Free SLP Praxis Practice Questions

Question 1

A 74-year-old man is three days out from a left middle cerebral artery stroke. Nursing reports two low-grade fevers and a new infiltrate on chest film, yet he coughs on none of the ice-chip, thin-liquid, or puree trials at bedside and his vocal quality stays clear after each swallow. Which action MOST appropriately addresses this clinical picture?

Accepted Answer

Recommend a modified barium swallow study to visualize swallow physiology across all phases.

Answer

Clear him for a regular diet with thin liquids, since he shows no coughing or wet vocal quality at bedside.

Answer

Downgrade him to honey-thick liquids empirically and re-screen at bedside in 48 hours.

Answer

Recommend NPO with non-oral nutrition until the pneumonia resolves.

Question 2

A 7-year-old has persistent difficulty with grammar and comprehension that interferes with schoolwork. Nonverbal cognition is within normal limits, hearing is normal, and there is no autism, intellectual disability, acquired brain injury, or known genetic syndrome. Using current CATALISE consensus terminology, which label is MOST accurate?

Accepted Answer

Developmental language disorder

Answer

Language disorder associated with a biomedical condition

Answer

No language disorder can be diagnosed because there is no significant gap between his nonverbal IQ and his language scores

Answer

Late language emergence

Question 3

Priya, 3;10, is understood by unfamiliar listeners roughly 30% of the time. A speech sample shows she deletes most final consonants, reduces every cluster, stops fricatives, and fronts velars. Her errors are consistent and rule-governed, and she is stimulable for several sounds. Which treatment approach is BEST suited to her profile?

Accepted Answer

The cycles phonological remediation approach

Answer

Minimal pair contrast therapy

Answer

A motor-based drill grounded in principles of motor learning

Answer

Watchful waiting with parent-implemented recasts

Question 4

A 60-year-old right-handed man is one year post left frontal stroke with chronic, severely nonfluent aphasia: verbal output is limited to a few effortful words, but auditory comprehension is relatively well preserved and he is motivated. The clinician wants an evidence-based approach specifically developed for this nonfluent-with-good-comprehension profile to increase propositional speech. Which approach is the BEST match?

Accepted Answer

Melodic Intonation Therapy

Answer

Script training

Answer

Semantic Feature Analysis

Answer

Constraint-Induced Language Therapy

Question 5

A 4-year-old girl was diagnosed with stuttering eight months ago. She produces part-word repetitions and silent blocks at about 8% of syllables, shows mild jaw tension on blocks, and has a mother who has stuttered persistently since childhood. Her receptive and expressive language are typical. The parents ask which treatment has the strongest evidence for a child her age. Which is the MOST appropriate initial approach?

Accepted Answer

The Lidcombe Program, with parent-delivered verbal contingencies during structured and conversational practice

Answer

Van Riper stuttering modification, teaching her cancellations and pull-outs on stuttered words

Answer

Fluency shaping using prolonged-speech and easy-onset drills across all utterances

Answer

Continued monitoring only, since most preschoolers who stutter recover without treatment

Question 6

Aaliyah, 7, is described by her mother as sounding “stuffed up all the time,” even when she is not sick. She mouth-breathes, snores nightly, and the pediatrician noted enlarged adenoids. During your screening, her /m/, /n/, and /ŋ/ come out sounding like /b/, /d/, and /g/. Which BEST describes her resonance?

Accepted Answer

Hyponasality

Answer

Mixed hyper- and hyponasality

Answer

Cul-de-sac resonance

Answer

Hypernasality

Question 7

A 58-year-old man was diagnosed with ALS four months ago. Speech is currently 88% intelligible to unfamiliar listeners but slowing, and he has full hand function today with early fatigue on repetitive tasks. He asks what communication supports he should plan for. Which is the BEST next step?

Accepted Answer

Complete a feature-matching assessment that anticipates changing motor and speech abilities over time

Answer

Wait until speech is unintelligible before any AAC referral so he is not discouraged prematurely

Answer

Prescribe an eye-gaze speech-generating device now as his primary system

Answer

Provide a low-tech alphabet board and consider nothing further unless speech worsens

Question 8

A 7-year-old is seen after a school hearing screening referral. Pure-tone testing shows air-conduction thresholds averaging 40 dB HL in the right ear with bone-conduction thresholds at 5 dB HL for the same frequencies. Word recognition is excellent at a comfortable level. Which finding BEST describes this ear?

Accepted Answer

Conductive hearing loss

Answer

Mixed hearing loss

Answer

Sensorineural hearing loss

Answer

Auditory processing disorder

Question 9

A 41-year-old electrician returning to work after a TBI can list the steps of a wiring job correctly but repeatedly skips steps, does not check his own work, and fails to notice mistakes until a supervisor points them out. His standardized language scores fall within normal limits. Which treatment approach BEST targets this profile?

Accepted Answer

Metacognitive strategy instruction such as Goal–Plan–Do–Review

Answer

Word-retrieval therapy to strengthen expressive language

Answer

Restorative computer-based attention drills

Answer

A written checklist supplied for each task, without strategy instruction

Question 10

A new rehab director at a SNF hands a clinician a schedule of neuromuscular electrical stimulation (e-stim) sessions for three residents with pharyngeal-phase dysphagia and asks her to begin them Monday. The clinician has never been trained in e-stim application, has no supervised practice with it, and holds no certification in the technique. A physician has signed orders for the treatment. Which action is MOST appropriate?

