Group C Flashcards
Researchers are conducting an experiment that depends on the use of professional judgments of the speech produced by 30 research subjects. Which of the following actions should the researchers take to determine interjudge reliability?
A. Asking two SLPsS L Ps to each independently rate the 30 subjects
B. Asking an SLPS L P to rate the 30 subjects
C. Asking one SLPS L P to rate the 30 subjects before treatment and another SLPS L P to rate them after treatment
D. Asking an SLPS L P to rate the 30 subjects and then rate them again two weeks later
Option (A) is correct. The definition of interjudge (or interrater) reliability is the level of agreement in scoring between two or more judges scoring the same observation.
After an evaluation of a patient’s communication needs, an SLPS L P pursues acquisition of a high-tech AACA A C device. The patient’s private health insurance rejects the request, stating that the device is “not medically necessary.” The SLPS L P can best advocate for the patient by immediately appealing
A.to the insurance company to determine a lower-technology device that is covered by the payer
B.the denial and providing a review of how the patient’s quality of life is impacted by the device
C.the denial and providing data regarding the medical necessity for the device
D.to a member of the state government for coverage of high-tech AACA A C devices
Option (C) is correct. Appealing the denial and providing the insurance company with data indicating the device is medically necessary in advocacy for the patient is the most direct response to the denial of the claim.
An SLPS L P works at a hospital with the adult acute-care inpatient team. During a clinical bedside swallow evaluation, a patient asks the SLPS L P how common it is for adults to experience a swallowing disorder. The SLPS L P tells the patient that recent research indicates the prevalence of adults with swallowing problems each year is
A.1 in 25
B.1 in 50
C.1 in 100
D.1 in 200
Option (A) is correct because recent research indicates that 1 in 25 adults are affected by a swallowing problem per year.
A typically developing child who is 4 years and 5 months old was referred to a school-based SLPS L P for an evaluation because of poor speech intelligibility. Assessment results indicated a moderate phonological impairment with receptive language skills developing as expected for the child’s age. Based on the assessment, eligibility for speech-language services was determined. In accordance with the Individuals with Disabilities Education Act (IDEAI D E A), which of the following service plans is most appropriate for the SLPS L P to recommend?
A.Services will be provided by the SLPS L P when the student enters kindergarten.
B.Services will be provided by the SLPS L P in the least restrictive environment.
C.Services will be provided by the school’s intensive-needs preschool staff.
D.Services will be provided by a private SLPS L P with consultation from the school SLPS L P.
Option (B) is correct. Services must be provided in the least restrictive environment (LREL R E), according to the Free Appropriate Public Education (FAPEF A P E) component of IDEAI D E A.
An SLPS L P is working with a sixth-grade student who is having difficulty comprehending written text. Which of the following strategies would be most effective for the SLPS L P to use to target this difficulty?
A.Creating a log in which unfamiliar sight words are written down for later practice
B.Developing the student’s ability to chunk multisyllabic words into smaller units
C.Selecting words from a text that can be used as both spelling and sight words
D.Using semantic networks in which ideas are displayed in connected clusters
Option (D) is correct. Semantic networks improve reading comprehension by showing students not only how vocabulary words are related to each other in a conceptual hierarchy, but how ideas in texts are organized in an associative way.
A 60-year-old male is referred to the SLPS L P in an acute rehabilitation center for a videofluoroscopic swallowing study (VFSSV F S S) following a first-time stroke: a lateral medullary stroke damaging the right nucleus ambiguus and other centers. The clinical examination revealed ptosis of the left eye, soft palate elevation to the right of midline, symmetrical lingual protrusion, and a breathy dysphonia with precise articulation of all consonants. The patient is unable to swallow his saliva and coughs when he attempts to do so.
Based on the stroke type and clinical examination observations, which THREE of the following swallow impairments would the SLPS L P likely observe on the VFSSV F S S?
A.Incomplete clearance of material from the oral cavity
B.Impaired or absent opening of the upper esophageal sphincter
C.Anterior loss of bolus contents during the oral preparatory stage
D.Nasopharyngeal regurgitation during the pharyngeal stage
E.Adequate excursion of the hyolaryngeal complex
F.Unilateral pharyngeal paralysis
Options (B), (D), and (F) are correct. Impaired or absent opening of the upper esophageal sphincter, nasopharyngeal regurgitation during the pharyngeal stage, and unilateral pharyngeal paralysis are all to be expected based on this type of stroke and the clinical observations.
An SLPS L P will be working with a new mother to evaluate a term infant’s feeding and swallowing skills to determine the infant’s readiness for oral feeding. The infant has been diagnosed with a unilateral, complete cleft lip without cleft palate. The mother asks the SLP about what caused the infant’s cleft lip. The SLPS L P explains that while we know that both genetic and environmental factors are likely involved with this congenital birth abnormality, there is no consensus in research about a single cause of cleft lip.
The SLP completes a comprehensive oral sensorimotor and behavioral observation examination prior to initiating an oral-feeding trial. The following is documented in the SLP’sS L P’s assessment notes:
Right-sided complete cleft lip; otherwise unremarkable oral peripheral mechanism examination; medical chart notes no associated neurological difficulties or diagnosed syndromes; primitive reflexes present (e.g.for example, rooting); normal observation of posture, positioning, tone, and motor activity; infant presents awake, alert, and calm; baseline vital signs at rest are normal and no changes in respiratory rate, heart rate, or oxygen saturation noted with nonnutritive sucking; no respiratory stridor noted; mild external support needed to increase lip closure at introduction of pacifier nipple, and mother with strong desire to breastfeed. The mother expressed some anxiety and concern surrounding feeding an infant with a cleft lip.
