Mock Exam 6 Questions

  1. Monique, a 24-year-old patient, completes an assessment revealing a cognitive profile of impaired learning, processing speed, and executive functioning skills. She has bipolar I disorder in remission and a diagnosis of insomnia. In this situation, which of the following statements is correct?
    a. Monique should be recommended to try behavioral sleep strategies to potentially improve everyday cognition.
    b. Monique should prioritize management of her mood disorder before attempting behavioral sleep strategies.
    c. Monique should be told that neuropsychological test performances are resistant to effects of insomnia.
    d. The neuropsychologist should wait for a repeat assessment to determine best recommendations in this case.
  2. A 50-year-old man with atrial fibrillation suddenly becomes “confused.” He is alert and attentive. His speech is fluent but paraphasic, and he has difficulty following commands. Which of the following other neurological abnormalities might be expected?
    a. Hemiparesis
    b. Left lower quadrantanopia
    c. Apraxia
    d. Dysarthria
  3. You are assessing an 8-year-old child Cas one month after they sustained a mild TBI playing soccer. Cas tells you during the assessment that they don’t want to go back to school since they prefer staying at home to play video games. What is the best way to know if Cas’ cognitive profile is valid?
    a. Symptom validity indicators on self-report measures
    b. Symptom validity indicators on parent-report measures
    c. Multiple embedded performance validity indicators
    d. Multiple standalone performance validity measures
  4. A lesion in which of the following areas is least likely in a 14-year-old female with new onset multiple sclerosis?
    a. Corpus callosum
    b. Juxtacortical
    c. Periventricular
    d. Basal ganglia
  5. You complete a neuropsychological evaluation of an individual with epilepsy. As part of the assessment you determine that they meet DSM-5 criteria for a diagnosis of ADHD, predominantly inattentive presentation. If the family asks for information regarding stimulant treatments for this individual, which of the following is most evidence based?
    a. Stimulant medications are ineffective in this population
    b. Stimulant medications may be considered, but there can be increased risk of seizure exacerbation
    c. Stimulant medication may not be as effective as in those with ADHD alone
    d. Treatment of epilepsy takes priority over stimulant treatment of ADHD
  6. A 50-year-old gentleman attends an initial assessment for behavioral and functional concerns. Evaluation reveals estimated baseline functioning in the mild/moderately impaired range, which is consistent with information gathered during clinical interview and from collateral report. As such, which of the following normative comparative standards is most appropriate to interpret findings from the WAIS-IV?
    a. Demographically-adjusted norms
    b. Population-based norms
    c. Regression-based norms
    d. Age-only norms
  7. You are evaluating a 6-year-old girl who presents with problems with learning and behavior. Her history is significant for premature birth at 29 weeks and a 3-month hospital stay prior to discharge. Which of the following is least likely part of her history?
    a. Hypoxic ischemic encephalopathy
    b. Intraventricular hemorrhage
    c. Multifocal Leukoencephalopathy
    d. Periventricular Leukomalacia
  8. A 60-year-old white female was admitted following a fall from standing. Prior to her fall, she experienced dizziness, lethargy, and syncope, with an estimated loss of consciousness of two to four minutes. In ER, she was found to have hyponatremia and complained of pain but was described as alert and oriented times three. After a surgery to address a hip fracture, she displayed confusion and fluctuating attention. Behavioral disturbance, including disorganized thinking and agitation, were also noticed by staff. What diagnosis best captures the etiology of her post-surgery symptoms?
    a. Hemorrhagic stroke
    b. Traumatic brain injury
    c. Schizophrenia
    d. Delirium
  9. An 81-year-old female patient with a remote history of traumatic brain injury who presents to your office with new progressive language and memory complaints impacting her job as an administrative assistant. She recently has gotten lost while driving on occasion and began having difficulty managing her finances. Upon evaluation, she is noted to have deficits in memory, language, and executive functioning. Neuroimaging demonstrated atrophy greater than expected for age as well mild small vessel vascular disease. Which of the following diagnoses is most likely?
    a. Neurocognitive disorder due to late effects of TBI
    b. Dementia of Alzheimer’s disease Type
    c. Vascular Dementia
    d. Dementia of Mixed Etiology
  10. A neuropsychologist completes a bedside cognitive screening with a 19-year-old patient with fluctuating mental status admitted to the ICU. The next day he discusses the results with the patient, her nurse, and the patient’s parent who is visiting. Which of the following reflects an ethical concern in this case?
    a. Disclosure of confidential information to a nurse rather than a physician
    b. Disclosure of confidential information to a parent without appropriate assent of patient
    c. Basing neurocognitive conclusions on a brief cognitive assessment at patient’s bedside
    d. Waiting a day to explain assessment results to the patient could jeopardize care
  11. Which of the following is least likely to be associated with errors in neuronal migration?
    a. Cerebral palsy
    b. Intractable epilepsy
    c. Intellectual disability
    d. Agenesis of the corpus callosum
  12. A 35-year-old, Asian-American, right-handed male is admitted to the hospital after a motor vehicle collision. Structural imaging showed scattered subarachnoid hemorrhages. His GCS on admission was 10, and he was estimated to be unconscious for three hours. He exhibited signs of posttraumatic confusion for about five days. Based on this information, what is the most appropriate traumatic brain injury severity classification?
