Advanced Review Praxis Practice Questions

Patricia, a 64-year-old retired librarian, is undergoing outpatient speech-language therapy following a stroke that affected the language-dominant hemisphere. She presents with mild to moderate Wernicke’s aphasia, with primary difficulties in auditory comprehension. During therapy, the clinician wants to incorporate communication strategies that support her understanding of verbal input. Patricia becomes frustrated when she misses information in conversations and often misinterprets longer or more complex utterances. The clinician’s goal is to build an environment and communication style that fosters optimal listening and comprehension success. 

Which of the following is not a factor that will promote better auditory comprehension in aphasia treatment?

a. The use of alerting stimuli before presenting the evoked stimulus

b. Repeating instructions and messages continuously

c. Speaking loudly to get the attention of the client

d. Pausing frequently when speaking, provides additional stress on key terms, and speaking at a slower rate

c. Speaking loudly to get the attention of the client

A 62-year-old patient is referred for evaluation following a left-hemisphere stroke. During the assessment, the patient exhibits inconsistent speech errors, visible groping during articulation, and disrupted prosody. Muscle tone and strength in the articulators are within normal limits. Based on these characteristics, a diagnosis of Apraxia of Speech (AOS) is considered.

What is the primary cause of Apraxia of Speech (AOS)?

a. Muscle weakness

b. Brain damage or injury

c. Genetic predisposition

d. Viral infections

b. Brain damage or injury

What is one of the main differences between neurogenic stuttering and stuttering of childhood onset?

a. Frequency of dysfluencies

b. Rapid speech rate

c. Adult onset

d. Repetitions of initial syllables

c. Adult onset

How does resonance contribute to speech acoustics?

a. It modifies laryngeal tone primarily.

b. It affects the speed of sound transmission.

c. It determines the fundamental frequency of speech.

d. It is responsible for compression and rarefaction phases.

a. It modifies laryngeal tone primarily.

An audiologist is explaining the protective mechanisms of the auditory system to a patient who experiences sensitivity to loud sounds. The audiologist describes how the auditory system has natural defenses to protect the inner ear from damage caused by intense noise. One of these mechanisms involves a reflexive contraction of a specific muscle in the middle ear in response to intense acoustic stimuli, such as loud sounds. This contraction helps dampen the movement of the ossicular chain, which is essential for transmitting sound vibrations from the eardrum to the inner ear. By reducing the movement of the ossicles, this muscle protects the sensitive structures of the inner ear, particularly the cochlea, from potential damage.

Which muscle in the middle ear helps reduce the vibrations of the ossicular chain in response to loud sounds?

a. Tensor tympani

b. Stapedius

c. Eustachian tube

d. Auricle

b. Stapedius

A school-aged child is referred for a speech-language evaluation due to inconsistent speech sound errors and groping behaviors when attempting to produce multisyllabic words. During assessment, the speech-language pathologist observes that the child has difficulty planning and sequencing speech movements, although muscle strength and tone appear normal. These signs suggest an impairment at the level of motor planning rather than execution. 

What is the term for the difficulty in programming the precise movements for speech in the absence of muscle weakness?

a. Dysarthria

b. Apraxia

c. Ankyloglossia

d. Stuttering

b. Apraxia

In a neuroanatomy review session, a graduate student preparing for a clinical rotation is asked to identify the structure that connects the two hemispheres of the cerebellum. The instructor explains that this central structure plays a vital role in postural control and coordination, particularly during locomotion and balance. Damage to this area can result in gait disturbances and poor motor coordination—features often evaluated in patients with ataxia or cerebellar dysfunction.

What is the name of the structure that bridges the two halves of the cerebellum?

a. Thalamus

b. Midbrain

c. Medulla

d. Vermis

d. Vermis

Lindsey is a high school teacher who also works as a coach for a local sports team. Recently, she’s noticed that some of her students and athletes struggle with understanding each other during group discussions and team meetings. In particular, they have difficulty following longer sentences, especially when ideas are not clearly separated. To improve communication, Lindsey begins to explain the importance of marking the boundaries between ideas in both verbal and written communication. In her explanation, she mentions that certain cues in speech help to clearly separate ideas and make speech easier to follow. She asks her students to identify which part of speech serves to mark divisions in spoken language, allowing listeners to understand the organization of ideas. 

