Transcript & Exam Bundle Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed Rationales |
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Section A: Client Background & Clinical Profile (10 Questions)
Q1: Don is a 59-year-old male receiving outpatient speech-language pathology services.
His medical history includes stroke(s) resulting in Broca's aphasia. Which statement
BEST characterizes his primary communication profile?
A. Fluent, paraphasic speech with poor comprehension
B. Non-fluent, effortful speech with relatively intact auditory comprehension [CORRECT]
C. Global loss of all language modalities with severe comprehension deficits
D. Isolated word-finding deficits with normal grammar and prosody
Correct Answer: B
Rationale: Broca's aphasia is characterized by non-fluent, agrammatic, effortful speech
production with relatively preserved auditory comprehension. Option A describes
Wernicke's aphasia; C describes global aphasia; D describes anomic aphasia. Simucase
best practice: Accurate diagnosis guides functional intervention selection.
Q2: During the intake interview, Don's wife reports that he has difficulty hearing,
especially in noisy environments. In addition to his hearing concerns, Don also presents
with significant visual impairments. Which visual deficit is documented in his clinical
profile?
A. Complete bilateral blindness
B. No sight on the right side with macular degeneration [CORRECT]
,C. Cortical visual impairment affecting central vision only
D. Diplopia and ptosis of the left eye
Correct Answer: B
Rationale: Don's clinical profile documents right-sided visual field loss and macular
degeneration, which are critical considerations when selecting visual supports and
positioning materials. Complete blindness (A), cortical impairment (C), and
diplopia/ptosis (D) are not documented. Simucase best practice: Sensory deficits
determine material modifications and seating arrangements.
Q3: Don reports that "My pain controls everything" and identifies chronic back pain as a
major barrier to participation. How should the SLP BEST integrate this information into
the clinical plan?
A. Discharge Don from therapy until his pain is completely resolved
B. Schedule shorter sessions, allow position changes, and embed pain management
strategies into the therapy plan [CORRECT]
C. Ignore the pain reports and focus exclusively on language tasks to maintain
therapeutic intensity
D. Refer Don to physical therapy only and defer all communication intervention
Correct Answer: B
Rationale: Chronic pain must be accommodated through flexible scheduling,
positioning, and pacing to maximize Don's engagement and therapeutic benefit.
Discharge (A) or deferral (D) denies indicated services; ignoring pain (C) violates
client-centered care principles. Simucase best practice: Pain is a contextual factor that
requires environmental and procedural modifications.
,Q4: Don's coping strategies for his communication difficulties and pain are described as
primarily involving isolation and avoidance. Which psychosocial factor should the SLP
prioritize addressing during the therapeutic alliance-building phase?
A. Immediate pharmacologic management of depression
B. Anxiety and frustration related to communication breakdown [CORRECT]
C. Complete resolution of his sleep disturbance before therapy begins
D. Family conflict resolution unrelated to his aphasia
Correct Answer: B
Rationale: Anxiety and frustration are directly linked to Don's communication disability
and are within the SLP's scope to address through counseling, rapport building, and
success-oriented activities. Pharmacologic management (A) is outside SLP scope;
deferring therapy for sleep (C) is unnecessary; unrelated family conflict (D) is not the
priority. Simucase best practice: Addressing emotional responses to disability fosters
therapeutic engagement.
Q5: Don's long-term goals include holding a job and increasing public awareness about
aphasia. According to client-centered practice principles, how should the SLP use this
information?
A. Dismiss employment goals as unrealistic given his diagnosis
B. Use these goals to guide functional, participation-based intervention targeting
vocational communication and advocacy skills [CORRECT]
C. Focus only on impairment-level naming tasks and defer goal discussion until
discharge
D. Substitute the family's goals for Don's stated priorities
Correct Answer: B
Rationale: Client-centered practice requires that intervention be driven by the patient's
own priorities; Don's employment and advocacy goals should directly inform functional
, activity selection. Dismissing goals (A) or substituting family goals (D) violates
autonomy; deferring goal discussion (C) is non-collaborative. Simucase best practice:
Goals must reflect the patient's life participation priorities.
Q6: During the initial session, Don indicates that he wants to improve his ability to
communicate with "important people" in his life. Which assessment domain is MOST
relevant to this priority?
A. Standardized single-word confrontation naming tests only
B. Functional communication assessment with his identified communication partners
[CORRECT]
C. Comprehensive neuropsychological testing for dementia screening
D. Pure-tone audiometry without speech recognition measures
Correct Answer: B
Rationale: Don's priority involves communicative participation with significant others; a
functional communication assessment examines real-world interactions with these
partners. Single-word tests (A) are insufficiently contextual; dementia screening (C) is
not indicated; audiometry alone (D) does not address interaction. Simucase best
practice: Partner-inclusive assessment aligns with the ICF framework.
Q7: Don's wife is identified as a significant communication partner. What is the
PRIMARY rationale for involving her in the therapeutic process?
A. To translate for Don when he cannot express himself
B. To provide training in supportive communication strategies and enhance the home
communication environment [CORRECT]
C. To serve as the primary decision-maker for all therapeutic goals
D. To document Don's deficits for insurance authorization purposes
Correct Answer: B