Wgu D574 Hlth 4360 Neuropsychology Bs Psychology Study
Guide Original Practice Questions And Answer With Rationales
This exam assesses mastery of neuroanatomy and the functional organization of the nervous system, emphasizing
structure-function relationships, clinical lesion analysis, vascular territories, and systems-level integration.
Questions require synthesis across neuroanatomical pathways, developmental and pathological alterations, and
applied clinical reasoning at the level of a rigorous university neuropsychology course. It contains 98
multiple-choice questions, each with four distractors and a fully worked rationale that explains why the keyed
answer is correct. Content is organized into 12 focused sections: Neuroanatomy and Functional Organization of
the Nervous System, Neurons, Neurotransmission, and Neurophysiology, Neuropsychological Assessment and Test
Interpretation, Neuroimaging and Other Diagnostic Methods, Lateralization, Hemispheric Specialization, and
Split-Brain Research, Memory Systems and Amnesic Disorders, Language and Aphasia, Executive Function,
Attention, and Frontal Lobe Disorders, Visuospatial, Perceptual, and Agnosic Disorders, Neuropsychological
Rehabilitation and Recovery, Neurodevelopmental and Neurodegenerative Disorders, Research Methods, Ethics,
and Psychometrics in Neuropsychology. Targeted learning outcomes include: Analyze how focal lesions and
disconnection syndromes reveal functional neural systems.; Map vascular territories and explain selective
vulnerability of brain regions to ischemia.; Integrate knowledge of neurotransmitter systems, cortical-subcortical
loops, and plasticity in clinical contexts.. Every item has been reviewed for clinical accuracy, current guidelines,
Section 1: Neuroanatomy and Functional Organization of the Nervous System (Questions 1-9)
1 A patient shows left-sided tactile extinction and hemispatial neglect after a
right hemisphere stroke. Which vascular territory is most implicated?
A) Right anterior cerebral artery (ACA)
B) Right middle cerebral artery (MCA)
C) Right posterior cerebral artery (PCA)
D) Right posterior inferior cerebellar artery (PICA)
Answer: B
Rationale: Right MCA infarction commonly damages the inferior parietal
lobule and temporoparietal junction, producing contralateral neglect and
extinction. ACA and PCA territories are less associated with these signs, and
PICA affects cerebellum/lateral medulla.
2 Which basal ganglia circuit dysfunction best explains the cognitive and
affective symptoms in Huntington's disease?
A) Direct pathway overactivity causing hyperkinesia
B) Indirect pathway degeneration leading to disinhibition of thalamocortical
loops
C) Nigrostriatal dopamine excess producing rigidity
D) Cerebellar-thalamic dysregulation of motor timing
,Answer: B
Rationale: Huntington's disease primarily involves loss of striatal medium spiny
neurons in the indirect pathway, reducing inhibition of the thalamus and
disrupting frontal-subcortical circuits that mediate cognition and affect. Direct
pathway overactivity and dopamine excess do not match the pathophysiology.
3 A patient has intact recognition of objects but cannot reach accurately under
visual guidance. Which pathway is disrupted?
A) Ventral 'what' stream from occipital to temporal cortex
B) Dorsal 'how' stream from occipital to posterior parietal cortex
C) Ventral stream from occipital to inferior temporal cortex
D) Medial temporal lobe memory circuit
Answer: B
Rationale: Optic ataxia results from damage to the dorsal visual stream
(occipitoparietal), which supports visually guided action. The ventral stream
supports object recognition, and medial temporal circuits support memory.
4 Which brain region is most selectively vulnerable to hypoxic-ischemic injury
due to high metabolic demand and glutamate receptor density?
A) Precentral gyrus
B) Hippocampal CA1 sector
C) Globus pallidus
D) Cerebellar white matter
Answer: B
Rationale: CA1 pyramidal neurons of the hippocampus have high densities of
NMDA receptors and are highly vulnerable to excitotoxic injury after
hypoxia-ischemia. Other regions listed are less selectively vulnerable.
5 A patient with a thalamic stroke shows fluent speech but poor
comprehension and repetition. Which thalamic nucleus is most likely
involved?
A) Ventral posterior lateral nucleus
B) Anterior nucleus
C) Pulvinar
D) Mediodorsal nucleus
Answer: C
,Rationale: The pulvinar, especially the left, connects with posterior language
areas; lesions can produce a fluent aphasia with impaired comprehension and
repetition. Ventral posterior lateral nucleus is somatosensory, anterior nucleus
is limbic, and mediodorsal is prefrontal.
6 Which neurotransmitter system degeneration best accounts for the early
REM sleep behavior disorder in prodromal Parkinson's disease?
A) Dopaminergic nigrostriatal pathway
B) Cholinergic basal forebrain system
C) Noradrenergic locus coeruleus system
D) Serotonergic raphe nuclei
Answer: C
Rationale: REM sleep behavior disorder in prodromal Parkinson's disease is
linked to early degeneration of the locus coeruleus noradrenergic system and
associated brainstem circuits. Nigrostriatal dopamine loss occurs later, and
cholinergic/serotonergic changes are less specifically tied to this symptom.