Which of the following best describes the primary function of juncture in speech?

a. Marking special distinctions or grammatical divisions

b. Indicating pitch variations

c. Determining the intensity of speech

d. Controlling the rate of speech

a. Marking special distinctions or grammatical divisions

As part of a developmental language assessment with the parents of a 5-month-old infant, the clinician explains typical communication milestones that occur during the first year of life, emphasizing that the period between 4 to 6 months is especially important for early speech and language development. At this stage, infants begin to engage more actively with their environment through vocalizations, gestures, and responses to stimuli. These milestones reflect growing cognitive abilities and provide insight into developing communication skills. The clinician then asks the parents to identify which developmental milestone is expected between 4 and 6 months of age.

Which of the following milestones is typically achieved by a child between 4 and 6 months of age?

a. Using first true words

b. Comprehending “no”

c. Responding to name

d. Using variegated babbling

c. Responding to name

During a multidisciplinary assessment of a 62-year-old man named Leonard, a retired carpenter, the speech-language pathologist observes signs of dysarthria. Leonard has a soft, breathy voice, imprecise articulation, hypernasality, and significant nasal emission during speech. Neurological examination reveals damage to cranial nerves associated with speech production, particularly involving lower motor neuron pathways. Muscle tone is noticeably reduced, and fasciculations are visible in the tongue. 

Based on these findings, which type of dysarthria is most consistent with Leonard’s symptoms?

a. Spastic Dysarthria

b. Ataxic Dysarthria

c. Flaccid Dysarthria

d. Hyperkinetic Dysarthria

c. Flaccid Dysarthria

DeShawn, a 71-year-old retired school principal, is referred to you following a recent stroke that resulted in moderate nonfluent aphasia. As the evaluating clinician you review his medical records. It is revealed that DeShawn experienced an intracerebral hemorrhage, leading to immediate neurological deterioration and extended hospitalization in the ICU. In contrast, a separate patient with a comparable aphasia profile had experienced an ischemic stroke and showed a more stable acute course. You are tasked with developing individualized treatment plans and discussing prognostic expectations with the families of both patients. Considering the neuropathology of ischemic and hemorrhagic strokes, how do their immediate and long-term impacts on brain tissue and function differ?

What implications do these differences have for the prognosis and rehabilitation strategies for patients with aphasia resulting from these types of strokes?

a. Ischemic strokes lead to immediate widespread brain damage and poorer long-term prognosis, while hemorrhagic strokes cause localized brain damage with better recovery outcomes and fewer long-lasting deficits.

b. Hemorrhagic strokes cause immediate widespread damage with high mortality rates and poorer prognosis, while ischemic strokes cause localized damage with a better chance of recovery if treated promptly, affecting rehabilitation strategies for aphasia patients differently.

c. Both ischemic and hemorrhagic strokes cause similar brain damage and long-term impacts, leading to identical rehabilitation strategies for aphasia patients.

d. Ischemic strokes cause less severe immediate damage than hemorrhagic strokes, but both types lead to the same long-term deficits and recovery outcomes.

b. Hemorrhagic strokes cause immediate widespread damage with high mortality rates and poorer prognosis, while ischemic strokes cause localized damage with a better chance of recovery if treated promptly, affecting rehabilitation strategies for aphasia patients differently.

Which type of stroke is associated with a higher mortality rate?

a. Ischemic stroke

b. Hemorrhagic stroke

c. Transient ischemic stroke

d. Silent stroke

b. Hemorrhagic stroke

Patricia, a 58-year-old school principal, presents to the speech-language pathology clinic with complaints about her speech sounding “off” to others. Upon examination, the clinician observes slow rate, distorted sound substitutions, and disrupted prosody. While Patricia demonstrates relatively intact muscle strength and coordination for non-speech tasks, her speech lacks natural rhythm and melody. During differential diagnosis, the clinician considers both Apraxia of Speech (AOS) and dysarthria.

