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

Question 1: Which of the following best describes 'resilience' in human development?

Genetic immunity to mental health conditions
Rapid recovery from physical illness
The capacity to adapt positively despite significant adversity (Correct answer)
The absence of any adverse childhood experiences

Correct answer: The capacity to adapt positively despite significant adversity

Resilience is the dynamic process through which individuals demonstrate positive adaptation in the context of significant risk or adversity.

Question 2: According to attachment theory, an infant who is distressed when the caregiver leaves but NOT comforted upon return most likely has which attachment style?

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

Correct answer: Anxious-ambivalent attachment

Anxious-ambivalent (resistant) attachment is characterized by high distress at separation combined with inability to be soothed upon the caregiver's return.

Question 3: Due to her strained connection with her mother, a young, beginning social worker experiences some intrapersonal and interpersonal difficulties with women in leadership roles. Client of the social worker is a successful female CEO of an Internet start-up who is around 50 years old. The social worker may have difficulties in therapy because of:

Transference
Counter-transference (Correct answer)
Counter-resistance
Resistance

Correct answer: Counter-transference

Due to her intrapersonal and interpersonal conflicts with women in authoritative positions, which result from her strained connection with her mother, the social worker is likely to encounter countertransference in treatment. <br> The term "countertransference" describes how the therapist's feelings, prejudices, or unsolved issues may surface during therapy and affect their interaction with the client. In this instance, the social worker's personal challenges and unresolved concerns with women in leadership roles, particularly those related to her mother, may have an impact on how she perceives, feels, and responds to the client who is a female CEO.

Question 4: A social worker notices that their agency's intake forms only include binary gender options. What is the most appropriate action to address this structural issue?

Accept the forms as they reflect community norms
Refer all LGBTQ+ clients to specialized agencies
Advocate with administration to revise forms to include non-binary options (Correct answer)
Create personal workarounds without addressing the systemic issue

Correct answer: Advocate with administration to revise forms to include non-binary options

Advocacy to change institutional policies that exclude marginalized populations is a core social justice responsibility of LMSWs.

Question 5: A social worker applying an Ecological Systems perspective would MOST likely assess:

Irrational automatic thoughts that distort perception
Unconscious conflicts stemming from childhood experiences
The fit between the client and multiple environmental systems (Correct answer)
The sequence of steps needed to complete a behavioral task

Correct answer: The fit between the client and multiple environmental systems

The Ecological Systems model, associated with Bronfenbrenner and Germain, examines how individuals interact with and adapt to their environments across multiple system levels.

Question 6: Which stage of case management involves regularly checking whether clients are receiving services and whether those services are meeting their needs?

Assessment
Monitoring (Correct answer)
Planning
Termination

Correct answer: Monitoring

Monitoring involves ongoing review of service delivery and client progress to ensure the care plan remains appropriate and effective.

Question 7: Which concept describes the phenomenon where policies intended to help marginalized groups are systematically undermined by bureaucratic processes or eligibility restrictions?

Street-level bureaucracy (Correct answer)
Policy diffusion
Welfare retrenchment
Policy drift

Correct answer: Street-level bureaucracy

Street-level bureaucracy refers to how frontline workers' discretionary decisions can limit or shape how policies are actually implemented and experienced.

Question 8: When a social worker uses 'reframing' in therapy, they are:

Documenting a new treatment goal in the client's file
Confronting the client's irrational beliefs directly
Changing the conceptual context of a situation to alter its meaning (Correct answer)
Introducing a new therapeutic modality

Correct answer: Changing the conceptual context of a situation to alter its meaning

Reframing involves offering an alternative perspective on a situation to help the client see it differently and potentially respond differently.

Question 9: A social worker is conducting a mental status exam and notes the client is jumping between loosely related ideas with rapid topic changes. This thought process is called:

Perseveration
Circumstantiality
Tangentiality
Flight of ideas (Correct answer)

Correct answer: Flight of ideas

Flight of ideas is a rapid succession of thoughts with some associative connection but poor goal direction, commonly seen in manic episodes.

Question 10: Which of the following scenarios represents an ethical breach in the supervisory relationship?

A supervisor refers a supervisee to peer consultation for a complex case
A supervisor enters a romantic relationship with a supervisee they currently evaluate (Correct answer)
A supervisor provides direct feedback about a supervisee's clinical errors
A supervisor requires supervisees to document their session notes within 24 hours

Correct answer: A supervisor enters a romantic relationship with a supervisee they currently evaluate

The NASW Code of Ethics explicitly prohibits supervisors from engaging in dual relationships with supervisees — including romantic or sexual relationships — because of the inherent power differential and potential for exploitation. This applies as long as the supervisory relationship is active.

Question 11: A client with borderline personality disorder repeatedly calls the social worker between sessions during moments of distress. Which intervention best balances safety and limit-setting?

Refer immediately to a higher level of care without discussion
Encourage the client to call as often as needed to build trust
Ignore all between-session calls to enforce boundaries
Establish a structured crisis plan with designated contact times and emergency resources (Correct answer)

Correct answer: Establish a structured crisis plan with designated contact times and emergency resources

A structured crisis plan specifies when and how to reach the worker while also providing emergency resources, balancing safety with therapeutic boundaries.

Question 12: A client presents in a state of acute grief following a sudden loss and is unable to function. The social worker should recognize this as:

Adjustment disorder with depressed mood
A situational crisis requiring immediate stabilization support (Correct answer)
Complicated grief requiring long-term psychotherapy
Major depressive disorder requiring medication referral

Correct answer: A situational crisis requiring immediate stabilization support

Acute grief following a sudden loss is a situational crisis, and the immediate goal is stabilization and support, not diagnosis.

Question 13: Which of the following BEST describes the purpose of a safety plan in treatment?

To provide the client with specific coping steps and supports to use during a crisis (Correct answer)
To satisfy insurance requirements for high-risk clients
To document the agency's liability protections
To outline consequences if the client engages in self-harm

Correct answer: To provide the client with specific coping steps and supports to use during a crisis

A safety plan is a collaborative, personalized tool that outlines warning signs, coping strategies, support contacts, and means restriction to help the client manage a crisis.

Question 14: Client: "I'm feeling down. My hair is falling out far more quickly than I anticipated. I hate having to leave the house in front of people. Concerned about my baldness, I'm feeling incredibly uncomfortable and uneasy." Social worker: "You're worried and uneasy about the changes that come with aging naturally." The social worker replies as follows:

Paraphrase
Encouragement
Summarization
Reflection of feeling (Correct answer)

Correct answer: Reflection of feeling

To express understanding and empathy, a reflection of emotions requires mimicking or paraphrasing the client's emotional state. It seeks to validate the client's feelings and foster a safe space for further inquiry.

Question 15: A social worker of color discloses experiencing racial microaggressions from a supervisor. The agency's best response is to:

Suggest the worker develop thicker skin and focus on client work
Investigate and address the pattern through formal channels while supporting the worker (Correct answer)
Transfer the worker to a different supervisor without addressing the behavior
Remind the worker that microaggressions are unintentional and not harmful

Correct answer: Investigate and address the pattern through formal channels while supporting the worker

Organizations must take microaggressions seriously, investigate formally, and support affected employees to create equitable workplaces.

Question 16: A client repeatedly fails to complete homework assignments between sessions. The LMSW should FIRST:

Document noncompliance and consider termination
Notify the client's family of the noncompliance
Explore barriers to completing assignments collaboratively (Correct answer)
Assign simpler tasks without discussion

Correct answer: Explore barriers to completing assignments collaboratively

Exploring barriers collaboratively identifies practical or motivational obstacles and supports treatment engagement.

