LMSW Practice Test; Questions And Answers, Winter 2023/2024, Exams of Nursing

Download LMSW Practice Test; Questions And Answers, Winter 2023/2024 and more Exams Nursing in PDF only on Docsity! LMSW Practice Test; Questions And Answers, Winter 2023/2024.Latest Update.Assured Pass. 1.According to Beck, a depressed person does not see the positive aspects of his/her situation because of: a. Precipitating factors b. Lack of support c. A dysfunctional schema d. Lack of adaptive coping strategies - answers>c. A dysfunctional schema 2. It is necessary to obtain informed consent prior to giving out data about a patient. Which of the following statements is MOST correct regarding this issue? a. You must obtain informed consent from your patient in most situations, but not in all situations. b. If a significant other requests information about your patient, you may release it without informed consent. c. If you are going to consult with a colleague, you must have informed consent from your patient. d. You must always have informed consent from your patient. - answers>a. You must obtain informed consent from your patient in most situations, but not in all situations. Page 1 of 58 3. A soldier with combat-related Posttraumatic Stress Disorder desires to return to combat. What is the first thing you should do? a. Allow the soldier full self-determination, returning when he deems appropriate. b. Inform the client that return will likely cause an increase in symptoms and is not advised. c. Contact the commanding officer to determine if this is an option for the soldier. d. Assess progress in treatment and current level of functioning. - answers>d. Assess progress in treatment and current level of functioning. 4. A man is referred by his primary care provider and presents with a diagnosis of Hypochondriasis. What is the FIRST crucial step in treatment? a. History taking b. Establishment of trust and appreciation for the patient's problems c. Education about the link between stress, emotions and lifestyle and physical health d. Treatment planning - answers>b. Establishment of trust and appreciation for the patient's problems 5. Client: "I'm depressed. I've lost my hair at a much quicker rate than I thought possible. I'm terribly embarrassed to go out in public. I'm feeling extremely anxious and uneasy about my baldness." Social Worker: "You're anxious and uneasy about the transformations that are a natural process of aging." The social worker's response is: a. Encouragement Page 2 of 58 c. Future mental health risk d. Needs for various concrete services (e.g., transportation, alternate housing) - answers>a. Immediate needs for physical safety, food and clothing 7-year-old child is refusing to sleep in his own bed at night. When the parents sit with him in his room, he is fine. When they leave the room, he begins to cry. When they come back in, he stops crying. This is an example of Operant conditioning Classical conditioning Punishment cycles Higher order conditioning - answers>operant conditioning Older individuals are often misdiagnosed with Alzheimer's when, in fact, the more accurate diagnosis is Anxiety Depression Thyroid Disorder Delirium - answers>Depression. Approximately 55% of the elderly suffer from depression and are often misdiagnosed with Alzheimer's or Dementia. Anxiety (answer #1) is not correct, although anxiety can be a problem in older adults; anxiety is not a characteristic that would be a symptom of Alzheimer's. Thyroid disorder (answer #3) is not correct because this condition is a malfunction of the thyroid gland, resulting in a variety of medical symptoms, usually not similar to symptoms of Alzheimer's. Delirium (answer #4) is not correct, as Delirium is characterized by Page 5 of 58 a disturbance of consciousness and a change in cognition that develop over a short period of time. A social worker is seeing a new client, who is a college student, for therapy. After speaking with the client about her current enrollment at the university, the social worker spent a significant amount of time urging the client to work less so she could focus on school. The social worker wants the client to get all "A" grades this semester because she reminds him of his daughter at that same stage in life, as well as the anxieties that he experienced during that time in his life. The client really wants to please the social worker because he reminds her of her dad. Which of the following is reflected in the client? Transference Counter-transference Projection A dual relationship - answers>Tranference. In a therapeutic context, transference refers to redirection of a client's feelings from a significant person to the social worker. Counter- transference (answer #2) is incorrect because this is the redirection of a social worker's feelings toward a client, or more generally speaking a social worker's emotional entanglement with a client, which was reflected in the first part of the question; however, this does not describe what is being reflected in this client. Projection (answer #3) is demonstrated when a person's own unacceptable or threatening feelings are repressed and then attributed to someone else, which is not occurring in this case example. A dual relationship (answer #4) is incorrect, as this refers to a situation where multiple roles exist (not just perceived) between a social worker and a client, such as an actual father and daughter relationship between a social worker and client. A client was recently diagnosed with Multiple Sclerosis. She immediately began to learn everything she could about the illness: reading books, journal articles, and the latest Page 6 of 58 experimental research. The client's response to her diagnosis is representative of which defense mechanism? Intellectualization Regression Sublimation Repression - answers>Intellectualization A social worker has been working