1Which of the following best defines cognitive dysfunction?
A.A temporary emotional disturbance caused by stress
B.A deficit in intellectual and mental processes such as memory, attention, and executive function
C.A physical inability to control voluntary muscle movements due to spinal cord injury
D.A personality disorder characterized by unstable moods
Correct Answer: A deficit in intellectual and mental processes such as memory, attention, and executive function
Explanation:Cognitive dysfunction refers to deficits in cognitive domains like memory, attention, language, problem-solving, and executive functioning, often associated with neurological or psychiatric conditions.
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2In the context of cognitive dysfunction, what does the term agnosia refer to?
A.Inability to articulate speech
B.Inability to carry out motor activities despite intact motor function
C.Inability to recognize or identify objects despite intact sensory function
D.Loss of long-term memory
Correct Answer: Inability to recognize or identify objects despite intact sensory function
Explanation:Agnosia is the inability to process sensory information to recognize objects, persons, sounds, shapes, or smells, which is not due to a defect in the specific sense organ itself.
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3Which cognitive domain is primarily assessed by the Wisconsin Card Sorting Test (WCST)?
A.Long-term semantic memory
B.Executive function, specifically set-shifting and abstract reasoning
C.Visuospatial construction skills
D.Auditory processing speed
Correct Answer: Executive function, specifically set-shifting and abstract reasoning
Explanation:The WCST is a classic neuropsychological test used to assess executive functions, specifically the ability to display flexibility in the face of changing schedules of reinforcement (set-shifting).
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4Which of the following is considered a screening tool rather than a comprehensive neuropsychological battery?
A.Halstead-Reitan Neuropsychological Battery
B.Luria-Nebraska Neuropsychological Battery
C.Mini-Mental State Examination (MMSE)
D.Wechsler Adult Intelligence Scale (WAIS-IV)
Correct Answer: Mini-Mental State Examination (MMSE)
Explanation:The MMSE is a brief screening instrument used to grade cognitive impairment and screen for dementia, whereas the others are comprehensive batteries or intelligence tests.
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5What is the maximum possible score on the Mini-Mental State Examination (MMSE)?
A.20
B.30
C.50
D.100
Correct Answer: 30
Explanation:The MMSE is scored out of a maximum of 30 points. Scores below 24 are generally considered indicative of cognitive impairment.
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6Which condition is characterized by an acute, fluctuating disturbance in attention and awareness, often reversible?
A.Alzheimer's Disease
B.Vascular Dementia
C.Delirium
D.Mild Cognitive Impairment (MCI)
Correct Answer: Delirium
Explanation:Delirium is an acute confusional state characterized by fluctuating consciousness and attention, distinguishing it from the chronic and progressive nature of dementia.
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7The Stroop Color and Word Test is primarily used to assess which cognitive process?
A.Visuospatial memory
B.Phonological loop
C.Cognitive inhibition and selective attention
D.Motor dexterity
Correct Answer: Cognitive inhibition and selective attention
Explanation:The Stroop test evaluates the 'Stroop effect,' measuring a person's ability to inhibit an automatic response (reading a word) in favor of a less habitual one (naming the ink color), assessing cognitive control.
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8In the assessment of cognitive dysfunction, what does 'premorbid functioning' refer to?
A.The level of cognitive ability a patient had before the onset of injury or illness
B.The current level of cognitive functioning during a psychotic episode
C.The predicted decline in cognitive function over the next 5 years
D.The genetic predisposition to neurological disorders
Correct Answer: The level of cognitive ability a patient had before the onset of injury or illness
Explanation:Premorbid functioning is the baseline level of cognitive and intellectual performance prior to the onset of pathology, essential for determining the extent of decline.
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9Which of the following is a key ethical consideration when testing an individual with severe dementia?
A.Ensuring the test takes at least 4 hours to be thorough
B.Obtaining informed consent, often involving a legal proxy or guardian
C.Using only tests designed for children
D.Refusing to share results with the family to maintain total secrecy
Correct Answer: Obtaining informed consent, often involving a legal proxy or guardian
Explanation:Individuals with severe cognitive impairment may lack the capacity to provide informed consent, necessitating consent from a legally authorized representative while seeking assent from the patient where possible.
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10Which test requires a patient to connect numbered circles in a sequence (Part A) and alternate between numbers and letters (Part B)?