Accepted Answer

Decline to provide e-stim until she completes appropriate training and demonstrates competence

Answer

Begin the sessions, since a physician’s order authorizes the modality

Answer

Delegate the e-stim sessions to the facility’s speech-language pathology assistant

Answer

Refer all three residents to another facility for dysphagia management

Question 11

A 4-year-old’s parents report that he used to say “went” and “feet” but now says “goed” and “foots,” and they are alarmed that he seems to be moving backward. What is the BEST interpretation?

Accepted Answer

Overregularization — a normal sign that he is acquiring morphological rules

Answer

Language regression that warrants an autism evaluation

Answer

Developmental language disorder requiring immediate therapy

Answer

A phonological disorder affecting his word endings

Question 12

Tympanometry of the right ear in a 34-year-old yields a flat (Type B) tracing with a normal ear-canal volume. He came in two weeks after a bad head cold describing a plugged, muffled feeling that has not cleared, and otoscopy shows a dull, retracted tympanic membrane that barely moves. Which interpretation is MOST consistent with these findings?

Accepted Answer

Middle ear effusion behind an intact tympanic membrane

Answer

Tympanic membrane perforation

Answer

Normal, healthy middle ear function

Answer

Ossicular chain discontinuity

Question 13

Across three play-based observation sessions, a 4-year-old girl referred for “poor conversation skills” does not respond to peers’ play bids and cannot sustain back-and-forth exchanges. She lines her markers up in an exact color order every session, becomes highly distressed when the room’s routine changes, and flaps both hands when excited. Standardized testing places her vocabulary and grammar within normal limits. Which is the MOST appropriate next step?

Accepted Answer

Refer for a comprehensive, multidisciplinary autism spectrum evaluation

Answer

Diagnose social (pragmatic) communication disorder and begin pragmatic language therapy

Answer

Reassure the family that this is typical preschool variation

Answer

Diagnose developmental language disorder and target syntax

Question 14

A 6-year-old whose home and community language is African American English is referred by his teacher for “unclear speech.” Screening shows word-final consonant deletion, word-final “th” produced as /f/ (“baf” for bath), and reduction of word-final consonant clusters (“tes” for test). All other sounds are age-appropriate, he is fully intelligible, and the features are consistent and match his family’s speech. Which action is MOST appropriate?

Accepted Answer

Recognize these as rule-governed African American English features, not a disorder

Answer

Enroll him in articulation therapy to correct his word-final “th” productions

Answer

Refer him for a comprehensive phonological evaluation of the final consonant deletion

Answer

Provide dialect modification during the school day to improve his intelligibility

Question 15

A videofluoroscopic swallow study on a 74-year-old man shows moderate residue coating the valleculae and base of tongue after each swallow of puree, which he then aspirates on the following breath. Laryngeal elevation, UES opening, and airway closure are all adequate; the underlying deficit is reduced tongue-base retraction. Which maneuver BEST targets this finding?

Accepted Answer

Effortful (hard) swallow

Answer

Supraglottic swallow

Answer

Mendelsohn maneuver

Answer

Chin-down posture

Question 16

A 72-year-old man with Parkinson disease comes in with soft, breathy, monotone speech that has his family constantly asking him to repeat himself. Laryngeal exam shows vocal fold bowing with incomplete glottic closure and no lesion. He insists his voice sounds “normal” and plenty loud to him. Which treatment approach has the STRONGEST evidence for this presentation?

Accepted Answer

LSVT LOUD — intensive loudness therapy that recalibrates his sense of vocal effort

Answer

Surgical vocal fold medialization thyroplasty with a permanent implant

Answer

Confidential (soft) voice therapy to reduce vocal strain, effort, and tension

Answer

Bilateral botulinum toxin injection into the thyroarytenoid muscles

Question 17

During a sustained vowel, the vocal folds open and close roughly 200 times per second. Which explanation BEST describes the mechanism of normal vocal fold vibration?

Accepted Answer

Subglottal pressure blows the adducted folds apart, while their elastic recoil and the Bernoulli pressure drop draw them back together each cycle

Answer

The folds vibrate at the resonant frequency imposed on them by the supraglottic vocal tract, matching its formant frequencies cycle by cycle

Answer

Rhythmic contraction of the cricothyroid muscle actively pulls the folds open and closed on every glottal cycle

Answer

Each vibratory cycle is triggered by a separate volley of impulses from the vagus nerve to the laryngeal muscles

Question 18

In a connected-speech sample, Mateo, 15, talks at a rapid, irregular rate, packing in frequent whole-word and phrase repetitions and interjections while collapsing syllable sequences (“tevision” for “television”). Part-word repetitions, prolongations, and blocks are absent, and there is no physical tension. He does not seem to notice when listeners are lost, though his intelligibility clearly improves when he slows down and attends to his speech. Which is the MOST likely diagnosis?

Accepted Answer

Cluttering

Answer

Developmental stuttering

Answer

Neurogenic stuttering

Answer

Word-retrieval (language) disorder

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