ETS Praxis Audiology Practice Test

Which of the following is true of the occlusion effect observed during pure tone audiometry?

A.It results in artificially poorer thresholds at all frequencies.
B.It can affect the measurement of air-conduction thresholds at low frequencies.
C.It can affect the measurement of air-conduction thresholds at high frequencies.
D.It can affect the measurement of bone-conduction thresholds at low frequencies.
E.It can affect the measurement of bone-conduction thresholds at high frequencies.

Correct Answer: D
Option (D) is correct.The occlusion effect is the sensation of increased loudness of low-frequency sounds transmitted through bone conduction when the outer ear is blocked. In cases of conductive hearing loss, the greater the degree of hearing loss, the louder these sounds are likely to be perceived, so measurement of the bone-conduction threshold at low frequencies is affected

The caloric test is designed to stimulate which of the following structures?

A.The utricle
B.The saccule
C.The superior semicircular canal
D.The posterior semicircular canal
E.The lateral semicircular canal

Correct Answer: E
Option (E) is correct. The caloric test introduces a temperature differential that is designed to cause the fluid in the semicircular canal closest to the stimulus to move. The lateral semicircular canal is closest to the tympanic membrane, where the stimulus is introduced.

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?

A.Increasing the threshold kneepoint
B.Decreasing the threshold kneepoint
C.Enabling wide dynamic range compression
D.Decreasing the gain in all frequency bands
E.Enabling expansion

Correct Answer: E
Option (E) is correct. Expansion reduces the gain of low-level ambient sounds.

Individuals with normal hearing sensitivity in one ear and a severe hearing loss in the other ear experience which of the following?

A.An improvement in speech understanding when the noise is closer to the ear with hearing loss
B.Improved ability to localize when the noise source is closer to the ear with normal hearing
C.Better speech understanding and localization as the reverberation time increases
D.More difficulty understanding speech when the speaker moves closer to the ear with hearing loss
E.Improved localization when the noise is at 0° azimuth and the source is closer to the ear with hearing loss

Correct Answer: A
Option (A) is correct. It is well-known that for individuals with unilateral hearing loss, speech intelligibility improves when the more favorably placed ear (i.e., the better ear) is further from the noise source. When this occurs then the SNR improves in the better ear.

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

A.Ménière's disease
B.a central vestibular pathology
C.a statically uncompensated peripheral pathology affecting the right ear
D.a dynamically uncompensated peripheral pathology affecting the left ear
E.a dynamically uncompensated peripheral pathology affecting the right ear

Correct Answer: E
Option (E) is correct. Videonystagmography results normally provide site-of-lesion specific information (i.e., caloric irrigations) to determine probable side of weakness. In this example, the patient had a 50 percent right peripheral vestibular weakness, suggesting a peripheral pathology affecting the right side. The postactive head-shake left-beating nystagmus suggests that the lesion is dynamically uncompensated.

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?

A.The reimbursement for services rendered will be enhanced.
B.The incorrect validation of the physician as the predominant provider of audiology services.
C.The expansion of the scope of practice for audiologists.
D.The audiologist will not be liable for malpractice
E.The audiologist will no longer be eligible to maintain his or her own NPI.

Correct Answer: B
Option (B) is correct. It is detrimental to the profession of audiology to have audiology services billed under the NPI of a physician. Doing so can skew the Medicare claims data to incorrectly indicate that physicians are the predominant providers of audiology services and, as a result, limit the role of the profession of audiology in national and regional audiology coding and reimbursement processes.

Auditory brainstem response (ABR) testing indicates a prolonged wave I-V latency. These findings are consistent with which of the following?

A.Retrocochlear pathology, such as an acoustic neuroma
B.Conductive hearing loss due to middle ear effusion
C.Cochlear hearing loss due to ototoxicity
D.Middle-ear dysfunction due to otosclerosis
E.Auditory perceptual problems as a result of a stroke

Correct Answer: A
Option (A) is correct. A prolonged interval between waves I and V indicates a pathology in the area affected by neural conduction in the VIIIth nerve and the brainstem.

