Human Development
1. Which of the following is an example of role discomplementarity?
A. A husband complains that his wife does not take responsibility for keeping the house clean and a wife is upset that her husband does not financially provide for the family.
B. A woman states that she does not like working and wants to quit her job
C. A man struggles to fit in time at home with his family due to his hectic work schedule
Answer: A. A husband complains that his wife does not take responsibility for keeping the house clean and a wife is upset that her husband does not financially provide for the family.
Explanation: Role discomplementarity results when roles conflict or when the role expectations of others differ from one’s own. In this situation, the husband and wife do not have the same expectations with regard to the tasks for which each other should be responsible.
1. A social worker notices what appears to be burns on a child’s arm and asks the child about these markings. The child responds that “Grandma burned me, but mommy isn’t going to let me go over there anymore.” The social worker should:
A. Document the conversation in the file
B. Report the conversation immediately to Child Protective Services
C. Check the child regularly in the future for burns or bruises
Answer: B. Report the conversation immediately to Child Protective Services
Explanation: Social workers are mandatory reporters and must not delay in reporting or investigating such an incident themselves. All suspected abuse situations should be reported to the child protection agency immediately.
1. A client is currently taking Clozaril for the treatment of schizophrenia. The client is MOST likely going to be required to undergo what medical monitoring due to this medication use?
A. Weight checks
B. Blood work
C. Dietary restrictions
Answer: B. Blood work
Explanation: Clozaril increases the risk of agranulocytosis (low white blood cell count). Monitoring of the white blood cell count through regular blood work is required.
1. If a client has a substance use disorder in addition to schizophrenia, which BEST describes the relationship between these two disorders?
A. Premorbid
B. Comorbid
C. Contraindicated
Answer: B. Comorbid
Explanation: Comorbid refers to two problems, conditions, or disorders that exist at the same time—such as the presence of a mental health and substance use issue, or a mental health and medical problem.
1. A family comes into treatment because of their young daughter’s behavior. They report, upon intake, that she yells at her parents, doesn’t listen, and complains about their behavior. There is little progress during the course of treatment and the girl reports that she has no intention of changing. After the sixth session, a social worker tells the girl that she cannot help with her behavior and she should continue to “do as she wishes.” Which strategic family therapy technique is the social worker using in this situation?
A. Paradoxical Intent
B. Pretend technique
C. Relabeling paradigm
Answer: A. Paradoxical intent
Explanation: A paradoxical intent or directive prescribes the symptomatic behavior so the client realizes control over it and uses the strength of resistance to change.
2. A client has just been diagnosed with terminal cancer. Using a systems approach, the social worker should:
A. Develop a plan for long-term care aimed at meeting the client’s medical needs
B. Work with the client on addressing the impacts of this prognosis on psychological and spiritual well-being
C. Reexamine the treatment goals to see if they are still relevant or need to be revised given this health information
Answer: B. Work with the client on addressing the impacts of this prognosis on psychological and spiritual well-being
Explanation: A systems approach states that all parts of well-being are interrelated or interconnected. Thus, a change in physical health will impact on psychological and spiritual functioning. The treatment should not focus on just the health issues, but ensure that these other areas are considered.
2. A social worker employed in a youth recreation program is concerned as a child who developed a severe rash on her arm has not returned to the program after the agency director stated that she needed medical clearance. When contacting the mother, the social worker learns that she has not brought her young child to a doctor “for years” and does not plan to do so. The BEST response for the social worker is to:
A. Determine what occurred to cause the mother’s resistance
B. Speak to the agency director about reconsidering the child’s participation
C. Report the incident to the authorities
Answer: C. Report the incident to the authorities
Explanation: Failing to provide appropriate health care, including dental care and refusal of care or ignoring medical recommendations, is considered neglect and should be reported to the authorities immediately for further investigation. It is not the role of the social worker to investigate the allegations. As there are many names for child protection organizations, generic terms such as “the authorities” may be used in examination questions.
