SW 650 Final exam prep (all quizzes & midterm
exam) Exam Questions and Answers Practice
Questions with Solutions Newest Complete Questions
And Correct Detailed Answers| Already Graded A+
1. A clinical social worker is using a structural family therapy approach with a family presenting
with a child's behavioral issues. The therapist observes that the mother and child have an
enmeshed relationship, while the father is peripheral. According to Minuchin's model, which
intervention sequence is most appropriate to restructure the family system?
A. First, join the family in their existing interaction patterns, then challenge the enmeshment by blocking
mother-child cross-generational coalitions, and finally create boundaries that strengthen the parental subsystem.
B. Immediately confront the father about his disengagement, then prescribe the mother-child dyad to continue
their interactions to highlight the problem, and then reframe the child's behavior as a family issue.
C. Begin by forming a therapeutic alliance with the child, then instruct the mother to step back from parenting
duties, and finally assign the father to take over all discipline tasks.
D. Start with a genogram to map family patterns, then use circular questioning to deconstruct the enmeshment,
and then assign homework to disrupt the mother-child dyad.
Answer: A
Rationale: Minuchin's structural family therapy emphasizes joining, then restructuring via boundary
making. Option A correctly sequences: join, challenge cross-generational coalition, strengthen parental
hierarchy. B is too confrontational initially; C bypasses joining and may alienate the mother; D uses
techniques from other models (e.g., circular questioning is Milan systemic).
2. A social worker in a community mental health center is evaluating a program for homeless
veterans with PTSD. The program uses a peer support model. Which research design would
provide the strongest evidence of causal effectiveness while balancing ethical constraints?
A. A randomized controlled trial where veterans are assigned to peer support or treatment as usual, with blinded
outcome assessments.
B. A quasi-experimental design using propensity score matching to compare participants with non-participants
from a similar clinic.
C. A single-case experimental design (ABAB) with multiple baselines across participants.
D. A qualitative phenomenological study exploring veterans' lived experiences in the program.
Answer: A
Rationale: RCT with blinding is the gold standard for causal inference. Propensity score matching (B)
reduces selection bias but cannot control unmeasured confounders. Single-case designs (C) are strong
for individual outcomes but limited for generalizability. Qualitative (D) does not test effectiveness.
Ethical concerns about withholding treatment can be addressed by offering the intervention later.
Page 1
,3. A social worker is assessing a client who is a recent immigrant from a country with a collectivist
culture. The client reports anxiety and guilt about pursuing personal goals that conflict with family
expectations. Which culturally responsive approach best integrates the client's values?
A. Use cognitive-behavioral therapy to challenge irrational beliefs about family obligations.
B. Employ a narrative therapy approach to externalize the problem and separate the client's identity from family
narratives.
C. Adopt a culturally adapted family systems intervention that includes family members and negotiates a
balance between individual and collective needs.
D. Focus on empowerment by encouraging the client to assert individual rights and set boundaries with family.
Answer: C
Rationale: Collectivist cultures value family interdependence. Option C respects the cultural context by
involving family and seeking a balanced solution. A and D may pathologize cultural values. Narrative
therapy (B) could be useful but may not directly address family dynamics. Cultural adaptation of
evidence-based practice is key.
4. A social worker is conducting a biopsychosocial assessment for a client with chronic pain and
opioid use disorder. The client has been on buprenorphine/naloxone for 6 months. Which
laboratory finding would most concern the social worker regarding potential relapse or medication
non-adherence?
A. Urine drug screen positive for buprenorphine and negative for other opioids.
B. Urine drug screen negative for buprenorphine and positive for fentanyl.
C. Urine drug screen positive for buprenorphine and positive for cannabis.
D. Urine drug screen negative for buprenorphine and negative for all opioids.
Answer: B
Rationale: Negative buprenorphine suggests non-adherence; positive fentanyl indicates illicit opioid use,
signaling relapse. A shows adherence. C may indicate cannabis use but not necessarily relapse. D shows
no opioids but non-adherence to buprenorphine, which is concerning but B is more acute due to fentanyl
use.
5. A social worker is advocating for a policy change to expand Medicaid coverage for doula
services. Which ethical principle primarily underpins this advocacy, and which policy analysis
framework would best evaluate the potential impact?
A. Beneficence; cost-benefit analysis.
B. Justice; intersectional policy analysis.
C. Autonomy; stakeholder analysis.
D. Non-maleficence; risk assessment.
Answer: B
Rationale: Expanding doula services addresses health disparities for marginalized groups, aligning with
social justice (distributive justice). Intersectional policy analysis examines how race, class, and gender
intersect in policy effects. Beneficence (A) is about doing good, but justice is more central. Autonomy (C)
focuses on individual choice. Non-maleficence (D) is about avoiding harm.
