Praxis 5331 Medical SLP Questions

Medical SLP items often turn on setting. In acute care, length of stay is short, medical stability drives everything, and the SLP's job is screening, initial evaluation, diet recommendation, safety, and disposition planning. In inpatient rehab, patients tolerate three hours of therapy daily across disciplines and goals become functional and intensive. In skilled nursing, therapy is longer-term with maintenance and caregiver training weighted more heavily. In home health and outpatient, generalization to real environments dominates.

That means the same patient description can have different correct answers depending on the setting named in the stem. Read the setting first; it constrains what a reasonable plan looks like as much as the diagnosis does.

Before seeing a patient you check medical stability and precautions: current diagnosis and date of onset, imaging results, respiratory status including oxygen and ventilator settings, diet order and NPO status, alertness, medications with sedating effects, and any positioning or activity restrictions. Items reward candidates who confirm alertness and respiratory status before proceeding with a swallow evaluation.

The most reliably scored medical-SLP judgment is knowing when not to proceed. Lethargy, an unmanaged fever, active reflux with vomiting, respiratory distress, or an unstable ventilator wean are all reasons to defer the bedside evaluation and communicate with the medical team. Answers that push ahead with a trial in an unstable patient are almost always incorrect.

Skilled documentation must state what required the skills of an SLP: the clinical reasoning, the cueing hierarchy, the modifications made, and objective response data. Notes that describe activities without clinical decision-making read as unskilled and are denied on review. Medical necessity, functional outcomes, and measurable progress are the vocabulary the exam expects.

Role boundaries also appear. The dietitian manages nutrition and hydration adequacy, respiratory therapy manages the ventilator and trach hardware, nursing manages medication administration and oral care implementation, occupational therapy manages self-feeding positioning and adaptive equipment, and the physician orders diets and instrumental studies. The SLP recommends; the physician orders.