical self-reflection rather than achieving cultural expertise.

Question 23: A social worker who assumes that all clients from a particular ethnic group share the same values is demonstrating:

Ethnic sensitivity
Intersectionality
Stereotyping/overgeneralization (Correct answer)
Cultural humility

Correct answer: Stereotyping/overgeneralization

Applying uniform assumptions to all members of a group ignores individual variation and constitutes stereotyping, undermining culturally competent practice.

Question 24: A social worker is reviewing a genogram with a client and notes a pattern of substance use across three generations. This information is MOST useful for:

Proving the client's disorder is genetic and untreatable
Assigning primary responsibility for the client's current problems
Identifying multigenerational patterns that may inform assessment and treatment planning (Correct answer)
Determining insurance eligibility based on hereditary risk

Correct answer: Identifying multigenerational patterns that may inform assessment and treatment planning

Genograms reveal intergenerational patterns that provide important context for understanding current client functioning and informing intervention.

Question 25: You query Alice, your client, "What do you think your coworkers would say if a future employer asked them what they think about you?" You are evaluating:

None of the above
Self-concept (Correct answer)
Dependency
Reality testing

Correct answer: Self-concept

This question directly assesses how a client perceives their own identity, characteristics, and reputation through the lens of others. Self-concept encompasses an individual's beliefs about themselves, including their self-image and self-esteem. By asking what coworkers would say, the social worker is evaluating the client's understanding and perception of their own self-concept in a social context.

Question 26: What earlier phrase was used to describe dementia?

stupidity
senility (Correct answer)
slowness
mental retardation

Correct answer: senility

'Senility' was a widely used historical term to describe the cognitive decline and memory loss associated with aging. While now considered outdated and often stigmatizing, it was the common predecessor to the modern medical understanding and diagnosis of dementia. The other options refer to different conditions or are informal terms.

Question 27: Cognitive level and recent and distant memory capacities

sexual orientation
biopsychosocial assessment social section
mental status exam intellectual functioning/ memory (Correct answer)
mental status exam judgement/ insight

Correct answer: mental status exam intellectual functioning/ memory

The 'intellectual functioning/memory' section of a Mental Status Exam (MSE) assesses a client's cognitive abilities, including their general knowledge, abstract thinking, and both recent and distant memory recall. This helps gauge their overall cognitive capacity and identify any potential impairments in these areas. It provides insight into their ability to process information and learn.

Question 28: The social determinants of health most relevant to advanced generalist social work practice include:

Individual lifestyle choices exclusively
Medical diagnoses and pharmaceutical treatments
Genetics and hereditary factors only
Housing, income, education, and social support (Correct answer)

Correct answer: Housing, income, education, and social support

Social determinants of health — including housing, income, education, and social support — are the non-medical factors that significantly shape health outcomes and are central to generalist practice.

Question 29: A social worker who is testifying in court is questioned specifically about his client, who is a defendant in a criminal case. What principle ought to direct the social worker:

Agency policy requires the worker to maintain absolute confidentiality
The social work privilege is not absolute and the worker may be required to testify if ordered to do so by the judge. (Correct answer)
The social worker has social work privilege and cannot be asked to provide confidential case information.
The Code of Ethics requires that the worker refuse to testify.

Correct answer: The social work privilege is not absolute and the worker may be required to testify if ordered to do so by the judge.

While social workers are bound by confidentiality and privilege, these are not absolute, especially in legal proceedings. A judge can issue a court order (subpoena) compelling a social worker to testify or release client information, overriding general confidentiality principles. In such cases, the social worker must comply with the court order, though they should still advocate for the least intrusive disclosure necessary.

Question 30: In motivational interviewing, 'rolling with resistance' means the clinician should:

Redirect the conversation to a different topic
Agree with all client statements to build rapport
Avoid arguing and reflect the client's perspective without confrontation (Correct answer)
Challenge the client's ambivalence directly

Correct answer: Avoid arguing and reflect the client's perspective without confrontation

Rolling with resistance involves accepting and reflecting the client's perspective rather than arguing, which reduces defensiveness.

Question 31: A genogram is MOST useful in assessment for:

Assessing a client's daily functional abilities
Screening for substance use disorders
Mapping multigenerational family patterns and relationships (Correct answer)
Identifying community resources

Correct answer: Mapping multigenerational family patterns and relationships

A genogram is a pictorial representation of family relationships and history across generations, helping identify patterns such as mental illness, divorce, or trauma that may influence the current client.

Question 32: A school social worker notices that a student's academic performance has declined sharply following her parents' divorce. Using a systems perspective, the MOST appropriate first step is to:

Refer the student for individual psychotherapy for depression
Assess the impact of the family system change on the student's functioning (Correct answer)
Recommend the parents attend co-parenting counseling
Meet with teachers to develop an academic improvement plan

Correct answer: Assess the impact of the family system change on the student's functioning

A systems perspective requires first understanding how the change in the family system is affecting the student before selecting an intervention.

Question 33: Which defense mechanism involves unconsciously attributing one's own unacceptable feelings to another person?

Reaction formation
Rationalization
Sublimation
Projection (Correct answer)

Correct answer: Projection

Projection involves attributing one's own unwanted thoughts or feelings onto another person to reduce internal anxiety.

Question 34: What makes parental substance abuse such a problem?

It leads to poverty and crime.
It is the biggest cause of divorces.
It disrupts the bonding between parent and child. (Correct answer)
It encourages children to imitate their parents.

Correct answer: It disrupts the bonding between parent and child.

Parental substance abuse severely impairs a parent's ability to provide consistent care, emotional availability, and a stable environment. This often leads to neglect, inconsistent parenting, and emotional unavailability, which profoundly disrupts the crucial attachment and bonding process between parent and child. This disruption can have long-lasting negative impacts on the child's development and well-being.

Question 35: A parent reports using spanking as discipline. The child shows no injuries. The social worker should FIRST:

File a mandated report for physical abuse
Close the case as no abuse has occurred
Assess the frequency, severity, and context of the discipline and provide psychoeducation on effective alternatives (Correct answer)
Refer the family to parenting classes without further assessment

Correct answer: Assess the frequency, severity, and context of the discipline and provide psychoeducation on effective alternatives

Thorough assessment of disciplinary practices is required before making clinical or reporting decisions; psychoeducation supports safer parenting.

Question 36: For his contributions to the ____ perspective of educational psychology, Albert Bandura is well-known.

cognitive
developmental
social-cognitive (Correct answer)
constructivist

Correct answer: social-cognitive

Albert Bandura is renowned for his Social Cognitive Theory, which emphasizes the importance of observational learning, imitation, and modeling. His work highlights how individuals learn by observing others' behaviors, attitudes, and outcomes, and how personal factors, environmental influences, and behavior all interact in a reciprocal manner. This perspective bridges cognitive and behavioral approaches to learning.

Question 37: A BSW is facilitating a psychoeducational group for caregivers of adults with dementia. This is an example of which type of group?

Therapy group
Support and education group (Correct answer)
Self-help group
Task group

Correct answer: Support and education group

Psychoeducational groups combine support with skill-building and education, making them support and education groups rather than therapy or task groups.

Question 38: A social worker is working with a client from a collectivist culture who defers all treatment decisions to family elders. The MOST clinically appropriate response is to:

Explain that individual autonomy must be respected per professional ethics
Document the client's capacity for independent decision-making
Explore how family involvement aligns with the client's values and incorporate it into treatment (Correct answer)
Refer the client to a therapist from the same cultural background

Correct answer: Explore how family involvement aligns with the client's values and incorporate it into treatment

Culturally competent practice requires adapting the treatment approach to honor the client's cultural values, including family-centered decision-making in collectivist cultures.

Question 39: Lithium: Slower mental degeneration and decline

True
False (Correct answer)

Correct answer: False

Lithium is primarily known as a mood stabilizer, widely used in the treatment of bipolar disorder to prevent episodes of mania and depression. While it helps manage mood symptoms and improve overall functioning, it is not specifically indicated or known for slowing mental degeneration or cognitive decline. Its therapeutic effects are focused on mood regulation.

Question 40: A case worker has over ten years of experience in the social work field. The case worker has enjoyed his employment during those years, but he is emotionally spent and has started to feel unsatisfied with helping clients with their difficulties. The caseworker is probably going through

Vicarious Trauma
Secondary Trauma
Compassion Fatigue
Burnout (Correct answer)

Correct answer: Burnout

Burnout is characterized by emotional exhaustion, depersonalization (detachment from clients), and a reduced sense of personal accomplishment, often resulting from prolonged or excessive stress in the workplace. The caseworker's description of being 'emotionally spent' and 'unsatisfied with helping clients' after years of enjoyable work perfectly aligns with the symptoms of professional burnout. It's a cumulative effect of chronic work-related stress.

Question 41: A BSW in a hospital setting is asked by a physician to share a patient's mental health records without the patient's consent 'to help with treatment.' The BSW should:

Share the records since treatment team coordination is always permitted
Share only a verbal summary to avoid a formal HIPAA violation
Refuse entirely, as no health information can ever be shared
Explain HIPAA provisions and obtain proper authorization before sharing (Correct answer)

Correct answer: Explain HIPAA provisions and obtain proper authorization before sharing

HIPAA allows treatment-related sharing but typically requires the patient's authorization or a specific exception; the BSW must follow proper legal procedure.

Question 42: Which of the following best describes 'structural family therapy' as developed by Salvador Minuchin?

Focusing on circular communication patterns and cybernetics
Restructuring dysfunctional family hierarchies and boundaries (Correct answer)
Using narrative techniques to re-author the family's story
Exploring multigenerational family patterns through genograms

Correct answer: Restructuring dysfunctional family hierarchies and boundaries

Minuchin's structural family therapy targets family organization, including subsystems, hierarchies, and boundaries, to alleviate symptomatic behavior.

