NCMHCE Psychopharmacology and Co-occurring Disorders 3

Question 1

A client with major depression and type 2 diabetes is starting an antidepressant. Which medication warrants the MOST caution due to metabolic side effects?

Accepted Answer

Mirtazapine

Answer

Mirtazapine is associated with significant weight gain and increased appetite, which can worsen glycemic control in clients with type 2 diabetes.

Question 2

Which benzodiazepine is considered SAFEST for older adults with co-occurring anxiety and alcohol use disorder due to its lack of active metabolites?

Accepted Answer

Lorazepam

Answer

Lorazepam (Ativan) has no active metabolites and is metabolized by glucuronidation, making it safer in older adults and those with liver impairment from alcohol use.

Question 3

A client with bipolar I disorder and stimulant use disorder is in a manic episode. Which medication class is CONTRAINDICATED in this situation?

Accepted Answer

Antidepressants as monotherapy

Answer

Antidepressants as monotherapy in bipolar I disorder can precipitate or worsen mania and are contraindicated during acute manic episodes.

Question 4

Acamprosate (Campral) is thought to reduce alcohol cravings by acting on which neurotransmitter system?

Accepted Answer

Glutamate/GABA balance

Answer

Acamprosate modulates glutamate and GABA activity, restoring the neurochemical balance disrupted by chronic alcohol use and reducing protracted withdrawal symptoms.

Question 5

A counselor is reviewing a client's medication list and notices they are taking both an SSRI and tramadol prescribed by their PCP. What risk should the counselor flag?

Accepted Answer

Serotonin syndrome due to dual serotonergic activity

Answer

Tramadol has serotonergic properties; combined with an SSRI, it raises the risk of serotonin syndrome, characterized by hyperthermia, agitation, and autonomic instability.

NCMHCE - National Clinical Mental Health Counseling Examination Practice Test

NCMHCE - National Clinical Mental Health Counseling Examination Practice Test

NCMHCE Psychopharmacology and Co-occurring Disorders 3