Praxis Practice Test 1
Which of the following is the optimal range of stimulation rates for determining threshold for a click ABR? · 0.37 to 0.99 · 11.1 to 21.1 · 59.1 to 63.1 · 69.1 to 73.1 · 79.1 to 93.
11.1 to 21.1
Which of the following would be the most appropriate acoustic modifications for an earmold when fitting a precipitously sloping high-frequency sensorineural hearing loss? · 2 mm sound bore, standard tubing, no vent · 3 mm sound bore, Libby horn, narrow vent · 4 mm sound bore, Libby horn, no vent · 2 mm sound bore, Libby horn, wide vent · 4 mm sound bore, long tubing, narrow vent
2 mm sound bore, Libby horn, wide vent
Under Occupational Safety and Health Administration (OSHA) regulations adopted in March 1983, a standard threshold shift on an annual audiogram is defined as a change in hearing threshold relative to the baseline audiogram of an average of 10 dB or more at which of the following frequencies? · 500, 1000, and 2000 Hz · 1000, 2000, and 3000 Hz · 2000, 3000, and 4000 Hz · 500, 1000, 2000, and 3000 Hz · 500, 1000, 2000, and 4000 H
2000, 3000, and 4000 Hz
Click-evoked auditory brainstem response (ABR) thresholds are generally most closely correlated with behavioral thresholds for frequencies of · 1000 Hz only · 250-500 Hz · 500-1000 Hz · 2000-4000 Hz · 6000-8000 Hz
2000-4000 Hz
A patient in the early stages of Ménière's disease will have an increase in the amount of endolymph in the inner ear. At the same time, audiometric assessment is likely to show sensorineural hearing loss that primarily affects which of the following frequency ranges? · All frequencies equally · 250-2000 Hz · 2000-4000 Hz · 4000-8000 Hz · 8000-10000 Hz
250-2000 Hz
Which of the following reflects the compression ratio for the input-output function at 50 dB SPL? · 2:1; 50 dB SPL · 1:1; 50 dB SPL · 4:1; 90 dB SPL · 3:1; 50 dB SPL · 5:1; 90 dB SPL
2:1; 50 dB SPL
The American National Standards Institute (ANSI) standard for classroom acoustics (ANSI/ASA S12.60) pertains to noise levels in unoccupied classrooms and recommended reverberation times. The ANSI standards are intended for use in the design of new classrooms and in the renovation of existing classrooms. The recommended noise levels and reverberation times are · 10 dBA or less and 0.1 seconds or less · 50 dBA or less and 1.0 seconds or less · 35 dBA or less and 0.6 seconds or less · 55 dBA or less and 0.6 seconds or less · 45 dBA or less and 4.1 seconds or less
35 dBA or less and 0.6 seconds or less
Which of the following is considered to be the best AI-DI for a directional microphone performing in noise? · -5 dB · -3 dB · 0 dB · 3 dB · 5 dB
5 dB
A person calls to order tickets for a concert and is told that at the rear of the orchestra section, which is 20 meters from the stage, the average intensity is 65 dB SPL. The person decides to purchase tickets for seats that are 10 meters from the stage, where the sound-pressure level will average which of the following? · 59 dB SPL · 62 dB SPL · 65 dB SPL · 68 dB SPL · 71 dB SPL
71 dB SPL
According to the contralateral masked-threshold function shown in the figure above, which of the following values represents the true threshold for the test ear? (picture on separate document) · 50 dB HL · 55 dB HL · 65 dB HL · 75 dB HL · 95 dB HL
75 dB HL
A patient reports no major hearing loss but says she experiences tinnitus in both ears. She does not report difficulties understanding others except in noisy surroundings. She reports no difference between the two ears. Which of the following is the audiologist most likely to see when the client is tested with pure-tone audiometry? · Hearing within normal limits · A moderate conductive hearing loss below 500 Hz and above 8000 Hz · A hearing loss at frequencies above 8000 Hz · A high-frequency sensorineural hearing loss · A low-frequency sensorineural hearing loss
A high-frequency sensorineural hearing loss
Which of the following best describes American Sign Language? · A language that uses visual gestures to spell individual words · A language with its own syntax that relies on visual-gestural symbols · A language with English syntax that relies on visual-gestural symbols · A language of visual-gestural symbols easily transferable to written English · A language of visual-gestural symbols that are comprehensible to anyone who uses a signed language
A language with its own syntax that relies on visual-gestural symbols
An audiologist evaluates a 2-year-old child with a history of recurrent serous otitis media and limited expressive speech production. Pure tone audiometry reveals a mild conductive hearing loss from 500 to 2000 Hz. Based on these findings, the audiologist should first recommend which of the following? · An audiometric follow-up in one year · A trial period of speech-language therapy · An evaluation for a mild-gain, ear-level hearing aid · A home language-enrichment program · A medical referral and speech-language consultation
A medical referral and speech-language consultation
While tympanometry is being performed on a patient, a seal is obtained on the test ear. The volume of the external canal is 5 cubic centimeters. During the tympanometric measurement, the seal is lost intermittently whenever the patient swallows. Which of the following is the most likely cause of the problem? · Eustachian tube dysfunction · A collapsed canal · Otitis media · Impacted cerumen · A perforated tympanic membrane
A perforated tympanic membrane
