NCMHCE Psychopharmacology and Co-occurring Disorders 2

Question 1

A client with bipolar disorder and alcohol use disorder is stabilized on lithium. Which concern is MOST clinically significant when the client begins drinking heavily again?

Accepted Answer

Alcohol causes lithium toxicity by reducing renal clearance

Answer

Alcohol increases lithium excretion, causing subtherapeutic levels

Answer

Alcohol has no pharmacokinetic interaction with lithium

Answer

Alcohol blocks lithium absorption in the GI tract

Question 2

A client diagnosed with PTSD and opioid use disorder is being considered for medication-assisted treatment. Which medication is MOST appropriate given both conditions?

Accepted Answer

Naltrexone extended-release injection

Answer

Methadone only

Answer

Buprenorphine/naloxone (Suboxone)

Answer

Clonidine monotherapy

Question 3

Which of the following SSRIs is FDA-approved for BOTH major depressive disorder and obsessive-compulsive disorder in adults?

Accepted Answer

Fluoxetine

Answer

Citalopram

Answer

Escitalopram

Answer

Fluvoxamine

Question 4

A client with schizophrenia and cannabis use disorder reports that smoking marijuana reduces their anxiety. What is the counselor's BEST clinical response?

Accepted Answer

Validate their experience while educating on cannabis-induced psychosis risk

Answer

Support cannabis use if it reduces psychotic symptoms

Answer

Immediately refer for antipsychotic adjustment without discussing cannabis

Answer

Discharge the client for non-compliance

Question 5

Disulfiram (Antabuse) works by inhibiting which enzyme, causing acetaldehyde buildup when alcohol is consumed?

Accepted Answer

Aldehyde dehydrogenase

Answer

Alcohol dehydrogenase

Answer

Cytochrome P450 2E1

Answer

Monoamine oxidase

Question 6

A client taking an MAOI for treatment-resistant depression reports beginning to use cocaine on weekends. Which risk must be addressed IMMEDIATELY?

Accepted Answer

The combination can cause hypertensive crisis or serotonin syndrome

Answer

Cocaine reduces MAOI efficacy over time

Answer

MAOIs block cocaine's euphoric effects

Answer

Cocaine accelerates MAOI metabolism causing underdosing

Question 7

In treating a client with co-occurring generalized anxiety disorder and alcohol use disorder, which approach reflects best practice for sequencing treatment?

Accepted Answer

Treat both simultaneously using an integrated treatment model

Answer

Treat alcohol use disorder first; anxiety typically resolves with sobriety

Answer

Treat GAD first with benzodiazepines before addressing alcohol

Answer

Wait 6 months of sobriety before diagnosing or treating anxiety