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60. A social worker is evaluating a 46 year-old woman who is distressed by her husband's recent inability to sustain an erection. She reports that her husband has insulin-dependent diabetes. She says that the physician has explained that diabetes causes this problem, but she believes that her husband doesn't love her anymore. What is the social worker's MOST appropriate action?
A. Offer individual therapy to the woman
B. Give the woman literature on the effects of diabetes
C. Suggest that the husband seek a second medical opinion
D. Offer conjoint sessions to the woman and her husband
D. Offer conjoint sessions to the woman and her husband
Explain your rationale for your choice
65. A social worker meets with the parents of a 13-year-old client who as a moderate intellectual disability. The parents report that the client has been smoking marijuana given to him by an adult neighbor. What should the social worker do FIRST?
A. Suggest that the parents provide closer supervision of the client
B. Explain to the parents that a report must be made to the proper authorities
C. Encourage the parents to confront the neighbor
D. Recommend that the parents consider a residential placement for the client
B. Explain to the parents that a report must be made to the proper authorities
Explain your rationale for your answer choice
70. A client meets with a social worker and discusses sexual feelings for a coworker of the same gender. The client is uncomfortable with the attraction. What should the social worker do?
A. Assist the client in exploring the feelings
B. Invite the coworker to a session
C. Interview the client about sexual history
D. Assess the client's understanding of sexual orientation
A. Assist the client in exploring the feelings
*What is your rationale to your answer choice?
1. A social worker meets with a 75 year-old client whose spouse died six months ago. In the intake interview, the client reports losing weight, having very little energy, and having difficulty getting motivated to do things. What should the social worker do FIRST?
A. Complete a suicide risk assessment of the client
B. Explore available family and community resources
C. Suggest that the client scheduled an appointment with a doctor
D. Refer the client to a local bereavement group
A. Complete a suicide risk assessment of the client
Rationale: The client's self-report describes depression and suicide risk that the warrant further assessment (Key A). Options B, C, and D are all plausible, but not the FIRST action the social worker should take.
6. During the assessment process, a social worker learns that a client's self- reporting is incomplete. What approach would MOST likely improve self- reporting?
A. Guided imagery
B. Role play
C. Journaling
D. Family input
C. Journaling
Rationale: Journaling helps the client document and remember pertinent information between sessions (Key C). Guided imagery (A) and role play (B) are both interventions that are potentially not relevant to the self-reporting problem. Family input (D) is incorrect because it is collateral reporting, and the goal is to improve client self-reporting.
61. A social worker asks a client to sign a consent for treatment form. The client signs the form but seems uncomfortable with the decision. What should the social worker do FIRST?
A. Explain that the language is clear and understandable
B. Provide a document that meets the defined legal requirements
C. Explain that the client has the right to withdraw consent after it is given
D. Provide the client with a copy of the consent form
C. Explain that the client has the right to withdraw consent after it is given
Give your rationale for your answer choice
66. A client who meets with a social worker describes numerous problems, including an unhappy marriage, frequent verbal abuse, severe physical illnesses, mounting financial pressures, and a chaotic family situation. She tearfully says that she fears she is losing all control over her two teenage children. What should the social worker do FIRST?
A. Address the issue of the abuse
B. Refer the client for a medical evaluation
C. Help the client to prioritize her concerns
D. Offer the client family therapy
C. Help the client to prioritize her concerns
*What is your rationale to your answer choice?
71. An adult client meets with a social worker for an intake at a clinic. The client requests medications to help with anxiety and chronic pain. The social worker learns that the client is already taking narcotics and antianxiety drugs prescribed by several physicians. What should the social worker do NEXT?
A. Explain that the client cannot get medications from the clinic
B. Request further health information from the client
C. Ask the client to provide written permission to contact the prescribing physicians
C. Ask the client to provide written permission to contact the prescribing physicians
*What is your rationale to your answer choice?
2. A social worker is working with a 6-year-old child who was sexually abused. The social worker has been using play therapy techniques for several sessions, but the child is becoming more aggressive and continues to exhibit disturbing behaviors such as bed-wetting and masturbation. The child's foster parents feel that the patient is not making progress in therapy and have asked the foster care worker to assign a new social worker. What should the social worker do FIRST?
A. Tell the foster care worker that the child is progressing as quickly as can be expected
B. Transfer the child to someone who specializes in child cognitive-behavioral therapy
C. Educate the foster parents about the effects of child sexual abuse
C. Educate the foster parents about the effects of child sexual abuse
Rationale: The social worker should FIRST help the foster parents understand the long-term impacts of childhood sexual abuse and unpredictable treatment progress (Key C). Option A does not provide enough meaningful information to the foster care worker. There is no need to transfer the child (B) because play therapy is indicated for this age group.
