CRCC practice test, all twelve domains in one set

A counselor observes a hotel housekeeper's job and records its tasks, tools, physical demands, and work environment. This process is:

1. a job analysis
   A job analysis records the tasks, tools, physical and mental demands, and environment of a specific job, usually by on-site observation.
2. a task analysis
   A task analysis breaks one task into teachable steps, for example for job coaching; the stem describes the whole job, not a single task.
3. a labor market survey
   A labor market survey contacts employers about openings and wages across an occupation; it does not break down one job's demands on site.
4. a functional assessment
   A functional assessment looks at what the person can do; this counselor is studying the job, not the worker.

Research on assistive technology abandonment shows that devices are most often abandoned when:

1. the device was expensive to purchase
   Price did not predict abandonment; costly and cheap devices are both dropped when they do not fit the user's goals and routines.
2. the user received training on the device
   Training helps people keep using a device, so it works against abandonment rather than causing it.
3. a physician prescribed the device
   Who wrote the prescription is not the risk factor; the problem is selection without the user's input, whoever orders the device.
4. the user had no say in choosing the device
   In Phillips and Zhao's study of device abandonment, the strongest predictor was that the user's opinion was not considered when the device was selected; involving the user in selection is the main safeguard.

Although the Department of Labor replaced the DOT with O*NET, vocational experts in SSA disability hearings still cite the DOT mainly because:

1. SSA rules continue to rely on DOT data.
   SSA's regulations still name the DOT as reliable job information (20 CFR 404.1566(d)) and SSA has not adopted O*NET; since SSR 24-3p (effective January 2025) experts may add other sources, but the DOT is still cited.
2. the DOT includes current national wage data.
   The DOT has no wage data and was last revised in 1991; current wages come from sources such as the Bureau of Labor Statistics.
3. O*NET is updated less often than the DOT.
   O*NET is updated continually, while the DOT has not been revised since 1991; this option reverses the two.
4. O*NET is not a federal government product.
   O*NET is sponsored by the U.S. Department of Labor, so it is a federal product.

Under WIOA, an acceptable employment outcome for a state VR client must be:

1. any paid job, including sheltered employment.
   Sheltered or segregated work no longer counts as a VR outcome; WIOA requires integration with coworkers who do not have disabilities.
2. competitive integrated or supported employment.
   Since the 2016 WIOA regulations, a VR employment outcome must be competitive integrated employment or supported employment that works toward it.
3. a homemaker or unpaid family worker role.
   Homemaker and unpaid family worker outcomes were removed from the VR program by the WIOA rules; this option reflects the older rules.
4. subminimum-wage work under a 14(c) certificate.
   Section 511 of WIOA restricts subminimum wages, and VR cannot count a 14(c) job as an outcome; the job must pay at least minimum wage.

Which service provided by rehabilitation counselors most directly supports job retention after a client is hired?

1. comprehensive vocational evaluation
   A comprehensive vocational evaluation happens before planning to identify goals and needs; it does not support someone already on the job.
2. pre-employment training
   Pre-employment training prepares a person to get hired; this option puts a pre-placement service in the retention slot.
3. job development
   Job development finds or creates the opening before placement; it ends where retention support begins.
4. post-placement follow-up
   Post-placement follow-up checks in with the worker and, with consent, the employer after hire, catching problems early enough to save the job.

An IPS employment specialist finds a warehouse opening for a client, but the client says he wants to work in a bakery. According to IPS principles, the specialist should:

1. focus the search on bakery jobs
   IPS bases the job search on the client's preferences, and jobs that match preferences last longer, so the specialist looks for bakery work.
2. urge him to take the warehouse job first
   Steering him to an available job he does not want breaks the IPS preference principle and predicts early job loss.
3. explain he must earn the bakery job
   IPS has no stepwise ladder in which clients prove themselves in jobs they did not choose; this option reflects older train-then-place models.
4. refer him for a vocational evaluation
   IPS uses zero exclusion and skips lengthy prevocational evaluation; his preference is already clear.

A VR counselor attends IEP meetings and visits local clinics to identify people with disabilities who could benefit from services but have not yet applied. This activity is called:

1. intake
   Intake is the first meeting with a person who has already come forward, which comes after outreach.
2. case finding
   Case finding (outreach) identifies people who could benefit but have not applied, for example through schools and clinics.
3. eligibility determination
   Eligibility determination happens after someone applies; these people have not applied yet.
4. caseload management
   Caseload management organizes work on clients already being served; it does not look for new ones.

