ABCN Patient Assessment and Evaluation 2 — Questions and Answers
Question 1: When evaluating a patient with suspected mild traumatic brain injury (mTBI), which symptom cluster is MOST characteristic in the acute phase?
- Persistent amnesia lasting more than 24 hours
- Headache, dizziness, and cognitive fog lasting days to weeks (Correct answer)
- Immediate onset of focal neurological deficits
- Progressive memory decline over several months
Correct answer: Headache, dizziness, and cognitive fog lasting days to weeks
Acute mTBI typically presents with headache, dizziness, and cognitive fog that resolve within days to weeks.
Question 2: A neuropsychologist administering the Boston Naming Test (BNT) notes a patient consistently provides circumlocutory responses. This pattern is MOST associated with:
- Phonological paraphasia
- Anomia secondary to lexical retrieval failure (Correct answer)
- Semantic paraphasia
- Visual agnosia
Correct answer: Anomia secondary to lexical retrieval failure
Circumlocutions on the BNT indicate lexical retrieval failure (anomia), where the patient knows the concept but cannot access the word.
Question 3: Which validity indicator embedded within the California Verbal Learning Test-3 (CVLT-3) compares recognition hits versus false positives to detect suboptimal effort?
- Recall Consistency Index
- Recognition Discriminability (Correct answer)
- Forced-Choice Recognition
- Learning Slope Index
Correct answer: Recognition Discriminability
The Recognition Discriminability index on the CVLT-3 contrasts hits and false positives to flag invalid performance.
Question 4: During a pediatric neuropsychological assessment, the examiner uses the NEPSY-II. Which domain is directly assessed by the Geometric Puzzles subtest?
- Phonological processing
- Visuospatial processing (Correct answer)
- Executive function
- Language comprehension
Correct answer: Visuospatial processing
Geometric Puzzles on the NEPSY-II measures visuospatial processing by requiring mental rotation and part-whole assembly.
Question 5: A 72-year-old presents with rapid-onset fluctuating cognition, visual hallucinations, and REM sleep behavior disorder. Which neurodegenerative condition should be PRIORITIZED in the differential?
- Alzheimer's disease
- Dementia with Lewy bodies (Correct answer)
- Frontotemporal dementia
- Vascular dementia
Correct answer: Dementia with Lewy bodies
The triad of fluctuating cognition, visual hallucinations, and REM sleep behavior disorder is the hallmark presentation of Dementia with Lewy bodies.
Question 6: When interpreting the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the List Learning subtest PRIMARILY measures:
- Procedural memory acquisition
- Immediate verbal memory and learning rate (Correct answer)
- Semantic memory organization
- Prospective memory
Correct answer: Immediate verbal memory and learning rate
List Learning on the RBANS measures immediate verbal memory by assessing encoding and acquisition across multiple trials.
Question 7: Which of the following BEST describes the base rate problem in neuropsychological assessment?
- Test scores below average are rare in healthy populations
- Low scores occur commonly in normal individuals, inflating false-positive rates (Correct answer)
- Most clinical populations perform in the impaired range on all tests
- Base rates are only relevant when interpreting performance validity tests
Correct answer: Low scores occur commonly in normal individuals, inflating false-positive rates
The base rate problem acknowledges that low scores on any single test occur frequently in healthy individuals, increasing the risk of false-positive diagnoses.
ABCN Patient Assessment and Evaluation 2
When evaluating a patient with suspected mild traumatic brain injury (mTBI), which symptom cluster is MOST characteristic in the acute phase?