Deck 5: Feeding Problems of Infantswith Clefts or Craniofacial Anomalies

Question 1

Feeding problems are most likely to occur when the infant presents with which of the following?

A)Bilateral cleft lip
B)Incomplete cleft of the soft palate
C)Complete cleft of the palate
D)Glossoptosis
E)c and d

Answer 1

E

Question 2

What is the main reason that an infant with bilateral complete cleft lip and palate will have feeding difficulty?

A)The nipple gets pushed into the open cleft during attempts at feeding
B)There is not enough hard palate surface for compression of the nipple
C)The open cleft interferes with the ability to build up suction
D)The infant cannot purse the lip adequately around the nipple
E)The base of the tongue occludes the posterior cleft, making swallowing difficult

Answer 2

C

Question 3

When feeding an infant, a general rule of thumb to follow is that the infant should be burped after how many ounces of intake?

A)1/2 ounce
B)1 ounce
C)2 ounces
D)3 ounces
E)4 ounces

Answer 3

B

Question 4

The size of a newborn's larynx is approximately what proportion to that of an adult's larynx?

A)1/2
B)1/3
C)1/4
D)1/5
E)1/8

Question 5

What is the best way to determine the effectiveness of airway protection during rapid chain swallowing sequences?

A)Fiberoptic endoscopic evaluation of swallowing FEES)
B)Assessment of breathing after the swallow
C)Videofluoroscopy
D)Assessment of coughing after a swallow
E)Evaluation of nasal regurgitation

Question 6

What is the purpose of a nonnutritive stimulation?

A)To heighten sensory awareness
B)To facilitate oral motor action
C)To help prevent development of oral aversion
D)To elicit a sucking response
E)All of the above

Question 7

Which of the following describes the pacing strategy?

A)Providing oral feeding at defined intervals during a 24-hour period
B)Decreasing the rate of intake during feeding by imposing periodic pauses during feeding
C)Alternating feeding and burping at a predetermined schedule
D)Providing assistive squeezing at a certain rate per minute
E)Burping the infant every minute, regardless of oral intake

Question 8

Which of the following facilitates early suckling?

A)The tongue rests in a more anterior position
B)The tongue tip protrudes past the alveolar ridge and maintains contact with the lower lip
C)The temporomandibular joint does not allow for much movement, causing the mouth opening to be small
D)a and c
E)a, b, and c

Question 9

As the infant grows, which of the following structures does not descend?

A)Velum
B)Epiglottis
C)Hyoid
D)Larynx
E)Vocal cords

Question 10

Which of the following are essential for normal feeding?

A)Nipple compression
B)Generation of positive pressure suction
C)Generation of negative pressure suction
D)a and b
E)a and c

Question 11

Around what age is an infant ready to transition from a bottle to a cup?

A)4 to 6 months
B)8 to 9 months
C)10 to 12 months
D)12 to 13 months
E)15 to 18 months

Question 12

Which of the following structures is not actively involved in the physical act of sucking?

A)Jaw
B)Cheeks
C)Lips
D)Maxilla
E)Tongue

Question 13

Which of these is a feeding concern in children with Moebius syndrome?

A)Timing and coordination of sucking and swallowing
B)Achieving and maintaining an adequate lip seal
C)Excessive airflow through an open cleft
D)Nasal regurgitation
E)Airway obstruction

Question 14

Breastfeeding is more likely to be possible in which of the following circumstances?

A)Anterior cleft hard palate only)
B)Posterior cleft soft palate only)
C)Cleft lip only
D)a and c
E)b and c

Question 15

What two items must work synchronously to be effective for normal feeding?

A)Nipple compression and rooting reflex
B)Tongue elevation and cupping of the tongue
C)Nipple compression and generation of negative pressure suction
D)A and B
E)All of the above

Question 16

Which of the following is described as "assisted fluid delivery"?

A)Use of nasogastric feeding to supplement volume of intake
B)Use of gastrostomy tube feedings following oral intake
C)Use of gentle squeezing of a nipple or flexible bottle during feeding to deliver fluid
D)Use of a crosscut nipple to increase flow of fluid during sucking
E)Use of a tube in addition to breast feeding

Question 17

Which of the following is true about a child with Pierre Robin sequence?

A)There are fewer feeding difficulties in comparison to infants with other types of clefts.
B)Breastfeeding is easier due to the micrognathia.
C)A shorter wider nipple is best for bottle-feeding.
D)There are often respiratory difficulties associated with feeding attempts.
E)The glossoptosis affects the infant's ability to latch on to the nipple.

Question 18

What is the main reason that infants with cleft palate have difficulty with breastfeeding?

A)Abnormal swallowing
B)Inability to generate adequate suction
C)Abnormal compressions
D)Abnormal breathing
E)Poor coordination of suck-swallow-breathe

Question 19

What is the most effective feeding positioning to decrease nasopharyngeal regurgitation during feeding?

A)Supine
B)Semi-reclined
C)Fully reclined
D)Upright
E)Prone