    a. Mild traumatic brain injury
    b. Moderate traumatic brain injury
    c. Severe traumatic brain injury
    d. Extremely severe traumatic brain injury
  13. You recently evaluated a 6-year-old child who is diagnosed with Landau Kleffner Syndrome (LKS). What is the most important recommendation you can make in your report?
    a. Occupational therapy since LKS is associated with fine motor deficits
    b. Physical therapy since LKS is associated with gross motor and balance deficits
    c. Speech and language therapy since LKS is associated with language deficits
    d. Consultation with a pediatrician for ADHD symptom management
  14. You are evaluating a 15-year-old female who sustained a moderate traumatic brain injury 6 months ago. You are able to compare her current performance to results of a psychoeducational assessment performed 1 year prior to her TBI. In which area is the patient least likely to show post-injury changes?
    a. Math calculation
    b. Visual memory
    c. Expressive vocabulary
    d. Visuoconstruction
  15. You notice your referrals from a community prescriber include a number of patients over the age of 60 with chronic use of anticholinergic medications. Which of the following is most true about dementia risk?
    a. Anticholinergics do not increase dementia risk if the use occurred several years ago
    b. Anticholinergics have only temporary cognitive effects and do not increase dementia risk
    c. Long term use of anticholinergics has been linked to an increased dementia risk
    d. Dementia risk only increases when taking multiple anticholinergics
  16. You are interested in detecting the presence or absence of adequate engagement in cognitive testing with a test that has been normed across clinical populations. You want to be sure to minimize false positive errors (i.e., identifying someone as having suboptimal engagement when indeed their performance reflects true impairment). In order to do this, you will want to set your cut-off for the test on the basis of what?
    a. multi-trait multi-method matrix
    b. ROC curve analysis for the clinical group of interest
    c. the standard error of estimate
    d. the standard error of measurement
  17. Which of the following is not true of teleneuropsychology over traditional in-person methods?
    a. Teleneuropsychology has consistently established psychometric equivalence.
    b. Teleneuropsychology allows increased access to those with transportation barriers.
    c. Teleneuropsychology offers greater precision in stimulus presentation.
    d. Teleneuropsychology enables more reliable scoring.
  18. A colleague consults you about the cognitive impacts of statin use. Which of the following best represents current science related to statin prescription and its potential impacts on cognition?
    a. Statins are best for managing only the most intractable cardiovascular disorders.
    b. Prolonged statin use in elderly groups may contribute to cognitive complaints.
    c. Statins tend to have negative effects on cognition across patient age groups.
    d. Clear evidence shows reduced rates of vascular dementia in those regularly taking statins.
  19. Parents of a 10-year-old child have requested an evaluation for academic accommodation for suspected learning disability in reading. The child attends school where classes are taught entirely in French, through the French school board in your city. The family speaks English at home. What is the best way to assess this child?
    a. Complete the assessment in the language with the most robust test options
    b. Complete the assessment both in English and French
    c. Complete the assessment in French, since that is the child’s language of instruction
    d. Complete the assessment in English since that is what the child is most comfortable using
  20. A patient is scheduled to see Dr. Jones for comprehensive neuropsychological evaluation. Dr. Jones has access to limited medical records, but a brief referral note indicates a recent hospitalization in the context of stroke. Review of the records indicates the patient initially experienced “mild upper extremity weakness, difficulty finding words, and poor auditory comprehension.” What might Dr. Jones hypothesize as the potential area of insult?
    a. Left hemisphere infarct, involving the inferior division of the MCA
    b. Left hemisphere infarct, involving the superior division of the MCA
    c. Left hemisphere infarct, involving the ACA
    d. Left hemisphere infarct, involving the PCA
  21. As the developer of a new screening test for autism, your priority is to minimize false negatives. From a psychometric standpoint, your test will need to have:
    a. High positive predictive value/power
    b. High negative predictive value/power
    c. High specificity, lower sensitivity
    d. High sensitivity, lower specificity
  22. You conduct an evaluation with a patient following severe TBI without a disorder of consciousness and find profound deficits in information processing speed. You refer this individual to a physiatrist for pharmacological management of cognitive deficits. Which of the following medication has the strongest evidence to support use in this situation?
    a. Methylphenidate
    b. Modafinil
    c. Amantadine
    d. Sertraline
  23. Mutism, ataxia and emotional lability are features of:
    a. Marfan’s syndrome
    b. Posterior fossa syndrome
    c. Dandy-Walker syndrome
    d. Lead exposure in childhood
  24. You are conducting a neuropsychological evaluation with a 17-year-old transgender male who began masculinizing hormone therapy 3 months ago. You are least concerned about the impact of gender-specific norms for which of the following tests?
    a. Finger Tapping Test
    b. D-KEFS Sorting Test
    c. MMPI-2
    d. CVLT-3
  25. After unpacking from her trip to Africa, Erica is found by her spouse on the ground seizing. Upon regaining consciousness, she is observed to have altered mental status and a fever and is subsequently taken to the hospital emergency department for further work up. Based on symptom history and presentation as well as the most common worldwide cause of seizures, what is most likely to be the cause of Erica’s seizures?