Question 17: Which of the following is an example of a secondary crisis precipitant?

A sudden medical diagnosis received by the client
A violent assault experienced by the client
A natural disaster that destroys a client's home
Financial hardship that emerges following a job loss that triggered the initial crisis (Correct answer)

Correct answer: Financial hardship that emerges following a job loss that triggered the initial crisis

A secondary crisis precipitant is a downstream stressor (e.g., financial hardship following job loss) that compounds the original crisis, increasing overall vulnerability.

Question 18: A social worker is assessing a 4-year-old who engages in cooperative play, shows empathy, and can follow two-step directions. Which theorist's framework would classify this child as functioning in the preoperational stage?

Kohlberg
Piaget (Correct answer)
Freud
Vygotsky

Correct answer: Piaget

Piaget's preoperational stage (ages 2–7) is characterized by symbolic thinking, egocentrism, and emerging language use.

Question 19: When developing a treatment plan for a client with co-occurring PTSD and substance use disorder, the BEST approach is to:

Address both disorders concurrently using an integrated treatment model (Correct answer)
Treat PTSD first before addressing substance use
Treat the substance use disorder first, then address PTSD
Refer the client to separate providers for each disorder

Correct answer: Address both disorders concurrently using an integrated treatment model

Integrated treatment that addresses co-occurring disorders simultaneously is the evidence-based standard of care for dual diagnoses.

Question 20: Which of the following BEST describes the 'identified patient' concept in family systems practice?

The family member with the most severe individual diagnosis
The family member who carries the symptom that expresses the family's dysfunction (Correct answer)
The primary client designated by the referring agency
The family member who is most motivated to change

Correct answer: The family member who carries the symptom that expresses the family's dysfunction

In family systems theory, the identified patient is the symptomatic member whose difficulties are understood as a manifestation of the entire family system's problems.

Question 21: Which scenario BEST illustrates a dual relationship that an LMSW should avoid?

Treating a client who shares the social worker's cultural background
Providing therapy to the social worker's own child (Correct answer)
Accepting a $5 gift from a client at the end of treatment
Attending the same community event as a current client

Correct answer: Providing therapy to the social worker's own child

Providing therapy to one's own child creates a dual relationship that compromises objectivity and exploits the existing family power dynamic.

Question 22: In anti-oppressive practice (AOP), the concept of 'positionality' requires social workers to:

Position themselves as experts above clients in the therapeutic relationship
Take a position against all dominant culture values
Reflect on how their own social location shapes their perceptions and power in relationships (Correct answer)
Always agree with clients' perspectives to avoid imposing views

Correct answer: Reflect on how their own social location shapes their perceptions and power in relationships

Positionality requires practitioners to critically examine how their race, gender, class, and other identities privilege or marginalize them in relation to clients.

Question 23: A client reports persistent feelings of hopelessness, loss of interest in activities, and difficulty concentrating for the past three weeks. Which DSM-5 diagnosis is MOST appropriate?

Major Depressive Disorder (Correct answer)
Adjustment Disorder with Depressed Mood
Bipolar II Disorder, Depressive Episode
Persistent Depressive Disorder

Correct answer: Major Depressive Disorder

Major Depressive Disorder requires at least five depressive symptoms lasting a minimum of two weeks, which this client meets.

Question 24: The concept of 'resilience' in child development is best described as:

The ability to adapt positively despite significant adversity or stress (Correct answer)
A fixed genetic trait that protects children from all harm
The complete absence of risk factors in a child's environment
The process of eliminating all environmental stressors

Correct answer: The ability to adapt positively despite significant adversity or stress

Resilience is a dynamic process of positive adaptation within the context of significant adversity, shaped by protective factors across individual, family, and community levels.

Question 25: A social worker is treating a client who discloses they are undocumented and fears deportation. The social worker's primary ethical obligation is to:

Terminate services to avoid legal liability
Refer the client to an immigration attorney only
Maintain confidentiality and continue providing competent services (Correct answer)
Report the client's status to immigration authorities

Correct answer: Maintain confidentiality and continue providing competent services

Social workers must uphold confidentiality and provide services regardless of immigration status, consistent with the NASW values of dignity, worth of the person, and social justice.

Question 26: Which developmental milestone is typically associated with the emergence of 'stranger anxiety' in infants?

12–15 months
2–3 months
4–5 months
6–9 months (Correct answer)

Correct answer: 6–9 months

Stranger anxiety typically emerges between 6 and 9 months, coinciding with the development of specific attachment bonds and object permanence.

Question 27: A client who is grieving the death of a spouse reports she has been feeling sad for 14 months and cannot return to work. According to the DSM-5, this presentation may meet criteria for:

Prolonged Grief Disorder (Correct answer)
Adjustment Disorder with Depressed Mood
Persistent Depressive Disorder (Dysthymia)
Major Depressive Disorder, Single Episode

Correct answer: Prolonged Grief Disorder

Prolonged Grief Disorder (added in DSM-5-TR) describes grief that persists beyond 12 months and significantly impairs functioning.

Question 28: Margaret Mahler's theory of separation-individuation describes the 'rapprochement' subphase as a period when the toddler:

First recognizes the mother as a separate person
Begins symbiotic fusion with the caregiver
Returns to the mother after exploring, seeking reassurance (Correct answer)
Achieves full emotional object constancy

Correct answer: Returns to the mother after exploring, seeking reassurance

During rapprochement (15–24 months), toddlers oscillate between independence and closeness, frequently returning to the mother for emotional refueling.

Question 29: A social worker feels strong personal disapproval of a client's lifestyle choices. The MOST ethical response is to:

Avoid discussing the lifestyle choice in sessions
Continue providing services while seeking supervision to manage personal reactions (Correct answer)
Disclose the disapproval so the client can make an informed choice
Refer the client to a more compatible worker immediately

Correct answer: Continue providing services while seeking supervision to manage personal reactions

Social workers are ethically obligated to be aware of personal biases and use supervision to ensure those biases do not harm clients.

Question 30: When working with clients who have disabilities, the social model of disability suggests that practitioners should:

Address societal barriers and structures that disable people rather than the person's condition (Correct answer)
Refer clients primarily to medical professionals for needs assessment
Focus on curing or rehabilitating the individual's impairment
Encourage acceptance of limitations as permanent

Correct answer: Address societal barriers and structures that disable people rather than the person's condition

The social model locates disability in societal barriers—physical, attitudinal, and systemic—rather than in the individual's body or mind.

Question 31: Erik Erikson's stage of 'Generativity vs. Stagnation' is primarily associated with which life phase?

Late adulthood
Young adulthood
Middle adulthood (Correct answer)
Adolescence

Correct answer: Middle adulthood

Generativity vs. Stagnation occurs in middle adulthood, focusing on contributing to society and guiding the next generation.

Question 32: A social worker in a community mental health center is working with a client from a cultural background different from their own. The client describes a spiritual healing practice that the social worker is unfamiliar with. The BEST approach is to:

Educate the client about evidence-based treatments as superior alternatives
Recommend the client seek a social worker from the same cultural background
Ask the client to explain the practice and explore how it fits into their care (Correct answer)
Consult with a supervisor about discontinuing work with the client

Correct answer: Ask the client to explain the practice and explore how it fits into their care

Cultural humility requires social workers to approach unfamiliar practices with curiosity and openness. Asking the client to share their perspective fosters trust and ensures the care plan is culturally responsive and client-centered.