Which of the following is most likely to result from a head injury involving a transverse fracture of the temporal bone through the otic capsule? · No hearing loss · A transient sensorineural hearing loss · A permanent sensorineural hearing loss · A conductive hearing loss · A torn and painful auricle
A permanent sensorineural hearing loss
Click-evoked otoacoustic emissions are most likely to be recorded from the ears of which of the following individuals? · A person with a profound hearing loss · A person with severe presbycusis · A person with an upper brainstem lesion · A person with otitis media · A person who has ingested large quantities of aminoglycosides
A person with an upper brainstem lesion
A new patient, Mr. Harris, reports to an audiologist's clinic and reports that eight weeks ago he had surgery to repair a fistula in the round window in his left ear. The patient tells the audiologist that he was discharged by the surgeon and told that the procedure was successful. The patient indicates that he has not noticed any change in his hearing since the operation. Which of the following actions should the audiologist take first? · Referral for another medical evaluation · Auditory brainstem response (ABR) testing · A routine audiometric evaluation · Evaluation for a conventional CROS hearing aid · Evaluation for a transcranial CROS hearing aid
A routine audiometric evaluation
It is important to consider the gestational age of an infant, rather than the chronological age, when interpreting which of the following? · ABR Wave V latencies · DPOAE responses · TORCH factors · Apgar scores · WIPI scores
ABR Wave V latencies
A patient wearing a behind-the-ear hearing aid returns to an audiologist with a complaint that sound is hollow and that her own voice sounds as if it were in a barrel. Which of the following actions by the audiologist would likely be most helpful in this situation? · Lowering the OSPL90 · Adding a vent or enlarging the present vent · Ordering a new earmold without a helix portion · Adding a 680-ohm or 1500-ohm damper to the earhook · Widening the earmold bore
Adding a vent or enlarging the present vent
An audiologist is asked to establish a hearing-conservation program for an industrial firm. To ensure validity in monitoring the hearing of workers in conformance with the requirements of Occupational Safety and Health Administration (OSHA) regulations, the audiologist must do which of the following? · Test at the end of the work shift in order to record the observed temporary threshold shift (TTS) · Test at all frequencies in octaves between 250 and 8000 Hz and also at 3000 Hz and 6000 Hz · Include acoustic immittance measures in the hearing-test battery · Test only those employees whose daily noise dose exceeds maximum permissible noise levels · Administer threshold tests in areas where ambient noise levels conform to the regulations published in the Federal Register
Administer threshold tests in areas where ambient noise levels conform to the regulations published in the Federal Register
Functional gain of a hearing aid is best defined as the difference between which of the following? · Aided and unaided word-recognition scores · Input at the hearing-aid microphone and output into an HA-2 coupler · Aided and unaided ear-canal signal levels · Aided and unaided sound-field thresholds · Input at the hearing-aid microphone and output into the ear canal
Aided and unaided sound-field thresholds
Which of the following individuals should be referred to a speech-language pathologist? · A 2-month-old male with no expressive vocabulary · An 18-month-old female with no expressive vocabulary · A 24-month-old male who is starting to put words together in sentences · A 24-month-old female who is starting to put words together in sentences · A 42-month-old female who is able to tell stories
An 18-month-old female with no expressive vocabulary
Which of the following, if present in a 7-year-old patient's medical history, does NOT indicate that the patient is at risk for hearing impairment? · Treatment with ingestion of cisplatin · An Apgar score of 7 at one minute after birth · Family history of neurofibromatosis type II · Treatment with aminoglycosides · Treatment with loop diuretics
An Apgar score of 7 at one minute after birth
Individuals with normal hearing sensitivity in one ear and a severe hearing loss in the other ear experience which of the following? · An improvement in speech understanding when the noise is closer to the ear with hearing loss · Improved ability to localize when the noise source is closer to the ear with normal hearing · Better speech understanding and localization as the reverberation time increases · More difficulty understanding speech when the speaker moves closer to the ear with hearing loss · Improved localization when the noise is at 0° azimuth and the source is closer to the ear with hearing loss
An improvement in speech understanding when the noise is closer to the ear with hearing loss
Which of the following is the most sensitive measure of VIIIth-nerve dysfunction? · Otoacoustic emissions · Auditory brainstem response (ABR) · Speech recognition testing · Performance intensity-phonetically balanced (PI-PB) function · Acoustic reflex decay testing
Auditory brainstem response (ABR)
Of the following conditions that can affect children's hearing, which is the most likely cause of acquired sensorineural hearing loss? · Serous otitis media · Otosclerosis · Waardenburg syndrome · Bacterial meningitis · Turner syndrome
Bacterial meningitis
Which of the following is a type of test that provides information about the left horizontal semicircular canal independent of the right horizontal semicircular canal? · Caloric · Sinusoidal rotary · Pseudorandom rotary · Dynamic posturography · Fistula
