PMI EXAM 3

All following are examples of Soft mechanical foods EXCEPT?

 Cheese

Rice cereal

 Roast chicken

 Meatballs

 Boiled vegetables

Rice cereal

All following reflexes are protective EXCEPT __________.

 Phasic bite

Suckling

Tongue Protrusion

Gag

Suckling

In neonates and young infants up to 3mos old, which components of feeding are voluntary?

 Oral phase

Pharyngeal phase

Esophageal phase 

None

None

Which statement is CORRECT regarding bottle-feeding?

 Only compression is needed for bottle feeding.

Only suction is needed for bottle feeding.

Both compression and suction are needed for efficient bottle feeding.

Neither compression or suction is needed for bottle feeding.

Both compression and suction are needed for efficient bottle feeding.

Which statement is INCORRECT? Compared with older children or adults, the newborns's

Oral cavity is smaller

Jaw is smaller

Tongue is relatively smaller

Buccal fat pads are larger

Tongue is relatively smaller

Which difference between nutritive suckling and non-nutritive suckling is WRONG?

 Nutritive suckling is used during feeding while non-nutritive suckling is used to soothe.

 Suck/swallow ratio is approximately 1:1 during nutritive suckling while it increases to 6 :1 during non-nutritive suckling.

 Suck/swallow ratio is the same in both nutritive suckling and non-nutritive sucking.

Suck/swallow ratio is the same in both nutritive suckling and non-nutritive sucking.

Infants born before _________ weeks gestational age are considered preterm (or premature).

37

38

40

42

37

Which statement is CORRECT?

 Anatomic development of the fetal gut is essentially complete by 25 weeks gestational age.

The lungs are amongst the earliest organ systems to reach an ex-utero survival threshold.

 The central nervous system matures in a central to peripheral sequence.

 The brainstem is the most highly developed area of the brain at birth.

 The brainstem is the most highly developed area of the brain at birth.

All statements are correct regarding the rooting reflex EXCEPT:

It occurs when tactile stimulation occurs to the side of the lips or cheek.

During this reflex, the infant turns the head laterally toward the stimulus and opens his or her mouth.

This reflex emerges in utero during the third trimester and continues to approximately 12 months of age, when it integrates.

This reflex allows the infant to locate the source of the feed (e.g., the mother's breast or bottle).

This reflex emerges in utero during the third trimester and continues to approximately 12 months of age, when it integrates.

Which oral skills are expected at 9-12 months of age?

An increasing proportion of fluids may be taken from a cup, although they still require breastfeeds or bottle feeds to meet their nutritional requirements.

It is appropriate for them to only consume thin purees.

Oral feeding skills are very coordinated, which results in improved efficiency of mealtimes and no need for the bottle or breast.

 The suckling reflex integrates at this time.

An increasing proportion of fluids may be taken from a cup, although they still require breastfeeds or bottle feeds to meet their nutritional requirements.

All following are the signs and symptoms of feeding problems in early infants EXCEPT: 

 Gagging

 Slow or delayed swallows with residue

 Mealtimes take 15 mins or less

 Poor lip seal around nipple

 Mealtimes take 15 mins or less

All statements are correct regarding tracheoesophageal fistula EXCEPT

 There is a fistula between the esophagus and the trachea

 Usually co-occurs with esophageal atresia

 Surgical correction is required to close any openings between the airway and esophagus

 Short gut syndrome is a surgical side effect

 Short gut syndrome is a surgical side effect

Feeding difficulties are common in children with Down syndrome as a result of________.

 Oral anatomy

 Low muscle tone

 Comorbid cardiac issues

 All of the above

 All of the above

State regulation/control issues can affect feeding in which age group?

 Preemies

 Toddlers

 Preschoolers

 Adolescents

Preemies

Which of the following is a sign and/or symptom of feeding problem in older infants/ children?

 Coughing, choking, gagging

 Vomiting

 Poor weight gain

 Food aversion of specific texture or food groups

 All of the above

 All of the above

Increased intracranial pressure inside the skull and progressive enlargement of the head is called ________________.

 Microcephaly

 Hydrocephalus

 Cerebral palsy

 Necrotizing enterocolitis 

 Hydrocephalus

Which statement is CORRECT regarding feeding difficulty in children with cerebral palsy (CP)?

 CP is caused by damage to the motor control centers of the developing brain, which can occur up to 5 years of age after birth.

 CP does not affect swallowing.

 Children with CP and dysphagia have lower incidence of undernutrition and growth failure.

 Children with CP frequently have difficulty with oral motor movements necessary for feeding, such as lip closure.

 Children with CP frequently have difficulty with oral motor movements necessary for feeding, such as lip closure.

Poor postural control in preterm infants can be due to

 having less muscle bulk and body fat compare with full-term infants

 reduced flexor tone through the head and neck

 Both a and b

 Both a and b

Which of the following respiratory conditions is caused by insufficient surfactant production?