Question 33: Which concept describes the consistency of a measurement tool when applied repeatedly under the same conditions?

Reliability (Correct answer)
Construct equivalence
Sensitivity
Validity

Correct answer: Reliability

Reliability refers to the degree to which a measurement produces stable, consistent results across repeated administrations.

Question 34: When a treatment plan is not producing expected progress, the social worker should FIRST:

Review and reassess the accuracy of the initial assessment and goal relevance (Correct answer)
Consult with a psychiatrist for medication evaluation
Increase session frequency immediately
Terminate treatment and refer to a higher level of care

Correct answer: Review and reassess the accuracy of the initial assessment and goal relevance

Lack of progress warrants a reassessment of whether the initial assessment was accurate and whether goals and interventions remain appropriate before making other changes.

Question 35: The NASW Code of Ethics requires social workers to engage in social and political action PRIMARILY to:

Ensure that all people have equal access to resources and opportunities (Correct answer)
Advance their professional reputation
Promote evidence-based practice models
Expand social work employment opportunities

Correct answer: Ensure that all people have equal access to resources and opportunities

The NASW Code of Ethics mandates political and social action to ensure equal access to resources, services, and opportunities for all people.

Question 36: A case manager conducts a comprehensive biopsychosocial assessment. Which area is MOST important to assess when determining eligibility for intensive case management services?

Geographic proximity to the agency
Educational history exclusively
Level of functioning across biological, psychological, and social domains (Correct answer)
Client's insurance coverage only

Correct answer: Level of functioning across biological, psychological, and social domains

A biopsychosocial assessment examines functioning across all domains to determine the level and type of services a client needs.

Question 37: A cisgender social worker is assigned to work with a transgender client. What is the most important initial step?

Ask about the client's surgical history to understand their transition
Use the client's stated name and pronouns and follow the client's lead on disclosure (Correct answer)
Research transgender issues extensively before the first session and share learnings
Refer the client to a transgender-identified therapist

Correct answer: Use the client's stated name and pronouns and follow the client's lead on disclosure

Respecting a client's self-identified name and pronouns is a fundamental affirmative practice that establishes safety and respect.

Question 38: A trauma-informed approach to treatment planning prioritizes which of the following?

Building safety and stabilization before processing trauma (Correct answer)
Focusing exclusively on cognitive distortions
Minimizing discussion of trauma to prevent re-traumatization
Rapid exposure to traumatic memories in early sessions

Correct answer: Building safety and stabilization before processing trauma

Trauma-informed care follows a phase-based model in which establishing safety and stabilization precedes trauma processing.

Question 39: In structural family therapy, the concept of 'enmeshment' refers to:

A family's inability to communicate about problems
Overly diffuse boundaries where individual autonomy is compromised (Correct answer)
Rigid, impermeable boundaries between family subsystems
Triangulation of a child into parental conflicts

Correct answer: Overly diffuse boundaries where individual autonomy is compromised

Enmeshment describes family systems with diffuse boundaries where members are overly involved in each other's lives, limiting individual autonomy.

Question 40: Under the principle of 'least restrictive environment,' a social worker coordinating services for an older adult with mild cognitive impairment should FIRST explore which option?

Memory care unit admission
Skilled nursing facility placement
In-home supportive services and community day programs (Correct answer)
Assisted living with 24-hour supervision

Correct answer: In-home supportive services and community day programs

The least restrictive environment principle requires exploring community-based supports before recommending more restrictive residential placements.

Question 41: A social worker is conducting an initial assessment with a new client who presents with symptoms of depression. The client mentions they have been experiencing thoughts of suicide but denies any specific plan or intent. What should the social worker do FIRST?

Immediately hospitalize the client involuntarily
Refer the client to a psychiatrist and end the session
Contact the client's family members to inform them of the disclosure
Conduct a thorough suicide risk assessment to determine the level of danger (Correct answer)

Correct answer: Conduct a thorough suicide risk assessment to determine the level of danger

A thorough suicide risk assessment is the first step to determine lethality, intent, means, and protective factors. This information guides the appropriate level of intervention and whether hospitalization, a safety plan, or outpatient care is indicated.

Question 42: A social worker implementing a 'popular education' curriculum in a refugee community is drawing on which theoretical tradition?

Critical pedagogy (Correct answer)
Systems theory
Behavioral conditioning
Cognitive-behavioral theory

Correct answer: Critical pedagogy

Popular education, rooted in Freire's critical pedagogy, uses participatory learning to develop critical consciousness and collective action.

Question 43: Which statistical measure describes the spread of scores around the mean?

Median
Standard deviation (Correct answer)
Frequency
Mode

Correct answer: Standard deviation

Standard deviation quantifies how much individual scores vary from the mean of a dataset.

Question 44: A social worker reviews multiple studies on a topic and combines their statistical results into one overall estimate. This is called a:

Content analysis
Narrative review
Systematic review
Meta-analysis (Correct answer)

Correct answer: Meta-analysis

A meta-analysis statistically combines results from multiple studies to produce a single, more precise estimate of an effect.

Question 45: Which therapeutic approach focuses on identifying and changing maladaptive thought patterns to alter behavior and emotions?

Solution-Focused Brief Therapy
Cognitive Behavioral Therapy (Correct answer)
Psychodynamic therapy
Narrative therapy

Correct answer: Cognitive Behavioral Therapy

CBT targets distorted cognitions and their connection to feelings and behaviors to produce lasting therapeutic change.

Question 46: A client in crisis repeatedly uses the phrase 'There's no point anymore.' The MOST clinically appropriate response is:

Reassure the client that things will get better soon
Provide a list of community resources and end the session
Gently explore the meaning behind the phrase and directly inquire about suicidal thoughts (Correct answer)
Change the subject to prevent reinforcing hopelessness

Correct answer: Gently explore the meaning behind the phrase and directly inquire about suicidal thoughts

Verbal cues expressing hopelessness should be directly and compassionately explored, including asking about suicidal ideation, rather than deflected.

Question 47: A social worker is treating a veteran with PTSD who avoids driving due to a combat-related IED incident. Which intervention directly targets avoidance behavior?

Systematic desensitization or prolonged exposure (Correct answer)
Supportive listening and validation
Mindfulness-based stress reduction alone
Psychodynamic exploration of childhood attachment

Correct answer: Systematic desensitization or prolonged exposure

Systematic desensitization and prolonged exposure directly address avoidance by gradually confronting feared stimuli, reducing PTSD symptoms.

Question 48: A social worker notes that a 9-year-old child can sort objects by size, classify them by multiple attributes, and understand that operations can be reversed. This child is in Piaget's:

Formal operational stage
Concrete operational stage (Correct answer)
Preoperational stage
Sensorimotor stage

Correct answer: Concrete operational stage

Concrete operational thinking (ages 7–11) is characterized by logical operations applied to concrete objects, including classification, seriation, and reversibility.

Question 49: A social worker is treating a child with ADHD using behavioral intervention. Which element is most essential to include in the treatment plan?

Biofeedback therapy as the primary modality
Medication as the sole intervention
Weekly individual psychoanalytic sessions
Parent training, school consultation, and contingency management strategies (Correct answer)

Correct answer: Parent training, school consultation, and contingency management strategies

Evidence-based treatment for childhood ADHD includes parent training in behavior management, collaboration with school staff, and contingency management across settings.

