NCMHCE - National Clinical Mental Health Counseling Examination Psychopharmacology and Co-occurring Disorders Questions and Answers

Question 1

A 48-year-old client with co-occurring diagnoses of severe Alcohol Use Disorder and Post-Traumatic Stress Disorder (PTSD) is prescribed clonazepam (a benzodiazepine) by their primary care physician to manage anxiety and insomnia.
The client reports to their counselor that the medication initially helped but now seems less effective at the prescribed dose.
What is the MOST likely psychopharmacological reason for this phenomenon?

Accepted Answer

Cross-tolerance has developed between alcohol and the benzodiazepine.

Answer

The client has developed a paradoxical reaction to the medication.

Answer

The medication is primarily metabolized by the liver, which is likely compromised.

Answer

The client's PTSD symptoms are inherently resistant to anxiolytic medication.

Question 2

A counselor is part of a treatment team for a client diagnosed with Bipolar I Disorder and Amphetamine-Type Stimulant Use Disorder. The client's psychiatrist is considering prescribing a mood stabilizer. Which of the following statements reflects the counselor's MOST appropriate role regarding the client's medication?

Accepted Answer

Monitoring and documenting the client's mood fluctuations, medication adherence, and any reported side effects to share with the treatment team.

Answer

Advising the client that lithium is the 'gold standard' and they should request it specifically.

Answer

Recommending the client discontinue the medication if they experience a relapse in stimulant use.

Answer

Explaining the detailed neurochemical mechanism of action for various mood stabilizers to the client.

Question 3

A client with Opioid Use Disorder and Major Depressive Disorder is beginning Medication-Assisted Treatment (MAT). They are prescribed a medication that is a partial opioid agonist, designed to reduce cravings and withdrawal symptoms while having a 'ceiling effect' that lowers the risk of overdose. Which medication fits this description?

Accepted Answer

Buprenorphine

Answer

Naltrexone

Answer

Methadone

Answer

Disulfiram

Question 4

Which of the following represents the most significant risk of prescribing a benzodiazepine, such as alprazolam, for a client with Generalized Anxiety Disorder who also has an active, untreated Alcohol Use Disorder?

Accepted Answer

The high potential for dangerous synergistic effects and cross-addiction.

Answer

A high probability of inducing a manic episode.

Answer

The likelihood of the medication causing severe gastrointestinal distress.

Answer

The risk of serotonin syndrome when alcohol and alprazolam are combined.

Question 5

A 30-year-old client is stabilized in treatment for both Schizophrenia and Cannabis Use Disorder. The client's care is managed by a single team of professionals in one location, where they receive antipsychotic medication management, individual therapy addressing both psychosis and substance use, and case management services. This model of care is best described as:

Accepted Answer

Integrated treatment

Answer

Sequential treatment

Answer

Parallel treatment

Answer

Tertiary treatment

Question 6

A client with a co-occurring diagnosis of Alcohol Use Disorder, now in sustained remission, and persistent depressive disorder is being treated with sertraline (an SSRI). The client's psychiatrist wants to add a medication to help maintain alcohol abstinence by reducing cravings. Which FDA-approved medication accomplishes this by modulating glutamate transmission rather than by blocking opioid receptors?

Accepted Answer

Acamprosate

Answer

Naltrexone

Answer

Disulfiram

Answer

Buspirone