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

Question 1: An advanced generalist social worker conducting a community needs assessment should FIRST:

Identify and engage key community stakeholders (Correct answer)
Draft a grant proposal to fund services
Compile national statistics on the issue
Implement an intervention program

Correct answer: Identify and engage key community stakeholders

Engaging key stakeholders first ensures the needs assessment is participatory, culturally relevant, and reflects the actual priorities of the community rather than outside assumptions.

Question 2: A client presents with persistent sadness, anhedonia, hypersomnia, and psychomotor retardation lasting 6 weeks. Which diagnostic category BEST fits this presentation?

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

Correct answer: Major Depressive Disorder

The cluster of neurovegetative symptoms lasting at least two weeks with functional impairment meets DSM-5 criteria for Major Depressive Disorder.

Question 3: The LEAST probable diagnostic indicators of "disorganized" schizophrenia are:

Unusual language or speech patterns that may include echolalia, use of neologisms and/or tangential speech
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
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)
Situationally incongruent affective displays and/or relative deficits in affective experience and expression, which may be accompanied by bizarre or incongruous verbal behavior

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 4: Emotional development theories state that ______ .

3-year-olds and 11-year-olds have similar levels of emotional intelligence.
11-year-olds are better at understanding other people's emotions than 3-year-olds. (Correct answer)
11-year-olds are more emotional than 3-year-olds.
3-year-olds cry less than 11-year-olds.

Correct answer: 11-year-olds are better at understanding other people's emotions than 3-year-olds.

Emotional development theories suggest that as children mature, their capacity for emotional understanding, empathy, and emotional regulation increases. Eleven-year-olds typically possess more advanced cognitive abilities and social experiences than three-year-olds, enabling them to better interpret and understand the complex emotions of others. This reflects a progression in emotional intelligence and social cognition over time.

Question 5: A social worker practicing from a feminist therapy perspective would MOST likely emphasize which of the following in treatment?

The role of unconscious drives in shaping the client's behavior
Cognitive distortions as the primary cause of emotional distress
Behavioral reinforcement schedules to change maladaptive patterns
The impact of social and political power structures on the client's experience (Correct answer)

Correct answer: The impact of social and political power structures on the client's experience

Feminist therapy contextualizes personal problems within systemic inequalities, power imbalances, and social structures that affect clients, particularly women and marginalized groups.

Question 6: A group therapy practice called choreographing has a participant take on the role of the protagonist's alter ego.

True
False (Correct answer)

Correct answer: False

This statement is false. The group therapy practice where a participant takes on the role of the protagonist's alter ego is characteristic of psychodrama, specifically a technique called 'doubling.' Choreographing, while involving movement and spatial arrangements in therapy, is a broader term and does not specifically define this alter ego role.

Question 7: A social worker suspects a client is experiencing medication-induced akathisia. Which symptom would most support this concern?

Inability to remain still with a subjective sense of restlessness (Correct answer)
Slowed speech and blunted affect
Muscle rigidity and tremor
Tardive movements of the face and tongue

Correct answer: Inability to remain still with a subjective sense of restlessness

Akathisia is a medication side effect characterized by an inability to remain still combined with an intense subjective sense of inner restlessness.

Question 8: A BSW discovers their agency's intake forms do not include gender options beyond 'male' and 'female.' The MOST appropriate action is to:

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

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 9: Clients are instructed to use their imaginations to picture a specific behavior as another person thoroughly discusses the hypothetical circumstance.

reaction formation
covert modeling (Correct answer)
symbolic modeling
flooding

Correct answer: covert modeling

Covert modeling is a therapeutic technique where clients are instructed to use their imaginations to mentally rehearse a desired behavior or cope with a challenging situation. Instead of observing a real or videotaped model, the client visualizes themselves performing the action, often guided by a therapist's detailed description of the hypothetical circumstance. This mental practice helps build confidence and prepare for real-life scenarios.

Question 10: A client diagnosed with borderline personality disorder frequently calls the therapist between sessions in crisis. The BEST clinical response is to:

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

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 11: 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?

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

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 12: The 'strengths perspective' in social work practice emphasizes:

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

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 13: A teen starts high school and exhibits behavioral issues there. He has problems adhering to instructions and meeting the demands imposed on him academically. A school social worker is suggested for assistance. The best course of action for the social worker is to:

View the boy’s behavior within an ecological framework—being caused by the “degree of fit” between the boy and his environment (Correct answer)
Compare it with symptoms of disorders with childhood onset
Determine whether the boy’s behavior is a result of an undiagnosed learning disability
Complete a drug and alcohol evaluation because the boy is at an age when substance use commonly begins

Correct answer: View the boy’s behavior within an ecological framework—being caused by the “degree of fit” between the boy and his environment

The ecological framework is a foundational perspective in social work, emphasizing that an individual's behavior is best understood within the context of their interactions with their environment. This approach considers how the 'fit' between the boy and various systems (school, family, peers) contributes to his behavioral issues. It guides social workers to develop comprehensive interventions that address both individual needs and environmental factors.

Question 14: 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 must be approved by a supervisory authority
It is only used with informed consent
It is up to the social worker's discretion

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

A biochemical imbalance in the fear response system
Unresolved grief related to the accident
Unconscious guilt about surviving 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 16: Which of the following does NOT include a bodily change that takes place in the formative years?

Increased balance
Increased overall control of the body
Increased vocabulary (Correct answer)
Increased fine motor coordination

Correct answer: Increased vocabulary

Increased vocabulary is a cognitive change, reflecting language acquisition and intellectual development. The other options—increased balance, increased fine motor coordination, and increased overall control of the body—are all examples of physical changes and improvements in motor skills that occur during the formative years of childhood.

Question 17: A parent enrolls her child in therapy and later requests to review all session notes. Regarding the child's right to confidentiality, the social worker should FIRST:

Consult state law and agency policy regarding minor's privacy rights (Correct answer)
Refuse the request, as the child's confidentiality is absolute
Provide all records immediately, as the parent has legal authority
Ask the child to consent before releasing any information

Correct answer: Consult state law and agency policy regarding minor's privacy rights

Minor confidentiality rights vary by state and clinical context, requiring the social worker to review applicable law and policy before responding.

Question 18: Cognitive distortions such as all-or-nothing thinking and catastrophizing are central to which therapeutic model?

Narrative therapy
Cognitive-behavioral therapy (Correct answer)
Psychoanalytic therapy
Dialectical behavior therapy

Correct answer: Cognitive-behavioral therapy

CBT, developed by Aaron Beck, identifies and restructures maladaptive cognitive distortions that maintain emotional distress.

Question 19: Which of the following scenarios BEST illustrates a dual relationship (also called a dual role)?

A BSW provides counseling to a neighbor from the same community (Correct answer)
A BSW serves on a community board while working at a nonprofit agency
A BSW works with both a parent and their child simultaneously
A BSW sees a client who has previously seen another social worker

Correct answer: A BSW provides counseling to a neighbor from the same community

A dual relationship occurs when a social worker has a second role with a client (e.g., neighbor, friend, business contact) outside the professional relationship.

Question 20: Which of the following is a hallmark feature of Borderline Personality Disorder (BPD) per DSM-5?

Persistent auditory hallucinations lasting more than six months
Restricted affect and preference for solitary activities
Frantic efforts to avoid real or imagined abandonment (Correct answer)
Grandiosity and inflated sense of self-importance

Correct answer: Frantic efforts to avoid real or imagined abandonment

Frantic efforts to avoid abandonment—real or imagined—is one of the nine defining DSM-5 criteria for Borderline Personality Disorder.

Question 21: The BEST approach to managing cultural differences between a client and oneself as a practitioner is which of the following?

Understand how the differences affect the process of problem-solving (Correct answer)
None of the above
Develop a comprehensive understanding of all cultural differences
Involve the client in a deep dialogue about cultural differences

Correct answer: Understand how the differences affect the process of problem-solving

While understanding cultural differences is important, the most effective approach for a practitioner is to actively recognize and consider how these differences might impact the therapeutic relationship, communication, and the client's engagement in the problem-solving process. This allows the practitioner to adapt their approach, avoid misunderstandings, and provide culturally sensitive and effective care tailored to the client's specific context.

Question 22: According to Erikson, the primary developmental conflict for school-age children (ages 6-12) is:

Identity vs. Role Confusion
Industry vs. Inferiority (Correct answer)
Autonomy vs. Shame and Doubt
Initiative vs. Guilt

Correct answer: Industry vs. Inferiority

Industry vs. Inferiority is Erikson's stage for middle childhood, where children develop a sense of competence through mastering skills or risk feeling inferior.