A company with 60 employees at a single worksite asks which federal laws require it to provide reasonable accommodation and job-protected medical leave. The counselor should say that:

1. the FMLA applies, but the ADA does not.
   The ADA reaches employers with 15 or more employees, so it certainly applies at 60.
2. both the ADA and the FMLA apply.
   The ADA covers employers with 15 or more employees and the FMLA covers employers with 50 or more within 75 miles, so a 60-employee single site falls under both.
3. neither applies below 100 employees.
   Neither law uses a 100-employee threshold; this option invents a cutoff.
4. the ADA applies, but the FMLA does not.
   A 60-employee single worksite meets the FMLA's 50-employee, 75-mile test, so the FMLA applies too.

A VR participant disagrees with the counselor's decision not to fund a four-year degree. The counselor should inform the participant about:

1. the state counselor licensing board
   A licensing board handles professional misconduct complaints; disagreeing with a funding decision is not misconduct.
2. the Office for Civil Rights
   OCR handles discrimination complaints; a disagreement over what VR will fund is a service dispute, not discrimination.
3. the EEOC charge-filing process
   The EEOC handles employment discrimination by employers; a VR funding decision is not an employment charge.
4. the Client Assistance Program
   Every state has a Client Assistance Program under the Rehabilitation Act that advises VR applicants and clients and helps them pursue appeals; agencies must tell clients about it.

While assessing a laid-off worker's coping resources, a counselor asks about her savings, her spouse's help, her personality, and the ways she has tried to cope so far. In Schlossberg's transition model, her spouse's help represents:

1. situation.
   Situation describes the transition itself, such as its trigger, timing, and how much control she has over it, not help from other people.
2. support.
   In Schlossberg's 4 S model, support covers help from others such as a spouse, family, friends, and institutions.
3. strategies.
   Strategies are the ways she has tried to cope so far; the spouse's help is a resource from others.
4. self.
   Self covers her personal and psychological resources, such as personality and outlook.

A client with chronic neck pain says, 'This pain is unbearable, it will only get worse, and there is nothing I can do.' This thinking pattern is:

1. malingering
   Malingering is deliberate faking for an external reward; nothing suggests he is pretending to have pain.
2. somatic symptom disorder
   Somatic symptom disorder is a DSM-5-TR diagnosis requiring persistent, excessive thoughts, feelings, or behaviors about symptoms for at least 6 months; one statement describes a thinking style, not a diagnosis.
3. pain catastrophizing
   Pain catastrophizing combines magnification ('unbearable'), rumination, and helplessness ('nothing I can do') and predicts worse pain-related disability.
4. secondary gain
   Secondary gain is an external benefit that reinforces disability; the stem describes his thoughts about pain, not a reward.

In the DOT, a job's Specific Vocational Preparation (SVP) rating indicates the:

1. time needed to learn the job at an average level
   SVP is the time needed to learn the techniques, gather the information, and develop the skills for average performance in a job.
2. work complexity with data, people, and things
   Complexity with data, people, and things is the DOT worker-functions code, a different rating.
3. formal degree the job requires
   SVP counts all preparation time, including on-the-job training, not a required degree.
4. physical strength demanded by the job
   Strength demands are the DOT exertional level (sedentary to very heavy), not SVP.

To observe a client's work behaviors, such as punctuality and response to supervision, in a real or simulated job setting over several days, the counselor should arrange:

1. a standardized work sample
   A standardized work sample measures performance on specific tasks against norms, usually in one session, not work behaviors over several days.
2. a transferable skills analysis
   A transferable skills analysis is a records-based analysis of past work, with no observation of behavior.
3. a vocational interest inventory
   An interest inventory measures preferences on paper, not observed punctuality and response to supervision.
4. a situational assessment
   A situational assessment observes work behaviors such as punctuality and response to supervision in a real or simulated job over time.

During an FCE, a client with a back injury shows inconsistent grip-strength curves across trials and no heart-rate rise during 'maximal' lifts. The evaluator's report should state that:

1. the results reflect his true maximum capacity.
   The effort signs show the results probably understate his capacity, so they cannot be reported as his true maximum.
2. submaximal effort limits the validity of results.
   Inconsistent grip curves and no heart-rate rise during 'maximal' lifts point to submaximal or inconsistent effort, so the report states that the results cannot be taken as his true maximum.
3. the client is malingering.
   Effort indicators cannot show intent; pain, fear, or medication can also lower effort, so a malingering label goes beyond the data.
4. the client has reached MMI.
   MMI is a physician's medical judgment, not something an FCE's effort indicators can establish.

