1) An SLP working in a voice clinic receives a new referral for a voice evaluation. The presenting complaint is sudden onset of voice loss. Of the following case history questions, which are most likely to contribute to a differential diagnosis of the disorder? Select three. a) Have you experienced any recent emotional or psychological trauma? b) Do you have any history of smoking? c) Have you experienced any previous problems with your voice? d) How do you use your voice at work and in other daily situations? 2) A transgender female seeks voice therapy as part of the transitioning process. Which voice characteristics are the primary focus of the therapy for modifying voice characteristics? a) Pitch, articulation, and vocabulary b) Pitch, resonance, and intonation c) Pitch, resonance, and articulation d) Resonance, articulation, and intonation 3) Muscle relaxation approaches to voice therapy are typically used for: a) Vocal hyperfunction disorders b) Psychogenic voice disorders c) Gender-affirming voice therapy d) Vocal hypofunction disorders 4) Philip is a speech–language pathologist at an elementary school. During the previous year he noticed that several of the classroom teachers experienced periods of dysphonia throughout the year. Which of the following is an example of a primary prevention activity Philip might consider to prevent dysphonia? a) Offer to provide intervention services to teachers experiencing vocal strain through the private practice he maintains outside of his school-based employment b) Suggest 2 weeks of vocal rest for any teachers who experience difficulty with their voice c) Philip should not share prevention information with the classroom teachers because he is only employed to serve the children d) Share information about vocal hygiene and advocate funding to purchase voice amplification systems for teachers; emphasize the need to follow up with a physician and to seek speech-language pathology services if indicated 5) A laryngeal web can be caused by which of the following? Select three. a) Upper respiratory illness b) all of these are correct c) Prolonged intubation d) Trauma to the neck e) Human papillomavirus f) Congenital abnormality 6) A 78-year-old female professional voice user presents for a voice evaluation and is diagnosed with presbyphonia. Which of the following voice therapy recommendations is best for this individual? a) Behavioral voice therapy targeting phonation resistance exercises b) Behavioral voice therapy targeting patient education c) No behavioral voice therapy d) Behavioral voice therapy targeting muscle relaxation 7) You are preparing to conduct a voice evaluation on a patient diagnosed with paradoxical vocal fold motion (PVFM). Which of the following patient-reported outcome measures would best inform your assessment of this patient and should be included as part of the evaluation? a) Cough Severity Index b) Dyspnea Index 8) Hard glottal attacks are commonly assessed during a voice assessment. Which of the following tasks is most appropriate for assessing hard glottal attacks? a) Throat-clearing b) Counting from 80 to 89 c) Coughing d) The s/z ratio 9) Mr. Tallman is a 62-year-old man who recently experienced a viral infection and subsequently “lost his voice.” He scheduled an evaluation with an SLP to determine the nature of his problems and the appropriate course of treatment. Based on this limited information, which cranial nerve was likely impacted by the viral infection? a) Cranial nerve V (trigeminal nerve) b) Cranial nerve VII (facial nerve) c) Cranial nerve X (vagus nerve) d) Cranial nerve XII (hypoglossal nerve) 10) During an assessment, the patient was not able to produce voiced speech sounds. The SLP concludes that the vocal folds are not adducting. What are the two primary muscles responsible for vocal fold adduction? a) Posterior cricoarytenoid b) Lateral cricoarytenoid c) Thyrovocalis d) Transverse arytenoid 11) Which of the following parameters of voice does the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) assess? a) Frequency b) Quality c) Subglottal Pressure d) Intensity 12) Which of the following case history questions would help differentiate the underlying cause of a client’s spasmodic dysphonia as psychogenic versus organic? [Select 2] a) Are there situations in which you notice increased or decreased difficulty with your voice b) Could you describe your nutrition and hydration habits, including the amount of water you drink on a daily basis c) Could you describe any efforts to improve this difficulty, including whether you have received previous therapy d) Did you experience any significant life changes around the same time that you first noticed the increased difficulty with your voice 13) What is Mean frequency? a) The minimum level of pressure to initiate voicing b) Pitch during spontaneous speech 14) What is Maximum phonation time? a) The longest time that voicing can be sustained b) The range of pitches the patient is able to produce 15) Phonation frequency range is the range of pitches the patient is able to produce? a) true b) false 16) Phonation threshold pressure is the minimum level of pressure to initiate voicing? a) true b) false 17) Which of the following causes are related to external laryngeal trauma? Select three. a) Automobile exhaust inhalation b) Gastroesophageal reflux c) Intubation during surgical procedures d) Gunshot wound 18) Individuals at risk for voice disorders are often counseled to drink plenty of water in order to prevent a voice disorder. What is the rationale behind this recommendation? a) Maintaining good hydration is important to preventing strokes, which are a major cause of voice disorders b) Maintaining good hydration prevents the vocal folds and larynx from becoming dry and irritated, which can potentially lead to a voice disorder c) Maintaining good hydration helps prevent gastroesophageal reflux, which can lead to a voice disorder d) Maintaining good hydration helps prevent obesity, which is a major cause of voice disorders 19) Susan is an SLP who wants to engage in focused prevention activities. She collaborates with the administration of her local school district to improve the acoustics within