Question 23: A social worker begins experiencing romantic feelings toward a client. The MOST appropriate action is to:

Seek supervision and personal therapy to address the feelings (Correct answer)
Continue treatment while keeping feelings strictly private
Disclose the feelings to the client to maintain transparency
Transfer the client immediately without explanation

Correct answer: Seek supervision and personal therapy to address the feelings

When countertransference involves romantic feelings, seeking supervision and personal therapy is essential to protect the client and maintain professional boundaries.

Question 24: Which of the following BEST describes the purpose of psychosocial assessment in social work practice?

To evaluate the effectiveness of therapeutic interventions
To diagnose mental health disorders using DSM criteria
To determine eligibility for public assistance programs
To understand the client's functioning within their social environment (Correct answer)

Correct answer: To understand the client's functioning within their social environment

Psychosocial assessment examines how biological, psychological, and social factors interact to affect a client's overall functioning.

Question 25: Which attachment style in adults is characterized by discomfort with closeness, self-reliance, and dismissiveness of the importance of relationships?

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

Correct answer: Dismissive-avoidant

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

Question 26: A mandated reporter social worker suspects child abuse based on a child's disclosure. The social worker should:

Investigate further before reporting to avoid false allegations
Consult with the child's parents first
Report to child protective services immediately (Correct answer)
Document and review the case at next supervision

Correct answer: Report to child protective services immediately

Mandated reporters must report suspected abuse immediately without conducting their own investigation or waiting for confirmation.

Question 27: 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 interferes with problem solving (Correct answer)
When it lasts for a short amount of time
When it alerts one to a problem
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 28: A social worker finds out that a nurse is giving a patient more painkillers than the doctor has recommended. What is the social worker supposed to do?

immediately tell the nurse's supervisor
tell the doctor
report the nurse immediately to the medical board
discuss the issue with the nurse (Correct answer)

Correct answer: discuss the issue with the nurse

When a social worker observes potential professional misconduct, the initial ethical step is often to address the issue directly with the individual involved, if appropriate and safe. Discussing the issue with the nurse allows for clarification, potential misunderstanding resolution, and an opportunity for the nurse to correct the behavior. If the issue persists or is severe, then escalating to a supervisor or regulatory board would be the next step.

Question 29: A client diagnosed with major depressive disorder tells the social worker, 'I've been giving away my belongings and I finally feel at peace.' The social worker should FIRST:

Reinforce the client's sense of peace as a positive sign
Conduct a thorough suicide risk assessment (Correct answer)
Schedule more frequent therapy sessions
Contact the client's psychiatrist to adjust medication

Correct answer: Conduct a thorough suicide risk assessment

Giving away possessions and sudden calmness after depression are warning signs of suicidal intent, requiring immediate risk assessment.

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

Avoid arguing and instead explore the client's perspective without confrontation (Correct answer)
Educate the client about the negative consequences of their behavior
Firmly challenge the client's ambivalence about change
Refer the client when resistance becomes too strong

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

Rolling with resistance avoids confrontation and instead invites the client to examine their own perspective, preserving the therapeutic alliance.

Question 31: The DSM-5 replaced the multiaxial system with what type of diagnostic approach?

A non-hierarchical list of symptom clusters
A purely etiology-based diagnostic structure
A categorical-only classification without dimensions
A dimensional and cross-cutting symptom assessment approach (Correct answer)

Correct answer: A dimensional and cross-cutting symptom assessment approach

DSM-5 eliminated the five-axis system and introduced dimensional assessments (e.g., cross-cutting symptom measures) alongside categorical diagnoses.

Question 32: A social worker who uses the family systems model to provide family therapy would not agree with the following:

Boundaries are the main mechanism by which members' individual differences and separate identities are expressed and maintained
None of the above
Treating the "identified patient" will help the entire family to change (Correct answer)
Individual members of a family understand their roles and senses of self worth based on the other family members' behaviors

Correct answer: Treating the "identified patient" will help the entire family to change

The family systems model views the 'identified patient' (the person exhibiting symptoms) as a symptom bearer for underlying family dysfunction, not the sole source of the problem. Therefore, simply treating the identified patient in isolation is not considered sufficient to bring about lasting change in the entire family system. This model emphasizes that change must occur within the family's relational patterns and dynamics.

Question 33: Grace, her nine-year-old daughter, is gravely ill, your new client, who is also quite emotional, tells you. Shortly after Gracie's diagnosis, the client's husband abandoned her and their children. After saying that she is unsure of how to handle Grace's condition and the death of her husband, the client starts to cry. What must you first accomplish?

Discuss the treatment options for Grace
Discuss the client’s additional family support system
Acknowledge the overwhelming feelings of the client (Correct answer)
None of the above

Correct answer: Acknowledge the overwhelming feelings of the client

When a client presents with overwhelming emotions and multiple crises, the immediate priority is to establish rapport and provide emotional support. Acknowledging and validating the client's feelings demonstrates empathy and helps them feel heard and understood, which is crucial for building trust. This initial step creates a safe space for the client to process their emotions before moving on to problem-solving or treatment planning.

Question 34: 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?

Authoritative
Neglecting
Mixed modeling
Indulgent (Correct answer)

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 35: What stage does a child start to cry when a stranger tries to hold them or get close to them, according to John Bowlby's view of attachment theory.

Separation Anxiety Disorder
Learned behavior
Separation anxiety
Stranger anxiety (Correct answer)

Correct answer: Stranger anxiety

According to John Bowlby's attachment theory, stranger anxiety is a normal developmental stage where infants and young children show distress, fear, or wariness when approached by unfamiliar people. This typically emerges around 6-9 months of age and indicates the child's developing ability to differentiate between familiar caregivers and strangers, signifying a secure attachment to their primary caregiver.

Question 36: A social worker suspects a supervisee is impaired due to substance use affecting client care. The supervisor's FIRST obligation is to:

Ignore it unless a client complaint is filed
Terminate the supervisee immediately
Report directly to the licensing board
Address the concern directly with the supervisee and take steps to protect clients (Correct answer)

Correct answer: Address the concern directly with the supervisee and take steps to protect clients

Supervisors must address impairment directly and ensure client safety before formal reporting steps.

Question 37: Which stage of Prochaska and DiClemente's transtheoretical model describes a client who acknowledges a problem but is not yet committed to change?

Preparation
Action
Contemplation (Correct answer)
Precontemplation

Correct answer: Contemplation

In the contemplation stage, individuals recognize the problem and are ambivalent but have not yet committed to taking action.

Question 38: A client informs a social worker that he "can't tolerate it longer," but he doesn't think he can make the necessary changes in his life. He talks to the social worker about what his life would be like if he didn't have his problematic behaviors. Which stage of transformation is the client most likely in?

Preparation
Precontemplation
Contemplation (Correct answer)
Maintenance

Correct answer: Contemplation

In the contemplation stage of change, individuals acknowledge that a problem exists and are actively thinking about making a change, but they are not yet fully committed to taking action. The client's statements about 'not tolerating it longer' and imagining a different life indicate an awareness of the problem and a desire for change, but also a struggle with the commitment to act, which is characteristic of contemplation.

Question 39: A social worker working with a trauma survivor notices strong feelings of protectiveness and anger toward the client's abuser. This MOST likely represents:

Countertransference (Correct answer)
Vicarious liability
Compassion satisfaction
Parallel process

Correct answer: Countertransference

Countertransference refers to the clinician's emotional reactions to a client, which can be triggered by the client's trauma narrative.

Question 40: 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:

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
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

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 41: Which ASWB exam domain does assessment PRIMARILY fall under?

Professional Values and Ethics
Assessment and Intervention Planning (Correct answer)
Human Development, Diversity, and Behavior in the Environment
Psychotherapy, Clinical Supervision, and Advanced Practice

Correct answer: Assessment and Intervention Planning

Assessment and intervention planning is a core domain on the ASWB Masters exam, covering data collection, diagnosis, and treatment planning.

Question 42: A social worker assessing a client with a substance use disorder should use the DSM-5 criteria rather than older terminology because:

DSM-5 eliminates the abuse/dependence distinction and uses a severity specifier based on symptom count (Correct answer)
DSM-5 requires a 90-day sobriety period before diagnosis
DSM-5 uses criminal justice terminology that families prefer
DSM-5 added a biological test requirement for diagnosis

Correct answer: DSM-5 eliminates the abuse/dependence distinction and uses a severity specifier based on symptom count

DSM-5 consolidated abuse and dependence into a single Substance Use Disorder diagnosis with mild, moderate, or severe specifiers based on the number of criteria met.

Question 43: A social worker employed by a nonprofit discovers the executive director is misusing grant funds. According to ethics and the NASW Code, the worker should FIRST:

Discuss the concern with a trusted colleague or supervisor (Correct answer)
Immediately contact the funding agency
Report directly to the state attorney general
Confront the executive director privately about the concern

Correct answer: Discuss the concern with a trusted colleague or supervisor

Consulting a trusted colleague or supervisor first allows the worker to clarify concerns, consider options, and act thoughtfully before escalating, consistent with ethical consultation principles.

