2022 Edition

NCMHCE Practice Test

Take this free NCMHCE practice test to get an idea of the types of questions on the National Clinical Mental Health Counselor Exam. Once you pass the NCMHCE, you can become a National Certified Counselor (NCC), a credential offered by The National Board for Certified Counselors. The NCMHCE is composed of case studies with multiple-choice questions cover such areas as assessment, intervention and rehabilitation. When you are ready to prepare for the actual test, try our full-length 500 question Practice Exam for the NCMHCE.
 

1. Case Study 1

Initial Intake

Age: 45
Sex: Female
Gender:  Female
Sexuality:  Heterosexual
Ethnicity: Asian  
Relationship Status: Single
Counseling Setting: Community outpatient clinic
Type of Counseling: Individual
 
Presenting Problem:
Li is a self-referral. She walked into the clinic and stated that she had been experiencing feelings of anxiety.
 
Mental Status:
During the intake she looked visibly anxious. She appeared jumpy and kept looking at her watch. Although hesitated at times when she was asked a question. The counselor was concerned when Li paused for a long time when asked if she ever thought of hurting herself. Li eventually responded no. The counselor noticed that Li’s clothes looked disheveled and soiled. Li was not forthcoming with information about her past.
 
History:
Li came into the community outpatient clinic asking to pay a sliding scale fee in cash. When asked for identifying information, Li asked if she had to give that information. She explained that she was undocumented and was weary of leaving any information that may lead government officials to her. Li did not want to give the counselor much of her history and cut the intake session short, stating that she had to get back to work.
 
An appropriate response from the counselor to Li’s situation would be:
2. Li is concerned about her ability to pay. Which of the following is NOT true in regard to counselor code of ethics?
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3. An important area to gain more information on at this point is:
4. Counseling Session 1
 
During the first session, Li explained that she came to the United States four months ago after a wealthy US family invited her here to be their nanny. She was told that she would be able to get a stipend for clothes, decent pay, health benefits and even paid time off. However, Li shared that what was described is not currently the life she is living. Li described that for the past few months she has been basically sleeping in a closet with a bed in it, works tremendously long hours and is not allowed to eat the same things as the family. Additionally, the family frequently berates her and addresses her with racial slurs.
 
How should the counselor respond to Li's description of her situation?
5. Which of the following steps should the counselor take?
6. By saying, "Tell me about your experience coming into a new culture and going through what you did" The counselor is demonstrating the attribute of:
7. Counseling Session 2
After the initial session, Li was able to report her situation to the authorities and applied to live in a shelter for women. Li reported that since she has been at the shelter, things have been a bit better. Although she has not yet found employment, she feels a better sense of independence. Li did share that something upsetting that happened when she was on the subway. Li stated that she saw someone who looked like her previous employers, and she had an abrupt surge of fear. Li stated that she started sweating and shaking, her heart was pounding, and she felt like she couldn’t breathe. A passerby noticed that she was having difficulty and helped her to sit down and get a drink of water.
 
Li's reaction on the subway meets the criteria for:
8. Li should be referred to:
9. An effective treatment for anxiety is:
10. A symptom of Panic Disorder is:
11. Case Study 2

Initial Intake
 
Age: 8
Gender: Male
Sexual Orientation: N/A
Ethnicity: Caucasian
Relationship Status: N/A
Counseling Setting: Through agency inside school and via telehealth
Type of Counseling: Individual
Presenting Problem: Attention and concentration deficits
Diagnosis: Attention-deficit hyperactivity disorder, combined type (F90.2)

Presenting Problem:
Avery is an 8-year-old Caucasian male that has been referred to you by his school counselor because of emotional breakdowns, failing grades and falling asleep in class. You set up an initial assessment session with Avery and his parents in person at the school’s conference room and learn that he refers to his biological mother as “dad” and her wife as “mom”, and that he has a twin brother with Autism. Mom tells you Avery sees a psychiatrist for medications but frequently has them changed because she feels they are not working. Mom reports Avery has trouble sleeping at night, hits and kicks her and his brother when he’s angry and steals food from the kitchen and hides it in his room. She must ask him multiple times to complete a task and he often will not comply or forget each time he is told. Dad adds that Avery is very smart and does well in most subjects in school but struggles with reading comprehension and worded math problems. Avery is already on an IEP (Individualized Educational Plan) in school to better support his unique learning needs. They ask for your help in regulating his affect and behaviors.
 
Mental Status Exam:
Avery presents as fair, with some stains on his t-shirt. His mood is euthymic but with anxious affect as evidenced by hyperactivity, some pressured speech and fidgeting of the hands and feet as he cannot sit still. There is no evidence of suicidal or homicidal ideation and no reported hallucinations or delusions. The initial assessment revealed no significant trauma, other than not having his biological father around his entire life. Avery reports feeling tired often but overall happy. Mom reports his appetite is very good, but his diet could be better. He also has headaches at times in school or when he comes home.
 
Family History:
Avery is very close with his two mothers and does not seem to notice that he does not have his father present in his life. His mother mentions that he has made several remarks recently about wanting to be a girl. Avery’s brother is high functioning on the autism spectrum but has poor communication and coping skills, increasing Avery’s stress level at home due to their constant fighting. Both parents work full-time and take shifts in caring for the children, often sleeping at odd hours of the day and therefore have trouble keeping Avery on a regular schedule. Avery has some extended family on both sides and sees them occasionally. Dad reveals she was also diagnosed with ADHD and Dyslexia growing up and had trouble in school.