A.Digit Span Test
B.Trail Making Test
C.Boston Naming Test
D.Tower of London
Correct Answer: Trail Making Test
Explanation:The Trail Making Test (TMT) consists of Part A (visual scanning/processing speed) and Part B (mental flexibility/executive function) where the patient connects nodes in sequence.
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11The Montreal Cognitive Assessment (MoCA) is generally considered more sensitive than the MMSE for detecting:
A.Severe Alzheimer's Disease
B.Mild Cognitive Impairment (MCI)
C.Profound Intellectual Disability
D.Acute Coma
Correct Answer: Mild Cognitive Impairment (MCI)
Explanation:The MoCA was specifically designed to detect mild cognitive impairment (MCI) and is more sensitive to subtle deficits, particularly in executive function and visuospatial skills, compared to the MMSE.
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12Which type of cognitive dysfunction is primarily associated with chronic alcoholism and thiamine deficiency?
A.Huntington's Disease
B.Korsakoff's Syndrome
C.Pick's Disease
D.Lewy Body Dementia
Correct Answer: Korsakoff's Syndrome
Explanation:Korsakoff's Syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1), most commonly caused by alcohol misuse, resulting in severe anterograde amnesia and confabulation.
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13What is apraxia?
A.A language disorder affecting grammar
B.A deficit in motor planning and executing learned purposeful movements
C.A visual field cut
D.A loss of motivation
Correct Answer: A deficit in motor planning and executing learned purposeful movements
Explanation:Apraxia is a neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood and there is a willingness to perform the movement.
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14The Bender-Gestalt II is widely used to assess:
A.Verbal fluency and vocabulary
B.Visual-motor integration and visual perception
C.Auditory attention span
D.Logical deduction
Correct Answer: Visual-motor integration and visual perception
Explanation:The Bender Visual-Motor Gestalt Test involves copying geometric figures and is used to evaluate visual-motor maturity and detect developmental disorders or neurological impairment.
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15Which statistical concept is crucial when determining if a patient's score on a cognitive test represents a significant deficit?
A.The mode of the population
B.Standard deviation and Z-scores relative to normative data
C.The raw score only
D.The correlation coefficient between two different tests
Correct Answer: Standard deviation and Z-scores relative to normative data
Explanation:To identify a deficit, a clinician compares the patient's score to a normative sample. A score significantly below the mean (e.g., or ) usually indicates dysfunction.
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16Which part of the brain is most associated with the deficits measured by the Tower of London test?
A.Occipital Lobe
B.Temporal Lobe
C.Prefrontal Cortex
D.Cerebellum
Correct Answer: Prefrontal Cortex
Explanation:The Tower of London test assesses planning and problem-solving, which are executive functions heavily reliant on the prefrontal cortex.
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17The Boston Naming Test is specifically designed to assess:
A.Confrontation naming and word-retrieval abilities
B.Sentence construction
C.Reading comprehension
D.Writing speed
Correct Answer: Confrontation naming and word-retrieval abilities
Explanation:The Boston Naming Test assesses a patient's ability to name line drawings of objects, detecting anomia (difficulty finding words) common in aphasia and dementia.
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18What is the primary characteristic of Vascular Dementia?
A.Slow, insidious onset with primary memory loss
B.Step-wise decline in cognitive function related to cerebrovascular events (strokes)
C.Choreiform movements and psychosis
D.Early onset personality changes and loss of social inhibition
Correct Answer: Step-wise decline in cognitive function related to cerebrovascular events (strokes)
Explanation:Vascular dementia is caused by reduced blood flow to the brain (strokes/TIA). Its progression is often 'step-wise,' meaning stability followed by a sudden drop in function after a vascular event.
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19Which of the following describes ecological validity in the context of cognitive testing?
A.The extent to which test results predict real-world functioning
B.The use of environmentally friendly testing materials
C.The statistical reliability of the test across different cultures
D.The correlation between the test and MRI findings
Correct Answer: The extent to which test results predict real-world functioning
Explanation:Ecological validity refers to how well the performance on a psychological test predicts the patient's ability to function in their everyday environment (e.g., managing finances, driving).
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20The Halstead-Reitan Neuropsychological Battery is notable for:
A.Being a quick 10-minute screen
B.Its heavy reliance on qualitative observation only
C.Being a fixed battery used to detect brain damage and lateralization of defects
D.Testing emotional intelligence exclusively
Correct Answer: Being a fixed battery used to detect brain damage and lateralization of defects
Explanation:The Halstead-Reitan is a fixed set of tests developed to assess the presence, nature, and localization of brain dysfunction.