    a. Acute or subacute stroke
    b. Temporal lobe epilepsy
    c. An acute or postacute infection
    d. A genetic brain malformation
  26. Dr. Strangelove works in the oncology department. They have recently assessed several children with brain tumors who have undergone various forms of treatment. Which child is most likely to have the best cognitive outcomes?
    a. A female who was treated at age 15 with proton beam radiation
    b. A female who was treated at age 5 with proton beam radiation
    c. A female who was treated at age 15 with traditional photon radiation
    d. A female who was treated at age 5 with traditional photon radiation
  27. You are preparing to meet with the parents of a 9-year-old child who has a diagnosis of autism. The child has average IQ but struggles in multiple areas. Which of the following is most likely to be a strength for this child?
    a. List learning
    b. Language comprehension
    c. Fine motor skills
    d. Problem solving
  28. 73-year-old male with fluctuations in attention, confusion, tremor, and visual hallucinations was diagnosed with mild dementia. Assuming it is medically appropriate, which might be the most appropriate medication intervention to consider?
    a. seroquel
    b. haloperidol
    c. donepezil
    d. memantine
  29. Atypical antipsychotic medications, including clozapine, are preferred to traditional antipsychotic drugs in treatment of schizophrenia for several reasons. Which of these is least likely to be a reason that an atypical antipsychotic medication should be considered over a traditional one?
    a. Atypical antipsychotic drugs have led to symptom improvement with some otherwise treatment-resistant patients.
    b. There is a reduced risk for agranulocytosis with atypical antipsychotic drugs than traditional ones.
    c. There is a reduced risk for extrapyramidal symptoms with atypical antipsychotic drugs than traditional ones.
    d. Atypical antipsychotic drugs have improved both negative and positive symptoms at a higher rate than traditional ones.
  30. During the course of your assessment of a patient, you notice that they cannot see a post-it note placed on top of a piece of paper. You think this is odd and want to test it a little further. You administer the Cookie Theft subtask and find that they cannot perceive more than one object in a visual scene. This symptom is called:
    a. Ocular apraxia
    b. Prosopagnosia
    c. Apperceptive agnosia
    d. Simultanagnosia
  31. You are evaluating a 59-year-old patient with a history of chronic alcohol use that was diagnosed with Wernicke’s encephalopathy. You expect that their primary symptoms would include _ and be caused by ___.
    a. ataxia, confusional state, eye movement abnormalities; vitamin B1 deficiency
    b. vertigo, retrograde amnesia, nystagmus; vitamin B1 deficiency
    c. confabulation, retrograde amnesia, conduction aphasia; vitamin B6 deficiency
    d. ataxia, vertigo, transient amnesia; vitamin B6 deficiency
  32. Dr. Miller sees a juvenile patient who sustained a recent traumatic brain injury. During the clinical interview, Dr. Miller observes ophthalmoplegia accompanied by a fixed, dilated pupil. Neuroimaging indicates a complete lesion of the cavernous sinus. Which cluster of cranial nerves is involved in this presentation?
    a. CN IX, XI, and XII
    b. CN III, IV, and VI
    c. CN I, II, and VIII
    d. CN II, IV, and VII
  33. Dr. Jones is conducting a record review in preparation for an evaluation. Some records suggest left hemisphere stroke, while others suggest right hemisphere stroke. During the clinical interview the patient displays very little rhythmic variation in speech as well as volume changes in the patient’s verbal expression. Additional evaluation of language suggests intact auditory comprehension and expression. Based on the above, which of the following is most accurate? The quality of the patient’s speech could be viewed as impaired and is localized to the _ hemisphere.
    a. Prosody, left
    b. Semantics, right
    c. Syntax, right
    d. Prosody, right
  34. A neuropsychologist decides to improve a test’s clinical utility by developing a recognition trial. Evaluation of the data reveals a significant negative skew in the distribution. Which of the following is the most appropriate means of interpreting a patient’s scores?
    a. Percentile rank
    b. z-score
    c. Standard score
    d. Demographically adjusted T-score
  35. You are conducting psychotherapy with a patient that has been diagnosed with systemic lupus erythematosus with the goal of treatment being adjustment to medical illness. Your patient frequently asks you questions about prognosis. After a review of the literature, you feel comfortable communicating that:
    a. The course of SLE is too variable to answer questions about prognosis.
    b. Prognosis for SLE has improved in recent years due to earlier detection and treatment.
    c. Prognosis for SLE has improved in recent years due to more targeted treatment options.
    d. Prognosis for SLE has worsened in recent years due to complications of targeted treatments.
  36. You are designing a longitudinal study of neuropsychological outcomes in normal adults utilizing the same test battery administered yearly over a 4-year time frame. Which of the following is most true regarding practice effects?
    a. An equal improvement in the test scores across the four assessments is expected.
    b. The greatest improvement in test scores will be evident between the first and second assessments.
    c. The greatest improvement in test scores will be evident between the third and fourth assessments.
    d. Practice effects are unlikely if the assessments are at least one year apart.
