SLP - Speech-Language Pathology Swallowing and Feeding Disorders Questions and Answers

Question 1

An SLP is conducting a clinical bedside swallowing evaluation on an 82-year-old male post-CVA.
When the patient is trialed with a small sip of thin liquid from a cup, he immediately coughs.
What is the most immediate and appropriate next step for the SLP?

Accepted Answer

Modify the liquid consistency to nectar-thick and administer a small sip to assess the patient's response.

Answer

Document the cough and continue the trial with larger sips of thin liquid to confirm the response.

Answer

Immediately make the patient NPO (nothing by mouth) and recommend a videofluoroscopic swallow study (VFSS).

Answer

Assume the patient is aspirating and begin implementing the Mendelsohn maneuver.

Question 2

Which of the following is a key diagnostic feature that distinguishes a pediatric feeding disorder from typical "picky eating"?

Accepted Answer

The child's nutritional intake is compromised, leading to weight loss, failure to thrive, or specific nutrient deficiencies.

Answer

The child refuses to eat vegetables but accepts a variety of fruits.

Answer

The child's accepted food repertoire consists of fewer than 30 different foods.

Answer

The child exhibits occasional tantrums during mealtimes when presented with a non-preferred food.

Question 3

A 55-year-old female patient with a tracheostomy tube is referred for a swallowing evaluation in the ICU. She is ventilator-dependent and cannot be safely transported to the radiology suite. The primary concerns are managing copious secretions and assessing laryngeal function during swallowing attempts. Which instrumental assessment is the most appropriate choice?

Accepted Answer

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Answer

Videofluoroscopic Swallow Study (VFSS)

Answer

High-Resolution Pharyngeal Manometry (HRM)

Answer

Cervical Auscultation

Question 4

The oral preparatory phase of swallowing, which involves manipulating and chewing the bolus, is primarily dependent on motor innervation from which cranial nerve?

Accepted Answer

CN V (Trigeminal)

Answer

CN IX (Glossopharyngeal)

Answer

CN X (Vagus)

Answer

CN XII (Hypoglossal)

Question 5

A patient is observed to have significant post-swallow residue in the valleculae during a videofluoroscopic swallow study (VFSS). Which of the following compensatory maneuvers would be most effective for clearing this specific residue?

Accepted Answer

Effortful swallow

Answer

Chin tuck

Answer

Head turn to the weak side

Answer

Supraglottic swallow

Question 6

An SLP evaluates a 92-year-old resident of a long-term care facility who has advanced dementia and is aspirating thin liquids. The resident consistently refuses thickened liquids, becoming agitated when they are offered. She derives significant pleasure from drinking regular coffee with her family. The family understands the risks but wishes to prioritize her comfort and quality of life. What is the most appropriate and ethical approach for the SLP?

Accepted Answer

Collaborate with the patient, family, and medical team to develop a comfort-focused feeding plan that balances safety with quality of life, which may include options like a Frazier Free Water Protocol.

Answer

Insist on a pureed diet and nectar-thick liquids to eliminate all aspiration risk, regardless of the resident's preference.

Answer

Discharge the resident from speech therapy services due to non-compliance with recommendations.

Answer

Document that the family is refusing recommendations and have them sign a waiver to absolve the facility of all responsibility.