Question 43: The LEAST probable diagnostic indicators of "disorganized" schizophrenia are:

Extreme impairment in the ability to perform/maintain activities of daily living and basic social behavior, which may include inadequate personal hygiene, unusual or climate-inappropriate choices of clothing, inability to prepare meals, inappropriate behavior toward others, or socially unacceptable public behavior
Unusual language or speech patterns that may include echolalia, use of neologisms and/or tangential speech
Situationally incongruent affective displays and/or relative deficits in affective experience and expression, which may be accompanied by bizarre or incongruous verbal behavior
Periods of relatively adequate daily functioning scattered with episodes of severe psychotic thought/behaviors that cause pervasive disruption in areas such as activities of daily living, communication, relations with others, etc (Correct answer)

Correct answer: Periods of relatively adequate daily functioning scattered with episodes of severe psychotic thought/behaviors that cause pervasive disruption in areas such as activities of daily living, communication, relations with others, etc

Disorganized schizophrenia (now part of Schizophrenia Spectrum and Other Psychotic Disorders in DSM-5) is characterized by severe and pervasive disorganization of speech, behavior, and affect, leading to chronic impairment in daily functioning. Option D describes an episodic course with periods of *relatively adequate* functioning, which is less typical of the consistently severe and pervasive disruption seen in the disorganized presentation. The other options describe core features of disorganized schizophrenia.

Question 44: Which of the following is an example of a macro-level social work intervention?

Facilitating a support group for survivors of domestic violence
Providing individual counseling to a homeless veteran
Conducting a biopsychosocial assessment for a new client
Advocating for policy changes to expand affordable housing (Correct answer)

Correct answer: Advocating for policy changes to expand affordable housing

Macro-level practice focuses on systems change, including policy advocacy, community organizing, and legislative reform.

Question 45: A client with schizophrenia is stable on medication but refuses to take it because of side effects. The most appropriate clinical response is to:

Discharge the client from services for non-compliance
Arrange involuntary hospitalization to ensure medication compliance
Collaborate with the client and prescriber to explore side effect management and medication alternatives (Correct answer)
Document the refusal and take no further action

Correct answer: Collaborate with the client and prescriber to explore side effect management and medication alternatives

Person-centered care involves partnering with the client to address barriers to treatment adherence rather than coercing or abandoning them.

Question 46: A social worker is assessing a client who reports excessive worry about multiple life domains for over a year, accompanied by muscle tension and sleep difficulty. The MOST likely diagnosis to explore is:

Specific Phobia
Panic Disorder
Generalized Anxiety Disorder (Correct answer)
Obsessive-Compulsive Disorder

Correct answer: Generalized Anxiety Disorder

Pervasive, uncontrollable worry across multiple domains lasting at least 6 months with physical symptoms like tension and insomnia is characteristic of GAD.

Question 47: A client with obsessive-compulsive disorder is BEST treated with which evidence-based approach?

Exposure and response prevention (ERP) (Correct answer)
Psychoanalytic therapy
Hypnotherapy
Supportive therapy only

Correct answer: Exposure and response prevention (ERP)

Exposure and response prevention is the gold-standard behavioral treatment for OCD, involving gradual exposure to fears while preventing compulsive rituals.

Question 48: A social worker assesses a client who reports believing that TV news anchors are sending coded messages specifically intended for him. This belief is BEST described as:

An auditory hallucination
Magical thinking within normal limits
A persecutory delusion
A delusion of reference (Correct answer)

Correct answer: A delusion of reference

A delusion of reference is a fixed false belief that neutral external events carry a special, personal significance directed at the individual.

Question 49: A social worker is assessing attachment patterns in a young child using observational methods. Which behavior MOST strongly indicates a disorganized attachment pattern?

Showing separation distress but being difficult to soothe
Approaching the caregiver with fearful or contradictory behaviors upon reunion (Correct answer)
Crying briefly at separation, quickly comforted on reunion
Ignoring the caregiver upon reunion after brief separation

Correct answer: Approaching the caregiver with fearful or contradictory behaviors upon reunion

Disorganized attachment is characterized by contradictory, fearful, or disoriented behaviors toward the caregiver who is simultaneously the source of fear.

Question 50: A social worker in private practice sees a client who is also a neighbor. After careful consideration, this arrangement is best described as:

Permissible only with supervisor approval
A prohibited dual relationship that should be avoided (Correct answer)
An acceptable dual relationship if disclosed and documented
Allowed because the relationship predates treatment

Correct answer: A prohibited dual relationship that should be avoided

NASW ethics and LCSW standards advise against dual relationships that could impair judgment or exploit the client, including neighbor-client situations.

Question 51: A client in a substance use program tells the BSW they plan to drive home while intoxicated. The social worker's FIRST step is to:

Attempt to persuade the client to use an alternative form of transportation (Correct answer)
Call law enforcement to intercept the client
Notify the client's emergency contact without consent
Document the situation and allow the client to leave

Correct answer: Attempt to persuade the client to use an alternative form of transportation

The social worker should first attempt to de-escalate and find a safer alternative before considering breach of confidentiality or third-party contact.

Question 52: A social worker is conducting a community needs assessment. Which method would provide the MOST representative data about the community's perceptions of service gaps?

Interviewing agency directors in the target community
Reviewing existing agency utilization statistics
Holding focus groups with current service recipients
Distributing a random sample survey to community residents (Correct answer)

Correct answer: Distributing a random sample survey to community residents

A random sample survey of residents provides statistically representative data about community-wide perceptions, unlike purposive or convenience sampling methods.

Question 53: What did the local government get if the state government granted them $50,000 to fix a particular state route?

Revenue sharing
Categorical grant (Correct answer)
All of the above
Block grant

Correct answer: Categorical grant

A categorical grant is federal funding given to state and local governments for a specific purpose, often with strict conditions on how the money can be spent. In this scenario, the $50,000 is explicitly granted 'to fix a particular state route,' which perfectly fits the definition of a categorical grant. Block grants offer more flexibility, and revenue sharing is a different concept of distributing tax revenue.

Question 54: A social worker is presenting a client's case at a multidisciplinary team meeting. To protect confidentiality, the social worker should:

Share only information directly relevant to the treatment being coordinated
Obtain written consent from the client before any information is shared (Correct answer)
Share the full case history so team members have complete context
Avoid sharing any client information with non-social work professionals

Correct answer: Obtain written consent from the client before any information is shared

Even in multidisciplinary settings, informed written consent should be obtained before sharing client information, and disclosure should be limited to what is necessary for care coordination.

Question 55: What is atypical development?

Development that is right on track for their age.
Development that is different from their peers, but right on track for their age.
Development that has been delayed, but the same as their peers.
Development that has been delayed or is different from their peers. (Correct answer)

Correct answer: Development that has been delayed or is different from their peers.

Atypical development refers to patterns of development that significantly deviate from what is considered typical or expected for a child's age group. This can manifest as delays in reaching developmental milestones, or as qualitative differences in how skills and behaviors emerge compared to their peers. It encompasses both delayed progression and distinct developmental pathways.

Question 56: What is another phrase for "steady state" in the systems theory?

Input
Differentiation
Homeostasis (Correct answer)
Open system

Correct answer: Homeostasis

In systems theory, homeostasis refers to a system's tendency to maintain a stable, relatively constant internal state. It describes the dynamic processes by which a system regulates itself to achieve equilibrium and resist change. This 'steady state' ensures the system's continued functioning despite external fluctuations, making it synonymous with maintaining balance.

Question 57: When conducting an assessment of an elderly client, the social worker should FIRST consider:

Whether the client's family agrees with the assessment findings
Whether the client can afford ongoing services
How age-related physical and cognitive changes may influence the presentation (Correct answer)
The client's insurance coverage and eligibility

Correct answer: How age-related physical and cognitive changes may influence the presentation

Age-related changes in cognition, sensory function, and health can significantly affect assessment findings with elderly clients.

Question 58: Psychiatrist training is uncommon among social caseworkers. What ought they to do if they come across a person who is experiencing mental health issues?

try to treat the problem to the best of your ability
inform the patient that you cannot help and they need to go to someone else for help
ignore the problem because you cannot help
be able to recognize these problems when they exist and refer the person to the proper source for treatment (Correct answer)

Correct answer: be able to recognize these problems when they exist and refer the person to the proper source for treatment

When someone is experiencing distress, repeatedly telling them 'everything will be okay' without acknowledging their feelings or the seriousness of their situation can be dismissive and invalidating. This approach often makes the client feel unheard and misunderstood, leading them to doubt the helper's ability to truly comprehend or assist with their problem. Effective communication requires empathy and validation before offering reassurance.

Question 59: An example of a situation in which family counseling is NOT advised is as follows:

When the family members are resistant/unmotivated
None of the above
When deceit is apparent between family members (Correct answer)
When boundaries are violated between family members

Correct answer: When deceit is apparent between family members

While issues like resistance, lack of motivation, or boundary violations can be addressed in family counseling, pervasive deceit among family members can fundamentally undermine the therapeutic process. Effective family therapy relies on a degree of trust and willingness to be open, which deceit directly compromises. Without a foundation of honesty, it becomes extremely difficult to identify and resolve underlying family dynamics or achieve therapeutic goals.