Question 50: In interpersonal therapy (IPT) for depression, which of the following is identified as one of the four core problem areas?

Unresolved Oedipal conflict
Role transitions (Correct answer)
Existential meaninglessness
Dysfunctional automatic thoughts

Correct answer: Role transitions

IPT's four problem areas are grief, role disputes, role transitions, and interpersonal deficits; role transitions address difficulties adapting to major life changes.

Question 51: Which documentation element is MOST critical to include when recording a treatment plan in a client's record?

Insurance authorization numbers
Diagnosis codes only
The client's verbal consent and participation in goal development (Correct answer)
The clinician's theoretical orientation

Correct answer: The client's verbal consent and participation in goal development

Documenting client participation and consent in goal development reflects ethical practice and supports client self-determination.

Question 52: A client with major depressive disorder refuses medication but is open to therapy. Which evidence-based intervention should the LMSW prioritize?

Psychoeducation only
Cognitive Behavioral Therapy (CBT) (Correct answer)
Crisis debriefing
Supportive counseling without structure

Correct answer: Cognitive Behavioral Therapy (CBT)

CBT has robust empirical support for treating major depressive disorder without medication.

Question 53: A social worker is asked by a client to write a letter supporting their disability claim. The worker believes the client may be exaggerating symptoms. The ethical obligation is to:

Write the letter as requested to advocate for the client
Refuse to write the letter and refer the client to another professional
Consult with the client's physician before making any decision
Write only an accurate, truthful account based on clinical observations (Correct answer)

Correct answer: Write only an accurate, truthful account based on clinical observations

Social workers must maintain honesty and integrity in all professional communications, including documentation and letters, reflecting only accurate clinical findings.

Question 54: In program evaluation, a needs assessment is conducted PRIMARILY to:

Determine whether a program should continue
Identify gaps between current services and community needs (Correct answer)
Assign a monetary value to program benefits
Measure the outcomes of an existing program

Correct answer: Identify gaps between current services and community needs

A needs assessment identifies the difference between current service availability and what is actually needed by the target population to inform program planning.

Question 55: Which assessment tool is MOST appropriate for screening a client for alcohol use disorder during an initial clinical interview?

CAGE Questionnaire (Correct answer)
Hamilton Anxiety Rating Scale
PHQ-9
Columbia Suicide Severity Rating Scale

Correct answer: CAGE Questionnaire

The CAGE Questionnaire is a widely validated four-question screening tool specifically designed to identify problematic alcohol use.

Question 56: In the empowerment model of social work practice, which of the following is MOST consistent with the approach?

The client and worker engage as partners in identifying barriers and building collective power (Correct answer)
The worker uses behavioral contracts to reward desired client actions
The worker interprets unconscious conflicts to increase client insight
The social worker acts as an expert who prescribes solutions to the client's problems

Correct answer: The client and worker engage as partners in identifying barriers and building collective power

The empowerment model views clients as capable agents and emphasizes partnership, consciousness-raising, and addressing systemic oppression alongside individual challenges.

Question 57: Which of the following is the primary goal of crisis intervention?

To resolve all underlying and long-standing psychological issues.
To eliminate all future stressors from the client's environment.
To provide the client with a definitive psychiatric diagnosis.
To help the client return to their pre-crisis level of functioning. (Correct answer)

Correct answer: To help the client return to their pre-crisis level of functioning.

The primary goal of crisis intervention is to provide immediate, short-term support to help an individual stabilize and restore their ability to function as they did before the crisis event. It is not intended to be a substitute for long-term therapy, which addresses deeper psychological issues, nor is its main purpose diagnosis or the impossible task of removing all life stressors.

Question 58: Coalition building as an advocacy strategy involves:

A single organization lobbying independently for policy change
Filing legal challenges to existing policies
Providing testimony before a legislative committee
Bringing together multiple groups with shared interests to amplify advocacy efforts (Correct answer)

Correct answer: Bringing together multiple groups with shared interests to amplify advocacy efforts

Coalition building unites diverse organizations and groups around a common policy goal, increasing collective power, resources, and influence over decision-makers.

Question 59: Carol Gilligan critiqued Kohlberg's moral development theory primarily because:

It overemphasized cultural relativism
It did not account for cognitive development stages
It focused too heavily on emotion over reason
It was based on samples that excluded women and undervalued care ethics (Correct answer)

Correct answer: It was based on samples that excluded women and undervalued care ethics

Gilligan argued that Kohlberg's model was androcentric, based on male subjects, and failed to capture the ethics of care more commonly voiced by women.

Question 60: A social worker is providing services to an older adult client with mild cognitive impairment who has difficulty understanding complex information. To adhere to the ethical principle of informed consent, which of the following actions is MOST critical?

Have the client sign the consent form and document that they agreed to treatment.
Use clear, simple language to explain the services and check for the client's understanding, while also seeking permission from a legally authorized third party if necessary. (Correct answer)
Provide the services without formal consent, as the client's cognitive impairment prevents them from providing it.
Obtain consent from the client's adult child, who is their emergency contact.

Correct answer: Use clear, simple language to explain the services and check for the client's understanding, while also seeking permission from a legally authorized third party if necessary.

According to the NASW Code of Ethics (Standard 1.03), when clients lack the capacity to provide full informed consent, social workers must still take steps to ensure their comprehension to the greatest extent possible. This includes using understandable language. Concurrently, the social worker should seek permission from an appropriate third party, such as a legal guardian, to protect the client's interests. Simply getting a signature is insufficient if understanding is absent, and relying solely on an emergency contact (who may not be a legal guardian) bypasses the client's right to be included in the process.

Question 61: A social worker discovers that their agency offers fewer services to undocumented immigrant clients than to documented clients. This is an example of:

Individual worker bias
Appropriate resource allocation
Legally required service prioritization
Institutional discrimination (Correct answer)

Correct answer: Institutional discrimination

When institutional policies systematically disadvantage certain groups, this constitutes institutional discrimination regardless of individual worker intent.

Question 62: Title XIX of the Social Security Act established which program?

Medicare
Medicaid (Correct answer)
Social Security Disability Insurance
Children's Health Insurance Program

Correct answer: Medicaid

Title XIX of the Social Security Act of 1965 established Medicaid, a joint federal-state program providing health coverage to low-income individuals.

Question 63: A social worker discovers that a client's 10-year-old child has unexplained bruises on their arms and legs. What is the social worker's primary obligation?

Discuss the concern privately with the client before taking action
Refer the family to family therapy
Report the suspected abuse to child protective services (Correct answer)
Consult with a supervisor and document but take no further action

Correct answer: Report the suspected abuse to child protective services

Social workers are mandated reporters and must report suspected child abuse to child protective services regardless of client relationship.

Question 64: Ecological systems theory, developed by Urie Bronfenbrenner, describes which environmental layer as the system of relationships between the microsystems surrounding a person?

Mesosystem (Correct answer)
Chronosystem
Exosystem
Macrosystem

Correct answer: Mesosystem

The mesosystem represents the interactions and relationships among the various microsystems (e.g., how family and school influence each other).

Question 65: Which of the following scenarios BEST illustrates the ethical concept of 'dual relationship'?

A social worker sees two members of the same family for separate issues
A social worker works in both a hospital and a private practice
A social worker provides therapy to a neighbor with whom they also have a personal friendship (Correct answer)
A social worker provides services to a client of a different cultural background

Correct answer: A social worker provides therapy to a neighbor with whom they also have a personal friendship

A dual relationship occurs when a social worker has both a professional and a personal relationship with the same individual, which can impair judgment and harm the client.

