Exam# 3 (Final) -Multiple Choice

EMST can be suggested for

a. Patients with degenerative neurological disorders

b. Elderly individuals with sarcopenia

c. Children with neuromuscular disorders

d. All of the above

Occupational therapists' role in dysphagia management involves

a. Assessment and management of oral care

b. Recommending environmental modifications to improve mealtime experience

c. Assessment of nutrition

d. Decision making on swallowing management

Changes in treatment may be affected by

a. Treatment technique

b. Passage of time

c. Strength of the patient

d. Types of food eaten

e. Only a, b, and c

f. a, b, c, d

Compensatory swallowing therapy involves all of the following except

a. Improving oral strength

b. Changing the size of the bolus to be swallowed

c. Stimulating lips/tongue

d. Modifying posture to improve airway closure

Compensatory swallowing is limited by which of the following

a. Time since onset of dysphagia

b. Lack of evidence that shows it is efficacious \

c. Willingness to follow the recommendations

d. All of the above

Swallowing postures are used as they have been shown to

a.Reduce penetration and aspiration

b.Improve bolus transit time during the oral and pharyngeal phases

c.Reduce residue post swallow

d.All of the above

Thermal tactile oral stimulation is an exercise to stimulate

a.Tongue elevation

b.Oral awareness to the brainstem

c.Taste

d.All of the above

The primary outcome from studies using the Shaker exercise is

a.Significant increase in the anterior excursion of the larynx

b.Reduced opening of the upper esophageal

sphincter

c.Decrease in the hypopharyngeal intrabolus pressure

d.No improvement in the types of liquid that patients with UES difficulty could swallow

When should therapy begin for patients diagnosed with head and neck cancer?

a.As soon as the patient completes the requisite medical treatment

b.After the patient has recovered sufficiently from medical treatment

c.As soon as the diagnosis is made

d.After the patient is confirmed to be in remission

Proper nutrition

A. Provides increased strength

B. Builds immune status

C. Prevents aspiration

D. Only A and B

E. A, B, and C

Which professional is mainly responsible for monitoring the nutritional status

A. SLP

B. Medical doctor/ physician

C. Registered Dietician

D.Nurse

Standardization of foods through analysis of their properties will help in all of the following ways except

A. Reducing aspiration during testing

B. Improving test to test reliability

C. Allowing a comparison of FEES and MBS results more carefully

D. Calculating nutrition requirements.

The key to recommending thickened fluids is to

A. Protect the airway and ensure maximal swallow safety

B. Allow the patient to swallow without complaint

C. Minimize residue post swallow

D. A and C

Viscosity represents a characteristic of a liquid that can be described more simply as

A. Thickness

B. Resistance to flow

C. Degree of elasticity

D. Type of texture

What factors might limit a patient's intake of recommended thickened fluids?

A. Limited access to thickened fluids

B. Patient is unused to the change in taste and texture

C. Patient feels that thickened fluids do not quench their thirst

D. All of the above

Who may benefit from the Free Water Protocol?

A. All individuals who are on a modified diet

B. Only individuals who are mobile and have good cognitive functions

C. Elderly patients who have dementia

D. All of the above

Examples of minced and moist foods include

A. Thick and smooth cereal

B. Greek yogurt

C. Mashed banana

D. A and C

E. All of the above

For patients who require long-term nonoral feeding, gastrostomy tubes are preferred as:

A. They last longer and therefore require less replacing

B. They are more comfortable than other forms of enteral feeding

C. They are more fixed in place and do not dislodge easily

D. Patients do not find them as disfiguring

E. All of the above

F. All except D

A squeeze may help in propelling the bolus into the oropharynx due to weakness in the tongue is one of the purposes of the:

A. Effortful swallow

B.super-supraglottic swallow

C. Mendelson maneuver

D. head tilt

This type of therapy is easiest for patients who have trouble with multiple stage commands, children, or patients with significant sensory loss:

A.tongue hold

B.supraglottic swallow

C. effortful swallow

D.chin tuck

E. head back posture

Head back posture helps, improves or is used to/for

A. People with tongue paralysis or partial or total removal of the tongue due to oral cancer may benefit from this posture

B.airway protection by moving the tongue base and epiglottis posterior toward the posterior pharyngeal wall.

C. to promote the flow of the bolus to the more normal side of the pharynx or larynx

D. for patients who have unilateral oral or pharyngeal weakness

Chin down posture/chin tuck helps, improves or is used to/for

A. Relies on gravity to move the bolus out of the oral cavity

B. airway protection by moving the tongue base and epiglottis posterior toward the posterior pharyngeal wall.

C.this posture is used in patients with unilateral pharyngeal or vocal fold weakness or impairment

D. patients who have unilateral oral or pharyngeal weakness

Refers to exercises and techniques that aim to achieve long-term improvement in neuromuscular control of swallowing:

A.Rehabilitative swallow therapy

B.Compensatory swallow therapy

C.swallow posture therapy

D.Preventative swallow therapy

E. a and b

If a person has not had a Modified Barium Swallow Study, but has pooling of saliva or food in their throat, which might be noticed by a "wet" or "gurgly" voice quality what treatment method would work best?

A.Shaker exercise

B.rTMS

C.tDCS

D.vitalStim

E.Masako exercise

This type of procedure is helps with laryngeal elevation and is kind of like acupuncture.

A.Intramuscular stimulation

B. rTMS

C. tDCS

D. vitalStim

E. Mendelsohn maneuver

In making the transition to IDDSI from the NDD diet it is important to be aware that some of the NDD levels correspond to specific IDDSI levels. Level 3 of the IDDSI diet corresponds to what level of the NDD?

A. pudding thick

B.nectar thick

C.honey thick

D.spoon thick

Level 4 of the IDDSI diet has bolus that sits in a mound or pile above the fork. The description for this level is:

A. moderately thick/liquidized

B.Extremely thick/pureed

C.soft & bite-sized

D. mildly thick

E. minced & moist

What level of the IDDSI notes that the thumb nail is blanched to white?

A. minced & moist

B. mildly thick

C. level 4

D. soft and bite-sized

The suggested target population for individuals who have slightly reduced tongue control is:

A.slightly thick

B.mildly thick

C. moderately thick

D. extremely thick

The suggested target population is mainly used in the pediatric population as a thickened drink:

A. slightly thick

B. mildly thick

C. moderately thick

D. extremely thick

E. thin

When the flow test leaves 1 to 4 ml in the syringe after 10 seconds this corresponds to what level IDDSI?

A. thin

B.mildly thick

C. moderately thick

D. extremely thick

E. slightly thick

A nasoduodenal tube is placed through the nose and then into the:

A. stomach

B. jejunum

C. mid-section of the small intestines

D. small bowel

NJ tubes are used when patients have:

A. chronic vomiting

B. respiratory problems from reflux

C. poor stomach function

D. high risk of aspiration

E. all the above

This type of gastrostomy is performed for patients who cannot open their mouth wide enough for PEG often as a result of cancer:

A. PEG tube

B. surgical gastrostomy

C. PRG

D. PEJ tube