  37. Which of the following is more common in boys with autism compared to girls with autism?
    a. Intellectual disability
    b. Repetitive behaviors
    c. Seizures
    d. Gender fluidity
  38. You received a referral from a subacute rehabilitation facility for a 38-year-old woman to clarify her cognitive abilities as relate to her ability to complete activities of daily living after a resolved medical crisis. The patient, whose first language is Twi, immigrated from Ghana as an adult, is known to have no formal education, but is described as having “conversational” English skills. You do not speak Twi, nor do you know of any local neuropsychologists who speak Twi or professional interpreters fluent in this dialect. What is your best course of action in this situation?
    a. Request that the patient bring her cousin to the assessment who speaks both Twi and English and proceed with the assessment using the cousin as an interpreter.
    b. Begin the assessment with the patient, using only non-verbal tests and a verbal list-learning measure with the word list translated into Twi using an on-line language translation program.
    c. Conduct a non-traditional neuropsychological assessment in English focusing on practical skills (e.g., prospective memory, auditory comprehension), noting in the report the importance of cultural and language issues for best engagement in rehabilitation activities.
    d. Given the language and cultural complexity, decline the referral
  39. In addition to confabulation, which of the following patterns best characterizes Wernicke-Korsakoff syndrome?
    a. Orbitofrontal abnormalities, anterograde and retrograde amnesia, and poor insight.
    b. Thalamic abnormalities, anterograde amnesia, and good insight.
    c. Mammillary body abnormalities, anterograde and retrograde amnesia, and poor insight.
    d. Hippocampal and perihippocampal abnormalities, retrograde amnesia, and good insight.
  40. Andre has been having episodes of significant fear and panic. Which of the following would suggest psychiatric rather than neurologic etiology?
    a. No history of febrile seizures
    b. Witnessed motor automatisms
    c. Lack of response to diazepam
    d. Attack lasting more than 5 minutes
  41. You are interviewing the parents of a 3-year-old with autism. They report that the child has a genetic condition, but they can’t remember the name. Considering base rates of autism in genetic syndromes, which condition is least likely?
    a. Fragile X Syndrome
    b. Rett Syndrome
    c. Angelman Syndrome
    d. Klinefelter Syndrome
  42. An Asian-American male with 16 years of education in the US is referred for a fitness for duty evaluation. Which of the following is least relevant when interpreting his profile:
    a. Choice of normative dataset
    b. His occupation and job demands
    c. Handedness
    d. Level of acculturation
  43. Which of the following is not true regarding behavioral variant frontotemporal dementia (bvFTD)?
    a. Symptom onset of bvFTD is typically slightly earlier than Alzheimer’s disease dementia.
    b. Prominent, pervasive deficits across executive subdomains commonly occur in early stages of bvFTD.
    c. The presence of early memory deficits may not rule out a bvFTD cognitive pattern.
    d. Hyperorality is seen in patients with bvFTD who have inhibitory control deficits.
  44. Which of the following statements best reflects current research on the impact of regular physical activity in children with ADHD?
    a. It improves attention but not motor function.
    b. It primarily reduces hyperactivity and aggression.
    c. It worsens ADHD symptoms due to increased stimulation.
    d. It improves executive functions such as working memory.
  45. A 63-year-old female with a history of hypertension and cognitive complaints presents with progressive memory and language complaints impacting her job as an administrative assistant. She is noted to have severe language deficits, characterized by impaired confrontation naming, single-word comprehension, dyslexia and dysgraphia in the context of relatively spared repetition. Neuroimaging demonstrated anterior temporal lobe atrophy. Which of the following diagnoses is most likely?
    a. Dementia due to Alzheimer’s disease
    b. Dementia due to Nonfluent Variant Primary Progressive Aphasia
    c. Dementia due to Logopenic Variant Primary Progressive Aphasia
    d. Dementia due to Semantic Variant Primary Progressive Aphasia
  46. You are evaluating a right-handed, 13-year-old for the presence of a learning disorder. It is determined that the patient’s full-scale IQ is 1.5 SD below the expected range. Which of the following is likely the most important consideration in the context of the referral question?
    a. The patient sustained a concussion early in their schooling
    b. The patient’s low IQ may better account for verbal learning difficulties
    c. The patient had a late preterm birth with average birthweight
    d. The patient’s mother has a self-reported history of verbal learning disability
  47. A 68-year-old presents with a 3-year history of frequent falls, axial rigidity, slowed vertical saccades, and progressive cognitive decline, as well as limited benefit from levodopa, according to Neurology records. Behaviorally, you observe hypophonic, dysarthric speech, persistent startled facial expression, episodes of involuntary tearfulness, and mild disinhibition. His test results show prominent deficits on tests of processing speed, verbal fluency, and executive functioning. His symptoms are most concerning for:
    a. Parkinson’s disease
    b. Progressive supranuclear palsy
    c. Dementia with Lewy Bodies
    d. Corticobasal degeneration
  48. Roberto is a 7-year-old boy with anxiety, OCD, and newly diagnosed Tourette’s Syndrome. His teachers have noticed that he is struggling to learn in his classes. Which cognitive domain is he most likely to have difficulty in?
    a. Psychomotor speed
    b. Visuoperception
    c. Memory
    d. Executive functioning
  49. You begin training an extern who has strong opinions about long-term disability after mild TBI from social media accounts. Which of the following is false about the research regarding return to work after mild TBI?
    a. Psychosocial factors appear to be more predictive than biomedical ones after mild TBI.
    b. Occupation type affects one’s likelihood to return to work after mild TBI.
    c. Data is limited regarding sustained employment outcomes beyond two years.
    d. Standardized classification of Mild TBI helps strengthen conclusions across studies.