with a 35-year-old divorced woman who has joint custody of her son, but is the custodial parent. Her ex-husband, whom the social worker has never met, is taking the client to court in an attempt to gain full custody of the son. The social worker receives a subpoena from the husband's attorney requesting records regarding the wife's therapy sessions with the social worker. The social worker is required to do which of the following? The social worker must release the entire record of the therapy sessions to the attorney The social worker is allowed to release only those records that make direct reference to the wife's relationship with the son, not her treatment issues The social worker is required to respond to the subpoena, but is not required to release records since the subpoena was issued by the attorney and not a judge The social worker does not have to respond to the subpoena because the client's records are confidential - answers>The social worker is required to respond to the subpoena, but is not required to release records since the subpoena was issued by the attorney and not a judge A 22-year-old female client is considering having an abortion. Her social worker is pro-choice and feels passionately about the issue. Which of the following is the FIRST thing that the social worker should do in this situation? She should talk with the client about abortion alternatives Page 7 of 58 Pre-conventional Morality Conventional Morality Post-Conventional Morality Morality of Social Contract - answers>The correct answer is #1 - Pre-conventional Morality. Pre- conventional Morality is Level 1, Stage 2 and involves "you scratch my back and I'll scratch your back" types of behavior. Conventional Morality (answer #2) and Post-Conventional Morality (answer #3) are both incorrect, as they are both identified as levels involving moral reasoning that goes beyond a self-focused perspective. Morality of Social Contract (answer #4) is not correct because it is a stage, not a level, according to Kohlberg. Moreover, it involves higher moral reasoning than that demonstrated by the politician. A client has been drinking frequently since the death of his son last year. He states that he feels better physically when he drinks more, especially in the mid-morning, and that he does not feel intoxicated as often as he did immediately after his son's death. He expresses his desire to quit but says that he cannot get away from the craving. The client feels embarrassed because his sister found him unconscious one night as a result of his drinking. Which of the following would most likely be the social worker's FIRST diagnosis? Depression Alcohol Dependence Alcohol Abuse Avoidant Personality Disorder - answers>Alcohol Dependence. Depression (answer #1) is not correct because while the client may be depressed, more data would be needed to make this diagnosis. Alcohol Abuse (answer #3) is not correct because the client would need to show at least two physiological factors and five behavioral patterns over a twelve-month period, which is severe and exceeds the requirements for Alcohol Abuse. Avoidant Personality Disorder (answer Page 10 of 58 #4) is not correct because this question does not provide sufficient information to determine this diagnosis. A social worker has recently learned from the wife of a couple he is seeing that the wife believes that she is a lesbian. She states she does not want to share this with her husband. During the next session, the husband asks his wife if she likes women better than men. The wife answers "No." What is the FIRST response that the social worker should make in this situation? Encourage the wife to be honest Encourage the husband to ask the wife after the session Say nothing but plan on speaking with the wife after the session Encourage the couple to discuss the issue - answers>Encourage the couple to discuss the issue. The responsibility for establishing a relationship of honesty rests with the couple. The social worker can facilitate the process of developing such a relationship by encouraging dialogue about this and other important issues. Encouraging the wife to be honest (answer #1) is not the best answer for this scenario, as the social worker would be indicating that he has information that the husband does not have. The social worker may, at another time, need to help the wife decide how she will handle this information with her husband. Encouraging the husband to ask the wife after the session (answer #2) and saying nothing but planning on speaking with the wife after the session (answer #3) are both incorrect answers because these would be interfering with the couple dealing with their own situation. A social worker receives a new client who is seeking cognitive behavioral therapy, which is not the social worker's treatment of expertise. The social worker should Attempt this intervention Refer the client to an expert Page 11 of 58 Explore the client's reasons for wanting cognitive behavioral therapy Use his own techniques as he or she is well trained to meet the client's needs - answers>Explore the client's reasons for wanting cognitive behavioral therapy. As the social worker discusses this with the client, it may become evident that the social worker is able to provide the services the client desires. Alternatively, the discussion may reveal the need to refer the client elsewhere. Attempting this intervention (answer #1) is not correct because a social worker should be trained and competent in the interventions he or she uses. Referring the client to an expert (answer #2) is not the best answer because the social worker should find out more about the client's request before referring the client to an expert in cognitive behavioral therapy. Using the social worker's own techniques as he or she is well trained to meet the client's needs (answer #4) is not correct