Which characteristic is common to both conditions and can help guide further assessment and treatment planning?

a. Consistent and predictable speech errors

b. Muscle weakness

c. Prosodic impairments

d. Difficulty with non-speech motor tasks

c. Prosodic impairments

Alex, a 22-year-old college student, works part-time as a stagehand for live concerts and frequently attends music festivals. He reports occasional ringing in his ears after events and sometimes has difficulty understanding conversations in noisy settings. He is unaware of the long-term risks associated with high-decibel environments and seeks guidance about how this lifestyle may affect his hearing and communication abilities. Considering the impact of sensorineural hearing loss on speech comprehension and production, how would prolonged exposure to high noise levels likely affect a young adult’s auditory processing and speech intelligibility, and what preventive measures should be taken?

a. Prolonged exposure to high noise levels would primarily affect low-frequency hearing, causing minimal impact on speech comprehension and production; using earplugs or earmuffs would be sufficient preventive measures.

b. Prolonged exposure to high noise levels would damage high-frequency hair cells in the cochlea, impairing the ability to understand high-frequency speech sounds and leading to difficulties in speech intelligibility; preventive measures include avoiding loud environments and using protective hearing devices.

c. Prolonged exposure to high noise levels would not significantly impact auditory processing and speech intelligibility as long as exposure is intermittent; preventive measures are unnecessary.

d. Prolonged exposure to high noise levels would enhance auditory processing abilities due to increased auditory stimulation; preventive measures should focus on maintaining exposure. 

b. Prolonged exposure to high noise levels would damage high-frequency hair cells in the cochlea, impairing the ability to understand high-frequency speech sounds and leading to difficulties in speech intelligibility; preventive measures include avoiding loud environments and using protective hearing devices.

A speech-language pathologist is teaching a group of graduate students about how language is organized and the rules that govern its use. The lesson highlights that language involves more than just communication—it includes how words are formed, how sentences are structured, how meaning is conveyed, and how sounds are produced. The students are then asked to identify the term that best represents the broad field of study that focuses on these aspects of language.

Which of the following terms best describes the broad field of study that examines language structure, word meanings, sentence construction, and sound patterns?

a. Phonology

b. Syntax

c. Semantics

d. Linguistics

d. Linguistics

Mr. and Mrs. Alvarez, whose 4-year-old son is receiving treatment for a speech-sound disorder, express an interest in understanding more about their child’s therapy techniques. After reading some phonetics materials online, Mrs. Alvarez asks the clinician, “What exactly are glides? I saw that term mentioned but couldn’t make sense of it.” The clinician takes the opportunity to educate the parents about speech sound classifications to help them better understand the focus of therapy and the types of sounds being targeted. You respond:

a. /l/ and /r/

b. /w/ and /j/

c. /s/ and /z/

d. /b/ and /p/

b. /w/ and /j/

A 40-year-old individual reports increased fatigue during daily activities and difficulty staying alert throughout the day. Following a neurological assessment, the physician explains that the reticular activating system (RAS) plays a critical role in regulating alertness and sleep-wake cycles. However, the RAS does not perform all functions related to brain arousal and processing.

Which of the following is not a function of the reticular activating system?

a. Controlling emotions and balance

b. Controlling sleep-wake cycles

c. Maintaining consciousness and alertness

d. Sending diffuse impulses to the cortex

d. Sending diffuse impulses to the cortext

A 35-year-old man presents to an audiologist reporting gradual hearing loss, particularly after years of working in construction without consistent use of ear protection. Audiometric testing reveals a bilateral high-frequency sensorineural hearing loss. 

