NCMHCE National Clinical Mental Health Counseling Exam |
450 Practice Questions & Detailed Answers | NBCC Clinical
Simulation Test Bank | A+ Guide
Question 1
A 32yearold client presents with depressed mood, anhedonia, significant weight loss, insomnia, fatigue,
feelings of worthlessness, and recurrent thoughts of death for the past 3 weeks. The symptoms began
shortly after a divorce. What is the most appropriate DSM5TR diagnosis?
A) Adjustment Disorder with Depressed Mood
B) Major Depressive Disorder, Single Episode
C) Persistent Depressive Disorder (Dysthymia)
D) Unspecified Depressive Disorder
Answer: B
Rationale: Major Depressive Disorder requires at least 5 symptoms (including depressed mood or
anhedonia) present for at least 2 weeks, causing clinically significant distress. The duration and number
of symptoms here meet criteria. Adjustment Disorder would be considered if symptoms were milder
and did not meet full MDD criteria. Persistent Depressive Disorder requires symptoms for at least 2
years.
Question 2
A client reports excessive anxiety and worry about multiple events for more days than not over the past
8 months. She reports difficulty controlling the worry and experiences restlessness, fatigue, difficulty
concentrating, irritability, muscle tension, and sleep disturbance. What is the most likely diagnosis?
A) Panic Disorder
B) Generalized Anxiety Disorder
C) Social Anxiety Disorder
D) Separation Anxiety Disorder
,Answer: B
Rationale: Generalized Anxiety Disorder (GAD) is characterized by excessive anxiety and worry about
multiple domains, difficulty controlling worry, and at least 3 associated symptoms (restlessness, fatigue,
concentration difficulty, irritability, muscle tension, sleep disturbance) for at least 6 months. This client
meets all criteria.
Question 3
A 45yearold client reports recurrent, unexpected panic attacks followed by at least 1 month of
persistent concern about having additional attacks and maladaptive behavioral changes related to the
attacks. Which diagnosis is most appropriate?
A) Panic Disorder
B) Agoraphobia
C) Generalized Anxiety Disorder
D) Specific Phobia
Answer: A
Rationale: Panic Disorder is diagnosed when a client experiences recurrent unexpected panic attacks
and subsequently develops persistent concern about additional attacks, worry about consequences, or
significant maladaptive behavioral changes for at least 1 month.
Question 4
A client presents with a 6month history of intense fear of social situations where they may be
scrutinized by others. They avoid parties, meetings, and public speaking. They experience significant
distress and impaired occupational functioning. What is the most appropriate diagnosis?
A) Agoraphobia
,B) Social Anxiety Disorder (Social Phobia)
C) Panic Disorder
D) Avoidant Personality Disorder
Answer: B
Rationale: Social Anxiety Disorder is characterized by marked fear or anxiety about social situations in
which the individual is exposed to possible scrutiny by others, lasting 6 months or more, and causing
clinically significant distress or impairment.
Question 5
A 28yearold client reports intrusive memories, nightmares, and flashbacks of a traumatic event they
experienced 4 months ago. They avoid reminders of the event, have negative alterations in cognition
and mood, and have marked alterations in arousal and reactivity. Which diagnosis is most appropriate?
A) Acute Stress Disorder
B) Posttraumatic Stress Disorder
C) Adjustment Disorder
D) Brief Psychotic Disorder
Answer: B
Rationale: PTSD requires exposure to actual or threatened death, serious injury, or sexual violence, with
symptoms (intrusions, avoidance, negative alterations in cognition/mood, alterations in
arousal/reactivity) lasting more than 1 month. Acute Stress Disorder is diagnosed if symptoms last 3
days to 1 month.
Question 6
, A client reports persistent difficulty discarding possessions, regardless of their actual value, leading to
significant clutter that prevents normal use of living spaces. This causes clinically significant distress and
impairment. What is the most appropriate diagnosis?
A) ObsessiveCompulsive Disorder
B) Hoarding Disorder
C) Major Depressive Disorder
D) Generalized Anxiety Disorder
Answer: B
Rationale: Hoarding Disorder is characterized by persistent difficulty discarding possessions, perceived
need to save items, and distress associated with discarding, resulting in accumulation that compromises
living spaces. This is distinct from OCD.
Question 7
A 19yearold college student presents with a 2year history of restrictive eating, intense fear of gaining
weight, and disturbance in selfperceived weight. Her BMI is 16.5. She reports amenorrhea for 6 months.
What is the most appropriate diagnosis?
A) Bulimia Nervosa
B) Anorexia Nervosa, Restricting Type
C) Avoidant/Restrictive Food Intake Disorder
D) Anorexia Nervosa, BingeEating/Purging Type
Answer: B
Rationale: Anorexia Nervosa is characterized by restriction of energy intake relative to requirements
leading to significantly low body weight, intense fear of weight gain, and disturbance in selfperceived
weight. BMI <17 is consistent with significantly low weight. The absence of bingeeating/purging
behaviors suggests the restricting type.