Which of the following is the most appropriate action for an audiologist to take when counseling a patient with a hearing impairment?

A.Encouraging the patient to buy a hearing aid
B.Recommending that the patient buy an assistive device
C.Informing the patient of his or her rehabilitative options
D.Persuading the patient to accept limitations in communications
E.Advising the patient to minimize public activity

Correct Answer: C
Option (C) is correct. Informing patients about rehabilitative options offers them opportunities to learn how to manage hearing loss and improve communication.

Which of the following is an accurate statement concerning measures of speechreading ability?

A.Speechreading test results are likely to have a high correlation with measures of visual intelligence.
B.Intertalker differences are eliminated as a test variable when speechreading test results are scored on the basis of viseme recognition.
C.The most realistic measures of speechreading ability are administered in a visual mode only.
D.The most realistic measures of speechreading ability are administered in a combined auditory-visual mode.
E.The most appropriate material to use in measuring speechreading ability is nonsense syllables.

Correct Answer: D
Option (D) is correct. Speechreading in actual use depends on both auditory and visual input for most clients. The measure of speechreading ability that best reflects a client's real ability is one that is administered in a combined auditory-visual mode.

One component of the adult aural rehabilitation process is listening training. In listening training, the patient is trained to

A.use clear speech and assertiveness training
B.hear the frequencies within the human vocal range better
C.be alert, attentive, and set to receive communication
D.visually perceive phonemic differences
E.hear better in the presence of noise

Correct Answer: C
Option (C) is correct. Being alert, attentive, and set to receive communication are the important components to improve listening skills.

Answer the question below by clicking on the correct response.

Question:

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?

A.Both microphone openings are probably blocked.
B.The microphones are probably wired backward.
C.Low-frequency gain is too high.
D.The vent is too large.
E.The vent is too small.

Correct Answer: B
Option (B) is correct. Directional microphones are designed to reduce sounds from behind the listener. If the listener perceives that sounds are loud from behind, likely the front microphone is functioning like the back microphone and undesirable sounds are not being cancelled from behind.

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?

A.There is a significantly higher incidence of middle-ear pathology among children than among adults.
B.There is a significantly lower incidence of middle-ear pathology among children than among adults.
C.Screenings for children often take place in challenging acoustic environments.
D.Hearing-conservation programs for children primarily focus on the impact that middle-ear pathology can have on educationally significant hearing loss.
E.Acoustic-immittance measures for adults are less sensitive in identifying middle-ear pathology in adults.

Correct Answer: A
Option (A) is correct. Acoustic-immittance measures, although they do not test hearing sensitivity, detect the possible presence of middle-ear pathology. For appropriate hearing care, therefore, both acoustic-immittance and pure-tone measures are necessary for children. Because adults are less susceptible to pathologies detected by acoustic-immittance measures, such measures are not efficient for adult screening programs

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Question:

Diagnostic audiometers generally provide one-third-octave noise bands for use in masking pure tones. This bandwidth is used because bands of that width

A.are centered in the frequency range of normal speech
B.encompass the width of a critical band
C.produce more masking than pink noise does
D.produce more masking than half-octave bands do
E.are less than the width of a critical band

Correct Answer: B
Option (B) is correct. Narrow bands of masking noise should be wider than a critical band so that they will provide good masking for the frequency being tested without requiring high overall intensity just to achieve effective masking levels on that one frequency.

It is important to consider the gestational age of an infant, rather than the chronological age, when interpreting which of the following?

A.ABR Wave V latencies
B.DPOAE responses
C.TORCH factors
D.Apgar scores
E.WIPI scores

Correct Answer: A
Option (A) is correct. Prematurity affects the stage of myelinization of the auditory nervous system, which affects the latencies of auditory evoked potentials up to 18 months of age.