Page 2
,6. A social worker is using the DSM-5-TR to diagnose a client with recurrent, unexpected panic
attacks and persistent worry about future attacks for over a month. The client also reports
avoidance of situations where escape might be difficult. Which specifier, if any, should be added to
the diagnosis of panic disorder?
A. With agoraphobia.
B. With limited symptom attacks.
C. With panic attacks.
D. No specifier; agoraphobia is a separate diagnosis.
Answer: A
Rationale: DSM-5-TR allows specifier 'with agoraphobia' for panic disorder when agoraphobia criteria
are met. The client's avoidance indicates agoraphobia. Option D is incorrect because agoraphobia can
be coded as a specifier. B is not a specifier. C is redundant.
7. A social worker in a school setting is implementing a universal screening for depression using
the PHQ-9. A student scores 15, indicating moderately severe depression. However, the student
reports no suicidal ideation and appears euthymic during the interview. What is the most
appropriate next step?
A. Immediately refer to a psychiatrist for medication evaluation.
B. Conduct a comprehensive clinical assessment including collateral information from teachers and parents.
C. Schedule a follow-up screening in two weeks to confirm the score.
D. Provide psychoeducation and monitor for symptom progression.
Answer: B
Rationale: A PHQ-9 score of 15 warrants further assessment before intervention. Collateral information
helps validate the score and rule out overreporting. Immediate referral (A) may be premature. Waiting
(C) risks delay. Psychoeducation alone (D) is insufficient for moderate severity. Comprehensive
assessment aligns with evidence-based practice.
8. A social worker is supervising a practicum student who is working with a family in which the
father has been diagnosed with antisocial personality disorder. The student expresses frustration
that the father manipulates sessions and blames others. Which supervisory approach best supports
the student's professional development?
A. Advise the student to terminate the case due to the client's difficult personality.
B. Encourage the student to confront the father's behavior directly in the next session.
C. Help the student process countertransference and explore how to maintain therapeutic boundaries while
validating the client's perspective.
D. Suggest the student refer the family to a colleague with more experience with personality disorders.
Answer: C
Rationale: Supervision should address countertransference and boundary management. Option C
promotes self-reflection and skill development. A and D avoid the learning opportunity. B may escalate
conflict and is not therapeutic. Effective supervision builds competence in managing challenging cases.
Page 3
, 9. A social worker is evaluating a community-based program that uses a harm reduction approach
for individuals who use intravenous drugs. Which outcome measure would best capture the
program's effectiveness in alignment with its philosophy?
A. Number of participants who achieve complete abstinence from all substances.
B. Reduction in needle-sharing incidents and incidence of new HIV/HCV infections.
C. Increase in participants' employment rates over six months.
D. Decrease in self-reported frequency of drug use per week.
Answer: B
Rationale: Harm reduction prioritizes reducing negative consequences, not necessarily abstinence.
Needle-sharing and infection rates directly measure harm reduction. Abstinence (A) is not the primary
goal. Employment (C) is secondary. Frequency of use (D) is less relevant than risky behaviors.
10. A social worker is using the Strengths Perspective with a client who is homeless and has a
history of substance use. The client states, 'I have nothing going for me.' Which response best
exemplifies the Strengths Perspective?
A. You have survived many challenges, which shows resilience. What skills have helped you get through tough
times?
B. It sounds like you're feeling hopeless. Let's work on finding a shelter first.
C. You mentioned you used to be a cook. How might that experience be useful now?
D. I understand you feel that way, but I see someone who is capable of change.
Answer: A
Rationale: Strengths Perspective focuses on identifying and mobilizing client strengths. Option A
acknowledges resilience and invites the client to identify their own skills. C is also strengths-based but is
more specific; A is broader and more empowering. B focuses on deficits. D is dismissive of the client's
feelings.
11. A client with a history of opioid use disorder is admitted for elective surgery. The anesthesia
team plans to use multimodal analgesia. Which combination of agents is most appropriate to
minimize opioid use while addressing both acute pain and underlying opioid dependence?
A. Ketamine infusion + acetaminophen + ibuprofen + buprenorphine continuation
B. Fentanyl PCA + ondansetron + lorazepam
C. Morphine PCA + gabapentin + celecoxib
D. Hydromorphone PCA + ketorolac + methadone initiation
Answer: A
Rationale: Option A is correct because multimodal analgesia with ketamine, acetaminophen, NSAIDs,
and continuation of buprenorphine (partial agonist) provides effective pain control while reducing
opioid requirements and avoiding withdrawal. B uses only full agonists and antiemetics; C and D rely
heavily on full agonist opioids, which may precipitate withdrawal or require high doses.