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21In the assessment of memory, anterograde amnesia refers to:
A.Loss of memories formed before the injury
B.Inability to form new memories after the injury
C.Loss of procedural memory only
D.A temporary memory loss due to fatigue
Correct Answer: Inability to form new memories after the injury
Explanation:Anterograde amnesia is the inability to create new memories after the event that caused the amnesia, while long-term memories from before the event remain intact.
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22What is a Symptom Validity Test (SVT) used for in cognitive assessment?
A.To diagnose schizophrenia
B.To measure the severity of a stroke
C.To detect malingering or insufficient effort
D.To validate the credentials of the psychologist
Correct Answer: To detect malingering or insufficient effort
Explanation:SVTs are designed to assess whether a patient is providing full effort or if they are feigning/exaggerating cognitive deficits (malingering) for secondary gain (e.g., insurance, legal outcomes).
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23Which subtest of the WAIS-IV measures Working Memory?
A.Block Design
B.Digit Span
C.Matrix Reasoning
D.Symbol Search
Correct Answer: Digit Span
Explanation:The Digit Span subtest (Forward, Backward, and Sequencing) measures auditory working memory and attention.
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24The Rey-Osterrieth Complex Figure Test assesses which combination of skills?
A.Verbal memory and language
B.Visuospatial construction and non-verbal memory
C.Auditory discrimination and pitch
D.Social cognition and empathy
Correct Answer: Visuospatial construction and non-verbal memory
Explanation:This test involves copying a complex geometric figure and then drawing it from memory, assessing visuospatial constructional ability and visual memory.
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25Which of the following causes of cognitive dysfunction is typically considered degenerative?
A.Traumatic Brain Injury (TBI)
B.Alzheimer's Disease
C.Viral Encephalitis
D.Carbon Monoxide Poisoning
Correct Answer: Alzheimer's Disease
Explanation:Alzheimer's disease is a neurodegenerative disorder, meaning it involves the progressive loss of structure or function of neurons.
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26When assessing a patient from a different cultural background, a psychologist must be wary of cultural bias. This refers to:
A.The patient disliking the psychologist
B.The test items measuring cultural knowledge rather than cognitive ability
C.The test being too short
D.The lack of translation services
Correct Answer: The test items measuring cultural knowledge rather than cognitive ability
Explanation:Cultural bias occurs when a test was developed in one culture and is used in another, leading to scores that reflect cultural familiarity (e.g., specific vocabulary or objects) rather than the underlying cognitive construct.
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27Which of the following is a symptom of Frontotemporal Dementia (FTD)?
A.Early loss of episodic memory
B.Significant changes in personality, behavior, and language
C.Visual hallucinations early in the disease
D.Severe tremors
Correct Answer: Significant changes in personality, behavior, and language
Explanation:FTD often presents with behavioral variants (disinhibition, apathy, personality change) or language variants (primary progressive aphasia), unlike Alzheimer's which typically starts with memory loss.
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28What is confabulation?
A.Deliberate lying to hide a crime
B.The production of fabricated, distorted, or misinterpreted memories without the conscious intention to deceive
C.Refusal to speak
D.Repeating words spoken by others
Correct Answer: The production of fabricated, distorted, or misinterpreted memories without the conscious intention to deceive
Explanation:Confabulation is a memory error defined as the production of fabricated, distorted, or misinterpreted memories about oneself or the world, often seen in Korsakoff's syndrome and ruptured aneurysm survivors.
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29The Clock Drawing Test is a simple tool used to screen for:
A.Hearing loss
B.Visuospatial and executive dysfunction
C.Reading speed
D.Color blindness
Correct Answer: Visuospatial and executive dysfunction
Explanation:Asking a patient to draw a clock face and set a specific time assesses visuospatial abilities, planning, and abstract thinking (executive function).
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30Which of the following is an application of cognitive assessment in a legal setting?
A.Determining the correct medication dosage
B.Assessing competency to stand trial
C.Identifying suitable hobbies for the patient
D.Measuring physical strength
Correct Answer: Assessing competency to stand trial
Explanation:Forensic neuropsychology uses cognitive assessment to determine if a defendant has the cognitive capacity to understand legal proceedings and assist in their own defense.