Question 66: Which defense mechanism involves attributing one's own unacceptable feelings or impulses to another person?

Displacement
Reaction formation
Sublimation
Projection (Correct answer)

Correct answer: Projection

Projection involves unconsciously attributing one's own unacceptable thoughts or feelings to someone else.

Question 67: The ethical concept of 'informed consent' in social work requires that the client:

Receive written documentation of all session notes
Agree to all treatment recommendations made by the social worker
Consent to having their information shared with all treatment team members
Understand the nature of services, risks, benefits, and alternatives before agreeing to participate (Correct answer)

Correct answer: Understand the nature of services, risks, benefits, and alternatives before agreeing to participate

Informed consent requires clients to receive adequate information about services including risks, benefits, and alternatives so they can make a voluntary and knowledgeable decision.

Question 68: The Empowerment model in social work practice is MOST aligned with which underlying value?

Professional neutrality is essential to avoid dual relationships
Therapist expertise guides all clinical decisions
Symptom reduction is the primary measure of success
Clients gain power and control over their own lives and environments (Correct answer)

Correct answer: Clients gain power and control over their own lives and environments

The Empowerment model centers on helping clients develop a sense of personal and collective power to effect change in their own lives and communities.

Question 69: Which of the following best illustrates the concept of 'goodness of fit' in child development?

A child's intelligence matching their academic curriculum level
A parent's income level adequately meeting a child's material needs
The match between a child's temperament and the expectations and demands of their environment (Correct answer)
A child's physical development aligning with age-appropriate norms

Correct answer: The match between a child's temperament and the expectations and demands of their environment

Goodness of fit, introduced by Thomas and Chess, refers to how well a child's temperament aligns with their environment's demands, which predicts adjustment and wellbeing.

Question 70: A social worker is treating a client who is HIV-positive and refuses to inform their sexual partner. The partner is also a client of the same agency. What is the MOST appropriate action?

Explore the client's reasons for non-disclosure and discuss options (Correct answer)
Immediately disclose the client's status to the partner
Contact public health authorities and disclose without client consent
Terminate services with the HIV-positive client

Correct answer: Explore the client's reasons for non-disclosure and discuss options

The social worker should first explore the client's reluctance and work toward voluntary disclosure, while consulting legal and ethical guidelines about duty to protect.

Question 71: Which of the following is NOT one of the six core values identified in the Preamble of the NASW Code of Ethics?

Integrity
Service
Social Justice
Self-Determination (Correct answer)

Correct answer: Self-Determination

The Preamble of the NASW Code of Ethics outlines six core values: Service, Social Justice, Dignity and Worth of the Person, Importance of Human Relationships, Integrity, and Competence. While Self-Determination is a fundamental ethical principle (Standard 1.02), it is not listed as one of the six core values.

Question 72: A social worker discovers that a colleague is billing Medicaid for sessions that never occurred. What is the MOST appropriate first step?

Ignore it to avoid damaging the working relationship
Confront the colleague directly and demand they stop
Document the behavior and wait to see if it continues
Report the behavior to a supervisor or appropriate authority (Correct answer)

Correct answer: Report the behavior to a supervisor or appropriate authority

The NASW Code of Ethics requires social workers to take action when a colleague engages in unethical conduct, including reporting to supervisors or licensing boards.

Question 73: A client has a pervasive pattern of instability in interpersonal relationships, self-image, and affect, along with impulsivity and recurrent self-harming behavior. She describes intense fear of abandonment and reports alternately idealizing and then devaluing her close relationships. These features BEST align with which personality disorder?

Antisocial Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Borderline Personality Disorder (Correct answer)

Correct answer: Borderline Personality Disorder

Borderline Personality Disorder (BPD) is defined by unstable relationships, self-image, and affect, combined with impulsivity, self-harm, and frantic efforts to avoid abandonment. The hallmark features — splitting (idealization/devaluation), self-harm, and abandonment fears — distinguish it from other Cluster B disorders.

Question 74: A social worker using Narrative Therapy would PRIMARILY help a client by:

Exploring unconscious conflicts from childhood
Challenging irrational beliefs and replacing them with rational ones
Separating the client's identity from their problem through re-authoring (Correct answer)
Analyzing behavioral reinforcement patterns

Correct answer: Separating the client's identity from their problem through re-authoring

Narrative Therapy externalizes problems and helps clients re-author their life stories, separating their identity from the problem narrative.

Question 75: The 'Strange Situation' procedure developed by Mary Ainsworth identified which attachment pattern in infants who show distress on separation but resist comfort on reunion?

Anxious-ambivalent (resistant) attachment (Correct answer)
Disorganized attachment
Anxious-avoidant attachment
Secure attachment

Correct answer: Anxious-ambivalent (resistant) attachment

Anxious-ambivalent (resistant) attachment is characterized by high distress at separation and difficulty being soothed upon the caregiver's return, often showing anger or passivity.

Question 76: When a social worker is confronted with a complex ethical dilemma involving conflicting professional values, what is the MOST appropriate initial step in the ethical problem-solving process?

Review the relevant sections of the NASW Code of Ethics.
Identify the specific ethical issues, including the conflicting values and duties. (Correct answer)
Consult with a supervisor and document the consultation.
Develop and weigh several alternative courses of action.

Correct answer: Identify the specific ethical issues, including the conflicting values and duties.

All the options are important steps in ethical decision-making, but the foundational first step is to clearly define the problem. This involves identifying the specific ethical standards and principles that are in conflict. Without a clear understanding of the dilemma itself, subsequent steps like consulting, reviewing the code, or developing action plans cannot be effectively implemented.

Question 77: A social worker observes a client shifting rapidly from discussing sadness to laughing inappropriately within minutes without an external trigger. This is best described as:

Labile affect (Correct answer)
Blunted affect
Flat affect
Euphoric mood

Correct answer: Labile affect

Labile affect refers to rapid, unpredictable shifts in emotional expression that are disproportionate or unrelated to context.

Question 78: The desire to fight again is present in a soldier who has posttraumatic stress disorder connected to battle. Which action should you take first?

Inform the client that return will likely cause an increase in symptoms and is not advised.
Assess progress in treatment and current level of functioning. (Correct answer)
Allow the soldier full self-determination, returning when he deems appropriate.
Contact the commanding officer to determine if this is an option for the soldier.

Correct answer: Assess progress in treatment and current level of functioning.

In this case, the soldier's treatment progress and present level of functioning should be evaluated first. Before considering a return to combat, it is essential to assess the success of ongoing posttraumatic stress disorder (PTSD) treatment as well as the person's present functional abilities and mental health status.

Question 79: A client from a collectivist cultural background insists that family members make all treatment decisions on their behalf. The social worker's ethical approach should be to:

Insist that the client make independent decisions to preserve their self-determination
Refuse family involvement to maintain client confidentiality
Explore the client's wishes regarding family involvement and incorporate their cultural values (Correct answer)
Contact a cultural liaison before beginning any services

Correct answer: Explore the client's wishes regarding family involvement and incorporate their cultural values

Culturally responsive practice requires understanding that self-determination may be expressed collectively in some cultures, and services should reflect the client's own definition of decision-making.

Question 80: Which of the following symptom clusters is required for a DSM-5-TR diagnosis of Generalized Anxiety Disorder (GAD)?