classrooms. She contributes to efforts in her community to reduce smoking and alcohol use disorder. Finally, she joins an interprofessional group that promotes mental health within the community by teaching healthy ways to deal with stress. What type of communication disorder could Susan prevent with these efforts? a) Voice disorders b) Speech sound disorders c) Hearing loss d) Dysarthria 20) An ENT conducts a laryngeal examination of a 6-year-old child. The ENT observes bilateral lesions in the mid-membranous portion of the true vocal folds. What is the MOST LIKELY diagnostic conclusion of the ENT? a) Paradoxical vocal fold motion b) Vocal nodules 21) The SLP instructs the client to “sit in the chair, firmly grasp the seat on each side, and push downward while producing /a/”. In this example, what type of voice disorder is being treated? a) Vocal hyperfunction voice disorder b) Paradoxical vocal fold dysfunction c) Vocal hypofunction voice disorder d) Psychogenic voice disorder 22) A patient who has recently undergone cardiac surgery is referred for an SLP evaluation due to concerns of vagus nerve damage during the surgery. Which of the following tasks would be most appropriate to quickly inform the SLP as to whether this damage may have occurred a) Ask the patient to sustain /a/ and rate vocal quality b) Ask the patient to repeat /pʌtʌkʌ/ as quickly as possible and count the number of repetitions per 10 seconds c) Ask the patient to blow into a straw to make bubbles in water and measure the length of time he can sustain this action d) Ask the patient to sustain /a/ and rate resonance 23) A 7-year-old boy presents with a hoarse, low-pitched, but within age expectations, voice. An ear, nose, and throat examination revealed bilateral vocal nodules, with swollen and irritated vocal folds. According to parent report, the child is active and frequently shouts and screams. He is also noted to “talk incessantly” and to make sound effects. Which of the following are the most appropriate targets for therapy? Select three. a) Identification of vocally abusive situations b) Establishment of appropriate pitch c) Establishment of target voice d) Elimination of abusive behaviors 24) Semi-occluded vocal tract exercises use which one of the following methods? a) Straw phonation b) Yawn-sigh 25) An SLP is approached by an individual who is transgender. This potential client says she is transitioning from male to female and wants to sound more feminine. The SLP should: a) Work with the client on gender-related aspects of voice, articulation, language, and nonverbal communication b) Assess the client for any possible communication disorders, then treat those disorders 26) Which of the following techniques is used with patients who have paradoxical vocal fold dysfunction? a) Respiratory retraining b) Increasing loudness c) Cough suppression d) Adjusting pitch 27) In general, which of the following etiologies is MOST likely to be associated with a very good prognosis for improvement with behavioral voice therapy? a) Functional voice disorders with no associated medical pathology b) Velopharyngeal insufficiency 28) What treatment approach emphasizes voice awareness, efficient voice production, and conversational narratives and is grounded in motor learning theory a) Lee Silverman Voice Treatment b) Flow phonation therapy c) Lessac-Madsen Resonant Voice Therapy d) Conversational training therapy 29) To view the vibration of the vocal folds during phonation, which laryngeal visualization procedure is recommended a) Laryngeal endoscopy b) Ultrasound c) Videoflouroscopy d) Videostroboscopy 30) A 37-year-old woman presents with right unilateral adductor vocal fold paralysis subsequent to damage to the vagus nerve during intubation during a surgical procedure. Which therapy technique would be most appropriate for this client?I a) Pushing/pulling b) Chant talk c) Yawn-sigh d) Relaxing muscles 31) Which of the following strategies might be effective for reducing coughing and throat-clearing behaviors? a) Maintain a wide, open mouth b) Complete a hard, effortful swallow 32) Which one of the following descriptions best describes the target of physiologic voice therapy approaches? a) Modification of neurologic characteristics of the vocal mechanism b) Modification of functionality characteristics of the vocal mechanism 33) Precancerous, plaque-like formations on surface of vocal folds, primary cause is chronic irritation. Voice quality is rough and/or hoarse. a) laryngopharyngeal reflux b) Granuloma c) leukoplakia d) vocal fold nodules 34) Some management options for an individual with vocal fold polyps are: (select all that apply) a) Phonosurgery b) Radiation c) Behavioral voice therapy d) Vocal hygiene 35) Sulcus Vocalis is a wart-like or raspberry-like growths. Increased stiffness on the vocal folds. a) true b) false 36) Thinning or loss of the superficial layer of vocal fold tissue is a characteristic of which vocal pathology a) Varix/Ectasia b) Sulcus Vocalis, c) Muscle tension dysphonia d) Subglottic stenosis 37) This scale measures how a voice problem influences an adult patient's quality of life. a) Voice Handicap Index b) Consensus on Auditory Perceptual Evaluation of Voice 38) Narrowband spectrograms are useful in acoustic evaluation because they can provide information about the stability of vibration in the patient's voice. a) true b) false 39) What is the acoustic terminology for what we perceive as loudness? It is often measured as part of an acoustic voice evaluation. a) Air flow b) Pitch c) Intensity d) Jitter 40) Which of the following acoustic measures is most useful for assessing the degree of acoustic noise in a voice? a) Harmonic-to-noise ratio (HNR) b) Maximum phonation time (MPT) 41) Leukoplakia is the most common cause of inspiratory stridor in infancy. a) true b) false 42) Reinke's Edema results from buildup of fluid in the superficial layer of the vocal folds? a) true b) false 43) Dyspnea is the conscious awareness of labored breathing or air hunger a) true b) false 44) Pulmonary function screening is completed using which tool? a) Surgery b) Sound level meter c) Spirometry d) MBS

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