Based on epidemiological data, what is the most likely cause of this type of hearing loss in young and middle-aged adults

a. Otitis media

b. Noise exposure

c. Genetic factors

d. Otosclerosis

b. Noise exposure

Dr. Alyssa Grant, a neurologist specializing in voice disorders, is giving a guest lecture to graduate students in a speech-language pathology program. She explains that producing voice involves more than just the vocal folds—it also requires precise coordination across multiple regions of the brain and specific cranial nerves. 

Which neuroanatomical structures are critical for optimal laryngeal function and voicing?

a. Cortical areas, cerebellum, and cranial nerves VII and X

b. Cortical areas, cerebellum, and cranial nerves I and V

c. Cerebellum, cranial nerves II and VI, and cortical areas

d. Cranial nerves I and V, cerebellum, and cortical areas

a. Cortical areas, cerebellum, and cranial nerves VII and X

Researchers using neuroimaging to study children with Specific Language Impairment (SLI) have identified structural and functional differences in regions associated with auditory processing and language comprehension. 

Which of the following brain areas are most often found to be atypical in children with SLI?

a. Occipital lobe and cerebellum

b. Heschl’s gyrus and planum temporale

c. Amygdala and hippocampus

d. Parietal lobe and thalamus

b. Heschl’s gyrus and planum temporale

During a speech sound assessment, a clinician observes that 3-year-old Layla consistently substitutes velar sounds for alveolar or fricative targets. For example, she says /ko/ instead of /so/, and /gʌn/ instead of /dʌn/. These substitutions involve producing sounds further back in the oral cavity than the target sound. 

What phonological process is Layla demonstrating?

a. coalescence

b. fronting

c. backing

d. epenthesis

c. backing

You are assigned a new pediatric client who underwent surgical repair for a cleft lip and palate within the first year of life. During your initial assessment, you observe that the child presents with unintelligible speech marked by distorted consonants, particularly in pressure sounds. The child demonstrates glottal stops and pharyngeal fricatives during attempts to produce high-pressure oral sounds such as /s/, /k/, and /p/. Given the medical history and the nature of the articulation errors, you suspect the child is using maladaptive speech patterns developed to compensate for structural deficits prior to surgical intervention.

Which of the following speech deviations would you expect as a result of the cleft lip and palate?

a. Hyponasal resonance of vowels and semivowels

b. Strong pressure consonants and increased intraoral air pressure

c. Lack of nasality in stops and fricatives

d. Compensatory articulatory gestures in the vocal tract

d. Compensatory articulatory gestures in the vocal tract

While reviewing treatment documentation, Marcus, a speech-language pathologist working in a pediatric outpatient clinic, is considering using a single-subject design (SSD) to monitor a client’s progress with a new phonological therapy. He is familiar with the general structure of SSDs and their ability to track individual progress over time. As he reflects on the terminology used in SSDs, he encounters the following question in his review materials:

Which of the following statements is not true about single-subject designs?

a. The A phase is the treatment phase.

b. They are useful in establishing treatment efficacy.

c. The multiple-baseline design avoids the disadvantage of treatment withdrawal.

d. A disadvantage of single-subject designs is that they cannot efficiently predict the behavior of groups of individuals.

a. The A phase is the treatment phase

In a speech-language therapy session, Angela, a speech-language pathologist, is working with Lucas, a 7-year-old child who is struggling with morphological development. Lucas has difficulty modifying words to express more complex meanings, such as turning a verb into a noun or adjusting the tense of a word. Angela is helping him understand how morphemes, the smallest units of meaning in language, work. She explains that some morphemes are derivational in nature, which means they can be added to a base word to change its meaning or part of speech. Angela then asks Lucas and his parents to identify the purpose of these types of morphemes that can modify the structure of a word to create a new meaning.