Excessive worry about multiple domains, difficult to control, plus at least 3 associated symptoms (e.g., fatigue, irritability, sleep disturbance) for at least 6 months (Correct answer)
Anxiety related specifically to separation from major attachment figures
Marked fear of a specific object or situation with immediate anxiety response
Recurrent unexpected panic attacks with persistent concern about future attacks

Correct answer: Excessive worry about multiple domains, difficult to control, plus at least 3 associated symptoms (e.g., fatigue, irritability, sleep disturbance) for at least 6 months

GAD requires excessive, difficult-to-control anxiety and worry occurring more days than not for at least 6 months across multiple areas, accompanied by at least 3 of 6 somatic/cognitive symptoms (adults): restlessness, fatigue, concentration difficulty, irritability, muscle tension, and sleep disturbance.

Question 81: A social worker is meeting with a family experiencing conflict. The worker deliberately asks each member to speak only to the therapist rather than to each other. This structural family therapy technique is called:

Blocking (Correct answer)
Reframing
Joining
Enactment

Correct answer: Blocking

Blocking is a structural family therapy technique used to interrupt dysfunctional communication patterns by redirecting interaction through the therapist.

Question 82: A client presents with a 2-week period of depressed mood most of the day, loss of interest in previously enjoyed activities, hypersomnia, psychomotor retardation, and feelings of worthlessness. There is no history of manic or hypomanic episodes. Which diagnosis BEST fits this presentation?

Bipolar I Disorder, depressive episode
Cyclothymic Disorder
Persistent Depressive Disorder (Dysthymia)
Major Depressive Disorder (Correct answer)

Correct answer: Major Depressive Disorder

A discrete episode of at least 5 DSM symptoms (including depressed mood or anhedonia) lasting at least 2 weeks, without a history of mania or hypomania, meets criteria for Major Depressive Disorder. Persistent Depressive Disorder requires symptoms lasting at least 2 years. Bipolar diagnoses require a manic/hypomanic history.

Question 83: Which of the following BEST describes the concept of 'functional analysis' in Behavioral Social Work?

Identifying antecedents, behaviors, and consequences (ABC) of a target behavior (Correct answer)
Evaluating the client's ego strengths and defenses
Assessing the client's level of social functioning
Analyzing the family's structural hierarchy

Correct answer: Identifying antecedents, behaviors, and consequences (ABC) of a target behavior

Functional analysis (ABC model) examines the antecedents, the behavior itself, and its consequences to understand and modify behavior.

Question 84: When designing a community health education program, the principle of cultural humility requires the social worker to:

Hire translators to convert existing materials into other languages
Recognize the limits of their own cultural knowledge and engage in ongoing learning with community members (Correct answer)
Become an expert in every culture represented in the community
Apply DSM criteria uniformly regardless of cultural context

Correct answer: Recognize the limits of their own cultural knowledge and engage in ongoing learning with community members

Cultural humility emphasizes lifelong self-reflection and openness to learning from community members rather than claiming cultural competence as a fixed endpoint.

Question 85: A social worker who is recovering from substance use disorder begins working in an addiction treatment program. Which is TRUE regarding ethical practice?

Personal history of addiction disqualifies a worker from this field
The worker must disclose their history to all clients
Self-disclosure of recovery status is always required for rapport
The worker may practice if competent and the history does not impair practice (Correct answer)

Correct answer: The worker may practice if competent and the history does not impair practice

Personal history does not bar practice; what matters is whether the worker can perform duties competently and without impairment.

Question 86: During a home visit, an LMSW notices signs that an elderly client may be experiencing financial exploitation by a family member. What is the PRIORITY action?

Confront the suspected family member during the visit
Discuss the observation with colleagues at the next team meeting
Document observations but wait for the client to disclose abuse voluntarily
Report suspected elder financial abuse to adult protective services as required by law (Correct answer)

Correct answer: Report suspected elder financial abuse to adult protective services as required by law

All U.S. states have mandatory reporting laws requiring social workers to report suspected elder abuse, including financial exploitation, to adult protective services.

Question 87: A social worker discovers that a colleague is billing Medicaid for services never rendered. According to the NASW Code of Ethics, what is the social worker's primary obligation?

Report the misconduct through appropriate channels, including supervisors or licensing boards (Correct answer)
Confront the colleague privately and give them a chance to self-report
Ignore the situation to avoid damaging the colleague's career
Document the issue internally without reporting to external authorities

Correct answer: Report the misconduct through appropriate channels, including supervisors or licensing boards

The NASW Code of Ethics obligates social workers to report unethical conduct by colleagues, including fraud, to appropriate professional or regulatory bodies.

Question 88: A social worker advocates on behalf of a client who has been denied housing benefits for which they are legally eligible. This is an example of:

Case advocacy (Correct answer)
Cause advocacy
Community organizing
Legislative advocacy

Correct answer: Case advocacy

Case advocacy focuses on securing rights and resources for an individual client, as opposed to cause advocacy which targets systemic change for a population.

Question 89: When using a task-centered approach in treatment planning, the LMSW and client focus on:

Pharmacological symptom management
Exploring the client's family of origin over an open-ended period
Completing specific, agreed-upon tasks to resolve target problems within a time limit (Correct answer)
Achieving unconscious insight into past experiences

Correct answer: Completing specific, agreed-upon tasks to resolve target problems within a time limit

Task-centered practice is structured around collaboratively identifying problems and completing specific tasks within a defined, brief time frame.

Question 90: A social worker assumes a soft-spoken Asian American client has no opinions because they do not volunteer them in group therapy. This reflects:

Accurate cross-cultural observation
A racial microaggression based on the model minority stereotype (Correct answer)
Appropriate group facilitation technique
Culturally informed silence interpretation

Correct answer: A racial microaggression based on the model minority stereotype

Projecting stereotypes about Asian passivity onto individual clients constitutes a microaggression that can harm the therapeutic relationship.

Question 91: In Bowlby's attachment theory, the concept of the 'internal working model' refers to:

The caregiver's mental representation of the child's needs
A neurological template for language acquisition
A child's biological drive to seek proximity to caregivers under stress
A cognitive-emotional schema formed from early attachment experiences that guides future relationships (Correct answer)

Correct answer: A cognitive-emotional schema formed from early attachment experiences that guides future relationships

Internal working models are mental representations of self and others formed through early attachment experiences that shape expectations in future relationships.

Question 92: Historical trauma, as described by Maria Yellow Horse Brave Heart, refers to:

Trauma experienced by social workers from hearing clients' difficult stories
Individual PTSD from specific traumatic events in childhood
Cumulative trauma across generations resulting from massive group trauma such as genocide or forced relocation (Correct answer)
The historical record of trauma treatment in psychiatric hospitals

Correct answer: Cumulative trauma across generations resulting from massive group trauma such as genocide or forced relocation

Historical trauma describes intergenerational psychological wounds transmitted through communities that experienced collective catastrophic losses.

Question 93: When a social worker sets SMART goals in a treatment plan, the 'M' stands for:

Meaningful
Measurable (Correct answer)
Manageable
Motivational

Correct answer: Measurable

In SMART goals, 'M' stands for Measurable, meaning progress toward the goal can be tracked with observable, quantifiable indicators.

Question 94: Which statement BEST describes the role of the social worker in the Empowerment Model?

Interpreting unconscious material to promote insight
Collaborating with clients to build on their strengths and challenge oppressive structures (Correct answer)
Acting as a neutral expert who diagnoses and treats pathology
Providing directive advice and concrete resources

Correct answer: Collaborating with clients to build on their strengths and challenge oppressive structures

The Empowerment Model positions the social worker as a collaborator who helps clients recognize their strengths and addresses systemic and structural barriers.

