**NORTH CAROLINA SPEECH LANGUAGE PATHOLOGY EXAM –QUESTIONS AND CORRECT ANSWE
*Core Domains*
*• Speech Sound Disorders and Phonology*
*• Voice and Resonance Alterations*
*• Fluency and Stuttering Management*
*• Receptive and Expressive Language Disorders*
*• Cognitive-Communication Aspects*
*• Dysphagia and Feeding Assessment*
*• Augmentative and Alternative Communication*
*• Professional Issues, Ethics, and NC Rules*
*Introduction*
The purpose of this comprehensive assessment is to evaluate the clinical
competency, foundational knowledge, and ethical decision-making skills required for
speech-language pathologists seeking licensure in North Carolina. This examination
covers critical domains including diagnostic procedures, intervention planning, and
regulatory compliance. It utilizes multiple-choice and complex, scenario-based
questions designed to simulate real-world clinical practices across pediatric,
educational, and medical settings. Candidates must apply advanced critical thinking,
,evidence-based practices, and regulatory awareness to navigate clinical dilemmas,
accurately analyze diagnostic profiles, and ensure high-quality, patient-centered care
in accordance with state and national standards.
Question 1
A 4-year-old child demonstrates consistent backing of alveolar stops /t/ and /d/ to /k/
and /g/. Which of the following initial targets is most appropriate for a phonological
intervention utilizing a minimal pairs approach?
A. /k/ vs. /g/
B. /t/ vs. /k/
C. /s/ vs. /t/
D. /p/ vs. /t/
🟢 B. /t/ vs. /k/
🔴 RATIONALE: The child exhibits the phonological process of backing, where
alveolar sounds are replaced by velar sounds. A minimal pairs approach targets the
contrast between the error pattern and the target sound to eliminate the homonymy.
,Contrasting /t/ and /k/ directly addresses the alveolar/velar distinction that is missing
in the child's phonological system.
Question 2
Under North Carolina Board of Examiners for Speech and Language Pathologists
rules, how many hours of continuing education must a licensed speech-language
pathologist complete during each annual licensure renewal period?
A. 10 hours
B. 15 hours
C. 20 hours
D. 30 hours
🟢 B. 15 hours
🔴 RATIONALE: North Carolina administrative code specifies that licensed speech-
language pathologists must complete a minimum of 15 hours of approved continuing
education (CE) activities during each annual license renewal cycle to maintain an
active license.
, Question 3
An 82-year-old patient in a skilled nursing facility presents with a severe flaccid
dysarthria following a brainstem stroke. Which of the following speech characteristics
is most likely to be observed during a perceptual speech evaluation?
A. Strained-strangled voice quality and slow rate
B. Hypernasality, breathiness, and nasal emission
C. Irregular articulatory breakdowns and variable rate
D. Excess and equal stress with prolonged phonemes
🟢 B. Hypernasality, breathiness, and nasal emission
🔴 RATIONALE: Flaccid dysarthria results from damage to the lower motor neurons,
causing weakness, hypotonia, and diminished reflexes. Hypernasality, breathiness,
and nasal emission are classic perceptual characteristics due to weakness of the
velopharyngeal valve and laryngeal musculature. Strained quality is typical of spastic
dysarthria, while irregular breakdowns signify ataxic dysarthria.
Question 4
*Core Domains*
*• Speech Sound Disorders and Phonology*
*• Voice and Resonance Alterations*
*• Fluency and Stuttering Management*
*• Receptive and Expressive Language Disorders*
*• Cognitive-Communication Aspects*
*• Dysphagia and Feeding Assessment*
*• Augmentative and Alternative Communication*
*• Professional Issues, Ethics, and NC Rules*
*Introduction*
The purpose of this comprehensive assessment is to evaluate the clinical
competency, foundational knowledge, and ethical decision-making skills required for
speech-language pathologists seeking licensure in North Carolina. This examination
covers critical domains including diagnostic procedures, intervention planning, and
regulatory compliance. It utilizes multiple-choice and complex, scenario-based
questions designed to simulate real-world clinical practices across pediatric,
educational, and medical settings. Candidates must apply advanced critical thinking,
,evidence-based practices, and regulatory awareness to navigate clinical dilemmas,
accurately analyze diagnostic profiles, and ensure high-quality, patient-centered care
in accordance with state and national standards.
Question 1
A 4-year-old child demonstrates consistent backing of alveolar stops /t/ and /d/ to /k/
and /g/. Which of the following initial targets is most appropriate for a phonological
intervention utilizing a minimal pairs approach?
A. /k/ vs. /g/
B. /t/ vs. /k/
C. /s/ vs. /t/
D. /p/ vs. /t/
🟢 B. /t/ vs. /k/
🔴 RATIONALE: The child exhibits the phonological process of backing, where
alveolar sounds are replaced by velar sounds. A minimal pairs approach targets the
contrast between the error pattern and the target sound to eliminate the homonymy.
,Contrasting /t/ and /k/ directly addresses the alveolar/velar distinction that is missing
in the child's phonological system.
Question 2
Under North Carolina Board of Examiners for Speech and Language Pathologists
rules, how many hours of continuing education must a licensed speech-language
pathologist complete during each annual licensure renewal period?
A. 10 hours
B. 15 hours
C. 20 hours
D. 30 hours
🟢 B. 15 hours
🔴 RATIONALE: North Carolina administrative code specifies that licensed speech-
language pathologists must complete a minimum of 15 hours of approved continuing
education (CE) activities during each annual license renewal cycle to maintain an
active license.
, Question 3
An 82-year-old patient in a skilled nursing facility presents with a severe flaccid
dysarthria following a brainstem stroke. Which of the following speech characteristics
is most likely to be observed during a perceptual speech evaluation?
A. Strained-strangled voice quality and slow rate
B. Hypernasality, breathiness, and nasal emission
C. Irregular articulatory breakdowns and variable rate
D. Excess and equal stress with prolonged phonemes
🟢 B. Hypernasality, breathiness, and nasal emission
🔴 RATIONALE: Flaccid dysarthria results from damage to the lower motor neurons,
causing weakness, hypotonia, and diminished reflexes. Hypernasality, breathiness,
and nasal emission are classic perceptual characteristics due to weakness of the
velopharyngeal valve and laryngeal musculature. Strained quality is typical of spastic
dysarthria, while irregular breakdowns signify ataxic dysarthria.
Question 4