Question 60: According to NASW ethical standards, a social worker who becomes aware that a colleague is practicing while impaired by substance use should FIRST:

Report the colleague directly to the state licensing board
Confront the colleague and encourage them to seek help (Correct answer)
Inform the agency administrator without talking to the colleague
Document observations and wait to see if impairment continues

Correct answer: Confront the colleague and encourage them to seek help

NASW standards direct social workers to first address the issue with the colleague directly before escalating to formal reporting, when feasible.

Question 61: At two different social gatherings, both held in public eateries, you overheard a coworker discussing his clients. The colleague would even mention the clients by name when talking to them. What step should you TAKE RIGHT AWAY?

Notify your colleague's supervisor about his unethical behavior (Correct answer)
None of the above
Threaten to report the social worker if he continues to discuss his clients in public
Understand the social worker’s need to vent about his clients

Correct answer: Notify your colleague's supervisor about his unethical behavior

A social worker has an ethical obligation to address a colleague's unethical conduct, especially when it involves a breach of client confidentiality. The most immediate and appropriate step is to report the behavior to the colleague's supervisor, who has the authority and responsibility to intervene, ensure ethical practice, and protect client privacy. This is a professional and effective way to address the breach.

Question 62: A social worker treating a veteran who avoids driving, has nightmares about an IED explosion, and feels emotionally numb is MOST likely addressing:

Generalized anxiety disorder
Post-traumatic stress disorder (Correct answer)
Acute stress disorder
Specific phobia

Correct answer: Post-traumatic stress disorder

Avoidance, intrusive nightmares, and emotional numbing persisting beyond one month after a traumatic event meet criteria for PTSD.

Question 63: A client describes feeling that she is watching herself from outside her body during stressful situations. This experience BEST describes:

Magical thinking
Dissociation/depersonalization (Correct answer)
Visual hallucinations
Derealization

Correct answer: Dissociation/depersonalization

Depersonalization involves feeling detached from one's own body or mental processes, as if observing oneself from outside.

Question 64: Which of the following BEST describes the concept of 'dual relationship' in social work practice?

Providing services in two different settings simultaneously
A situation where the social worker has both a professional and personal relationship with a client (Correct answer)
Having two clients in the same family system
A worker who holds both clinical and administrative roles

Correct answer: A situation where the social worker has both a professional and personal relationship with a client

A dual relationship occurs when a social worker engages in a secondary role with a client outside the professional relationship, creating an ethical boundary concern.

Question 65: A social worker is conducting a suicide risk assessment. Which factor would be considered MOST indicative of HIGH lethality?

Fleeting thoughts of death without intent
History of a previous high-lethality attempt (Correct answer)
Expressing ambivalence about suicide
Passive ideation without a specific plan

Correct answer: History of a previous high-lethality attempt

A prior high-lethality suicide attempt is one of the strongest predictors of future completed suicide and indicates significantly elevated risk.

Question 66: A social worker assesses that a client lacks stable housing, has untreated diabetes, and is experiencing depression. Addressing the housing issue FIRST is consistent with which theoretical framework?

Psychoanalytic theory
Cognitive Behavioral Theory
Maslow's Hierarchy of Needs (Correct answer)
Systems Theory

Correct answer: Maslow's Hierarchy of Needs

Maslow's Hierarchy of Needs holds that basic physiological and safety needs (such as housing) must be addressed before higher-order needs can be meaningfully targeted.

Question 67: Erikson's stage of 'Generativity vs. Stagnation' is most associated with which life period?

Middle adulthood (Correct answer)
Young adulthood
Adolescence
Late adulthood

Correct answer: Middle adulthood

Generativity vs. Stagnation occurs in middle adulthood (roughly ages 40–65), focusing on contributing to society and guiding the next generation.

Question 68: Middle childhood health in particular depends on two things: and _.

exercise; dieting
meditation; dieting
exercise; nutrition (Correct answer)
weightlifting; nutrition

Correct answer: exercise; nutrition

During middle childhood, maintaining good health is fundamentally dependent on regular physical exercise and balanced nutrition. These two factors are crucial for healthy growth, development, maintaining a healthy weight, and providing the energy needed for daily activities and learning. They are foundational for preventing childhood obesity and promoting overall well-being.

Question 69: During intake, a client discloses they are undocumented. The BSW should:

Document immigration status in the case file for agency records
Refer the client to an immigration attorney before providing services
Provide services and maintain confidentiality as with any client (Correct answer)
Inform the client that their status may need to be reported

Correct answer: Provide services and maintain confidentiality as with any client

Social workers are obligated to provide services without discrimination and maintain confidentiality regardless of immigration status.

Question 70: Which of the following interventions is MOST consistent with an ecological systems perspective?

Exploring the client's unresolved conflicts with parental figures
Teaching relaxation techniques to manage anxiety symptoms
Helping a client identify and dispute automatic negative thoughts
Advocating for workplace policy changes to reduce client stress (Correct answer)

Correct answer: Advocating for workplace policy changes to reduce client stress

The ecological perspective focuses on the person-in-environment, including systemic and macro-level factors; advocacy for policy change addresses environmental stressors.

Question 71: A client who has been excessively reliant on drugs and alcohol is looking for medical help. Working together on secondary prevention is the client and his counselor. In the course of this intervention, the counselor should:

Identify the client's issue with alcoholism and drug abuse and determine the best treatment to overcome his reliance on drugs and alcohol (Correct answer)
Evaluate any underlying, subconscious factors that might be associated with the client's predilection to turn to alcohol and drugs
Help the client to manage living a life as an alcoholic and drug abuser
Discuss steps the client can take to determine what provokes him to drink or use drugs to an extent that is unhealthy

Correct answer: Identify the client's issue with alcoholism and drug abuse and determine the best treatment to overcome his reliance on drugs and alcohol

Secondary prevention aims to identify and address problems early to prevent them from worsening or becoming chronic. In this case, for a client already exhibiting substance abuse, secondary prevention involves diagnosing the existing issue and initiating appropriate treatment to halt its progression and mitigate its impact. This focuses on early intervention rather than primary prevention (preventing onset) or tertiary prevention (managing chronic conditions).

Question 72: Charles has asked for respect for everything he has accomplished since elementary school. He tends to exaggerate his achievements and exhibits a mind-boggling drive for advancement, power, and love. Chuck believes that only people who are similar to him and are dominant in a particular area of life can really understand him. What mental illness does this guy represent?

Borderline personality disorder
Bi-polar disorder
Chauvinistic personality disorder
Narcissistic personality disorder (Correct answer)

Correct answer: Narcissistic personality disorder

Charles behavior does seem to align with some of the characteristics associated with Narcissistic Personality Disorder (NPD). NPD is a mental health condition characterized by a pattern of grandiosity, a lack of empathy, and an excessive need for admiration.

Question 73: The Health Insurance Portability and Accountability Act (HIPAA) primarily governs:

Eligibility for Medicare and Medicaid
Standards for mental health parity
Insurance coverage for pre-existing conditions
Privacy and security of protected health information (Correct answer)

Correct answer: Privacy and security of protected health information

HIPAA establishes national standards for protecting the privacy and security of individually identifiable health information.

Question 74: According to Erikson's psychosocial theory, the primary developmental conflict for a healthy 70-year-old is:

Generativity vs. stagnation
Identity vs. role confusion
Ego integrity vs. despair (Correct answer)
Industry vs. inferiority

Correct answer: Ego integrity vs. despair

Erikson's eighth stage (late adulthood) centers on ego integrity—accepting one's life as meaningful—versus despair over missed opportunities.

Question 75: A client with borderline personality disorder frequently calls the crisis line between sessions and reports that the social worker is 'the only one who truly helps.' This pattern MOST likely reflects:

Dependency resulting from inadequate coping skills
Splitting and idealization (Correct answer)
Countertransference in the therapeutic relationship
Genuine therapeutic progress and trust

Correct answer: Splitting and idealization

Idealization—viewing the therapist as 'all good' while devaluing others—is a manifestation of the splitting defense mechanism common in borderline personality disorder.

Question 76: A client diagnosed with PTSD avoids driving after a car accident. From a cognitive-behavioral perspective, what maintains this avoidance?

Unconscious guilt about surviving the accident
A biochemical imbalance in the fear response system
Unresolved grief related to the accident
Negative reinforcement—avoidance reduces anxiety and prevents fear extinction (Correct answer)

Correct answer: Negative reinforcement—avoidance reduces anxiety and prevents fear extinction

Avoidance is negatively reinforced when it reduces distress, thereby preventing the extinction of the fear response.

Question 77: When conducting a mental status examination, 'affect' specifically refers to:

The cognitive appraisal of a stressful event
A client's reported inner emotional experience
A client's long-standing personality traits
The observable outward expression of emotion (Correct answer)

Correct answer: The observable outward expression of emotion

Affect is the observable, external manifestation of emotion (e.g., flat, labile, constricted), while mood refers to the client's subjective internal feeling.

Question 78: The process of 'termination' in social work practice refers to:

Firing a client from services for non-compliance
The planned ending of the professional relationship and consolidation of gains (Correct answer)
Transferring a client to another worker without preparation
Abruptly ending services when funding is cut

Correct answer: The planned ending of the professional relationship and consolidation of gains

Termination is an intentional, planned phase of the helping process focused on reviewing progress, consolidating gains, and preparing the client for independence.

Question 79: A client tells her social worker, 'I know you probably think I'm stupid for staying with him.' The social worker responds, 'It sounds like you're worried about being judged.' This response BEST demonstrates:

Confrontation
Reframing
Reflection of feeling (Correct answer)
Interpretation

Correct answer: Reflection of feeling

Reflecting feeling involves naming the emotion the client is experiencing, which validates and deepens the therapeutic relationship.

Question 80: A social worker uses role-playing during a session to help a client practice assertiveness with her supervisor. This technique is BEST associated with which theoretical approach?