What is the function of derivational morphemes?

a. To modify word structures to change meaning

b. To denote variations of morphemes

c. To change the state of a free morpheme

d. To increase the precision of a free morpheme

a. To modify word structures to change meaning

A 55-year-old patient presents with reduced speech intelligibility. Clinical examination reveals a speech pattern marked by visible effort, inconsistent articulatory errors (especially distorted substitutions and occasional omissions), and disrupted prosody, including abnormal stress and intonation. The rate of speech is slowed due to difficulty planning and initiating movements for speech. Oral motor abilities are intact during non-speech tasks, and muscle strength is within functional limits. Repeated attempts to produce certain words result in increased difficulty and error variability. 

Which speech disorder is primarily characterized by these features?

a. Dysarthria

b. Aphasia

c. Apraxia of Speech (AOS)

d. Nonverbal Oral Apraxia

c. Apraxia of Speech (AOS)

Dr. Moore, an early intervention specialist, is reviewing current data on language outcomes in children diagnosed with Autism Spectrum Disorder (ASD). Dr. Moore notes that a significant portion of these children do not go on to develop functional natural speech, making augmentative and alternative communication (AAC) systems critical for intervention.

Based on current estimates, what percentage of children with autism fall into this group?

a. 5%-10%

b. 15%-25%

c. 20%-50%

d. 60%-70%

c. 20%-50%

Dr. Perry, a clinical psychologist, is collaborating with a speech-language pathologist to evaluate a 7-year-old child with persistent difficulties in understanding and using spoken language. The child’s deficits are not attributable to intellectual disability, hearing loss, or other neurological conditions. In documenting the diagnosis for insurance and educational services, Dr. Perry refers to the terminology outlined in the DSM-5. 

Which of the following is the correct term used in the DSM-5 to describe this condition?

a. Language delay

b. Specific language impairment (SLI)

c. Developmental language disorder (DLD)

d. Language disorder

d. Language Disorder

A developmental psychologist is assessing a 9-month-old infant and observes that the infant has begun to show interest in toys that are briefly hidden from view. The psychologist explains to the parents that this behavior is a significant milestone in cognitive development, known as object permanence. This concept refers to a child’s understanding that objects continue to exist even when they cannot be seen, heard, or touched. The parents are curious about when infants typically begin to demonstrate this cognitive ability. 

Which of the following milestones marks the beginning of object permanence in infants?

a. Responding to name

b. Understanding simple directions

c. Uncovers hidden toy

d. Variegated babbling

c. Uncovers hidden toy

A speech-language pathologist is working with a 3-year-old child who is beginning to combine words in speech. The child’s caregivers are interested in learning about the types of word combinations typically used at this stage. The pathologist introduces the concept of an entity + locative combination, where a noun (the entity) is paired with a location (the locative). 

Which of the following combinations is an example of an entity + locative?

a. that chair

b. more juice

c. jump [on] bed

d. juice [in] glass

d. juice [in] glass

In speech acoustics, the shape and configuration of the vocal tract, including the pharynx, oral cavity, and nasal passages, play a crucial role in shaping the sound produced by the vibrating vocal folds. This process is known as resonance and is essential for amplifying certain frequencies while dampening others. The way the vocal tract shapes and filters sound is what gives speech its unique quality and contributes to its intelligibility. Resonance is responsible for emphasizing some parts of the sound spectrum (such as formants for vowels) while attenuating others. 

In the context of speech production, what role does resonance play in shaping speech sounds?

a. It modifies laryngeal tone primarily.

b.It affects the speed of sound transmission.

c. It determines the fundamental frequency of speech.

d. It is responsible for compression and rarefaction phases.

a. It modifies laryngeal tone primarily

During a graduate-level head and neck anatomy seminar, a speech-language pathology student is reviewing the muscles involved in swallowing and voice production. The instructor highlights the role of muscles above and below the hyoid bone in laryngeal movement. While discussing the infrahyoid muscles, which lie below the hyoid and contribute to laryngeal depression during the final phase of swallowing, the instructor asks:

Which cranial nerve provides motor innervation to the infrahyoid muscles?

a. Cranial nerve V

b. Cranial nerve VII

c. Cranial nerve X

d. Cranial nerve XII

d. Cranial nerve XII