An employee whose disability is not obvious requests telework as an accommodation. Under the ADA, the employer may:

1. require her complete medical records.
   Employers may request only documentation enough to establish the disability and need, not a complete medical history.
2. ask for reasonable medical documentation.
   When a disability or the need for accommodation is not obvious, the employer may ask for reasonable documentation of both the disability and the need.
3. require an independent exam of all conditions.
   Any exam must be job-related and limited to the condition in question, not all of her health conditions.
4. require a written request citing the ADA.
   A request can be made in plain words, even orally; no written form or mention of the ADA is required.

An employer wants free, confidential, expert guidance on workplace adjustments for a worker with a rare neuromuscular condition. The counselor should refer the employer to the:

1. Job Accommodation Network.
   JAN, funded by the Department of Labor's Office of Disability Employment Policy, offers free, confidential, expert guidance on accommodations for specific conditions.
2. Occupational Safety and Health Administration.
   OSHA regulates workplace safety, not disability accommodation.
3. EEOC field office.
   The EEOC enforces Title I and handles charges; it does not provide individual accommodation consulting.
4. Department of Justice ADA Information Line.
   The DOJ ADA line answers general questions mostly about Titles II and III, not detailed job accommodation design.

An employer hires a VR client through an on-the-job training (OJT) agreement. Typically, the VR agency:

1. reimburses part of the wages for a set period.
   In OJT agreements, VR usually reimburses the employer for part of the wages during a set training period, offsetting training costs.
2. exempts the employer from ADA duties.
   No agreement can exempt an employer from the ADA.
3. pays the worker's full wage for a year.
   VR does not pay the full wage for a year; the employer pays the worker, and VR shares part of the cost for a limited time.
4. becomes the worker's employer of record.
   The hiring business is the employer and pays the worker, while VR is a funding partner.

An employer claims that a $12,000 workstation modification for an employee with a disability would be an undue hardship. Under the ADA, this is judged mainly by:

1. the cost against the business's resources.
   Undue hardship is judged case by case: the cost and nature of the accommodation are weighed against the employer's overall financial resources and operations.
2. whether coworkers would also benefit from it.
   Whether coworkers would also benefit is not an undue-hardship factor; the test weighs the net cost and nature of the accommodation against the employer's resources and operations.
3. a fixed dollar limit set in EEOC rules.
   EEOC rules set no dollar limit on accommodation costs.
4. whether it exceeds 10% of the worker's pay.
   There is no percentage-of-salary test; a proposal to set one was rejected when the ADA was drafted.

A group program in which job seekers meet daily, share leads, practice calls, and make supervised employer contacts with a buddy system is:

1. a clubhouse program
   A clubhouse is a member-run community for adults with mental illness built around a work-ordered day; it is not a daily job-search group.
2. work adjustment training
   Work adjustment training builds general work habits such as pace and punctuality; it does not center on finding openings.
3. a sheltered workshop
   A sheltered workshop provides segregated paid work, not a structured search for jobs in the community.
4. a job club
   Azrin's job club is a structured behavioral group in which members treat the job search as a daily job: they share leads, rehearse calls, and make supervised employer contacts with a buddy.

A client placed a month ago says he is struggling at work but does not want his employer to know he receives VR services. The counselor should:

1. offer off-site support without contacting the employer
   Disclosure is the client's decision, so the counselor offers support off-site, such as problem-solving and skills coaching, without contacting the employer.
2. contact his supervisor to discuss the problems
   Calling the supervisor without consent breaks confidentiality and discloses his VR involvement against his wishes.
3. tell him support requires employer contact
   Support does not depend on employer contact; making it a condition overrides his choice not to disclose.
4. close the case as successfully employed
   A VR case cannot be closed as successful until the job has lasted at least 90 days, and he is asking for help now.

A client has a three-year employment gap due to psychiatric hospitalizations. The counselor's BEST resume advice is to:

1. use a skills-focused combination resume
   A combination resume puts skills and accomplishments first while still listing jobs, so the gap is less prominent and nothing false is stated.
2. extend earlier job dates to cover the gap
   Falsifying dates is dishonest and can lead to firing when it is discovered.
3. remove every date from the resume
   A resume with no dates at all raises suspicion with employers and screening software.
4. list the hospital stays to explain the gap
   Applicants have no duty to disclose a psychiatric history, and listing hospitalizations invites discrimination.

Under WIOA, which of the following must be included in every IPE?

1. The employment goal and services to reach it
   Every IPE must include the employment goal, chosen consistent with the individual's informed choice, and the services, timelines, providers, and progress measures to reach it.
2. Results of standardized aptitude testing
   Assessment results may inform the plan, but standardized aptitude testing is not a required element.
3. The client's complete medical records
   Full medical records are not part of the IPE; only information relevant to services is used.
4. A labor market survey for the occupation
   Labor market information may support the chosen goal, but a formal survey is not a required IPE component.

