MoCA Executive Functioning 5

Question 1

A patient with early Parkinson's disease is given the MoCA. Which executive function subtest is MOST likely to show impairment in this population?

Accepted Answer

Trail Making B due to frontostriatal circuit disruption

Answer

Parkinson's disease disrupts frontostriatal circuits that support set-shifting, making Trail Making B particularly sensitive to the executive deficits seen in this population.

Question 2

Which of the following correctly describes the phonemic fluency task on the MoCA?

Accepted Answer

Generate words beginning with the letter 'F' in 60 seconds

Answer

The MoCA phonemic fluency task requires generating as many words as possible starting with the letter 'F' within 60 seconds, with 11 or more words earning 1 point.

Question 3

How does the MoCA address the potential confound of low education on executive task scores?

Accepted Answer

It adds 1 bonus point for individuals with 12 or fewer years of education

Answer

The MoCA adds 1 point to the total score for individuals who have 12 or fewer years of formal education, partially correcting for education-related performance differences.

Question 4

A patient cannot complete the Trail Making B task due to motor tremor but clearly understands the alternating rule and can verbally describe the correct sequence. The examiner should:

Accepted Answer

Document the motor limitation and use clinical judgment about executive ability

Answer

When motor limitations prevent task completion, clinicians should document the reason and use clinical judgment, recognizing that the verbal demonstration suggests intact cognitive set-shifting despite the motor barrier.

Question 5

Which of the following is an example of an 'executive' error on the MoCA clock drawing task?

Accepted Answer

Placing numbers in the correct positions but failing to include clock hands entirely due to impaired planning

Answer

Omitting clock hands entirely due to planning failure — rather than forgetting the instruction — reflects an executive breakdown in task monitoring and completion.

(MoCA) Montreal Cognitive Assessment Practice Test

(MoCA) Montreal Cognitive Assessment Practice Test

MoCA Executive Functioning 5