How to Break Down Question #2



  • Read the question stem in segments. Read slowly and let information sink in. You will have enough time.

  • It’s normal to re-read the question stem. It will help you see what you didn’t see.

When reading the question stem, break it down:

  • Setting (agency, clinic, hospital, school, etc.)

  • SW role (SW, clinician, colleague)

  • Stage of therapy (when provided)

  • Primary Client

    • Cultural description (important)

    • Physical health problem? *address first

  • Presenting problem (what the client sees you for?)

  • Dilemma (other additional factors competing with the presenting problem)

  • What is the theme of the stem? (Recall question, ethics, Dx, intervention, etc.)

  • What are you tasked to do?

    • First, next, should, most

*color items always present in stem


When the question presents a problem and a dilemma, like testing ethics or clinical judgement, it asks you to evaluate and prioritize. (law, safety, ethics, clinical judgement, self determination)

When the question asks SW to intervene, focus on the client’s presenting problem.

  • If the client is in the same room with you (therapy), when the question asks what you do FIRST to address the presenting problem, DO choose the answer that you can do it within the therapy room. Do NOT choose the answer that you can do after the client leave.


FIRST question: approach with sequence.

NEXT question: similar to FIRST, but it usually provides you more info in stem of what has already been done.

MOST: approach with urgency and priority

SHOULD: know your ethics (what not to do, what to do)

Try to rank the answers (excluding recalls and Dx):

  • First rule out 1 or 2 bad answers

  • Rank the good answers (what can you do first, and can this question be done next), what’s more important or more urgent?

  • READ all the question stem and use ALL of them to help you weed out and rank.

Factors that takes precedence:

  • Law, Safety, imminent SI/HI, active substance use, medical problems. Address them first

Please also review the video on How to Break Down Exam Questions
Hope it helps!
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Texas Licensed clinical social worker, Doctor of Social Work, clinical supervisor (LCSW-S), life-long learner. I grew up in Vietnam and came to the United States when I was 14. I am currently living and practicing clinical social work in Houston, Texas. My interests are maternal mental health, Asian American psychological wellness, language acquisition (English, Vietnamese), and very much in cognitive psychology. In my free time, I like to garden and do arts and crafts.


    • Hi Stephan, for the “BEST” question it’s usually test your judgment and choose the answer that addresses the dilemma and problem, with the least harm.

  1. Hi chinh I’m just curious what did you get on your test? With the information your giving I can see you getting 170/170! Thank you so much for all these helpful tips!

    • Hi Kitty,
      A client presents in your office intoxicated. What would you do FIRST?

      In application question, you are given a setting and you are asked to apply your skills. In this simplified question, you are asked to apply your therapeutic communication skills, which is confrontation .

  2. Thank you so much for this useful info! Passed my exam today!! Your tips were right on point and helped greatly. Thanks again!

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