Below you will find six sample LMSW exam questions as well as their respective answers. Each one of the responses have been provided employing the acronym technique.
1. A woman is referred by her primary care provider and presents with a diagnosis of Hypochondriasis. What is the FIRST crucial step in treatment?
a. Establishment of trust and appreciation for the patient's problems
b. History taking
c. Education about the link between stress, emotions and lifestyle and physical health
d. Treatment planning
2. A soldier with combat-related Post Traumatic Stress Disorder desires to return to combat. What is the FIRST thing you should do?
Employ the acronym FAREAFI to assist (in this order) because it is most useful for FIRST/NEXT type test questions. As a reminder, the letters stand for:
F: Feelings of the client be acknowledged first above all. Begin building rapport.
To clarify how you use this acronym, you select the response that is closest in hierarchy to the first letter/item of FAREAFI. In this case, the the correct answer is a; this corresponds with F in FAREAFI for feelings of the client to be acknowledged first.
a. Allow the soldier full self-determination, returning when she 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
d. Assess progress in treatment and current level of functioning
Use the acronym FAREAFI to assist (in this order) because it is most helpful for FIRST/NEXT type test questions.
The correct answer is d; this corresponds with A for Assess in the FAREAFI acronym.
3. A client has been working through childhood sexual abuse issues with you in therapy. Child protective services (CPS) removed her from the home for several months, and the perpetrator, an uncle who resided in the home, went to treatment. The uncle now works in a daycare setting and the client strongly suspects he is molesting some of the children. The client is unwilling to make a report to CPS. What is your BEST course of action?
a. Review mandated reporting laws to ensure you know what is required, inform the client you must report and terminate services with the client
b. Review mandated reporting laws with the client and your requirements, inform the client you must report and provide her the opportunity to make the report with you
c. Make the report without informing the client you will do so, knowing she may never learn from where the report initiated
d. Abide by the client's wishes to not report - the uncle completed perpetrator treatment, he had to disclose it when hired and sexual abuse perpetrators are listed in accessible public registries, so the daycare is already aware and informed
Use the acronym AASPIRINS to assist (in this order); it is most helpful for questions that ask what is the BEST (or MOST reasonable) option/plan of action. As a reminder, the letters stand for:
A: Acknowledge client/patient. Begin building rapport.
S: Start where the patient is at
P: Protect life (of the individual and community…this one is about
determining/preventing danger to self and others)
I: Intoxicated do not treat. Refer
R: Rule out medical issue
I: Informed consent
N: Non-judgmental stance
S: Support patient self-determination
To clarify how you use this acronym, you select the response that is closest in hierarchy to the first letter/item of AASPIRINS.
In this case, the correct answer is b; this corresponds with p in AASPIRINS to protect life (the limits of confidentiality should have been mentioned to the client at the outset of relationship) - the social work mandate is to report...clarify mandated requirement and offer opportunity to the client to make the report.
4. A 25 year old woman presents for therapy when her spouse begins pressing her to start a family like they had planned years ago. She is frightened about becoming a mother, fearing the abuse she experienced as a child will make her a bad mother. What is your BEST course of treatment?
a. Assure her she has nothing to worry about because of her current awareness
b. Refer her to parenting classes while you assess the depth of the abuse
c. Assess her history of abuse and current fears, then make a positive parenting plan
d. Educate her on the generational patterns of abuse, and refer to parenting classes
Use the acronym AASPIRINS to assist because it is most helpful for questions that ask what is the BEST (or MOST reasonable) option.
The correct answer is c; this corresponds with A in AASPIRINS for assess; you would want to assess her history of abuse and current fears, set goals for parenting accordingly and address other issues as they arise.
5. A 35 year old wife and mother of two has a recurrence of breast cancer four years after a lengthy, painful battle involving radiation, chemotherapy and mastectomy. She has been offered the opportunity to participate in a new treatment, likely her only option for survival, but it is invasive and carries a high risk for significant side-effects. She denies treatment. What is your NEXT step?
a. Abide by her decision and let her die
b. Recommend to the spouse that he work with the doctor and the legal system to enforce treatment because of the minor children
c. Confirm that all the information needed to make an informed decision was available and offered; offer counseling, links to palliative care and hospice
d. Remind her that the children and spouse need her and it is best to exhaust all options before giving up
Employ the acronym FAREAFI to assist because it is most useful for FIRST/NEXT type test questions. In this question, you could also employ the AASPIRINS acronym.
The correct answer is c; this corresponds with E in FAREAFI for educate or S in AASPIRINS for support self-determination (social worker role is to make sure that the client has all the necessary information to make an informed decision and to provide needed resources to support client and family)
6. What is always the FIRST step in any therapeutic relationship?
Use the acronym FAREAFI to assist because it is most helpful for FIRST/NEXT type test questions.
The correct answer is a; this corresponds with A in FAREAFI for assessment (it is done throughout treatment and determines the type of treatment provided).
I hope that you found the above questions helpful illustrations of how to employ the FAREAFI and AASPIRINS acronyms.
Interestingly, I have found that you could use either acronym at times for many questions. The dilemma appears to arise only when the "wrong" acronym does not include enough options to fully address the question because you are attempting to apply the "wrong" acronym. Have you found this to be true as well?
Additional Helpful Resources/Links
Since my post Tools to Help You Pass the LMSW Exam, I have discovered that another group of social workers regularly meets in order to prepare for either the LCSW or the LMSW exam (aside from the one I mentioned that meets on Google). They do this via a variety of methods: Google, Facebook and Skype (3x/week). For more information about this group, please visit LMSW/LCSW Exam Study Group.
50 Tips and Strategies to Ace the LMSW Exam - Mozart Guerrier has put together a great list; my favorite item is: Dr. Dawn Hall Apgar’s Self Assessment Tool (useful for those who have failed the test or who want to know which areas need boosting prior to the exam)
Socialworkerhelper - a new network community specifically geared for social workers. It currently has an LCSW support group. I'm not sure how often or active this group is but it is certainly worth checking out :)
What Do I Do When I Fail the Social Work Exam? - an article from the New Social Worker magazine to address some of the questions some of you have raised.
Do you find these two acronyms helpful in figuring out the correct answer to some of the practice questions? What are some things that you are doing in order to prepare for your LMSW (or LCSW) exam? Do you have any lessons learned and/or additional tips to share?
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