Which of the following is not a behavioral definition of ADHD?
12. Which instrument is the most appropriate for further screening Avery’s diagnosed symptoms?
13. Regarding Avery’s comments about desired gender, which of the following courses of action is the most clinically appropriate?
14. Which of the following is a long-term goal as opposed to a short-term objective?
15. First session, two weeks after the intake session
You visit with Avery back in the school’s conference room during his math class. He tells you he does not like that class and is happy to be out of it, saying “I am too stupid. It’s too hard.” Throughout the session Avery abruptly interrupts you and races off to gather a different activity off the shelf or wants to switch topics of conversation. You call mom afterwards to touch base with how his moods and behaviors have been in the past two weeks. She reports that he is still stealing foods and hiding them, fighting with his brother, and having trouble sleeping. She asks what she should be doing at home to resolve the behaviors.
 
What is the best response for how to guide this parent while building the therapeutic alliance?
16. First session, two weeks after the intake session
You visit with Avery back in the school’s conference room during his math class. He tells you he does not like that class and is happy to be out of it, saying “I am too stupid. It’s too hard.” Throughout the session Avery abruptly interrupts you and races off to gather a different activity off the shelf or wants to switch topics of conversation. You call mom afterwards to touch base with how his moods and behaviors have been in the past two weeks. She reports that he is still stealing foods and hiding them, fighting with his brother, and having trouble sleeping. She asks what she should be doing at home to resolve the behaviors.

Which of the following interventions support the objective to improve Avery’s ability to identify positive traits and talents about himself?
17. First session, two weeks after the intake session
You visit with Avery back in the school’s conference room during his math class. He tells you he does not like that class and is happy to be out of it, saying “I am too stupid. It’s too hard.” Throughout the session Avery abruptly interrupts you and races off to gather a different activity off the shelf or wants to switch topics of conversation. You call mom afterwards to touch base with how his moods and behaviors have been in the past two weeks. She reports that he is still stealing foods and hiding them, fighting with his brother, and having trouble sleeping. She asks what she should be doing at home to resolve the behaviors.

Avery has a history of multiple medication switches with his psychiatrist. Which of the following steps would not be necessary to do for your treatment planning?
18. Second session, two weeks after the first session
You decide to meet with Avery’s parents again together and in person along with Avery’s school counselor briefly before having your next session with Avery. The school counselor reports Avery’s emotional responses to difficulties in class have not been as severe as in past weeks, but that he is still falling asleep during morning classes. Dad mentions that Avery is often up late playing video games despite their attempts to get him to sleep. Mom adds they have settled on a medication regimen that has reduced Avery’s physical aggression, but that he is less communicative now and “spaces out” more. In meeting with Avery, he presents as more focused on your intervention attempts but when you ask how he has been feeling he reports “I don’t feel anything, really.”

Which type of therapy encompasses teaching emotion regulation and distress tolerance that would be helpful for Avery in case of future behavioral outbursts?
19. Second session, two weeks after the first session
You decide to meet with Avery’s parents again together and in person along with Avery’s school counselor briefly before having your next session with Avery. The school counselor reports Avery’s emotional responses to difficulties in class have not been as severe as in past weeks, but that he is still falling asleep during morning classes. Dad mentions that Avery is often up late playing video games despite their attempts to get him to sleep. Mom adds they have settled on a medication regimen that has reduced Avery’s physical aggression, but that he is less communicative now and “spaces out” more. In meeting with Avery, he presents as more focused on your intervention attempts but when you ask how he has been feeling he reports “I don’t feel anything, really.”

In response to Avery’s parents telling you how difficult it is to get him to sleep, you reply saying “I completely understand it must be difficult! I am here to help however I can.” This is an example of:
 
20. Second session, two weeks after the first session
You decide to meet with Avery’s parents again together and in person along with Avery’s school counselor briefly before having your next session with Avery. The school counselor reports Avery’s emotional responses to difficulties in class have not been as severe as in past weeks, but that he is still falling asleep during morning classes. Dad mentions that Avery is often up late playing video games despite their attempts to get him to sleep. Mom adds they have settled on a medication regimen that has reduced Avery’s physical aggression, but that he is less communicative now and “spaces out” more. In meeting with Avery, he presents as more focused on your intervention attempts but when you ask how he has been feeling he reports “I don’t feel anything, really.”

As you are concluding your conversation with Avery’s parents, they ask if you can also treat his twin brother Marc, who has autism spectrum disorder and is non-verbal. You should reply:

NCE - LPC Practice Test

Quality starts with who wrote the material.
Our practice exam writer
s
:
Jenny Preffer-Davis, LMHC, ACS, NCC, RN
 is a professor in the Graduate Counseling Department at Grace College. She has been a LMHC for over fifteen years and is an owner of a mental health clinic and career coaching service in Jacksonville, Florida.


Joanne Fortune, LMHC
 is an adjunct professor in counseling at Mercy College in New York where she assists students in preparation for board certification. She is also Regional Director of SCO Family Services in New York City.


Tara Williams, LPC, MCAP
 is a community therapist in Georgia in a number of elementary and middle schools. She has also worked as a primary therapist and clinical compliance coordinator in outpatient treatment centers in substance abuse and family therapy.