Mock Exam 5 Questions

  1. You are hired by Mr. Patient’s attorney to perform a neuropsychological assessment of Mr. Patient to clarify cognitive deficits related to a possible brain injury following a workplace fall. The defense attorney contacts you to request that she be present and record the evaluation. In this situation, which of the following statements is correct?
    a. It is unacceptable to allow the defense attorney to observe the assessment unless she has training in psychological assessment.
    b. It is acceptable to allow the defense attorney to observe the assessment as long as Mr. Patient provides his informed consent.
    c. It is unacceptable to allow the defense attorney to observe the assessment due to test security and exam validity issues.
    d. It is acceptable for the defense attorney to observe but not record the standardized testing aspects of the assessment.
  2. Marcos is working on his dissertation and is in the analysis phase. He finds a correlation coefficient of .80 between two of his primary variables. This means that the proportion of variance in Y that can be accounted for by knowing X is:
    a. 64%
    b. 80%
    c. 20%
    d. 36%
  3. Dr. Williams conducts serial assessments in the context of longitudinal tracking of a novel intervention for multiple sclerosis. Which of the following is most accurate about comparing test results across time?
    a. Practice effects can persist for years after testing, though inconsistently across tests.
    b. Retesting typically results in better scores, so domains with scores that remain constant represent stable functioning.
    c. Practice effects are eliminated by using alternate forms of test stimuli.
    d. Practice effects are always a source of error, and efforts should be made to correct for their effects.
  4. Chantal was in a Motor Vehicle Collision (MVC) seven months ago where she had 1-2-minute loss of consciousness (LOC) with normal head CT. Based on the literature, which factor would likely account for a continued delay in her return to work status?
    a. Initial Glasgow Coma Scale
    b. Loss of consciousness
    c. Depressive symptoms
    d. Post-traumatic amnesia
  5. Dr. Rivera has concluded that her patient Mark’s neuropsychological performance was inconsistent with an organic etiology due to a pattern of failed validity indicators. How should Dr. Rivera approach these invalid assessment results?
    a. Dr. Rivera should write up the inconclusive results and share with the referring physician, refraining from direct discussion with Mark.
    b. Once the second validity indicator is failed, Dr. Rivera should pause the assessment to encourage Mark to give his best effort on testing.
    c. Dr. Rivera should conclude that Mark has no neurocognitive impairments due to failed validity indicators.
    d. Using clear language, Dr. Rivera should inform the patient of the lack of diagnostic clarity without referring to specific tests.
  6. Mr. Green is a Black American 70-year-old high school graduate brought by family for concerns about cognitive decline. Which of the following is true regarding accounting for the effects of demographic variables when considering his results?
    a. The rate of dementia diagnosis is the same across White and Black older adults.
    b. Current sociocultural factors play a bigger role on test scores than childhood ones.
    c. Using demographically corrected norms increases the likelihood that his scores will fall in the impaired range.
    d. Education quality accounts for much of the effect of racial disparities on neuropsychological results.
  7. You are consulted regarding Mrs. Brown, a 76-year-old inpatient, presenting with marked confusion, disorientation, and impaired memory that reportedly became noticeable in the past 48 hours. Among the following choices, which is the most likely cause?
    a. Depression
    b. Dementia
    c. Acute atrial fibrillation
    d. Urinary tract infection
  8. Mr. Patel is a 70-year-old male who underwent an MRI of his brain at the recommendation of his neurologist as part of a work-up for dementia. His MRI revealed prominent white matter ischemia. He also had a finding of ventriculomegaly, which refers to:
    a. Atypically developed ventricles associated with migrational disorders
    b. Attenuation of cerebral white matter surrounding the ventricles
    c. Compressed ventricles associated with mass lesions in the cranium
    d. Ventricular enlargement with or without hydrocephalus
  9. How can stereotype threat affect neuropsychological test results?
    a. A Latino patient may perform below capacity on tests of cognitive ability when primed with negative expectations.
    b. A transgender patient may be inclined to dispute their test findings due to perceived examiner implicit bias.
    c. A Black patient may perform more poorly in real world conditions as compared to a controlled environment.
    d. As long as the neuropsychologist follows standard procedures, stereotype threat effects will be minimal.
  10. To assist with school re-entry, you completed an evaluation of a 9-year-old boy with longstanding ADHD diagnosis who had recently sustained a severe TBI. You requested pre-injury records but had not yet received them for several weeks despite multiple inquiries. The school requests the report as soon as possible to plan appropriate school re-entry. What should you do?
    a. Wait to complete the report until you have received the records as they can significantly change your conclusions
    b. Complete the report but include a disclaimer that all records were not available for review at the time of report completion
    c. Wait for three months, periodically checking your records request status, then complete the report if you still have no records
    d. Offer to provide an unsigned report draft, but wait to send a formal report until record information can be integrated
  11. Fine motor problems related to hydrocephalus are least likely to occur in children with:
    a. Spina bifida myelomeningocele
    b. Angelman Syndrome
    c. Dandy Walker Syndrome
    d. Intraventricular hemorrhage related to prematurity
  12. A 25-year-old White female presents with a 3-day history of monocular loss of central vision, eye pain that is worse with lateral eye movement, and reduced color vision. This patient’s medical provider is likely concerned about which of the following disorders?