Caloric
Among children with nonsyndromic clefts of the lip and palate, which of the following types of hearing loss is most common? · Sensorineural · Congenital · Mixed · Central auditory · Conductive
Conductive
A patient tells an audiologist that she recently had surgery for otosclerosis in her right ear. The ENT indicated that the procedure was successful. However, the surgeon nicked the chorda tympani. Which of the following is the patient likely to report? · Decreased hearing in the low frequencies · Difficulty swallowing · Decreased sensation of taste · Decreased hearing in the high frequencies · Numbness on one side of her face
Decreased sensation of taste
In this study, speech recognition performance can best be described as which type of variable? · Independent · Dependent · Classification · Criterion · Predicted
Dependent
Which of the following hearing-aid features would MOST benefit a patient who is having trouble understanding speech in background noise? · Compression limiting · Directional microphones · Feedback cancellation · Digital noise reduction · Frequency lowering
Directional microphones
Which of the following is a VNG/ENG test designed to determine whether nystagmus will occur with a specific rapid body maneuver? · Epley · Dix-Hallpike · Bárány · Gaze · Spontaneous nystagmus
Dix-Hallpike
An audiologist fit a young woman with binaural digital behind-the-ear hearing aids three weeks ago. The patient reports that the devices have provided suitable amplification in most environments, but she complains that low-level ambient noise has been distracting. In an effort to reduce the adverse noise effect, what adjustment might the audiologist make to the hearing aids? · Increasing the threshold kneepoint · Decreasing the threshold kneepoint · Enabling wide dynamic range compression · Decreasing the gain in all frequency bands · Enabling expansion
Enabling expansion
A research study tested the hypothesis that individuals with symmetrical hearing loss who have been fit with one hearing aid would demonstrate improved speech recognition in background noise with increases in head angle. Fourteen individuals were fit monaurally with a behind-the-ear (BTE) hearing aid with directional and omnidirectional microphone modes. Speech recognition performance in noise was tested using the audiovisual version of the Connected Speech Test (CST v.3). The test was administered in auditory-only conditions as well as with the addition of visual cues for each of three head angles: 0º, 20º, and 40º. Results indicated improvement in speech recognition performance with changes in head angle for the auditory-only presentation mode at the 20º and 40º head angles when compared to 0º. Improvement in speech recognition performance for the auditory + visual mode was noted for the 20º head angle when compared to 0°. Additionally, a decrement in speech recognition performance for the auditory + visual mode was noted for the 40º head angle when compared to 0º. These results support a speech recognition advantage for listeners fit with one BTE hearing aid listening in a close listener-to-speaker distance when they turn their head slightly in order to increase signal intensity. This study can best be described as an example of which of the following types of research? · Retrospective · Normative · Randomized clinical trial · Experimental · Case study
Experimental
A child with a moderate sensorineural hearing loss who wears binaural hearing aids is referred to the clinic because of problems understanding the teacher at school. The child's aided speech recognition scores in quiet at 55 dB HL were 88 percent correct and in noise with a +5 SNR were 60 percent correct. Which of the following is the best recommendation for this child? · Referral for a cochlear implant evaluation · Use of digital noise reduction features in the hearing aids · Fitting with a personal FM system coupled to the hearing aids · Fitting with a personal FM system that uses earbuds · An increase in the gain of the hearing aids
Fitting with a personal FM system coupled to the hearing aids
On a case history form, a patient reports having low-pitched tinnitus and a hearing loss. While conducting acoustic immittance measures, the audiologist notes periodic fluctuations in compliance that are synchronous with the patient's pulse. Which of the following medical conditions is the most likely cause of the audiologist's findings? · An acoustic neuroma · Cholesteatoma · Glomus jugulare tumor · Otosclerosis · A squamous cell carcinoma
Glomus jugulare tumor
Mr. Smith, an audiologist who works at a rural speech-language-hearing center, is scheduled to conduct several follow-up assessments for patients who have been fitted with hearing aids. Mr. Smith has an acrimonious relationship with the owner of the practice and objects to the charges imposed by the owner for follow-up evaluations. He quits work and walks out at noon on the day the patients are scheduled to be seen for follow-up. There are no other audiologists in the practice. Which of the following is true of Mr. Smith? · He was justified in leaving because there is customarily no charge for follow-up visits. · He should have called the patients to let them know there would be a charge for their follow-up visits. · He can be charged with patient abandonment. · He should report the owner to the licensure board. · He should inform the patients that they can be seen in a neighboring communit
He can be charged with patient abandonment.