7. A social worker is facilitating a group for teenage fathers. The goal of the group is to support and encourage the fathers to become more engaged with their children. After reviewing the rules of the group and eliciting introductions, what should the social worker do NEXT?
A. Ask each father to describe the circumstances of his child's life
B. Invite the fathers to discuss how they view their roles as parents
C. Identify challenges to becoming more involved in their children's lives
D. Ask each father to express his expectations of the group experience
D. Ask each father to express his expectations of the group experience
Rationale: This is an unscored item. This item requires knowledge of the stages of group formation. Engaging group members in a discussion of expectations early on helps to establish group norms and will help to guide subsequent stages of group development (key D). Options A, B, and C focused more on individual member concerns and experiences which should occur only after group norms have been established.
62. A social worker meets with a new client who is 75 years old. The client was referred to the social worker by a neighbor after the deaths of the client's spouse of 45 years and two long-term friends. In the initial interview, the client said he was experiencing recent difficulties with memory loss and confusion, increasing physical problems, sadness, feelings of loneliness, and a sense of uselessness. The client also noted the pain of losing a spouse. What should the social worker do FIRST?
A. Refer the client for a medical evaluation
B. Explore the nature of marriage and family before the loss
C. Assess the client for depression and suicide risk
D. Encourage the client to become involved in a local community center
C. Assess the client for depression and suicide risk
Explain your rationale for your answer choice
67. A social worker wants to increase understanding of her clients' cultural backgrounds. To gain this understanding, what should the social worker do FIRST?
A. Talk with the social workers from other cultures
B. Take a course in applied diversity
C. Develop a strong awareness of her own culture
D. Make friends with individuals from diverse groups
C. Develop a strong awareness of her own culture
*What is your rationale to your answer choice?
An inpatient social worker meets with a client who was referred by an outpatient therapist due to suicide risk. The client tells the social worker that a rape that has not been disclosed to the outpatient therapist. What should the social worker do FIRST?
A. Complete the admission for inpatient services
B. Contact the outpatient therapist
C. Refer the client for a medication evaluation
D. Refer the client for psychological testing
A. Complete the admission for inpatient services
*Explain your rational for your answer choice
3. A social worker meets with a man who is of Japanese descent. The man is anxious because his spouse is pressuring him to move his mother into a skilled nursing facility. He prefers that she lives with them. The social worker asks the man if he has any siblings and what his birth order is. This information is important to the social worker's understanding of the man's:
A. Cultural Perspective
B. Support System
C. Financial options
D. Attachment style
A. Cultural Perspective
Rationale: It is always important for a social worker to understand the cultural context of client situations. Information about siblings and birth order can reveal so much about the impact of culture on a client from the broadcast perspective (Key A). The information is less likely to provide an understanding of a client's support system (B), financial options (C), or attachment style (D).
8. A 14-year-old client is referred to a family agency because of recent poor academic performance and behavioral changes, including lack of paying attention and social withdrawal. During the second family session, the client angrily describes physical punishment from her father. The father says the punishment is necessary to prevent her from imitating the behaviors of her friends. What should the social worker do FIRST?
A. Assists the parents in exploring alternative modes of discipline
B. Inform the parents that their behavior requires a report of suspected abuse
C. Attempt to determine the severity of the physical punishment
D. Help the client understand her parents' concerns
C. Attempt to determine the severity of the physical punishment
Rationale: The social worker must FIRST gather more information about the details of the punishment (Key C). Alternative modes of discipline (A) might be appropriate after the social worker has a better understanding of the situation. Informing the parents that a report must be made (B) is premature at this time. Option (D) ignores the possibility that the behavior could be abusive.
63. A parents brings a four-year-old child to a family services agency because the child is having fantasies about being chased by a giant and a tiger, and has nightmares of running in terror. What should the social worker do FIRST?
A. Ask the child to describe the fantasies
B. Do a comprehensive biopsychosocial assessment
Refer the child for play therpay
B. Do a comprehensive biopsychosocial assessment
Explain your rationale for your answer choice
68. What should the social worker do when using evidence-based practice methods in developing a treatment plan with a client?
A. Base the client's treatment plan on a theoretical approach
B. Use treatments that have been successful for others with the client's diagnosis
C. Consider client preferences and values when arriving at a treatment plan
D. Consult practice textbooks to find an applicable theory model
B. Use treatments that have been successful for others with the client's diagnosis
*What is your rationale to your answer choice?
