NCMHCE
NCMHCE is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
NCMHCE is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
10 sample questions for the NCMHCE, 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: Intake, Assessment, and Diagnosis, Areas of Clinical Focus, Counseling Skills and Interventions, Professional Practice and Ethics, Treatment Planning, Core Counseling Attributes, Mandated Reporting, Value Imposition, Repairing a Rupture, Broaching Religion, Repairing a Microaggression, Reporting Infant Shaking.
Question 1 · Intake, Assessment, and Diagnosis
Answer: A. Major depressive disorder, recurrent episode
Gregory has at least five depressive symptoms, including depressed mood and anhedonia, for more than two weeks, and a prior full episode at age 33 separated by years of remission, so 'Major depressive disorder, recurrent episode' fits. 'Adjustment disorder with depressed mood' is not given when full criteria for another disorder are met, even with a clear stressor. 'Major depressive disorder, single episode' ignores the earlier episode, and dysthymia requires at least two years of chronic symptoms.
Question 2 · Professional Practice and Ethics
Answer: C. Review the custody order to confirm Tanya's authority to consent
Where state law requires parental consent, the counselor should verify legal decision-making authority, since custody orders can require joint consent or restrict a parent's rights. Living with a parent does not by itself establish authority to consent. Joint legal custody does not automatically require both signatures unless the order says so, and a 14-year-old's assent does not replace required parental consent.
Question 3 · Intake, Assessment, and Diagnosis
Answer: D. Hyperthyroidism
Unintended weight loss, heat intolerance, and a tremor that persists between episodes, together with palpitations, point to hyperthyroidism, which can mimic panic attacks and must be excluded. Hypothyroidism typically causes weight gain, fatigue, and cold intolerance. Anemia and hypoglycemia can cause some panic-like sensations but would not explain the persistent heat intolerance and weight loss.
Question 4 · Areas of Clinical Focus
Answer: D. Major depressive disorder, single episode
Four months of anhedonia, weight loss, early morning waking, worthlessness, and a passive death wish with a PHQ-9 of 17 meet criteria for major depressive disorder, and her cognitive pattern (recall improving with cues, frequent 'I don't know' answers, poor effort, and relatively recent onset alongside mood symptoms) suggests depression-related cognitive impairment rather than a primary neurocognitive disorder. Mild or major neurocognitive disorder due to Alzheimer's disease typically shows insidious decline with encoding deficits that cues do not help, and cognition should be reassessed after mood improves. Prolonged grief disorder requires persistent yearning for or preoccupation with the deceased, which Eleanor does not describe.
Question 5 · Intake, Assessment, and Diagnosis
Answer: C. Borderline personality disorder
A long-standing pattern of unstable relationships with idealization and devaluation, abandonment fears, recurrent self-injury, impulsivity, chronic emptiness, intense anger, and reactive mood shifts lasting hours meets criteria for borderline personality disorder. Bipolar II disorder and cyclothymic disorder require hypomanic periods lasting days with decreased need for sleep, which she denies. Histrionic personality disorder centers on attention seeking and shallow emotionality without the self-injury and abandonment-driven instability she describes.
Question 6 · Intake, Assessment, and Diagnosis
Answer: C. Generalized anxiety disorder
Marisol has excessive, hard-to-control worry across many domains for well over six months, with muscle tension, irritability, poor concentration, and sleep disturbance, which meets criteria for generalized anxiety disorder. Caffeine-induced anxiety disorder is unlikely because her worry predates the caffeine increase and persisted during a caffeine-free pregnancy. She denies panic attacks, and there is no identifiable recent stressor to support an adjustment disorder.
Question 7 · Intake, Assessment, and Diagnosis
Answer: B. Prolonged grief disorder
More than 12 months after his son's death, Hector has daily yearning and preoccupation plus identity disruption, intense emotional pain, loneliness, meaninglessness, and avoidance of reminders, which meets criteria for prolonged grief disorder. His distress centers on the loss, and his preserved appetite, functioning, capacity for enjoyment, and self-worth argue against major depressive disorder. Persistent depressive disorder requires two years of depressed mood, and although learning of a family member's accidental death can qualify as a traumatic event, he reports no intrusive memories, flashbacks, or nightmares about the crash.
Question 8 · Intake, Assessment, and Diagnosis
Answer: A. Anorexia nervosa, restricting type
Lily restricts intake to a significantly low weight, fears weight gain, and shows body image disturbance, and she has no binge eating or purging in the past three months; excessive exercise is consistent with the restricting type. Avoidant/restrictive food intake disorder lacks weight and shape concerns, and an other specified diagnosis such as atypical anorexia applies when weight remains in or above the normal range despite significant loss.
Question 9 · Areas of Clinical Focus
Answer: B. Social anxiety disorder
Ethan has marked fear of scrutiny and negative evaluation with avoidance, lasting well over 6 months, across both performance and interactional situations. The performance-only specifier does not apply because he also avoids eating with others, team dinners, and casual conversation. Generalized anxiety disorder is unlikely because his worry is confined to social evaluation, and agoraphobia centers on fear that escape or help would be unavailable, not on being judged.
Question 10 · Intake, Assessment, and Diagnosis
Answer: A. Major depressive disorder, single episode
Julian has at least five depressive symptoms, including depressed mood and anhedonia, for more than two weeks with clear impairment and no prior episodes, meeting criteria for major depressive disorder, single episode; a clear stressor does not rule this out. Adjustment disorder is not diagnosed when criteria for another specific disorder are met. Persistent depressive disorder requires two years of symptoms in adults, and other specified depressive disorder is reserved for presentations that do not meet full criteria.
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