Narrative therapy
Psychodynamic therapy
Solution-focused brief therapy
Cognitive-behavioral therapy (Correct answer)

Correct answer: Cognitive-behavioral therapy

Role-playing and behavioral rehearsal are core CBT techniques used to practice new skills in a safe environment.

Question 81: You get a demand from a client named Charlie stating that you must provide him access to his records or he will sue you. However, you last saw Charlie two months ago, and during that visit, he was not only incredibly nasty but also spent the majority of it either pacing or standing above you while speaking loudly. You believe that if you gave him access to the records, it may possibly result in serious harm. Which of the following would be the BEST course of action to pursue to prevent breaking the law?

Contact your boss and inform her of the situation
Decline Charlie's request for his records
Record Charlie's request and the reason why you will not release the record (Correct answer)
Release Charlie's records as he had requested

Correct answer: Record Charlie's request and the reason why you will not release the record

Social workers have an ethical and legal obligation to provide clients access to their records, but this right is not absolute if there's a belief that releasing them could cause substantial harm. In such cases, the social worker can deny access, but it is crucial to *document* Charlie's request and the specific, clinical reasons for the denial. This protects the social worker legally and ethically while prioritizing the client's safety and well-being.

Question 82: After a fight including physical and verbal abuse, the batterer makes a vow to the victim that "I will never do this again." The abuser repeatedly apologizes to the victim and professes to love and care for her. Where is the batterer in the "cycle of violence"?

Phase IV
Phase I
Phase II
Phase III (Correct answer)

Correct answer: Phase III

The 'cycle of violence' typically consists of three phases: tension-building (Phase I), acute battering incident (Phase II), and the 'honeymoon' or 'calm' phase (Phase III). In Phase III, the abuser expresses remorse, apologizes, promises change, and may shower the victim with affection, creating a false sense of hope. The batterer's actions of vowing 'never again,' apologizing, and professing love perfectly match this honeymoon phase.

Question 83: Which eating disorder is characterized by recurrent episodes of binge eating without compensatory behaviors, occurring at least once a week for 3 months?

Anorexia Nervosa
Avoidant/Restrictive Food Intake Disorder
Bulimia Nervosa
Binge Eating Disorder (Correct answer)

Correct answer: Binge Eating Disorder

Binge Eating Disorder involves recurrent binge eating episodes without the purging or compensatory behaviors seen in Bulimia Nervosa.

Question 84: The group discusses its successes and feelings around the group's dissolution.

social justice
group polarization
end-stage of group (Correct answer)
static risk factors

Correct answer: end-stage of group

The end-stage of a group, also known as termination, is characterized by members reflecting on their experiences, accomplishments, and feelings about the group's dissolution. This includes processing feelings of loss or sadness, celebrating successes, and preparing for the transition out of the group. It's a crucial phase for consolidating learning and ensuring a positive closure.

Question 85: A social worker is conducting an assessment and notices the client repeatedly changes the subject when asked about their childhood. This is BEST understood as:

A sign of intellectual disability
A possible indicator of avoidance related to distressing material (Correct answer)
Confirmation that early childhood is irrelevant to the presenting problem
Evidence that the client is being dishonest

Correct answer: A possible indicator of avoidance related to distressing material

Avoidance of specific topics may indicate emotional distress or trauma associated with that content, and warrants gentle clinical exploration.

Question 86: A social worker receives a subpoena for a client's records. What is the FIRST step?

Contact the opposing attorney for clarification
Release the records immediately to comply with the court
Notify the client and consult an attorney (Correct answer)
Destroy sensitive records before the court date

Correct answer: Notify the client and consult an attorney

Upon receiving a subpoena, the social worker should first notify the client and consult with legal counsel before releasing any records.

Question 87: Inability to recognize familiar faces (prosopagnosia)

False
True (Correct answer)

Correct answer: True

Prosopagnosia, often referred to as 'face blindness,' is a specific type of agnosia characterized by the inability to recognize familiar faces. Individuals with prosopagnosia can see facial features but cannot connect them to a person's identity, even for close family members or their own reflection. It results from damage to specific brain regions involved in face processing.

Question 88: During termination, a client who has made significant progress suddenly begins exhibiting symptoms that had resolved earlier in treatment. This is BEST understood as:

An indicator that the client has developed a new psychiatric disorder
A sign that treatment goals were not actually met
Counter-transference on the part of the social worker
Regression as a response to the anticipated loss of the therapeutic relationship (Correct answer)

Correct answer: Regression as a response to the anticipated loss of the therapeutic relationship

Regression during termination is common and reflects the client's anxiety about losing the support of the therapeutic relationship, not a failure of treatment.

Question 89: The social worker is evaluating the client's history of drug misuse. Which model offers the most thorough justification for how complex substance abuse diseases are?

Medical Model
Biopsychosocial Model (Correct answer)
Family and Environmental Model
Social Model

Correct answer: Biopsychosocial Model

The Biopsychosocial Model offers the most comprehensive framework for understanding complex conditions like substance abuse by considering the interconnected roles of biological, psychological, and social factors. This model acknowledges that genetic predispositions, individual thoughts and emotions, and environmental influences all contribute to the development and maintenance of addiction. It provides a holistic view, unlike models that focus on a single dimension.

Question 90: A social worker is piecing together the client's presenting behaviors during an interview with a client to develop a fresh picture of the challenges the client is facing. What method of interviewing is the social worker employing?

Interpretation (Correct answer)
Reframing and relabeling
Clarification
Universalization

Correct answer: Interpretation

Interpretation in social work involves offering a new perspective or deeper meaning to a client's behaviors, thoughts, or feelings, often connecting them to underlying patterns or unconscious processes. By 'piecing together the client's presenting behaviors... to develop a fresh picture of the challenges,' the social worker is going beyond surface-level understanding to provide an interpretive framework. This helps the client gain insight into their situation.

Question 91: A BSW is assigned a client whose religious beliefs conflict with the social worker's personal values. The MOST ethical response is to:

Provide competent, non-judgmental services while setting aside personal values (Correct answer)
Disclose personal values to the client so they can decide to continue
Transfer the client to another worker who shares the client's beliefs
Consult with a supervisor about whether to accept the case

Correct answer: Provide competent, non-judgmental services while setting aside personal values

Social workers are ethically obligated to provide competent, unbiased services regardless of personal value differences.

Question 92: Individuals who endure protracted periods of significant physical disease in their early years are almost often found to have the following:.

Assumption of a "sick role" within the nuclear family and long-term, most often permanent effects on relationships with parents and siblings
Lower than average tolerance for stress and higher incidence of anxiety-related problems compared to healthy peers
Lasting concerns about somatic complaints and symptoms, and substantially more frequent utilization of medical resources throughout adulthood, relative to individuals who did not experience significant childhood illness
Delays in achieving expected milestones in academic achievement and social development, for which a long-term prognosis is dependent on a number of factors and vary substantially from case to case (Correct answer)

Correct answer: Delays in achieving expected milestones in academic achievement and social development, for which a long-term prognosis is dependent on a number of factors and vary substantially from case to case

Protracted physical illness in early childhood often leads to significant disruptions in a child's life, including missed school, limited social interaction, and reduced energy for developmental tasks. These interferences directly impact academic progress and opportunities for social learning and peer engagement. The long-term prognosis for these delays is complex and depends on various factors, including the severity of the illness, available support systems, and timely interventions.

Question 93: What is cognitive development?

Growth in thinking skills (Correct answer)
Growth in sexuality
Growth in hormones
Growth in height

Correct answer: Growth in thinking skills

Cognitive development refers to the growth and maturation of a person's thinking, reasoning, and problem-solving abilities over time. It encompasses processes like memory, perception, language, and intelligence. This development is crucial for learning and adapting to the world.

Question 94: The concept of 'double ABCX model' in family stress theory addresses:

How families adapt to stressors over time using resources and perception (Correct answer)
Concurrent diagnosis of mental illness in both parents
The impact of dual-income households on family functioning
The bidirectional nature of parent-child conflict

Correct answer: How families adapt to stressors over time using resources and perception

McCubbin's Double ABCX model extends Hill's ABCX model to explain post-crisis adaptation using accumulated stressors, resources, and family perception.

Question 95: A social worker is assessing a client's level of motivation to change substance use. According to the Stages of Change model, a client who says 'I know drinking is a problem, but I'm not ready to quit yet' is in which stage?

Contemplation (Correct answer)
Action
Preparation
Precontemplation

Correct answer: Contemplation

Contemplation involves awareness that a problem exists and ambivalence about change, without commitment to take action in the near future.

Question 96: A social worker is conducting a mental status examination. Which element assesses whether a client can perform serial sevens or spell 'world' backwards?

Abstract thinking
Insight
Orientation
Concentration and attention (Correct answer)

Correct answer: Concentration and attention

Serial sevens and spelling 'world' backwards are standard tasks used to evaluate concentration and attention during a mental status examination.

Question 97: A social worker assesses a client who describes discrete episodes of intense fear, heart pounding, shortness of breath, and a sense of impending doom that peak within 10 minutes and occur unexpectedly. This BEST describes:

A panic attack (Correct answer)
An acute stress reaction
An ataque de nervios
A generalized anxiety flare

Correct answer: A panic attack

Panic attacks are defined by sudden surges of intense fear reaching a peak within minutes, accompanied by physical and cognitive symptoms, and can occur unexpectedly.