    a. AIDS
    b. Multiple Sclerosis
    c. Myasthenia gravis
    d. Meniere’s disease
  13. Gabriel is a 17-year-old admitted to inpatient rehab following a severe traumatic brain injury. He is currently in a state of post-traumatic confusion, with severe memory impairments. Each day, you tell him the day of the week instead of asking him, “What is the day of the week?” This is an example of:
    a. Prospective Memory Training
    b. Graduated Exposure
    c. Priming
    d. Errorless Learning
  14. Joachim has medical records confirming a severe TBI including significant findings on MRI and extended hospital and inpatient rehabilitation stays. Which of the following is the most true related to performance validity testing in this case?
    a. Performance validity measures should be conducted as some patients with confirmed neurologic injuries may have suboptimal engagement.
    b. Performance validity measures are less reliable for patients with severe neurologic injuries, thus “failures” on PVTs are not meaningful.
    c. There is little incremental validity supporting inclusion of performance validity measures for patients with severe neurologic injury.
    d. Inclusion of performance validity measures is important only for the patients in litigation or other suspected motivation for feigning.
  15. A patient presents for neuropsychological evaluation for long COVID. Which of the following is not correct about failure of performance validity tests (PVT) in this population?
    a. PVT failure in long COVID is similar to that seen in patients with ADHD, mTBI, and pain
    b. PVT failure rate in patients with long COVID is approximately 10%
    c. Approximately 25% of patients with long COVID have a known external incentive to perform poorly
    d. PVT failure in long COVID was higher among women and those with lower education
  16. Dr. Sacks, a Spanish-English bilingual neuropsychologist, has started practicing in a New York City neighborhood with a high density of Spanish-only speaking residents of Puerto Rican heritage. Which of the following best reflects how she should plan to best provide neuropsychological services to this community?
    a. Dr. Sacks should use the Spanish-language tests with the most up-to-date and robust demographic corrections.
    b. Dr. Sacks should create her own translations of gold-standard English-language neuropsychological tests.
    c. Dr. Sacks should choose the Spanish-language tests with the best matching normative data for her Puerto Rican patient population.
    d. Dr. Sacks should use standard English-language tests supplemented with Spanish-language tests based on the available normative data.
  17. A 52 y.o. hypertensive, diabetic man awakens unable to speak coherently and has right arm and face weakness but the leg is not affected. Exam shows dysarthria, Broca aphasia, right hemiparesis (face and arm). What is the most likely diagnosis?
    a. Left putaminal hemorrhage
    b. Left middle cerebral artery (MCA) occlusion
    c. Left carotid occlusion
    d. Left anterior cerebral artery occlusion
  18. Tony’s neurologist wants to prescribe him an antiseizure medication for his new onset partial seizures but is concerned about Tony’s pre-existing executive dysfunction and difficulty with verbal fluency. Given this, which antiseizure medication should Tony’s neurologist avoid?
    a. Vimpat (lacosamide)
    b. Lamictal (lamotrigine)
    c. Topamax (topiramate)
    d. Tegretol (carbamazepine)
  19. You are a pediatric neuropsychologist, and the parents of a 12-year-old child request an updated assessment after having received a diagnosis of learning disorder from psychologist, Dr. Weiss, one year ago. Dr. Weiss made the diagnosis of learning disorder in writing and math due to a significant discrepancy between the child’s exceptionally high verbal comprehension score (WISC-V VCI 155) and average spelling and numerical operations scores. This is one of several reports you have seen written by Dr. Weiss that base diagnostic decisions on the discrepancy model. What should you do next?
    a. Report the psychologist to his hospital ethics committee
    b. File a formal complaint about the psychologist to the state licensing board
    c. Call the other psychologist to discuss your concerns
    d. Note in your report the flaws of Dr. Weiss’s evaluation
  20. Dr. Smith wants to follow best practices regarding base rates of abnormal neuropsychological test scores in healthy people. Which of the following best reflects knowledge regarding base rates of abnormal scores?
    a. As long as Dr. Smith uses at least one measure for each cognitive domain, she can have confidence in her diagnostic decisions.
    b. The more tests Dr. Smith administers, the greater the confidence she can have that low scores are due to a disorder.
    c. The more tests Dr. Smith administers, the greater the likelihood that at least some low scores are due to normal variability.
    d. To reduce the effects of high base rates of abnormal scores, Dr. Smith should rely on a battery of co-normed tests.
  21. Tim is a practicum student working with his supervisor on a new case. This week’s case is a 68-year-old with suspected Lewy Body dementia. Last week was a 70-year-old with Alzheimer’s dementia. In thinking about the similarities and differences in these disorders, Tim has learned that:
    a. AD patients do better on confrontation naming tests than those with DLB
    b. AD patients have day-to-day fluctuations in cognition, which does not occur with DLB
    c. AD patients exhibit parkinsonism early in the course of illness and in DLB it occurs late
    d. AD patients can have hallucinations, but these are more common in DLB
  22. Dr. Zion plans a clinic to support those who have recently sustained a mild traumatic brain injury. Which of the following is true related to treating this population?
    a. Interventions targeting self-efficacy are likely to be most helpful for treatment success.
    b. Interventions focused on immediate full return to previous activity levels have best outcomes.
    c. Psychosocial interventions do not significantly improve outcomes in this population.
    d. Targeted interventions are unnecessary, as these patients report fewer symptoms over time.