Question 44: Erikson's stage of 'Generativity vs. Stagnation' is most associated with which life period?

Young adulthood
Late adulthood
Middle adulthood (Correct answer)
Adolescence

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 45: A school social worker notices that a 10-year-old student frequently arrives unwashed and without lunch. The child denies problems at home. The social worker should:

File a report of suspected neglect with child protective services (Correct answer)
Consult with the school principal before taking any action
Accept the child's account and monitor the situation for two more weeks
Contact the parents to ask them to improve the child's hygiene

Correct answer: File a report of suspected neglect with child protective services

Observable signs of neglect (poor hygiene, inadequate food) meet the threshold for a mandated report regardless of the child's denial.

Question 46: Describe a gene.

the only factor that determines differences between people
the physical environment that influences development
the process that changes the brain
inherited segment of DNA that encodes a trait (Correct answer)

Correct answer: inherited segment of DNA that encodes a trait

A gene is the fundamental unit of heredity, consisting of a specific segment of DNA (or RNA in some viruses) that carries genetic information. These inherited segments of DNA contain the instructions for building proteins or functional RNA molecules, which in turn determine specific traits or characteristics passed from parents to offspring.

Question 47: A client with borderline personality disorder frequently calls the crisis line between sessions and threatens self-harm when the social worker sets limits. This pattern BEST illustrates:

Passive-aggressive behavior
Splitting and emotional dysregulation (Correct answer)
Antisocial manipulation
Malingering for secondary gain

Correct answer: Splitting and emotional dysregulation

Splitting and emotional dysregulation are hallmark features of BPD, driving intense reactions to perceived abandonment or limit-setting.

Question 48: The following are all potential triggers for violence, EXCEPT:

Affiliation with violent peers
Mental illness (Correct answer)
Violence before age 13
Other risky behaviors

Correct answer: Mental illness

While mental illness can be a factor in a very small percentage of violent acts, it is not a direct trigger for violence in the vast majority of cases, and most people with mental illness are not violent. Attributing violence primarily to mental illness is a harmful stereotype. In contrast, affiliation with violent peers, engaging in other risky behaviors, and a history of violence (especially at an early age) are well-established risk factors and potential triggers for violent behavior.

Question 49: After four weeks of therapy, a social worker with a client isn't seeing any improvement. What might a social worker possibly do?

schedule a case consultation (Correct answer)
confront the client about their lack of motivation
refer the client to another social worker
continue with treatment, it's too early for progress to occur

Correct answer: schedule a case consultation

When a social worker isn't seeing improvement after a reasonable period (like four weeks), it's best practice to seek a case consultation. This allows for an objective review of the case by another professional, offering fresh perspectives, identifying potential blind spots, and suggesting alternative strategies or interventions. It ensures the client receives the most effective care and supports the social worker's professional development.

Question 50: During a meeting, a social worker requests that a mother and son take turns playing different roles. Most likely, this method is being applied to

Assist them with understanding their own feelings about the other person (Correct answer)
Educate them about the challenges faced by the other person
Explore communication styles when interacting with others
Develop coping strategies that can be used if conflicts arise in the future

Correct answer: Assist them with understanding their own feelings about the other person

Role-playing, particularly role reversal, is a therapeutic technique designed to help individuals step into another person's shoes. By taking on the role of the other, the mother and son can gain a deeper understanding of each other's perspectives, experiences, and, most importantly, their emotional responses and feelings. This process fosters empathy and can lead to greater insight into their own feelings within the relationship.

Question 51: exaggerating health symptoms in order to gain sympathy or play the "sick role"

Factitious disorder (Correct answer)
Conversion disorder
Illness anxiety disorder
Somatic symptom disorder

Correct answer: Factitious disorder

Factitious disorder is characterized by intentionally feigning or exaggerating physical or psychological symptoms to assume the 'sick role' and gain attention, sympathy, or care. The primary motivation is internal, stemming from a psychological need to be seen as ill, rather than external incentives like financial gain or avoiding responsibilities (which would be malingering). This distinguishes it from somatic symptom disorder (where symptoms are genuinely experienced but cause excessive distress) and illness anxiety disorder (preoccupation with having a serious illness despite minimal symptoms).

Question 52: Which stage of Kübler-Ross's model involves clients making deals or promises in hopes of reversing a loss?

Bargaining (Correct answer)
Depression
Denial
Anger

Correct answer: Bargaining

Bargaining is the stage where individuals attempt to negotiate to postpone or undo a loss, often with a higher power or healthcare providers.

Question 53: Which of the five levels of Maslow's hierarchy of needs allows a person to discover their actual purpose, cope with the world "as it is," and get a glimpse of what it means to be whole?

Physiological needs
Self-actualization (Correct answer)
Safety needs
Esteem needs

Correct answer: Self-actualization

Self-actualization is the highest level in Maslow's hierarchy of needs, representing the realization of one's full potential and the desire to become the most one can be. Individuals at this stage are often characterized by creativity, problem-solving, acceptance of facts, and a deep sense of purpose, striving for personal growth and peak experiences. It involves coping with reality and achieving wholeness.

Question 54: The social work value of 'social justice' is most directly operationalized when a BSW:

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

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 55: When a social worker is evaluating a client who has mental difficulties, how can they distinguish between delusions and hallucinations?

Delusions and Hallucinations share the same concepts.
Delusions are fixed beliefs, while hallucinations consist of loose beliefs or half-truths.
Delusions are based on visual misconceptions of one's past, while hallucinations are based on visual misconceptions of one's present.
Delusions are false, fixed beliefs despite evidence to the contrary, while hallucinations are hearing, seeing, smelling, or feeling something that is not real. (Correct answer)

Correct answer: Delusions are false, fixed beliefs despite evidence to the contrary, while hallucinations are hearing, seeing, smelling, or feeling something that is not real.

Delusions are false, fixed beliefs that are firmly held despite clear evidence to the contrary and are not shared by others in the individual's culture. Hallucinations, on the other hand, are sensory experiences (seeing, hearing, smelling, tasting, or feeling) that occur in the absence of an external stimulus. The key distinction is that delusions are thought disturbances (beliefs), while hallucinations are perceptual disturbances (sensory experiences).

Question 56: In family therapy, the concept of 'triangulation' refers to:

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

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 57: People's capacity to handle challenging circumstances and overcome challenges is referred to as:

all of the above
anger
frustration tolerance (Correct answer)
conflict

Correct answer: frustration tolerance

Frustration tolerance is an individual's capacity to withstand or delay gratification when faced with obstacles, difficulties, or unmet desires without becoming excessively distressed or giving up. It is a crucial component of resilience, enabling individuals to persist through challenging circumstances and manage their emotional responses effectively to overcome challenges.

Question 58: A BSW is asked to provide a written report about a client to the court. Before doing so, the worker should FIRST:

Consult with colleagues about what to include in the report
Summarize only positive information to protect the client
Check with the agency director about what the court wants to hear
Obtain the client's informed written consent or a valid court order (Correct answer)

Correct answer: Obtain the client's informed written consent or a valid court order

Disclosing client information requires either informed consent from the client or a legally valid court order to comply with confidentiality and HIPAA requirements.

Question 59: Erikson's stage of 'Intimacy vs. Isolation' is associated with which life period?

Middle adulthood
Early adulthood (Correct answer)
Adolescence
Late adulthood

Correct answer: Early adulthood

Erikson placed the Intimacy vs. Isolation stage in early adulthood, roughly ages 18–40, when individuals seek deep relationships.

Question 60: Social connection lengthens lifelong selection processes, and conversing with family members as opposed to friends enhances the likelihood that elderly people's emotional stability will be maintained.

face validity
construct validity (Correct answer)
content validity
criterion validity

Correct answer: construct validity

Construct validity refers to the degree to which a test or instrument accurately measures the theoretical construct it is intended to measure. The statement describes a complex theoretical relationship between abstract concepts like 'social connection,' 'lifelong selection processes,' and 'emotional stability' in elderly people. If a research study were to investigate these relationships, it would need to ensure its measures accurately reflect these underlying theoretical constructs, thus relating to construct validity.

Question 61: Which of the following BEST describes the purpose of an eco-map in social work assessment?

Mapping a client's family history across three generations
Identifying the quality and nature of relationships between a client and their social environment (Correct answer)
Assessing a client's eligibility for community resources
Tracking the client's progress toward treatment goals

Correct answer: Identifying the quality and nature of relationships between a client and their social environment

An eco-map visually represents a client's connections and the quality of relationships with systems in their environment.

Question 62: A client with schizophrenia reports that their neighbor is controlling their thoughts through the television. This belief is BEST described as:

Thought disorganization
A grandiose delusion
A delusion of reference (Correct answer)
An auditory hallucination

Correct answer: A delusion of reference

A delusion of reference involves the false belief that neutral environmental stimuli have special personal significance.