Question 98: What distinguishes private social agencies from public welfare programs?

for public welfare, only financial assistance can be offered
for public welfare, the needs of the client cannot be met due to costs
public welfare requires all policies and procedures be based upon statutory authorizations (Correct answer)
for public welfare, all case records are open to the public

Correct answer: public welfare requires all policies and procedures be based upon statutory authorizations

Public welfare programs are governmental entities, meaning their operations, policies, and procedures are directly mandated and authorized by laws (statutes). In contrast, private social agencies are typically non-profit organizations or businesses whose policies are guided by their mission, board, and funding sources, not direct statutory requirements for every operational detail. This fundamental difference in legal basis is a key distinguishing factor.

Question 99: A client reports feeling detached from her body as if watching herself from the outside during stressful events. This experience is BEST described as:

Dissociative amnesia
Hypnagogic hallucination
Depersonalization (Correct answer)
Derealization

Correct answer: Depersonalization

Depersonalization involves feeling detached from one's own mind or body, often described as being an outside observer of one's own thoughts or sensations.

Question 100: A social worker who is feeling burned out begins taking long lunches and arriving late to client sessions. This BEST illustrates:

Secondary traumatic stress
Countertransference
Compassion fatigue affecting professional behavior (Correct answer)
Vicarious trauma

Correct answer: Compassion fatigue affecting professional behavior

Compassion fatigue can erode professional conduct, leading to behaviors like tardiness and boundary erosion with clients.

Question 101: Which principle guides the social worker to start where the client is during assessment?

Informed consent
Self-determination
Confidentiality
Meeting the client where they are (Correct answer)

Correct answer: Meeting the client where they are

The principle of meeting the client where they are directs social workers to begin assessment by acknowledging the client's current readiness, perspective, and emotional state.

Question 102: A social worker is legally required to break confidentiality without client consent when:

A client shares embarrassing personal information
A client admits to a previous undisclosed crime
A client makes a credible threat to harm an identifiable third party (Correct answer)
A client discloses past illegal drug use

Correct answer: A client makes a credible threat to harm an identifiable third party

The Tarasoff duty requires clinicians to protect identifiable third parties from credible threats made by clients, which may include warning the potential victim or law enforcement.

Question 103: A social worker named Anthony has been assisting Jake, who has been in a crisis since being released from prison and has nowhere to go, for about a month. Anthony and Jake are now meeting to create a detailed list of things for Jake to undertake in order to start resolving his issue after the two have grown close and Kai has had an opportunity to explore his feelings (s). Which of the four crisis intervention objectives does Anthony's strategy BEST illustrate?

Relieving the impact of stress with emotional and social resources
Returning Jake to a previous level of functioning (Correct answer)
Developing adaptive coping skills
Helping strengthen coping skills during Jake's crisis

Correct answer: Returning Jake to a previous level of functioning

The primary goal of crisis intervention is to help individuals stabilize and return to their pre-crisis level of functioning as quickly as possible. By developing a detailed action plan for Jake to resolve his immediate issue of homelessness, Anthony is directly working towards restoring Jake's stability and helping him regain a sense of control and normalcy, which aligns with the objective of returning to a previous level of functioning.

Question 104: Under the Americans with Disabilities Act (ADA), social service agencies are required to provide 'reasonable accommodations.' This means:

Providing full time personal aides to all clients with disabilities
Making modifications that do not cause undue hardship to the organization (Correct answer)
Eliminating all barriers regardless of cost or feasibility
Replacing existing staff with specialized disability advocates

Correct answer: Making modifications that do not cause undue hardship to the organization

The ADA requires reasonable accommodations that do not impose an undue hardship (significant difficulty or expense) on the organization.

Question 105: A BSW is conducting an initial intake with a new client and wants to gather information efficiently. Which interviewing technique is MOST appropriate?

Closed-ended questions to gather specific facts quickly
Leading questions to help the client identify their problem
Multiple questions asked together to cover more ground
Open-ended questions to allow the client to share their perspective (Correct answer)

Correct answer: Open-ended questions to allow the client to share their perspective

Open-ended questions invite clients to share their own narrative and provide richer, more relevant information than closed or leading questions.

Question 106: The 'strengths perspective' in social work practice emphasizes:

Prioritizing evidence-based interventions over client preferences
Diagnosing deficits to develop targeted treatment plans
Focusing on environmental barriers before internal factors
Identifying and building on client capacities and resources (Correct answer)

Correct answer: Identifying and building on client capacities and resources

The strengths perspective shifts focus from pathology to clients' inherent resilience, capabilities, and existing resources.

Question 107: A social worker is treating a client using EMDR. This therapy was originally developed to treat which condition?

Post-Traumatic Stress Disorder (Correct answer)
Social Anxiety Disorder
Panic Disorder
Obsessive-Compulsive Disorder

Correct answer: Post-Traumatic Stress Disorder

Eye Movement Desensitization and Reprocessing (EMDR) was developed by Francine Shapiro specifically for the treatment of trauma and PTSD.

Question 108: Which of the following statements about a token economy is not always accurate?

For the system to be effective, a substantial number of points or rewards must be taken away for undesirable behavior. (Correct answer)
Rewards must be of value to the client
Points or rewards must be consistently given when the targeted behavior is exhibited.
It works best when a client can see the points earned toward a reward.

Correct answer: For the system to be effective, a substantial number of points or rewards must be taken away for undesirable behavior.

While some token economies may incorporate response cost (taking away tokens for undesirable behavior), it is not always a necessary or primary component for effectiveness. The core of a token economy relies on consistently providing positive reinforcement (tokens/rewards) for desired behaviors. The effectiveness primarily stems from the consistent reinforcement and the value of the rewards to the client.

Question 109: Which of the following is an example of 'secondary trauma' in social work?

A client who retraumatizes a social worker through aggressive behavior
A supervisor who is injured during a workplace incident
A social worker who experiences burnout from high caseloads
A worker who develops trauma symptoms after repeated exposure to clients' traumatic stories (Correct answer)

Correct answer: A worker who develops trauma symptoms after repeated exposure to clients' traumatic stories

Secondary traumatic stress (secondary trauma) results from indirect exposure to clients' trauma experiences, mirroring symptoms of primary trauma.

Question 110: The empowerment approach in social work practice focuses on:

Advocating for policy changes at the legislative level
Providing clients with direct resources to meet immediate needs
Helping clients recognize and utilize their own power to effect change (Correct answer)
Developing the social worker's cultural competence

Correct answer: Helping clients recognize and utilize their own power to effect change

Empowerment practice aims to help individuals and communities recognize their strengths and capacity to create change rather than dependence on the worker.

Question 111: Sam has frequently experienced brief bouts of feeling wretched and depressed. Recent times have seen a significant increase in the intensity of defenselessness, unhappiness, and uselessness feelings. What analysis or diagnostic might one receive if they encounter about five symptoms of this disorder?

Bi-polar disorder
Major depression (Correct answer)
Post-traumatic stress disorder
Insomnia

Correct answer: Major depression

Major Depressive Disorder (MDD), commonly known as major depression. MDD is a serious mental health condition characterized by persistent feelings of sadness, low mood, and a loss of interest or pleasure in most activities. To receive a diagnosis of Major Depressive Disorder, a person generally needs to experience a combination of specific symptoms over a minimum period of two weeks. The symptoms should cause significant distress or impairment in daily functioning.

Question 112: A client diagnosed with borderline personality disorder frequently calls the therapist between sessions in crisis. The BEST clinical response is to:

Refer the client to a higher level of care immediately
Ignore calls to extinguish attention-seeking behavior
Provide a cell phone number for 24/7 access
Set clear boundaries around between-session contact while developing a crisis plan (Correct answer)

Correct answer: Set clear boundaries around between-session contact while developing a crisis plan

Maintaining consistent, clear limits while collaboratively building a crisis plan addresses BPD crisis behavior without reinforcing maladaptive patterns.

Question 113: You are told at a client's initial consultation that the client has previously received care from other social workers. When you inquire about the client's prior therapies, he says they were in the past and he'd like to move on, adding that he would prefer that the records of those therapies not be made public. You ought to FIRST:

Acknowledge the client’s right to decide whether to release the records or not (Correct answer)
Inform the client that his treatment will only focus on present topics
Determine why the client does not want his past treatment examined
None of the above

Correct answer: Acknowledge the client’s right to decide whether to release the records or not

Clients have a fundamental right to confidentiality and to control their personal information, including past treatment records. While obtaining past records can be helpful, the social worker must first respect the client's autonomy and acknowledge their right to refuse release. Pressuring the client or making assumptions about their reasons would violate ethical principles and potentially damage rapport.

Question 114: Which of the following signs or symptoms is typical among PTSD sufferers?

disturbing dreams & hypervigilance (Correct answer)
hypervigilance
disturbing dreams
none of the above

Correct answer: disturbing dreams & hypervigilance

Post-Traumatic Stress Disorder (PTSD) is characterized by a cluster of symptoms following exposure to a traumatic event. Disturbing dreams, often vivid and repetitive, are a common re-experiencing symptom, while hypervigilance, an exaggerated state of alertness and sensitivity to potential threats, is a key arousal symptom. Both are core diagnostic criteria for PTSD.

Question 115: A school social worker discovers that a 14-year-old student is being cyberbullied. The FIRST step is to:

Notify law enforcement about the cyberbullying
Immediately suspend the student doing the bullying
Contact the parents of both students simultaneously
Assess the student's safety and emotional well-being (Correct answer)

Correct answer: Assess the student's safety and emotional well-being

Assessing the targeted student's immediate safety and emotional state is the priority before other interventions.

Question 116: A social worker is meeting with a client from a collectivist cultural background. The client insists on involving family members in all decisions. The social worker should:

Gently encourage the client to make independent decisions
Meet separately with the family without the client's knowledge
Refer the client to a social worker from the same culture
Respect the client's cultural values and include family in the process (Correct answer)

Correct answer: Respect the client's cultural values and include family in the process

Culturally competent practice requires respecting collectivist values where family involvement in decision-making is the norm.