An audiometer attenuator is set to 0 dB HL. Which of the following is true about the sound pressure level output at the earphone?

A.It is constant across all frequencies.
B.It is lowest at midfrequencies.
C.It increases as a function of frequency.
D.It is highest at 4000 Hz.
E.It decreases 6 dB per octave.

Correct Answer: B
Option (B) is correct. The sound pressure level necessary to achieve 0 dB hearing level is highest at low frequencies, lessens in the middle frequencies, and then increases at high frequencies.

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?

A.All frequencies equally
B.250-2000 Hz
C.2000-4000 Hz
D.4000-8000 Hz
E.8000-10000 Hz

Correct Answer: B
Option (B) is correct. The increase in the amount of endolymph in the inner ear expands the apical end of the cochlea because of a decreasing stiffness gradient of the basilar membrane. Since it is the low frequencies that are sensed in this location, it is the low frequencies that are diminished when there is too much endolymph.

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?

A.59 dB SPL
B.62 dB SPL
C.65 dB SPL
D.68 dB SPL
E.71 dB SPL

Correct Answer: E
Option (E) is correct. According to the inverse square law, the sound intensity decreases by 6 dB when the distance from a sound source doubles. Conversely, the sound intensity increases by 6 dB when the distance to the sound source is halved.

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

A.10 dBA or less and 0.1 seconds or less
B.50 dBA or less and 1.0 seconds or less
C.35 dBA or less and 0.6 seconds or less
D.55 dBA or less and 0.6 seconds or less
E.45 dBA or less and 4.1 seconds or less

Correct Answer: C
Option (C) is correct. The ANSI standards for classroom acoustics specifies that ambient noise levels in unoccupied classrooms should not exceed 35 dBA and that reverberation times not exceed 0.6 seconds.

The cochlear implant signal-processing strategy in which brief pulses are presented to each electrode in a nonoverlapping sequence is known as

A.feature extraction
B.continuous interleaved sampling
C.fine structure
D.current steering
E.a filter bank

Correct Answer: B
Option (B) is correct. Continuous interleaved sampling (CIS) is a cochlear implant signal-processing strategy that minimizes channel interaction by presenting pulses in a nonoverlapping sequence.

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?

A.Loud amplified sounds may frighten a young child and result in rejection of the hearing aid.
B.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.
C.Measuring the degree of hearing loss in preschoolers is often imprecise and may lead to improper fitting of an aid.
D.Parents and teachers of children with hearing impairments typically talk louder than do people who interact with adults with hearing impairments.
E.The primary speech signal will be masked because room noise and reverberation will be amplified.

Option (B) is correct. The sound-pressure level (SPL) at the eardrum is a function of the volume of the external auditorymeatus: the smaller the volume, the greater the sound pressure. An OSPL90 set to a level appropriate for adults may produce an undesirably high maximum SPL in a child.

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?

A.Visual reinforcement audiometry (VRA)
B.Pure-tone play audiometry
C.Otoacoustic emissions
D.Auditory brainstem response (ABR) audiometry
E.Behavioral observation audiometry (BOA)

Correct Answer: A
Option (A) is correct. At 9 months, a typically developing infant can provide reliable responses to all octave band frequencies, and VRA is the most valid and reliable method for doing that: the infant's behavior can be reinforced and will be consistent.

In the measurement of real-ear sound pressure levels with a probe microphone system, insufficient probe-tube depth will tend to

A.increase the high-frequency response
B.decrease the high-frequency response
C.decrease the response at all frequencies
D.decrease the low-frequency response
E.increase the low-frequency response

Correct Answer: B
Option (B) is correct. Probe tubes for measuring real-ear sound pressure levels (SPL) should be inserted as close to the tympanic membrane as possible, because it is the SPL at the tympanic membrane that is being measured. If the probe tube is too far from the tympanic membrane, high-frequency sound waves bounced off the eardrum will dissipate before reaching the probe, but low-frequency sound waves, which do not dissipate as easily, will be essentially unaffected. The overall effect will thus be a decrease only in the high-frequency response.

