NCE Practice Questions (2026) — Free Sample Questions with Answers

Answer: D

Notify the partner of the client's status.: Disclosure may sometimes be justified, but only after assessing the client’s intent and consulting law; doing it first skips required steps.

Report the diagnosis to the local health department.: Reporting obligations vary by law and are not a counselor’s first clinical step here.

Maintain confidentiality and leave the topic to the client.: Ignoring a serious, foreseeable risk to an identifiable person fails the counselor’s duty to explore it.

Assess whether the client intends to inform the partner.: Correct. Before any disclosure about a communicable, life-threatening disease, the counselor assesses the client’s intent to inform the partner or to continue risky behavior, then consults applicable law and supervision.

Disclosure to an identifiable third party at serious and foreseeable risk may be justified, but only after assessing the client’s intent and consulting law; assessment comes first.

Answer: D

Develop a written safety plan with the client.: Right step, wrong time: the plan depends on how high the risk is, which has not been assessed yet.

Arrange emergency transport to a hospital.: Premature: emergency transport is for imminent risk, and nothing is yet known about intent, timing or access.

Explore what triggered the thoughts this week.: Exploring triggers is useful later, but it skips the immediate risk questions.

Ask about intent, timing and access to the pills.: Correct. A disclosure of suicidal ideation with a method calls for an immediate, direct risk assessment (intent, plan, timing, access to means, history) before choosing the response.

When a client discloses suicidal thoughts, assess risk directly before acting; the level of risk determines safety planning, lethal-means steps or emergency care.

Answer: B

Ask whether her symptoms match panic attack criteria.: Checking criteria may come later; the CFI first elicits the client’s own understanding of the problem.

Ask what she believes is causing the problem.: Correct. After the client defines the problem in her own words, the CFI asks for her own perceived causes before turning to others’ views, stressors and help seeking.

Explain that this phrase is not a DSM-5-TR diagnosis.: Correcting her framing dismisses her explanatory model, which the CFI aims to understand.

Ask how her family explains the symptoms.: The CFI does ask about others’ views, but after it elicits the client’s own explanation of the cause.

The CFI is a person-centered interview: the client’s definition of the problem, then her own perceived causes, then others’ views, stressors, supports and help seeking.

Answer: C

Screen her for a primary psychotic disorder.: Assumes a psychiatric cause; acute onset with disorientation in late life points first to a medical cause such as delirium.

Explore the cultural meaning of the visions.: Cultural context matters, but it does not come before ruling out an urgent medical condition signalled by acute confusion.

Arrange an immediate medical evaluation.: Correct. Sudden visual hallucinations plus disorientation in an older adult with no history suggest delirium or another medical cause, so urgent medical evaluation comes first.

Assess her cognition with a brief mental status exam.: Noting orientation is useful, but acute confusion with new hallucinations is a possible medical emergency; further counselor assessment should not delay medical evaluation.

New hallucinations with acute confusion in late life are a medical red flag (e.g., delirium); refer for medical evaluation before any psychiatric work-up.

Answer: C

binge-eating disorder: Binge-eating disorder excludes recurrent compensatory behavior, and fasting counts as compensation.

anorexia nervosa, binge-eating/purging type: Anorexia requires significantly low body weight; this client is of average weight.

bulimia nervosa: Correct. Recurrent binges with loss of control plus compensatory fasting, at least weekly for 3 months, without low weight, meet DSM-5-TR criteria for bulimia nervosa.

other specified feeding or eating disorder: OSFED is for presentations that fall short of full criteria; this one meets the frequency and duration for bulimia.

Fasting and excessive exercise are compensatory behaviors; binges plus any compensation at normal weight point to bulimia nervosa, not binge-eating disorder.

Answer: B

Begin joint sessions focused on communication skills.: Conjoint work with ongoing violence and fear can put the partner at risk; safety comes before couples work.

Assess safety and safety-plan with this partner.: Correct. Physical violence, fear and financial control signal intimate partner violence; the first step is a private safety assessment and safety plan with the at-risk partner.

Have both partners sign a no-violence contract.: A no-violence contract does not protect a partner who fears the other and may give false reassurance; safety planning comes first.

Refer both partners to an anger-management group.: Anger management does not address coercive control and skips the urgent safety step.

Screen each partner privately for intimate partner violence; when it is present, prioritize safety planning over conjoint counseling.

Answer: D

Teach a gentle startup using "I" statements.: A gentle startup is the antidote to criticism; eye-rolling and mockery go beyond criticism to contempt.

Coach her to accept responsibility for part of the problem.: Accepting responsibility is the antidote to defensiveness.

Schedule breaks for physiological self-soothing.: Self-soothing breaks are the antidote to stonewalling and flooding.

Build a culture of appreciation and fondness.: Correct. Eye-rolling and sarcasm are contempt, the strongest Gottman predictor of divorce; its antidote is building a culture of appreciation, fondness and respect.

Each of Gottman's Four Horsemen has an antidote: criticism–gentle startup, contempt–appreciation, defensiveness–responsibility, stonewalling–self-soothing.

Answer: A

Decline reassurance and encourage tolerating the uncertainty.: Correct. Reassurance-seeking is a compulsion; withholding it is response prevention and lets her learn she can tolerate uncertainty and anxiety.