In order to minimize the chances of exacerbating tinnitus, which of the following should be avoided? · Exposure to high levels of chlorine · Using hearing protection devices · Taking high doses of beta carotene · High stress · High-intensity exercise
High stress
When an audiologist gives an adult with a hearing loss an explanation of hearing impairment and its effects, and explains the function of a hearing aid, the audiologist is providing which of the following types of counseling? · Informational · Person-centered · Rational-emotive · Directive · Behavioral
Informational
Which of the following is the most appropriate action for an audiologist to take when counseling a patient with a hearing impairment? · Encouraging the patient to buy a hearing aid · Recommending that the patient buy an assistive device · Informing the patient of his or her rehabilitative options · Persuading the patient to accept limitations in communications · Advising the patient to minimize public activity
Informing the patient of his or her rehabilitative options
Which of the following is true of the occlusion effect observed during pure tone audiometry? · It results in artificially poorer thresholds at all frequencies. · It can affect the measurement of air-conduction thresholds at low frequencies. · It can affect the measurement of air-conduction thresholds at high frequencies. · It can affect the measurement of bone-conduction thresholds at low frequencies. · It can affect the measurement of bone-conduction thresholds at high frequencies
It can affect the measurement of bone-conduction thresholds at low frequencies.
An audiometer attenuator is set to 0 dB HL. Which of the following is true about the sound pressure level output at the earphone? · It is constant across all frequencies. · It is lowest at midfrequencies. · It increases as a function of frequency. · It is highest at 4000 Hz. · It decreases 6 dB per octave
It is lowest at midfrequencies.
Which of the following always applies to nystagmus caused by a labyrinthine lesion? · It is right-beating on right gaze and left-beating on left gaze. · It is pendular when the eyes are closed. · It is enhanced with eyes open. · It is up-beating on up gaze and down-beating on down gaze. · It is suppressed by visual fixation.
It is suppressed by visual fixation.
A VNG/ENG test shows a caloric response yielding a left unilateral weakness. Which of the following statements about the results is most accurate? · It suggests a right peripheral vestibular disorder of the labyrinth. · It is of no real interpretive value · It suggests a nonspecific (nonlocalizing) vestibular disorder. · It suggests a left peripheral vestibular disorder of either the labyrinth or the VIIIth nerve. · It suggests a central vestibular disorder.
It suggests a left peripheral vestibular disorder of either the labyrinth or the VIIIth nerve.
An audiologist fits a patient with a hearing aid that uses wide dynamic range compression (WDRC). Which of the following reflects the compression parameters used with WDRC? · Low compression threshold, low compression ratio · High compression threshold; high compression ratio · Low compression threshold; high compression ratio · High compression threshold, low compression ratio · Variable compression ratio; high compression threshold
Low compression threshold, low compression ratio
Which of the following are common medical conditions associated with pediatric balance disorders that may require further vestibular assessment and medical referral for treatment? · Congenital conductive hearing losses · Skull base fracture and congenital atresia · Diabetes and thyroid disease · Migraine, benign paroxysmal vertigo of childhood (BPVC), otitis media, viral infection, and head trauma · Pediatric patients usually only experience vestibular disorders that are viral in nature, and they usually exhibit spontaneous recovery.
Migraine, benign paroxysmal vertigo of childhood (BPVC), otitis media, viral infection, and head trauma
Which of the following types of speech recognition materials is most useful to rule out a lesion affecting the VIIIth nerve? · Closed-set monosyllabic and bisyllabic words that vary in stress pattern · Closed-set sentences approximating natural syntax, administered in varying intensity levels as in an ongoing message · Open-set, monosyllabic, phonetically balanced word lists that are representative of the patient's language · Open-set, monosyllabic, phonetically balanced word lists, administered at several intensity levels · A closed-set test that requires a picture-pointing response
Open-set, monosyllabic, phonetically balanced word lists, administered at several intensity levels
Jonathon is a 2-year-old male who was recently identified as having a severe-to-profound sensorineural hearing loss bilaterally after a bout with meningitis. Prior to contracting meningitis (which occurred at 18 months of age), Jonathon had begun to develop some speech and language, but since his illness he uses very few words expressively. In terms of receptivity, he is performing at the level of an 18 month old. His initial responses to binaural amplification have been very positive. Jonathon has parents with normal hearing and a 5-year-old sister with normal hearing. Jonathon's parents appear highly motivated to do what is necessary for his development. Based on the information provided, what communication methodology would be the best option for the family to pursue? · Signed Exact English · Total communication · Oral/aural communication · Rochester method · Simultaneous communication
Oral/aural communication
Jon, a 45-year-old computer sales representative, was treated with aminoglycoside antibiotics for an infection years ago. Now he says he has trouble understanding speech, especially in noisy situations, and he complains of tinnitus in both ears. He was treated with aminoglycoside antibiotics for an infection. The problems have existed for several years, but they seem to be getting worse with passing time. Which of the following is the most likely cause of Jon's hearing problems? · Bilateral otosclerosis · Ménière's disease · Ototoxicity · Pseudohypacusis · Multiple sclerosis
Ototoxicity
Some individuals no longer go to the movies because their hearing loss makes it difficult for them to enjoy the experience. Which of the following domains of auditory function is being described by this behavior as defined by the International Classification of Functioning, Disability and Health from the World Health Organization? · Hearing impairment · Hearing handicap · Body function · Activity limitation · Participation restriction
