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

Tobacco smoke (not nicotine itself) induces CYP1A2 enzymes that metabolize clozapine, potentially lowering levels below the therapeutic threshold and risking relapse.

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

The counselor should explore the client's subjective experience and collaborate with the prescriber to assess therapeutic response versus misuse patterns.

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 3 of the ASAM criteria specifically evaluates emotional, behavioral, and cognitive conditions, including co-occurring psychiatric disorders, to inform level of care placement.

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

Benzodiazepines carry significant abuse potential and cross-tolerance with alcohol, making them contraindicated for long-term sleep management in individuals with AUD.

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

Stimulant use during hypomania can escalate mood dysregulation and precipitate a full manic or psychotic episode in bipolar clients.

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 5