  23. Lester is a former collegiate football player expressing concerns about his cognitive status due to his history of concussions. What correlation in the literature is an important consideration for assessment of former athletes?
    a. Subjective cognitive complaints are strongly related to self-reported number of concussions.
    b. Subjective cognitive complaints are moderately related to objective cognitive performance.
    c. Self-reported number of concussions is moderately related to objective cognitive performance.
    d. Subjective cognitive complaints are unrelated to self-reported number of concussions.
  24. You are doing a re-evaluation of a patient who was previously diagnosed with Dementia of the Alzheimer’s Type. On his last evaluation, he showed consolidation-based memory deficits. Based on what you know about Alzheimer’s disease progression, what findings would be least likely on the patient’s current neuropsychological evaluation:
    a. Reduced semantic memory (e.g., a lower score on WAIS-IV Information)
    b. Problem solving deficits (i.e. lower score on the Wisconsin Card Sorting Test)
    c. Increased perceptual errors on naming tests (e.g., “snake” for a pretzel)
    d. Reduced basic attention performance (e.g., lower Digit Span Forward score)
  25. Tyler is working on his inpatient rehab rotation and is prepping for a case in which the patient has suffered a dominant hemisphere lesion. He is reading about a syndrome resulting in right-left confusion, dyscalculia and finger agnosia. Tyler is reading about:
    a. Anton’s syndrome
    b. Gerstmann’s syndrome
    c. Callosal disconnection syndrome
    d. Balint’s syndrome
  26. Trey is an 8-year-old with a prior diagnosis of Tourette’s Syndrome. Which of the following is Trey least likely to exhibit related to this condition?
    a. Coprolalia, or obscene vocalizations
    b. Changes of tic location and frequency
    c. Tics that worsen with stress
    d. Comorbidity with ADHD and/or OCD symptoms
  27. Mr. Henderson is a 60-year-old man who has been referred for differential diagnosis of dementia vs. depression and has impaired memory testing. Which of the following is most true?
    a. The diagnosis is likely to be early-onset Alzheimer’s disease due to impaired memory performance.
    b. Including praxis testing would be helpful to rule-out cognitive complaints due to depression.
    c. Screening for depressive symptoms will be helpful, as those with dementia are unlikely to be elevated.
    d. Late-life depression would be unlikely to cause impaired scores on standardized memory tests.
  28. Which behavioral recommendations have the most support regarding resilience in neurodegenerative diseases?
    a. Mental health interventions consistently increase a patient’s resilience.
    b. Social support can help patient and caregiver adjustment to neurodegenerative conditions.
    c. Mental health interventions tend to improve resilience rather than engagement.
    d. Resilience results from external factors (e.g., money) and, thus, is not directly modifiable.
  29. You receive a referral from a neurologist who recently saw a 9-year-old female with a suspected history of fetal alcohol syndrome (FAS) rather than a fetal alcohol spectrum disorder. If these features are all present, which confirms an FAS diagnosis?
    a. Known pattern of maternal binge drinking, particularly in the first trimester.
    b. Height and/or weight deficiency (≤10th percentile for chronological age)
    c. Facial anomalies (smooth philtrum, thin vermilion border, short palpebral fissures)
    d. Evidence of both cognitive and behavioral impairment (≥ 1.5 SD below the mean)
  30. Sundeep was noted to have anosognosia by his treatment team. Which of the following would he have difficulty with?
    a. Accurately differentiating between visual details.
    b. Accurately differentiating between faces.
    c. Accurately differentiating between objects by touch.
    d. Accurately describing his current deficits.
  31. Upon examination, Yasmin passed all embedded performance and symptom validity measures. Which of the following statements best represents this data?
    a. Yasmin showed excellent effort on all measures of task engagement.
    b. No conclusions can be drawn from embedded validity measures alone.
    c. Yasmin’s performance on testing reflects her full abilities.
    d. None of Yasmin’s scores were suggestive of invalid responding.
  32. When designing a study to understand potential cognitive benefits of a behavioral intervention, clinical significance refers to:
    a. The likelihood that the dependent variable caused the effect in the independent variable due to non-chance differences
    b. The likelihood that the outcome is due to chance
    c. The extent to which an investigation can detect a difference when a difference exists
    d. The practical value or importance of the impact of the intervention
  33. When presented with a patient with a recent diagnosis of multiple sclerosis, which of the following cognitive skills is least likely to be affected by the disease?
    a. Processing speed
    b. Memory storage
    c. Word retrieval
    d. Executive functioning
  34. When starting his second year of independent neuropsychological practice, Dr. Hendrix considers best practices of serial assessments. Which of the following is not supported by evidence?
    a. Repeating neuropsychological tests can help differentiate between neurologic and environmental factors affecting test performance.
    b. Reliable-change scores can be used to determine how likely the patient’s change in scores reflect neurologic change.
    c. Repeating neuropsychological tests in the presence of severe disease or brain injury is likely to show large changes.
    d. There are limited data regarding optimal test-retest intervals between testing sessions to minimize practice effects.
  35. In children with arterial ischemic stroke, all of the following are associated with worse cognitive outcomes except:
    a. Larger lesion volume.
    b. Presence of epilepsy
    c. Perinatal onset
    d. Male sex
  36. Mr. Santos, who immigrated to Boston from Chile as an adult, was referred for concerns about sequelae of a recent left MCA stroke. Which of the following choices is least relevant to the determination of how and when to use Spanish or English throughout the assessment process?
    a. Given the importance of assessing language skills, this testing should be conducted in both languages.
    b. Given that Spanish is his primary language, the assessment must be completed in Spanish to accurately guide his rehabilitation.
    c. It is preferable for Mr. Santos to be assessed by a bilingual neuropsychologist rather than through an interpreter.
    d. Level of acculturation, including language dominance of his education and family experiences, would be important.
