1|P a g e
SW 650 FINAL ACTUAL EXAM PREP 2026
ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK|CURRENTLY TESTING |NEW
AND REVISED
1. A clinical social worker is conducting an initial biopsychosocial
assessment with a client who reports low mood, anhedonia, and sleep
disturbance for the past three weeks following a job loss. The most
appropriate preliminary diagnostic consideration is:
A. Persistent depressive disorder (dysthymia).
B. Major depressive disorder, single episode.
C. Adjustment disorder with depressed mood.
D. Bipolar II disorder, current episode depressed.
Rationale: The symptoms began within three months of an identifiable
stressor (job loss) and cause significant distress. Adjustment disorder
is diagnosed when the emotional or behavioral symptoms occur in
response to an identifiable stressor and do not meet criteria for
another disorder.
2. According to the NASW Code of Ethics, a social worker’s primary
responsibility is to:
A. The agency employing the social worker.
B. The client or the person seeking services.
C. The broader community and societal well-being.
D. The social work profession itself.
*Rationale: NASW Code of Ethics Standard 1.01 states that social
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workers’ primary responsibility is to promote the well-being of
clients.*
3. A client with borderline personality disorder frequently calls the
social worker after hours, leaving lengthy voicemails threatening self-
harm. The social worker has established clear boundaries regarding
after-hours contact. The most appropriate next step is to:
A. Answer all calls immediately to prevent harm.
B. Implement the crisis safety plan and, if necessary, initiate a
wellness check or emergency services per protocol.
C. Terminate the therapeutic relationship due to boundary violations.
D. Ignore the calls and discuss them in the next scheduled session.
Rationale: The social worker must balance boundary maintenance
with duty to protect. A pre-established crisis plan should be activated;
ignoring threats of self-harm is negligent.
4. A 16-year-old client discloses to the school social worker that they
have been sexually abused by a family member. The social worker’s
first action should be:
A. Maintain confidentiality because the client is a minor and requested
privacy.
B. Report the abuse to child protective services or the appropriate
state agency as mandated by law.
C. Confront the family member directly to stop the abuse.
D. Encourage the client to report the abuse themselves.
Rationale: Social workers are mandated reporters; child abuse or
neglect must be reported immediately regardless of the client’s request
for confidentiality.
5. In motivational interviewing (MI), the acronym OARS stands for:
A. Observe, Ask, Reflect, Summarize.
B. Open-ended questions, Affirmations, Reflections, Summaries.
C. Offer, Advise, Refer, Support.
D. Outline, Analyze, Reassure, Self-disclose.
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Rationale: OARS are core MI communication skills: Open-ended
questions elicit change talk; Affirmations build confidence;
Reflections demonstrate empathy; Summaries consolidate the
conversation.
6. A client with a history of alcohol use disorder has been abstinent for
six months but recently relapsed after a family conflict. Using a
cognitive-behavioral therapy (CBT) framework, the social worker
should first:
A. Confront the client about their lack of commitment to sobriety.
B. Explore the antecedents (triggers) and consequences of the
relapse to identify high-risk situations.
C. Refer the client to a higher level of care immediately.
D. Focus solely on the client’s strengths and ignore the relapse.
Rationale: CBT for substance use disorders involves functional
analysis to identify triggers, thoughts, and behaviors leading to
relapse, then developing coping strategies.
7. Which of the following is a key principle of trauma-informed care?
A. Avoiding discussion of the traumatic event to prevent re-
traumatization.
B. Emphasizing physical, psychological, and emotional safety for
clients and providers.
C. Requiring clients to disclose all trauma details before any
intervention.
D. Assuming all clients have experienced trauma.
Rationale: SAMHSA’s trauma-informed approach prioritizes safety,
trustworthiness, peer support, collaboration, empowerment, and
cultural, historical, and gender issues.
8. A social worker in a private practice setting terminates services with a
client who has achieved treatment goals. The client later contacts the
social worker requesting to be friends on social media. According to
NASW ethics, the social worker should:
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A. Accept the friend request to maintain a positive relationship.
B. Decline the request and explain that dual relationships are
avoided to protect the client’s welfare.
C. Accept the request but block the client from viewing personal posts.
D. Ignore the request and not respond.
Rationale: NASW Standard 1.06(c) states social workers should not
engage in dual or multiple relationships with clients or former clients
that could be harmful.
9. A client presents with excessive worry about multiple life domains
(work, health, finances) occurring more days than not for the past eight
months, accompanied by muscle tension, fatigue, and difficulty
concentrating. The most likely DSM-5-TR diagnosis is:
A. Panic disorder.
B. Social anxiety disorder.
C. Generalized anxiety disorder (GAD).
D. Obsessive-compulsive disorder.
Rationale: GAD is characterized by excessive, uncontrollable worry
about various events or activities for at least six months, with at least
three associated symptoms.
10. In dialectical behavior therapy (DBT), the primary purpose of
“distress tolerance” skills is to:
A. Eliminate all negative emotions permanently.
B. Help clients survive crises without making the situation worse.
C. Replace emotional regulation with cognitive restructuring.
D. Encourage clients to avoid distressing situations.
Rationale: DBT distress tolerance skills (e.g., TIPP, ACCEPTS) are
crisis survival strategies to manage intense emotions without resorting
to self-harm or harmful behaviors.