because the client has asked specifically for cognitive behavioral therapy and should be part of the decision-making process regarding whether other techniques could be as beneficial. A 60-year-old female client has been meeting with a social worker to discuss dissatisfaction in her marriage. Over the course of the first few sessions, the social worker noticed that the client spent little time discussing substantive marital issues and instead discussed her accomplishments, even when it did not fit into the conversation. She also talked about how she felt that it was important for her to spend her time with other well-educated individuals. The client described work situations in which she became angry and then tearful when not validated for her achievements. She also tried to get a manager fired for not implementing her ideas. The most likely diagnosis for this client would fall into which category? Cluster A Cluster B Cluster C None of the above - answers>Narcissistic Personality Disorder- a Cluster B classification- is characterized by many of the behaviors the client exhibits. Cluster B Personality Disorders are Page 12 of 58 The nature of the client's problem(s) The level of care needed The treatment provider's knowledge and skill level The philosophy of the agency - answers>The level of care needed. While all of the other answer options: the nature of the client's problem(s) (answer #1), the treatment provider's knowledge and skill level (answer #3), and the philosophy of the agency (answer #4) are important, the level of care needed must be the first consideration. If the client needs hospitalization, incarceration, home healthcare, or hospice, the treatment options would be much different than if the client can receive services on an out-patient basis. A 40-year-old male client explains that he is seeking care because he suffers from panic attacks. He notes that he gets chills, nausea, dizziness, and experiences fear about once a day. A social worker's FIRST step with this client would be to Teach relaxation therapy Set goals for reduction of anxiety Arrange for a doctor's appointment Assess the client's current situation - answers>Assess the client's current situation In a Task-Centered Treatment approach, once a social worker establishes the client(s) needs, which of the following is the BEST option? As the expert, the social worker should be the primary person to establish the treatment goals The client should be the primary person to establish the treatment goals The client and the social worker should jointly establish the treatment goals Page 15 of 58 A medical doctor should be included in establishing the treatment goals - answers>The client and the social worker should jointly establish the treatment goals You are called to evaluate a 64-year-old male with chronic obstructive pulmonary disease. He lives in an assisted living facility, and was brought to the emergency room by his daughter. She had taken him to lunch, and became distressed when he refused to return to the facility. He states he wants to live in his motor home, as he resents the loss of privacy at the facility. His daughter confirms he owns a working, fully self-contained motor home (i.e., stove, shower, refrigerator, etc). He has adequate funds. He plans to park the motor home in a nearby Kampgrounds of America (KOA) campground, where all utilities can be hooked up. He can have food and other supplies delivered. However, it is November and it is unseasonably cold. The doctor confirms that the patient is prone to pneumonia, and the daughter states "he will die if he doesn't return to the facility." The patient refuses to consider any other living situation. In this situation, the social worker should: a. Call the police and have them take the patient back to the facility. b. Call adult protective services for further intervention. c. Allow the patient to move into his motor home. d. Place the patient on an involuntary hold for suicidal behavior. - answers>C: Allow the patient to move into his motor home. The patient has a plan sufficient to meet his needs for food, clothing, and shelter. He has the legal right to choose where he wishes to live, even if others are not comfortable with his choice. Calling the police will not help, as they cannot force him to return to the facility. Adult protective services may have a subsequent role, if the patient begins to exhibit marked self- neglect or cognitive changes, but they cannot force the patient either. Finally, the patient is not eligible for an involuntary hold, as he is not placing himself or others in danger based upon a diagnosable mental illness, intoxication, or other substance abuse. Careful collateral planning, however, will be important (ensuring the daughter visits and checks in on him, etc) to try and Page 16 of 58 maximize his potential for success. After coping with the hardships of independent living, he may willingly return to assisted living. 2. You have just had your first session with a 24-year-old college student. She is seeing you following the break-up of a two-year relationship, which occurred without warning about six weeks prior to this visit. As she explained it, "He met someone else and just moved on." She has been having trouble sleeping and concentrating on her studies since that time. Today she presents as dysphoric and tearful, but is affectively expressive and responsive to humor and other interactive stimuli. The university she attends is a considerable distance from her family and friends, leaving her with limited support during this difficult time. The most appropriate diagnosis would be: a. Primary insomnia. b. Major depression. c. Adjustment disorder with depressed mood. d. Acute stress disorder. - answers>2 - C: Adjustment disorder with depressed mood. Criteria for this disorder includes a time-limited nature, usually