Question 63: Which of the following BEST describes the concept of 'dual relationship' in social work practice?

Having two clients in the same family system
A worker who holds both clinical and administrative roles
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)

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 64: A client diagnosed with Borderline Personality Disorder tells the social worker, 'You are the only one who truly understands me — my last therapist was completely useless.' The social worker recognizes this as:

Idealization, a hallmark feature of splitting (Correct answer)
Transference based on attachment to a parental figure
An accurate reflection of the therapeutic alliance
Evidence that the previous therapist was clinically incompetent

Correct answer: Idealization, a hallmark feature of splitting

Splitting involves seeing others as all-good or all-bad; idealizing the current therapist while devaluing the previous one is a classic presentation.

Question 65: When does a client express opposition to a strategy of intervention?

throughout the intervention but it is very rare
at the beginning of an intervention plan
at the end of an intervention plan
any time during an intervention (Correct answer)

Correct answer: any time during an intervention

Client resistance or opposition to an intervention strategy is not confined to a specific phase; it can manifest at any point during the therapeutic process. Clients might express hesitation at the beginning, encounter difficulties and push back during the intervention, or even show reluctance towards the end. A skilled practitioner must be prepared to address resistance flexibly throughout the entire intervention.

Question 66: Which legal concept grants a social worker the authority to hospitalize a client involuntarily when the client poses an imminent danger to self or others?

Parens patriae and police power doctrines (Correct answer)
Duty to warn
Informed consent waiver
Advance directive

Correct answer: Parens patriae and police power doctrines

Involuntary hospitalization is legally grounded in parens patriae (state as protector) and police power (public safety), justifying restriction of liberty.

Question 67: Which of the following is a key indicator that a therapeutic relationship may have crossed into a professional boundary violation?

The clinician adjusts the fee based on the client's financial situation
The clinician uses self-disclosure to normalize a client's experience
The clinician extends a session by five minutes to complete a thought
The clinician accepts gifts, shares personal contact information, or engages in social contact with the client (Correct answer)

Correct answer: The clinician accepts gifts, shares personal contact information, or engages in social contact with the client

Accepting gifts, personal contact outside sessions, and social contact are classic boundary violations that compromise the professional relationship.

Question 68: In program evaluation, formative evaluation is conducted primarily to:

Justify budget cuts to a program
Compare results to a national benchmark
Inform improvements during program implementation (Correct answer)
Measure final program outcomes after completion

Correct answer: Inform improvements during program implementation

Formative evaluation is ongoing and conducted during program implementation to provide feedback that helps improve the program as it runs.

Question 69: A BSW working in a school setting notices a student has unexplained bruises and seems fearful. The FIRST action should be to:

Consult with a supervisor before taking any action
Speak with the student privately to gather more information
File a report with child protective services (Correct answer)
Call the student's parents to discuss the concern

Correct answer: File a report with child protective services

Social workers are mandated reporters and must report reasonable suspicion of child abuse to child protective services without delay.

Question 70: During an intake, a client discloses active suicidal ideation with a plan and access to means. The social worker should FIRST:

Notify the client's family without the client's consent
Ensure immediate safety and arrange for the highest appropriate level of care (Correct answer)
Schedule a follow-up appointment for the next week
Conduct a no-suicide contract and continue outpatient care

Correct answer: Ensure immediate safety and arrange for the highest appropriate level of care

Active suicidal ideation with plan and means requires immediate safety intervention and likely hospitalization.

Question 71: The MOST suitable design for this kind of clinical practice environment is a single topic design:

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

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 72: A social worker is completing an intake with a Spanish-speaking client who has limited English proficiency. The client's bilingual adult child offers to interpret. What is the BEST response?

Accept the offer to save time and build rapport
Arrange for a qualified professional interpreter (Correct answer)
Use the child as an interpreter only for non-sensitive topics
Conduct the session in English with written translations

Correct answer: Arrange for a qualified professional interpreter

Professional interpreters ensure accuracy and confidentiality; using family members can compromise both and create ethical concerns.

Question 73: 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:

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

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 74: A stuttering client has turned into a blogger and author. Which defense mechanism from the list below is the client employing?

Projection
Identification
Compensation (Correct answer)
Displacement

Correct answer: Compensation

Compensation is a defense mechanism where an individual unconsciously attempts to make up for perceived deficiencies or weaknesses by excelling in another area. In this scenario, the client, who struggled with verbal communication (stuttering), compensates by achieving success and recognition through written communication as a blogger and author. This allows them to overcome a perceived limitation by focusing on an alternative strength.

Question 75: Which attachment style is characterized by a child who shows distress when a caregiver leaves but is not easily comforted upon return?

Avoidant attachment
Anxious-ambivalent attachment (Correct answer)
Disorganized attachment
Secure 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 76: What the caregiver learns from the patient's symptoms (like an MD on an interesting case)

secondary gain
tertiary gain (Correct answer)
no gain
primary gain

Correct answer: tertiary gain

Tertiary gain refers to the benefits that someone *other than* the patient receives from the patient's illness or symptoms. This can include a caregiver gaining attention, sympathy, or even professional satisfaction and knowledge, such as a doctor learning from an interesting or complex case. It is distinct from primary gain (internal psychological benefits for the patient) and secondary gain (external benefits for the patient).

Question 77: What is another phrase for "steady state" in the systems theory?

Differentiation
Input
Open system
Homeostasis (Correct answer)

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 78: Which of the following best describes the principle of 'least restrictive environment' in social work practice?

Interventions should use the minimum level of restriction necessary to meet the client's needs (Correct answer)
Clients should always be treated in outpatient rather than inpatient settings
Minors must be placed with family before entering foster care
Social workers should avoid using involuntary commitment at all times

Correct answer: Interventions should use the minimum level of restriction necessary to meet the client's needs

The least restrictive environment principle holds that services should be provided in the setting that maximizes client freedom while still meeting their care needs.

Question 79: A mother visits a social worker because she is worried about her child's cognitive development. The child performs academically far worse than her peers. This youngster is recommended by a social worker for diagnostic testing. Which of the following evaluations will the child most likely receive in light of the mother's worries?

The Thematic Apperception Test
The Minnesota Multiphasic Personality Inventory
The Wechsler Intelligence Scale (Correct answer)
The Myer-Briggs Type Indicator

Correct answer: The Wechsler Intelligence Scale

The Wechsler Intelligence Scale (e.g., WISC for children) is a widely recognized and standardized assessment tool used to evaluate cognitive abilities and intellectual functioning. Given the mother's concerns about her child's academic performance and cognitive development, this evaluation would be the most appropriate to assess the child's intellectual strengths and weaknesses.

Question 80: School social worker Christine works there. Teenager Dawn, one of her customers, excels in the classroom, earning perfect grades and participating in a wide range of extracurricular activities. Christine is informed by Dawn that she does not feel good about herself, frequently considers death, and has problems falling asleep. Which traditional parenting approach has Dawn's parents most likely used?

Uninvolved
Permissive
Authoritarian (Correct answer)
Authoritative

Correct answer: Authoritarian

Authoritarian parenting is characterized by high demands, strict rules, and low responsiveness, often prioritizing obedience over emotional needs. While children from such homes may achieve academic success due to pressure, they often struggle with self-esteem, anxiety, and depression, aligning with Dawn's internal distress despite her external achievements. This style can lead to a disconnect between outward success and inner well-being.

Question 81: In motivational interviewing, the concept of 'rolling with resistance' means the BSW should:

Confront the client directly about their denial
Agree with the client that change is unnecessary
Avoid arguing and instead reflect the client's ambivalence back to them (Correct answer)
Refer the client to a more experienced clinician

Correct answer: Avoid arguing and instead reflect the client's ambivalence back to them

Rolling with resistance means the worker avoids arguing and instead reflects and explores the client's ambivalence, reducing defensiveness and promoting engagement.

Question 82: A social worker suspects a child client is being sexually abused but the child denies it. The MOST appropriate next step is to:

Confront the suspected abuser directly
Obtain written consent from the parent before reporting
File a mandated report based on reasonable suspicion (Correct answer)
Accept the child's denial and close the case

Correct answer: File a mandated report based on reasonable suspicion

Mandated reporters must report reasonable suspicion of abuse; a child's denial does not override the legal and ethical duty to report.

Question 83: 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?

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

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 84: 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?

Normal bereavement (Correct answer)
Anticipatory grief
Complicated grief
Disenfranchised 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 85: Positive reinforcement differs from negative reinforcement in that positive reinforcement:

Increases behavior by removing an unpleasant stimulus
Increases behavior by adding a desirable stimulus (Correct answer)
Decreases behavior by removing a pleasant stimulus
Decreases behavior by adding an aversive stimulus

Correct answer: Increases behavior by adding a desirable stimulus

Positive reinforcement strengthens a behavior by following it with the addition of a rewarding or pleasant stimulus.