  50. Which of the following conditions has been linked to early mortality associated with heart disease, dementia due to Alzheimer’s disease, and cancer?
    a. Epilepsy
    b. Multiple Sclerosis
    c. Cerebral Palsy
    d. Down syndrome
  51. When considering the adoption of a new test for an underserved population, the criterion validity of the test is critical. Evidence for a test’s criterion validity includes:
    a. How sensitive test scores are to treatment effects.
    b. How robust the theoretical basis for the test is.
    c. How well responses to individual test items relate.
    d. How highly correlated the test is with similar measures.
  52. You are evaluating a six-year-old patient with concern for a fetal alcohol spectrum disorder. Assessment results indicate problems with learning and impulse control in the setting of documented prenatal alcohol exposure. You observe no physical (including facial) abnormalities. What diagnosis appears most appropriate?
    a. Fetal alcohol syndrome
    b. Partial fetal alcohol syndrome
    c. Alcohol-related neurodevelopmental disorder
    d. Cannot assign a diagnosis with a patient this young
  53. A 59-year-old male was referred for neuropsychological evaluation by his ophthalmologist. The evaluation revealed an insidious onset of cognitive and motor difficulties, including limb rigidity, tremor, and alien limb phenomenon. Testing suggested executive functioning and visuocognitive deficits. Which of the following is most likely?
    a. Dementia with Lewy Bodies
    b. Progressive supranuclear palsy
    c. Corticobasal syndrome
    d. Frontotemporal dementia due to motor neuron disease
  54. You are evaluating an 11-year-old boy with a pre-existing diagnosis of ODD who was identified as having elevated blood lead levels at 3 different time points across 2 years. His elevated lead levels would have the greatest impact on which of the following domains?
    a. Motor skills
    b. Memory
    c. Language
    d. Overall IQ
  55. A patient who was referred by Neurology with suspected limbic-predominant age-related TDP-43 encephalopathy (LATE) presents for neuropsychological evaluation. Which of the following is not true regarding LATE?
    a. The neuropsychological profile is similar to Alzheimer’s disease with primarily progressive amnestic dysfunction.
    b. The presentation is expected to be milder than other common forms of dementia.
    c. Rates tend to increase with age until the 9th decade and decrease after the age of 100.
    d. Hippocampal sclerosis may be present on neuroimaging, but it is not necessary or sufficient.
  56. Dr. Hsu completes a comprehensive assessment of a 17-year-old one year after left temporal lobe surgery for epilepsy management. Dr. Hsu finds that some scores have changed since the pre-surgical assessment and decides to calculate a Reliable Change Index (RCI). Which of the following tests is most likely to show a reliable change?
    a. The test with the largest rxy (e.g., 0.98)
    b. The test with the smallest rxy (e.g., 0.78)
    c. The test with the largest standard error of measurement
    d. The test with the smallest standard error of measurement
  57. A researcher hypothesizes that individuals who perform yoga the night before their Board Written Exam score higher on the exam than students who don’t. She obtains a sample of 40 candidates and assigns 20 to the “yoga” group and 20 to the “no yoga” group. She concludes, on the basis of a simple statistical test, that her hypothesis was correct. In the general population, however, there is no difference on the Board Written Exam between individuals who do and do not perform yoga the night before they take the exam. What type of error has been made?
    a. Type I Error
    b. Type II Error
    c. Sampling error
    d. Standard error
  58. Dr. Lee is consulted to assess a 25-year-old inpatient who is acutely manic to determine whether she has decisional capacity to refuse a mood-stabilizing medication. The patient is able to describe what bipolar disorder is, the risks and benefits of the proposed medication on manic symptoms, and the risk of forgoing treatment. However, she is unable to elaborate on the personal risks of refusing treatment. The patient is exhibiting difficulty with which component of medical decision-making capacity?
    a. Understanding
    b. Appreciation
    c. Reasoning
    d. Awareness
  59. A 70-year-old African American male is referred for a neuropsychological evaluation due to memory complaints. What is the potential consequence of using only age- and gender-based norms?
    a. The patient is classified as being impaired when he is actually unimpaired
    b. The likelihood of misdiagnosis is unaffected by the choice of norms
    c. The patient is classified as being unimpaired when he is actually impaired
    d. The likelihood of correct diagnosis will be improved if race-related norms are not used
  60. You’re evaluating a 70-year-old man with mild dementia whose family expresses concern about his driving safety. Based on meta-analyses regarding neuropsychological correlates of driving performance, which of the following cognitive domains is likely to show the strongest relationship with his driving capacity?
