NCE/LPC Exam Study Guide
Questions and Answers | Latest
Version | 2025/2026 | Correct & Verified
What is the first step a counselor should take when a client presents with suicidal thoughts?
✔✔Conduct a thorough suicide risk assessment and develop a safety plan
A client reports recurring nightmares and hypervigilance after a car accident. What condition
should the counselor assess for?
✔✔Post-traumatic stress disorder (PTSD)
If a counselor begins to feel strong personal emotions toward a client, what is this an example
of?
✔✔Countertransference
When a client refuses to attend sessions, what should a counselor do first?
✔✔Explore the reasons for resistance empathetically and collaboratively
A counselor suspects child abuse but the client denies it. What is the ethical response?
1
,✔✔Report to the appropriate child protective services while maintaining client safety
A client frequently interrupts others and dominates conversations in group therapy. What is the
counselor’s first step?
✔✔Address group norms and facilitate balanced participation
What is the primary goal of using cognitive-behavioral therapy with clients who have anxiety?
✔✔To identify and modify maladaptive thoughts and behaviors
A client presents with obsessive hand-washing and checking behaviors. What evidence-based
approach should the counselor use?
✔✔Exposure and response prevention (ERP)
When a client asks for the counselor’s personal phone number, what is the correct response?
✔✔Explain professional boundaries and maintain confidentiality
A client reports intense sadness and loss of interest for three weeks following a job loss. What is
the most likely diagnosis?
2
,✔✔Adjustment disorder with depressed mood
A counselor receives a subpoena for client records. What is the first ethical step?
✔✔Consult legal counsel and review client consent before releasing information
What is the first intervention for a client expressing homicidal thoughts toward another person?
✔✔Assess risk and take steps to warn and protect the intended victim according to legal and
ethical guidelines
A counselor notices a client avoids eye contact and changes the subject when discussing trauma.
What is this an example of?
✔✔Defense mechanism
When a counselor suspects substance abuse in a client, but the client denies it, what is the best
approach?
✔✔Use motivational interviewing to explore ambivalence and readiness to change
A couple reports constant arguments over parenting styles. What should the counselor address
first?
3
, ✔✔Family interaction patterns and communication styles
A client reports feeling detached and disconnected from reality. Which intervention is
appropriate?
✔✔Teach grounding and mindfulness techniques to reconnect with the present
A counselor feels emotionally drained after multiple trauma sessions. What is the best course of
action?
✔✔Seek supervision, consultation, and practice self-care
A client presents with persistent worry about multiple life domains. What is the most likely
diagnosis?
✔✔Generalized anxiety disorder (GAD)
When working with a cross-cultural client, what is the counselor’s primary responsibility?
✔✔Demonstrate cultural humility and adapt interventions to the client’s cultural context
A client refuses to discuss family issues during therapy. How should the counselor respond?
4
Questions and Answers | Latest
Version | 2025/2026 | Correct & Verified
What is the first step a counselor should take when a client presents with suicidal thoughts?
✔✔Conduct a thorough suicide risk assessment and develop a safety plan
A client reports recurring nightmares and hypervigilance after a car accident. What condition
should the counselor assess for?
✔✔Post-traumatic stress disorder (PTSD)
If a counselor begins to feel strong personal emotions toward a client, what is this an example
of?
✔✔Countertransference
When a client refuses to attend sessions, what should a counselor do first?
✔✔Explore the reasons for resistance empathetically and collaboratively
A counselor suspects child abuse but the client denies it. What is the ethical response?
1
,✔✔Report to the appropriate child protective services while maintaining client safety
A client frequently interrupts others and dominates conversations in group therapy. What is the
counselor’s first step?
✔✔Address group norms and facilitate balanced participation
What is the primary goal of using cognitive-behavioral therapy with clients who have anxiety?
✔✔To identify and modify maladaptive thoughts and behaviors
A client presents with obsessive hand-washing and checking behaviors. What evidence-based
approach should the counselor use?
✔✔Exposure and response prevention (ERP)
When a client asks for the counselor’s personal phone number, what is the correct response?
✔✔Explain professional boundaries and maintain confidentiality
A client reports intense sadness and loss of interest for three weeks following a job loss. What is
the most likely diagnosis?
2
,✔✔Adjustment disorder with depressed mood
A counselor receives a subpoena for client records. What is the first ethical step?
✔✔Consult legal counsel and review client consent before releasing information
What is the first intervention for a client expressing homicidal thoughts toward another person?
✔✔Assess risk and take steps to warn and protect the intended victim according to legal and
ethical guidelines
A counselor notices a client avoids eye contact and changes the subject when discussing trauma.
What is this an example of?
✔✔Defense mechanism
When a counselor suspects substance abuse in a client, but the client denies it, what is the best
approach?
✔✔Use motivational interviewing to explore ambivalence and readiness to change
A couple reports constant arguments over parenting styles. What should the counselor address
first?
3
, ✔✔Family interaction patterns and communication styles
A client reports feeling detached and disconnected from reality. Which intervention is
appropriate?
✔✔Teach grounding and mindfulness techniques to reconnect with the present
A counselor feels emotionally drained after multiple trauma sessions. What is the best course of
action?
✔✔Seek supervision, consultation, and practice self-care
A client presents with persistent worry about multiple life domains. What is the most likely
diagnosis?
✔✔Generalized anxiety disorder (GAD)
When working with a cross-cultural client, what is the counselor’s primary responsibility?
✔✔Demonstrate cultural humility and adapt interventions to the client’s cultural context
A client refuses to discuss family issues during therapy. How should the counselor respond?
4