beginning within three months of the stressful event, and lessening within six months-either with removal of the stressor or through new adaptation skills. Adjustment disorder is a "sub-threshold disorder," allowing for early classification of a temporary condition when the clinical picture remains vague. While the patient does have insomnia, it arises from the stressful loss and not as an independent condition. Many of the essential criteria for a major depression are absent (weight loss, psychomotor agitation, blunted affect, etc), although without successful treatment this condition could emerge. The diagnosis of acute stress disorder is not appropriate as the precipitating event did not involve threatened or actual serious injury or death. Page 17 of 58 b. Rapprochement. c. Differentiation. d. Transmuting internalization. - answers>D: Transmuting internalization. Empathic mirroring is the process by which the mother demonstrates ("reflects") care and understanding of the child, in turn helping the child to develop a self-identity. Rapprochement is a term from object relations theory, indicating the need for an infant to seek independence while still retaining security. Differentiation is a substage in object relations theory, where an infant begins to look at the outside world, as opposed to the inward focus common to infants younger than five months of age. 7. An early cognitive theorist, who worked directly with Freud, established a theoretical orientation that differed from Freud's in three key features: 1) an individual's personality is best perceived as a whole, rather than as having hierarchical segments or parts; 2) social relationships drive behavior more than sexual motivations; and 3) current beliefs and thoughts play a far greater role in human behavior than is suggested via psychoanalytic theory, which is based largely in the unconscious and in past experiences and beliefs. The name of this theorist is: a. Lawrence Kohlberg. b. Anna Freud. c. Albert Ellis. d. Alfred Adler. - answers>D: Alfred Adler. Adlerian theory also includes a biological view, largely absent in Psychoanalytic Theory, recognizing that hormonal changes, physical illness, chemical imbalances, and neurological disorders can dramatically influence capacity and behavior. It is important to note, however, that Alder still locates false beliefs, irrational thoughts, and misconceptions in the unconscious mind. Page 20 of 58 8. In working with a client, you become aware that she persistently behaves in ways to please or gain the approval of others. While this is not always problematic, you discover that she is obsessed with wearing the "right" clothes, living in the "right" neighborhood, and marrying the "right" person. At present, her finances are in a shambles as she tries desperately to "keep up with the Joneses," and her romantic life is suffering, as she only pursues relations that she believes others think are optimum, rather than judging relationships on more personally relevant values, such as her feelings for them, baseline compatibility, etc. Utilizing Kohlberg's Theory of Moral Development, specify the Level and Stage of moral development that applies to this individual: a. Conventional Level, Stage 3. b. Pre-conventional Level, Stage 1. c. Post-conventional Level, Stage 6. d. Conventional Level, Stage 4. - answers>A: Conventional Level, Stage 3. The Theory of Moral Development was created by Lawrence Kohlberg, to extend and enhance Jean Piaget's theory. Overall, Kohlberg felt that the process of moral development was more complex and extended than that put forth by Piaget. 9. You have been contacted by a couple to assist them with issues of marital discord. They have been married about six months. The wife presents as vulnerable, tearful, and anxious, and the husband presents as angry and overwhelmed. The wife openly claims that "he has never loved me," and expresses anger that he married her without "the proper feelings." The husband responds that he has "done everything possible" to "prove" his love (to the point of near bankruptcy and jeopardizing his employment with frequent absences), but nothing is sufficient. During the interview, you discover that she has had many short-term relationships in the past, that she has a history of suicide gestures and "fits of rage." Further, she frequently demands a Page 21 of 58 divorce and then begs him to stay, is routinely physically assaultive, etc. The most likely diagnosis is: a. Intermittent explosive disorder. b. Histrionic personality disorder. c. Paranoid personality disorder. d. Borderline personality disorder. - answers>D: Borderline personality disorder. Individuals with this diagnosis will exhibit: frantic efforts to avoid real or imagined abandonment; unstable and intense interpersonal relationships (especially extremes of idealization and devaluation); an unstable sense of self; extreme impulsivity (e.g., spending, sex, drug use, reckless driving, binge eating, etc); recurring suicidal behavior (gestures or threats, or self-mutilating behavior); affective instability due to reactivity of mood; chronic feelings of emptiness; intense anger (e.g., frequent displays of temper, recurrent physical fights); transient, stress-related paranoid ideation; or severe dissociative symptoms. However, as with all Axis II disorders, this diagnosis cannot properly be made during a first contact, but must be substantiated over a course of clinical contacts sufficient to compel the diagnosis to be made (DSM-IV). 