MoCA Practice Test: Video 2 Answers (23 Questions) Flashcards

If a patient on the Trail Making B task connects 1-A-2-B-3-D (skipping C) but then self-corrects, how is this scored?

Answer: 1 point — prompt self-correction is acceptable

On the MoCA, the examiner is instructed to point out errors immediately and allow the patient to self-correct without penalty, as long as the correction is made promptly. A successful self-correction does not automatically fail the trial.

A patient earns 0 on Trail Making B, 0 on clock drawing, and 0 on letter fluency. What does this pattern suggest?

Answer: Broad executive dysfunction across multiple components

Failure across all three executive domain tasks (Trail Making B, clock, fluency) indicates a broad executive impairment affecting cognitive flexibility, planning, and generative thinking.

Clock drawing is included in the MoCA Visuospatial/Executive domain because it requires:

Answer: Executive planning and spatial construction together

Beyond spatial construction, clock drawing requires the patient to plan and execute a sequence of steps (draw circle, place numbers, set hands to a time), engaging the executive planning system.

How many words beginning with F must a patient generate in 60 seconds to earn the MoCA letter fluency point?

Answer: 11 or more

The patient must produce 11 or more F-words in 60 seconds to earn 1 point. Proper nouns and the same word said again (with different endings) do not count.

Which MoCA tasks fall under the Visuospatial/Executive domain?

Answer: Trail Making B, cube copy, and clock drawing

The Visuospatial/Executive domain includes the Trail Making B task, the cube copy task, and the clock drawing task — all requiring spatial organization and/or executive planning.

Which MoCA task most directly evaluates calculation and numerical reasoning skills?

Answer: Serial 7 subtraction

The serial 7 subtraction task (100, 93, 86, 79, 72, 65) is the primary arithmetic task in the MoCA and is the standard measure of calculation under the attention/concentration domain.

When evaluating calculation ability with the MoCA serial 7 task, clinicians should be cautious interpreting low scores in patients who:

Answer: Have limited formal education or low numeracy backgrounds

Education and cultural background strongly influence performance on arithmetic tasks. Low serial 7 scores in individuals with limited formal education may not reflect cognitive impairment.

What does calculation ability refer to in cognitive assessments?

Answer: It involves performing mathematical operations.

Calculation ability, in cognitive assessments, specifically refers to the capacity to perform arithmetic operations such as addition, subtraction, multiplication, and division. This skill requires not only knowledge of numbers but also attention, working memory, and sequential processing. It is a key indicator of numerical reasoning and executive function.

In MoCA scoring, a patient who correctly subtracts 7 only once (getting 93 right, then failing) earns:

Answer: 1 point

Per MoCA scoring rules, exactly 1 correct subtraction earns 1 point. Errors on subsequent attempts do not negate the one correct response.

A patient who scores 0 on serial 7s but performs well on all other MoCA domains likely has difficulty with:

Answer: Selective arithmetic or sustained concentration difficulty

Zero on serial 7s in isolation may indicate selective arithmetic difficulty, high test anxiety, or limited education rather than global cognitive impairment, especially when other domains are intact.

What is the maximum possible total score on the MoCA?

Answer: 30

The MoCA has a total of 30 points distributed across eight domains: Visuospatial/Executive (5), Naming (3), Attention (6), Language (3), Abstraction (2), Delayed Recall (5), and Orientation (6). The Memory learning trials are unscored.

For an examinee with 12 or fewer years of formal education, how should the MoCA total score be adjusted?

Answer: Add 1 point to the raw score to correct for educational bias

Standard MoCA guidelines instruct the examiner to add 1 point to the total raw score for any examinee who has completed 12 or fewer years of formal education. This corrects for the well-documented effect of lower educational attainment on cognitive test performance independent of impairment.

What is the standard cutoff score indicating normal cognitive function on the MoCA?

Answer: 26/30 or above

A score of 26/30 or above is considered within the normal range on the MoCA, as established in the original validation study by Nasreddine et al. (2005). Scores below 26 may indicate MCI or dementia and warrant further evaluation.

On the MoCA, a patient draws a square instead of a circle for the clock contour. The contour criterion is scored:

Answer: 0 points — the contour must be a circle

The clock contour must be a recognizable circle. A clearly non-circular shape (square, rectangle) does not meet the criterion for the contour point, scoring 0 for that sub-point.

On the MoCA Clock Drawing task, the examiner asks the patient to draw a clock showing 10 minutes after 11. What is the correct target time?

Answer: 11:10

The standard MoCA clock-drawing instruction specifies 11:10 (ten minutes past eleven).

A patient draws a perfect clock circle and places all numbers correctly but forgets to add the hands. The clock drawing score is:

Answer: 2 points

Without hands, only the contour (1 pt) and number placement (1 pt) criteria can be met. The hand placement point (1 pt) cannot be awarded, yielding a maximum of 2 out of 3.

The MoCA clock drawing task belongs to which cognitive domain on the assessment form?

Answer: Visuospatial/Executive

Clock drawing is placed within the Visuospatial/Executive domain on the MoCA form because it tests both spatial construction and executive planning simultaneously.

A patient with a left parietal lesion attempts clock drawing. Which type of error is most expected?

Answer: Neglect of the left side of the clock face

Left parietal lesions produce right hemispatial neglect, causing the patient to omit or crowd numbers on the right side of the clock.

When administering the MoCA cube copy task, the examiner should provide the patient with:

Answer: The MoCA form with the pre-printed cube model and a pencil

The examiner provides the printed MoCA form (which has the cube drawing already on it) and a pen or pencil. No additional tools or grids are given. The patient draws directly on the form.

A patient copies the cube but draws it as a flat square with lines attached. This copy earns:

Answer: 0 points — the copy is not three-dimensional

A flat two-dimensional representation of a cube does not meet the requirement for a three-dimensional copy. It scores 0 on the cube copy task.