2. A client who has schizophrenia has not been taking his medication. He is in crisis, but does not pose a danger to himself or others. The client was recently discharged from an inpatient hospitalization after an involuntary commitment. In the social worker’s opinion, the client would benefit from rehospitalization, but the client does not want to be readmitted. The social worker should:
A. Identify community resources to meet his immediate needs
B. Contact the hospital to see if he can be readmitted
C. Recommend that the client be involuntarily committed to get the medication needed
Answer: A. Identify community resources to meet his immediate needs
Explanation: The scenario states that the client is not a danger to himself or others, so he cannot be involuntarily committed. The social worker should not contact the hospital because the client is not agreeable to admission. The client is in crisis, so community resources aimed at meeting his immediate needs are the priority.
2. A social worker is reviewing a client’s record and sees that a client was recently taking Zoloft after being switched from Lexapro. Which of the following is the BEST diagnosis for this client?
A. Major depressive disorder
B. Schizoaffective disorder
C. Attention-deficit/hyperactivity disorder
Answer: A. Major depressive disorder
Explanation: These medications are antidepressants. The client may have one of the other diagnoses and/or more than one diagnosis, but is MOST likely taking these medications for depressive symptoms that are associated with major depressive disorder.
2. A client enters a social worker’s office and is outraged at an interaction that has just taken place with another agency staff member. The client is indignant and demands that the social worker “do something.” In this situation, the social worker should FIRST:
A. Explain to the client that the issue is best handled directly with the staff member
B. Instruct the client to go to the agency director who is in a position to take action
C. Listen to the client’s account of the interaction with the staff member
Answer: C. Listen to the client’s account of the interaction with the staff member
Explanation: Silence is effective when faced by a client who is experiencing a high degree of emotion. The social worker should not send the client to someone else or take action until the nature of the situation is known. Listening and finding out more is the FIRST step in deciding the appropriate next steps, if any.
3. A woman complains that her 7-year-old son “makes things up and exaggerates.” He often adds information when recalling experiences and talks about knights and dragons being part of his everyday world. The woman is angry about this behavior and worried that it is an indication of some mental health problem. In order to BEST assist in this situation, the social worker should:
A. Explain that the behaviors are associated with the preoperational thought stage of cognitive development
B. Conduct a mental status examination on the child
C. Determine whether this behavior is a concern to others, including his teachers
Answer: A. Explain that the behaviors are associated with the preoperational thought stage of cognitive development
Explanation: Magical thinking is a hallmark of Piaget’s preoperational thought stage. Understanding that children learn through this process, and that it is typical, may assist the mother in better coping with this behavior. There is no indication that there are any mental health issues, so the social worker should not see the child or take other action based on this report alone.
3. What immediate action must be taken when a parent is diagnosed with factitious disorder imposed on another for acts toward their children?
A. Child(ren) must be removed from the parent’s care to ensure protection from harm
B. An evaluation must be completed to assess the ability to fulfill parenting responsibilities
C. Support services must be provided to meet the basic needs of all family members
Answer: A. Child(ren) must be removed from the parent’s care to ensure protection from harm
Explanation: Factitious disorder imposed on another is a mental health disorder in which caregivers make up or causes an illness or injury in persons under their care, such as a children, elderly adults, or persons who have disabilities. Because vulnerable people are the victims, it is a form of abuse. Most instances are between mothers and children. Caregivers may lie about symptoms, change test results to make victims appear ill, or physically harm to produce symptoms. Victims need to be protected. They need to be immediately removed from direct care and may require medical care to treat complications from injuries, infections, medicines, surgeries, or tests.
3. Which BEST describes culturally specific ways in which individuals or communities express, experience, and communicate psychological distress or emotional suffering that must be considered when intervention planning?
A. Cultural biases
B. Cultural stratification
C. Cultural concepts of distress
Answer: C. Cultural concepts of distress
Explanation: The DSM acknowledges that cultural factors play a significant role in shaping how mental health issues are understood and manifested across different cultural groups. Cultural concepts of distress refer to culturally specific ways in which individuals or communities express, experience, and communicate psychological distress or emotional suffering.