A VR applicant with a significant psychiatric disability has little work history, and the counselor doubts he could benefit from services. Before finding him ineligible, the counselor must:

1. place him on the order of selection waiting list
   Order of selection ranks people who are already eligible; it is not a step before finding someone ineligible.
2. refer him to a sheltered workshop for evaluation
   A sheltered workshop evaluation is a segregated setting, while trial work experiences must be realistic and integrated where possible.
3. get a psychiatrist's statement of unemployability
   A statement of unemployability does not replace the required trial work experiences; VR presumes people can benefit.
4. explore his abilities through trial work experiences
   Before finding someone ineligible because they cannot benefit, VR must explore their abilities through trial work experiences, in realistic settings, unless clear and convincing evidence already exists.

When a state VR agency lacks the funds to serve all eligible individuals, it must implement an order of selection that gives priority to:

1. students and youth under age 25 with disabilities.
   Pre-employment transition services for students continue under order of selection, but they do not set the priority categories.
2. applicants with the lowest household income.
   Income may affect cost sharing, but order of selection is based on significance of disability, not financial need.
3. people with the most significant disabilities.
   Under an order of selection, the Rehabilitation Act requires priority for individuals with the most significant disabilities.
4. applicants in the order their applications arrived.
   Arrival date is used within a category, but the categories themselves are set by significance of disability.

Before a VR case can be closed as successfully employed, the individual must have maintained the employment outcome for at least:

1. 60 days.
   Sixty days is the deadline for an eligibility decision, not the employment period before closure.
2. 30 days.
   Thirty days is too short to show stable employment under VR rules.
3. 90 days.
   Federal VR rules require at least 90 days in the employment outcome before closing the case as successfully employed.
4. 6 months.
   Six months exceeds the federal minimum of 90 days.

An SSI recipient's earnings have risen so her cash payment stops, but she still needs Medicaid to pay for personal care. The provision that lets Medicaid continue is:

1. the Extended Period of Eligibility
   The EPE is an SSDI rule, not an SSI Medicaid protection.
2. Section 1619(a)
   Section 1619(a) keeps SSI cash payments going above SGA; her cash has already stopped, so 1619(b) is the one that protects Medicaid.
3. Section 1619(b)
   Section 1619(b) keeps Medicaid for SSI recipients whose earnings end their cash payment if they still need Medicaid to work and earn under a state threshold.
4. an Impairment-Related Work Expense
   An IRWE deducts disability-related work costs from countable earnings; it does not continue Medicaid on its own.

A state VR counselor buys job coaching and job development services for a client from a local nonprofit. The nonprofit is best described as a:

1. State Rehabilitation Council
   The SRC is an advisory council that reviews VR policy, not a service vendor.
2. Community Rehabilitation Program
   A community rehabilitation program is a provider, often a nonprofit, from which VR buys services such as job development, job coaching, and evaluation.
3. Protection and Advocacy agency
   A Protection and Advocacy agency gives legal advocacy to people with disabilities; it does not sell job coaching or job development to VR.
4. Center for Independent Living (CIL)
   CILs provide independent living core services and are consumer-controlled; buying job coaching is the typical role of a CRP.

According to DeJong's independent living paradigm, the main problem to be addressed lies in:

1. the person's weak motivation to recover
   Blaming weak motivation fits the medical rehabilitation view that DeJong criticized.
2. the person's impairment and lack of skills
   Locating the problem in impairment and skill deficits is the rehabilitation paradigm DeJong set the IL paradigm against.
3. the lack of medical treatment options
   The IL paradigm moves away from medical solutions toward consumer control and barrier removal.
4. dependence on professionals and barriers
   DeJong's independent living paradigm places the problem in dependence on professionals and in environmental barriers, not in the person's impairment.

A VR client needs knee surgery before he can return to construction work. Before VR pays for the surgery, the counselor must generally:

1. get the employer to share the cost.
   Employers have no duty to pay for a worker's medical treatment; the ADA requires accommodation, not health care.
2. wait until the client has started the job.
   He needs the surgery in order to return to work, so delaying it until after he starts defeats its purpose.
3. confirm the client's income is below poverty.
   VR eligibility is not income-based; financial need affects cost sharing only where the state has such a policy.
4. check for comparable benefits such as Medicaid.
   Physical restoration services such as surgery are subject to the comparable services and benefits search (34 CFR 361.53), so VR first checks Medicaid, private insurance, or workers' compensation before paying.