Question 117: A BSW discovers their agency's intake forms do not include gender options beyond 'male' and 'female.' The MOST appropriate action is to:

Use whichever option most closely matches the client's presentation
Inform clients that the form is required as-is by state regulation
Raise the concern with supervisors and advocate for more inclusive intake forms (Correct answer)
Leave the question blank for clients who do not fit the options

Correct answer: Raise the concern with supervisors and advocate for more inclusive intake forms

Social workers have an obligation to advocate for inclusive practices within their agencies that affirm the dignity and identity of all clients.

Question 118: Under the ecological systems theory, a child's relationship with their teacher is an example of which system level?

Macrosystem
Microsystem (Correct answer)
Chronosystem
Exosystem

Correct answer: Microsystem

The microsystem consists of the immediate environments in which a person directly participates, including family, school, and peer relationships.

Question 119: Which of the following BEST defines the concept of 'dual relationship' in social work ethics?

Providing services to two members of the same family simultaneously
Having both a professional and a personal or business relationship with a client (Correct answer)
Working with a client across two different service settings
Co-treating a client with another licensed professional

Correct answer: Having both a professional and a personal or business relationship with a client

A dual relationship occurs when a social worker holds more than one role with a client, such as combining a therapeutic relationship with a personal friendship or business relationship.

Question 120: Mandatory reporting is true in every way, EXCEPT for:

None of the above
Social workers have a responsibility to both the client and the larger society
Though social workers are required to report abuse, there are no legal consequences for neglecting to do so (Correct answer)
Social workers can report abuse even if it violates client confidentiality

Correct answer: Though social workers are required to report abuse, there are no legal consequences for neglecting to do so

Mandatory reporting laws are legal requirements for social workers and other professionals to report suspected abuse (e.g., child, elder, vulnerable adult). Failing to make a mandated report can have serious legal consequences for the social worker, including fines, loss of license, and even criminal charges. Therefore, the statement that there are no legal consequences for neglecting to report is false; social workers are legally accountable for fulfilling this duty.

Question 121: In cognitive behavioral therapy, the term 'cognitive distortion' refers to:

A hallucination caused by psychosis
A defense mechanism identified in psychodynamic theory
A memory impairment related to trauma
A systematic error in thinking that maintains negative emotions and maladaptive behavior (Correct answer)

Correct answer: A systematic error in thinking that maintains negative emotions and maladaptive behavior

Aaron Beck identified cognitive distortions as inaccurate thought patterns (e.g., catastrophizing, all-or-nothing thinking) that perpetuate depression and anxiety.

Question 122: Which of the following is an example of secondary trauma in a social worker?

Intrusive thoughts about a client's traumatic experience after hearing their story (Correct answer)
Compassion satisfaction gained from helping a client recover
Counter-transference feelings toward a client who resembles a family member
Burnout caused by an excessive caseload over several years

Correct answer: Intrusive thoughts about a client's traumatic experience after hearing their story

Secondary traumatic stress involves trauma-like symptoms that arise from indirect exposure to another person's traumatic experiences.

Question 123: The primary focus of general systems theory is regarded as being on the:

Roles/relationships among component parts of a system
Boundaries among the parts of a system
Mechanisms of homeostasis (Correct answer)
The means and effectiveness with which information is communicated amongst a group

Correct answer: Mechanisms of homeostasis

General systems theory views families and other social groups as complex systems that naturally strive to maintain a state of equilibrium or stability, known as homeostasis. The primary focus is on understanding the mechanisms by which these systems regulate themselves and resist change, even when the existing balance is dysfunctional. While boundaries, roles, and communication are important, they all contribute to the system's overall homeostatic functioning.

Question 124: What is the sequence of the five phases of grief?

anger, denial, depression, bargaining, acceptance
denial, anger, depression, bargaining, and acceptance
denial, anger, bargaining, depression, and acceptance (Correct answer)
denial, depression, anger, bargaining, acceptance

Correct answer: denial, anger, bargaining, depression, and acceptance

Elisabeth Kübler-Ross's model of grief outlines five distinct stages that individuals often experience when coping with loss or terminal illness. The universally recognized sequence of these stages is denial, followed by anger, then bargaining, leading to depression, and finally, acceptance. This specific order is a foundational concept in psychology and social work.

Question 125: Which of the stereotype-related claims below is FALSE?

Stereotypes can lead to discrimination of a group of people
Stereotypes of others contribute to group cohesion
Stereotypes limit the acknowledgment of intragroup diversity
Stereotypes are often more helpful than harmful (Correct answer)

Correct answer: Stereotypes are often more helpful than harmful

Stereotypes are oversimplified and often negative generalizations about groups of people. They are inherently harmful because they lead to prejudice, discrimination, and prevent individuals from being seen for their unique qualities. Stereotypes limit the recognition of diversity within groups, contribute to group cohesion by defining 'us' versus 'them,' and are a root cause of discrimination. Therefore, the claim that stereotypes are often more helpful than harmful is false.

Question 126: What does the term 'disenfranchised grief' describe?

Grief that is complicated by a co-occurring mood disorder
Grief that is not openly acknowledged or publicly mourned (Correct answer)
Grief following the death of a non-family member
Grief that leads to prolonged functional impairment

Correct answer: Grief that is not openly acknowledged or publicly mourned

Coined by Kenneth Doka, disenfranchised grief refers to losses that are not recognized or sanctioned by society, leaving mourners without social support.

Question 127: Which of the following is a hallmark of the strengths-based perspective in assessment?

Identifying client resources, resilience, and capabilities (Correct answer)
Emphasizing barriers over opportunities
Focusing primarily on DSM-5 diagnosis
Cataloging all client deficits and pathologies

Correct answer: Identifying client resources, resilience, and capabilities

The strengths-based perspective centers on recognizing and mobilizing client assets, resilience, and potential rather than focusing on problems and deficits.

Question 128: A social worker is meeting with a family experiencing food insecurity. Which intervention reflects a strengths-based perspective?

Identifying and building on the family's existing coping strategies and resources (Correct answer)
Referring the family to services without exploring their own solutions
Educating the family about the consequences of inadequate nutrition on child development
Completing a deficit-focused assessment to determine eligibility for services

Correct answer: Identifying and building on the family's existing coping strategies and resources

A strengths-based perspective focuses on identifying and amplifying existing competencies and resources rather than cataloging deficits.

Question 129: You are working with Timmy, a lady who has recently been the victim of sexual assault and displacement, in a women's shelter. Timmy is not a threat to herself or others, and you have been able to build rapport with her and occasionally even get a smile out of her. What should you DO NEXT to assist Teddi in getting over her crisis?

Encourage an exploration of feelings and emotions
Identify the major problems (Correct answer)
Implement an action plan
Generate alternatives and coping strategies

Correct answer: Identify the major problems

In crisis intervention, after establishing rapport and ensuring safety, the next crucial step is to clearly identify and define the precipitating problems and the client's current needs. This allows the social worker to understand the core issues causing the crisis and to then develop appropriate, targeted interventions. Without a clear understanding of the problems, subsequent steps like generating alternatives or implementing a plan would be less effective.

Question 130: Anxiety is shown as a response to difficulties that affect our typical day-to-day life. A forthcoming divorce, losing a job, or a child performing appallingly in school are a few instances. These are thought of as psychological catalysts that encourage us to try to fix the problem. When does worry turn from a minor problem to a major one?

When it alerts one to a problem
When it interferes with problem solving (Correct answer)
When it lasts for a short amount of time
When thoughts turn to self-harm

Correct answer: When it interferes with problem solving

Anxiety is indeed a normal and adaptive response to various challenges and stressors in life. It can serve as a motivational force to help us address problems and find solutions. However, when anxiety becomes overwhelming, persistent, and interferes with daily functioning, it may transition from a normal stage to a more serious issue.

Question 131: According to NASW ethical standards, when a social worker discovers an agency policy conflicts with client rights, the worker should FIRST:

Immediately report the agency to a licensing board
Ignore the policy and act on personal judgment
Attempt to change the policy through legitimate organizational channels (Correct answer)
Resign from the position

Correct answer: Attempt to change the policy through legitimate organizational channels

The NASW Code of Ethics directs social workers to work to improve agency policies through internal, legitimate means before taking more drastic action.

Question 132: A social worker using a strengths-based perspective would MOST likely begin an assessment by:

Asking the client what has worked for them in the past (Correct answer)
Administering a standardized depression screening instrument
Identifying the client's presenting problem in behavioral terms
Reviewing the client's psychiatric history and prior diagnoses

Correct answer: Asking the client what has worked for them in the past

The strengths-based approach centers the client's own resources, past successes, and resilience as the foundation for intervention.

Question 133: A client experiencing a major depressive episode reports passive suicidal ideation with no plan or intent. The most appropriate next step is to:

Hospitalize the client immediately
Increase session frequency without further evaluation
Conduct a thorough suicide risk assessment and document findings (Correct answer)
Refer to a psychiatrist and close the case

Correct answer: Conduct a thorough suicide risk assessment and document findings

A comprehensive risk assessment is required to determine appropriate level of care and intervention.

Question 134: Which of the following is an example of secondary prevention in a community mental health context?

Delivering inpatient psychiatric services to people in acute crisis
Providing parenting education classes before problems arise
Offering early intervention counseling to individuals showing signs of depression (Correct answer)
Lobbying for mental health parity legislation

Correct answer: Offering early intervention counseling to individuals showing signs of depression

Secondary prevention targets individuals who are at risk or show early signs of a problem to reduce its severity and duration.

