NCMHCE - National Clinical Mental Health Counseling Examination Psychopharmacology and Co-occurring Disorders 3

Question 1

A client with bipolar I disorder and alcohol use disorder presents for treatment.
Which medication is considered first-line for mood stabilization while also having evidence for reducing alcohol cravings?

Accepted Answer

Valproate

Answer

Lithium

Answer

Naltrexone

Answer

Acamprosate

Question 2

A client taking an SSRI for depression begins using St. John's Wort to 'boost' its effects. The counselor should be most concerned about which potential adverse reaction?

Accepted Answer

Serotonin syndrome

Answer

Hypertensive crisis

Answer

Neuroleptic malignant syndrome

Answer

Tardive dyskinesia

Question 3

When counseling a client with opioid use disorder maintained on methadone, the counselor notices the client has begun taking a benzodiazepine prescribed by another provider. The primary clinical concern is:

Accepted Answer

Increased risk of fatal respiratory depression

Answer

Reduced methadone efficacy due to enzyme induction

Answer

Accelerated methadone metabolism requiring dose increases

Answer

Benzodiazepine-induced mania

Question 4

A client with PTSD and cannabis use disorder reports using marijuana to manage nightmares. The counselor should explain that chronic cannabis use in PTSD is most likely to:

Accepted Answer

Impair emotional processing and increase avoidance

Answer

Permanently resolve trauma-related nightmares

Answer

Enhance the effectiveness of EMDR therapy

Answer

Reduce hyperarousal without impacting sleep architecture

Question 5

Which of the following is the most accurate statement regarding disulfiram (Antabuse) used in alcohol use disorder treatment?

Accepted Answer

It requires client motivation as it relies on aversion conditioning

Answer

It reduces alcohol cravings by blocking opioid receptors

Answer

It works best without the client's knowledge of its mechanism

Answer

It is the preferred medication for clients with liver disease

Question 6

A client with schizophrenia and cocaine use disorder is being assessed. Which symptom cluster is most likely to be masked or mimicked by acute cocaine intoxication, complicating differential diagnosis?

Accepted Answer

Positive symptoms such as paranoia and hallucinations

Answer

Negative symptoms such as flat affect and alogia

Answer

Cognitive deficits such as working memory impairment

Answer

Prodromal symptoms such as social withdrawal

Question 7

A pregnant client in her first trimester is being treated for opioid use disorder. According to current guidelines, the recommended approach is:

Accepted Answer

Maintenance with methadone or buprenorphine throughout pregnancy

Answer

Medically supervised withdrawal to achieve abstinence before delivery

Answer

Immediate discontinuation of all opioids to protect fetal development

Answer

Naltrexone as the safest option due to its non-opioid mechanism