NCMHCE - National Clinical Mental Health Counseling Examination Psychopharmacology and Co-occurring Disorders 5

Question 1

A counselor reviews a client's chart and notes they are taking clozapine for schizophrenia and have begun using tobacco more heavily.
The primary clinical concern regarding tobacco use in this client is:

Accepted Answer

Tobacco smoke induces CYP1A2 enzymes, reducing clozapine blood levels

Answer

Increased risk of cardiovascular events due to nicotine

Answer

Nicotine potentiates clozapine's antipsychotic effect

Answer

Tobacco use increases the risk of tardive dyskinesia with clozapine

Question 2

A client with ADHD and stimulant use disorder reports that their prescribed amphetamine salts help them feel 'normal.' The counselor's best response is to:

Accepted Answer

Explore the subjective experience while consulting with the prescriber about monitoring

Answer

Discontinue the stimulant prescription immediately and refer to detox

Answer

Reassure the client that feeling normal indicates they do not have a stimulant use disorder

Answer

Switch the client to a non-stimulant ADHD medication without prescriber consultation

Question 3

In the ASAM criteria for level of care placement, which dimension most directly addresses a client's co-occurring psychiatric conditions?

Accepted Answer

Dimension 3: Emotional, Behavioral, or Cognitive Conditions

Answer

Dimension 1: Acute Intoxication and Withdrawal Potential

Answer

Dimension 2: Biomedical Conditions and Complications

Answer

Dimension 5: Relapse, Continued Use, or Continued Problem Potential

Question 4

A client recovering from alcohol use disorder reports severe insomnia and requests medication. The counselor should advise the prescribing provider that the highest-risk option for this population would be:

Accepted Answer

Benzodiazepines

Answer

Trazodone

Answer

Melatonin

Answer

Hydroxyzine

Question 5

A client with bipolar II disorder and stimulant use disorder is most at risk for which outcome if stimulants are used during a hypomanic episode?

Accepted Answer

Conversion to a full manic or psychotic episode

Answer

Sedation and mood stabilization due to stimulant-mood interaction

Answer

Rapid cycling that resolves within 24 hours

Answer

Immediate transition to a depressive phase

Question 6

Which of the following best describes the 'kindling' phenomenon relevant to alcohol use disorder and counseling treatment planning?

Accepted Answer

The tendency for each withdrawal episode to produce progressively more severe symptoms

Answer

The gradual increase in alcohol tolerance requiring escalating consumption

Answer

The client's increasing emotional sensitivity to relapse triggers over time

Answer

The rapid onset of alcohol dependence in individuals with a family history

Question 7

A counselor working with a client on antipsychotic medication notices the client has developed repetitive, involuntary movements of the tongue, lips, and jaw. The counselor should recognize these as signs of:

Accepted Answer

Tardive dyskinesia

Answer

Akathisia

Answer

Neuroleptic malignant syndrome

Answer

Parkinsonism