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LCSW 284 Exam Prep Comprehensive
Questions
A 24 yr old woman complains of depressed mood. She tells the social worker that she has felt this way the past 2-3 yrs. She has little energy for social or work activities, has difficulty making decisions and concentrating, and has poor appetite. There are no delusions or hallucinations. Her most likely DSM IV diagnosis is? (a) Dysthymic disorder (b) Bipolar disorder, depressed (c) Cyclothymic disorder (d) Major depression, recurrent - ✔ ✔ (a) Dysthymic disorder A 28 Yr old client with a long standing history of drug use is referred to a social worker by a concerned relative. In the assessment interview, the client tells the social worker about frequent cocaine use. The social worker should FIRST: (A) conduct a family interview to evaluate the family's concern (B) begin treatment, focusing on the reason for drug abuse (C) refer the client to a substance abuse program (D) evaluate the client's motivation for change - ✔ ✔ (C) refer the client to a substance abuse program A 45 yr old recently divorced mail carrier complains his memory and logic skills have diminished. He is on a new delivery route and is embarrassed that he can't visualize the exact boundaries of the route or calculate his workload and schedules. These are important factors in his job and he is worried. He has developed a slight limp and tires easily. What would the social worker first consider? (a) a referral for a medical and neurological evaluation (b) a diagnosis of early onset Alzheimer's (c) the possibility of a substance abuse problem (d) an adjustment reaction to his divorce - ✔ ✔ (a) a referral for a medical and neurological evaluation
A child can provide answers to simple questions, dress and undress semi-independently, and play group games with other children. The child also can recite his full name and ask questions beginning with "what," "where," and "who." At approximately what age do these abilities MOST likely begin? A. Two years B. Four years C. Six years - ✔ ✔ B. Four years A client who expresses no overt anger accuses her social worker of being angry, hostile, suspicious and cold. The process being used is most likely: (a) projective identification (b) paranoia (c) reaction formation (d) isolation of affect - ✔ ✔ (a) projective identification A client who has received services for several years in a dialysis unit appears for a routine visit. The nurse notices a markedly changed affect and refers the client to the social worker. When seeing the social worker, the client seems detached, self-absorbed, and tearful. The social worker should FIRST assess the client's: (A) life situation and recent changes (B) compliance with medical care (C) concerns about dying (D) feelings about dialysis - ✔ ✔ (A) life situation and recent changes A client who was briefly admitted to the hospital after a panic attack is being discharged with a prescription for a benzodiazepine. Which of the following medications has been recommended? A.Prolixin B.Lithium C.Prozac D.Ativan - ✔ ✔ D.Ativan A client whose mother dies following a long term illness states to the social worker that he believes that his angry thoughts about his mother caused the death. This is an example of:
(C) a discussion of the social worker's perception of the marital relationship (D) developing the child's insight into behavior as a reaction to marital stress - ✔ ✔ (C) a discussion of the social worker's perception of the marital relationship A former client emails a social worker to invite the social worker on a date at a restaurant three months after treatment has been terminated. What is the social worker's BEST response? A. Explain ethical boundaries to the client B. Avoid responding to the client C. Obtain consultation from a supervisor - ✔ ✔ A. Explain ethical boundaries to the client A hospital social worker interviews a couple whose six month old infant has recently been hospitalized for cystic fibrosis. The social worker notices that the parents are reluctant to touch the child. Based on this information, the social worker's FIRST intervention should be to: (A) explore the parent's reaction to the child's illness (B) refer the couple to a support group (C) evaluate the situation for out-of-home placement (D) provide the couple with information - ✔ ✔ (A) explore the parent's reaction to the child's illness A hospital social worker meets with a patient to recommend an assisted living placement at discharge. The patient declines the recommendation and asks the social worker not to discuss it with the patient's adult children. The patient has mild cognitive impairment but has not been declared incompetent. What is the BEST action for the social worker to take? A. Report the patient as a vulnerable adult to the jurisdictional authorities B. Discuss community services that could help meet the patient's increasing needs C. Remind the patient about limits of confidentiality when there is risk of harm D. Determine other supportive people the patient would want informed of the needs - ✔ ✔ B. Discuss community services that could help meet the patient's increasing needs A man is seen in the ER with complaints of visual hallucinations, confusion and restlessness. He also has chills, dilated pupils and nausea. He says "nothing is wrong, I just need sleep". Which of the following substances is most likely the cause of the condition? (a) alcohol (b) marijuana
