NCMHCE Intake, Assessment, and Diagnosis 4 — Questions and Answers
Question 1: A counselor completes a clinical intake and must document the client's overall level of functioning. Which DSM-5 tool is used for this purpose?
- Global Assessment of Functioning (GAF)
- World Health Organization Disability Assessment Schedule (WHODAS 2.0) (Correct answer)
- Hamilton Anxiety Rating Scale
- Psychiatric Status Rating Scales
Correct answer: World Health Organization Disability Assessment Schedule (WHODAS 2.0)
The DSM-5 replaced the GAF with the WHODAS 2.0 as its recommended measure of disability and overall functioning.
Question 2: A client presents with recurring, intrusive thoughts about contamination and spends 4 hours daily washing hands. Which DSM-5 diagnosis is MOST appropriate?
- Generalized Anxiety Disorder
- Illness Anxiety Disorder
- Obsessive-Compulsive Disorder (Correct answer)
- Somatic Symptom Disorder
Correct answer: Obsessive-Compulsive Disorder
OCD is characterized by obsessions (intrusive contamination thoughts) and compulsions (hand-washing) causing significant time loss and distress.
Question 3: During an intake, a client endorses auditory hallucinations, disorganized speech, and flat affect for the past 7 months. No mood episodes are identified. The MOST appropriate diagnosis is:
- Schizoaffective Disorder
- Schizophreniform Disorder
- Schizophrenia (Correct answer)
- Brief Psychotic Disorder
Correct answer: Schizophrenia
Schizophrenia requires two or more active-phase symptoms lasting at least 6 months; this client meets criteria with 7 months of symptoms.
Question 4: A school counselor assesses a 9-year-old who has been inattentive and hyperactive at school for 8 months but shows no symptoms at home. Which DSM-5 criterion is NOT met for ADHD?
- Symptom onset before age 12
- Duration of at least 6 months
- Symptoms present in two or more settings (Correct answer)
- Several symptoms causing impairment
Correct answer: Symptoms present in two or more settings
DSM-5 requires ADHD symptoms to be present in two or more settings; symptoms only at school do not meet this cross-situational criterion.
Question 5: Which of the following BEST describes the purpose of a mental status examination (MSE)?
- To determine a client's insurance eligibility
- To provide a structured assessment of current psychological functioning (Correct answer)
- To replace the clinical diagnostic interview
- To establish a long-term treatment plan
Correct answer: To provide a structured assessment of current psychological functioning
The MSE systematically evaluates appearance, behavior, speech, mood, affect, thought process, cognition, insight, and judgment at the time of assessment.
Question 6: A client describes recurrent unexpected panic attacks and persistent worry about having more attacks for 6 months, leading to avoidance of public places. The MOST accurate diagnosis is:
- Specific Phobia
- Social Anxiety Disorder
- Panic Disorder with Agoraphobia (Correct answer)
- Generalized Anxiety Disorder
Correct answer: Panic Disorder with Agoraphobia
Panic Disorder with Agoraphobia involves recurrent unexpected panic attacks, anticipatory anxiety, and avoidance of situations where escape may be difficult.
Question 7: During intake, a client presents with symptoms after a traumatic car accident 6 weeks ago, including nightmares, hypervigilance, and avoidance of driving. The counselor should FIRST consider:
- PTSD, as the 1-month threshold is met (Correct answer)
- Acute Stress Disorder, which occurs within 1 month of trauma
- Adjustment Disorder, given the recent stressor
- Specific Phobia to driving
Correct answer: PTSD, as the 1-month threshold is met
PTSD can be diagnosed when symptoms persist beyond one month post-trauma; at 6 weeks, PTSD criteria may be met if all symptom clusters are present.
NCMHCE Intake, Assessment, and Diagnosis 4
A counselor completes a clinical intake and must document the client's overall level of functioning.
Which DSM-5 tool is used for this purpose?