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Medical SLP items focus on the acute care and ICU setting: tracheostomy/ventilator management, Passy-Muir valve, NPO decisions, and ICU-acquired weakness. Expect 4-6 items.
Try answering before revealing the rationale — mark misses to retry later.
Q1.Before placing a Passy-Muir Valve on a tracheostomized patient, the tracheostomy cuff must be:
Correct: C. The PMV is a one-way valve; on exhalation, air is redirected up through the vocal folds. This requires a fully deflated cuff so air can pass around the trach tube.
Q2.A patient in the ICU is unresponsive, cannot follow commands, and has retained secretions. The MOST appropriate SLP recommendation is:
Correct: A. An unresponsive patient with retained secretions is at high aspiration risk. NPO with reassessment when alert and stable is the appropriate recommendation.
Q3.Which finding on MBSS most directly indicates aspiration?
Correct: B. Aspiration is specifically defined as bolus passing below the level of the true vocal folds. Penetration is bolus at/above the folds. Both are captured on the Penetration-Aspiration Scale.
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Do SLPs make NPO decisions independently?
No — NPO status is a team decision. SLPs contribute swallow evaluation findings and recommendations; the physician orders NPO.
Can SLPs manage tracheostomy in the ICU?
Yes — within scope for swallow, voice, and communication assessment, in collaboration with respiratory therapy and physicians.
What is the difference between aspiration and penetration?
Penetration = bolus enters laryngeal vestibule but stays at/above the true vocal folds. Aspiration = bolus passes below the true vocal folds.