Participation restriction
Which of the following is the most valid method of monitoring a 5-year-old child's progress in aural rehabilitation? · Having the child report his or her own perceptions of change · Periodically administering probes of treatment targets in naturalistic contexts · Using questionnaires to be answered by the child's parents · Having teachers report on the child's classroom performance · Administering a norm-referenced test at the end of each session
Periodically administering probes of treatment targets in naturalistic contexts
Mr. Jones is a 92-year-old man with moderate sensorineural hearing loss, dementia, reduced manual dexterity, and a history of losing personal medical devices. He has limited financial resources but would like an amplification device for everyday use. Which amplification device is the most appropriate recommendation for Mr. Jones? · FM system with receiver and transmitter · Personal listening system with headphones · Half-shell hearing aids · Receiver-in-the-canal hearing aids · Full-shell hearing aids
Personal listening system with headphones
When performing identification audiometry for school-age children, which of the following types of signals should be used? · Speech stimuli in quiet · Speech stimuli in noise · Frequency-modulated signals · Pure-tone signals · Octave bands of noise
Pure-tone signals
An 8-week-old child is brought to an audiology clinic by the parents, who report that the child appears to respond only to very loud sounds. Both the birth and medical history are unremarkable, and there is no family history of hearing loss. Tympanograms are normal, and acoustic reflexes are present bilaterally at 1000 Hz at 90 dB HL. Which of the following additional steps should be taken to rule out a significant hearing loss? · Performing threshold testing of the child using behavioral observation audiometry · Referring the child for an auditory evoked brainstem evaluation · Scheduling the child to return at 6 months of age so visual reinforcement audiometry can be performed · Reassuring the parents that since acoustic reflexes are present and there are no known risk factors, the child's hearing is normal and that they should return in a year if they are still concerned · Testing the child using visual reinforcement audiometr
Referring the child for an auditory evoked brainstem evaluatio
An otologically normal 13-year-old boy presents the following audiometric results: normal acoustic immittance battery, pure-tone average of 50 dB bilaterally, bilateral speech-recognition thresholds of 20 dB, and word-recognition scores of 100 percent bilaterally at 50 dB HL. Which of the following is the most appropriate next step for the audiologist to take? · Administer pure-tone Stenger tests · Obtain reflex thresholds · Administer a central-auditory-processing test battery · Reinstruct the boy and use an ascending-threshold measurement technique · Refer the boy for an educational evaluation
Reinstruct the boy and use an ascending-threshold measurement technique
A native Spanish speaker who speaks very little English is seen for a hearing evaluation by an audiologist who does not speak Spanish. The audiologist does not have any Spanish materials for speech recognition testing. Which of the following is the most appropriate course of action for the audiologist? · Referring the patient to a Spanish-speaking otolaryngologist · Rescheduling the patient for a time when a Spanish-speaking interpreter is available · Administering an English word recognition test and scoring it as accurately as possible based on the patient's responses in English · Administering an English SRT and word recognition test, recording the responses, and having a Spanish-speaking friend score the responses · Administering an English word recognition test, having the patient write down the responses in Spanish, and asking a Spanish-speaking interpreter to score the responses
Rescheduling the patient for a time when a Spanish-speaking interpreter is available
Auditory brainstem response (ABR) testing indicates a prolonged wave I-V latency. These findings are consistent with which of the following? · Retrocochlear pathology, such as an acoustic neuroma · Conductive hearing loss due to middle ear effusion · Cochlear hearing loss due to ototoxicity · Middle-ear dysfunction due to otosclerosis · Auditory perceptual problems as a result of a stroke
Retrocochlear pathology, such as an acoustic neuroma
Which of the following tests most directly predicts the presence of a conductive hearing loss? · Rinne · Weber · Schwabach · Stenger · Bone conduction using forehead placement
Rinne
An audiologist suspects that a patient who has had a traumatic brain injury may not have understood the directions for a test given for pure-tone thresholds. Which of the following is a test that the audiologist could appropriately use to confirm that the patient's responses represent true thresholds? · Tympanometry · Acoustic-reflex thresholds · A word-recognition test · Speech-awareness or speech-recognition thresholds · Most-comfortable loudness levels
Speech-awareness or speech-recognition thresholds
An audiologist fits a patient with a hearing aid. This is the first time the patient has worn a hearing aid. Which of the following is the best indicator that the patient is exhibiting early positive acceptance of the hearing aid? · Aided versus unaided single-word recognition scores in quiet · The presence of a high-frequency sensorineural hearing loss · Self-assessment of listening difficulties · Strong motivation to wear a hearing aid · Close match between hearing-aid frequency response and prescription specifications
Strong motivation to wear a hearing aid
Which of the following tests would yield information of greatest importance in the audiologic evaluation of an adult with an average unmasked air-conduction threshold of 90 dB HL in one ear and normal sensitivity in the other ear? · Tympanometry · Reflex-decay test · The Stenger test · Acoustic reflex testing · The distorted-speech test
The Stenger test
Which of the following is true about an audiologist who bills a CPT code of 92557 for a routine hearing screening? · The audiologist is billing appropriately. · The audiologist could be charged with fraudulent billing practices. · The audiologist should use an ICD code to modify the billing. · The audiologist should be reimbursed for the service by all private insurers. · The audiologist can bill the code only once per month
The audiologist could be charged with fraudulent billing practices.