Question 86: In ecosystems theory, the term 'goodness of fit' refers to:

The compatibility between a person's needs and the resources in their environment (Correct answer)
A client's ability to adapt to treatment modalities
How well a client's culture aligns with agency services
The match between a social worker's skills and a client's presenting problem

Correct answer: The compatibility between a person's needs and the resources in their environment

Goodness of fit describes the degree to which an individual's needs, capacities, and goals are matched by the environment's qualities and resources.

Question 87: A social worker notices a client has unexplained bruises during a home visit. The client is a 9-year-old child. What is the social worker's FIRST priority?

Document observations and report to child protective services (Correct answer)
Call the child's pediatrician for medical advice
Ask the child's parent about the bruises
Schedule a follow-up visit to monitor the situation

Correct answer: Document observations and report to child protective services

Suspected child abuse mandates immediate reporting to child protective services before taking any other action.

Question 88: The ecological perspective in social work is BEST described as:

Examining the fit between people and their environments across multiple systems (Correct answer)
Applying biological principles to understand human development
Focusing exclusively on environmental policy advocacy
Prioritizing community-level interventions over individual work

Correct answer: Examining the fit between people and their environments across multiple systems

The ecological perspective examines how people interact with and adapt to their environments across micro, mezzo, and macro system levels.

Question 89: In cognitive behavioral therapy, the term 'cognitive distortion' refers to:

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

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 90: A social worker is providing case management for an elderly client who refuses home health aide services despite significant functional decline. Which principle should guide the social worker's approach?

Paternalism, because the client lacks insight into their own needs
Beneficence, because the social worker must act in the client's best interest
Justice, because resources should be allocated to those who will accept them
Self-determination, because competent adults have the right to refuse services (Correct answer)

Correct answer: Self-determination, because competent adults have the right to refuse services

Competent adults retain the right to make decisions about their own care, even decisions the social worker believes are unwise.

Question 91: A social worker receives a subpoena for a client's therapy records. The BEST course of action is to:

Release only a summary of the records rather than the full file
Notify the client and consult with an attorney before releasing any records (Correct answer)
Immediately release the records to comply with the legal order
Destroy the records to protect the client's confidentiality

Correct answer: Notify the client and consult with an attorney before releasing any records

Upon receiving a subpoena, the social worker must notify the client and consult legal counsel; a subpoena does not automatically waive privilege.

Question 92: A social worker documents that a client is 'oriented x3.' This means the client correctly identified:

Person, place, and time (Correct answer)
Immediate, recent, and remote memory
Current mood, affect, and thought content
Their name, address, and date of birth

Correct answer: Person, place, and time

Being oriented x3 means the client accurately identifies person, place, and time during the mental status examination.

Question 93: A social worker notes that a client consistently shifts to unrelated topics before completing a thought, making the conversation hard to follow. This thought process is BEST described as:

Circumstantial thinking
Flight of ideas
Tangential thinking (Correct answer)
Thought blocking

Correct answer: Tangential thinking

Tangential thinking is characterized by responses that veer off to unrelated subjects, never returning to the original point, unlike circumstantial thinking which eventually returns.

Question 94: It is known as the tendency for informal group rules and practices to emerge and regulate how the group functions.

group coalitions
groupthink
group dynamics (Correct answer)
none of the above

Correct answer: group dynamics

Group dynamics refers to the complex interactive processes and relationships that occur within a group. This includes the emergence of informal rules, roles, communication patterns, and power structures that collectively influence how the group functions, interacts, and achieves its goals. It encompasses the forces that operate within a group, shaping its behavior and outcomes.

Question 95: Under HIPAA, which of the following does NOT require a written authorization from a client to disclose protected health information?

Sharing records with a client's employer for background checks
Releasing records for marketing purposes
Disclosing records to another treating provider for treatment purposes (Correct answer)
Sending records to a life insurance company

Correct answer: Disclosing records to another treating provider for treatment purposes

HIPAA's treatment exception allows disclosure of PHI to other health care providers involved in the client's treatment without written authorization.

Question 96: Your cultural background is based on everything below, with the exception of?

where you were born
when you were born
how you were born (Correct answer)
how you were raised

Correct answer: how you were born

Cultural background is shaped by shared experiences, values, beliefs, and practices learned within a community. Factors like upbringing ('how you were raised'), geographical origin ('where you were born'), and historical context ('when you were born') significantly influence this. 'How you were born' refers to the biological process of birth itself, which does not contribute to one's cultural identity.

Question 97: 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 98: The concept of 'unconditional positive regard,' central to person-centered therapy, means the worker:

Focuses exclusively on the client's positive behaviors
Avoids giving the client any constructive feedback
Accepts the client as a person without conditions or judgment (Correct answer)
Agrees with everything the client says to build rapport

Correct answer: Accepts the client as a person without conditions or judgment

Carl Rogers defined unconditional positive regard as accepting the client's worth as a person regardless of their behaviors or attitudes.

Question 99: A client who survived a car accident six months ago continues to experience nightmares, hypervigilance, and emotional numbing. The MOST likely diagnosis is:

Adjustment disorder with anxious mood
Acute stress disorder
Generalized anxiety disorder
Post-traumatic stress disorder (Correct answer)

Correct answer: Post-traumatic stress disorder

PTSD requires symptoms lasting more than one month following a traumatic event; at six months, this diagnosis is most appropriate.

Question 100: A client from a collectivist cultural background defers all treatment decisions to their family. A culturally competent social worker would:

Document that the client lacks decision-making capacity
Explore the client's values and incorporate family involvement if the client consents (Correct answer)
Exclude the family from all sessions to maintain confidentiality
Insist the client make all decisions independently to build autonomy

Correct answer: Explore the client's values and incorporate family involvement if the client consents

Culturally competent practice respects collectivist values and incorporates family involvement with client consent.

Question 101: Which defense mechanism is illustrated when a person who is angry at their boss comes home and yells at their spouse?

Displacement (Correct answer)
Sublimation
Rationalization
Projection

Correct answer: Displacement

Displacement involves redirecting emotions from the original target to a safer substitute, as seen when anger toward a boss is vented on a spouse.

Question 102: A social worker is using narrative therapy with a client who feels defined by their anxiety disorder. The technique of 'externalizing the problem' involves:

Separating the client's identity from the problem so the problem can be examined as distinct from the person (Correct answer)
Identifying environmental stressors that trigger the client's anxiety
Helping the client blame external circumstances for their anxiety
Encouraging the client to express anxious feelings outwardly rather than suppressing them

Correct answer: Separating the client's identity from the problem so the problem can be examined as distinct from the person

Externalization is a core narrative technique that positions the problem as separate from the person — 'the anxiety' rather than 'I am anxious' — creating space for agency.

Question 103: 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?

Precontemplation
Action
Preparation
Contemplation (Correct answer)

Correct answer: Contemplation

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

Question 104: Piaget's stage of 'formal operations' is characterized by:

Symbolic thinking and egocentrism
Abstract reasoning and hypothetical thinking (Correct answer)
Object permanence and sensorimotor exploration
Logical thinking applied to concrete objects

Correct answer: Abstract reasoning and hypothetical thinking

Formal operations (ages 12+) is Piaget's final stage, marked by the ability to think abstractly, reason hypothetically, and use deductive logic.

Question 105: You are assisting a family who has trouble getting along and spending quality time together. The father works too much and spends his free time working or playing golf rather than with his family. The mother feels abandoned by her husband because she is left with little choice but to take care of the kids herself. The kids ponder why their father is absent so frequently and never shows up for any of their performances or sporting events. This family's dynamic is BEST characterized as:

competitive
uninvolved (Correct answer)
communal
none of the above

Correct answer: uninvolved

This family dynamic describes a father who is largely absent and disengaged from family life and responsibilities, leaving the mother feeling burdened and the children feeling neglected. This pattern aligns with an 'uninvolved' or neglectful parenting style and family dynamic, characterized by a lack of emotional support, responsiveness, and active participation from one or more family members.

Question 106: When a social worker documents that a client's affect was 'constricted,' this means:

The client's reported emotion did not match visible expression
The client was crying throughout the session
The client showed rapidly shifting emotional states
The client's emotional expression was reduced in range but not entirely absent (Correct answer)

Correct answer: The client's emotional expression was reduced in range but not entirely absent

Constricted affect refers to a narrowed range of emotional expression — less than the typical range but not the complete absence seen in flat affect.

Question 107: What distinguishes private social agencies from public welfare programs?

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
for public welfare, only financial assistance can be offered

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 108: A client reports hearing voices telling him he is worthless. This symptom is BEST classified as:

Disorganized thinking
A delusion of grandeur
An auditory hallucination (Correct answer)
A visual hallucination

Correct answer: An auditory hallucination

Hearing voices that are not externally present is an auditory hallucination, a common positive symptom of psychotic disorders.

