Top Tip For Reading Question Vignettes

Nursing Home
Source: Flickr user maotx. License: Creative Commons.

One of the first things I always try to impart to students taking the social work exam (looking at both Masters and Clinical exam students here) is that the test is a reasoning test, not a memorization test.

What does this mean? It means that reviewing your practice theories is important, since as social workers you’ll need a solid knowledge-base to inform your interventions. However, memorization alone won’t be an effective way to study since the test wants to see if you can appropriately apply your theoretical knowledge to real-world situations.

Let’s look at this vignette (continued below):

A social worker is working at a short-term rehabilitative facility and meeting for the first time with an 80-year-old client who will be discharged with home care services. During discharge planning, the client decides to share a story about his time as a service-member at war. In order to effectively work with this client, what should the social worker do FIRST?

A. Facilitate the client’s sharing of his experience
B. Redirect the client and clarify the social worker’s role as a discharge planner
C. Evaluate the client for dementia
D. Ask for informed consent to include the family in discharge planning.

Theory: Developmentally, you should know that the client is an older adult, which ties into two things: one, the desire and right for self-determination (helping us eliminate choice (D) since there’s no indicator the client is impaired to make choices), and two, the desire to reflect back on one’s life and impart wisdom (this ties into Erik Erikson’s ego integrity versus despair in the stages of psychosocial development).

While it’s important and necessary to clarify your role (B), redirecting the client right away would not be effective, since we want to validate and engage the client with what’s important to him during the process of intervention.

There is no cognitive indicator of dementia, so we can eliminate choice (C). This then leaves us with choice (A), which communicates value of the client’s experience and helps us know more about the client to meet his needs. Perhaps a follow-up question could explore if he remains connected to the veteran community.

Takeaway tip: Developmental theory will help you determine the type of intervention you will use with clients of different ages, and you always want to stay where the client is at.

Need more support? Contact me for tutoring!

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