Reassure her once, then return to the exposure.: Even one reassurance acts as a compulsion that lowers anxiety and reinforces the cycle.

Pause the exposure until her anxiety drops.: Stopping when anxiety is high acts as escape and teaches that the exposure was dangerous.

Have her replace the doubt with a safe thought.: A "safe" replacement thought is mental neutralizing, another form of compulsion.

In ERP, any reassurance, neutralizing or escape is a compulsion; response prevention means blocking these so the obsessional fear can extinguish.

Answer: C

prolonged grief disorder, because yearning is daily: Daily yearning is a core symptom, but for adults the death must have occurred at least 12 months earlier.

major depressive disorder, because grief has lasted over 2 months: The 2-month bereavement exclusion was removed in DSM-5, and she lacks pervasive depressed mood and low self-worth.

no prolonged grief disorder yet, because 12 months have not passed: Correct. DSM-5-TR prolonged grief disorder requires that at least 12 months have passed since the death for adults (6 months for children and adolescents), so her grief cannot yet be diagnosed as PGD.

posttraumatic stress disorder, because she avoids reminders: Avoiding reminders of the loss is grief-related; nothing suggests a traumatic death with intrusive re-experiencing.

Prolonged grief disorder requires at least 12 months since the death for adults (6 months for children and adolescents), plus daily yearning or preoccupation and impairment beyond cultural norms.

Answer: C

Prescribe that the teen make every house rule this week.: Prescribing the symptom is a strategic (paradoxical) technique, not structural.

Construct a genogram tracing parentified children across generations.: Multigenerational genogram work is Bowenian.

Have the parents negotiate a rule while blocking the teen's input.: Correct. Structural therapy uses enactment and boundary making to strengthen the parental subsystem and restore the generational hierarchy.

Ask how rules would look after a miracle overnight.: The miracle question is a solution-focused technique.

Structural therapists change the family's organization in the session through enactments and boundary making that strengthen the parental subsystem.

Answer: C

Reassure her that the office is completely safe.: Reassurance tells her how to feel; it does not give her the sense of control that builds safety.

Ask what about the door is bothering her today.: Exploring her reaction may come later, but questioning it first puts her on the spot before she feels safe.

Offer her choices about the door and seating.: Correct. Trauma-informed care builds safety through choice and control; letting her decide on the door and seat addresses the cue she is showing.

Lead a grounding exercise to lower her anxiety.: Grounding can help, but it treats her vigilance as a symptom to reduce rather than responding to the safety need behind it.

Trauma-informed counseling builds trust and safety by offering choice, collaboration and control over the environment before exploring or treating reactions.

Answer: D

Write a safety plan for her and schedule a call tomorrow.: A safety plan needs the client’s collaboration and suits lower risk; a stated plan and intent for tonight is imminent risk.

Give her the 988 number and end the session as asked.: Sharing 988 is good practice, but letting a client with imminent intent leave alone does not keep her safe.

Ask her to promise to call if the urges get stronger.: A promise or no-suicide contract is not evidence-based and does not protect a client with a plan and intent for tonight.

Arrange an emergency evaluation and stay with her.: Correct. A specific plan, intent, a time frame and access to means signal imminent risk, so the counselor arranges emergency evaluation and does not leave her alone.

Match the response to the level of risk: lower risk calls for collaborative safety planning, while a plan, intent and means for the near term call for emergency evaluation without leaving the client alone.

Answer: C

Ask where the client learned to expect failure.: Exploring the origins of a belief is problem-focused and historical, which SFBT deliberately avoids.

Teach the client to dispute the overgeneralization.: Disputing an overgeneralization is cognitive restructuring (CBT/REBT).

Ask about times when work went even slightly better.: Correct. SFBT exception questions look for times the problem was absent or smaller, building on what already works.

Ask about a time he stood up to the “failure” story.: Asking about times the client resisted a dominant “story” is the narrative search for unique outcomes; SFBT asks plainly about exceptions without externalizing a story.

SFBT signatures are exception, miracle, scaling and coping questions; narrative therapy signatures are externalizing the problem story, unique outcomes and re-authoring.

Answer: D

Let the son interpret, since she trusts him.: Family interpreters, especially children, may filter content and face burdens; the client may also withhold information in front of her son.

Conduct the intake in simple English.: Simplified English risks misunderstanding and limits her ability to express grief in her own language.

Ask a bilingual receptionist to interpret.: An untrained staff interpreter may lack mental health terminology and raises confidentiality concerns.

Use the trained interpreter for the session.: Correct. A trained interpreter supports accurate communication and confidentiality and avoids placing a child in the role of interpreting a parent’s emotional disclosures.

With clients who have limited English proficiency, counselors use trained interpreters rather than family members, especially children, or untrained staff.

Answer: D

"Not at all. I'm fully focused on what you're saying.": Incongruent: it denies what the counselor is actually experiencing.

"What makes you wonder whether you're boring me?": A useful exploration, but it deflects the client's accurate observation.

"It sounds like you worry about being a burden.": An empathic reflection that may be valid, but it sidesteps the counselor's own state.

"I am tired today, but it isn't about you.": Correct. Congruence matches what the counselor says to what she feels, briefly and in the client's interest.

Congruence means the counselor's words match her inner experience, shared briefly and for the client's benefit.