An audiologist who has extensive training in the making of earmold impressions inadvertently allows the impression material to go beyond the cotton block, resulting in trauma to the tympanic membrane. The audiologist explains the situation to the patient and makes an appropriate referral for follow-up medical care. Which of the following statements about the situation is most accurate? · The audiologist may be guilty of an ethical violation. · The audiologist may be subject to litigation for malpractice. · The audiologist should refer the patient elsewhere for another earmold impression. · The audiologist should use a different type of earmold impression material. · The audiologist should receive additional training in the making of earmolds.
The audiologist may be subject to litigation for malpractice.
Which of the following is a possible outcome of an audiologist using a physician's NPI for billing rather than using his or her own NPI? · The reimbursement for services rendered will be enhanced. · The incorrect validation of the physician as the predominant provider of audiology services. · The expansion of the scope of practice for audiologists. · The audiologist will not be liable for malpractice · The audiologist will no longer be eligible to maintain his or her own NPI.
The incorrect validation of the physician as the predominant provider of audiology services.
The caloric test is designed to stimulate which of the following structures? · The utricle · The saccule · The superior semicircular canal · The posterior semicircular canal · The lateral semicircular canal
The lateral semicircular canal
During subjective verification of hearing-aid directionality, a patient indicates that when noise comes from behind, the noise seems especially loud. Which of the following is most likely the cause? · Both microphone openings are probably blocked. · The microphones are probably wired backward. · Low-frequency gain is too high. · The vent is too large. · The vent is too small
The microphones are probably wired backward
Which of the following is an accurate statement concerning measures of speechreading ability? · Speechreading test results are likely to have a high correlation with measures of visual intelligence. · Intertalker differences are eliminated as a test variable when speechreading test results are scored on the basis of viseme recognition. · The most realistic measures of speechreading ability are administered in a visual mode only. · The most realistic measures of speechreading ability are administered in a combined auditory-visual mode. · The most appropriate material to use in measuring speechreading ability is nonsense syllables
The most realistic measures of speechreading ability are administered in a combined auditory-visual mode
Which of the following is a reason for an audiologist to monitor and evaluate the vestibular function of a patient who has been diagnosed with cancer and is undergoing a cisplatin-based chemotherapy regime? · The patient reports experiencing lightheadedness upon standing up abruptly. · The patient exhibits ataxia of gait or stance. · The patient reports experiencing dizziness and has type B tympanograms. · The patient reports having blurred vision and headaches. · The patient reports having experienced hearing los
The patient exhibits ataxia of gait or stance.
Which of the following is the primary reason investigators have given for limiting a hearing aid's OSPL90 to a lower level when it is worn by a child than when it is worn by an adult? · Loud amplified sounds may frighten a young child and result in rejection of the hearing aid. · The volume of the external auditory meatus in children is less than that represented by a 2 cc coupler, and consequently the SPL at the eardrum is greater. · Measuring the degree of hearing loss in preschoolers is often imprecise and may lead to improper fitting of an aid. · Parents and teachers of children with hearing impairments typically talk louder than do people who interact with adults with hearing impairments. · The primary speech signal will be masked because room noise and reverberation will be amplified.
The volume of the external auditory meatus in children is less than that represented by a 2 cc coupler, and consequently the SPL at the eardrum is greater.
Hearing-conservation programs for children often include screening with pure tones and acoustic immittance measures, whereas such programs for adults will likely use only pure tones for screening. Which of the following justifies this difference? · There is a significantly higher incidence of middle-ear pathology among children than among adults. · There is a significantly lower incidence of middle-ear pathology among children than among adults. · Screenings for children often take place in challenging acoustic environments. · Hearing-conservation programs for children primarily focus on the impact that middle-ear pathology can have on educationally significant hearing loss. · Acoustic-immittance measures for adults are less sensitive in identifying middle-ear pathology in adults.
There is a significantly higher incidence of middle-ear pathology among children than among adults.