During which of the following weeks of pregnancy did the infant’s craniofacial structures not develop completely?
A. 4-to7
B. 8-to11
C. 12-to15
D. 16-to19
Option (A) is correct. A cleft lip results from incomplete closure of lip tissues as the lips form early in pregnancy, between weeks four and seven. Both genetic and environmental factors likely contribute to a cleft lip, a congenital birth defect; however, a singular cause has not been identified.
Based on information from the oral sensorimotor and behavioral observation assessments, which of the following plans for continuing with an oral-feeding trial is most appropriate with the infant?
A. An oral-feeding trial should not be attempted until the infant’s cleft lip is repaired.
B. An oral-feeding trial should not be attempted until a VFSSV F S S or FEESF E E S instrumental examination is completed.
C. An oral-feeding trial should be postponed until the infant’s airway is examined by a physician.
D. An oral-feeding trial by the SLPS L P can proceed during this initial feeding and swallowing assessment.
Option (D) is correct. There is no evidence from the case review and oral sensorimotor/behavioral observations to suggest a neurological abnormality, respiratory disorder, or syndrome associated with feeding and swallowing disorders in infants. In the absence of respiratory and neurological signs, an instrumental evaluation or referral to a physician for a respiratory evaluation would not be indicated prior to an oral-feeding trial at bedside. Many infants with an isolated cleft lip are successful oral feeders prior to surgical repair of the cleft lip. All the evidence presented in the case supports the SLPS L P proceeding with the oral-feeding trial piece of the comprehensive feeding and swallowing assessment.
Which THREE of the following treatment strategies is most appropriate for the patient if the SLPS L P finds the infant is safe for continued oral breastfeeding and follows up with the infant and mother with therapy and education prior to discharge home from the hospital?
A.Introducing external pacing with the infant’s intake rate to support airway protection
B.Providing the mother with contact information for the local cleft lip and palate team for ongoing care and support
C.Incorporating adaptive seating for the infant during oral feedings
D.Positioning the infant in the optimal feeding position at the mother’s breast
E.Completing education with the infant’s mother about feeding interactions, strategies, and oral care
Options (B), (D), and (E) are correct. Providing the mother with contact information for the local cleft lip and palate team for ongoing care and support would be an appropriate strategy. Positioning an infant with either the cleft lip at the top of the mother’s breast or with the cleft lip against the mother’s breast can aid in achieving lip closure around the nipple and/or help prevent leakage of milk from the infant’s oral cavity. Completing education with this new mother will be very important, especially considering that this mother expressed concern and anxiety surrounding feeding her infant with a cleft lip.
A 65-year-old-male who is hospitalized with pneumonia completed a videofluoroscopic swallowing study. Findings showed aspiration after the swallow due to a reduced upper esophageal sphincter opening diameter separating the bolus tail, which was then retained in the pyriform sinuses. Which of the following interventions was designed to and is shown to improve upper esophageal sphincter opening?
A.Effortful swallow
B.Valsalva (breath hold)
C.Shaker (head lift) exercise
D.Lingual resistance exercise
Option (C) is correct. Shaker et aland others. (2002) showed that the head lift exercise significantly increased the diameter of the upper esophageal sphincter opening in people with dysphagia.
An endoscopic examination of swallowing is the best instrumental assessment when the SLPS L P wishes to evaluate the
A.volume of and patient’s response to pharyngeal secretions
B.duration and extent of hyolaryngeal elevation
C.penetration of material into the laryngeal vestibule during the swallow
D.efficiency of lingual manipulation during bolus formation and anterior-posterior bolus transit
Option (A) is correct. Endoscopic viewing is superior to other examinations when the primary goal is to evaluate the volume of and the patient’s response to pharyngeal secretions.
After completing an evaluation of a 5-year-old patient, an SLPS L P finds that the child’s speech contains numerous phonological error patterns. If the SLPS L P follows a developmental sequence in planning intervention, which of the following is most appropriate to target first?
A.Consonant assimilation
B.Gliding
C.Deaffrication
D.Cluster reduction
Option (A) is correct. Consonant assimilation processes rarely persist beyond 3 years of age.
An SLPS L P in a private practice receives a letter from the state licensing office informing her that her license expired the previous week. The SLPS L P was unaware that she had been practicing with a lapsed license for seven working days. Which THREE of the following actions are the best course of action for the SLPS L P?
A.Continuing to see patients as scheduled
B.Discontinuing treatment documentation
C.Informing the practice administrator
D.Reassigning patients to a licensed SLPS L P
E.Alerting patients to the lapse in licensure
Option (C) is correct. The practice administration can begin to move forward with corrective action with patients, families, payers, and the licensing body. Option (D) is correct. Without a license, the SLPS L P should not see patients, so patients should be reassigned for continuing care. Option (E) is correct. Without a license, the SLPS L P should not see patients, so patients should be reassigned for continuing care.
Which of the following reflexive responses is primarily responsible for expelling material from the airway of healthy adult individuals?
A.Rooting reflex
B.Gag reflex
C.Cough reflex
D.Swallowing reflex
Option (C) is correct. The cough reflex occurs when the vocal folds and trachea are stimulated by the laryngeal nerves, resulting in expulsion of material from the airway.
Question:
One treatment option for adductor spasmodic dysphonia involves the percutaneous injection of which of the following into the thyroarytenoid muscle?
A.Gelfoam
B.Collagen
C.Botulinum toxin
D.Autologous fat
Option (C) is correct. Adductor spasmodic dysphonia is a neurological voice disorder. Botulinum toxin is the only treatment listed that acts on the neuronal end plate, thereby treating a neurological deficit.