  37. Maya, Suny, Jamila, and Claire, all young female college students, sustained a concussion in the same MVC six weeks ago. As a neuropsychologist, which of the students are you most concerned will have the highest number of symptoms?
    a. Suny because she also has a history of depression
    b. Maya because she also has a history of ADHD
    c. Jamila because she has persistent neck pain
    d. Claire because she is in litigation after the MVC
  38. Given the demands on her staff’s time, a Psychology Department director is considering implementing screening tests in addition to comprehensive neuropsychological assessments. Which of the following is false regarding uses of cognitive screening measures?
    a. Screening tools can be administered by support staff or self-administered on an electronic device.
    b. The sensitivity of the most commonly used screening tools is quite low.
    c. Screening tools often include indicators of motivational factors that can impact results.
    d. Screening tools are never diagnostic or conclusive regarding a specific condition or disorder.
  39. You are conducting a neuropsychological evaluation for an individual who sustained a severe TBI one year ago. MRI showed diffuse axonal injury. In which of the following domains would you least expect to find impairment?
    a. Mental efficiency
    b. Complex reasoning
    c. Receptive vocabulary
    d. Mental arithmetic
  40. Dr. Rojas just completed an evaluation for a patient with a parieto-occipital lesion that he believes may have Balint’s syndrome. During testing, he observed the patient to have the inability to move her hand to a specific object by using vision. This is called:
    a. Ocular apraxia
    b. Visual agnosia
    c. Optic ataxia
    d. Simultanagnosia
  41. Javier is a neuropsychology intern planning to rotate through a schizophrenia program. Which of the following statements is most true regarding the longitudinal course of neurocognitive impairments in individuals with schizophrenia?
    a. Cognitive functioning, particularly verbal skills, declines following the first psychotic break.
    b. Measurable cognitive deficits, most often in attention, are seen prior to the first psychotic break.
    c. Cognitive functioning, particularly executive functions, improves following initiation of anti-psychotic medication.
    d. Neurocognitive functioning progressively declines throughout the adult years and is correlated with positive psychotic symptoms.
  42. A second edition of the Attention Battery for Children (ABC) was published in November. Dr. Javon wonders how he should transition this into his archival research and clinical work. Which of these is the best answer?
    a. Dr. Javon should plan a transition to the second edition within a year of publication after reviewing psychometric properties.
    b. The first edition of the ABC is obsolete, so Dr. Javon’s research and clinical projects must transition within one month of publication.
    c. Given his intensive training in the original administration and interpretation, Dr. Javon should continue to rely on the first edition.
    d. Leaders within national organizations will determine the best timeframe to adopt a new test version.
  43. When providing an in-service to local neurologists regarding differentiating cognitive screening profiles of subcortical versus cortical etiologies, what is a hallmark of subcortical dementia impairment that is relatively spared in typical Alzheimer’s disease presentations?
    a. Letter fluency
    b. Figure copying
    c. Verbal recognition
    d. Orientation
  44. For which of the following conditions is deep brain stimulation an approved treatment?
    a. Parkinson’s disease but not essential tremor
    b. Essential tremor but not Parkinson’s disease
    c. Essential tremor, Parkinson’s disease, and dystonia
    d. Parkinson’s disease and essential tremor but not dystonia
  45. When reviewing the neuropsychological results of a retired lawyer with prior IQ of 115 for possible MCI, Dr. Dang identifies low scores (1 SD below his premorbid estimate) on WCST perseverations and CVLT recognition discriminability. Which of the following is most likely true regarding this pattern?
    a. Correlations between neuropsychological tests and intelligence are weaker in persons with above average intelligence.
    b. Non-normally distributed tests, like these, are often quite sensitive to brain dysfunction compared to normally distributed ones.
    c. Interpreting negatively skewed tests via normative comparisons is more accurate than using cut scores.
    d. Correlations between IQ and neuropsychological performances are expected to be consistent across domains.
  46. Dr. Johnson has been asked to cover a multidisciplinary sickle cell disease (SCD) clinic while her colleague is on maternity leave. In this clinic, the role of the neuropsychologist is to screen patients to determine who may need a comprehensive evaluation. Which of the following risk factors is least important when considering cognitive outcomes in SCD?
    a. Age of patient
    b. History of silent stroke
    c. The patient’s SCD genotype
    d. Severity of pain crises
  47. Upon reviewing referral notes for possible scheduling, you see a note about a patient who identifies as gender diverse. You have no prior experience working with such an individual. Which of the following considerations is not indicated for optimal assessment of this patient?
    a. Prepare to probe for stress and traumatic experiences, as these are more common for individuals of a gender minority.
    b. Expect that their educational history and occupation may underrepresent true premorbid capacities.
    c. Plan to have an open discussion about preferred names and pronouns to use in the room and in the report.
    d. Refer this patient to a specialty Gender Dysphoria clinic to ensure that their experience is most respectful.
