Michigan Speech-Language Pathology
Advanced Exam Practice Questions And
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1. A 45-year-old patient presents with progressive difficulty in
swallowing and frequent choking episodes. Which cranial nerve is
primarily implicated in oropharyngeal dysphagia?
A. Optic nerve (CN II)
B. Facial nerve (CN VII)
C. Glossopharyngeal nerve (CN IX)
D. Hypoglossal nerve (CN XII)
Rationale: The glossopharyngeal nerve (CN IX) provides sensory
innervation to the oropharynx and contributes to the swallowing
reflex, making it critical in oropharyngeal dysphagia.
2. In assessing a child with suspected phonological disorder, which
standardized test is most appropriate for evaluating speech sound
production in connected speech?
A. Peabody Picture Vocabulary Test
B. Clinical Evaluation of Language Fundamentals
C. Goldman-Fristoe Test of Articulation-3 (GFTA-3)
D. Test of Pragmatic Language
Rationale: The GFTA-3 is specifically designed to assess articulation
and phonological patterns in connected speech, making it the
preferred tool for phonological disorder evaluation.
,3. Which neuroimaging finding is most commonly associated with
Broca’s aphasia following a stroke?
A. Bilateral temporal lobe atrophy
B. Lesion in the left inferior frontal gyrus
C. Lesion in the right parietal lobe
D. Cerebellar vermis degeneration
Rationale: Broca’s aphasia typically results from damage to the left
inferior frontal gyrus, leading to nonfluent, effortful speech while
comprehension remains relatively intact.
4. When performing a videofluoroscopic swallow study, a patient
demonstrates nasal regurgitation during liquid intake. Which
structural or functional deficit is most likely?
A. Esophageal stricture
B. Velopharyngeal insufficiency
C. Vocal fold paresis
D. Cricopharyngeal dysfunction
Rationale: Nasal regurgitation occurs when the soft palate fails to
close properly against the posterior pharyngeal wall, indicating
velopharyngeal insufficiency.
5. In patients with amyotrophic lateral sclerosis (ALS), which speech
characteristic is most commonly observed early in disease
progression?
A. Hypernasality with intact articulation
B. Spastic dysarthria with slow, strained speech
C. Fluent speech with word-finding difficulties
D. Pure apraxia of speech
Rationale: ALS often leads to upper motor neuron involvement
causing spastic dysarthria, which manifests as slow, strained, and
effortful speech early in progression.
6. During an evaluation of a patient with suspected apraxia of speech,
which feature best distinguishes it from dysarthria?
A. Weakness of articulators
B. Hypernasality
C. Inconsistent errors on repeated productions
D. Slurred, monotone speech
, Rationale: Apraxia of speech is characterized by inconsistent
articulatory errors despite intact strength, contrasting with
dysarthria where errors are consistent due to motor weakness.
7. Which treatment approach is most evidence-based for improving
expressive language in a child with semantic-pragmatic disorder?
A. Oral motor exercises
B. Phoneme discrimination drills
C. Social communication and script-based interventions
D. Hearing amplification
Rationale: Children with semantic-pragmatic disorders benefit most
from interventions targeting social communication, turn-taking, and
contextual language use, rather than isolated articulation or
phonological exercises.
8. A patient with right hemisphere damage presents with flat affect,
impaired prosody, and difficulty understanding jokes. Which
communication deficit is most likely?
A. Broca’s aphasia
B. Wernicke’s aphasia
C. Conduction aphasia
D. Right hemisphere communication disorder
Rationale: Right hemisphere damage often results in pragmatic and
prosodic deficits, including impaired affective expression, figurative
language comprehension, and discourse cohesion.
9. When using the Lee Silverman Voice Treatment (LSVT) approach for
Parkinson’s disease, the primary target is:
A. Articulation accuracy
B. Vocal loudness and breath support
C. Prosodic modulation
D. Swallowing coordination
Rationale: LSVT focuses on increasing vocal loudness through high-
effort vocal exercises, which also improves respiratory support and
phonatory function in Parkinson’s patients.
10. Which type of hearing loss most commonly co-occurs with
speech sound disorders in children?
