10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
These 10 free NA-CLTM questions are organized by exam domain, so you can see how each part of the NeuroAnalyst-CLTM (NA-CLTM) blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Validate patient identification and recording period, review the patient history and clinical data and information. 5% of exam
Question 1
An 18-month-old referred for staring spells is developmentally typical and interacts with a parent during EEG. With eye closure, a symmetric 7-Hz posterior rhythm appears and consistently attenuates with eye opening. No persistent focal slowing is present. A reviewer calls the background abnormal because the dominant rhythm is below 8 Hz. Which appraisal of that conclusion is justified?
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Correct answer: B - The conclusion overlooks age-appropriate maturation of the posterior rhythm.
Question 2
A patient monitored after cardiac arrest has a continuous slow EEG that changes abruptly to burst-suppression during ventilator care. Electrode checks are satisfactory, and oxygenation, blood pressure, and temperature remain stable. Before attributing the new pattern to worsening hypoxic-ischemic injury, which medication record entry deserves the greatest weight?
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Correct answer: A - A propofol bolus immediately before the EEG change
Domain 2: Review the technical description and recording parameters. 5% of exam
Question 3
After additional conductive paste is applied, F3-C3 becomes nearly flat in a bipolar montage. In a referential montage, F3 and C3 contain nearly identical, normal-amplitude activity, while neighboring channels remain distinct. Both contacts now measure below 100 ohms. What single technical problem accounts for this combination?
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Correct answer: A - F3-C3 electrolyte bridging
Domain 3: Analyze, classify, annotate, and delineate the EEG and video data, and evaluate seizure semiology based upon clinical and electrographic findings. 70% of exam
Question 4
During ICU monitoring, six-second runs of sharply contoured 6-Hz activity have a left central maximum and a field over adjacent frontocentral electrodes. Each run coincides with rhythmic right-hand jerking; the EEG pattern and jerking start and stop together. Muscle artifact does not account for the cerebral field. How does the clinical correlate affect classification under ACNS 2021 terminology?
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Correct answer: C - The events qualify as focal electroclinical seizures despite their short duration.
Question 5
An EEG/video event log records left temporal rhythmic activity evolving at 14:08:10, sustained right-arm dystonic posturing at 14:08:24, and spread to the right temporal region at 14:08:32. The right-sided rhythm then becomes larger than the left-sided rhythm. Bilateral tonic-clonic movements begin at 14:08:44. Which localization is supported by the onset sequence and the lateralizing motor sign?
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Correct answer: D - Left temporal onset with later right temporal propagation
Question 6
An overnight EEG from a 62-year-old contains short trains of 8-Hz, arch-shaped left temporal waves during drowsiness. An isolated sharp-looking wave lasts about 110 milliseconds and matches the contour of waves within the trains. There is no aftergoing slow wave, background disruption, spatial evolution, or associated behavioral change. How should these transients be handled during review?
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Correct answer: B - Recognize wicket waves and continue routine review.
Question 7
In a fully recorded 60-minute ICU interval, raw-EEG review confirms four nonoverlapping electrographic seizures lasting 2, 3, 4, and 6 minutes. A separate six-minute detector alert is verified as muscle artifact. No definite clinical correlate accompanies the seizures. Select the seizure burden and ACNS 2021 classification that should be communicated.
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Correct answer: A - 25% burden; electrographic status epilepticus
Question 8
Photic stimulation at 12 flashes per second produces a symmetric occipital 12-Hz rhythm; at 15 flashes per second, the rhythm follows at 15 Hz. The responses have no spike-wave components and stop with each flash train. The patient remains responsive, and no facial contractions are observed. Which response to these findings is appropriate?
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Correct answer: C - Document normal photic driving and continue the planned stimulation.
Question 9
A sharp transient appears in every derivation containing T7, without a convincing field at adjacent electrodes. Each transient follows a QRS complex by approximately 240 milliseconds, maintaining that delay as the heart rate changes. Repositioning the T7 contact slightly away from a palpable scalp vessel eliminates the transients while the ECG is unchanged. Identify their source.
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Correct answer: D - Mechanical pulse artifact at T7
Domain 4: Write the NeuroAnalyst Report. 20% of exam
Question 10
A seven-year-old with drug-resistant seizures and developmental impairment undergoes overnight video-EEG. The awake background is slow, with generalized 2-Hz spike-wave. NREM sleep contains generalized 14-Hz paroxysmal fast activity, and several episodes of sustained axial stiffening are captured. The report's syndrome correlation is most strongly supported by which diagnosis?
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Correct answer: D - Lennox-Gastaut syndrome
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