A client weighing a return to work lists the pros and cons of working and of staying on benefits. This motivational exercise is called:

1. a functional analysis.
   A functional analysis maps the triggers and consequences of a behavior, a behavioral assessment, not a pros-and-cons list.
2. a values card sort.
   A values card sort ranks personal values; it does not list the pros and cons of two options.
3. a miracle question.
   The miracle question comes from solution-focused therapy and asks what would be different if the problem were solved.
4. decisional balance.
   Decisional balance has the client weigh the pros and cons of changing and of not changing, a core motivational interviewing exercise for ambivalence.

A client with a recent spinal cord injury has angry outbursts. Research suggests that encouraging him to vent by hitting a punching bag will MOST likely:

1. have no measurable effect.
   Studies found a measurable effect in the wrong direction: venting increased aggression.
2. prevent later depression.
   There is no evidence that venting prevents depression after a spinal cord injury.
3. increase later aggression.
   Experiments on venting, such as Bushman's punching-bag studies, found it increased later aggression rather than relieving it.
4. reduce anger through catharsis.
   The catharsis hypothesis predicts relief from venting, but research has not supported it.

Routine outcome monitoring with feedback to the counselor (e.g., the OQ-45) has been shown to MOST benefit clients who are:

1. in their very first session.
   A single early score gives no trend; feedback helps by comparing progress against expected recovery over time.
2. not on track to improve.
   Lambert's research on routine outcome monitoring found the largest benefit for clients who were not on track, as feedback alerted counselors to adjust before dropout or deterioration.
3. improving faster than expected.
   Clients who are already improving gain little from feedback; the benefit is concentrated in those at risk of failure.
4. close to planned termination.
   Clients near planned termination have usually met their goals, so feedback changes little for them.

In the Stanley-Brown Safety Planning Intervention, the first item the client identifies is:

1. personal warning signs of a crisis
   The Stanley-Brown safety plan starts with recognizing personal warning signs, so the client knows when to use the rest of the plan.
2. steps to make the environment safer
   Making the environment safe, such as limiting access to lethal means, is the final step.
3. people and places that provide distraction
   Internal coping strategies and then distracting people and places come after warning signs.
4. professionals to contact in a crisis
   Contacting professionals and crisis lines comes late in the plan, after self-help and social steps.

A county opens a hurricane evacuation shelter. Under ADA Title II, the county must ensure that the shelter:

1. places disabled people in separate medical shelters
   Automatically sending people with disabilities to separate shelters is unnecessary segregation, which the ADA prohibits.
2. is accessible and communicates effectively
   Under ADA Title II, public emergency shelters must be physically accessible and communicate effectively, for example through interpreters and accessible formats.
3. admits service animals only with prior approval
   Service animals must be admitted without advance approval or certification.
4. admits disabled people only with a caregiver
   Requiring a caregiver as a condition of entry is a discriminatory eligibility criterion.

A counselor helps a client who uses a power wheelchair and lives alone plan for emergencies. A key recommendation is to:

1. build a personal support network
   A personal support network of people who check on him and help evacuate is a core emergency planning step for someone who lives alone and uses a power chair.
2. keep all medications at the pharmacy
   Keeping medications at the pharmacy leaves him without them in an emergency; plans call for a supply on hand.
3. rely on 911 crews to evacuate everyone
   Emergency crews may be overwhelmed or delayed in a disaster; relying on them alone is not a plan.
4. expect shelters to supply equipment
   Shelters may lack chargers and specialized equipment, so planning should not assume they will provide them.

During a crisis assessment with a client who has an intellectual disability, the counselor should:

1. rely only on the caregiver's account of events
   Caregivers add information, but relying on them alone silences the client and may miss the client's own view.
2. postpone the assessment until a psychologist arrives
   A crisis cannot wait, and any trained counselor can do the assessment with adaptations.
3. use simple language and check understanding
   Adapting language and checking comprehension, for example with teach-back, lets a person with an intellectual disability take part in their own crisis assessment.
4. use abstract rating scales without adapting them
   Abstract scales without adaptation may produce invalid answers from someone who processes concrete language.

Rolland's family systems-illness model classifies chronic conditions by onset, course, outcome, and:

1. level of genetic risk to relatives
   Genetic risk matters to many families, but it is not one of the dimensions Rolland uses to classify conditions.
2. cost of long-term treatment
   Treatment cost is a practical burden, not a dimension of Rolland's typology.
3. age of the person at diagnosis
   Age at diagnosis affects how an illness fits the family life cycle, but it is not one of the typology dimensions.
4. degree of incapacitation
   Rolland's psychosocial typology sorts illnesses by onset, course, outcome, and degree of incapacitation, with uncertainty added later as a dimension.