  48. Ms. Briers’ family brought her to the ED after she was suddenly unable to recognize her family’s faces. In which right hemisphere area is she likely to have a lesion?
    a. Occipital pole
    b. Fusiform gyrus
    c. Occipitotemporal gyrus
    d. Optic tract
  49. Dr. Washburn is meeting with the parents of an 8-year-old boy who he recently diagnosed with ADHD-Combined Type. Which of the following is Dr. Washburn most likely to recommend?
    a. Consultation with a psychiatrist to discuss stimulant medication options
    b. Weekly behavioral therapy with parent training
    c. Weekly social skills group
    d. Both a and b
  50. Which of the following regarding the impact of child poverty on development is false?
    a. Low socioeconomic status (SES) is associated with atypical gray matter development.
    b. Children from low-income households score lower on standardized tests of achievement.
    c. The degree of poverty does not impact academic achievement test performances.
    d. Children from low-income households show reduced gray matter volumes in frontal and temporal lobes.
  51. Dr. Lee is reviewing potential caregiver-report measures of depression symptoms for use in her urban neuropsychological clinic with a large refugee population. As she reviews the literature about different measures, she is concerned about the validity of the measure used, particularly how well the measure assesses the depressive experience in refugee populations. What aspect of validity is Dr. Lee considering?
    a. Concurrent validity
    b. Construct validity
    c. Content validity
    d. Criterion validity
  52. You just completed an evaluation of a 63-year-old patient who is prescribed quite a few medications. Which medication on their list may most likely result in anticholinergic side effects?
    a. Topiramate
    b. Amitriptyline
    c. Tamsulosin
    d. Gabapentin
  53. When assessing a college student for ADHD, which of the following data is the most important when making diagnostic decisions?
    a. Collateral report of childhood symptoms
    b. Performance on a continuous performance task
    c. Executive function behavior rating scales
    d. Performance on digits forward and backward
  54. Dr. Barnes is reviewing medical records for a 4-year-old patient who was born at 30 weeks gestation. When reviewing the brain MRI report, which of the following is she least likely to find?
    a. Hypoxic ischemic encephalopathy
    b. Intraventricular hemorrhage
    c. Multifocal leukoencephalopathy
    d. Periventricular leukomalacia
  55. Among the following prenatal factors, which has not consistently shown increased risk of intellectual disability in children?
    a. Maternal infections during pregnancy
    b. Maternal age at conception
    c. Maternal exposure to air pollution
    d. Maternal medication use during pregnancy
  56. A 62-year-old patient presents to Dr. Davis’ office for a neuropsychological evaluation. Results suggest deficits in inhibitory control, memory, and naming. Dr. Davis is unsure whether the profile represents Alzheimer’s dementia (AD) or frontotemporal dementia (FTD) and thinks neuroimaging would be helpful. Based on what you know, what type of neuroimaging would you recommend?
    a. Positron emission tomography with fluorodeoxyglucose (FTD-PET) is superior in differentiating between AD and FTD.
    b. Single positron emission tomography (SPECT) is superior in differentiating between AD and FTD.
    c. Magnetic Resonance Imaging (MRI) is superior in differentiating between AD and FTD.
    d. Resting state functional magnetic resonance imaging (fMRI) is superior in differentiating between AD and FTD.
  57. Dr. Ahmed was asked by a rehab colleague to check on a left hemisphere stroke patient. All she knows is that the patient has fluent speech, understands and can follow commands, but cannot repeat information. What type of aphasia is present, and where is the likely lesion?
    a. Global aphasia; large left MCA territory stroke
    b. Anomic aphasia; stroke near the supramarginal gyrus
    c. Wernicke’s aphasia; Left inferior MCA territory stroke
    d. Conduction aphasia; stroke near the supramarginal gyrus
  58. A concussion clinic neuropsychologist Dr. Mariana asks you about the best practices for ensuring validity of her evaluations. Which of the following is best?
    a. Either performance or symptom validity indicators should be included, depending on the nature of the presenting symptoms.
    b. Both stand-alone and embedded validity indicators are important to include.
    c. Dr. Mariana should avoid encouraging optimal effort and avoid mention of validity tests in written reports.
    d. Multiple validity indicators are not needed when conducting multimodal assessments.
  59. Jenny is a 10-year-old female with a history of myelomeningocele with shunted hydrocephalus and Chiari II malformation. Her test performance shows intact decoding and simple addition skills, but impaired reading comprehension and math problem solving skills. This may be an example of:
    a. Intact associative processing, intact assembled processing
    b. Intact associative processing, impaired assembled processing
    c. Intact assembled processing, impaired associative processing
    d. Impaired associative processing, impaired assembled processing
  60. Your practicum student asks you what domains are most important to assess fitness to drive in older adults. Your answer should be:
    a. Visual perception, attention, processing speed, and executive functioning.
    b. Visual construction, attention, processing speed, and executive functioning.
    c. Visual perception, attention, memory, and executive functioning.
    d. Visual perception, attention, processing speed, and fine motor dexterity.