7 A patient develops alexia without agraphia after a left PCA stroke. Which
additional structure is typically spared to allow writing?
A) Left angular gyrus
B) Splenium of the corpus callosum
C) Left primary visual cortex
D) Left postcentral gyrus
Answer: A
Rationale: Alexia without agraphia results from left PCA infarction damaging
the left occipital lobe and splenium, disconnecting visual word forms from
language areas; writing is preserved because the left angular gyrus and
language output areas remain intact. Splenium and visual cortex are typically
damaged, not spared.
8 Which cerebellar region is most critical for cognitive and affective
modulation, rather than motor coordination?
A) Anterior lobe
B) Posterior lobe (neocerebellum)
C) Vestibulocerebellum
D) Spinocerebellum
, Answer: B
Rationale: The posterior lobe (neocerebellum) connects with prefrontal and
parietal association cortices and is implicated in cerebellar cognitive affective
syndrome. Anterior lobe and spinocerebellum are mainly sensorimotor, and
vestibulocerebellum supports balance and eye movements.
9 Which cortical area is the primary target of thalamic input for conscious
proprioception and discriminative touch?
A) Postcentral gyrus
B) Precentral gyrus
C) Superior temporal gyrus
D) Cingulate gyrus
Answer: A
Rationale: The postcentral gyrus (primary somatosensory cortex) receives
thalamic (VPL) projections carrying proprioception and discriminative touch.
Precentral gyrus is motor, superior temporal is auditory, and cingulate is
limbic.
Section 2: Neurons, Neurotransmission, and Neurophysiology (Questions 10-18)
10 A neuron with a resting membrane potential of -70 mV is exposed to a
toxin that selectively blocks voltage-gated K+ channels. What is the most
likely immediate effect on the action potential?
A) Prolonged depolarization and inability to repolarize
B) Increased amplitude of the action potential
C) Immediate failure to reach threshold
D) Enhanced frequency of action potentials
Answer: A
Rationale: Voltage-gated K+ channels mediate repolarization; blocking them
delays return to resting potential, prolonging depolarization. They do not affect
the initial depolarization (Na+ channels) or threshold directly, and increased
amplitude or frequency would not occur without repolarization.
11 Which mechanism best explains the therapeutic lag (2-4 weeks) for SSRIs
in treating depression despite immediate serotonin reuptake inhibition?
A) Downregulation of presynaptic 5-HT1A autoreceptors and subsequent
increase in serotonergic firing
Guide Original Practice Questions And Answer With Rationales
This exam assesses mastery of neuroanatomy and the functional organization of the nervous system, emphasizing
structure-function relationships, clinical lesion analysis, vascular territories, and systems-level integration.
Questions require synthesis across neuroanatomical pathways, developmental and pathological alterations, and
applied clinical reasoning at the level of a rigorous university neuropsychology course. It contains 98
multiple-choice questions, each with four distractors and a fully worked rationale that explains why the keyed
answer is correct. Content is organized into 12 focused sections: Neuroanatomy and Functional Organization of
the Nervous System, Neurons, Neurotransmission, and Neurophysiology, Neuropsychological Assessment and Test
Interpretation, Neuroimaging and Other Diagnostic Methods, Lateralization, Hemispheric Specialization, and
Split-Brain Research, Memory Systems and Amnesic Disorders, Language and Aphasia, Executive Function,
Attention, and Frontal Lobe Disorders, Visuospatial, Perceptual, and Agnosic Disorders, Neuropsychological
Rehabilitation and Recovery, Neurodevelopmental and Neurodegenerative Disorders, Research Methods, Ethics,
and Psychometrics in Neuropsychology. Targeted learning outcomes include: Analyze how focal lesions and
disconnection syndromes reveal functional neural systems.; Map vascular territories and explain selective
vulnerability of brain regions to ischemia.; Integrate knowledge of neurotransmitter systems, cortical-subcortical
loops, and plasticity in clinical contexts.. Every item has been reviewed for clinical accuracy, current guidelines,
Section 1: Neuroanatomy and Functional Organization of the Nervous System (Questions 1-9)
1 A patient shows left-sided tactile extinction and hemispatial neglect after a
right hemisphere stroke. Which vascular territory is most implicated?
A) Right anterior cerebral artery (ACA)
B) Right middle cerebral artery (MCA)
C) Right posterior cerebral artery (PCA)
D) Right posterior inferior cerebellar artery (PICA)
Answer: B
Rationale: Right MCA infarction commonly damages the inferior parietal
lobule and temporoparietal junction, producing contralateral neglect and
extinction. ACA and PCA territories are less associated with these signs, and
PICA affects cerebellum/lateral medulla.
2 Which basal ganglia circuit dysfunction best explains the cognitive and
affective symptoms in Huntington's disease?