Question 109: A social worker is planning to terminate services with a client who has met treatment goals. What is the MOST important aspect of planned termination?

Conducting a final formal assessment using standardized tools
Referring the client to another provider immediately
Ending sessions abruptly to avoid dependency
Reviewing progress, processing the client's feelings, and planning for the future (Correct answer)

Correct answer: Reviewing progress, processing the client's feelings, and planning for the future

Planned termination should include a review of progress, acknowledgment of the therapeutic relationship, processing of emotions, and a relapse prevention or maintenance plan.

Question 110: Asking the customer what would be different if the problem didn't exist is known as the "miracle question."

False
True (Correct answer)

Correct answer: True

The 'miracle question' is a foundational technique in Solution-Focused Brief Therapy (SFBT). It encourages clients to envision a future where their problem has miraculously disappeared, helping them identify desired outcomes, strengths, and initial steps toward positive change. This question shifts the focus from dwelling on problems to exploring potential solutions and possibilities.

Question 111: Which of the following best describes the 'working phase' of a therapeutic group?

Members test boundaries and vie for leadership roles
Members engage in deep self-disclosure and mutual problem-solving (Correct answer)
Members summarize gains and prepare for termination
Members experience anxiety and resistance to participation

Correct answer: Members engage in deep self-disclosure and mutual problem-solving

The working phase is characterized by cohesion, trust, and members actively engaging in meaningful self-disclosure and helping one another.

Question 112: Which of the following is NOT a method that senior citizens can employ to prevent a halt in their cognitive development?

Completing crossword and Sudoku puzzles
Taking classes
Sleeping more (Correct answer)
Physical exercise

Correct answer: Sleeping more

While adequate sleep is vital for overall health and cognitive function, simply 'sleeping more' is not a direct method to actively prevent a halt in cognitive development. Engaging in mentally stimulating activities like puzzles and classes, and maintaining physical exercise, are known strategies that actively promote cognitive function and neuroplasticity in older adults. Excessive sleep, beyond healthy requirements, does not inherently stimulate cognitive growth.

Question 113: In solution-focused brief therapy (SFBT), the 'miracle question' is primarily used to:

Identify past trauma triggers
Explore a client's preferred future without the problem (Correct answer)
Assess suicidal ideation
Assign cognitive restructuring homework

Correct answer: Explore a client's preferred future without the problem

The miracle question invites clients to imagine life as they want it, helping therapist and client co-construct goal-directed solutions.

Question 114: The NASW Code of Ethics identifies the primary obligation of social workers as being to:

Society and the broader good
Their professional colleagues
Their clients (Correct answer)
Their employing agency

Correct answer: Their clients

The NASW Code of Ethics states that the social worker's primary obligation is to the client's wellbeing and interests.

Question 115: A client with a history of trauma becomes suddenly silent and appears detached during a session. This response is MOST consistent with:

Psychosis
Dissociation (Correct answer)
Malingering
Resistance

Correct answer: Dissociation

Dissociation during trauma processing is a common protective response where the client mentally detaches from distressing material.

Question 116: A social worker who accepts expensive gifts from grateful clients is violating which ethical principle?

Informed consent
Fidelity
Boundary maintenance and conflict of interest (Correct answer)
Social justice

Correct answer: Boundary maintenance and conflict of interest

Accepting significant gifts creates a conflict of interest and blurs professional boundaries, violating NASW standards on dual relationships and conflicts of interest.

Question 117: During a crisis intervention, the social worker's PRIMARY goal is to:

Diagnose the underlying mental health disorder
Restore the client to at least their pre-crisis level of functioning (Correct answer)
Identify long-term treatment goals
Refer the client to inpatient psychiatric services

Correct answer: Restore the client to at least their pre-crisis level of functioning

Crisis intervention focuses on stabilization and restoring the individual to their baseline level of functioning, not on long-term treatment or diagnosis.

Question 118: A social worker is conducting a suicide risk assessment. Which factor would be considered MOST indicative of HIGH lethality?

History of a previous high-lethality attempt (Correct answer)
Fleeting thoughts of death without intent
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 119: A social worker notices feeling overly protective of a young client who reminds her of her own child. This reaction is an example of:

Sublimation
Transference
Projection
Countertransference (Correct answer)

Correct answer: Countertransference

Countertransference occurs when the clinician's own unresolved issues or personal reactions are evoked by and directed toward the client.

Question 120: Which of the following is an example of a macro-level social work intervention?

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)
Facilitating a support group for survivors of domestic violence

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 121: Which of the following BEST exemplifies a protective factor in a risk assessment?

History of prior psychiatric hospitalizations
Strong social support network and reasons for living (Correct answer)
Recent significant loss
Access to lethal means

Correct answer: Strong social support network and reasons for living

Protective factors such as strong social support and reasons for living reduce risk and buffer against suicidal behavior.

Question 122: You often take the same bus as a mother who appears to be carrying her child to school while you commute to work every day in a big city. You have seen her act in ways toward the child during the rides that you believe to be abusive (threatening to hit the child if he misbehaves, turning the child's head toward her by pulling his hair, pinching him), and you have also, less frequently, seen her drag the child off the bus by lifting him up by one arm. Which of the following best describes your position as a required reporter?

You are mandated to report your suspicions of abuse in some jurisdictions, even though the report is derived from casual observations outside of your work-related professional role. (Correct answer)
You are not legally liable for making a report under these circumstances, and any decision regarding how to proceed would be a personal one on your part.
Your role as a mandated reporter would never extend to the situation described. However, your ethical obligation to the profession of social work would indicate that you should approach the woman and offer information/assistance.
None of the above

Correct answer: You are mandated to report your suspicions of abuse in some jurisdictions, even though the report is derived from casual observations outside of your work-related professional role.

Mandated reporter laws vary by jurisdiction, but in many places, the obligation to report suspected child abuse or neglect applies to designated professionals, such as social workers, regardless of whether the observation occurs within or outside of their professional role. The critical factor is the professional's status as a mandated reporter, meaning the duty to report extends beyond the confines of their workplace.

Question 123: 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?

Precontemplation
Preparation
Action
Contemplation (Correct answer)

Correct answer: Contemplation

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

Question 124: When someone is told repeatedly that "everything will be okay," you can anticipate the following response:

have a great confidence in your ability to help
be indifferent
doubt the person's ability to help and understand their problem (Correct answer)
be cautiously optimistic

Correct answer: doubt the person's ability to help and understand their problem

When a client confides about a spouse's substance misuse and potential job loss, the social worker's primary step is to conduct a thorough assessment of the situation's impact on the couple and family. Option B, 'figure out if the couple needs additional casework services,' allows the social worker to understand the full scope of the problem, including the client's safety, the husband's willingness to seek help, and the family's resources, before recommending specific interventions like AA or couples counseling. Prematurely suggesting solutions without a full assessment can be ineffective.

Question 125: A recent client self-reports to you that she has been using cocaine frequently for a number of years. What should you do first, exactly?

Gather as much information from her as you can (Correct answer)
Push for additional family support
Recommend inpatient treatment
Diagnose her

Correct answer: Gather as much information from her as you can

In any initial assessment, especially with complex issues like substance abuse, the first and most crucial step is to gather comprehensive information from the client. This involves understanding the history, frequency, impact, and the client's perspective on their cocaine use, as well as other relevant life circumstances. This thorough information gathering is essential for accurate diagnosis, developing an appropriate treatment plan, and building a trusting therapeutic relationship.

Question 126: 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?

Clarification
Reframing and relabeling
Interpretation (Correct answer)
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 127: What is the best course of action if you are meeting with a client for the first time and they seem hesitant?

allowing the client to share their thoughts and feelings while emphasizing that relationships are built with time and effort (Correct answer)
set firm rules for the client to help them feel more comfortable
have the client agree with you so no conflict happens
give the client your personal background and accomplishments to establish some trust

Correct answer: allowing the client to share their thoughts and feelings while emphasizing that relationships are built with time and effort

When a client is hesitant during a first meeting, the primary goal is to build rapport and trust. Allowing them to share at their own pace and acknowledging that relationships take time validates their feelings and reduces pressure. This approach fosters a safe and non-judgmental environment, encouraging the client to gradually open up and engage in the therapeutic process.

Question 128: A social worker notices a pattern of countertransference toward a particular client. The BEST response is to:

Transfer the client to a colleague immediately
Disclose the feelings to the client to maintain transparency
Increase session frequency to resolve the dynamic faster
Seek clinical supervision to examine the reaction (Correct answer)

Correct answer: Seek clinical supervision to examine the reaction

Clinical supervision is the appropriate professional response when a social worker identifies countertransference, allowing exploration without harming the therapeutic relationship.