10. All but one of the following are National Association of Social Workers (NASW) standards for cultural competence: a. Social workers should endeavor to seek out, employ, and retain employees who provide diversity in the profession. b. Social workers shall endeavor to resources and services in the native language of those they serve, including the use of translated materials and interpreters. c. Social workers should develop the skills to work with clients in culturally competent ways, and with respect for diversity. Page 22 of 58 However, emotional disorders, anxiety, or oppositional defiant disorder can sometimes underlie the behavior. Incidence of the condition drops steadily after age six. 14. The following criteria are all used to distinguish substance abuse from substance dependence except: a. Symptoms of substance abuse are usually less severe than those of dependence. b. The problematic effects of abuse are usually limited to family, finances, employment, and legal issues (e.g., driving under the influence), while dependence also involves significant physiological problems. c. Substance abuse typically involves narcotics, while dependence typically involves non- narcotic drugs. d. Abuse is typically limited to recreational use, while dependence involves the need for increasing doses for the desired effect and withdrawal symptoms of not used regularly. - answers>C: Substance abuse typically involves narcotics, while dependence typically involves non-narcotic drugs. In general, narcotics are more addictive than non-narcotic substances. Even relatively "benign" substances of abuse, such as marijuana, can produce dependence if used often enough, and mounting clinical and preclinical evidence suggests that a marijuana withdrawal syndrome also exists (however, it is not yet in the DSM). Common treatment medications include: Antabuse (disulfiram; for alcohol abuse); ReVia (naltrexone; for alcohol and narcotics); and Trexan (naltrexone; for alcohol and opioid dependence). 15. Name the four classic diagnostic "A's" of schizophrenia: a. Awareness, ambivalence, autism, and associations. b. Agitation, awareness, associations, and autism. Page 25 of 58 c. Affect, anxiety, ambivalence, and awareness. d. Affect, associations, ambivalence, and autism. - answers>D: Affect, associations, ambivalence, and autism. In 1911, Eugen Bleuler coined the term schizophrenia, and defined it using his now-classic four "As:" Affect (blunted emotional response to stimuli); associations (loosening, disordered thought patterns), ambivalence (an inability to make decisions due to poor information integration and processing), and autism (a preoccupation with the self and one's thoughts). Common medications for treatment: Clorazil (clozapine), Haldol (haloperidol), Loxitane (loxapine), Mellaril (thioridazine), Prolixin (fluphenazine), Risperdal (risperidone), Stelazine (trifluoperazine), Thorazine (chlorpromazine), and Zyprexa (olanzapine). 16. You are called to see a young black man in his mid-twenties. Two adult sisters brought him for an urgent appointment. The young man is clean, neatly dressed in slacks, dress shoes, and a tweed sport coat. He is also calm, relaxed, and without any signs of agitation. The two sisters, however, appear disheveled, frazzled, and almost histrionic. They blurt out the he "has problems" and urge you to talk with him. Privately, he tells you that he is fine. Later, however, the ladies tell you he left home abruptly and traveled cross-country with no destination. He didn't sleep for three days (with them pursuing him), was spending money excessively and writing checks he couldn't cover. He ended up in a nationally famous amusement park at 3:00 a.m. (having scaled a fence), sitting on an empty roller coaster "waiting for the ride to start." When confronted, he admits all of this, but says he's now rested, and doing better. The most likely diagnosis would be: a. Brief psychotic disorder. b. Bipolar I, single manic episode, in full remission. c. Bipolar I, single hypomanic episode, in full remission. d. Cyclothymic disorder. - answers>B: Bipolar I, single manic episode, in full remission. Page 26 of 58 There is no evidence of frank psychosis, thus brief psychotic disorder can be ruled out. Hypomania does not appear appropriate, as the client's behavior would likely have resulted in hospitalization had anyone been able to evaluate him during his period of mania. Cyclothymic disorder does not appear appropriate, as the client's conduct exceeded the threshold severity for hypomania, and no information is provided regarding depressive symptoms (though he may well have them). Finally, the Bipolar I, single manic episode is identified to be in full remission, as the client's manic symptoms appear to have completely resolved. 17. A therapeutic approach that views the client from a social context, that sees behavior as derived from unconscious drives and motivations, that views disorders and dysfunction as emerging from internal conflicts and anxiety, and that seeks to facilitate the conscious awareness of previously repressed information is called a: a. Cognitive approach. b. Psychoanalytic approach. c. Gestalt approach. d. Behavior approach. - answers>B: Psychoanalytic approach. This approach is built upon the concepts and theory of Sigmund Freud and others who have followed him. The approach is also sometimes called a "psychodynamic" approach. 