Parents of a young adult with a recent TBI say he is lazy because he keeps forgetting household tasks. The counselor's most helpful response is to:

1. advise them that he will not improve
   Many people improve for months to years after a TBI; a hopeless forecast is inaccurate and discouraging.
2. encourage stricter consequences for forgetting
   Consequences do not fix a memory deficit and may increase conflict and frustration.
3. educate them about TBI effects on memory
   Memory problems after a TBI are a brain injury effect, not laziness; education helps the family respond with cues and routines instead of blame.
4. focus on family conflicts from before the injury
   Old conflicts may matter later, but the immediate need is to correct their misreading of his symptoms.

A newly injured member of a spinal cord injury peer group feels encouraged after meeting a member who returned to work two years after injury. In Yalom's terms, this is:

1. universality
   Universality is the relief of learning that others share the same problems; the stem stresses encouragement about the future, not feeling less alone.
2. instillation of hope
   Seeing a peer with the same injury who is back at work shows the new member that progress is possible; Yalom calls this instillation of hope.
3. imitative behavior (modeling)
   Imitative behavior means copying another member's actions or skills; the new member is encouraged, not yet adopting the peer's behavior.
4. altruism
   Altruism is the benefit a member gets from helping others; here the new member is the one receiving the benefit.

An injured warehouse worker cannot return to his previous job, even with accommodation. Following the return-to-work hierarchy, the next option to explore is:

1. self-employment in a related field
   Self-employment is usually the last option because it carries the most risk and needs feasibility work.
2. retraining for a new occupation at college
   Retraining for a new occupation is near the bottom of the hierarchy because it costs the most and takes the longest.
3. the same job with a new employer
   The same job elsewhere does not solve a job he cannot do even with accommodation, and options with his own employer come first.
4. a different job with the same employer
   The usual return-to-work hierarchy goes same job, modified job, different job with the same employer, then options with a new employer, retraining, and self-employment; since accommodation fails, a different job with his employer is next.

An employer asks a counselor to design a disability management program to reduce lost work time. Which component has the strongest evidence for shortening disability duration?

1. Waiting for full medical recovery first
   Waiting for full recovery lengthens absences, while graded return often aids recovery.
2. Annual wellness fairs for staff
   Wellness fairs promote general health but have little evidence for shortening the length of disability once it occurs.
3. Early contact and transitional duty
   Early contact after an absence begins and transitional (modified) duty are among the best-supported disability management practices for shortening time away from work.
4. Returning workers only at MMI
   Waiting for maximum medical improvement delays return far longer than needed; many workers can return earlier with restrictions.

An employee is off work after non-work-related back surgery. Her short-term disability plan pays for up to 26 weeks. If she still cannot work after that, the income source that usually follows is:

1. workers' compensation benefits
   The surgery was not work-related, so workers' compensation does not apply.
2. long-term disability insurance
   Long-term disability insurance usually starts when short-term disability ends, often after 90 to 180 days, and covers longer absences.
3. unemployment insurance benefits
   Unemployment insurance requires being able and available to work, which she is not.
4. Social Security disability benefits
   SSDI requires a disability expected to last at least 12 months and an SSA decision that often takes months; it is not the routine next step when an employer's short-term plan ends, which is group long-term disability.

A surgeon's disability insurance policy pays benefits if she cannot perform the material duties of her own specialty, even if she could work in another job. This definition of disability is:

1. residual disability
   Residual disability pays partial benefits for partial loss of income or duties, not for total inability to do her own occupation.
2. own-occupation
   An own-occupation definition pays when the insured cannot perform the material duties of her own occupation or specialty, even if she could do other work.
3. presumptive disability
   Presumptive disability provisions pay automatically for catastrophic losses, such as loss of sight, not for inability to do one's specialty.
4. any-occupation
   An any-occupation definition pays only if she cannot do any job she is suited for, the opposite of this policy.

After a moderate TBI, a warehouse supervisor has full motor recovery but often forgets multi-step instructions. The MOST appropriate job-site strategy is:

1. reducing the physical demands of his current job
   His motor recovery is full; changing physical demands does nothing about forgetting instructions.
2. written checklists and electronic reminders
   Checklists and electronic reminders compensate for impaired memory so he can work now; compensation is the standard approach after a TBI.
3. waiting until cognitive recovery is complete before placement
   Waiting for complete recovery may mean waiting forever and loses the job; support on the job works better.
4. repetitive memory drills to restore memory before he returns
   Repetitive drills improve performance on the drill itself but transfer poorly to real job tasks.

A client with COPD reports 'dyspnea on exertion.' This means that the client experiences:

1. low blood oxygen levels during sleep
   Low oxygen during sleep is nocturnal hypoxemia, unrelated to exertion.
2. rapid breathing even while at rest
   Rapid breathing is tachypnea, and 'on exertion' rules out an at-rest symptom.
3. coughing up blood after physical effort
   Coughing up blood is hemoptysis, a different term.
4. shortness of breath during activity
   Dyspnea means difficult or labored breathing, and 'on exertion' means it happens during activity.

