MoCA Executive Functioning 2

Question 1

On the MoCA Trail Making B task, a patient connects numbers and letters in this order: 1-A-2-B-3-C. What cognitive ability does this primarily test?

Accepted Answer

Cognitive set-shifting and mental flexibility

Answer

Trail Making B requires the patient to alternate between number and letter sequences, directly assessing cognitive set-shifting, a core executive function.

Question 2

A patient scores 0 on the MoCA phonemic fluency task (words beginning with 'F'). Which threshold determines full credit?

Accepted Answer

11 or more words

Answer

The MoCA awards 1 point for generating 11 or more words beginning with the letter 'F' within 60 seconds.

Question 3

Which of the following best explains why executive functioning deficits appear early in Alzheimer's disease progression?

Accepted Answer

Prefrontal cortex circuits are disrupted by early amyloid pathology

Answer

Early amyloid accumulation in prefrontal and associated circuits disrupts executive networks before global cognitive decline becomes apparent.

Question 4

During the MoCA abstraction task, a patient is asked how a train and a bicycle are alike. The answer 'they both have wheels' receives what score?

Accepted Answer

0 points — too concrete or superficial

Answer

Responses citing a concrete physical feature (wheels) rather than an abstract category (means of transportation/vehicles) receive 0 points on the MoCA abstraction task.

Question 5

A clinician notices a patient can recall stored information but struggles to initiate problem-solving strategies spontaneously. This pattern most suggests impairment in which executive subdomain?

Accepted Answer

Initiation and generativity

Answer

Difficulty spontaneously initiating strategies while retrieval remains intact points to impaired initiation and generativity, a key executive subdomain.

(MoCA) Montreal Cognitive Assessment Practice Test

(MoCA) Montreal Cognitive Assessment Practice Test

MoCA Executive Functioning 2