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Quiz Session - Attempts With Random Questions

NBCC NCMHCE Exam Questions

Page 1 of 33

1.

Use the following case study to answer this question.

What diagnostic prerequisite must a client have in order to qualify for antisocial personality disorder?

  • There is no such diagnostic prerequisite

  • Conduct disorder before age 10

  • Conduct disorder before age 12

  • Conduct disorder before age 15

Correct answer: There is no such diagnostic prerequisite 

In order to be diagnosed with antisocial personality disorder, the client must have had a history of conduct disorder before the age of 15; however, this history may not be in the form of a recognized diagnosis and a diagnosis of conduct disorder per se is not required. 

2.

Use the following case study to answer this question. 

Is the client's participation in the second group objectively a success or a failure? 

  • A success due to the patient's insight 

  • A failure due to the patient leaving 

  • A success due to the patient's attendance 

  • A failure due to the patient's tearfulness 

Correct answer: A success due to the patient's insight 

Objectively speaking, the client's participation has been a success, due to the amount of insight he was able to express, but also due to the emergence of group therapeutic factors such as the giving and recieving of support.

Patients can come and go during groups, especially in an acute settings, and still meaningfully participate. Clients are often tearful in group settings; this is only an expression of emotion and can mean many things; in this case, it does not mean failure. The client attending would be a success, especially in the early phases of an acute stay; the more substantial success is his insight into his problems.  

3.

Use the following case study to answer this question. 

Is the client's use of pornography unusual to this problem? 

  • No, as it is a manifestation of his urges

  • Yes, as those with frotteuristic disorder prefer action in real environments 

  • No, as those with frotteuristic disorder tend to overuse pornography 

  • Yes, as pornographic use is its own disorder 

Correct answer: No, as it is a manifestation of his urges 

As internet pornography has become more and more widely known and commonly available, a greater use of pornography to address the urges of some paraphilias would be expected as a manifestation of the underlying urges of the individual. 

The action preferences of those with frotteuristic disorder do not impact the fact that they might use pornography. Pornography use is not a disorder. 

4.

Use the following case study to answer this question.

Could coping skills be learned as a family?

  • Yes, coping skills can be learned as a family

  • No, coping skills should be taught to individuals

  • Yes, if the family all have the same issues

  • No, coping skills are not going to help this client

Correct answer: Yes, coping skills can be learned as a family 

Coping skills can be taught usefully to clients in family systems as a family unit, which may strengthen the learning and give tools to everyone in the system. In this case, almost everyone in the family situation will already have been trying to help with the situation to some degree, and the coping skills taught will be useful to them as well.

The family need not have all the same issues in order to benefit from this training.

5.

Use the following case study to answer this question.

Which of the following is a strength related to goal attainment for this client? 

  • His effort at practicing skills 

  • His active personal interests 

  • His secure employment 

  • His questions about medication 

Correct answer: His effort at practicing skills 

Strengths for goal attainment can present differently in the presentation of different clients. In the case of this client, it's important and encouraging that he has already started practicing skills, especially in light of the fact that this exercise is likely to be challenging for him. This demonstrates that he is committed to treatment and will contribute positively to goal attainment.

His personal interests, his secure employment, and his questions about medication can all be seen as strengths in some way, but they do not indicate a commitment to goal attainment. 

6.

Use the following case study to answer this question.

If the client were to desire to be discharged after the first session, what would you do? 

  • Inform the client about the rules of the setting 

  • Attempt to persuade the client that they need care

  • Have the client review the admission paperwork

  • Refer the client to another therapist 

Correct answer: Inform the client about the rules of the setting 

It is safe to say that most clients who are involuntarily committed do not wish to be so, and wish to be released in a way that would be considered unsafe and premature. In this case, it is probably best to gently inform the client about the general process of inpatient commitment and the rules of the inpatient setting. This would be more responsible than persuasion, which may give the client false hope about their options, and more empathic than simply having the patient review the admission paperwork. 

It would not be necessary to refer the client in these circumstances. 

7.

Use the following case study to answer this question.

How might you be impacting the therapeutic environment for this client with your presence? 

