ETS Domain: Treatment

Praxis 5331 Laryngectomy Questions

Laryngectomy items on the Praxis 5331 test your knowledge of the three main alaryngeal speech options, stoma care, and the anatomical changes post-surgery. Expect scenarios about a patient choosing between an electrolarynx and a TEP, or troubleshooting a voice prosthesis in the outpatient setting.

Why this topic matters

Total laryngectomy questions appear in the medical SLP block and test comprehensive post-op knowledge.
ETS wants you to know how anatomy changes (airway/foodway are separated) and what that means for swallowing, smell, and communication.
TEP vs electrolarynx vs esophageal speech is a common comparison item.

High-yield concepts

After total laryngectomy the airway and foodway are separated — the patient breathes through a permanent stoma.
TEP (tracheoesophageal puncture) with a voice prosthesis is the most common and typically produces the best voice quality.
Electrolarynx: external device, robotic quality, no anatomical requirements — good backup option.
Esophageal speech: injects air into the esophagus and releases it — hard to learn, low volume, but no device.
Loss of smell/taste after laryngectomy — SLPs can teach the 'polite yawn' nasal airflow inducing maneuver.

Sample practice questions

Try answering before revealing the rationale — mark misses to retry later.

Q1.A 65-year-old male, three weeks post total laryngectomy, has a TEP with a voice prosthesis but reports the prosthesis is leaking during drinking. The SLP should:

A.Recommend the patient stop drinking liquids permanently
B.Assess the prosthesis for leakage through vs around the device and refer for replacement if needed
C.Reinsert the prosthesis and continue therapy
D.Refer to a psychologist

Show answer & rationale

Correct: B. Leakage through the prosthesis indicates a failing valve — the device needs replacement. Leakage around suggests a fistula issue. Assessing which is happening and referring is the correct next step.

Q2.Which alaryngeal option produces the most natural-sounding voice for most patients?

A.Electrolarynx
B.Esophageal speech
C.Tracheoesophageal speech (TEP with prosthesis)
D.Whispered speech

Show answer & rationale

Correct: C. TEP voice, powered by pulmonary air through the prosthesis, generally produces the most natural voice with the best loudness and duration. Electrolarynx is robotic; esophageal speech is quiet and difficult to master.

Q3.A patient after total laryngectomy asks why he can no longer smell his coffee. The best explanation is:

A.The olfactory nerve was severed during surgery
B.Air no longer flows through the nose because breathing occurs at the stoma
C.He needs a nasal steroid spray
D.This is a psychosomatic response

Show answer & rationale

Correct: B. The olfactory nerve is intact, but no air passes through the nose because respiration occurs at the stoma. The 'polite yawn' maneuver can restore some nasal airflow and smell.

Common wrong-answer traps

Forgetting that airway and foodway are separated — aspiration risk is different from a typical dysphagia patient.
Confusing TEP leakage through vs around the prosthesis.
Believing patients cannot regain any sense of smell.

Study moves this week

Draw pre- and post-laryngectomy anatomy showing airway/foodway separation.
Make a comparison table: TEP vs electrolarynx vs esophageal speech across voice quality, effort, and cost.
Practice explaining each option in plain language for a patient counseling role-play.

Want 400+ scenario questions with rationales?

Praxis Path unlocks a full question bank + 132-question timed mock exam and spaced-repetition flashcards.

See what's included Try free practice test

FAQ

Can a laryngectomy patient aspirate?

Aspiration into the airway is anatomically impossible after total laryngectomy because the airway and foodway are separated. Swallowing problems are still possible but the mechanism differs.

How long does it take to learn TEP speech?

Many patients produce voicing within days of prosthesis fitting, but conversational fluency takes weeks of therapy.

Is an electrolarynx a bad option?

No — it is a valid, reliable backup and often the first mode of communication used immediately post-op before a TEP is placed.

Praxis 5331 Laryngectomy Questions

Why this topic matters

High-yield concepts

Sample practice questions

Common wrong-answer traps

Study moves this week

Want 400+ scenario questions with rationales?

FAQ

Related topic question sets