NCMHCE COUNSELING CONCEPTS EXAM
ACTUAL PREP QUESTIONS AND WELL
REVISED ANSWERS - LATEST AND COMPLETE
UPDATE WITH VERIFIED SOLUTIONS –
ASSURES PASS
1. A client reports persistent sadness, difficulty sleeping, and loss of appetite
for the past three weeks. According to the DSM-5, which diagnosis is most
appropriate?
A. Major Depressive Disorder
B. Adjustment Disorder with Depressed Mood
C. Persistent Depressive Disorder (Dysthymia)
D. Bipolar II Disorder
Rationale: Major Depressive Disorder requires at least two weeks of depressed
mood or loss of interest, along with associated symptoms such as sleep or
appetite disturbance, which aligns with the client’s presentation.
2. During a counseling session, a client discloses thoughts of self-harm but
refuses to create a safety plan. What is the counselor’s primary ethical
responsibility?
A. Respect client autonomy and avoid intervention
B. Ensure client safety by following duty-to-warn or duty-to-protect
protocols
C. Refer the client to another counselor without further discussion
D. Ask the client to delay acting on thoughts until the next session
,Rationale: Counselors have a legal and ethical duty to protect clients from
imminent harm. Duty-to-warn or duty-to-protect procedures may require direct
intervention, including contacting emergency services if necessary.
3. A counselor notices that a client consistently avoids eye contact and speaks
softly during sessions. The counselor hypothesizes social anxiety disorder.
Which assessment approach is most appropriate to confirm this hypothesis?
A. Projective testing
B. Structured clinical interview based on DSM-5 criteria
C. Neuropsychological testing
D. Behavioral observation alone
Rationale: Structured clinical interviews aligned with DSM-5 criteria provide
reliable diagnostic data for anxiety disorders, rather than relying solely on
behavioral observation or projective methods.
4. A client presents with panic attacks occurring unexpectedly. The client fears
losing control and reports chest tightness, palpitations, and shortness of
breath. The counselor should first:
A. Prescribe anti-anxiety medication
B. Conduct a thorough assessment to rule out medical conditions
C. Teach relaxation techniques immediately
D. Diagnose generalized anxiety disorder
Rationale: Physical symptoms of panic can mimic medical conditions (e.g.,
cardiac issues), so it is essential to rule out medical causes before confirming a
psychological diagnosis.
, 5. A counselor is working with a client whose cultural background emphasizes
collective family decisions. The client resists individual therapy due to
family obligations. Which approach reflects culturally competent practice?
A. Encourage client to prioritize personal needs over family
B. Integrate family values into goal setting and therapeutic
interventions
C. Refer client to a family therapist without discussion
D. Ignore cultural context and proceed with standard therapy
Rationale: Culturally competent counseling requires understanding and
incorporating the client’s cultural and familial context into treatment planning.
6. A 15-year-old client exhibits aggressive behavior at school and reports
frequent conflict with peers. Which intervention aligns with evidence-based
practice for adolescents?
A. Psychoanalysis
B. Cognitive-behavioral therapy focusing on anger management
C. Pharmacological intervention only
D. Group therapy without structured skill training
Rationale: CBT interventions for anger management in adolescents are well-
supported in research and focus on identifying triggers, developing coping
strategies, and improving social problem-solving.
7. A client states, “I feel like I can’t trust anyone, and everyone is against me.”
The counselor suspects paranoid personality traits. Which approach is most
appropriate initially?
A. Confront the client about irrational thoughts
, B. Build a strong therapeutic alliance and maintain consistent
boundaries
C. Use expressive art therapy to uncover hidden trauma
D. Challenge delusional thinking directly
Rationale: Clients with paranoid personality traits often respond poorly to direct
confrontation. Establishing trust, maintaining boundaries, and consistency in
therapy are essential first steps.
8. A counselor is considering using solution-focused brief therapy (SFBT)
with a client experiencing mild depression. Which statement reflects the
primary focus of SFBT?
A. Exploring early childhood experiences
B. Identifying exceptions and client strengths to promote solutions
C. Analyzing cognitive distortions in detail
D. Addressing unconscious conflicts
Rationale: SFBT emphasizes the client’s resources and exceptions to problems
to develop practical solutions, rather than exploring deep past causes.
9. Which of the following is an example of transference in counseling?
A. A client discloses past trauma reluctantly
B. A client attributes feelings from a parent onto the counselor
C. Counselor provides empathetic feedback
D. Client resists homework assignments
Rationale: Transference occurs when a client unconsciously projects feelings
and attitudes from past relationships onto the counselor.