Page 4
exam) Exam Questions and Answers Practice
Questions with Solutions Newest Complete Questions
And Correct Detailed Answers| Already Graded A+
1. A clinical social worker is using a structural family therapy approach with a family presenting
with a child's behavioral issues. The therapist observes that the mother and child have an
enmeshed relationship, while the father is peripheral. According to Minuchin's model, which
intervention sequence is most appropriate to restructure the family system?
A. First, join the family in their existing interaction patterns, then challenge the enmeshment by blocking
mother-child cross-generational coalitions, and finally create boundaries that strengthen the parental subsystem.
B. Immediately confront the father about his disengagement, then prescribe the mother-child dyad to continue
their interactions to highlight the problem, and then reframe the child's behavior as a family issue.
C. Begin by forming a therapeutic alliance with the child, then instruct the mother to step back from parenting
duties, and finally assign the father to take over all discipline tasks.
D. Start with a genogram to map family patterns, then use circular questioning to deconstruct the enmeshment,
and then assign homework to disrupt the mother-child dyad.
Answer: A
Rationale: Minuchin's structural family therapy emphasizes joining, then restructuring via boundary
making. Option A correctly sequences: join, challenge cross-generational coalition, strengthen parental
hierarchy. B is too confrontational initially; C bypasses joining and may alienate the mother; D uses
techniques from other models (e.g., circular questioning is Milan systemic).
2. A social worker in a community mental health center is evaluating a program for homeless
veterans with PTSD. The program uses a peer support model. Which research design would
provide the strongest evidence of causal effectiveness while balancing ethical constraints?
A. A randomized controlled trial where veterans are assigned to peer support or treatment as usual, with blinded
outcome assessments.
B. A quasi-experimental design using propensity score matching to compare participants with non-participants
from a similar clinic.
C. A single-case experimental design (ABAB) with multiple baselines across participants.
D. A qualitative phenomenological study exploring veterans' lived experiences in the program.
Answer: A
Rationale: RCT with blinding is the gold standard for causal inference. Propensity score matching (B)
reduces selection bias but cannot control unmeasured confounders. Single-case designs (C) are strong
for individual outcomes but limited for generalizability. Qualitative (D) does not test effectiveness.
Ethical concerns about withholding treatment can be addressed by offering the intervention later.
Page 1
,3. A social worker is assessing a client who is a recent immigrant from a country with a collectivist
culture. The client reports anxiety and guilt about pursuing personal goals that conflict with family
expectations. Which culturally responsive approach best integrates the client's values?
A. Use cognitive-behavioral therapy to challenge irrational beliefs about family obligations.
B. Employ a narrative therapy approach to externalize the problem and separate the client's identity from family
narratives.
C. Adopt a culturally adapted family systems intervention that includes family members and negotiates a
balance between individual and collective needs.
D. Focus on empowerment by encouraging the client to assert individual rights and set boundaries with family.
Answer: C
Rationale: Collectivist cultures value family interdependence. Option C respects the cultural context by
involving family and seeking a balanced solution. A and D may pathologize cultural values. Narrative
therapy (B) could be useful but may not directly address family dynamics. Cultural adaptation of
evidence-based practice is key.
4. A social worker is conducting a biopsychosocial assessment for a client with chronic pain and
opioid use disorder. The client has been on buprenorphine/naloxone for 6 months. Which
laboratory finding would most concern the social worker regarding potential relapse or medication
non-adherence?
A. Urine drug screen positive for buprenorphine and negative for other opioids.
B. Urine drug screen negative for buprenorphine and positive for fentanyl.
C. Urine drug screen positive for buprenorphine and positive for cannabis.
D. Urine drug screen negative for buprenorphine and negative for all opioids.
Answer: B
Rationale: Negative buprenorphine suggests non-adherence; positive fentanyl indicates illicit opioid use,
signaling relapse. A shows adherence. C may indicate cannabis use but not necessarily relapse. D shows
no opioids but non-adherence to buprenorphine, which is concerning but B is more acute due to fentanyl
use.
5. A social worker is advocating for a policy change to expand Medicaid coverage for doula
services. Which ethical principle primarily underpins this advocacy, and which policy analysis
framework would best evaluate the potential impact?
A. Beneficence; cost-benefit analysis.
B. Justice; intersectional policy analysis.
C. Autonomy; stakeholder analysis.
D. Non-maleficence; risk assessment.
Answer: B
Rationale: Expanding doula services addresses health disparities for marginalized groups, aligning with
social justice (distributive justice). Intersectional policy analysis examines how race, class, and gender
intersect in policy effects. Beneficence (A) is about doing good, but justice is more central. Autonomy (C)
focuses on individual choice. Non-maleficence (D) is about avoiding harm.