 Apnea of a newborn

 Pulmonary hypoplasia

 Respiratory distress syndrome

 Bronchopulmonary Dysplasia

 Respiratory distress syndrome

Which perinatal condition can affect an infant's ability to feed?

 Jaundice

 Hyperglycemia

 Neonatal Abstinence Syndrome

 All of the above

 All of the above

You want to know whether your three-year-old client is consuming enough daily calories. Who is the best health professional to refer your patient to?

 Pediatrician

Occupational therapist

Dietician

Lactation consultant

Dietician

When conducting a pediatric feeding evaluation, which of the following is an important consideration?

Evaluating the child in a separate room from the caregiver 

Using only parent report to assess the child's feeding

Considering the child's developmental stage

Ignoring the child's behavioral cues during feeding

Considering the child's developmental stage

A clinical feeding evaluation by speech language pathologists will entail all of the following activities, EXCEPT _______________. (hint: this activity is not within the scope of our practice)

Inspecting oral anatomy

Obtaining a case history of the child's feeding and swallowing

Assessing oral-motor skills during non-feeding tasks

Determining energy and nutrient requirements based on age and gender

Determining energy and nutrient requirements based on age and gender

All of the following are adverse clinical signs of potential aspiration in children, EXCEPT: 

 Wet voice

Cyanosis

Rattly chest/frequent respiratory infections

Tongue protrusion

Tongue protrusion

Penetration occurs when the bolus

enters the valleculae

enters the laryngeal vestibule but stays above or at the level of the true vocal cords

enters the laryngeal vestibule and passes the level of the true vocal cords

enters into the pharyngoesophageal sphincter

enters the laryngeal vestibule but stays above or at the level of the true vocal cords

Which of the following feeding behaviors is a feature of sensory defensiveness?

Messy hands and face

Overfills mouth

Gags on certain foods

Prefers foods to be rich in flavors and textures

Gags on certain foods

White/bland food diet is common in children with_________.

 Hyposensitivity

Autism

Oral motor impairments

Tongue-Tie

Autism

True or False: VFSS/MBS are more commonly used to assess infants and younger children's feeding skills vs. FEES.

True

False

True

When completing a case history and parent interview regarding a patient's feeding difficulties, it's important to ask about all of the following things EXCEPT: 

 Bowel movements/habits

Where the child sits for meals

Pregnancy and birth history

What town the patient lives in

What town the patient lives in

When assessing bottle feeding, it's important to assess all the following EXCEPT: 

Latch

Suck/swallow/breathe coordination

The type of car seat the infant is brought to the assessment in.

How quickly the infant finishes the bottle

The type of car seat the infant is brought to the assessment in.

All of the following are true rationale supporting the use of thickened liquids with infants, EXCEPT _____________.

Slow the flow of liquids

Gives more time to protect the airway

Decreased risk of penetration pre-swallow

Decreased risk of aspiration post-swallow

Decreased risk of aspiration post-swallow

Imposing breaks during feeding and and drinking to interrupt the flow of liquid is called ____________________.

Pacing

 Positioning

 Fading

 Operant conditioning

 Non-nutritive sucking

Pacing

Which of these equipment may be used with older children to slow the flow of fluids? (Select all that apply)

Slow-flow nipples

Infatrainer cup

Cut-out cups

Gum brushes

You are exposing your child client with feeding difficulty to a range of foods in play-based activities. You intend to make the activity more challenging over time. What behavioral feeding therapy approach do you use?

 Operant conditioning

Systematic desensitization

Fading

Thinning

Systematic desensitization

You want to know whether your two-year-old client's daily calorie intake is improved secondary to feeding therapy success. Who is the best health professional to collaborate with?

 Pediatrician

Nobody. I can do it on my own

Dietician

Lactation consultant

Dietician

Which of the following is least effective in improving feeding and swallowing in children?

Change in feeding equipment

Positioning

Pacing

Swallowing maneuvers

Swallowing maneuvers

Which statement is correct regarding Oral-Sensory Motor (OSM) therapy?

It is not commonly used in clinical practice.

The basic intent of OSM therapy is to improve eating, not speaking.

Sufficient evidence exists to support the effectiveness of OSM therapy when addressing dysphagia in children with different etiologies.

A common criticism of OSM therapy is that performing sensory and motor exercises in isolation rarely leads to functional changes in feeding or swallowing skills.

A common criticism of OSM therapy is that performing sensory and motor exercises in isolation rarely leads to functional changes in feeding or swallowing skills.

Which statement is WRONG regarding the factors affecting the thickness of thickened fluids?

Thickening agents are generally starch-based, gum-based, or a combination of both

More or less thickening agent may be required when thickening different fluid types

Thickened liquids should always be used when aspiration occurs

Thickened liquids generally get thicker with time

Thickened liquids should always be used when aspiration occurs

True or False: A z-vibe is an oral motor-sensory tool that can be used during feeding therapy to work on oral motor movement, as well as decreased or increased sensitivity in the mouth.

True

False

True

True or False: Gagging is noisy, while choking is silent. 

True

False

True