ACTUAL PREP QUESTIONS AND WELL
REVISED ANSWERS - LATEST AND COMPLETE
UPDATE WITH VERIFIED SOLUTIONS –
ASSURES PASS
1. A client reports persistent sadness, difficulty sleeping, and loss of appetite
for the past three weeks. According to the DSM-5, which diagnosis is most
appropriate?
A. Major Depressive Disorder
B. Adjustment Disorder with Depressed Mood
C. Persistent Depressive Disorder (Dysthymia)
D. Bipolar II Disorder
Rationale: Major Depressive Disorder requires at least two weeks of depressed
mood or loss of interest, along with associated symptoms such as sleep or
appetite disturbance, which aligns with the client’s presentation.
2. During a counseling session, a client discloses thoughts of self-harm but
refuses to create a safety plan. What is the counselor’s primary ethical
responsibility?
A. Respect client autonomy and avoid intervention
B. Ensure client safety by following duty-to-warn or duty-to-protect
protocols
C. Refer the client to another counselor without further discussion
D. Ask the client to delay acting on thoughts until the next session
,Rationale: Counselors have a legal and ethical duty to protect clients from
imminent harm. Duty-to-warn or duty-to-protect procedures may require direct
intervention, including contacting emergency services if necessary.
3. A counselor notices that a client consistently avoids eye contact and speaks
softly during sessions. The counselor hypothesizes social anxiety disorder.
Which assessment approach is most appropriate to confirm this hypothesis?
A. Projective testing
B. Structured clinical interview based on DSM-5 criteria
C. Neuropsychological testing
D. Behavioral observation alone
Rationale: Structured clinical interviews aligned with DSM-5 criteria provide
reliable diagnostic data for anxiety disorders, rather than relying solely on
behavioral observation or projective methods.
4. A client presents with panic attacks occurring unexpectedly. The client fears
losing control and reports chest tightness, palpitations, and shortness of
breath. The counselor should first:
A. Prescribe anti-anxiety medication
B. Conduct a thorough assessment to rule out medical conditions
C. Teach relaxation techniques immediately
D. Diagnose generalized anxiety disorder
Rationale: Physical symptoms of panic can mimic medical conditions (e.g.,
cardiac issues), so it is essential to rule out medical causes before confirming a
psychological diagnosis.
, 5. A counselor is working with a client whose cultural background emphasizes
collective family decisions. The client resists individual therapy due to
family obligations. Which approach reflects culturally competent practice?
A. Encourage client to prioritize personal needs over family
B. Integrate family values into goal setting and therapeutic
interventions
C. Refer client to a family therapist without discussion
D. Ignore cultural context and proceed with standard therapy
Rationale: Culturally competent counseling requires understanding and
incorporating the client’s cultural and familial context into treatment planning.
6. A 15-year-old client exhibits aggressive behavior at school and reports
frequent conflict with peers. Which intervention aligns with evidence-based
practice for adolescents?
A. Psychoanalysis
B. Cognitive-behavioral therapy focusing on anger management
C. Pharmacological intervention only
D. Group therapy without structured skill training
Rationale: CBT interventions for anger management in adolescents are well-
supported in research and focus on identifying triggers, developing coping
strategies, and improving social problem-solving.
7. A client states, “I feel like I can’t trust anyone, and everyone is against me.”
The counselor suspects paranoid personality traits. Which approach is most
appropriate initially?
A. Confront the client about irrational thoughts
, B. Build a strong therapeutic alliance and maintain consistent
boundaries
C. Use expressive art therapy to uncover hidden trauma
D. Challenge delusional thinking directly
Rationale: Clients with paranoid personality traits often respond poorly to direct
confrontation. Establishing trust, maintaining boundaries, and consistency in
therapy are essential first steps.
8. A counselor is considering using solution-focused brief therapy (SFBT)
with a client experiencing mild depression. Which statement reflects the
primary focus of SFBT?
A. Exploring early childhood experiences
B. Identifying exceptions and client strengths to promote solutions
C. Analyzing cognitive distortions in detail
D. Addressing unconscious conflicts
Rationale: SFBT emphasizes the client’s resources and exceptions to problems
to develop practical solutions, rather than exploring deep past causes.
9. Which of the following is an example of transference in counseling?
A. A client discloses past trauma reluctantly
B. A client attributes feelings from a parent onto the counselor
C. Counselor provides empathetic feedback
D. Client resists homework assignments
Rationale: Transference occurs when a client unconsciously projects feelings
and attitudes from past relationships onto the counselor.