Question 135: Ron and James, a couple who are both dealing with addiction, have decided to call it quits on their union, but their split was disastrous and rife with resentment. However, they both trust you as the social worker at the neighborhood community center, so they decide to come to you for advice on how to proceed without getting into any more difficulty. You are acting in a

Advocate
Broker
Change agent
Mediator (Correct answer)

Correct answer: Mediator

In this scenario, the social worker is helping Ron and James, who are in conflict due to their separation, to navigate their issues and reach a resolution without further difficulty. This role involves facilitating communication, promoting understanding, and assisting parties to find common ground, which are the core functions of a mediator. The social worker remains neutral while guiding the process.

Question 136: You run into Helen in the grocery store; she was a client you terminated effectively a year ago. You hook up with her and discover that she has opened her own pool cleaning company. Since you need someone to clean your pool for the summer, you pay her to do so. How would YOU BEST describe this circumstance?

An acceptable dual relationship
A nonacceptable dual relationship (Correct answer)
Bartering
None of the above

Correct answer: A nonacceptable dual relationship

A dual relationship occurs when a social worker has both a professional and another relationship (e.g., business, personal) with a client or former client. Even though the therapy terminated a year ago, entering into a business relationship with a former client creates a potential conflict of interest, blurs professional boundaries, and can exploit the power imbalance inherent in the therapeutic relationship. This is generally considered unethical and non-acceptable in social work practice.

Question 137: A clinical supervisor in an outpatient mental health environment learns that a client who has just started therapy with one of her supervisees also happens to be the ex-current husband's girlfriend, with whom the supervisor still gets along reasonably well after their divorce. The MOST suitable course of action for the supervisor to pursue in this circumstance would be:

Maintain the normal course of supervision in the case, given that there is no animosity between the supervisor and her ex-husband, which reduces the probability of any serious conflict on the part of the supervisor
Arrange for a colleague to provide supervision in this case (Correct answer)
Request that the case be transferred to a therapist who is supervised by someone other than herself
Instruct the supervisee to discuss only the relevant facts/information with the client, explore how she feels regarding the arrangement, and act in accordance with the feedback obtained

Correct answer: Arrange for a colleague to provide supervision in this case

This situation presents a clear conflict of interest for the supervisor due to the personal relationship with her ex-husband's current girlfriend, who is a client of her supervisee. Even without animosity, this connection could compromise the supervisor's objectivity, create a dual relationship, or impact the integrity of the supervisory process. The most ethical course of action is to remove herself from the supervisory role for this specific case by arranging for a colleague to provide supervision, ensuring impartiality and protecting all parties involved.

Question 138: A social worker in a hospital setting disagrees with the treatment team's decision to discharge a client who the social worker believes is not ready. The BEST course of action is to:

Document the concern and raise it formally through proper channels (Correct answer)
Contact the client's family to override the team decision
Accept the decision without comment to maintain team harmony
Refuse to complete the discharge paperwork

Correct answer: Document the concern and raise it formally through proper channels

Social workers must advocate for clients through proper institutional channels while documenting professional concerns to uphold ethical and professional standards.

Question 139: Which defense mechanism is a client using when they attribute their own unacceptable anger to their therapist, claiming the therapist is hostile toward them?

Displacement
Projection (Correct answer)
Rationalization
Reaction formation

Correct answer: Projection

Projection involves attributing one's own unacceptable feelings or impulses to another person.

Question 140: Working with Wendy, a client of the women's shelter where you work. After experiencing a domestic assault and subsequent displacement, Wendy is in distress. With Wendy, you established rapport, provided her with a wealth of resources, convinced her to commit to an action plan, and gave her the time to process her emotions. Wendy left the first session a little early and hasn't come back to the others, despite the fact that you think you did a fantastic job. What was your initial error?

Not taking time to establish rapport
Not following an orderly process (Correct answer)
Not identifying major problems
Not providing trauma-informed psychotherapy

Correct answer: Not following an orderly process

The social worker's error was likely not following an orderly process, as indicated by providing 'a wealth of resources,' 'convincing her to commit to an action plan,' and 'giving her time to process her emotions' all in the first session. This can overwhelm a client in distress. Effective initial engagement, especially in crisis, requires a structured approach, prioritizing immediate safety and emotional stabilization before moving to resources and action plans, ensuring the client feels heard and not rushed.

Question 141: In solution-focused brief therapy (SFBT), the 'miracle question' is primarily used to:

Explore the root causes of the client's problem
Assess the client's level of magical thinking
Identify the client's defensive coping styles
Help the client envision life without the presenting problem (Correct answer)

Correct answer: Help the client envision life without the presenting problem

The miracle question invites clients to imagine what their life would look like if the problem were suddenly resolved, helping generate concrete goals and exceptions.

Question 142: A BSW-level social worker is assigned a case involving complex trauma and PTSD treatment. What is the most appropriate action?

Research PTSD treatment independently and proceed
Consult with a supervisor and refer to a more qualified clinician (Correct answer)
Attempt the case using basic counseling skills
Decline the case entirely

Correct answer: Consult with a supervisor and refer to a more qualified clinician

Social workers must practice within their scope of competence and seek supervision or referral when cases exceed that scope.

Question 143: Under the NASW Code of Ethics, a social worker who becomes aware that a colleague is impaired by substance use should FIRST:

Report the colleague directly to the state licensing board
Confront the colleague and encourage them to seek help (Correct answer)
Notify law enforcement if clients are at risk
Terminate the professional relationship immediately

Correct answer: Confront the colleague and encourage them to seek help

The NASW Code of Ethics requires social workers to first address colleague impairment directly by encouraging the colleague to seek assistance.

Question 144: A client presents with persistent sadness, anhedonia, hypersomnia, and increased appetite for six weeks. Which DSM-5 diagnosis best fits?

Bipolar II Disorder, depressive episode
Adjustment Disorder with depressed mood
Major Depressive Disorder with atypical features (Correct answer)
Persistent Depressive Disorder

Correct answer: Major Depressive Disorder with atypical features

Hypersomnia and increased appetite are atypical features; a six-week duration with anhedonia meets MDD criteria.

Question 145: A disturbed 15-year-old named Mario. He always looks for conflicts with other students at school. As a result of stealing from his teacher, he is also on probation. Mario exhibits aggressive conduct toward other people. Which of the following disorders best fits Mario?

attention deficit hyperactivity disorder (ADHD)
antisocial personality disorder (Correct answer)
bipolar disorder
obsessive compulsive disorder (OCD)

Correct answer: antisocial personality disorder

Mario's behaviors, including seeking conflicts, stealing, being on probation, and exhibiting aggressive conduct, are highly indicative of a pervasive pattern of disregard for and violation of the rights of others. While Antisocial Personality Disorder is typically diagnosed in adulthood (age 18+), these symptoms in a 15-year-old strongly align with Conduct Disorder, which is a precursor to ASPD. Among the given options, antisocial personality disorder best describes the severe and persistent pattern of rule-breaking and aggression.

Question 146: In family therapy, the concept of 'triangulation' refers to:

Using three therapeutic modalities simultaneously
Three family members attending the same session
A third party being pulled into tension between two others to reduce anxiety (Correct answer)
A three-generational analysis of family patterns

Correct answer: A third party being pulled into tension between two others to reduce anxiety

Triangulation occurs when a dyadic conflict is stabilized by involving a third person, diverting tension away from the original pair.

Question 147: A social worker at a community mental health center has a very high caseload and feels emotionally exhausted and detached from clients. This is MOST consistent with:

Countertransference
Burnout (Correct answer)
Compassion satisfaction
Secondary traumatic stress

Correct answer: Burnout

Burnout is characterized by emotional exhaustion, depersonalization, and reduced sense of accomplishment resulting from chronic workplace stress.

Question 148: The concept of 'confidentiality' in social work practice means that:

Client information shared in the professional relationship is protected from unauthorized disclosure (Correct answer)
Confidentiality automatically expires when a client is no longer receiving services
Only written records are protected; verbal disclosures may be shared freely
No client information can ever be shared with anyone under any circumstances

Correct answer: Client information shared in the professional relationship is protected from unauthorized disclosure

Confidentiality protects client information from unauthorized disclosure, though it has specific legal exceptions such as mandatory reporting and imminent danger.

Question 149: A social worker in a hospital is asked by a patient's adult child to share the patient's diagnosis without the patient's consent. The patient is competent. The social worker should:

Consult with the attending physician before responding
Share the information since family members have a right to know
Decline to share and explain confidentiality protections to the family member (Correct answer)
Ask the patient if they want their child informed, then decide

Correct answer: Decline to share and explain confidentiality protections to the family member

Confidentiality protects a competent patient's health information from being shared without their explicit consent, even with family members.

Question 150: When developing a biopsychosocial assessment, which domain does the 'social' component PRIMARILY address?

The client's coping mechanisms and defense structures
Psychiatric diagnoses and medication history
The client's relationships, support systems, and environmental factors (Correct answer)
Cultural beliefs and spiritual practices

Correct answer: The client's relationships, support systems, and environmental factors

The social component of a biopsychosocial assessment focuses on interpersonal relationships, social supports, family systems, and the broader environmental context.

Question 151: The social work value of 'social justice' is most directly operationalized when a BSW:

Practices within their scope of competence
Obtains informed consent before beginning services
Maintains confidentiality for all clients
Advocates for equitable distribution of resources and elimination of discrimination (Correct answer)

Correct answer: Advocates for equitable distribution of resources and elimination of discrimination

Social justice in social work practice involves advocating for fair access to resources, opportunities, and rights, particularly for vulnerable and marginalized populations.