  • You are likely a source of fear 

  • You are most likely not having an effect 

  • You are creating an environment of comfort

  • You are confusing the client

Correct answer: You are likely a source of fear 

It is important to be aware of how one's status, appearance, or other characteristics affect clients. To the extent possible, these factors should be called out so that they can be openly addressed. In this case, selective mutism is often exacerbated by novel surroundings or people through fear. Your position of authority and relatively unknown status to the client has the unsurprising effect of causing them to be selectively mute in the early phases of treatment. 

In this case, you are much more likely to be a cause of fear than comfort or confusion. 

8.

Use the following case study to answer this question.

In clients with dissociative identity disorder, what changes with identity?

  • Behavior, consciousness, cognition, and perception

  • Behavior, consciousness, cognition, and speech

  • Behavior, sensorium, cognition, and perception

  • Mood, consciousness, cognition, and perception

Correct answer: Behavior, consciousness, cognition, and perception

Clients who have dissociative identity disorder experience a change in behavior, consciousness, cognition, and perception with their shifts of personality. 

Speech, sensorium, and mood are included in an assessment of behavior, consciousness, cognition, and perception. 

9.

Use the following case study to answer this question.

During which session, including intake, has the client shown the most distress?

  • The second session 

  • The intake 

  • The first session 

  • The mental status exam 

Correct answer: The second session 

Though the client has shown little that rises to the level of actual distress, what can be seen is that in the second session (which the client has avoided), the client shows the most inner conflict about treatment, and the most ambivalence about his problem. The client did get angry in the second session, but this was a reaction to being challenged that is characteristic of narcissism. 

The intake, the mental status exam, and the first session do not show as much discomfort in the client as the second session. 

10.

Use the following case study to answer the question.

Why is this patient not diagnosed with Severe Alcohol Use Disorder?

  • His symptoms do not reach diagnostic threshold 

  • His symptoms do not involve others 

  • His symptoms are in remission 

  • His symptoms have not involved legal consequences 

Correct answer: His symptoms do not reach diagnostic threshold 

The diagnostic criteria for Alcohol Use Disorder involve an array of symptoms such as craving, lack of control of use, and tolerance, among other psychosocial consequences. The number of these symptoms is totaled up, and along with other diagnostic considerations, determines the level of Alcohol Use Disorder diagnosed. In this case, the client's symptoms do not meet the diagnostic threshold for Severe Alcohol Use Disorder.

The client's symptoms are not in remission. His symptoms likely involve others to some degree, and may or may not include legal consequences at this time; in any event, he does not have the required number of symptoms.

11.

Use the following case study to answer this question.

What would be the main problem in using constructive confrontation with this client? 

  • The client's relationship with authority

  • The client's relationship with his mother 

  • The client's lack of insight 

  • The client's cultural background

Correct answer: The client's relationship with authority

As this client is diagnosed with Oppositional Defiant Disorder, anyone in a position of perceived authority (such as a counselor) must be careful not to alienate the client by using a confrontational strategy. Though the client may not react badly, other techniques are likely to be better choices due to the patient's diagnosis.

The client's relationship with his mother would not seem to be a barrier to confronting him. The client's insight would be a strength and not a reason to discount a particular technique. The client's cultural background does not appear to be a factor influencing his ability to deal with confrontation. 

12.

Use the following case study to answer this question.

Is this client suffering from paranoid personality disorder in addition to depersonalization/derealization disorder? 

  • No, as his beliefs are not based in persecutory anxiety 

  • Yes, as he believes others are out to get him 

  • Yes, as he believes others do not understand him 

  • No, unless his beliefs were to include hallucinations 

Correct answer: No, as his beliefs are not based in persecutory anxiety 

Paranoid personality disorder is a pervasive pattern of behavior with evidence throughout a person's life indicating an irrational belief in persecution by others. In this case, the client is simply lonely (likely as a result of his disorder) and has the understandable feeling of not being well understood. 

The client does not appear to believe others are out to get him. Hallucinations would not be characteristic of depersonalization/derealization disorder. 

13.

Use the following case study to answer this question.

In order to qualify for a diagnosis of conduct disorder, how many behaviors must be present? 

  • At least three in the past year and one in the last six months 

  • At least four in the past year and one in the last six months 

  • At least three in the past year

  • At least four in the past year

Correct answer: At least three in the past year and one in the last six months 

In order to qualify for the conduct disorder diagnosis, at least three of the problematic behavioral symptoms must be present within the past year, with at least one being in evidence in the past six months. 

14.

Use the following case study to answer this question.

When should you assess this client for at-risk behavior? 