18. The concepts of "pre-affiliation" (becoming acquainted), "power and control" (setting the roles), "intimacy" (developing cohesion), "differentiation" (independent opinion expression), and "separation" (moving to closure and termination) are all stages in: a. The lifecycle of a therapeutic relationship. b. General relationship cycles. c. Group development. Page 27 of 58 3. Common indicators of sexual, physical and emotional abuse include all of the following EXCEPT: a. violence against younger children b. sexualized behavior c. isolation d. stuttering - answers>d. stuttering 4. The concept of gender roles is BEST defined as: a. attitudes and behaviors attached to individuals because of their sex b. an individual's sex orientation and/or preference c. biological characteristics that influence an individual's behavior d. interplay of biological and sociocultural influences - answers>a. attitudes and behaviors attached to individuals because of their sex 5. Which type of interviewing question is MOST likely to generate client defensiveness? a. open ended b. closed c. leading Page 30 of 58 d. why - answers>d. why 6. When interviewing a client whose speech patterns are different from the social worker's, the social worker's PRIMARY consideration should be that: a. communication patterns vary due to economic conditions b. speech is influenced by culture and experience c. psychosocial conditions will cause variations in speech d. speech is influenced by group taboos and norms and may indicate false beliefs - answers>b. speech is influenced by culture and experience 7. The initial symptoms of schizophrenia MOST often occur between which of the following years of age? a. 6 to 12 b. 13 to 16 c. 17 to 45 d. 16 to 60 - answers>c. 17 to 45 8. Which of the following approaches would be MOST appropriate to use in evaluating client satisfaction with the social worker's provision of services? a. using a single system design, evaluate the quality of services Page 31 of 58 b. in the final interview, ask the client about their level of satisfaction c. after submitting process recordings, ask supervisor for feedback d. at termination, ask clients to complete a service evaluation and satisfaction form - answers>d. at termination, ask clients to complete a service evaluation and satisfaction form 9. When conducting an assessment of the risk factors of child abuse for a child of a different ethnic background, a social worker must FIRST: a. be aware of how personal cultural biases affect the social worker's ability to deal with issues of diversity b. realize that assessment models are not a substitute for clinical judgment or experience c. use a strengths' perspective rather than a deficit model to form a partnership with the child's family d. understand the need for appropriate eye contact, tone of voice and question techniques during the assessment - answers>a. be aware of how personal cultural biases affect the social worker's ability to deal with issues of diversity 10. A social worker is receiving a client with long-standing depression. It becomes known that the client has racist beliefs. The social worker should: a. respectfully confront the client's prejudiced beliefs b. educate the client about the negative effects of racism c. refer the client to another therapist who might have similar belief Page 32 of 58 6. In facilitating a hospital support group for bereaved parents, a social worker can discuss a personal experience of a death of a child to: a. create empathy with the participants b. receive help from the group c. create a sense of shared experience d. establish role as expert on grief issues - answers>c. create a sense of shared experience 7. The primary role of a social worker is: a. building rapport b. providing support systems c. acting as a resource d. curing emotional or mental dysfunction - answers>c. acting as a resource 8. A client with a history of drug abuse was referred to a social worker by a concerned relative. The social worker should FIRST: a. conduct a family interview b. begin treatment, focusing on the reason for the drug abuse c. refer the client for substance abuse treatment Page 35 of 58 d. evaluate the client's motivation for change - answers>c. refer the client for substance abuse treatment 9. In adult survivors of childhood sexual abuse, the most frequently encountered defense mechanism is: a. denial b. intellectualism c. suppression d. projection - answers>a. denial 10. Which of the following approaches would be MOST appropriate to use in evaluating client satisfaction with the social worker's provision of services? a. using a single system design, evaluating the quality of services b. in the final interview, ask the clients about their level of satisfaction c. through process recordings, ask the supervisor for feedback d. at termination, ask clients to complete a services evaluation and satisfaction form - answers>d. at termination, ask clients to complete a services evaluation and satisfaction form Physiological: hunger, thirst, bodily comforts, etc. - answers>Maslow's 1st Hierarchy of Need Safety and security: out of danger - answers>Maslow's 2nd Hierarchy of Need Page 36 of 58 Belongingness and Love: affiliate with others, be accepted - answers>Maslow's 3rd Hierarchy of Need Esteem: to achieve, be competent, gain approval, and recognition - answers>Maslow's 4th Hierarchy of Need - birth to 12 months - primary interaction through mouth - rooting sucking is important - conflict is weaning - answers>Freud's oral stage - 1 to 3 years old - controlling bladder and bowels - conflict in potty training - learn to control body needs which leads to accomplishment and independence - answers>Freud's anal stage - discovering difference in boys and girls (genitals) - 3 to 6 years old - conflict can be castration anxiety as mother's attention is sought - answers>Freud's Phalic stage Page 37 of 58 - career and family - feel like contributing to the world by being active in home/community - develop care in this stage - proud of your accomplishments, unity w/partner, watching children grow up - answers>Erikson's Generativity/Stagnation Stage - old age - reflecting back on life - feels like life was wasted and regrets - bitterness /despair - but if proud of life will feel integrity - answers>Erikson's Integrity/Despair stage Holistic approach to look at an individual's systems and how they interact with each other - answers>General Systems Theory Constant interaction with environment and each system impacts one another - answers>Ecological systems theory Family affects individual and family functioning across life span - answers>Family systems A concept where person has