73. In an initial interview, a client reveals that she recently stopped treatment with two other therapists in the community. What should the social worker do FIRST?
A. Make the client feel comfortable since she has already rejected two other therapist
B. Explore the client's reasons for termination from the other therapists
C. Discuss the goals and objectives of the previous therapy
D. Defer questions about previous therapy until later
B. Explore the client's reasons for termination from the other therapists
4. A social worker who leads a therapy group plans to begin an extended leave. What should the social worker discuss with the group FIRST?
A. Arrangements for continuity of the group
B. The group's progress to date
C. Options for transferring to other groups
D. Detailed reasons for the leave
A. Arrangements for continuity of the group
This is an unscored item. The absence of the regular group leader, even if temporary, can be a highly disruptive event for the therapy group, making it imperative that the leader focus on ensuring continuity by discussing how the group will continue during the absence (key A). It would be inappropriate to discuss detailed reasons for the absence (D). Option B and C may be possible topics of discussion, but not what she social worker should discuss FIRST.
9. A social work director is revising the process of orienting new staff to the agency. The revised process includes a day of training. The training will include time to tour the agency and review agency policies and procedures. To be MOST effective in helping new staff to succeed, what should the training program include?
A. Time to meet with a board member
B. Group discussion about treatment methods
C. A session on clinical documentation requirements
D. Presentation of the agency's philosophy and values
D. Presentation of the agency's philosophy and values
Rationale: Presenting the agency's philosophy and values (key D) establishes what is expected of all staff in accordance with the agency's mission. Meeting with a board member A), group discussion about treatment methods (B), and training on clinical documentation (C) should occur, but these activities reflect only parts of the overall agency culture. It is MOST important to ensure that all staff understand the agency's overall philosophy and values
64. An adult client with an intellectual disability has been living with a parent. The parent requires hospitalization. Using a resilience framework, what should the social worker do to BEST prepare the client for transition to respite care?
A. Identify the duration of the parent's hospitalization
B. Discuss respite care options with the client
C. Arrange for an in-home respite worker
D. Prepare the client for the parent's role change from caregiver to patient
B. Discuss respite care options with the client
Explain your rationale for your answer choice
69. In a treatment session, a client diagnosed with social anxiety disorder discusses having joined a new community group whose members are picketing to protest the local library's current policy for book purchases. The social worker personally agrees with the library's current policy. What should the social worker do?
A. Explain why the policy should stay as it is
B. Explore other ways to advocate for policy changes
C. Advise the library staff about the new group
D. Discuss the pros and cons of joining the group
D. Discuss the pros and cons of joining the group
*What is your rationale to your answer choice?
74. A social worker interviews a couple who want to engage in marital therapy. One spouse discusses the lack of communication and intimacy. After discussing the presenting problem, what part of the history should the social worker review NEXT?
A. Psychiatric
B. Relationship
C. Medical
D. Sexual
B. Relationship
5. A resident is bedridden in a nursing care facility because of complications from surgery. The social worker is contacted after the resident deliberately twists an aide's finger while receiving a bath. The resident reports being injured during the bath and asked the aided to stop the bath. What should the social worker do FIRST?
A. Have the resident transferred to another nursing care facility
B. Provide ongoing staff training to deal with the diverse needs of residents
C. Begin individual therapy to address the resident's anger
D. Meet with staff members and the resident to resolve differences
D. Meet with staff members and the resident to resolve differences
Rationale: Initially, the social worker should attempt to mediate between the staff and the resident as the most straightforward approach (Key D). Transferring the resident (A) is not warranted and defers problem. It is not clear from the information that staff training (B) is needed. It is also unclear at this time how individual therapy (C) might address the problem.
10. A social worker is working with a client who has been told that he must lose weight because his health is being affected. He reports that diets have not worked because he lacks the willpower to control his eating. He ends by saying how lonely he feels even with family and friends. He says that he feels like a "big fat failure". What should the social worker do FIRST?
A. Encourage the client to set up a realistic exercise program
B. Refer the client for nutrition consultation
C. Suggest that the client join a self-help group
D. Help the client explore the dynamics of the eating problem
D. Help the client explore the dynamics of the eating problem
Rationale: The FIRST thing the social worker should do is to help the client gain an understanding of the connection between his self-esteem and his eating problem (Key D). After exploring the dynamics, an exercise program (A), a nutrition consultation (B), or a self-help group (C), could be suggested. Discussed earlier, these suggestions may be a set-up for further failure.