A) Direct pathway overactivity causing hyperkinesia
B) Indirect pathway degeneration leading to disinhibition of thalamocortical
loops
C) Nigrostriatal dopamine excess producing rigidity
D) Cerebellar-thalamic dysregulation of motor timing
,Answer: B
Rationale: Huntington's disease primarily involves loss of striatal medium spiny
neurons in the indirect pathway, reducing inhibition of the thalamus and
disrupting frontal-subcortical circuits that mediate cognition and affect. Direct
pathway overactivity and dopamine excess do not match the pathophysiology.
3 A patient has intact recognition of objects but cannot reach accurately under
visual guidance. Which pathway is disrupted?
A) Ventral 'what' stream from occipital to temporal cortex
B) Dorsal 'how' stream from occipital to posterior parietal cortex
C) Ventral stream from occipital to inferior temporal cortex
D) Medial temporal lobe memory circuit
Answer: B
Rationale: Optic ataxia results from damage to the dorsal visual stream
(occipitoparietal), which supports visually guided action. The ventral stream
supports object recognition, and medial temporal circuits support memory.
4 Which brain region is most selectively vulnerable to hypoxic-ischemic injury
due to high metabolic demand and glutamate receptor density?
A) Precentral gyrus
B) Hippocampal CA1 sector
C) Globus pallidus
D) Cerebellar white matter
Answer: B
Rationale: CA1 pyramidal neurons of the hippocampus have high densities of
NMDA receptors and are highly vulnerable to excitotoxic injury after
hypoxia-ischemia. Other regions listed are less selectively vulnerable.
5 A patient with a thalamic stroke shows fluent speech but poor
comprehension and repetition. Which thalamic nucleus is most likely
involved?
A) Ventral posterior lateral nucleus
B) Anterior nucleus
C) Pulvinar
D) Mediodorsal nucleus
Answer: C
,Rationale: The pulvinar, especially the left, connects with posterior language
areas; lesions can produce a fluent aphasia with impaired comprehension and
repetition. Ventral posterior lateral nucleus is somatosensory, anterior nucleus
is limbic, and mediodorsal is prefrontal.
6 Which neurotransmitter system degeneration best accounts for the early
REM sleep behavior disorder in prodromal Parkinson's disease?
A) Dopaminergic nigrostriatal pathway
B) Cholinergic basal forebrain system
C) Noradrenergic locus coeruleus system
D) Serotonergic raphe nuclei
Answer: C
Rationale: REM sleep behavior disorder in prodromal Parkinson's disease is
linked to early degeneration of the locus coeruleus noradrenergic system and
associated brainstem circuits. Nigrostriatal dopamine loss occurs later, and
cholinergic/serotonergic changes are less specifically tied to this symptom.
7 A patient develops alexia without agraphia after a left PCA stroke. Which
additional structure is typically spared to allow writing?
A) Left angular gyrus
B) Splenium of the corpus callosum
C) Left primary visual cortex
D) Left postcentral gyrus
Answer: A
Rationale: Alexia without agraphia results from left PCA infarction damaging
the left occipital lobe and splenium, disconnecting visual word forms from
language areas; writing is preserved because the left angular gyrus and
language output areas remain intact. Splenium and visual cortex are typically
damaged, not spared.
8 Which cerebellar region is most critical for cognitive and affective
modulation, rather than motor coordination?
A) Anterior lobe
B) Posterior lobe (neocerebellum)
C) Vestibulocerebellum
D) Spinocerebellum
, Answer: B
Rationale: The posterior lobe (neocerebellum) connects with prefrontal and
parietal association cortices and is implicated in cerebellar cognitive affective
syndrome. Anterior lobe and spinocerebellum are mainly sensorimotor, and
vestibulocerebellum supports balance and eye movements.
9 Which cortical area is the primary target of thalamic input for conscious
proprioception and discriminative touch?
A) Postcentral gyrus
B) Precentral gyrus
C) Superior temporal gyrus
D) Cingulate gyrus
Answer: A
Rationale: The postcentral gyrus (primary somatosensory cortex) receives
thalamic (VPL) projections carrying proprioception and discriminative touch.
Precentral gyrus is motor, superior temporal is auditory, and cingulate is
limbic.
Section 2: Neurons, Neurotransmission, and Neurophysiology (Questions 10-18)
10 A neuron with a resting membrane potential of -70 mV is exposed to a
toxin that selectively blocks voltage-gated K+ channels. What is the most
likely immediate effect on the action potential?
A) Prolonged depolarization and inability to repolarize
B) Increased amplitude of the action potential
C) Immediate failure to reach threshold
D) Enhanced frequency of action potentials
Answer: A
Rationale: Voltage-gated K+ channels mediate repolarization; blocking them
delays return to resting potential, prolonging depolarization. They do not affect
the initial depolarization (Na+ channels) or threshold directly, and increased
amplitude or frequency would not occur without repolarization.
11 Which mechanism best explains the therapeutic lag (2-4 weeks) for SSRIs
in treating depression despite immediate serotonin reuptake inhibition?
A) Downregulation of presynaptic 5-HT1A autoreceptors and subsequent
increase in serotonergic firing
