Which of the following best defines a psychoactive substance?

A chemical that alters mood, perception, or brain function

A substance used only for recreational purposes

A compound that stimulates appetite

A drug that affects only motor coordination

Which of the following contributes most to the compulsion seen in addiction?

Altered prefrontal cortex functioning

Which area would be considered a non-drug issue in treatment planning?

Legal history and housing stability

Why is involving family in addiction treatment beneficial?

Families can support recovery and address enabling behaviors

It guarantees relapse won’t happen

Family members often cause addiction

It reduces the counselor’s workload

A counselor suspects financial abuse of an elderly client. What is the correct action?

Follow mandatory reporting laws and consult as needed

Wait for client permission to report

Which of the following behaviors is most indicative of a moderate substance use disorder?

Meeting four DSM-5 diagnostic criteria in a 12-month period

Using a substance once a month socially

Experiencing mild anxiety without using substances

Having no desire to stop using substances

Chronic substance use can result in what kind of brain changes?

Decreased reward sensitivity and impaired executive function

Enhanced memory and mood regulation

Shortened synaptic transmission

In family systems theory, addiction is often seen as:

A symptom of dysfunction in the broader family system

A problem only for the individual

What should a counselor document after making a mandated report?

Date, time, person contacted, reason for report, and steps taken

Nothing—reports are confidential

The client’s home address only

NCAC I and II (Addiction Counselor)

Free NCAC I/II Practice Questions

10 sample questions for the NCAC I and II (Addiction Counselor), with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: The Pharmacology of Psychoactive Substances, The Counseling Practice, The Theoretical Base of Counseling, The Professional Issues.

Question 1 · The Pharmacology of Psychoactive Substances
Which of the following best defines a psychoactive substance?
- A.A substance used only for recreational purposes
- B.A compound that stimulates appetite
- C.A chemical that alters mood, perception, or brain function
- D.A drug that affects only motor coordination
Show answer and explanation
Answer: C. A chemical that alters mood, perception, or brain function
Psychoactive substances are chemicals that change brain function, leading to alterations in perception, mood, consciousness, cognition, or behavior.
Question 2 · The Pharmacology of Psychoactive Substances
Which of the following contributes most to the compulsion seen in addiction?
- A.Fear of legal consequences
- B.Initial experimentation phase
- C.Lack of education about drugs
- D.Altered prefrontal cortex functioning
Show answer and explanation
Answer: D. Altered prefrontal cortex functioning
Addiction affects the prefrontal cortex, impairing decision-making, impulse control, and judgment, which drives compulsive use.
Question 3 · The Counseling Practice
Which area would be considered a non-drug issue in treatment planning?
- A.Type of substance used
- B.Frequency of use
- C.Tolerance development
- D.Legal history and housing stability
Show answer and explanation
Answer: D. Legal history and housing stability
Non-drug issues include social, legal, financial, or vocational factors that affect a client's life and treatment outcomes.
Question 4 · The Theoretical Base of Counseling
Why is involving family in addiction treatment beneficial?
- A.It guarantees relapse won’t happen
- B.Families can support recovery and address enabling behaviors
- C.Family members often cause addiction
- D.It reduces the counselor’s workload
Show answer and explanation
Answer: B. Families can support recovery and address enabling behaviors
Family involvement can enhance outcomes by addressing unhealthy dynamics, improving communication, and building support systems.
Question 5 · The Professional Issues
A counselor suspects financial abuse of an elderly client. What is the correct action?
- A.Follow mandatory reporting laws and consult as needed
- B.Ignore it to preserve rapport
- C.Discuss it only in supervision
- D.Wait for client permission to report
Show answer and explanation
Answer: A. Follow mandatory reporting laws and consult as needed
Counselors must report suspected abuse of vulnerable populations according to state law, even without client consent.
Question 6 · The Pharmacology of Psychoactive Substances
Which of the following behaviors is most indicative of a moderate substance use disorder?
- A.Using a substance once a month socially
- B.Experiencing mild anxiety without using substances
- C.Meeting four DSM-5 diagnostic criteria in a 12-month period
- D.Having no desire to stop using substances
Show answer and explanation
Answer: C. Meeting four DSM-5 diagnostic criteria in a 12-month period
DSM-5 classifies substance use disorders as moderate when 4–5 criteria are met within 12 months.
Question 7 · The Pharmacology of Psychoactive Substances
Chronic substance use can result in what kind of brain changes?
- A.Increased prefrontal activity
- B.Decreased reward sensitivity and impaired executive function
- C.Enhanced memory and mood regulation
- D.Shortened synaptic transmission
Show answer and explanation
Answer: B. Decreased reward sensitivity and impaired executive function
Addiction alters brain pathways, especially in the prefrontal cortex and reward systems, reducing impulse control and reward sensitivity.
Question 8 · The Counseling Practice
Which area is considered a non-drug issue during assessment?
- A.Cravings
- B.Housing insecurity
- C.Frequency of use
- D.Method of administration
Show answer and explanation
Answer: B. Housing insecurity
Housing is a non-drug factor that significantly influences a client's ability to engage in and benefit from treatment.
Question 9 · The Theoretical Base of Counseling
In family systems theory, addiction is often seen as:
- A.An isolated issue
- B.A symptom of dysfunction in the broader family system
- C.A problem only for the individual
- D.Caused by peers
Show answer and explanation
Answer: B. A symptom of dysfunction in the broader family system
Family systems theory views addiction as interconnected with family dynamics, where each member affects the whole system.
Question 10 · The Professional Issues
What should a counselor document after making a mandated report?
- A.Date, time, person contacted, reason for report, and steps taken
- B.Only the client’s name
- C.Nothing—reports are confidential
- D.The client’s home address only
Show answer and explanation
Answer: A. Date, time, person contacted, reason for report, and steps taken
Clear, factual documentation ensures compliance and protects both client and counselor in legal matters.

Keep practicing for the NCAC I/II

TTP Prep has 200 NCAC I/II practice questions with explanations, timed and mock-exam modes, 90 flashcards, interactive lessons, a printable cheat sheet and a readiness score. Start free, no card needed.

Take a free Quick 10 See everything in the NCAC I/II prep