LMSW Practice Questions 4 — Questions and Answers
Question 1: A client with bipolar disorder tells their LMSW that they have stopped taking their mood stabilizer because it causes weight gain. What is the BEST initial response?
- Immediately contact the prescribing psychiatrist to report non-compliance
- Explore the client's concerns about the side effects and their feelings about the medication (Correct answer)
- Educate the client about the risks of stopping medication abruptly
- Document the refusal and continue with other treatment goals
Correct answer: Explore the client's concerns about the side effects and their feelings about the medication
Exploring the client's concerns first respects autonomy, builds rapport, and gathers information needed to collaboratively address medication adherence.
Question 2: Under the NASW Code of Ethics, when a social worker's personal values conflict with a client's choices, the social worker should PRIMARILY:
- Refer the client to another provider who shares the client's values
- Set aside personal values and prioritize the client's right to self-determination (Correct answer)
- Discuss the conflict openly with the client during sessions
- Seek supervision to determine whether to continue working with the client
Correct answer: Set aside personal values and prioritize the client's right to self-determination
The NASW Code of Ethics requires social workers to uphold client self-determination, setting aside personal values that could interfere with professional obligations.
Question 3: A mother reports that her 10-year-old child has been having nightmares and bedwetting since witnessing domestic violence in the home. These symptoms MOST likely indicate:
- Oppositional Defiant Disorder
- Adjustment Disorder with Depressed Mood
- Post-Traumatic Stress Disorder (Correct answer)
- Separation Anxiety Disorder
Correct answer: Post-Traumatic Stress Disorder
Nightmares and regression such as bedwetting following trauma exposure are classic presentations of PTSD in children.
Question 4: An LMSW working in a hospital is asked by a patient's employer for information about the patient's condition. The social worker should:
- Provide general information without disclosing the specific diagnosis
- Decline to release any information without the patient's written consent (Correct answer)
- Release information only if the employer can demonstrate a legitimate need
- Consult with the hospital's legal team before responding
Correct answer: Decline to release any information without the patient's written consent
HIPAA and professional ethics require written client authorization before disclosing any protected health information to third parties, including employers.
Question 5: When using Motivational Interviewing (MI) with an ambivalent client, the technique of 'rolling with resistance' means the social worker should:
- Firmly redirect the client toward behavior change goals
- Acknowledge and reflect the client's ambivalence without arguing or confronting (Correct answer)
- Postpone the session until the client is ready to engage
- Provide psychoeducation to overcome the client's objections
Correct answer: Acknowledge and reflect the client's ambivalence without arguing or confronting
Rolling with resistance in MI involves reflecting ambivalence back without confrontation, preserving the therapeutic relationship and the client's autonomy.
Question 6: A social worker discovers that a colleague is billing Medicaid for services that were never provided. The MOST appropriate first action is to:
- Confront the colleague directly and give them a chance to self-report
- Report the fraud to the appropriate supervisor or administration
- Report the fraud anonymously to the Medicaid fraud hotline
- Document the observation and consult with a supervisor before taking action (Correct answer)
Correct answer: Document the observation and consult with a supervisor before taking action
Consulting with a supervisor before acting allows the social worker to obtain guidance on proper procedures, protect themselves legally, and ensure accurate reporting.
Question 7: A client in a community mental health setting discloses that they are undocumented and fears deportation if they seek additional services. The social worker's PRIORITY response is to:
- Reassure the client that mental health records are protected and explain their rights (Correct answer)
- Refer the client immediately to an immigration attorney
- Contact immigration authorities to clarify the client's legal status
- Document the disclosure and continue with the mental health assessment
Correct answer: Reassure the client that mental health records are protected and explain their rights
Informing the client of their privacy rights under HIPAA and applicable confidentiality laws directly addresses their barrier to care and upholds the social work value of social justice.
LMSW Practice Questions 4
A client with bipolar disorder tells their LMSW that they have stopped taking their mood stabilizer because it causes weight gain.
What is the BEST initial response?