Subscribe to RSS
DOI: 10.1055/s-0039-1691747
Self-Assessment Questions
Publication History
Publication Date:
03 June 2019 (online)
This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.
Article One (pp. 151–161)
-
Type 1 clinical reasoning is also referred to as:
-
Detail-oriented, explicit clinical reasoning.
-
Intuitive, implicit clinical reasoning.
-
Computer-assisted reasoning.
-
Not applied in clinical environments.
-
Developmental clinical reasoning.
-
-
Type 2 clinical reasoning is also referred to as:
-
Computer-assisted reasoning.
-
Developmental clinical reasoning.
-
Intuitive, implicit clinical reasoning.
-
Not applied in clinical environments.
-
Detail-oriented, explicit clinical reasoning.
-
-
Case-based learning has got the following advantages:
-
Scaffolded learning environment.
-
Gradually increasing cognitive load.
-
Peer-assisted learning.
-
Authentic clinical learning opportunities in the classroom.
-
All of the above.
Article Two (pp. 162–169)
-
-
An individual's competence, or legal capacity, is determined by:
-
A court of law.
-
A police officer.
-
A physician.
-
A surrogate decision-maker.
-
The patient himself.
-
-
Which of the following are acknowledged as key functional abilities for making a clinical decision?
-
Ability to express a choice.
-
Ability to understand the relevant information.
-
Ability to appreciate the situation as unique applies to oneself.
-
Ability to reason through the options and consequences.
-
All of the above.
-
-
Decision-making capacity reflects a particular decision to be made:
-
At that distinct moment in time.
-
For the duration of 1 week.
-
For the duration of the illness.
-
For the remainder of one's life.
-
-
The informed consent process must disclose:
-
Material facts.
-
Provider disclosure.
-
Personnel to be involved in the patient's care.
-
Additional procedures that may be required.
-
All of the above.
Article Three (pp. 170–187)
-
-
In infants born prematurely, all of the following can indicate an increased risk of late oral feeding excep t:
-
Gestational age.
-
Sex of the infant.
-
Birthweight.
-
Lung disease.
-
Necrotizing enterocolitis.
-
-
Which of the following is an unacceptable reason for endotracheal intubation?
-
Maintain an open airway.
-
Maintain ventilation.
-
Rest the patient's respiratory system.
-
Maintain a proper level of oxygenation.
-
Protect the airway from aspiration.
-
-
Why is it important to identify tracheostomy tube characteristics such as the manufacturer, style, and size?
-
The angle of the tracheostomy tube varies.
-
The length of the tracheostomy tube varies.
-
The cuff shape varies.
-
Inflation materials change between tracheostomy tubes.
-
All of the above vary between manufacturer, style, and size of the tracheostomy tube.
-
-
Which of the following statements is true about tracheostomy tubes?
-
Cuff deflation must be continuous before evaluation and treatment can begin.
-
There are no current validated criteria for cuff deflation.
-
A patient breathing at a respiratory rate of 30 breaths per minute must be deferred until a reduced breathing rate is established.
-
Patients with oxygen saturations of 90% SpC>2 have greater risk for aspiration.
-
A speech-language pathologist is capable of determining medical stability, enough for a swallow screening and/or evaluation.
-
-
Which of the following statements about fiberoptic endoscopic evaluation of swallowing (FEES) is true when considering the advantages of its use in the ICU setting?
-
FEES is contraindicated in pediatric populations.
-
Breastfeeding mothers are not permitted to hold the infant during FEES.
-
Positioning/seating is no different than during the videofluoroscopic swallow study.
-
FEES cannot be performed in the patient's room because of the number of IV pumps, the ventilator, and other equipment.
-
Secretion management, spontaneous swallows, and very small volume oral trials may be assessed.
Article Four (pp. 188–202)
-
-
Following a positive “failed” swallowing screening for acute stroke, the patient should be:
-
Made NPO until speech-language pathology evaluation.
-
Rescreened every nursing shift until the screening is negative
passed.
-
Made NPO except for medication.
-
Started on a thickened liquid diet pending speech-language pathology consultation.
-
Made NPO and rescreened every nursing shift until the screening is negative “passed.”
-
-
Why is it important to assess compensatory swallowing strategies under instrumental assessment prior to prescribing them to a patient with dysphagia?
-
The patient may not want to follow a compensatory strategy unless it is evaluated with instrumental assessment.
-
It is important to evaluate compensatory swallowing strategies with instrumental assessment to determine if they improve safety or efficiency of intake, and if any negative effects occur with implementation.
-
This is done to determine the number of compensatory strategies that are effective.
-
It is important to assess compensatory swallowing strategies with instrumental assessments to determine if it is appropriate to bill for dysphagia therapy.
-
You should evaluate compensatory swallowing strategies under instrumental assessment only if the patient presents with continued signs of dysphagia after implementing them following the clinical swallowing examination.
-
-
In both the clinical swallowing examination and instrumental assessment, why is it recommended that the speech-language pathologist begin with administration of small volumes of thin liquids, prior to administration of thicker consistencies?