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31Which neurotransmitter is most significantly depleted in Alzheimer's Disease, leading to the use of cholinesterase inhibitors?
A.Dopamine
B.Serotonin
C.Acetylcholine
D.GABA
Correct Answer: Acetylcholine
Explanation:The cholinergic hypothesis of Alzheimer's suggests that a deficiency in acetylcholine is critical in the genesis of the symptoms, hence treatments focus on inhibiting the breakdown of this neurotransmitter.
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32The Luria-Nebraska Neuropsychological Battery differs from the Halstead-Reitan in that it:
A.Is much longer to administer
B.Is flexible and allows for qualitative analysis alongside quantitative scoring
C.Does not measure motor skills
D.Is only for children
Correct Answer: Is flexible and allows for qualitative analysis alongside quantitative scoring
Explanation:Luria's approach emphasizes a qualitative analysis of the nature of the errors (process approach) combined with quantitative data, and the battery is generally more portable and takes less time than the Halstead-Reitan.
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33What is the phenomenon called when a patient with a disability is unaware of their own deficits?
A.Anosognosia
B.Prosopagnosia
C.Aphasia
D.Alexia
Correct Answer: Anosognosia
Explanation:Anosognosia is a lack of ability to perceive the realities of one's own condition. It's a person's inability to accept that they have a condition that matches up with their symptoms or a formal diagnosis.
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34In the context of Traumatic Brain Injury (TBI), a coup-contrecoup injury refers to:
A.A penetrating injury from a bullet
B.Injury at the site of impact and on the opposite side of the brain due to rebound
C.A purely chemical injury
D.Injury to the spinal cord only
Correct Answer: Injury at the site of impact and on the opposite side of the brain due to rebound
Explanation:Coup injuries occur at the point of impact; contrecoup injuries occur on the opposite side of the brain as the brain slams against the skull.
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35Which assessment focuses on the speed of information processing and visual scanning?
A.Symbol Digit Modalities Test (SDMT)
B.Boston Diagnostic Aphasia Examination
C.California Verbal Learning Test
D.Hooper Visual Organization Test
Correct Answer: Symbol Digit Modalities Test (SDMT)
Explanation:The SDMT involves pairing specific numbers with given geometric figures within a time limit, primarily measuring psychomotor speed, visual scanning, and attention.
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36Pseudo-dementia refers to cognitive deficits caused by:
A.Severe Depression
B.Brain Tumor
C.Stroke
D.Meningitis
Correct Answer: Severe Depression
Explanation:Pseudo-dementia is a condition where cognitive impairment mimics dementia but is actually caused by a major depressive disorder. Unlike true dementia, the deficits often improve when the depression is treated.
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37When providing feedback on cognitive tests to a patient with mild impairment, an ethical psychologist should:
A.Use complex medical jargon to maintain professionalism
B.Provide the feedback in clear, understandable language and discuss implications
C.Mail the results without explanation to save time
D.Lie about the results to prevent patient anxiety
Correct Answer: Provide the feedback in clear, understandable language and discuss implications
Explanation:Ethical practice requires that assessment results are communicated clearly, accurately, and in a manner the client can understand, minimizing harm and maximizing the utility of the findings.
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38The Wechsler Memory Scale (WMS-IV) typically includes indices for:
A.Verbal Comprehension and Perceptual Reasoning
B.Auditory Memory, Visual Memory, Visual Working Memory
C.Emotional Stability and Agreeableness
D.Kinesthetic processing
Correct Answer: Auditory Memory, Visual Memory, Visual Working Memory
Explanation:The WMS-IV is a battery designed specifically to evaluate various memory functions, including auditory and visual memory in both immediate and delayed contexts.
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39Which of the following is an example of a Verbal Fluency task?
A.Reciting the alphabet backwards
B.Naming as many animals as possible in one minute
C.Reading a paragraph aloud
D.Defining the word 'Procrastinate'
Correct Answer: Naming as many animals as possible in one minute
Explanation:Verbal fluency tasks (semantic or phonemic) ask participants to generate as many words as possible from a category (e.g., animals) or starting with a letter (e.g., F) within a time limit.
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40Which area of the brain is primarily assessed by tasks requiring the patient to distinguish between right and left, and calculate simple math problems?