    a. Visuospatial skills
    b. Attention/concentration
    c. Processing speed
    d. Memory
  61. You are reviewing MRI findings of a 41-year-old woman with seizures and autism diagnosed in early childhood. Which area of the brain is least likely to be abnormal?
    a. Pons
    b. Cerebellum
    c. Corpus Callosum
    d. Thalamus
  62. You are a neuropsychologist evaluating a patient who had a basal ganglia stroke suspected to be cardioembolic. The MRI showed a small lesion within the territory of the lenticulostriate arteries. Given this information, you expect the stroke was caused by an embolism:
    a. that entered the ACA via the internal carotid artery
    b. that entered the MCA via the vertebral arteries
    c. that entered the PCA via the vertebral arteries
    d. that entered the MCA via the internal carotid artery
  63. You are testing a patient with mostly fluent, spontaneous speech but paraphasic errors are common. This patient is unable to repeat single words or statements on command. Oral reading is also inefficient. This patient’s profile is most consistent with:
    a. Wernicke’s aphasia
    b. Broca’s aphasia
    c. Global aphasia
    d. Conduction aphasia
  64. Jonathan is referred for “debilitating memory problems” that he attributes to a concussion sustained 6 months ago after a fall at a local store. Jonathan arrives at the appointment independently and on time and completes the evaluation. Which of the following is least likely to be helpful in determining the presence of Malingered Neurocognitive Dysfunction?
    a. Engagement in ongoing litigation.
    b. Overall performance on PVTs and SVTs.
    c. Consistency across functioning and test performance.
    d. Presence of psychological diagnosis or trauma history.
  65. Dr. Sharma is scheduled to see a 95-year-old retired physician to assess cognitive changes noted by family. Which of the following issues is least likely when using normative data for “oldest-old” adults:
    a. Normative samples may include individuals with sensory or motor limitations.
    b. Sample sizes of the oldest-old age group tend to be small and gender imbalanced.
    c. Individuals with preclinical dementia may be included unintentionally.
    d. After adjusting for age, education does not affect neuropsychological performance.
  66. A neuropsychologist wants to avoid practice effects on the repeat assessment of a patient. Which strategy would best help achieve that goal?
    a. Schedule the examinee for a reevaluation after at least six months.
    b. Choose a measure with high test-retest reliability.
    c. Select tests that have options for alternate forms.
    d. Present test items in the reverse order on the repeat evaluation.
  67. Which of the following genetic conditions is not typically associated with intellectual disability?
    a. Sturge-Weber Syndrome
    b. Tuberous Sclerosis
    c. Prader-Willi Syndrome
    d. Turner Syndrome
  68. When using a one-way ANOVA to compare three different styles of results dissemination on patient satisfaction, the null hypothesis would be that
    a. There is no relationship between results dissemination forms and satisfaction.
    b. Different forms of results dissemination yield more satisfaction.
    c. Not all forms of results dissemination yield the same satisfaction.
    d. All forms of results dissemination yield the same satisfaction.
  69. Dr. Green plans to present at a local senior center about brain health. Which of the following statements regarding physical exercise on brain health is not supported by research?
    a. Research suggests that, compared with a sedentary lifestyle, all forms of exercise are associated with improved cognitive health.
    b. Resistance training is less supported than aerobic exercise for cognitive health related to MCI and dementia.
    c. Exercise is helpful for both older adults with mild cognitive impairment and dementia, but more effective for those without dementia.
    d. Exercise’s benefit for brain health may be through the improvements of medical conditions such as diabetes and heart disease.
  70. You are preparing to conduct a neuropsychological evaluation of a 4-year-old boy born at 28 weeks gestation. Which of the following is least likely?
    a. Vision impairment due to retinopathy of prematurity
    b. History of perinatal brain injury affecting motor coordination
    c. Hearing impairment requiring cochlear implantation
    d. Developmental delay related to hypoxic ischemic encephalopathy
  71. A neuropsychologist assesses a patient and finds an 18 point difference between the patient’s WAIS-IV Full Scale IQ (FSIQ) score and WMS-IV General Memory Index (GMI) score. What other patient information is crucial in order to find the statistical significance of this difference at the .05 level?
    a. Their gender
    b. Their FSIQ
    c. Their performance validity score
    d. Their age
  72. Which of the following neuropsychological findings is least likely in a 9-year-old with Turner syndrome?
    a. Fine motor deficits
    b. Visual memory deficits
    c. Social deficits
    d. Verbal reasoning deficits
  73. Following a stroke, a 45-year-old patient who is right-handed dominant is experiencing impaired language comprehension with normal speech fluency and repetition. Their symptoms are most consistent with:
    a. Mixed transcortical aphasia
    b. Transcortical sensory aphasia
    c. Transcortical motor aphasia
    d. Wernicke’s aphasia
  74. A patient’s referral question raises concern for degenerative neurologic condition versus functional neurological disorder. During your evaluation, you suspect internal inconsistency. All of the following could be signs of internal inconsistency except:
    a. The patient’s cognitive abilities fluctuate across cognitive domains.
    b. The patient’s reported cognitive abilities directly contrast with observed abilities.
    c. The patient’s reported cognitive abilities directly contrast with collateral report of abilities.
    d. The patient’s reported cognitive abilities directly contrast with objective test performances.