Question 95: According to Jean Piaget, a child in the 'concrete operational stage' is best characterized by the ability to:

Perform logical operations on abstract concepts
Understand conservation and classify objects by multiple dimensions (Correct answer)
Use symbolic thinking and language
Engage only in sensorimotor exploration of the environment

Correct answer: Understand conservation and classify objects by multiple dimensions

During the concrete operational stage (ages 7–11), children master conservation tasks and can classify objects by more than one attribute simultaneously.

Question 96: Which of the following is an example of 'secondary aging' as opposed to 'primary aging'?

Development of Type 2 diabetes related to poor diet (Correct answer)
Reduction in lung capacity with age
Gradual decrease in skin elasticity
Slowing of reflexes due to neurological changes

Correct answer: Development of Type 2 diabetes related to poor diet

Secondary aging refers to changes caused by disease, lifestyle, or environmental factors, whereas primary aging refers to universal, inevitable biological changes.

Question 97: A social worker using Acceptance and Commitment Therapy (ACT) would encourage a client to:

Explore the origins of their attachment style
Accept difficult thoughts and commit to values-based action (Correct answer)
Challenge and dispute irrational beliefs
Identify and restructure cognitive schemas

Correct answer: Accept difficult thoughts and commit to values-based action

ACT promotes psychological flexibility by encouraging acceptance of difficult internal experiences and commitment to actions aligned with personal values.

Question 98: Which ethical standard is MOST relevant when a social worker charges sliding-scale fees based on client income?

Confidentiality
Competence
Social justice (Correct answer)
Integrity

Correct answer: Social justice

Sliding-scale fees reflect the social justice value of ensuring services are accessible to people across economic circumstances.

Question 99: A social worker helping a client with anger management chooses to use a cognitive-behavioral intervention. Which technique is most consistent with this approach?

Cathartic expression through expressive arts therapy
Reiki and mindfulness-only practices
Free association to explore unconscious roots of anger
Identifying triggers, automatic thoughts, and replacing them with adaptive responses (Correct answer)

Correct answer: Identifying triggers, automatic thoughts, and replacing them with adaptive responses

CBT for anger management focuses on identifying triggering situations, automatic thoughts, and developing more adaptive cognitive and behavioral responses.

Question 100: A social worker is providing services to a family, and the parents have given legal consent for their 12-year-old child to participate in counseling. During the first individual session, the social worker explains the purpose of therapy, confidentiality, and the child's role in the process using age-appropriate language. This process of securing the child's willing participation is best described as obtaining:

Assent (Correct answer)
Informed consent
Legal guardianship
Parental permission

Correct answer: Assent

While the parents provide legal informed consent, the social worker is ethically obligated to obtain the child's assent. Assent is the agreement of a minor, who is not able to give legal consent, to participate in services after being provided an age-appropriate explanation of the treatment. This respects the child's developing capacity for self-determination, as outlined in the NASW Code of Ethics (Standard 1.03).

Question 101: During a session, a client who has a history of domestic violence makes a specific, credible threat to seriously harm their ex-partner, naming the individual and describing a plan. The social worker's primary ethical and legal responsibility is to:

Work with the client to create a safety plan to manage their anger without involving outside parties.
Immediately break confidentiality and take steps to protect the potential victim. (Correct answer)
Consult with a supervisor before taking any action that would breach confidentiality.
Maintain strict client confidentiality as a core tenet of the therapeutic relationship.

Correct answer: Immediately break confidentiality and take steps to protect the potential victim.

This scenario directly involves the 'duty to protect,' a legal and ethical mandate that overrides client confidentiality when a client poses a serious, foreseeable, and imminent threat to an identifiable third party. This principle was established in the Tarasoff v. Regents of the University of California case. While consultation is good practice, the immediacy of a credible threat requires prompt action to warn the potential victim and notify law enforcement. Maintaining confidentiality or only creating a safety plan would neglect the responsibility to protect the potential victim from harm.

Question 102: An adolescent discloses being sexually abused by a family member and says, 'Please don't tell anyone.' The LMSW's primary obligation is to:

Consult with a supervisor before taking any action
Encourage the adolescent to tell a trusted adult themselves
Honor the client's confidentiality to preserve the therapeutic alliance
Report to child protective services immediately as mandated by law (Correct answer)

Correct answer: Report to child protective services immediately as mandated by law

Mandated reporter laws require social workers to report known or suspected child abuse regardless of client confidentiality.

Question 103: Bowlby's attachment theory proposes that infants form attachments primarily because:

Caregivers provide food and reduce hunger drives
Proximity-seeking behavior is evolutionarily adaptive for survival (Correct answer)
Infants are conditioned through operant reinforcement
Social learning from peers shapes attachment patterns

Correct answer: Proximity-seeking behavior is evolutionarily adaptive for survival

Bowlby argued attachment is an innate biological system that keeps vulnerable infants close to caregivers for protection and survival.

Question 104: In Loewenberg and Dolgoff's Ethical Principles Screen, which principle takes the highest priority when resolving ethical dilemmas?

Autonomy and Freedom
Least Harm
Equality and Inequality
Protection of Life (Correct answer)

Correct answer: Protection of Life

Loewenberg and Dolgoff rank Protection of Life (Principle 1) as the highest priority in their seven-principle hierarchy for resolving ethical dilemmas.

Question 105: A client offers a social worker a small, handmade scarf as a gift at the end of their final session to express gratitude. The agency has a strict 'no gifts' policy. What is the social worker's BEST ethical response?

Politely decline the gift, explaining the agency's policy to the client.
Explore the gift's meaning with the client, consider the potential impact on the therapeutic relationship, and discuss the situation with a supervisor. (Correct answer)
Accept the gift to avoid offending the client, but do not report it.
Accept the gift and donate it to a local charity.

Correct answer: Explore the gift's meaning with the client, consider the potential impact on the therapeutic relationship, and discuss the situation with a supervisor.

The NASW Code of Ethics does not have an absolute prohibition on accepting gifts. The ethical decision-making process involves assessing the gift's meaning, the client's motivation, its monetary value, and the potential impact on the professional relationship. While agency policy is a factor, the primary consideration is the client's well-being. Exploring the meaning with the client is a crucial first step. Flatly rejecting a gift of small sentimental value could damage the client's sense of self and the therapeutic rapport. Consulting with a supervisor is essential for navigating the conflict between ethical considerations and agency policy.

Question 106: A social worker learns that a colleague is billing insurance for sessions that were never conducted. According to the NASW Code of Ethics, the worker should FIRST:

Report the colleague to the state licensing board immediately
Document the concern and report to the agency supervisor or ethics board (Correct answer)
Confront the colleague directly and encourage self-reporting
Ignore it because it is not directly affecting clients

Correct answer: Document the concern and report to the agency supervisor or ethics board

The NASW Code of Ethics requires social workers to address unethical conduct by colleagues, typically through internal reporting channels before external authorities.

Question 107: An LMSW wants to advocate for affordable housing policy affecting low-income clients. This activity reflects which NASW ethical standard?

Social and political action (Correct answer)
Integrity
Competence
Confidentiality

Correct answer: Social and political action

NASW's ethical standard on Social and Political Action calls on social workers to engage in policy advocacy to expand choice and opportunity for all people.

Question 108: During an intake assessment, a client describes hearing voices that comment on their behavior, believing their thoughts are being broadcast on television, and having had these experiences for eight months. Which diagnosis best fits this presentation?

