NCE Exam Questions & Answers 2026 (11–20)

✓ Correct answer: D. Protect self and others

When dealing with an aggressive, hostile client who has successfully removed a towel rod and is wielding it as a weapon, the primary course of action for the counselor should be to protect themselves and others. Disarming the client (Option A) can potentially escalate the situation and put the counselor at risk. Subduing the client (Option B) might also lead to a physical confrontation which could result in harm. Leaving the client's immediate environment (Option D) may not be a safe option as the client is wielding a weapon. <br/><br/>In situations of danger, the safety and protection of oneself and others present should always take priority over attempting to disarm or subdue the client.

✓ Correct answer: A. The email server is secure and no one in the counselor’s home has access to it.

In telemental health services, it is crucial to ensure the security and privacy of client information. To maintain ethical standards, the counselor offering services through email must use a secure email server to protect the confidentiality of client communications. In addition, ensuring that no one in the counselor's home has access to these emails further safeguards the privacy of clients.<br/><br/>Option B (The counselor is in the same state as the client) is incorrect because the location of the counselor in relation to the client does not determine the ethicality of providing telemental health services through email. The key factor is the security of the email server and access to it.<br/><br/>Option C (The counselor tells her clients that the email service is insecure) is unethical as it violates the trust and confidentiality expected in mental health counseling. Disclosing that the email service is insecure could compromise the privacy and wellbeing of clients.<br/><br/>Option D (Email communications are not allowed in telemental health counseling) is incorrect as email communication can be a legitimate and effective means of providing telemental health services when done securely. It is essential to ensure that confidentiality and security measures are in place to maintain ethical standards.

✓ Correct answer: A. Evaluating

Evaluating is the fourth step in the action research process. During this step the action results are studied to see the overall impact.<br/><br/>The first step of the action research process is diagnosing. During the diagnosing step, the actual problem is identified. The next step is action planning, which involves creating solutions and alternative paths of action. Taking action is when a specific solution or alternative is selected to solve the issue.

✓ Correct answer: A. At the initial visit

When dealing with a client who has a managed care plan that limits the number of therapy visits, it is crucial for the counselor to address this potential restriction right from the beginning, at the initial visit. By discussing this limitation early on, both the counselor and the client can collaboratively develop a treatment plan that takes into account the finite number of visits available. This ensures that the therapy process is efficient and effective within the confines of the managed care plan.<br/><br/>Option B: At the half-point of therapy<br/><br/>Addressing the potential impact of the visit limitation at the halfway point of therapy may be too late, as it does not allow for sufficient time to adjust the treatment plan accordingly.<br/><br/>Option C: Five visits before termination<br/><br/>Waiting until five visits before the termination to address the visit limitation is not ideal, as it limits the time available for the counselor and client to make necessary adjustments and ensure the therapy process is not abruptly terminated.<br/><br/>Option D: At termination<br/><br/>Addressing the potential impact of the visit limitation at termination is too late and does not allow for the necessary time to mitigate any negative effects of the restriction on the therapy process.

✓ Correct answer: D. Ageism

Ageism is the unfair treatment, prejudice, or discrimination against people based on their age. In this scenario, the human resources manager is exhibiting ageism by exclusively considering applications from individuals aged between twenty-two and thirty, without taking into account any other qualifications or experience.<br/><br/>Option A) Sexism refers to discrimination or prejudice against someone based on their gender, not age.<br/><br/>Option B) Millennial-leaning bias is not a recognized behavior. The term "millennial-leaning" suggests a benevolent attitude or preference towards the millennial generation.<br/><br/>Option D) Classism refers to discrimination based on social class, not age. This is not relevant to the scenario described in the question.

✓ Correct answer: C. The Outcome Rating Scale (ORS)

The Outcome Rating Scale (ORS) is a questionnaire typically provided to clients at the start of a counseling session to assess their progress and gather valuable feedback on the effectiveness of therapy sessions. The ORS helps counselors track changes in clients' well-being and outcomes over time.<br/><br/>Option A) The Counselor Competencies Scale (CCS) - The Counselor Competencies Scale is not typically provided to clients at the start of a counseling session. This scale is used to evaluate counselor performance and skills, rather than gather feedback from clients.<br/><br/>Option B) The Session Rating Scale (SRS) - The Session Rating Scale is another valuable tool used in counseling, but it is focused on measuring the quality of the therapeutic relationship, rather than assessing outcomes. It is completed by clients at the end of a counseling session.<br/><br/>Option D) The Group Session Rating Scale (GSRS) - The Group Session Rating Scale is used to assess the effectiveness of group therapy sessions rather than individual counseling sessions. It is completed by participants in group therapy settings to provide feedback on the session.

✓ Correct answer: A. Structured personality assessment

The structured personality assessment would be considered the assessment which involves the use of a self-administered multiple choice, objective test of personality. This assessment helps to determine the relatively stable and distinctive patterns of behavior which would characterize the individual and their reactions to the environment.

✓ Correct answer: B. Dementia

Amnesia is the cognitive disorder where an individual has the inability to remember events, experiences, or other information for a period of time. Amnesia can be caused by brain injury, illness, or substance use. It is different than the other cognitive disorders because the memory loss is often temporary.<br/><br/>Dementia occurs when an individual loses cognitive abilities, memories, thoughts, language, problem solving abilities, and judgment. Delirium is similar to dementia, but often has a much faster onset. Delirium can happen suddenly; the individual will be disoriented and confused.

✓ Correct answer: B. Both b and c

Self-report tests by their very nature make accuracy difficult. They can be useful tools to assess current symptoms, however.

✓ Correct answer: C. Attention Deficit/Hyperactivity Disorder (ADHD)

Compared to girls, boys are four times more likely to be diagnosed with ADHD, which is still the most common disorder among youngsters.<br/><br/>Because of the greater confinement of sitting at a desk and paying attention for longer periods of time, the majority of children are not diagnosed with this disorder until they reach school age.