Page 2
,6. A social worker is using the DSM-5-TR to diagnose a client with recurrent, unexpected panic
attacks and persistent worry about future attacks for over a month. The client also reports
avoidance of situations where escape might be difficult. Which specifier, if any, should be added to
the diagnosis of panic disorder?
A. With agoraphobia.
B. With limited symptom attacks.
C. With panic attacks.
D. No specifier; agoraphobia is a separate diagnosis.
Answer: A
Rationale: DSM-5-TR allows specifier 'with agoraphobia' for panic disorder when agoraphobia criteria
are met. The client's avoidance indicates agoraphobia. Option D is incorrect because agoraphobia can
be coded as a specifier. B is not a specifier. C is redundant.
7. A social worker in a school setting is implementing a universal screening for depression using
the PHQ-9. A student scores 15, indicating moderately severe depression. However, the student
reports no suicidal ideation and appears euthymic during the interview. What is the most
appropriate next step?
A. Immediately refer to a psychiatrist for medication evaluation.
B. Conduct a comprehensive clinical assessment including collateral information from teachers and parents.
C. Schedule a follow-up screening in two weeks to confirm the score.
D. Provide psychoeducation and monitor for symptom progression.
Answer: B
Rationale: A PHQ-9 score of 15 warrants further assessment before intervention. Collateral information
helps validate the score and rule out overreporting. Immediate referral (A) may be premature. Waiting
(C) risks delay. Psychoeducation alone (D) is insufficient for moderate severity. Comprehensive
assessment aligns with evidence-based practice.
8. A social worker is supervising a practicum student who is working with a family in which the
father has been diagnosed with antisocial personality disorder. The student expresses frustration
that the father manipulates sessions and blames others. Which supervisory approach best supports
the student's professional development?
A. Advise the student to terminate the case due to the client's difficult personality.
B. Encourage the student to confront the father's behavior directly in the next session.
C. Help the student process countertransference and explore how to maintain therapeutic boundaries while
validating the client's perspective.
D. Suggest the student refer the family to a colleague with more experience with personality disorders.
Answer: C
Rationale: Supervision should address countertransference and boundary management. Option C
promotes self-reflection and skill development. A and D avoid the learning opportunity. B may escalate
conflict and is not therapeutic. Effective supervision builds competence in managing challenging cases.
Page 3
, 9. A social worker is evaluating a community-based program that uses a harm reduction approach
for individuals who use intravenous drugs. Which outcome measure would best capture the
program's effectiveness in alignment with its philosophy?
A. Number of participants who achieve complete abstinence from all substances.
B. Reduction in needle-sharing incidents and incidence of new HIV/HCV infections.
C. Increase in participants' employment rates over six months.
D. Decrease in self-reported frequency of drug use per week.
Answer: B
Rationale: Harm reduction prioritizes reducing negative consequences, not necessarily abstinence.
Needle-sharing and infection rates directly measure harm reduction. Abstinence (A) is not the primary
goal. Employment (C) is secondary. Frequency of use (D) is less relevant than risky behaviors.
10. A social worker is using the Strengths Perspective with a client who is homeless and has a
history of substance use. The client states, 'I have nothing going for me.' Which response best
exemplifies the Strengths Perspective?
A. You have survived many challenges, which shows resilience. What skills have helped you get through tough
times?
B. It sounds like you're feeling hopeless. Let's work on finding a shelter first.
C. You mentioned you used to be a cook. How might that experience be useful now?
D. I understand you feel that way, but I see someone who is capable of change.
Answer: A
Rationale: Strengths Perspective focuses on identifying and mobilizing client strengths. Option A
acknowledges resilience and invites the client to identify their own skills. C is also strengths-based but is
more specific; A is broader and more empowering. B focuses on deficits. D is dismissive of the client's
feelings.
11. A client with a history of opioid use disorder is admitted for elective surgery. The anesthesia
team plans to use multimodal analgesia. Which combination of agents is most appropriate to
minimize opioid use while addressing both acute pain and underlying opioid dependence?
A. Ketamine infusion + acetaminophen + ibuprofen + buprenorphine continuation
B. Fentanyl PCA + ondansetron + lorazepam
C. Morphine PCA + gabapentin + celecoxib
D. Hydromorphone PCA + ketorolac + methadone initiation
Answer: A
Rationale: Option A is correct because multimodal analgesia with ketamine, acetaminophen, NSAIDs,
and continuation of buprenorphine (partial agonist) provides effective pain control while reducing
opioid requirements and avoiding withdrawal. B uses only full agonists and antiemetics; C and D rely
heavily on full agonist opioids, which may precipitate withdrawal or require high doses.
Page 4