  75. As the director of your institution’s rehab center you are asked to design a neuropsychological test battery that will be administered yearly to children with sickle cell disease in Africa, the UK, and the US. Which of the following factors is most crucial?
    a. Choosing tests that cover a wide range of cognitive domains
    b. Ensuring that appropriate norms are available for each population
    c. Choosing tests that can be administered by interpreters
    d. Ensuring that each test has adequate predictive validity
  76. You are testing the hypothesis that there is no difference between approaches to neuropsychological assessment with regards to patient satisfaction scores. Your design calls for two groups— treatment as usual versus a therapeutic assessment approach. You use a t-test to analyze the data. The t-value exceeds the tabled critical value at the .01 level for a 2-tailed test. You should:
    a. Accept the null and conclude the alternative hypothesis is false.
    b. Reject the null and conclude the alternative hypothesis is supported.
    c. Accept the null and conclude the alternative hypothesis is supported.
    d. Not make an interpretation, as you should have used a one-tailed test.
  77. Ms. Grayson was recently diagnosed with multiple sclerosis. Which of the following is not characteristic of this disease?
    a. Paresthesia
    b. Hearing loss
    c. Diplopia
    d. Incontinence
  78. The basic tenet of the Flynn effect challenges the assumption that:
    a. Intelligence is solely determined by genetics
    b. Intellectual abilities decline with age
    c. Standardized tests accurately measure intelligence
    d. Socioeconomic factors have no impact on intelligence
  79. A 77-year-old patient is referred by neurology for neuropsychological evaluation due to a 2-year history of cognitive and behavioral decline. Considering base rates of various dementia syndromes, which of the following pure dementia phenotypes is most likely?
    a. Frontotemporal dementia given the patient’s age and behavioral concerns.
    b. Alzheimer’s dementia is most likely given that likelihood increases with age.
    c. Vascular dementia is most likely given the patient’s age and changes reported.
    d. Lewy body dementia is unlikely given the patient’s age and absence of motor symptoms.
  80. When considering the validity of testing in pediatric populations, the following are true except:
    a. Common PVTs developed for adults can be used for many children with reasonable confidence.
    b. When discussing noncredible findings, it is common that a child will admit to feigning or exaggerating.
    c. Reasons for children’s failure of validity measures may differ from adults’ reasons.
    d. Children who fail PVTs are likely to perform worse across other neuropsychological performances.
  81. You receive a consult to work with a 40-year-old individual admitted to a medical unit experiencing cognitive changes. Diffusion weighted imaging MRI brain showed isolated subcortical white matter changes. In terms of differential diagnosis, which of the following conditions would be expected to produce a different neuroimaging pattern?
    a. Heroin inhalation toxicity
    b. Acute disseminated encephalomyelitis
    c. Delayed posthypoxic leukoencephalopathy
    d. Severe acute anoxic brain injury
  82. You evaluate someone with a left MCA stroke at the level of M1. Based on this, which is least likely to be present?
    a. Visuospatial neglect
    b. Left gaze preference
    c. Global aphasia
    d. Anomia
  83. A patient is referred to you for treatment of chronic pain and anxiety. During the intake, they identify long-term prescriptions for Zoloft and Oxycodone. When assessing symptoms, they describe generalized pain, worry, nausea, constipation, and dizziness. Symptoms are most likely due to:
    a. Physiological effects of anxiety.
    b. Physiological effects of untreated chronic pain.
    c. Side effects of selective serotonin reuptake inhibitors.
    d. Side effects of narcotic pain medication.
  84. Which of the following statements is false regarding the relationship between cognitive dysfunction and immune system suppression in HIV/AIDS?
    a. Asymptomatic patients with CD4 levels greater than 400-500 cells/ml have minimal cognitive impairment attributed to HIV.
    b. Plasma viral loads of >50,000 copies/mL are predictive of subsequent dementia.
    c. Cognitive performance has a stronger correlation with plasma viral load than with CSF viral load.
    d. Cognitive dysfunction can occur in some individuals despite CART treatment and undetectable viral loads (e.g., HIV-RNA <50 copies/mL).
  85. The most important factor to consider when interpreting discrepancies between tests scores in children is:
    a. the base rate of the discrepancy
    b. the magnitude of the discrepancy
    c. the statistical significance of the discrepancy
    d. the child’s age
  86. A study is conducted to assess the effectiveness of a new sustained attention intervention for elementary and middle school students. The Continuous Performance Test (CPT) is used to measure sustained attention. If the mean score of subjects who undergo the intervention is compared to that of a waitlist control group, the statistical test that would be used would be:
    a. t-test for independent samples
    b. t-test for correlated samples
    c. ANCOVA
    d. one-way ANOVA
  87. Diego is a 13-year-old who you recently diagnosed with ADHD-combined type. His parents have some questions in preparation for an initial medication consultation regarding psychostimulants. Which of the following statements has the least evidence?
    a. Caution should be exercised if Diego has a family history of substance use disorder.
    b. Stimulant medications can contribute to cardiac arrhythmias and other heart concerns.
    c. A majority of kids grow out of ADHD by early adulthood, with no ongoing symptoms.
    d. Timing of medication administration is important for optimal sleep and eating routines.