ability for family member to tell difference between their experience's and identify themselves from others - answers>Differentiation of self Page 40 of 58 When family identifications are fused - answers>Undifferentiated family ego mass when parents pull children closer to one side - answers>Triangulation Mutual emotional force within a family which occurs when there is a chronic family tension - answers>Nuclear family emotional process unhealthy way of dealing with family growing up or building one's own individual identity - answers>Emotional cut off people tend to have many similarities with those sharing birth order - answers>sibling position parents pour emotional problems on to child - answers>family projection process family projection process repeats itself from each generation - answers>multigenerational transmission process theory that is concerned with how internal processes such as needs, desires, emotions motivate human bx - answers>psychodynamic theory theory that believes unconscious and conscious mental activity serves as motivating force in human bx - answers>psychodynamic theory Page 41 of 58 theory that believes early childhood experiences are central in patterning an individual's emotions which leads to problems in life - answers>psychodynamic theory theory that says individual's get overwhelmed with internal/external demands and use ego defense mechanisms - answers>psychodynamic theory believe healing occurs through attention to transferences and treatment relationships - answers>psychodynamic theory theories that support individual's cognitive functioning and learn through acting on their environment - answers>behavior theory / cognitive theory / learning theory behaviors learned through conditioning and we must help teach new skills and behaviors - answers>Behavior theory theory focused on internal states, such as motivation, problem solving, decision-making, thinking, attention and how we interact with the world - answers>cognitive theory - birth to 2 years old - perception of world is limited to sensory and motor - learn through sucking, grasping, listening - need to learn object permenance - answers>sensorimotor stage (Piaget) Page 42 of 58 First stage of group development where you become oriented to goals and procedures of the group. Info and structure are critical - answers>Forming Second stage of group development where there is resistance and challenging of leadership - answers>Storming Third stage of group development where there is cooperation and team building. - answers>Norming Fourth stage of group development where there is functioning to achieve group goals. - answers>Performing Fifth stage of group development where there is not functioning as group much longer and you work on closure - answers>Mourning Understanding an individual and their bx in light of environmental contexts in which they live and act - answers>Person In Environment Type of addiction model where addiction acts as a "brain disease", there is neurotransmitter imbalance. The agent is the drug, the vector is the dealer and the host is the addict. They think "stamp out" disease by eliminating drugs. - answers>Medical Model Page 45 of 58 Type of addiction model that looks as drug abusers as "self-medicating" and that drug abuse is a symptom of underlying psychological problems. Drug is a maladaptive coping strategy. They need to resolve inner conflict and then drugs won't be necessary. - answers>Psychodynamic model Type of addiction model where the drug use is a learned behavior and drugs are used because they were modeled. Use drugs due to peer pressure. Environment leads to drug use (advertising). Drug use is a maladaptive relationship negotiation strategy. - answers>Social Model Type of addiction model where addicts are "weak" and can overcome a compulsion to use with willpower. Drug abusers choose to use drugs. Drug abusers are anti-social and should be punished. Drugs are evil. - answers>Moral model Type of addiction model which says all other models are true to greater or lesser degrees. Each person's drug use is result of some aspects of some or all other models. Treatment and recovery require addressing the body/mind/social environment and spiritual needs of an individual. - answers>Bio-psycho-social model - this theory identifies range of concepts to describe how people, groups, communities exchange information and how messages are conveyed and received - answers>Communication theory Ability to communicate is central to effective social work practice and has many forms - language, speech, written word - answers>Communication theory Page 46 of 58 Non-verbal forms of communication - answers>body language, dress, space, tone, some which is unconscious Way knowledge and skills can be adapted if they are to be made relevant and applicable to different situations encountered in social work practice - answers>transferability person replaces 1 feeling or emotion in place of another - answers>substitution refocusing of aggression or emotions evoked from an external force into one's self - answers>inversion manifestation of emotional anxiety into physical symptoms - answers>somatization separation of postponement of a feeling that normally would accompany a situation or thought - answers>Dissocation Attributing a painful thought or idea to another person - answers>Projection Attempting to provide a logical / rational explanation for something to avoid guilt or shame - answers>Rationalization Page 47 of 58 What should an infant be doing at 10 months? - answers>Crawl, exhibit stranger shyness/anxiety What should an infant be doing at 1 year old? - answers>Stand by holding on to supports, able to stand unsupported What should an infant be doing at 18 months old? - answers>Walking without supervision/support What should an infant be doing at 2 years old? - answers>Run or walk up stairs