(c) cocaine (d) barbiturates - ✔ ✔ (c) cocaine A patient complains of sleeplessness, loss of appetite, feeling hopeless, general apathy. To help diagnose, a social worker would most need to know: (a) medications the client is taking (b) family history of depression (c) how long the symptoms have persisted (d) if the patient lives alone - ✔ ✔ (c) how long the symptoms have persisted A previously motivated client seems ambivalent during recent meetings with the social worker. The social worker attempts to discuss the ambivalence, but the client responds with anger and denial. After exploring the client's emotions, what should the social worker do NEXT? A. Refer the client to an anger management group B. Refer the client to a different social worker C. Review the client's goals to determine any needed changes D. Recommend termination to the client - ✔ ✔ C. Review the client's goals to determine any needed changes A school social worker answers a call from a parent asking for help with a teenager's behavior. The parent tells the social worker the teenager is frequently defiant and aggressive toward a younger sibling and family pets. What is the social worker's MOST appropriate response to the parent's request? A. Suggest new discipline strategies for the parent to use B. Recommend the teenager receive a mental health assessment C. Explain that the teenager's behaviors are normal for this age D. Consult with the psychiatrist for a medication evaluation - ✔ ✔ B. Recommend the teenager receive a mental health assessment A school social worker meets with a child diagnosed with autism spectrum disorder. The child has difficulty understanding the social cues of other children and forming friendships. What technique should the social worker use that would MOST likely help the child? A. Confrontation, to identify how the child's behavior affects others B. Reflection, to support the child's feelings of isolation
C. Summarization D. Clarification - ✔ ✔ A. Education A social worker at an inpatient psychiatric facility meets with a 40-year-old patient and the patient's family to discuss discharge planning. The patient has a diagnosis of schizophrenia and a history of assaultive behavior and substance use disorder. The patient's parents want the patient to move into their home. What factor should the social worker evaluate FIRST? A. History of medication compliance B. Potential danger to the family C. Likelihood of exposure to illegal substances D. Opportunities for outpatient treatment - ✔ ✔ B. Potential danger to the family A social worker facilitates a treatment group for clients with dual diagnoses of major depressive disorder and substance use disorder. The social worker wants to use role play to help clients recognize triggers for depressive symptoms. What action by the social worker is MOST likely to engage participants in role play? A. Meet with significant others to obtain informed consent before using role play B. Ask reluctant group members to not attend group when role play is used C. Plan extra time in the schedule to explain role play to group members D. Determine each member's capacity to participate in role play - ✔ ✔ D. Determine each member's capacity to participate in role play A social worker facilitates a treatment group for juveniles who are court mandated to attend. During the first session, a 13-year-old brags to the others about vandalism committed in the neighborhood. What should the social worker do FIRST? A. Discuss the client's behavior with the parents B. Confront the client about the behavior C. Encourage the client to talk about possible motivation for the behavior D. Report the client to the court - ✔ ✔ C. Encourage the client to talk about possible motivation for the behavior A social worker has been asked to assist an elderly client in making alternative living arrangements. In the initial interview, the client repeatedly attempts to discuss past experiences. What is the social worker's MOST appropriate response to the client?
(A) ignore the references to the past (B) facilitate discussion of the recollections (C) refer the client for psychiatric evaluation (D) administer a geriatric evaluation scale - ✔ ✔ (B) facilitate discussion of the recollections A social worker interviews a client with a history of resistance to treatment and hostility toward agency staff. To involve the client and establish a therapeutic alliance, what should the social worker do FIRST? A. Conduct a mood assessment with the client B. Engage the client in a discussion of the presenting problem C. Review the history of services with the client D. Refer the client to an anger management group - ✔ ✔ B. Engage the client in a discussion of the presenting problem A social worker is assigned to evaluate a client convicted of sexual assault. During the initial interview, the client expresses anger about the requirement to obtain treatment because he is convinced he was wrongly convicted. When the social worker explains the evaluation process, the client directs his anger to the social worker and challenges the social worker's competence to adequately evaluate him. What should the social worker do FIRST to begin to build a therapeutic relationship? A. Confront the client's displacement of anger B. Suggest a time-out C. Acknowledge the client's anger - ✔ ✔ C. Acknowledge the client's anger A social worker is interested in determining the impact of culture and race on self-image using an ethnographic approach. The BEST method for this inquiry would be: A.Statistical regression B.Participant observation C.Experimental design D.Self-administered questionnaires - ✔ ✔ B.Participant observation A social worker is observing to determine if the frequency of a high rate behavior has declined due to operant conditioning. What is the MOST significant concern about using this approach? A.Observation is a very costly method of data collection.