3. A young boy is stopped by a police officer and claims that he is a member of the armed forces, though it is obvious that he is not. Which of the following BEST describes the boy’s assertion?
A. Dissociation
B. Folie à deux
C. Delusion
Answer: C. Delusion
Explanation: A delusion is a false, fixed belief despite evidence to the contrary (i.e., believing something that is not true). Dissociation is a change in memory, perception, or consciousness. Folie à deux is a shared delusion.
3. During an intake interview, a client uses derogatory language to refer to individuals of a particular ethnic group. This language causes the social worker to become angry. In order to appropriately deal with the anger, the social worker should:
A. Explain to the client that this language is inappropriate and upsets the social worker
B. Recognize the anger and discuss it later with the supervisor
C. Tell the client about the reaction so that a decision can be made about whether the social worker is the best match for the client
Answer: B. Recognize the anger and discuss it later with the supervisor
Explanation: A client must feel understood and valued as a person, though the client’s performance may be unsatisfactory. If a client feels judged, the client will not speak freely during a social work interview. Hence, a social worker must be interested, genuinely concerned and encouraging, and at the same time, objective, but neither condemning nor praising. In this scenario, the social worker should use the supervisor to process the feelings that arise as a result of the client’s actions. The other response choices involve telling the client about the anger, which could interfere with the helping process. Social workers must be skilled in the principles and techniques of interviewing, as well as appropriately dealing with their emotions in a manner that does not negatively impact the therapeutic process.
4. Which of the following represents the order of client needs within a hierarchy?
A. Physiological, safety, social, esteem, and self-actualization
B. Physiological, safety, esteem, social, and self-actualization
C. Safety, physiological, social, esteem, and self-actualization
Answer: A. Physiological, safety, social, esteem, and self-actualization
Explanation: According to Maslow’s hierarchy of needs, the needs of individuals are ordered as physiological, safety, social, esteem, and self-actualization
4. Which of the following is a form of institutional discrimination?
A. Providing translation services rather than having agency paperwork available in all languages
B. Offering therapy and other services only on Saturdays
C. Referring a client to another social worker based on cultural background
Answer: B. Offering therapy and other services only on Saturdays
Explanation: Institutional discrimination is when the policies or practices of an agency are discriminatory to a group of people. Saturday services will preclude those who observe this day as the Sabbath. Social workers may refer individuals to others based on cultural factors for appropriate therapeutic reasons. If the reason for the referral is simply based on cultural background, this may be a form of discrimination, but is not institutional discrimination unless it is a repeated practice or policy. Forms cannot be printed in all languages so translation services are useful to meet the needs of linguistically diverse client populations.
4. A client was referred to a mental health agency for treatment. Upon admission, he reported feeling lethargic and hopeless and had difficulty getting out of bed. Several weeks later, he states that he is sleepless, agitated, and unable to focus. Which of the following medications is the client MOST likely going to be prescribed?
A. Ativan (lorazepam)
B. Lithium (lithium carbonate)
C. Buspar (buspirone)
Answer: B. Lithium (lithium carbonate)
Explanation: Ativan and Buspar are antianxiety medications. Lithium is a mood stabilizer, and this client appears to be experiencing depression upon admission, as well as mania later in treatment. A mood stabilizer is used for the treatment of bipolar disorder.
4. A new client enters the office walking slowly, using a cane, and has difficulty picking up objects, swallowing, and speaking as a result of a stroke. Which of the following is the BEST diagnosis for this client?
A. Agnosia
B. Ataxia
C. Prosopagnosia
Answer: B. Ataxia
Explanation: Ataxia describes a lack of muscle control during voluntary movements, such as walking or picking up objects. A sign of an underlying condition, ataxia can affect movement, speech, eye movement, and swallowing. Persistent ataxia usually results from damage to the cerebellum—the part of the brain that controls muscle coordination. Many conditions can cause ataxia, including alcohol abuse, stroke, tumor, cerebral palsy, and multiple sclerosis. An inability to recognize familiar objects is agnosia, and an inability to recognize familiar faces is prosopagnosia.