11. A social worker is providing clinical supervision to an associate
clinical social worker (ACSW). The supervisor learns that the supervisee
has been engaging in a sexual relationship with a former client who
SW 650 FINAL ACTUAL EXAM PREP 2026
ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK|CURRENTLY TESTING |NEW
AND REVISED
1. A clinical social worker is conducting an initial biopsychosocial
assessment with a client who reports low mood, anhedonia, and sleep
disturbance for the past three weeks following a job loss. The most
appropriate preliminary diagnostic consideration is:
A. Persistent depressive disorder (dysthymia).
B. Major depressive disorder, single episode.
C. Adjustment disorder with depressed mood.
D. Bipolar II disorder, current episode depressed.
Rationale: The symptoms began within three months of an identifiable
stressor (job loss) and cause significant distress. Adjustment disorder
is diagnosed when the emotional or behavioral symptoms occur in
response to an identifiable stressor and do not meet criteria for
another disorder.
2. According to the NASW Code of Ethics, a social worker’s primary
responsibility is to:
A. The agency employing the social worker.
B. The client or the person seeking services.
C. The broader community and societal well-being.
D. The social work profession itself.
*Rationale: NASW Code of Ethics Standard 1.01 states that social
,2|P a g e
workers’ primary responsibility is to promote the well-being of
clients.*
3. A client with borderline personality disorder frequently calls the
social worker after hours, leaving lengthy voicemails threatening self-
harm. The social worker has established clear boundaries regarding
after-hours contact. The most appropriate next step is to:
A. Answer all calls immediately to prevent harm.
B. Implement the crisis safety plan and, if necessary, initiate a
wellness check or emergency services per protocol.
C. Terminate the therapeutic relationship due to boundary violations.
D. Ignore the calls and discuss them in the next scheduled session.
Rationale: The social worker must balance boundary maintenance
with duty to protect. A pre-established crisis plan should be activated;
ignoring threats of self-harm is negligent.
4. A 16-year-old client discloses to the school social worker that they
have been sexually abused by a family member. The social worker’s
first action should be:
A. Maintain confidentiality because the client is a minor and requested
privacy.
B. Report the abuse to child protective services or the appropriate
state agency as mandated by law.
C. Confront the family member directly to stop the abuse.
D. Encourage the client to report the abuse themselves.
Rationale: Social workers are mandated reporters; child abuse or
neglect must be reported immediately regardless of the client’s request
for confidentiality.
5. In motivational interviewing (MI), the acronym OARS stands for:
A. Observe, Ask, Reflect, Summarize.
B. Open-ended questions, Affirmations, Reflections, Summaries.
C. Offer, Advise, Refer, Support.
D. Outline, Analyze, Reassure, Self-disclose.
,3|P a g e
Rationale: OARS are core MI communication skills: Open-ended
questions elicit change talk; Affirmations build confidence;
Reflections demonstrate empathy; Summaries consolidate the
conversation.
6. A client with a history of alcohol use disorder has been abstinent for
six months but recently relapsed after a family conflict. Using a
cognitive-behavioral therapy (CBT) framework, the social worker
should first:
A. Confront the client about their lack of commitment to sobriety.
B. Explore the antecedents (triggers) and consequences of the
relapse to identify high-risk situations.
C. Refer the client to a higher level of care immediately.
D. Focus solely on the client’s strengths and ignore the relapse.
Rationale: CBT for substance use disorders involves functional
analysis to identify triggers, thoughts, and behaviors leading to
relapse, then developing coping strategies.
7. Which of the following is a key principle of trauma-informed care?
A. Avoiding discussion of the traumatic event to prevent re-
traumatization.
B. Emphasizing physical, psychological, and emotional safety for
clients and providers.
C. Requiring clients to disclose all trauma details before any
intervention.
D. Assuming all clients have experienced trauma.
Rationale: SAMHSA’s trauma-informed approach prioritizes safety,
trustworthiness, peer support, collaboration, empowerment, and
cultural, historical, and gender issues.
8. A social worker in a private practice setting terminates services with a
client who has achieved treatment goals. The client later contacts the
social worker requesting to be friends on social media. According to
NASW ethics, the social worker should:
, 4|P a g e
A. Accept the friend request to maintain a positive relationship.
B. Decline the request and explain that dual relationships are
avoided to protect the client’s welfare.
C. Accept the request but block the client from viewing personal posts.
D. Ignore the request and not respond.
Rationale: NASW Standard 1.06(c) states social workers should not
engage in dual or multiple relationships with clients or former clients
that could be harmful.
9. A client presents with excessive worry about multiple life domains
(work, health, finances) occurring more days than not for the past eight
months, accompanied by muscle tension, fatigue, and difficulty
concentrating. The most likely DSM-5-TR diagnosis is:
A. Panic disorder.
B. Social anxiety disorder.
C. Generalized anxiety disorder (GAD).
D. Obsessive-compulsive disorder.
Rationale: GAD is characterized by excessive, uncontrollable worry
about various events or activities for at least six months, with at least
three associated symptoms.
10. In dialectical behavior therapy (DBT), the primary purpose of
“distress tolerance” skills is to:
A. Eliminate all negative emotions permanently.
B. Help clients survive crises without making the situation worse.
C. Replace emotional regulation with cognitive restructuring.
D. Encourage clients to avoid distressing situations.
Rationale: DBT distress tolerance skills (e.g., TIPP, ACCEPTS) are
crisis survival strategies to manage intense emotions without resorting
to self-harm or harmful behaviors.
11. A social worker is providing clinical supervision to an associate
clinical social worker (ACSW). The supervisor learns that the supervisee
has been engaging in a sexual relationship with a former client who