A social worker meets with a client in a domestic violence shelter. The client tells the social worker that a decision has been made to return home to an abusive partner. What should the social worker do FIRST? A. Help the client develop a safety plan B. Refer the client for counseling services C. Encourage the client to remain in the shelter - ✔ ✔ A. Help the client develop a safety plan A social worker meets with a client who is concerned about frequently leaving tasks unfinished. This behavior has resulted in family conflict and job loss. To further assess this behavior, what should the social worker do NEXT? A. Discuss options that might diminish the behavior B. Explore factors that have contributed to the behavior C. Help the client identify personal strengths for problem-solving D. Evaluate the client's motivation for changing the behavior - ✔ ✔ B. Explore factors that have contributed to the behavior A social worker meets with a couple to discuss options for assisted living. During the session, one partner begins to cry and expresses fear about dying. What should the social worker do FIRST? A. Assess the couple's concerns relative to their stage in the family life cycle B. Refer the couple to a therapist who specializes in gerontology C. Ask the couple's children for their recommendations D. Plan for the couple to move into an assisted living unit - ✔ ✔ A. Assess the couple's concerns relative to their stage in the family life cycle A social worker meets with a family experiencing stress because one member recently became unemployed. What should the social worker do FIRST? A. Begin family counseling B. Assess the family's needs C. Refer for financial services - ✔ ✔ B. Assess the family's needs A social worker meets with a patient who has been in a psychiatric hospital for three weeks. The patient's diagnoses include depression and substance use disorder. The patient is prescribed psychotropic medication and an anticonvulsant for a seizure disorder. For several days the patient has experienced drowsiness, stumbling, and slurring of speech. What should the social worker do FIRST?
A. Consult with a behavior therapist for a behavior management plan B. Review the patient's discharge plan C. Evaluate the patient for hidden substance use D. Consult with the psychiatrist for a medication evaluation - ✔ ✔ D. Consult with the psychiatrist for a medication evaluation A social worker meets with an adolescent who is in an emergency department for a dog bite. During the mental status exam, the adolescent discloses abusing the dog and reports hearing internal commands to hurt a teacher. What should the social worker do FIRST? A. Assess the adolescent's understanding of cause and effect B. Assess whether the adolescent has a specific plan for harming the teacher C. Determine whether the adolescent has told the teacher about these thoughts D. Determine whether the parents are aware of the adolescent's impulses - ✔ ✔ B. Assess whether the adolescent has a specific plan for harming the teacher A social worker meets with an adult client who rarely leaves home except to go to work. For the past seven months, the client has experienced excessive worry and reports feeling irritable and restless. What is the MOST likely diagnosis? A. Generalized anxiety disorder B. Posttraumatic stress disorder C. Panic disorder D. Adjustment disorder with anxiety - ✔ ✔ A. Generalized anxiety disorder A social worker meets with the parent of a newborn diagnosed with severe cranial facial deformities. The parent expresses feelings of sadness and guilt and talks of wishing that the baby would die. What should the social worker do NEXT? A. Contact child protective services B. Explore the parent's feelings further C. Reassure the parent that the feelings will pass - ✔ ✔ B. Explore the parent's feelings further A social worker who provides family therapy realizes that one of the children in a family receiving services reminds him of his own child who died. The social worker notices that he aligns with the child in the family sessions. What should the social worker do NEXT?
ADL - ✔ ✔ activities of daily living (related to personal care) After 6 weeks of marital therapy, a couple continues their destructive pattern of fighting. In the next session when the couple begins yelling at each other, the social worker stops them and states "your situation is hopeless, fight as often as you wish". She is using the technique of? (a) encouragement (b) reframing (c) prescribing a ritual (d) paradoxical directive - ✔ ✔ (d) paradoxical directive After completing an assessment, a social worker diagnoses a client with Binge Eating Disorder. In order to MOST effectively treat the client for this condition, the social worker should use: A.Psychoanalysis B.Ego psychology C.Task-centered treatment D.Cognitive behavioral therapy - ✔ ✔ D.Cognitive behavioral therapy All of the following are appropriate reasons for seeking feedback from a client during the beginning phase of treatment EXCEPT: A.Ensuring an understanding of what is going to happen during treatment B.Focusing the treatment on a client's feelings and thoughts C.Emphasizing that treatment is a mutual and reciprocal process D.Conveying an interest in a client's views - ✔ ✔ B.Focusing the treatment on a client's feelings and thoughts Alprazolam - ✔ ✔ Xanax Anal Stage - ✔ ✔ pleasure focuses on bowel and bladder elimination; coping with demands for control (age 2-3) Anosognosia - ✔ ✔ A condition in which a person with an illness seems unaware of the existence of his or her illness. -largest reason why individuals with Schizophrenia and Bipolar Disorder do not take their medications.