4. A teenager is having problems initiating conversations with peers. In order to BEST assist the teenager, the social worker should:
A. Ask the teenager to journal thoughts that can be used in later conversations with peers
B. Explore with the teenager the underlying reasons for the problems with peer relationships
C. Engage in role play with the teenager to practice needed communication skills
Answer: C. Engage in role play with the teenager to practice needed communication skills
Explanation: Role-playing is a very effective teaching strategy and provides active learning. None of the other response choices that may be useful provides the teenager with an intervention (as the question is about the best way to assist) that allows the youth to practice communication skills that can be used with peers.
5. An 11-year-old child would like to start helping around the house with chores. She approaches her mother many times, but is told she cannot assist because “she won’t do it right.” During several attempts to do things on her own, she is scolded. According to psychosocial development theory, she may experience doubts in her abilities due to a crisis in which of the following stages?
A. Industry versus inferiority
B. Initiative versus guilt
C. Autonomy versus shame/doubt
Answer: A. Industry versus inferiority
Explanation: Industry versus inferiority—From age 6 to puberty, children begin to develop a sense of pride in their accomplishments. If children are encouraged and reinforced for their initiative, they begin to feel industrious and feel confident in their ability to achieve goals. If this initiative is not encouraged and is restricted, children begin to feel inferior, doubting their abilities.
5. Which of the following practices is MOST likely to promote cultural diversity within an organization?
A. Ensuring that personnel represent the broader community
B. Incorporating cultural competence requirements in hiring decisions
C. Appointing diverse personnel to decision-making positions
Answer: C. Appointing diverse personnel to decision-making positions
Explanation: While all response choices listed are important, only appointing diverse personnel to decision-making positions will help increase diversity within an organization as they will be in positions to ensure that varied viewpoints are considered. Just because personnel represent the broader community or cultural competence requirements are used in hiring decisions does not mean that an organization will be diverse or that those from diverse backgrounds will be in positions of power.
5. Which of the following accurately describes the relationship between expressive and receptive communication?
A. Receptive communication usually develops at an earlier age than does expressive communication
B. Expressive communication usually develops at an earlier age than does receptive communication
C. Some young children develop receptive communication skills before developing expressive communication skills; for other children, it is the reverse
Answer: A. Receptive communication usually develops at an earlier age than does expressive communication
Explanation: Language is a system of using words to communicate. It has two parts: using words and gestures to say what is meant (expressive communication) and understanding what others say (receptive communication). Receptive communication develops earlier than does expressive communication. Infants start learning in the womb, where they hear and respond to familiar voices.
5. A client reports that he has experienced some “ringing” in his ears for the last week, which is causing him great distress. The social worker should FIRST:
A. Refer the client for a neurological evaluation
B. Identify whether he is reporting an auditory hallucination
C. Explore with the client what changes in his life may have coincided with this symptom
Answer: A. Refer the client for a neurological evaluation
Explanation: “Ringing” or other sounds originating in the ears (tinnitus) can be a symptom of a neurologic or organic problem. The social worker needs to FIRST rule out a medical cause before determining other etiology.
5. A mother and teenage child yell at each other almost the entire time of a session. The mother says that she is upset with her daughter’s choice in boyfriend, her grades in school, her inappropriate dress, and her lack of help around the house. The daughter says that she is angry as her mother does not listen to her, does not respect her privacy, does not give her any “space,” and speaks to the daughter’s friends in a demeaning manner. In order to BEST assist with helping them resolve their conflicts, the social worker should:
A. Work with the mother and child to prioritize their concerns
B. Focus on both the mother’s and child’s strengths and skills
C. Acknowledge the level of conflict and discord between the mother and child
Answer: A. Work with the mother and child to prioritize their concerns
Explanation: Given that there is conflict over a number of issues, the social worker should help structure the interactions between the mother and child. Essential is deciding which of the complaints is most salient for the mother and child. Acknowledging the conflict and using the strengths and skills of each party during conflict resolution may be useful, but will not assist in helping with resolution like prioritization, given the number of issues raised.