  61. In adults treated for non-CNS cancer, increased risk of cognitive dysfunction is associated with all of the following except:
    a. Younger age at treatment
    b. Higher doses of chemotherapy
    c. Multiagent regimen
    d. Intrathecal chemotherapy
  62. Olivia is a 9-year-old girl who is undergoing neuropsychological evaluation for attention and learning difficulties. Dr. Baylor notices several areas of hyperpigmented skin on her arms and a large skin-colored mass on her neck. Which disorder does Olivia most likely have?
    a. Tuberous sclerosis
    b. Neurofibromatosis Type 1
    c. Sturge-Weber syndrome
    d. Angelman’s syndrome
  63. What aspect of attention and executive functioning is typically preserved among autistic individuals?
    a. Shifting
    b. Planning/organization
    c. Inhibition
    d. Sustained attention
  64. You are evaluating two siblings, ages 10 and 12 years. The children’s medical histories are unremarkable except the 10 year old underwent general anesthesia once for hernia surgery when he was 2 years old. In which of the following domains would you expect to find differences between the siblings?
    a. Intellectual functioning
    b. Attention
    c. Both intellectual functioning and attention
    d. Neither intellectual functioning nor attention
  65. Dr. Chen prepares to see a 101-year-old patient. What can he expect?
    a. Plaques and tangles associated with Alzheimer’s disease are never present in cognitively healthy individuals.
    b. Clock drawing is the test with the most sensitivity to neuropathological disease.
    c. Cognitive performance has a strongly inverse relationship with neuropathology load in the oldest old.
    d. There is no research regarding neurocognitive data in centenarians, so he will have to extrapolate from younger samples.
  66. To determine the degree of association between the number of reading intervention hours received and score on a nonsense word decoding test for a sample of 100 children with dyslexia, which of the following bivariate correlation coefficients would be most appropriate?
    a. Phi coefficient
    b. Spearman rho
    c. Pearson r
    d. Point biserial coefficient
  67. Dr. Stevens reviews the literature regarding cannabis use in developing brains. Which of the following is not currently supported by research?
    a. Exposure to cannabis in adolescence has equivalent effects to that of adult exposure.
    b. In utero exposure to cannabis has been linked to later anxiety and mood dysregulation.
    c. The younger one is when first using cannabis, the more likely they are to develop an addiction.
    d. Use of cannabis as a teen is linked with increased risk of addiction in general.
  68. Mrs. Harris is a 59-year-old Native American woman with a three-decade history of significant alcohol use and hypertension. After the ED initial exam, her provider is concerned that Mrs. Harris might have Wernicke’s encephalopathy. What triad of symptoms would Mrs. Harris most likely have to make the provider concerned?
    a. Ataxia, confusional state, eye movement abnormalities
    b. Vertigo, retrograde amnesia, eye movement abnormalities
    c. Confabulation, retrograde amnesia, conduction aphasia
    d. Ataxia, vertigo, transient global amnesia
  69. A middle-aged patient expresses fear of developing dementia. Which of the following is the incorrect information to provide your patient?
    a. Patients who regularly complete household chores do not have a reduced risk of developing dementia.
    b. All patients who regularly exercise have a moderately reduced risk of developing dementia.
    c. Only patients without a family history of dementia who regularly exercise have a moderately reduced risk of developing dementia.
    d. Only patients with a family history of dementia who regularly exercise have a moderately reduced risk of developing dementia.
  70. You will be seeing a 15-year-old male who was seen for an evaluation when he was 3 years old. What would be the best answer related to clinical prediction based on an early childhood evaluation?
    a. Results of his early evaluation may be predictive of current IQ, especially if findings at preschool level documented lower cognitive abilities.
    b. Results of his early evaluation may be predictive of current IQ given measurement stability of IQ over time from preschool to adulthood.
    c. Results of his early evaluation may not be predictive of current IQ due to lower stability of findings over time, particularly for longer measurement intervals.
    d. Results of his early evaluation may not be predictive of current IQ given instability of findings due to measurement error.
  71. You are evaluating a child diagnosed with temporal lobe epilepsy. As you consider the individual’s performance on memory tasks, what might you expect?
    a. Nonverbal memory deficits given location of seizures
    b. Intact memory functioning
    c. Memory deficits may not localize given mixed findings of memory deficits.
    d. Verbal memory deficits given location of seizures
  72. Dr. Lopez is conducting a study to compare the effects of four behavioral treatments for young children with ADHD. To compare the reduction of ADHD symptom severity in the four groups, she could conduct a series of t-tests or a one-way ANOVA. Dr. Lopez decides to use the one-way ANOVA because it:
    a. decreases the likelihood of a Type I error
    b. decreases the likelihood of a Type II error
    c. can control for the effects of an extraneous variable
    d. assesses for both main and interaction effects
  73. Sammi was diagnosed with medulloblastoma when they were 9 years old. Sammi underwent near total resection of the tumor and received chemotherapy, including intrathecal methotrexate. Two years later, Sammi’s neuropsychological evaluation results documented lower IQ performance, slowed processing speed, and fine motor deficits compared to a prior evaluation shortly after Sammi’s resection. What may explain the constellation of findings?
    a. Radiation necrosis
    b. Late effects of treatment
    c. Posterior fossa syndrome
    d. Ototoxic effects of treatment
  74. Willow, a 74-year-old female presents for a dementia evaluation with concerns for notable cognitive worsening after she underwent CABG surgery three months ago. The neuropsychologist informs Willow that, in older adults, general anesthesia can cause postoperative cognitive dysfunction:
    a. After both cardiac and non-cardiac procedures, but more in the latter
    b. Only after cardiac procedures
    c. Only after non-cardiac procedures
    d. After both cardiac and non-cardiac procedures, but more in the former
  75. Mr. Shingler is a 64-year-old gay man with Parkinson’s Disease. His physician commented that he looks sad, which the patient denied, but admitted that he no longer attends his boxing classes, has anhedonia, and is more frustrated. Which of the following is not true about mood treatment in Parkinson’s Disease?