Which of the following is an effective way to eliminate the cochlear microphonic from the electrocochleographic response? · Increasing the distance between the transducer and the electrode sites · Using insert earphones to eliminate artifact · Using ipsilateral masking to enhance the compound action potential · Lowering the intensity of the stimulus · Using alternating polarity clicks
Using alternating polarity clicks
An audiometric test produces the following results. With the probe in the right ear, the acoustic reflex is present on both contralateral and ipsilateral stimulation. With the probe in the left ear, the acoustic reflex is absent on both contralateral and ipsilateral stimulation. The most likely cause of the results is · conductive impairment in the right ear · VIIIth-nerve pathology on the right side · VIIIth-nerve pathology on the left side · VIIth-nerve pathology on the right side · VIIth-nerve pathology on the left side
VIIth-nerve pathology on the left side
An audiologist is using a tracking procedure to assess a cochlear-implant patient's progress in communicating under audition-plus-vision conditions. The materials used are articles from popular magazines. Data are collected for 15 minutes every working day for a week. Word-per-minute scores of 23.4, 43.6, 13.6, 54.2, and 27.3 are obtained. Which of the following is the most likely explanation for the variation in performance? · A learning effect · Variation in the print size used by the publishers · Variation in the vocabulary or syntax used by the authors · Normal response variation · Malfunction of the cochlear implant
Variation in the vocabulary or syntax used by the authors
Which of the following evaluation measures is most likely to provide valid and reliable information about a typically developing 9-month-old child's hearing sensitivity at 500 to 4000 Hz? · Visual reinforcement audiometry (VRA) · Pure-tone play audiometry · Otoacoustic emissions · Auditory brainstem response (ABR) audiometry · Behavioral observation audiometry (BOA
Visual reinforcement audiometry (VRA)
Which of the following best describes the type of research design used in this study? · Between-subjects design · Within-subjects design · Mixed (between- and within-subjects) design · Single-subject design · Crossover design
Within-subjects design
Which of the following word-recognition materials is most appropriate to use with a 5-year-old child who has otitis media and a severe articulation disorder? · Central Institute for the Deaf (CID) W-1 · Central Institute for the Deaf (CID) W-22 · Phonetically Balanced Kindergarten Test (PB-K) · Northwestern University Test No.6 (NU6) · Word Intelligibility by Picture Identification (WIPI)
Word Intelligibility by Picture Identification (WIPI)
A patient is seen for a vestibular evaluation with the primary complaint of persistent imbalance for the past six months. She states that she had one severe attack of true rotary vertigo six months ago, and since then fears another will occur. She has limited her activities, as quick head movements increase her symptoms. She reportedly takes meclizine daily. Videonystagmography results indicate normal saccade, optokinetic, and smooth pursuit testing. A second-degree left-beating nystagmus is observed during gaze testing without fixation. Postactive head-shake nystagmus reveals a left-beating nystagmus. No positioning or positional nystagmus is observed. Bilateral bithermal caloric results indicate a 50 percent right weakness with no significant directional preponderance. Based on the above information, the patient most likely has · Ménière's disease · a central vestibular pathology · a statically uncompensated peripheral pathology affecting the right ear · a dynamically uncompensated peripheral pathology affecting the left ear · a dynamically uncompensated peripheral pathology affecting the right ear
a dynamically uncompensated peripheral pathology affecting the right ear
The absence of an acoustic reflex threshold at 2000 Hz in the left ear is most likely the result of (see picture on separate page) · differences in interaural attenuation between ears · a possible brainstem lesion · the beginning of a possible middle-ear lesion · variations in probe placement from one ear to the other · a possible mixed hearing loss
a possible brainstem lesion
One component of the adult aural rehabilitation process is listening training. In listening training, the patient is trained to · use clear speech and assertiveness training · hear the frequencies within the human vocal range better · be alert, attentive, and set to receive communication · visually perceive phonemic differences · hear better in the presence of noise
be alert, attentive, and set to receive communication
For audiologic equipment that comes in contact with patients, disinfection and sterilization reduce the risk of cross contamination. The key consideration that calls for sterilization rather than disinfection is that the equipment · does not have disposable parts · is used with multiple patients · is used with patients with known infections · can survive the heat of sterilization in an autoclave · comes into contact with blood or other bodily substance
comes into contact with blood or other bodily substance
The cochlear implant signal-processing strategy in which brief pulses are presented to each electrode in a nonoverlapping sequence is known as · feature extraction · continuous interleaved sampling · fine structure · current steering · a filter bank
continuous interleaved sampling
In the measurement of real-ear sound pressure levels with a probe microphone system, insufficient probe-tube depth will tend to · increase the high-frequency response · decrease the high-frequency response · decrease the response at all frequencies · decrease the low-frequency response · increase the low-frequency response
decrease the high-frequency response
Reduced visual function that can complicate planning for aural rehabilitation is most likely to be found in patients with hearing losses who present with · Ménière's disease · Treacher-Collins syndrome · erythroblastosis fetalis · otitis media · diabetes
diabetes
A type of otoacoustic emission that requires the use of two oscillators and two attenuators is known as · spontaneous otoacoustic emission · transient evoked otoacoustic emission · stimulus-driven otoacoustic emission · fine-structure otoacoustic emission · distortion-product otoacoustic emission
distortion-product otoacoustic emission
An audiologist sees his professor entering a hotel room on a Saturday with a woman who is not his wife. He should · discuss the matter with the professor · do nothing since it did not occur with a patient and was not in the work setting · report the matter to the licensure board as a potential ethics violation · report the matter to the department head · report the matter to the dean