antisocial personality disorder - ✔ ✔ A personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist.psycho/sociopath Assuring Reasonableness - ✔ ✔ letting a client know that their feelings, thoughts, or behaviors are normal and quite reasonable; this provides reassurance and comfort At which age does object permanence typically develop? A.18 months B.8 months C.3 years D.5 years - ✔ ✔ B.8 months Attending - ✔ ✔ a term frequently used to describe the process of nonverbally communicating to clients that social workers are open, nonjudgmental, accepting of them as people, and interested in what they say authorative parenting style - ✔ ✔ an approach to parenting in which parents set rules, but also explain and negotiate those rules with their children, democratic, nurturing and forgiving of mistakes rather than punishing authoritarian parenting style - ✔ ✔ parents place a high value on conformity and obedience, are often rigid, and express little warmth to the child, have high demands, obedience- and status-oriented avoidant personality disorder - ✔ ✔ A personality disorder characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation
pattern of social discomfort Background - ✔ ✔ Relevant history Behavior modification is the generic term given to any process derived from learning theory where the goal is to change client behavior. To understand behavior modification, it is necessary to understand the two main concepts that it is based on: - ✔ ✔ classical and operant conditioning. Beneficence - ✔ ✔ Doing good or causing good to be done; kindly action Benzodiazepines - ✔ ✔ drugs that lower anxiety and reduce stress; minor tranquilizers
case notes - ✔ ✔ may be subject to a range of legislative processes and requirements during and following the conclusion of professional relationships case presentation - ✔ ✔ When a social worker communicate with others in order to ensure comprehensive and complete care for clients -includes 6 important components Chlordiazepoxide - ✔ ✔ Librium Classical conditioning - ✔ ✔ Refers to the pairing of naturally occurring stimulus-response chains with other stimuli in order to produce a similar response.
For example, whenever you come home wearing a baseball cap, you take your child to the park to play. So, whenever your child sees you come home with a baseball cap, he is excited because he has associated your baseball cap with a trip to the park. (Association) client center - ✔ ✔ developed by Carl Rogers, this humanistic therapy includes unconditional positive regard, congruency and empathy, also known as person-centered therapy client mental fitness - ✔ ✔ the process of evaluating whether clients are competent to stand trial -clients must understand the legal proceedings against them, roles of the court personnel, difference between pleading guilty vs not guilty, plea bargain -clients ability to assist in their own defense or their ability to work with their attorneys and to take an active part in their own defense Client-Centered Theory - ✔ ✔ A humanistic therapy, developed by Carl Rogers in which the therapist use techniques such as active listening within a genuine, accepting, empathetic, environment to facilitate clients' growth. Co-occurring disorders - ✔ ✔ Two conditions that affect health at the same time for example substance use disorders and other mental illnesses Comorbidity - ✔ ✔ The co-occurrence of two or more disorders (physical or mental) in a single individual. One does not cause the other. Need to be aware for treatment
i.e. anorexia nervosa and body dysmorphic disorder competency restoration - ✔ ✔ a psychoeducational intervention in which clients who have been found incapable of proceeding in legal trials due to any combination of limited understanding,
communication deficits, or impaired ability to conform their behaviors to the demands of the courtroom are rendered capable Confabulation - ✔ ✔ the unintended false recollection of episodic memories Conflict Theory - ✔ ✔ the family is viewed as contributing to social inequality by reinforcing economic inequality and by reinforcing patriarchy. Family problems stem from economic inequality and from patriarchal ideology. The family can also be a source of conflict, including physical violence and emotional cruelty, for its own members. Congruence - ✔ ✔ genuineness, authentic, the most important attribute of counseling, according to Carl Rogers conscious validation - ✔ ✔ within DBT, often used to help clients improve interpersonal effectiveness and mindfulness skills -6 levels of validation Conversion defense mechanism - ✔ ✔ repressed urge is expressed disguised as a disturbance of body function, usually of the sensory, voluntary nervous system (as pain, deafness, blindness, paralysis, convulsions, tics). Conversion is BEST defined as a: A.Therapeutic process aimed at turning negative thoughts directed at others into positive ones B.Reaction to trauma which limits emotional growth and development throughout the life course C.Defense mechanism in which a repressed