Question 152: A social worker is leading a task group for agency staff to improve discharge planning. Which group development stage is characterized by conflict and competition among members?

Performing
Storming (Correct answer)
Forming
Norming

Correct answer: Storming

The storming stage (Tuckman's model) is marked by interpersonal conflict and competition as members vie for roles and challenge group structure.

Question 153: The MOST suitable design for this kind of clinical practice environment is a single topic design:

Private practice
County health department
None of the above
Inpatient psychiatric facility (Correct answer)

Correct answer: Inpatient psychiatric facility

A single-subject (or single-case) design is particularly suitable for inpatient psychiatric facilities because it allows for intensive, individualized monitoring of treatment effectiveness for a single client or a small group. In such settings, interventions can be precisely controlled and measured against baseline behaviors, making it ideal for evaluating the impact of specific therapies on individual patients with severe and complex mental health conditions where group studies might be impractical or unethical.

Question 154: A client tells their social worker, 'I haven't felt like myself since my mother died three months ago.' Which type of grief does this BEST describe?

Disenfranchised grief
Normal bereavement (Correct answer)
Anticipatory grief
Complicated grief

Correct answer: Normal bereavement

Grief lasting three months following a significant loss with altered self-perception is consistent with normal bereavement, not complicated grief.

Question 155: When assessing for suicidal ideation, which factor is considered MOST associated with increased risk of a completed suicide attempt?

A specific plan with access to lethal means (Correct answer)
A history of depression without prior attempts
Expressing suicidal thoughts to others
Vague thoughts of death without a plan

Correct answer: A specific plan with access to lethal means

A specific plan combined with access to lethal means significantly elevates suicide risk because the individual has both intent and capability.

Question 156: Which interview technique involves reflecting back only the emotional content of what a client has communicated?

Clarification
Paraphrasing
Summarizing
Reflection of feeling (Correct answer)

Correct answer: Reflection of feeling

Reflection of feeling specifically mirrors the emotional component of a client's message to demonstrate empathy and deepen self-awareness.

Question 157: A social worker screens a 70-year-old client using the Montreal Cognitive Assessment (MoCA). What cognitive domains does this tool evaluate?

Personality traits and mood states only
Intelligence quotient and adaptive functioning
Only short-term memory and orientation
Multiple domains including visuospatial ability, executive function, memory, attention, and language (Correct answer)

Correct answer: Multiple domains including visuospatial ability, executive function, memory, attention, and language

The MoCA screens across several cognitive domains and is sensitive to mild cognitive impairment, making it broader than orientation-only tools.

Question 158: Which attachment style is characterized by a child who shows distress when a caregiver leaves but is not easily comforted upon return?

Anxious-ambivalent attachment (Correct answer)
Secure attachment
Disorganized attachment
Avoidant attachment

Correct answer: Anxious-ambivalent attachment

Anxious-ambivalent (also called resistant) attachment is marked by high separation distress and inconsistent responses to reunion, often alternating between seeking and resisting comfort.

Question 159: Which attachment style in adults is characterized by discomfort with closeness, self-reliance, and dismissiveness of the importance of relationships?

Anxious-preoccupied
Dismissive-avoidant (Correct answer)
Secure
Fearful-avoidant

Correct answer: Dismissive-avoidant

Dismissive-avoidant attachment involves minimizing the importance of relationships, valuing self-sufficiency, and feeling uncomfortable with emotional closeness.

Question 160: The landlord of one of Jessica's clients won't let him keep his assistance dog in the apartment without paying a pet deposit. When Jessica phones the landlord, she informs them that they are required by law to accept service animals without requiring a pet deposit. How does Jessica help her client?

Arbitrating
Advocating (Correct answer)
None of the above
Mediating

Correct answer: Advocating

Advocacy involves actively supporting and representing a client's rights and interests, often by speaking on their behalf or informing others of legal obligations. Jessica's action of informing the landlord about the legal requirement to accept service animals without a pet deposit is a direct intervention to ensure her client's rights are upheld. This is a clear example of a social worker acting as an advocate.

Question 161: In structural family therapy, the term 'enmeshment' refers to:

A family's refusal to engage with outside social systems
A triangulated relationship involving a third party
Blurred boundaries and excessive emotional closeness between family members (Correct answer)
Rigidly enforced roles and hierarchies within the family system

Correct answer: Blurred boundaries and excessive emotional closeness between family members

Enmeshment describes family systems where boundaries are diffuse, individuation is discouraged, and members are over-involved in each other's lives.

Question 162: Which domain makes up the largest portion of the ASWB Bachelor's exam?

Assessment and Intervention Planning
Human Development, Diversity, and Behavior in the Environment
Professional Relationships, Values, and Ethics
Direct and Indirect Practice (Correct answer)

Correct answer: Direct and Indirect Practice

Direct and Indirect Practice comprises the largest content area on the ASWB Bachelor's exam at approximately 44%.

Question 163: After years of substance abuse, a man visits a social worker and tells her that he stopped using heroin two days ago because "he has had enough." He says he's been throwing up and can't sleep, and he seems anxious and upset. The social worker should: in order to satisfy his immediate therapeutic needs.

Work with him to identify a long-term treatment program
Arrange for him to see a physician to address physical concerns (Correct answer)
Complete a biopsychosocial–spiritual–cultural assessment focusing on the reasons for the substance use
Assist him to develop a relapse prevention plan

Correct answer: Arrange for him to see a physician to address physical concerns

When a client reports recent cessation of heroin use and is experiencing withdrawal symptoms, the immediate priority is to address the potentially life-threatening physical aspects of opioid withdrawal. Heroin withdrawal can be extremely uncomfortable and, while rarely fatal on its own, requires medical supervision to manage symptoms, prevent complications, and ensure the client's safety before engaging in long-term therapeutic planning.

Question 164: Which of the following BEST encapsulates the NASW's recommendations for using self-disclosure?

It is only used as a last resort (Correct answer)
It is only used with informed consent
It is up to the social worker's discretion
It must be approved by a supervisory authority

Correct answer: It is only used as a last resort

The NASW Code of Ethics advises social workers to use self-disclosure cautiously and only when it serves a clear therapeutic purpose for the client. It should not be used for the social worker's personal benefit. Therefore, self-disclosure is generally considered a last resort, employed only when other interventions have been ineffective or when it is deemed essential for building rapport or normalizing an experience in a very specific and limited way.

Question 165: Joseph and Helen are meeting for their regular session. What would your life be like if you could cure the largest problem in it, Helen wonders? This is an illustration of:

Motivational interviewing
Miracle question (Correct answer)
Deficit question
Stagging question

Correct answer: Miracle question

The 'miracle question' is a core technique in solution-focused brief therapy (SFBT). It asks clients to imagine that their biggest problem has miraculously disappeared overnight and then describe what their life would look like. This helps clients envision a desired future state, identify goals, and recognize potential solutions or steps toward change, shifting focus from problems to possibilities.

Question 166: A social worker is conducting a home visit with an elderly client and notices signs of self-neglect including spoiled food and unsanitary conditions. What is the MOST appropriate next step?

Document observations and close the case
Conduct a capacity assessment and consider an adult protective services report (Correct answer)
Contact the client's family to take over care
Call law enforcement to remove the client immediately

Correct answer: Conduct a capacity assessment and consider an adult protective services report

Self-neglect in elderly clients warrants assessing decision-making capacity and reporting to Adult Protective Services if warranted.

Question 167: A social worker is working with a family where the eldest daughter consistently mediates all parental conflicts and takes care of younger siblings. This role is BEST described as:

Parentified child (Correct answer)
Triangulated member
Identified patient
Scapegoat

Correct answer: Parentified child

A parentified child takes on adult responsibilities within the family, sacrificing their own developmental needs to meet parental or sibling needs.

Question 168: Which of the following BEST describes the clinical concept of 'transference'?

The process of transferring case files between providers
The client redirecting feelings from past relationships onto the therapist (Correct answer)
The therapist's emotional reaction to the client
Generalizing skills learned in therapy to daily life

Correct answer: The client redirecting feelings from past relationships onto the therapist

Transference occurs when a client unconsciously projects feelings, expectations, or desires from past significant relationships onto the therapist.

Question 169: When assessing risk of suicide, which factor is considered the MOST significant predictor of future attempt?

Diagnosis of anxiety disorder
Current stressful life event
Previous suicide attempt (Correct answer)
Family history of depression

Correct answer: Previous suicide attempt

A prior suicide attempt is the strongest single predictor of future suicidal behavior.

Question 170: A social worker is conducting an initial assessment and the client reports hearing a voice that instructs them to harm others. The PRIORITY concern is:

Obtaining collateral information from family members
Assessing the command hallucination and duty to protect potential victims (Correct answer)
Establishing diagnostic clarity before any action
Reviewing the client's medication adherence history

Correct answer: Assessing the command hallucination and duty to protect potential victims

Command hallucinations with violent content require immediate assessment of risk to others, triggering potential duty-to-protect obligations.

Question 171: An ecomap is used in assessment primarily to:

Document a client's financial resources
Trace multigenerational family patterns
Map a client's relationships with systems and their quality (Correct answer)
Assess cognitive functioning

Correct answer: Map a client's relationships with systems and their quality

An ecomap visually represents the client's connections to various social systems (family, work, community) and indicates whether those relationships are supportive, stressful, or tenuous.

ASWB Licensed Master Social Worker (LMSW) Exam

The ASWB LMSW exam certifies candidates for master's-level social work practice, assessing their knowledge and skills in various social work competencies.

170

Questions

240 min

Time Limit

70%

To Pass

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