do nothing since it did not occur with a patient and was not in the work setting
Diagnostic audiometers generally provide one-third-octave noise bands for use in masking pure tones. This bandwidth is used because bands of that width · are centered in the frequency range of normal speech · encompass the width of a critical band · produce more masking than pink noise does · produce more masking than half-octave bands do · are less than the width of a critical band
encompass the width of a critical band
Elicitation of an acoustic reflex at a hearing level better than that obtained with voluntary behavioral responses suggests the presence of · loudness recruitment · abnormal adaptation or tone decay · high impedance or low compliance · functional or nonorganic hearing loss · conductive hearing los
functional or nonorganic hearing loss
According to PL 99-457, a child under 2 years of age who has a hearing loss is entitled to · be fitted with binaural hearing aids · have ABR testing · be enrolled in a center-based habilitation program · have a written Individualized Family Service Plan · be provided with total communication training
have a written Individualized Family Service Plan
A common medication known to be ototoxic is · ibuprofen · Benadryl · cough syrup · melatonin · high dosage vitamin C
ibuprofen
An adult with a progressive sensorineural hearing loss is no longer able to use a standard telephone at work. The managing audiologist should assist the patient with · learning a manual communication system · obtaining a job that does not require spoken communication · obtaining reasonable accommodation for telephone communication at work · working with vocational rehabilitation to be considered for a cochlear implant · using an assistive listening device that alerts the client that the phone is ringin
obtaining reasonable accommodation for telephone communication at work
A patient has been identified with normal hearing through 1500 Hz with a bilateral sharply-sloping sensorineural loss in the frequency range above 1500 Hz. The most appropriate system of amplification to recommend for this patient is · binaural completely-in-the canal hearing aids · receiver-in-the-ear (RITE) aids with an open ear fitting · binaural behind-the-ear aids with occluding earmolds · in-the-ear aids with no venting · an assistive listening device
receiver-in-the-ear (RITE) aids with an open ear fitting
If this hearing test and audiology exam represent the initial point of entry, the audiologist should · offer the patient a trial with an osseointegrated cochlear stimulator · have the patient complete a hearing handicap scale to determine the extent of his communication problems · obtain a complete family case history · offer aural rehabilitation classes · refer the patient for a complete otological evaluation
refer the patient for a complete otological evaluation
Based on the results of all the audiological tests, the site of lesion for the left-ear thresholds is most likely · related to Ménière's disease · retrocochlear in origin · a function of cochlear hydrops · related to chronic ear infections · related to familial hearing loss
retrocochlear in origin
In audiometric testing, a false-positive response means that the · signal was not presented and the patient did not respond · signal was not presented and the patient responded · signal was presented and the patient responded · signal was presented and the patient did not respond · patient is feigning a hearing loss
signal was not presented and the patient responded
The hearing-aid input transducer that is sensitive to electromagnetic energy is the · omnidirectional microphone · directional microphone · telecoil · internal receiver · external receiver
telecoil
In a clinical-decision analysis, sensitivity of a screening test refers to · the incidence of false positive results in patients who do not have the disorder · the accuracy of the test in correctly rejecting patients without the disorder · the predictive value of negative results · the accuracy of the test in correctly identifying patients with the disorder · the incidence of false negative results in patients who have the disorde
the accuracy of the test in correctly identifying patients with the disorder
A 1000 Hz tympanogram is obtained on a month-old infant by an audiologist, who reports a type B tympanogram. The parents seek a second opinion from another audiologist, who performs a low-frequency 226 Hz tympanogram and reports a type A tympanogram. The discrepancy is most likely the result of · differences in training between the two audiologists · a misinterpretation of the tympanogram by one of the audiologists · increased cooperation by the infant during one of the measurements · the decreased reliability of low-frequency tympanograms on infants · the use of tympanometers from different manufacturers for the two test
the decreased reliability of low-frequency tympanograms on infants
A patient who has a sudden profound sensorineural hearing loss with poor word recognition in the left ear undergoes a complete otological evaluation, including a prescribed course of steroids, an MRI, and serial audiograms. The otologist determines that the loss is irrreversible and refers the patient to an audiologist for follow-up. The most logical next step for the audiologist is to · fit the patient with a power behind-the-ear hearing aid on a trial basis · suggest the patient enroll in speechreading classes · try a transcranial CROS hearing-aid with the patient · make a referral to another otologist for a second opinion · make a referral to a speech-language pathologist for information regarding speech conservation
try a transcranial CROS hearing-aid with the patient
A 6-month old is brought to the clinic by her parents. They report that she has had two bouts of otitis media already and they want to be sure her hearing is okay. The audiologist would like to test using VRA. Prior to beginning testing, the audiologist should be certain that the infant is able to · cross the midline with an object · visually track objects laterally · localize sounds and objects from above · babble · point to different body parts
visually track objects laterally
The husband of a patient contacts the audiologist and asks for the results of his wife's hearing test. Before this information can be provided, it is necessary for the · husband to accompany his wife to the evaluation. · wife to give verbal permission over the phone. · wife to sign a HIPAA form listing individuals who may have access to her records. · husband to speak to the referring physician for the results. · wife and husband to make a second appointment for a consultatio
wife to sign a HIPAA form listing individuals who may have access to her records
