NCMHCE Psychopharmacology and Co-occurring Disorders 5

Question 1

A client with treatment-resistant depression is being considered for ketamine infusions. Which co-occurring condition would be the GREATEST contraindication?

Accepted Answer

Active psychosis or schizophrenia spectrum disorder

Answer

Ketamine's dissociative and psychotomimetic properties can significantly exacerbate psychotic symptoms, making active psychosis a primary contraindication.

Question 2

A pregnant client in her first trimester has severe bipolar disorder. Which medication carries the GREATEST risk of congenital malformations, particularly Ebstein's anomaly?

Accepted Answer

Lithium

Answer

Lithium is associated with Ebstein's anomaly (a cardiac malformation) when used in the first trimester, though the absolute risk is small and risk-benefit must be weighed.

Question 3

Which of the following BEST describes the mechanism by which buprenorphine reduces opioid cravings without causing euphoria at therapeutic doses?

Accepted Answer

It is a partial agonist at mu-opioid receptors with a ceiling effect

Answer

Buprenorphine's partial agonism at mu-opioid receptors means it activates those receptors sufficiently to reduce withdrawal and cravings but has a ceiling effect that limits euphoria.

Question 4

A counselor's client with co-occurring ADHD and methamphetamine use disorder achieves sobriety and asks about ADHD treatment. Bupropion is being considered. What should the counselor know?

Accepted Answer

Bupropion has shown some evidence for reducing both ADHD symptoms and methamphetamine cravings

Answer

Bupropion (Wellbutrin) has emerging evidence for reducing methamphetamine use and can address ADHD symptoms through dopamine/norepinephrine reuptake inhibition without significant abuse potential.

Question 5

Which of the following best describes 'pharmacodynamic tolerance' in the context of substance use?

Accepted Answer

The brain's receptors become less sensitive to a drug's effects with repeated exposure

Answer

Pharmacodynamic tolerance occurs when target receptors decrease in number or sensitivity (downregulation) in response to repeated drug stimulation.

NCMHCE - National Clinical Mental Health Counseling Examination Practice Test

NCMHCE - National Clinical Mental Health Counseling Examination Practice Test

NCMHCE Psychopharmacology and Co-occurring Disorders 5