    a. SNRIs or SSRIs medication is often a first line treatment for mood symptoms in patients with PD
    b. SSRI medications may cause or worsen tremor
    c. Patients with PD typically have minimal benefit from CBT due to their cognitive deficits
    d. Depression and anxiety occur in about 30% of patients with PD
  76. Jessie has been diagnosed with Relapsing Remitting Multiple Sclerosis. In addition to her disease modifying treatment she is also prescribed gabapentin, carbamazepine and dalfampridine to manage which combination of symptoms below?
    a. Neuropathic pain, bowel dysfunction and gait impairment
    b. Neuropathic pain, trigeminal neuralgia and gait impairment
    c. Spasticity, trigeminal neuralgia and bladder dysfunction
    d. Spasticity, fatigue and gait impairment
  77. Mr. Sim has been evaluated by neurology and diagnosed with vascular parkinsonism. Along with attention, executive, and visuoperceptual deficits, which of the following clinical and neuropsychological findings are likely to correspond to this diagnosis?
    a. Early disease stage changes in memory with upper body freezing and a preserved sense of smell.
    b. Intact memory earlier in the disease course with lower body freezing and an impaired sense of smell.
    c. Intact memory earlier in the disease course with lower body freezing and a preserved sense of smell.
    d. Early disease stage changes in memory with lower body freezing and a preserved sense of smell.
  78. Which neuropsychological data analytic method would be best for predicting functional driving abilities of an 85-year-old with an 8th grade educational level?
    a. Adjust the patient’s raw test scores using demographically (e.g., race, education) corrected norms.
    b. Refine the estimated prediction of premorbid abilities by using oral word reading performance.
    c. Compare the patient’s raw test scores to those scores of mixed-age adult population.
    d. Use age-based norms, as demographic factors have minimal impact on functional classification.
  79. Mr. Hinzman, a 63-year-old lifelong welder, presented to his neurologist with complaints of bradykinesia, rigidity, postural instability, tremors, and cognitive difficulties. Given his occupation, what condition would be highest on the differential?
    a. Idiopathic Parkinson’s Disease
    b. Parkinsonism due to manganese exposure
    c. Parkinsonism due to lead exposure
    d. Parkinsonism due to solvent exposure
  80. To determine whether fluctuations in a patient’s scores from a baseline assessment to a follow-up evaluation represent clinically significant change, a neuropsychologist must consider:
    a. Measurement error and practice effects
    b. Flynn effect and multicollinearity
    c. Criterion validity and internal consistency
    d. Test bias and discriminant validity
  81. You recently evaluated a preschool-aged a child with a history of perinatal hypoxic-ischemic injury with basal ganglia involvement suggesting extrapyramidal motor system involvement. What subtype of cerebral palsy is most likely?
    a. Spastic quadriplegic cerebral palsy
    b. Dyskinetic cerebral palsy
    c. Spastic hemiplegic cerebral palsy
    d. Ataxic-hypotonic cerebral palsy
  82. Which of the following statements about cognitive rehabilitation in the pediatric brain injury population is most accurate?
    a. There is no current consensus about the efficacy of cognitive rehabilitation for attention and working memory in this population.
    b. Several randomized controlled trials evaluating CogMed Working Memory Training have shown significant sustained improvements in working memory.
    c. Self-guided computerized cognitive training programs have similar benefits as those that are clinician-guided.
    d. Cognitive rehabilitation interventions show stable effects for memory benefits but not for other cognitive domains.
  83. Among children born very preterm or with very low birth weight, risk factors for global cognitive impairment under the age of 5 years include male sex, nonwhite race/ethnicity, lower level of parental education, and lower birth weight. Which of the following continues to be a risk factor in older children?
    a. Male sex
    b. Nonwhite race/ethnicity
    c. Lower level of parental education
    d. Lower birth weight
  84. A 58-year-old male presented to his PCP’s office with complaints of variability in attention, frequent misplacement of items, visions of a cat in his kitchen, and recent problems with gait. Without knowing anything else, which disorder would be highest on the differential?
    a. Lewy Body Dementia
    b. Wilson’s disease
    c. Multiple System Atrophy
    d. Corticobasal degeneration
  85. Ms. Johnson is a 35-year-old, right-handed female with a 5-year history of behavioral changes that include disinhibition, paranoia, and apathy along with more recent onset of deficits in attention/executive, psychomotor speed, and working memory. Without having any information about other clinical features, which disorder below might be suspected?
    a. Parkinson’s Disease
    b. Huntington’s Disease
    c. ADHD-Combined Type
    d. Corticobasal degeneration
  86. Which of the following is true regarding the long-term outcomes of children who survived out-of-hospital cardiac arrest?
    a. The likelihood of neurobehavioral morbidity is low due to neuroplasticity.
    b. Therapeutic hypothermia does not substantially improve neurobehavioral outcomes.
    c. Younger children sustain greater declines from baseline functioning than older children.
    d. Caregiver’s level of education is a strong predictor of outcome.
