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Executive Dysfunction in Parkinson's Disease without Dementia

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1.  Which of the following statements about cognitive impairment in Parkinson disease is TRUE?
  1. Everyone with Parkinson disease eventually develops dementia.
  2. Cognitive deficits can be reliably detected in the earliest stages of Parkinson disease.
  3. Cognitive impairment in Parkinson disease in the absence of dementia is NOT functionally relevant.
  4. Cognitive impairment only occurs in young-onset Parkinson disease.
2.  What cognitive domain is the most commonly impaired among non-demented individuals with Parkinson disease?
  1. Memory
  2. Visuospatial perception
  3. Metacognition
  4. Executive function
3.  Which of the following statements about executive functions is TRUE?
  1. Executive functions are required to plan and execute complex, goal-directed behavior.
  2. Executive functions are involved in regulating performance via error detection and correction.
  3. Executive functions are particularly important for performance in novel situations.
  4. All of the above.
4.  What is thought to be the primary neuropathological cause of executive dysfunction in Parkinson disease?
  1. Medications
  2. Dysfunction of the neural circuitry connecting the basal ganglia and prefrontal cortex (i.e., the frontostriatal circuitry)
  3. Hippocampal atrophy
  4. Depression
5.  What activity might be difficult for an individual with early Parkinson disease due to executive dysfunction?
  1. Cooking a new recipe
  2. Bathing
  3. Toilet transfer
  4. Swallowing
6.  Neuropsychological tests are designed to isolate and test single cognitive processes. Why does this pose a problem for OT-based evaluation of cognition?
  1. Because individuals with Parkinson disease have multiple cognitive deficits.
  2. Due to motor impairment, individuals with Parkinson disease cannot perform many neuropsychological tests.
  3. This approach is not adequately predictive of real-world cognitive performance, which involves the integration of multiple cognitive processes.
  4. All of the above
7.  Performance-based assessment of cognitively demanding activities is recommended for OT evaluation of cognitive performance because…
  1. They are quick and easy to administer.
  2. They allow the therapist to observe cognition in the context of meaningful and functional activity performance.
  3. They are not standardized, so the therapist can remain client-centered.
  4. They can help the therapist locate the region of the brain that is damaged.
8.  Which of the following statements about dynamic performance-based testing is TRUE?
  1. It is only appropriate if you are going to administer the test on multiple occasions.
  2. It provides a constantly changing testing environment for the participant.
  3. It helps to determine what supports can be provided to facilitate task performance.
  4. All of the above
9.  What is likely the best approach to develop an understanding of functional cognition in a client with Parkinson disease?
  1. Use a combination of self/informant-reported and performance-based assessments.
  2. Administer a comprehensive battery of standardized neuropsychological tests (e.g., Delis Kaplan Executive Function System (D-KEFS))
  3. Ask the caregiver.
  4. Administer the Montreal Cognitive Assessment (MoCA).
10.  Which of the following non-motor manifestations of Parkinson disease may affect an individual’s cognitive and functional performance?
  1. Apathy
  2. Fatigue
  3. Depression
  4. All of the above