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

Valproate (divalproex) is preferred in bipolar disorder with comorbid AUD as it stabilizes mood and has evidence supporting reduced heavy drinking days.

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

Combining SSRIs with St. John's Wort significantly increases serotonergic activity, raising the risk of serotonin syndrome characterized by agitation, hyperthermia, and neuromuscular abnormalities.

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

Concurrent use of methadone and benzodiazepines dramatically increases the risk of fatal respiratory depression due to additive CNS depression.

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

Chronic cannabis use in PTSD reinforces avoidance coping and interferes with the emotional processing needed for trauma recovery.

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

Disulfiram is most effective when the client is motivated and understands that consuming alcohol will cause an aversive reaction; it has no efficacy if taken covertly.

NCMHCE - National Clinical Mental Health Counseling Examination Practice Test

NCMHCE - National Clinical Mental Health Counseling Examination Practice Test

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