-
It is important to administer small liquid volumes first so that the patient can get accustomed to the assessment.
-
Starting with smaller volumes of thin liquids helps “warm-up” the muscles so that the patient is less likely to aspirate with larger volumes of liquids.
-
Thin liquids are less likely to result in residue which can affect subsequent swallows, and starting with small volumes can reduce the amount of liquid aspirated.
-
It is only recommended to start with larger volumes of thicker consistencies.
-
Small liquid volumes are less likely to be aspirated compared to small volumes of thicker consistencies.
-
-
What three rehabilitation exercises have been studied with disordered populations and have reported positive long-term biomechanical and clinical effects?
-
Mendelsohn maneuver, Shaker exercise, lingual resistance exercises.
-
Shaker exercise, lingual resistance exercises, expiratory muscle strength training.
-
Super-supraglottic swallow, effortful swallow, Masako maneuver.
-
Chin tuck against resistance exercise, lingual resistance training, and thermal-tactile application.
-
Expiratory muscle strength training, recline exercise, Mendelsohn maneuver.
-
-
A patient with an acute right hemispheric stroke and cognitive deficits including severely impaired attention, memory, and impulsivity demonstrates consistent thin liquid silent aspiration before the swallow during a videofluoroscopic swallowing study. Why it may be best to move directly into testing nectar-thick liquids rather than testing other compensatory swallowing strategies?
-
The patient does not like to drink thin liquids.
-
The patient does not like to use the other compensatory swallowing strategies.
-
Nectar-thick liquids always protect against aspiration.
-
Nectar-thick liquids do not require the cognitive demand and supervision that most other compensatory strategies do.
-
Chin tuck requires no more memory requirement than nectar thick liquids and should really be considered before thickened liquids.
Article Five (pp. 203–212)
-
-
The conversation about nonoral feeding should be initiated:
-
Cnly when the patients are unable to swallow by mouth.
-
Early in the disease process to allow patients and caregivers to make informed decision about whether they want a feeding tube.
-
When respiratory status declines.
-
Never.
-
-
Management of dysphagia in neurologic disease may include:
-
Exercises.
-
Diet modification.
-
Compensatory maneuvers or postures.
-
All of these.
-
-
The course of the disease will impact:
-
Frequency of swallow evaluation/ reevaluation.
-
Nothing. It does not matter with regard to swallow evaluation and management.
-
The management goals (i.e., maintaining vs. improving function).
-
Both A and C.
Article Six (pp. 213–226)
-
-
Which of the following does a speech-language pathologist provide within head and neck cancer patient management:
-
Intervention.
-
Rehabilitation.
-
Prehabilitation.
-
Risk-stratification
-
All of the above.
-
-
Late RAD refers to:
-
A progressive dysphagia associated with prior radiation therapy caused by fibrosis and degenerative cranial nerve.
-
A prophylactic exercise regimen used to protect pharyngeal musculature during radiotherapy.
-
An effect from radiotherapy identifiable within a week following treatment cessation.
-
A protective factor associated with chemoradiotherapy.
-
All of the above.
-
-
A speech-language pathologist would most likely utilize which of the following as part of their risk-stratification approach:
-
Patient- and clinician-reported outcome measures (e.g., FOIS or MDADI).
-
Swallowing evaluation with imagine (i.e., FEES or MBSS).
-
Evidence-based clinical assessment tools (e.g., MASA-C or IOPI).
-
Patient history and interview.
-
All of the above.
-
-
Patients with head and neck cancer-related dysphagia differ from other dysphagia populations because:
-
They are unable to make informed choices.
-
They are often neurotypical and able to engage in shared decision making.
-
They exhibit an inability to be an active participant in their rehabilitation.
-
They exhibit self-resolving dysphagia without any need for intervention.
-
All of the above.
-
-
A critical role in the management of the surgically managed head and neck cancer patient is:
-
Pretreatment education and counseling about expected functional changes with respect to swallowing.
-
Pretreatment baseline evaluation of swallowing function based on clinical risk stratification.
-
Investigation of swallowing strategy utility.
-
Prescription of range of motion and strengthening exercises.
-
All of the above.
Article Seven (pp. 227–242)
-
-
Select the change(s) to swallow physiology that is expected with age.
-
Increased swallow apnea.
-
Increased pressures exerted in the oral cavity.
-
Increased pressures exerted in the pharynx.
-
B and C only.
-
All of the above.
-
-
Spouses and children of older adults with dysphagia both suffer from:
-
Emotional burden.
-
Physical burden.
-
Financial burden.
-
A and B.
-
B and C.
-
-
Dehydration in older adults may lead to:
-
Delirium.
-
Xerostomia.
-
Infections.
-
Hypotension.
-
All of the above.
-
-
Ethnographic approach includes listening to the behaviors and beliefs of:
-
The patient only.
-
The caregiver only.
-
The patient and/or caregiver.
-
Other healthcare professionals.
-
The assessing clinician
-
-
Management of dysphagia in older adults should:
-
Be individualized.
-
Consider the physiological deficits.
-
Be implemented only for outpatients.
-
Only include compensatory techniques.
-
A and B.
-