  88. Dr. Barton is preparing a battery of tests for an interdisciplinary return to work program. Which form of validity is most important to consider for such a test battery?
    a. Concurrent validity
    b. Content validity
    c. Predictive validity
    d. Face validity
  89. Use of a highly specific sign or symptom (e.g., visual neglect) in identifying neurologic injury will results in a high rate of:
    a. false negative errors
    b. false positive errors
    c. true positive errors
    d. true negative errors
  90. You are scheduled to conduct a brief assessment of a 30-year-old veteran with risk for PTSD. Given the time constraints, it may be helpful to prioritize each of the following except:
    a. Estimated premorbid general intelligence
    b. Verbal list learning and memory
    c. Simple reaction time
    d. Visuospatial processing
  91. Dr. Jordan just began their first rotation in a pediatric epilepsy program. Of the following, which cognitive weakness should they expect to see in a case with Childhood Absence Epilepsy?
    a. Verbal memory deficits
    b. Attention deficits
    c. Language deficits
    d. Global cognitive delays
  92. Which of the following is true when considering recommendation of deep brain stimulation (DBS) for a person with Parkinson’s disease (PD) diagnosis? DBS is highly effective for:
    a. Rigidity but not for apathy and emotion dysregulation.
    b. PD-related apathy but not cognitive symptoms.
    c. PD-related cognitive symptoms but not rigidity.
    d. Rigidity and apathy but not cognitive symptoms.
  93. Which of the following is true regarding cognitive/behavioral differences observed between Alzheimer’s Disease (AD) and Dementia of Lewy Body type (DLB)?
    a. DLB patients may report auditory hallucinations.
    b. AD patients often experience rapid fluctuations in cognition/orientation.
    c. DLB patients could be expected to exhibit neuroleptic sensitivity.
    d. AD patients typically perform better on confrontation naming.
  94. Mr. Jackson’s daughter has been speaking with the neurology team following her father’s stroke 3 days ago. They described him as having Gerstmann’s Syndrome, which is associated with which of the following?
    a. Agraphia, acalculia, aphemia, and finger agnosia; Left angular gyrus
    b. Agraphia, aphemia, finger agnosia and right-left confusion; Supramarginal gyrus
    c. Agraphia, acalculia, finger agnosia and right-left confusion; Left angular gyrus
    d. Agraphia, acalculia, finger agnosia and right-left confusion; Supramarginal gyrus
  95. A 66-year-old Latina female presents with her bilingual daughter for evaluation following an apparent head injury. She is an immigrant from South America and does not speak English. Which course of action could cause the most harm?
    a. Working closely with a neurologist who is fluent in the preferred language and can conduct an extended mental status exam.
    b. Referring the patient to an out-of-state neuropsychologist who has fluency in the patient’s preferred language.
    c. Having the patient’s daughter, who knows the patient well, provide interpretation.
    d. Conducting an evaluation using an interpreter who speaks the patient’s preferred language.
  96. What is the base rate of primary vascular dementia relative to all dementia diagnoses regardless of country of origin?
    a. 10%
    b. 20%
    c. 30%
    d. 40%
  97. When describing assessment findings, a neuropsychologist identifies test scores as being “impaired.” According to the AACN consensus conference statement on uniform labeling of performance test scores, which of the following is true?
    a. This is recommended for standard scores with a normal distribution.
    b. This is recommended for standard scores with a skewed distribution.
    c. This is not recommended for scores with either a normal or skewed distribution.
    d. This is not mentioned in the consensus statement.
  98. You are asked to provide consultation about planning for a pediatric patient following remote TBI. Which of the following variables is least likely to impact outcome?
    a. Gender
    b. TBI severity
    c. Age at TBI
    d. Pre-injury psychosocial factors
  99. You are preparing for neuropsychological evaluation with a 15-year-old female who experienced near drowning 1 year ago. The referring neurologist has shared the patient’s brain imaging to guide your evaluation. Given your knowledge of hypoxic brain injury, which area is least likely to have been impacted?
    a. Hippocampus
    b. Thalamus
    c. Cerebellum
    d. Motor cortex
  100. Mr. Johnson was 92 and living with his daughter who was his caregiver. He had been chronically ill for years and struggled with memory, though this was not formally evaluated. In the weeks prior to his death, he was observed to be hallucinating. Two days prior to his death, his daughter procured a change to his existing Will that was not recorded by his attorney. His son is now claiming that his father did not have testamentary capacity at the time of the Will change. Which statement is most accurate regarding this forensic referral?
    a. Opinions regarding testamentary capacity cannot be formed as Mr. Johnson has passed away and cannot be formally evaluated even if his prior medical records are reviewed.
    b. It appears that his daughter coerced him into changing his Will, evidenced by her being a caregiver and having him change his Will just prior to his passing when he was clearly impaired.
    c. The Will is likely valid as the daughter’s attorney stated that the Will change occurred during a lucid interval; a thorough record review and interviewing the patient’s son will likely answer the referral question.
    d. Assessing the risk factors for testamentary incapacity, reviewing the records, and obtaining statements from all family members will likely be the most effective way to evaluate this issue.