urge is expressed by disturbance of a body function D.Strategy used in family therapy to get consensus among those with divergent viewpoints - ✔ ✔ C.Defense mechanism in which a repressed urge is expressed by disturbance of a body function Cultural convergence - ✔ ✔ The tendency for cultures to become more alike as they increasingly share technology and organizational structures in a modern world united by improved transportation and communication. cultural difference - ✔ ✔ involves the integrated and maintained system of socially acquired values, beliefs, and rules of conduct which impact the range of accepted behaviors distinguishable from one societal group to another; it is not negative in nature Current guidelines concerning social workers' duty to disclose confidential information without client consent to protect third parties from harm were initially established in: A.Case law B.Constitutional law
Devaluation (defense mechanism) - ✔ ✔ Attributing exaggerated negative qualities to oneself or another person Diazepam - ✔ ✔ Valium Displacement (defense mechanism) - ✔ ✔ The transfer of feelings from one target to another that is considered less threatening or that is neutral. DMDD (disruptive mood dysregulation disorder) - ✔ ✔ A condition in which a child has chronic irritability and anger that culminates in frequent tantrums that are inappropriate to the circumstances and to the child's age.
age: 8- doorknob disclosures - ✔ ✔ when patients blurt out their main concerns just as a physician is leaving the room, can be caused by fear or embarrassment about the information the patients are providing double bind communication - ✔ ✔ conflicting messages sent when verbal messages and body language don't agree Dual Diagnosis - ✔ ✔ The client with both substance abuse and another psychiatric illness During an initial session with a social worker, an adult who was sexually abused as a child is fearful and hesitant to respond to a request for specific information about the abuse. What should the social worker do FIRST? A. Change the subject to one more comfortable for the client B. Confront the client about these fears C. Acknowledge the client's reluctance to discuss these experiences D. Ask whether the client would prefer to end the session - ✔ ✔ C. Acknowledge the client's reluctance to discuss these experiences During an intake session, a client is unable to provide several details needed to complete a psychosocial history. The social worker obtains the client's consent to contact family members for additional information. What term BEST describes the type of information that will be obtained? A. Diagnostic B. Inferential C. Objective
D. Collateral - ✔ ✔ D. Collateral During Mrs. S's first appointment in a family agency, the social worker encourages her to express her feelings about the recent placement of her child in a residential facility for the developmentally disabled. Mrs. S talks at length instead about her physical health problems. The social worker should: (A) use Mrs. S's remarks about her health to identify unresolved parenting issues (B) refocus the interview on the child's behavior and the reason for the residential placement (C) explore with Mrs. S how her health problems are related to the recent placement of her child (D) listen to Mrs. S's description of her health as a beginning of a relationship and means of assessing her self-perception - ✔ ✔ (D) listen to Mrs. S's description of her health as a beginning of a relationship and means of assessing her self-perception
dysfunctional family dynamics - ✔ ✔ traits or behaviors that characterize unhealthy interactions between family members; poor communication and not listen to each other Dysthymia (Chronic Persistent Depressive Disorder) - ✔ ✔ 2years history of depressed mood, must not be without for 2 months, less severity than major depression, constant for a period of 2 years dysthymic disorder - ✔ ✔ A more mild, chronic depression that is insufficient in severity to merit diagnosis of a major depressive episode. ego - ✔ ✔ the largely conscious, "executive" part of personality that, according to Freud, mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain. Ego Psychology - ✔ ✔ a school of psychodynamic thought that emphasizes the skills and adaptive capacities of the ego Empathy - ✔ ✔ an understanding of another's feelings entropy - ✔ ✔ A measure of disorder or randomness. Existential theory - ✔ ✔ Theory from which crisis intervention took the ideas of choice and anxiety. The crisis worker believes that anxiety can be a motivator for change and encourages the client to master anxiety realistically by making choices and accepting responsibility for the choices. external validity - ✔ ✔ an attribute of an experiment in which variables have been defined in a normal, typical, or realistic way family therapy for substance use disorder - ✔ ✔ -can help the family as a whole recover and heal -typically introduced after the individual in treatment for addiction has made progress in recovery