A. Central auditory processing disorder
Advanced Exam Practice Questions And
Correct Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
1. A 45-year-old patient presents with progressive difficulty in
swallowing and frequent choking episodes. Which cranial nerve is
primarily implicated in oropharyngeal dysphagia?
A. Optic nerve (CN II)
B. Facial nerve (CN VII)
C. Glossopharyngeal nerve (CN IX)
D. Hypoglossal nerve (CN XII)
Rationale: The glossopharyngeal nerve (CN IX) provides sensory
innervation to the oropharynx and contributes to the swallowing
reflex, making it critical in oropharyngeal dysphagia.
2. In assessing a child with suspected phonological disorder, which
standardized test is most appropriate for evaluating speech sound
production in connected speech?
A. Peabody Picture Vocabulary Test
B. Clinical Evaluation of Language Fundamentals
C. Goldman-Fristoe Test of Articulation-3 (GFTA-3)
D. Test of Pragmatic Language
Rationale: The GFTA-3 is specifically designed to assess articulation
and phonological patterns in connected speech, making it the
preferred tool for phonological disorder evaluation.
,3. Which neuroimaging finding is most commonly associated with
Broca’s aphasia following a stroke?
A. Bilateral temporal lobe atrophy
B. Lesion in the left inferior frontal gyrus
C. Lesion in the right parietal lobe
D. Cerebellar vermis degeneration
Rationale: Broca’s aphasia typically results from damage to the left
inferior frontal gyrus, leading to nonfluent, effortful speech while
comprehension remains relatively intact.
4. When performing a videofluoroscopic swallow study, a patient
demonstrates nasal regurgitation during liquid intake. Which
structural or functional deficit is most likely?
A. Esophageal stricture
B. Velopharyngeal insufficiency
C. Vocal fold paresis
D. Cricopharyngeal dysfunction
Rationale: Nasal regurgitation occurs when the soft palate fails to
close properly against the posterior pharyngeal wall, indicating
velopharyngeal insufficiency.
5. In patients with amyotrophic lateral sclerosis (ALS), which speech
characteristic is most commonly observed early in disease
progression?
A. Hypernasality with intact articulation
B. Spastic dysarthria with slow, strained speech
C. Fluent speech with word-finding difficulties
D. Pure apraxia of speech
Rationale: ALS often leads to upper motor neuron involvement
causing spastic dysarthria, which manifests as slow, strained, and
effortful speech early in progression.
6. During an evaluation of a patient with suspected apraxia of speech,
which feature best distinguishes it from dysarthria?
A. Weakness of articulators
B. Hypernasality
C. Inconsistent errors on repeated productions
D. Slurred, monotone speech
, Rationale: Apraxia of speech is characterized by inconsistent
articulatory errors despite intact strength, contrasting with
dysarthria where errors are consistent due to motor weakness.
7. Which treatment approach is most evidence-based for improving
expressive language in a child with semantic-pragmatic disorder?
A. Oral motor exercises
B. Phoneme discrimination drills
C. Social communication and script-based interventions
D. Hearing amplification
Rationale: Children with semantic-pragmatic disorders benefit most
from interventions targeting social communication, turn-taking, and
contextual language use, rather than isolated articulation or
phonological exercises.
8. A patient with right hemisphere damage presents with flat affect,
impaired prosody, and difficulty understanding jokes. Which
communication deficit is most likely?
A. Broca’s aphasia
B. Wernicke’s aphasia
C. Conduction aphasia
D. Right hemisphere communication disorder
Rationale: Right hemisphere damage often results in pragmatic and
prosodic deficits, including impaired affective expression, figurative
language comprehension, and discourse cohesion.
9. When using the Lee Silverman Voice Treatment (LSVT) approach for
Parkinson’s disease, the primary target is:
A. Articulation accuracy
B. Vocal loudness and breath support
C. Prosodic modulation
D. Swallowing coordination
Rationale: LSVT focuses on increasing vocal loudness through high-
effort vocal exercises, which also improves respiratory support and
phonatory function in Parkinson’s patients.
10. Which type of hearing loss most commonly co-occurs with
speech sound disorders in children?
A. Central auditory processing disorder