Schizophreniform Disorder
Delusional Disorder
Schizophrenia (Correct answer)
Brief Psychotic Disorder

Correct answer: Schizophrenia

Schizophrenia requires two or more positive symptoms lasting at least six months, with at least one month of active-phase symptoms.

Question 109: A client presents with a 3-week history of depressed mood, anhedonia, hypersomnia, and psychomotor retardation. Which specifier best applies if these symptoms follow a seasonal pattern each winter?

With seasonal pattern (Correct answer)
With atypical features
With peripartum onset
With melancholic features

Correct answer: With seasonal pattern

The 'with seasonal pattern' specifier in DSM-5 applies when the onset and remission of Major Depressive Episodes follows a regular seasonal pattern, most commonly fall/winter onset.

Question 110: Which documentation element is MOST critical in a case management service plan to ensure continuity of care across multiple providers?

A list of all agencies the client has previously used
The client's insurance billing codes
Clearly defined goals, responsible parties, timelines, and measurable outcomes (Correct answer)
The case manager's theoretical orientation

Correct answer: Clearly defined goals, responsible parties, timelines, and measurable outcomes

Service plans that specify goals, assigned responsibilities, timelines, and measurable outcomes allow all providers to coordinate effectively and track progress.

Question 111: A customer just received a Multiple Sclerosis diagnosis. She started reading books, journal papers, and the most recent experimental studies as soon as she could to learn as much as she could about the sickness. Which type of defense mechanism is demonstrated by the client's reaction to her diagnosis?

Regression
Repression
Sublimation
Intellectualization (Correct answer)

Correct answer: Intellectualization

A defense mechanism known as intellectualization involves a concentration on thought and analysis in an effort to prevent or lessen emotional suffering. It entails directing emotionally charged or anxiety-inducing circumstances into cerebral and logical endeavors. In this instance, the client's fervent research and education regarding her diagnosis serve as a means for her to remove herself from the emotional toll and unpredictability brought on by the condition.

Question 112: Which type of case management model assigns one social worker to provide both clinical therapy and service coordination to the same client?

Clinical case management model (Correct answer)
Intensive Case Management (ICM) model
Assertive Community Treatment (ACT) model
Brokerage model

Correct answer: Clinical case management model

The clinical case management model integrates therapeutic intervention with service coordination, with one worker providing both functions to promote a strong therapeutic alliance.

Question 113: According to Roberts' Seven-Stage Crisis Intervention Model, which stage comes immediately AFTER conducting a thorough biopsychosocial assessment?

Generating and exploring alternatives
Formulating an action plan
Establishing rapport and a collaborative relationship (Correct answer)
Establishing priorities and generating alternatives

Correct answer: Establishing rapport and a collaborative relationship

In Roberts' model, after assessment, the worker focuses on establishing rapport and a collaborative, empathic relationship before exploring alternatives.

Question 114: A client with borderline personality disorder frequently calls the social worker in crisis between sessions. Which intervention framework is most evidence-based for this presentation?

Rational Emotive Behavior Therapy
Solution-Focused Brief Therapy
Dialectical Behavior Therapy (DBT) (Correct answer)
Psychodynamic therapy

Correct answer: Dialectical Behavior Therapy (DBT)

DBT was specifically developed by Marsha Linehan for borderline personality disorder and has the strongest evidence base for reducing self-harm and crisis behaviors.

Question 115: A social worker using Structural Family Therapy would focus primarily on:

Changing dysfunctional family structures, hierarchies, and subsystems (Correct answer)
Teaching communication skills through behavioral rehearsal
Exploring multigenerational family patterns using a genogram
Identifying irrational beliefs held by individual family members

Correct answer: Changing dysfunctional family structures, hierarchies, and subsystems

Structural Family Therapy, developed by Salvador Minuchin, targets problematic family structures, boundaries, and hierarchies to improve functioning.

Question 116: In the DSM-5 multiaxial system replacement, which domain captures psychosocial and contextual factors such as homelessness or family conflict?

Rule-Out Diagnoses
Specifiers
Z-codes (V-codes) (Correct answer)
Principal Diagnosis

Correct answer: Z-codes (V-codes)

Z-codes (formerly V-codes in DSM-IV) document psychosocial and environmental problems that may affect diagnosis, treatment, or prognosis.

Question 117: A social worker is developing a coalition to address food insecurity in a rural county. Which step should come FIRST?

Map existing resources and identify gaps in services (Correct answer)
Launch a public awareness campaign
Hire additional staff for program delivery
Apply for federal grant funding

Correct answer: Map existing resources and identify gaps in services

Mapping existing resources and identifying gaps is the essential first step to avoid duplication and ensure the coalition addresses unmet needs.

Question 118: Temperament research by Thomas and Chess identified which three broad temperament types in infants?

Active, passive, and reactive
Secure, avoidant, and anxious
Introverted, extroverted, and ambiverted
Easy, difficult, and slow-to-warm-up (Correct answer)

Correct answer: Easy, difficult, and slow-to-warm-up

Thomas and Chess categorized infant temperament into easy, difficult, and slow-to-warm-up types based on behavioral patterns like regularity, adaptability, and mood.

Question 119: Which of the following best describes the concept of 'self-determination' in social work practice?

The client follows the treatment plan developed by the interdisciplinary team
The client has the right to make their own choices, even ones the social worker disagrees with (Correct answer)
The social worker decides the best course of action for the client
The agency sets goals collaboratively with the client

Correct answer: The client has the right to make their own choices, even ones the social worker disagrees with

Self-determination is a core social work value that upholds the client's right to make their own decisions regarding their life and treatment.

Question 120: A social worker in private practice is asked by a close friend to provide therapy for their teenage son. The friend states that their pre-existing relationship will help the son build trust more quickly. What is the social worker's MOST ethical course of action?

Agree to provide the therapy but establish firm professional boundaries from the outset.
Provide the therapy but refuse to accept payment to eliminate the financial conflict of interest.
Suggest co-facilitating the therapy sessions with another therapist to manage the dual relationship.
Decline to provide therapy and refer the friend to other qualified professionals. (Correct answer)

Correct answer: Decline to provide therapy and refer the friend to other qualified professionals.

The NASW Code of Ethics, Standard 1.06(c), cautions social workers against engaging in dual or multiple relationships where there is a risk of exploitation or harm to the client. Providing therapy to a close friend's son creates a dual relationship that could impair the social worker's professional judgment and compromise the therapeutic process. The most ethical action is to avoid this conflict of interest by referring the friend to other qualified professionals to ensure the client's interests are primary.

Question 121: Which theoretical framework guides a treatment plan that focuses on identifying and modifying a client's distorted automatic thoughts?

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

Correct answer: Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy specifically targets automatic thoughts and cognitive distortions as central mechanisms of change in treatment planning.

Question 122: Which model holds that people construct meaning through the stories they tell about their lives, and therapy involves reauthoring those narratives?

Behavioral Activation
Narrative Therapy (Correct answer)
Cognitive Behavioral Therapy
Rational Emotive Behavior Therapy

Correct answer: Narrative Therapy

Narrative Therapy, developed by White and Epston, views problems as separate from persons and helps clients rewrite dominant, limiting life stories.

LMSW (Licensed Master Social Worker) Exam

The LMSW (Licensed Master Social Worker) Exam exam validates essential knowledge and skills required for certification or licensure in this field.

122

Questions

240 min

Time Limit

70%

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