A 62-year-old who had polio as a child and was stable for decades now reports new fatigue, muscle weakness, and joint pain. The MOST likely explanation is:

1. post-polio syndrome
   Post-polio syndrome appears decades after the original illness with new fatigue, weakness, and joint pain in people who were stable.
2. reinfection with the polio virus
   Post-polio syndrome is not a new infection; it is thought to result from overworked surviving motor neurons.
3. early amyotrophic lateral sclerosis
   ALS causes progressive weakness with other motor neuron signs, but a polio history plus decades of stability points to post-polio syndrome.
4. normal aging unrelated to polio
   Normal aging does not explain new weakness in muscles once affected by polio; this pattern is a recognized syndrome.

Pressure injuries, obesity, and depression that develop after a spinal cord injury and are causally related to it are called:

1. primary impairments
   The primary impairment is the spinal cord injury itself; problems that develop from it are secondary.
2. congenital conditions
   Congenital conditions are present at birth, while these developed after an injury.
3. secondary conditions
   Secondary conditions are health problems caused by or related to a primary disability, such as pressure injuries after a spinal cord injury.
4. comorbid conditions
   Comorbid conditions exist alongside the disability but are not causally related to it, which this stem rules out.

In clients with schizophrenia, which symptom domain is the strongest predictor of poor vocational outcomes?

1. Mood symptoms
   Mood symptoms can affect work, but they predict employment less strongly than cognition.
2. Catatonic symptoms
   Catatonia is uncommon and episodic; it is not the main long-term predictor of work outcomes.
3. Cognitive symptoms
   Cognitive deficits, such as in attention, memory, and processing speed, predict vocational functioning in schizophrenia better than positive symptoms do.
4. Positive symptoms
   Hallucinations and delusions often respond to medication and relate only weakly to work outcomes, unlike cognitive deficits.

In Olmstead v. L.C. (1999), the Supreme Court held that unjustified institutionalization of people with disabilities who could live in the community is:

1. discrimination under ADA Title II
   Olmstead held that unjustified institutional isolation of people who could live in the community is discrimination under ADA Title II, which covers state and local government services.
2. a violation of the Fair Housing Act
   The case was decided under the ADA's integration mandate, not the Fair Housing Act.
3. permitted when community care costs more
   The Court allowed a limited fundamental-alteration defense, but higher cost alone does not make unnecessary institutionalization permissible.
4. discrimination under ADA Title III
   Title III covers private public accommodations; Olmstead concerned state-run services under Title II.

Congress passed the ADA Amendments Act of 2008 primarily to:

1. remove the 'regarded as' prong from the definition
   The ADAAA kept and broadened the 'regarded as' prong rather than removing it.
2. restore a broad definition of disability
   The ADAAA reversed Supreme Court decisions that had narrowed the definition, telling courts to read disability broadly.
3. set a dollar cap on the cost of accommodations
   The ADAAA set no dollar cap; undue hardship remains a case-by-case test.
4. extend Title I to employers with 5 or more employees
   Title I coverage stays at 15 or more employees; the ADAAA did not change it.

A college freshman with a learning disability had an IEP in high school and needs extended test time. To receive this accommodation in college, the student must typically:

1. request it from instructors under IDEA.
   IDEA ends with high school graduation or aging out; it does not cover college.
2. rely on the IEP transferring to the college.
   An IEP does not transfer to college, though colleges may accept it as part of the documentation.
3. self-disclose and provide documentation.
   In college, Section 504 and the ADA apply, and the student must disclose to the disability services office and provide documentation.
4. wait for the college to identify his disability.
   Colleges have no duty to find and evaluate students as schools do under IDEA; the student must ask.

A client who is culturally Deaf calls herself 'Deaf' and prefers that term to person-first phrasing. Under the 2023 CRCC Code, the counselor should:

1. use 'hearing impaired' as the neutral term.
   Many Deaf people reject 'hearing impaired' as deficit-focused; imposing it ignores her preference.
2. avoid naming her disability in any document.
   Records sometimes need to describe the disability; the issue is respectful, preferred terminology, not avoiding the topic.
3. use person-first language, as the Code requires.
   The 2023 Code does not require person-first language; it names both forms and defers to the client.
4. use the identity terms she has chosen.
   The 2023 CRCC Code calls for affirming language aligned with the client's preference, which may be person-first or identity-first.

When evaluating a state VR program, which of the following is an outcome measure rather than a process measure?