  • Continuously 

  • At intake 

  • At the beginning of the first session

  • At the end of the second session 

Correct answer: Continuously 

Though formal assessments of at-risk behavior can and should be done during intake, clients go through changes in presentation and life circumstances during the course of treatment and should be continuously assessed in some way to ensure the counselor knows when the client is acting in a way that might harm themselves or others. This ongoing risk assessment can be informal or formal based on circumstances and presentation.

15.

Use the following case study to answer this question. 

How would you ethically describe the cause of the client's symptoms to the client?

  • Real but without documented medical cause 

  • Fabrications of the unconscious in response to stress

  • Aspects of a personality disorder needing treatment

  • Real and in need of consistent medical treatment 

Correct answer: Real but without documented medical cause 

The symptoms from which the client suffers are real. They cause distress and are not fabrications. This is probably the best way to introduce the idea to the client, while highlighting that the symptoms have no documented medical cause.

The symptoms are not aspects of a personality disorder, nor are they in need of consistent medical treatment. 

16.

Use the following case study to answer this question.

Generally speaking, with which of the following phenomena is dissociation usually associated? 

  • Trauma 

  • Organic disease

  • Dementia 

  • Delirium

Correct answer: Trauma 

Dissociative disorders in general are thought to have their basis in trauma that has occurred at some point in a person's life. Dissociative amnesia is an example of such a disorder. 

These disorders are not thought to have their basis in organic disease, dementia, or delirium.

17.

Use the following case study to answer this question.

What would be the purpose of a follow-up session after you are finished seeing this patient? 

  • To ensure safety and stability 

  • To finish administrative matters 

  • To administer final interventions 

  • To address new issues 

Correct answer: To ensure safety and stability 

In the majority of cases, a follow-up session with clients who have terminated is useful and necessary. Though administrative matters and interventions should all have been addressed within the established scope of therapy, and no new issues should be pursued without a new treatment plan, a follow-up session can ensure that the gains made in therapy have been stabilized and that the client's departure from therapy has been safe. 

18.

Use the following case study to answer this question.

What makes the discussion of emotions difficult with this client? 

  • Clients with antisocial personality disorder tend to be non-emotional

  • Clients with antisocial personality disorder tend to be highly emotional 

  • Clients with antisocial personality disorder tend to be fixated on emotions 

  • Clients with antisocial personality disorder do not feel emotions

Correct answer: Clients with antisocial personality disorder tend to be non-emotional

One of the many factors making the treatment of persons with antisocial personality disorder difficult is that they do not show or experience emotions as others do. They most likely feel no remorse for their actions and display little empathy for others. This is not to say they do not feel emotions such as rage, desire, or others; but their experience is qualitatively different than most of the population.

19.

Use the following case study to answer this question. 

If the client suggests that he would like to talk with others who have experienced similar events, what is the appropriate course of action? 

  • Recommend an open group appropriate to the issue concurrent with individual treatment

  • Find others who experienced the same event and bring them into treatment 

  • Refer to an open group appropriate to the issue and stop individual counseling

  • Recommend an open group appropriate to the issue after individual counseling is complete 

Correct answer: Recommend an open group appropriate to the issue concurrent with individual treatment

It's a good sign that the client wants to connect with others about his presenting issue. Especially in cases of trauma, group work can be very effective in establishing a sense of belonging and combating the isolation brought on by acute stress. However, there's no reason that this group work should take place after individual therapy is concluded and can be done at the same time, as the group and individual modalities will have very different methods and goals. There will still be important work to be done individually by this client in achieving their goals that will need the concentration of individual sessions. 

Bringing other people into treatment is a somewhat risky strategy, as the experience of connecting with peers is exactly what group work is all about and the addition of another person to therapy significantly changes the nature of the individual treatment modality. 

20.

Use the following case study to answer this question. 

How would you address the client's substance use? 

  • With a separate diagnostic procedure 

  • It is a mild issue not in need of addressing 

  • By suggesting substance use treatment 

  • By referring to a specialist in substance use 

Correct answer: With a separate diagnostic procedure 

The client does appear to be using cannabis much as she reports. Though it is not the reason the client came to treatment and the issue may be minor, it will still need to be assessed separately from her presenting issue of pica. Following this diagnostic procedure, decisions will need to be made based on those results about further treatment for that issue if, in fact, a problematic issue exists. 

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