  87. Dr. Davis is evaluating an 11-year-old girl and notes that she has an “elfin” appearance including a short, upturned nose, small jaw, wide mouth with small teeth, and a prominent forehead. The patient was very friendly and socially engaged. Results revealed moderate intellectual disability and stronger verbal than nonverbal skills. Which neurodevelopmental disorder does the patient most likely have?
    a. Noonan syndrome
    b. Turner syndrome
    c. Williams syndrome
    d. Marfan’s syndrome
  88. Mr. Perkins is a 66-year-old patient whose family has concerns of his gradually worsening memory and several near-miss road accidents as a driver. On exam, you find that he has intact encoding, poor recall, and intact recognition on memory testing. What diagnosis is most likely with this memory performance pattern?
    a. Early dementia of the Alzheimer’s type
    b. Vascular dementia
    c. Depression or anxiety
    d. Frontotemporal dementia
  89. Dr. Xavier conducts neuropsychological screening assessments to ensure that older adult patients who are candidates for a particular research study do not have dementia. In order to increase the _ of her tests, Dr. Xavier uses race/ethnicity-adjusted cut-offs for patients from minority groups.
    a. sensitivity
    b. positive predictive value
    c. reliability
    d. Specificity
  90. Carl is an 83-year old male with a previous medical history of COPD, myocardial infarction, and MCI. He underwent heart surgery two days ago. His daughter has noticed that he appears confused, lethargic, is moving very slowly, but sometimes seems like his old self. What is the most likely etiology of his symptoms?
    a. Vascular Dementia
    b. Lewy Body Dementia
    c. Mixed ICU Delirium
    d. Prolonged dehydration
  91. Which of the following is false about confidence intervals as related to assessment?
    a. A narrow confidence interval is preferred.
    b. Confidence intervals are a range of values.
    c. Confidence intervals describe the uncertainty surrounding an estimate.
    d. Confidence intervals are unaffected by the reliability of the measure.
  92. Dr. Robinson is reviewing records on an inpatient who is experiencing an acute onset of dysfluent speech, anomia, and intact comprehension and reading. She hasn’t reviewed the imaging yet, but if there is a lesion identified, it is most likely in the:
    a. Left Superior Middle Cerebral Artery
    b. Anterior Communicating Artery
    c. Left Anterior Cerebral Artery
    d. Left Inferior Middle Cerebral Artery
  93. While aiming to provide services to underserved families in her pediatric neuropsychological practice, Dr. Stevens notes that many contextual factors are linked with missed appointments. Which of the following is false?
    a. Families insured via Medicaid are more likely to miss appointments than those with commercial insurance.
    b. Families requiring interpreters are more likely to miss appointments than those who do not.
    c. Families scheduled for summer months are more likely to attend than those scheduled in the winter.
    d. Families completing pre-visit paperwork are more likely to attend than those who do not.
  94. Receiver operating characteristic (ROC) curves are used to:
    a. Determine cut points to minimize false positives or negatives
    b. Determine the practice effects of an individual’s retest scores
    c. Transform non-normally distributed score distributions
    d. Determine whether treatment effects are clinically significant
  95. Culture can impact test performance in many ways, and using a cultural framework for data collection and interpretation can improve diagnostic accuracy. Which of the following is not true?
    a. Measurement of an individual’s cognitive abilities is a Western idea that may not be valid in another culture.
    b. Masking pain by joking or smiling can be common in cultures where indirect communication is valued.
    c. Cultural minorities are at risk for high false positive rates of noncredible performances on PVTs.
    d. Effects of poverty on cognitive development are minimal once controlling for parents’ education level.
  96. You diagnosed Ms. Baker with a primary progressive aphasia (PPA). During feedback, her family asks what is the most common neuropathological cause of PPA. You note that it is most likely caused by abnormal accumulation of:
    a. TDP-43
    b. neuritic plaques and neurofibrillary tangles
    c. Both A and B
    d. Pick bodies
  97. Dr. Chen is a neuropsychologist in an acute care medical setting. She receives a referral to evaluate medical decision-making capacity on a patient with a history of dementia. In this case, the patient wants to change his code status. In reviewing the medical records, Dr. Chen notes that the patient has a payee related to VA benefits. The patient’s daughter reports that she has been acting with his durable power of attorney (DPOA). Given these factors, what is the best course of action?
    a. Given the history of dementia, it is likely the patient does not have capacity to make independent decisions and an evaluation is unlikely to be of added benefit.
    b. Given the daughter’s report, there is no reason to go see this patient, particularly if she has the appropriate paperwork to show that DPOA has been activated.
    c. The history of dementia and the need for a payee suggest that decision making has been deemed to be impaired.
    d. Given the daughter’s report and even with appropriate paperwork, it may still be necessary to evaluate for medical decision-making capacity.
  98. The rationale for specifically labeling a test score based on a percentile rank rather than a standard score is which of the following?
    a. When a score is highly sensitive but not specific
    b. When a set of scores falls within highly restricted range
    c. When a score is highly specific but not sensitive
    d. When a score is highly reliable but not valid
  99. When working within a pediatric neuro-oncology service, it is important to know which of the following is not one of the more common symptoms or signs of elevated intracranial pressure in children?
    a. Headache, possibly resembling migraine
    b. Altered mental status or seizures
    c. Focal cortical symptoms, such as aphasia
    d. Vertigo and vomiting
  100. A 52 y.o. experienced an aneurysm rupture 5 days ago and is now being evaluated by Dr. Roberts. Dr. Roberts observes that the patient is experiencing abulia, pseudobulbar affect, and a dense amnesia with confabulation. Dr. Roberts knows that the lesion is likely in which artery?
    a. Right middle cerebral artery
    b. Left middle cerebral artery
    c. Left posterior communicating artery
    d. Anterior communicating artery