Question 129: A social worker who discloses personal information to normalize a client's experience is using:

Interpretation
Self-disclosure (Correct answer)
Confrontation
Countertransference

Correct answer: Self-disclosure

Therapeutic self-disclosure involves the clinician intentionally sharing personal information to benefit the client's therapeutic process.

Question 130: A client presents with impulsivity, unstable relationships, chronic feelings of emptiness, and fear of abandonment. These features are MOST consistent with which personality disorder?

Histrionic personality disorder
Antisocial personality disorder
Narcissistic personality disorder
Borderline personality disorder (Correct answer)

Correct answer: Borderline personality disorder

Borderline personality disorder is characterized by instability in relationships, self-image, and affect, along with marked impulsivity and fear of abandonment.

Question 131: In Rothman's model of community organization, which approach focuses on self-help and building community capacity through broad participation?

Program development
Locality development (Correct answer)
Social planning
Social action

Correct answer: Locality development

Locality development (also called community development) emphasizes self-help, democratic participation, and building the capacity of community members to solve their own problems.

Question 132: Typically, prazosin is prescribed to treat:

Anorexia nervosa
Posttraumatic stress disorder (PTSD) (Correct answer)
Major depressive disorder
Bipolar disorder

Correct answer: Posttraumatic stress disorder (PTSD)

Prazosin is an alpha-1 adrenergic antagonist that is commonly prescribed off-label to treat nightmares and sleep disturbances associated with Posttraumatic Stress Disorder (PTSD). It works by reducing the physiological hyperarousal that contributes to these distressing symptoms, making it a valuable medication for managing specific aspects of PTSD.

Question 133: During termination of a long-term therapeutic relationship, a client gives the social worker an expensive gift. The MOST appropriate response is to:

Accept the gift but document it in the clinical record
Decline the gift and explore its meaning with the client therapeutically (Correct answer)
Immediately refer the client to another provider due to the boundary violation
Accept the gift to avoid hurting the client's feelings at a vulnerable time

Correct answer: Decline the gift and explore its meaning with the client therapeutically

Social workers should decline gifts that could compromise objectivity and use the opportunity to explore the gift's meaning as clinically meaningful material.

Question 134: A social worker suspects a client may have an intellectual disability. Which domain of functioning is ESSENTIAL to assess per DSM-5 criteria?

Sensory processing only
Academic achievement exclusively
Personality traits
Intellectual and adaptive functioning (Correct answer)

Correct answer: Intellectual and adaptive functioning

DSM-5 requires deficits in both intellectual functioning (reasoning, problem-solving) and adaptive functioning (daily life skills) for an intellectual disability diagnosis.

Question 135: In generalist social work practice, the term 'mezzo-level' intervention refers to:

Therapy and clinical treatment approaches
Work with individual clients and their immediate family members
National policy advocacy and legislative change
Work with organizations, groups, and communities (Correct answer)

Correct answer: Work with organizations, groups, and communities

Mezzo-level practice involves work with small groups, organizations, and communities, sitting between micro (individual) and macro (societal) levels.

Question 136: An advanced generalist social worker is writing a grant proposal. Which element is MOST critical to include to demonstrate program feasibility?

A list of competitor agencies
A logic model linking inputs, activities, outputs, and outcomes (Correct answer)
A detailed description of staff salaries
A biography of the agency's founder

Correct answer: A logic model linking inputs, activities, outputs, and outcomes

A logic model demonstrates the clear, evidence-based connection between resources, planned activities, and expected outcomes, which is central to establishing program feasibility for funders.

Question 137: Which of the following best describes 'informed consent' in social work practice?

Providing clients with sufficient information about services, risks, and alternatives so they can make voluntary, knowledgeable decisions (Correct answer)
Ensuring the client understands the social worker's professional credentials
Obtaining a client's signature on an intake form before services begin
Getting court authorization to provide services to an involuntary client

Correct answer: Providing clients with sufficient information about services, risks, and alternatives so they can make voluntary, knowledgeable decisions

Informed consent requires that clients receive complete information about services, voluntarily agree without coercion, and have the capacity to make decisions.

Question 138: You've been seeing a patient for a while who has been complaining about having a bad headache. What should we do next?

bring up the possibility of psychiatric testing
refer the client to a neurologist (Correct answer)
offer pain medication
change the way you are treating the patient

Correct answer: refer the client to a neurologist

Persistent and unexplained physical symptoms like a bad headache require medical evaluation to rule out underlying physiological causes. Social workers are not medical professionals, so it is outside their scope of practice to diagnose or treat such conditions. Referring the client to a neurologist ensures they receive appropriate specialized medical assessment and care for their physical health concern.

Question 139: A BSW is working with a family in which the parents use physical discipline. This practice is legal in their state. The social worker should FIRST:

Report the family to child protective services
Explore the family's beliefs about discipline and provide psychoeducation about alternatives (Correct answer)
Accept the practice without comment since it is legal
Recommend family therapy with a licensed clinician

Correct answer: Explore the family's beliefs about discipline and provide psychoeducation about alternatives

When practices are legal but potentially harmful, social workers should use psychoeducation and engagement rather than punitive measures as a first response.

Question 140: A social worker is conducting a mental status examination. Which domain is being assessed when the social worker asks a client to count backwards from 100 by sevens?

Abstract reasoning
Memory
Orientation
Concentration and attention (Correct answer)

Correct answer: Concentration and attention

Serial sevens is a standard concentration and attention task used in mental status examinations to assess cognitive processing.

Question 141: A social worker learns that a colleague is regularly seeing clients outside of office hours for social visits. The social worker should FIRST:

Ignore it since the clients appear willing participants
Document the behavior and wait for a formal complaint
Report the colleague directly to the state licensing board
Discuss the ethical concern directly with the colleague (Correct answer)

Correct answer: Discuss the ethical concern directly with the colleague

NASW ethics guidelines recommend first addressing ethical concerns directly with the colleague before escalating to supervisors or licensing bodies.

Question 142: A client with schizophrenia is stable on medication but refuses to take it because of side effects. The most appropriate clinical response is to:

Document the refusal and take no further action
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)

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 143: During a group therapy session, a member begins to talk about another member's personal disclosures outside the group. The group facilitator should FIRST:

Contact the disclosed-about member privately without group discussion
Address the confidentiality breach directly in the group and reinforce group norms (Correct answer)
Expel the breaching member immediately
Ignore it to avoid shaming the member

Correct answer: Address the confidentiality breach directly in the group and reinforce group norms

Addressing confidentiality breaches openly reinforces group norms and protects all members' trust in the process.

Question 144: When assessing basic "Activities of Daily Living" (ADLs) to identify an appropriate level of care for a person with a long-term disability, the following areas of capacity are LEAST likely to be considered:

Getting dressed/grooming
Basic household tasks (which can include shopping for food, cooking/food preparation, and/or cleaning/household maintenance) (Correct answer)
Self-feeding capacity
One's mobility, in regard to their capacity to move around adequately while performing tasks

Correct answer: Basic household tasks (which can include shopping for food, cooking/food preparation, and/or cleaning/household maintenance)

Activities of Daily Living (ADLs) refer to fundamental self-care tasks essential for independent living, such as self-feeding, mobility, and dressing/grooming. Basic household tasks like shopping, cooking, and cleaning fall under Instrumental Activities of Daily Living (IADLs), which are more complex activities. Therefore, when assessing basic ADLs, IADLs are the least likely to be considered as they represent a higher level of functioning beyond fundamental self-care.

Question 145: 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:

None of the above
Determine why the client does not want his past treatment examined
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

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 146: When conducting a cultural formulation as part of a clinical assessment, which element is MOST important to explore?

The client's insurance coverage and payment plan
The agency's demographic intake data
The client's cultural identity and how culture shapes their understanding of the problem (Correct answer)
Whether the client speaks English as a first language

Correct answer: The client's cultural identity and how culture shapes their understanding of the problem

The DSM-5 Cultural Formulation Interview centers on understanding how cultural identity, explanatory models, and cultural stressors shape the client's experience.

Question 147: A client describes feeling that she is watching herself from outside her body during stressful situations. This experience BEST describes:

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

Correct answer: Dissociation/depersonalization

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

Question 148: Which attachment style is associated with a child who shows distress when the caregiver leaves but is not comforted upon reunion?

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

Correct answer: Anxious-ambivalent (resistant) attachment

Anxious-ambivalent attachment involves high distress at separation and angry, inconsolable behavior at reunion due to inconsistent caregiving.

Question 149: This phrase describes the belief that one belongs to a specific cultural, national, or racial group that shares or has commonalities with other groups, such as a common language, history, society, culture, or religion.

Race
Cultural identity
Cultural diversity
Ethnicity (Correct answer)

Correct answer: Ethnicity

Ethnicity describes a group's shared cultural heritage, including common language, history, society, culture, or religion, which distinguishes them from other groups. It is a social construct encompassing a sense of belonging and identity based on shared traditions and ancestry. Unlike race, which is often tied to physical characteristics, ethnicity is primarily about cultural and social affiliation.

