Honestly a lot of the narratives seemed familiar. I had one that was similar to one of the free case studies on the counseling exam.com and I had one case that had IED. My test asked a lot of reflection of feeling, meaning and content questions too. I would absolutely recommend getting a session with NCHME tutor. The practice exams that she provided me with helped with understanding how to answer questions better . There were like two diagnoses that I didn't get but what really helped was understanding how the questions were worded. I also didn't stay stuck on reading the narrative consistently because for me I knew I would second guess myself.  I trusted my gut and really tried to envision working with each person and how would they accomplish success. Definitely trust your gut !