450 Practice Questions & Detailed Answers | NBCC Clinical
Simulation Test Bank | A+ Guide
Question 1
A 32yearold client presents with depressed mood, anhedonia, significant weight loss, insomnia, fatigue,
feelings of worthlessness, and recurrent thoughts of death for the past 3 weeks. The symptoms began
shortly after a divorce. What is the most appropriate DSM5TR diagnosis?
A) Adjustment Disorder with Depressed Mood
B) Major Depressive Disorder, Single Episode
C) Persistent Depressive Disorder (Dysthymia)
D) Unspecified Depressive Disorder
Answer: B
Rationale: Major Depressive Disorder requires at least 5 symptoms (including depressed mood or
anhedonia) present for at least 2 weeks, causing clinically significant distress. The duration and number
of symptoms here meet criteria. Adjustment Disorder would be considered if symptoms were milder
and did not meet full MDD criteria. Persistent Depressive Disorder requires symptoms for at least 2
years.
Question 2
A client reports excessive anxiety and worry about multiple events for more days than not over the past
8 months. She reports difficulty controlling the worry and experiences restlessness, fatigue, difficulty
concentrating, irritability, muscle tension, and sleep disturbance. What is the most likely diagnosis?
A) Panic Disorder
B) Generalized Anxiety Disorder
C) Social Anxiety Disorder
D) Separation Anxiety Disorder
,Answer: B
Rationale: Generalized Anxiety Disorder (GAD) is characterized by excessive anxiety and worry about
multiple domains, difficulty controlling worry, and at least 3 associated symptoms (restlessness, fatigue,
concentration difficulty, irritability, muscle tension, sleep disturbance) for at least 6 months. This client
meets all criteria.
Question 3
A 45yearold client reports recurrent, unexpected panic attacks followed by at least 1 month of
persistent concern about having additional attacks and maladaptive behavioral changes related to the
attacks. Which diagnosis is most appropriate?
A) Panic Disorder
B) Agoraphobia
C) Generalized Anxiety Disorder
D) Specific Phobia
Answer: A
Rationale: Panic Disorder is diagnosed when a client experiences recurrent unexpected panic attacks
and subsequently develops persistent concern about additional attacks, worry about consequences, or
significant maladaptive behavioral changes for at least 1 month.
Question 4
A client presents with a 6month history of intense fear of social situations where they may be
scrutinized by others. They avoid parties, meetings, and public speaking. They experience significant
distress and impaired occupational functioning. What is the most appropriate diagnosis?
A) Agoraphobia
,B) Social Anxiety Disorder (Social Phobia)
C) Panic Disorder
D) Avoidant Personality Disorder
Answer: B
Rationale: Social Anxiety Disorder is characterized by marked fear or anxiety about social situations in
which the individual is exposed to possible scrutiny by others, lasting 6 months or more, and causing
clinically significant distress or impairment.
Question 5
A 28yearold client reports intrusive memories, nightmares, and flashbacks of a traumatic event they
experienced 4 months ago. They avoid reminders of the event, have negative alterations in cognition
and mood, and have marked alterations in arousal and reactivity. Which diagnosis is most appropriate?
A) Acute Stress Disorder
B) Posttraumatic Stress Disorder
C) Adjustment Disorder
D) Brief Psychotic Disorder
Answer: B
Rationale: PTSD requires exposure to actual or threatened death, serious injury, or sexual violence, with
symptoms (intrusions, avoidance, negative alterations in cognition/mood, alterations in
arousal/reactivity) lasting more than 1 month. Acute Stress Disorder is diagnosed if symptoms last 3
days to 1 month.
Question 6
, A client reports persistent difficulty discarding possessions, regardless of their actual value, leading to
significant clutter that prevents normal use of living spaces. This causes clinically significant distress and
impairment. What is the most appropriate diagnosis?
A) ObsessiveCompulsive Disorder
B) Hoarding Disorder
C) Major Depressive Disorder
D) Generalized Anxiety Disorder
Answer: B
Rationale: Hoarding Disorder is characterized by persistent difficulty discarding possessions, perceived
need to save items, and distress associated with discarding, resulting in accumulation that compromises
living spaces. This is distinct from OCD.
Question 7
A 19yearold college student presents with a 2year history of restrictive eating, intense fear of gaining
weight, and disturbance in selfperceived weight. Her BMI is 16.5. She reports amenorrhea for 6 months.
What is the most appropriate diagnosis?
A) Bulimia Nervosa
B) Anorexia Nervosa, Restricting Type
C) Avoidant/Restrictive Food Intake Disorder
D) Anorexia Nervosa, BingeEating/Purging Type
Answer: B
Rationale: Anorexia Nervosa is characterized by restriction of energy intake relative to requirements
leading to significantly low body weight, intense fear of weight gain, and disturbance in selfperceived
weight. BMI <17 is consistent with significantly low weight. The absence of bingeeating/purging
behaviors suggests the restricting type.