A.Right Temporal Lobe
B.Left Parietal Lobe
C.Frontal Lobe
D.Brainstem
Correct Answer: Left Parietal Lobe
Explanation:Deficits in left-right orientation, finger agnosia, agraphia, and acalculia (Gerstmann syndrome) are associated with lesions in the dominant (usually left) parietal lobe (angular gyrus).
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41In cognitive testing, crystallized intelligence refers to:
A.The ability to solve novel problems
B.Processing speed
C.Accumulated knowledge and verbal skills
D.Short-term memory capacity
Correct Answer: Accumulated knowledge and verbal skills
Explanation:Crystallized intelligence () involves knowledge that comes from prior learning and past experiences, such as vocabulary and general information. It is often resilient to aging and early brain injury compared to fluid intelligence.
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42If a patient scores on a memory test, what percentile range does this roughly correspond to?
A.Average (50th percentile)
B.High Average (84th percentile)
C.Extremely Low (< 1st percentile)
D.Low Average (16th percentile)
Correct Answer: Extremely Low (< 1st percentile)
Explanation:A Z-score of -2.5 is 2.5 standard deviations below the mean. In a normal distribution, this falls in the bottom 0.6% (less than the 1st percentile), indicating significant impairment.
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43The Rivermead Behavioural Memory Test is designed to:
A.Measure IQ
B.Predict everyday memory problems
C.Assess unconscious desires
D.Test reflex speed
Correct Answer: Predict everyday memory problems
Explanation:The Rivermead is an ecologically valid test designed to detect impairment in everyday memory functioning (e.g., remembering a name, remembering an appointment, finding a belonging).
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44A specific learning disability affecting reading accuracy, fluency, and comprehension is known as:
A.Dyslexia
B.Dysgraphia
C.Dyscalculia
D.Dyspraxia
Correct Answer: Dyslexia
Explanation:Dyslexia is a neurodevelopmental disorder characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities.
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45When assessing an elderly patient, the practice effect refers to:
A.Improvement in test scores due to prior exposure to the test
B.The decline in scores due to fatigue
C.The anxiety caused by the testing environment
D.The benefit of practicing relaxation techniques
Correct Answer: Improvement in test scores due to prior exposure to the test
Explanation:Practice effects occur when a patient's performance improves simply because they have taken the test (or a similar one) recently, which can mask true cognitive decline.
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46Which of the following describes Broca's Aphasia?
A.Fluent speech that lacks meaning (word salad)
B.Non-fluent, effortful speech with relatively preserved comprehension
C.Total loss of ability to understand language
D.Inability to write
Correct Answer: Non-fluent, effortful speech with relatively preserved comprehension
Explanation:Broca's aphasia (expressive aphasia) is characterized by slow, halting, grammatically incorrect speech, though the person usually understands what is said to them.
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47The Glaser Coma Scale (GCS) is used to:
A.Assess long-term memory
B.Assess the level of consciousness after acute brain injury
C.Diagnose depression
D.Measure intelligence in comatose patients
Correct Answer: Assess the level of consciousness after acute brain injury
Explanation:The GCS assesses consciousness based on eye, verbal, and motor responses to stimuli, often used in emergency medicine for TBI.
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48In rehabilitation planning, cognitive assessment helps to:
A.Determine if the patient should be institutionalized immediately
B.Identify spared cognitive strengths to compensate for deficits
C.Prescribe psychiatric medication
D.Diagnose physical broken bones
Correct Answer: Identify spared cognitive strengths to compensate for deficits
Explanation:Cognitive assessment identifies both deficits and preserved functions (strengths), allowing rehabilitation specialists to design strategies that use strengths to compensate for weaknesses.
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49What is the primary cognitive deficit in Huntington's Disease?
A.Rapid memory loss
B.Psychomotor slowing and executive dysfunction
C.Aphasia
D.Visual agnosia
Correct Answer: Psychomotor slowing and executive dysfunction
Explanation:While Huntington's involves movement disorders (chorea), cognitive changes typically involve subcortical patterns like slowed thinking (bradyphrenia) and executive dysfunction, rather than the rapid cortical memory loss seen in Alzheimer's.
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50The Continuous Performance Test (CPT) is most often used to assist in the diagnosis of:
Explanation:CPTs measure sustained attention and impulsivity by requiring the subject to press a button for specific stimuli and refrain for others over a long period, key for assessing ADHD.
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