ASWB Clinical Assessment 3 — Questions and Answers
Question 1: A social worker screens a 70-year-old client using the Montreal Cognitive Assessment (MoCA). What cognitive domains does this tool evaluate?
- Only short-term memory and orientation
- Multiple domains including visuospatial ability, executive function, memory, attention, and language (Correct answer)
- Personality traits and mood states only
- Intelligence quotient and adaptive functioning
Correct answer: Multiple domains including visuospatial ability, executive function, memory, attention, and language
The MoCA screens across several cognitive domains and is sensitive to mild cognitive impairment, making it broader than orientation-only tools.
Question 2: During assessment, a client describes hearing a voice that commands her to harm herself. This symptom is BEST classified as:
- An auditory illusion
- A command auditory hallucination (Correct answer)
- Somatic delusion
- Depersonalization
Correct answer: A command auditory hallucination
Command auditory hallucinations involve perceived voices that instruct the individual to perform specific acts, representing a high-risk psychotic symptom.
Question 3: A social worker is assessing a client who reports excessive worry about multiple life domains for over a year, accompanied by muscle tension and sleep difficulty. The MOST likely diagnosis to explore is:
- Panic Disorder
- Specific Phobia
- Generalized Anxiety Disorder (Correct answer)
- Obsessive-Compulsive Disorder
Correct answer: Generalized Anxiety Disorder
Pervasive, uncontrollable worry across multiple domains lasting at least 6 months with physical symptoms like tension and insomnia is characteristic of GAD.
Question 4: When conducting a cultural formulation as part of a clinical assessment, which element is MOST important to explore?
- The client's insurance coverage and payment plan
- The client's cultural identity and how culture shapes their understanding of the problem (Correct answer)
- The agency's demographic intake data
- Whether the client speaks English as a first language
Correct answer: The client's cultural identity and how culture shapes their understanding of the problem
The DSM-5 Cultural Formulation Interview centers on understanding how cultural identity, explanatory models, and cultural stressors shape the client's experience.
Question 5: A social worker notes that a client consistently shifts to unrelated topics before completing a thought, making the conversation hard to follow. This thought process is BEST described as:
- Flight of ideas
- Circumstantial thinking
- Tangential thinking (Correct answer)
- Thought blocking
Correct answer: Tangential thinking
Tangential thinking is characterized by responses that veer off to unrelated subjects, never returning to the original point, unlike circumstantial thinking which eventually returns.
Question 6: A child's caregiver reports that the child has had a persistent pattern of defiance, argumentativeness with authority figures, and deliberate annoyance of others for 10 months but no property destruction or assault. Which disorder should the assessment primarily consider?
- Conduct Disorder
- Intermittent Explosive Disorder
- Oppositional Defiant Disorder (Correct answer)
- Antisocial Personality Disorder
Correct answer: Oppositional Defiant Disorder
ODD is characterized by a pattern of angry/irritable mood, argumentative/defiant behavior, and vindictiveness without the more severe rule violations seen in Conduct Disorder.
Question 7: A social worker assessing a client with a substance use disorder should use the DSM-5 criteria rather than older terminology because:
- DSM-5 uses criminal justice terminology that families prefer
- DSM-5 eliminates the abuse/dependence distinction and uses a severity specifier based on symptom count (Correct answer)
- DSM-5 added a biological test requirement for diagnosis
- DSM-5 requires a 90-day sobriety period before diagnosis
Correct answer: DSM-5 eliminates the abuse/dependence distinction and uses a severity specifier based on symptom count
DSM-5 consolidated abuse and dependence into a single Substance Use Disorder diagnosis with mild, moderate, or severe specifiers based on the number of criteria met.
ASWB Clinical Assessment 3
A social worker screens a 70-year-old client using the Montreal Cognitive Assessment (MoCA).
What cognitive domains does this tool evaluate?