1. Average number of counselor contacts per open case
   Contact frequency is a service-delivery (process) measure.
2. Number of IPEs written within 90 days of eligibility
   Timely IPEs show process efficiency, not whether participants got jobs.
3. Share of participants in competitive jobs at closure
   Employment at closure measures a result of services, while counts of IPEs, referrals, and contacts measure activity.
4. Number of referrals received from local high schools
   Referral counts measure outreach and intake activity, not results for participants.

Under WIOA, state VR programs report common performance indicators shared with other workforce programs. One of these indicators is:

1. median earnings two quarters after exit.
   WIOA common performance indicators include employment rates in the second and fourth quarters after exit, median earnings in the second quarter, credential attainment, measurable skill gains, and effectiveness in serving employers.
2. average cost of services per IPE.
   Average cost per IPE is a management statistic, not a WIOA common indicator.
3. number of applicants found eligible each year.
   Eligibility counts are agency workload data, not a WIOA common performance indicator.
4. percentage of cases closed within 90 days.
   Case-closure speed is not a WIOA indicator; 90 days is the minimum employment period before closure.

An employee's disability now prevents her from performing essential functions of her job even with accommodation. She is qualified for a vacant position at the same level. Under ADA Title I, the employer should:

1. place her on indefinite unpaid leave
   Indefinite leave is generally not a reasonable accommodation, and it skips the reassignment duty.
2. offer reassignment to that open position
   When no accommodation works in the current job, reassignment to a vacant position she is qualified for is the ADA's accommodation of last resort.
3. lower the production standard for her current job
   Employers are not required to lower production standards that apply to all employees.
4. remove the essential functions from her current job
   Removing essential functions is never required; doing so would turn it into a different job.

In a dispute over modified duty, a neutral third party helps an injured worker and the employer reach their own voluntary agreement without imposing a decision. This process is:

1. arbitration
   An arbitrator hears both sides and issues a decision, often binding, which the stem rules out.
2. mediation
   In mediation, a neutral helps the parties reach their own voluntary agreement and does not impose a decision.
3. adjudication
   Adjudication is a decision by a judge or hearing officer, the opposite of a voluntary agreement.
4. negotiation
   Negotiation happens directly between the parties, without a neutral third party.

A 19-year-old with a congenital disability plans to become an accountant because his parents chose that career, and he has never explored other options. Marcia would classify his identity status as:

1. moratorium.
   Moratorium is active exploration without commitment yet; he has explored nothing.
2. identity diffusion.
   Identity diffusion is neither exploration nor commitment; he has a firm commitment.
3. foreclosure.
   Foreclosure is commitment without exploration: he adopted his parents' career choice without considering alternatives.
4. identity achievement.
   Identity achievement is commitment that follows exploration, and the exploration is missing here.

A client who has misused alprazolam daily for months wants to stop on his own immediately. The counselor should know that abrupt cessation:

1. can cause seizures and needs a supervised taper.
   Benzodiazepine withdrawal can cause seizures, so stopping after daily use calls for a medically supervised taper.
2. is safe if he also cuts back on alcohol.
   Cutting back on alcohol does not prevent benzodiazepine withdrawal; stopping both raises the risk.
3. is unpleasant but never medically dangerous.
   Unlike opioid withdrawal, which is miserable but rarely life-threatening, benzodiazepine withdrawal can be dangerous; this option mixes up the two.
4. causes no withdrawal with a short-acting drug.
   Short-acting drugs such as alprazolam tend to produce faster and more intense withdrawal.

A job coach teaching a worker with an intellectual disability to fold towels first guides his hands fully, then uses a light touch, then a gesture, and finally no help. This strategy is:

1. least-to-most prompting
   Least-to-most prompting starts with the smallest cue and adds more help only when the worker does not respond; the order here is the reverse.
2. most-to-least prompting
   The coach starts with the most intrusive prompt and steps down to less help as the worker succeeds, which is most-to-least prompting.
3. backward chaining
   Backward chaining teaches the last step of a task first and works back; the stem changes the level of help, not the order of steps.
4. shaping
   Shaping reinforces closer and closer versions of a new behavior; here the behavior stays the same while the prompts fade.

Under the ADA, the earliest point at which an employer may require an applicant to undergo a medical examination is:

1. during the job interview
   Pre-offer medical examinations and disability inquiries are prohibited, including during interviews.
2. after 90 days of employment
   Exams are allowed after the offer, before starting work; after hire they must be job-related and consistent with business necessity.
3. after the application is screened
   Screening applications is still pre-offer, when medical exams are prohibited.
4. after a conditional job offer
   The ADA bars medical examinations and disability-related questions before an offer; after a conditional offer, an exam may be required if all entering employees in that job category get one.