Question 150: During assessment, a client describes hearing a voice that commands her to harm herself. This symptom is BEST classified as:

An auditory illusion
Somatic delusion
A command auditory hallucination (Correct answer)
Depersonalization

Correct answer: A command auditory hallucination

Command auditory hallucinations involve perceived voices that instruct the individual to perform specific acts, representing a high-risk psychotic symptom.

Question 151: A social worker assessing a client for Borderline Personality Disorder should use which time frame for symptom evaluation?

Symptoms present only during a current depressive episode
Symptoms triggered exclusively by identifiable stressors
A pervasive pattern present since early adulthood across multiple contexts (Correct answer)
Symptoms lasting at least two weeks

Correct answer: A pervasive pattern present since early adulthood across multiple contexts

Personality disorder diagnoses require a pervasive, enduring pattern that began in adolescence or early adulthood and is not limited to mood episodes or situational reactions.

Question 152: The profession of social work is based on six key beliefs. One of them is not which of the following?

independence (Correct answer)
integrity
importance of human relationships
competence

Correct answer: independence

The six core values of the social work profession, as outlined by the NASW Code of Ethics, are Service, Social Justice, Dignity and Worth of the Person, Importance of Human Relationships, Integrity, and Competence. While social workers often promote client independence, 'independence' itself is not one of the six foundational values of the profession. The other options listed are all core values.

Question 153: A social worker learns that a formerly suicidal client has purchased a firearm. The client denies current intent to harm themselves. The BEST immediate action is to:

Notify law enforcement without further assessment
Conduct a thorough suicide risk assessment (Correct answer)
Involuntarily hospitalize the client immediately
Do nothing, as the client denies current ideation

Correct answer: Conduct a thorough suicide risk assessment

Access to lethal means significantly elevates suicide risk; a thorough risk assessment is required to determine appropriate level of care.

Question 154: In solution-focused brief therapy (SFBT), the 'miracle question' is used to:

Challenge irrational beliefs about future outcomes
Help clients envision life without the problem to identify goals (Correct answer)
Explore the root cause of the presenting problem
Reframe the problem in systemic terms

Correct answer: Help clients envision life without the problem to identify goals

The miracle question invites clients to imagine a future where the problem is resolved, helping them articulate concrete therapeutic goals.

Question 155: An adult client discloses during a session that they are being financially exploited by their adult child. The BSW's FIRST responsibility is to:

Advise the client to cut off contact with the abusive child
Contact adult protective services without informing the client
Assess the client's safety and their wishes regarding intervention (Correct answer)
Call the police immediately on behalf of the client

Correct answer: Assess the client's safety and their wishes regarding intervention

Assessment of safety and client wishes is the essential first step; adult clients retain autonomy to make decisions about their own situations.

Question 156: A client from a collectivist culture refuses to make any decisions without consulting their extended family. The BSW social worker should:

Respect this cultural value and involve the family in the process as appropriate (Correct answer)
Document the client's dependence as a clinical concern
Encourage the client to practice individual decision-making skills
Refer the client to a social worker from the same cultural background

Correct answer: Respect this cultural value and involve the family in the process as appropriate

Cultural competence requires social workers to respect and incorporate clients' cultural values, including collectivist decision-making norms.

Question 157: The genogram is a clinical tool primarily used to:

Diagram the client's social support network in the community
Map multigenerational family relationships, patterns, and history (Correct answer)
Assess a client's financial resources and debts
Track symptom changes over time in treatment

Correct answer: Map multigenerational family relationships, patterns, and history

A genogram is a pictorial representation of family relationships and history across at least three generations, used to identify patterns, roles, and dynamics.

Question 158: The social determinants of health most relevant to advanced generalist social work practice include:

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

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 159: Summative evaluation: The ability of a test to foretell a certain behavior or trait.

False (Correct answer)
True

Correct answer: False

The statement describes predictive validity, which is the ability of a test to forecast future behavior or traits. Summative evaluation, however, is an assessment conducted at the end of a program or intervention to determine its overall effectiveness and impact. It focuses on outcomes and whether the program achieved its intended goals, rather than foretelling future behaviors.

Question 160: Which defense mechanism involves attributing one's own unacceptable feelings to another person?

Projection (Correct answer)
Rationalization
Displacement
Reaction formation

Correct answer: Projection

Projection involves unconsciously attributing one's own unacceptable thoughts or emotions to another person.

Question 161: According to Erikson's stages of psychosocial development, the primary conflict of adolescence is:

Identity vs. role confusion (Correct answer)
Intimacy vs. isolation
Autonomy vs. shame and doubt
Industry vs. inferiority

Correct answer: Identity vs. role confusion

Erikson identified identity vs. role confusion as the central task of adolescence, during which individuals develop a sense of self.

Question 162: What link exists between social development and self-esteem?

Healthy self-esteem can lead to positive interactions with others, and positive interactions lead to higher self-esteem (Correct answer)
It causes social development to take place more slowly.
Lower self-esteem frequently leads to positive interactions with others, which then keeps the self-esteem low.
All are correct, it depends on the child's personal experience.

Correct answer: Healthy self-esteem can lead to positive interactions with others, and positive interactions lead to higher self-esteem

There is a reciprocal relationship between healthy self-esteem and positive social interactions. Children with good self-esteem are more confident in social situations, leading to more positive interactions with peers and adults. These positive experiences, in turn, reinforce their sense of self-worth and further enhance their self-esteem, creating a beneficial cycle.

Question 163: A social worker is assessing a veteran who served in combat. The client reports nightmares, hypervigilance, avoidance of crowded spaces, and emotional numbing for the past two months. The MOST likely diagnosis to explore is:

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

Correct answer: Post-traumatic stress disorder

PTSD is characterized by intrusion, avoidance, negative alterations in cognition/mood, and hyperarousal lasting more than one month following trauma.

Question 164: 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:

Evidence that the client is being dishonest
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

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 165: A social worker notices a discrepancy between a client's verbal report and nonverbal cues during assessment. The BEST response is to:

Confront the client directly about lying
Document only the verbal report
End the session and consult a supervisor
Gently reflect the discrepancy and invite the client to share more (Correct answer)

Correct answer: Gently reflect the discrepancy and invite the client to share more

Gently reflecting discrepancies invites the client to explore inconsistencies in a non-threatening way, maintaining rapport and gathering more accurate assessment data.

Question 166: 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
Allowed because the relationship predates treatment
An acceptable dual relationship if disclosed and documented
A prohibited dual relationship that should be avoided (Correct answer)

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 167: A social worker learns that a client who was recently discharged from a hospital has stopped attending outpatient appointments. The BEST action is to:

Contact the hospital to have the client readmitted
Conduct outreach to re-engage the client and assess barriers (Correct answer)
Close the case due to non-compliance
Send a certified letter warning the client of termination

Correct answer: Conduct outreach to re-engage the client and assess barriers

Outreach to understand barriers to engagement reflects a client-centered, strengths-based approach and helps prevent deterioration.

Question 168: A social worker suspects a supervisor is engaging in insurance fraud. According to the NASW Code of Ethics, the worker should FIRST:

Seek consultation and address the concern through internal channels if possible (Correct answer)
Ignore the situation since it is the supervisor's responsibility
Resign from the position to avoid ethical liability
Report immediately to law enforcement without discussing with the supervisor

Correct answer: Seek consultation and address the concern through internal channels if possible

The NASW Code of Ethics encourages addressing ethical concerns through appropriate internal channels before escalating externally.

Question 169: Which theoretical framework emphasizes the therapeutic relationship itself as the primary agent of change?

Solution-focused brief therapy
Rational emotive behavior therapy
Person-centered therapy (Correct answer)
Behavioral therapy

Correct answer: Person-centered therapy

Person-centered therapy (Carl Rogers) holds that a genuine, empathic therapeutic relationship is the primary vehicle for change.

Question 170: A social worker is seeing a client who is undocumented. Ethically, the worker's PRIMARY obligation is to:

Limit services to those mandated by law
Provide competent, non-discriminatory services (Correct answer)
Refer the client to a specialized immigration agency only
Report the client's status to immigration authorities

Correct answer: Provide competent, non-discriminatory services

The NASW Code of Ethics requires social workers to provide competent services without discrimination based on immigration status.

Question 171: Which of the following is the PRIMARY goal of crisis intervention?

Preventing future crises through long-term psychotherapy
Resolving the underlying psychological issues that caused the crisis
Restoring the client to at least their pre-crisis level of functioning (Correct answer)
Diagnosing the psychiatric disorder contributing to the crisis

Correct answer: Restoring the client to at least their pre-crisis level of functioning

Crisis intervention is time-limited and aims to stabilize the client and restore equilibrium to pre-crisis functioning, not to achieve deeper therapeutic change.

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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