Physical development: - age 1-4 months head circumference should grow at a rate of about 1 and half inches for the first two months of life, and then at about an inch per month until an age of 4 months. Gums red. - answers>Brain is growing - great for development Physical development: - 4 to 8 months child's head and chest circumference should be about equal. The head should continue to grow, at a rate of about ¾ inch per month until 6 months of age, and about 1/3 inch for each month thereafter. It is during this time period that the first evidence of teeth will begin to appear. Normally the incisors will come in first. It is this period that is associated with teething in our society. - answers>On the motor skill development side, at this age the child should be able to pass an object from hand to hand, and should be able to grasp a bottle. Page 50 of 58 At 8-12 months the child will have arms and hands that are more developed that the feet and legs, with the legs possibly appearing bowed, and the feet appearing flat. - answers>It is at this age that the child will begin to explore, and has developed the ability to crawl and manipulate objects. At 12-24 months the child is deemed a toddler. At this age the rate of growth will slow, and the head growth rate will slow dramatically to about 1 inch every 6 months. - answers>It is at this developmental stage that the chest circumference will grow larger than that of the head. As the toddler reaches two years of age, the posture of the child will grow more erect, and the brain will reach about 4/5's of its final size. The trend of slower growth will continue as the child continues to age at the stage of 3 years old. The head will continue to experience slow growth until about age 5, where the child's head will be almost as large as that of an adult. - answers>Throughout these years, the child's body will become more adult like in proportion, and at age five should resemble that of an adults though on a smaller scale. At age six the child will begin to have their baby teeth start being replaced by their permanent teeth. - answers>... secure base where child sees caregiver as secure base from which to explore the world - protest caregiver departure - seek proximity and comfort upon caregiver's return -- show preference for caregiver over a stranger - answers>secure Page 51 of 58 little response from child to seperation or reunion, due to child feeling there is not an attachment - no distress upon departure of caregiver - no response to return of caregiver - treats strangers equal to caregiver - parent doesn't respond to child when child is in distress - discourges crying behavior - answers>avoidant child being unable to use a caregiver as secure base and has inability to explore - child distressed upon seperation - shows reluctance toward caregiver upon return - not able to be comforted by stranger - parent has inconsistent response to child distress - answers>ambivalent/resistant lack of coherent attachment strategy, child showing freezing, rocking, similar bxs upon return of caregiver - caregiver maltreatment, role confusion, abuse - answers>Disorganized - birth to puberty where childhood has 2 substages - archaic stage where there is sporadic consciousness -monarchic stage where beginning of logical and abstract thinking is - ego starts to develop - answers>Childhood stage (carl jung) Page 52 of 58 - taste buds change - touch and small sensitivity - arteries stiffen - bladder problems, frequent urination - body fat shifts to surround deeper organs - bones lose minerals - brain lose some of the structures that connect nerve cells - kidneys shrink/less efficient - lung tissue loses elasticity - muscle mass decline - skin and nails grow slowly - answers>... a set of social and behavioral norms that are widely considered to be appropriate for individuals of a specific sex - answers>gender role peace keeper role, mediating and reducing tension between conflicting parents; may be in response to unconscious anxiety about family breakdown - answers>peace keeper a visible symptom of troubled family system - answers>scapegoat head injuries, bruises, cuts, lacerations, internal injuries, burns, scald, reddening, blistering of tissues by any substance or force, injuries to body in any way, death - answers>physical abuse Page 55 of 58 rape, intercorse, sodomy, fondling, oral sex, incest, sexual penetration, sexual exploitation - answers>sexual abuse repeated negative acts or statements directed at child, exposure to repeated violent, brutal, intimidating acts or statements among members of household, cruel actions to attempt to gain submission, enforce maximum control, modify child's bx, rejection of child - answers>emotional abuse and maltreatment failure to provide and maintain adequate food, clothing, medical care, supervision, education - answers>neglect Chlorpromazine (thorazine) - answers>schizophrenic drug haloperidol (haldol) - answers>schizophrenic drug Perphenazine - answers>schizophrenic drug Fluphenazine - answers>schizophrenic drug Clozapine (clozaril) - answers>schizophrenic drug but can really affect white blood cell counts risperidone (risperdal) - answers>schizophrenic drug; bipolar Page 56 of 58 olanzapine (zyprexa) - answers>schizophrenic drug; bipolar quetiapine (seroquel) - answers>schizophrenic drug ziprasidone (geodon) - answers>schizophrenic drug; bipolar aripiprazole (abilify) - answers>schizophrenic drug; bipolar paliperidone (invega) - answers>schizophrenic drug lurasidone (latuda) - answers>schizophrenic drug; bipolar effects are major weight gain and change in metabolism, increase risk of diabetes and high cholesterol - answers>atypical antipsychotic meds fluoxetine (prozac) - answers>depression meds; bipolar citalopram (celexa) - answers>depression meds sertraline (zoloft) - answers>depression meds; bipolar Page 57 of 58