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?

A.FM system with receiver and transmitter
B.Personal listening system with headphones
C.Half-shell hearing aids
D.Receiver-in-the-canal hearing aids
E.Full-shell hearing aids

Correct Answer: B
Option (B) is correct. Mr. Jones could benefit from amplification and given the factors of dementia and reduced manual dexterity, the best option is a personal listening system that is easy to use and less likely to get lost.

Which of the following is the optimal range of stimulation rates for determining threshold for a click ABR?

A.0.37 to 0.99
B.11.1 to 21.1
C.59.1 to 63.1
D.69.1 to 73.1
E.79.1 to 93.1

Option (B) is correct. A click rate range of 11.1 to 21.1 elicits an optimal auditory brainstem response.

The hearing-aid input transducer that is sensitive to electromagnetic energy is the

A.omnidirectional microphone
B.directional microphone
C.telecoil
D.internal receiver
E.external receiver

Option (C) is correct. The telecoil is the only hearing-aid input transducer that is sensitive to electromagnetic energy.

Elicitation of an acoustic reflex at a hearing level better than that obtained with voluntary behavioral responses suggests the presence of

A.loudness recruitment
B.abnormal adaptation or tone decay
C.high impedance or low compliance
D.functional or nonorganic hearing loss
E.conductive hearing loss

Correct Answer: D
Option (D) is correct. Better hearing levels with acoustic reflexes than with voluntary responses are obtained only in cases of nonorganic hearing loss. If a person has a nonorganic hearing loss, then poor hearing levels on voluntary behavioral response tests will be due to voluntary action. Acoustic reflex elicitation, however, is involuntary.

In order to minimize the chances of exacerbating tinnitus, which of the following should be avoided?

A.Exposure to high levels of chlorine
B.Using hearing protection devices
C.Taking high doses of beta carotene
D.High stress
E.High-intensity exercise

Correct Answer: D
Option (D) is correct. High levels of stress can exacerbate tinnitus.

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?

A.Hearing impairment
B.Hearing handicap
C.Body function
D.Activity limitation
E.Participation restriction

Option (E) is correct. The individuals' hearing impairment limits their ability to participate in an activity as a result of their having trouble understanding speech. Consequently, the individuals restrict their participation in activities that require them to understand speech, such as movies.

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.A learning effect
B.Variation in the print size used by the publishers
C.Variation in the vocabulary or syntax used by the authors
D.Normal response variation
E.Malfunction of the cochlear implant

Correct Answer: C
Option (C) is correct. Tracking involves having the client repeat phrases read by the audiologist from different sources. Because each author has a different style, there will be considerable variation in how familiar the vocabulary is to the patient and in the number and degree of redundancy of syntactic clues, all factors that affect word-per-minute scores.

graph shows steadily rising masking effect. At 75dB HL there is a plateau all the way to 90dB. After that is rises again

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?

A.50 dB HL
B.55 dB HL
C.65 dB HL
D.75 dB HL
E.95 dB HL

Correct Answer: D
Option (D) is correct. According to the plateau method of determining true threshold, the true threshold is reached when the threshold of a test ear remains stable over a range of at least 20 dB increase in masking intensity. In the figure, the test-ear threshold plateaus at 75 dB.

Which of the following reflects the compression ratio for the input-output function at 50 dB SPL?

A.2:1; 50 dB SPL
B.1:1; 50 dB SPL
C.4:1; 90 dB SPL
D.3:1; 50 dB SPL
E.5:1; 90 dB SPL

Option (A) is correct. The compression ratio is the change in input over the change in output. From 50 to 60 dB SPL, there is a 10 dB change in input, with only a 5 dB change in output, resulting in a 2:1 compression input.

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?

A.Retrospective
B.Normative
C.Randomized clinical trial
D.Experimental
E.Case study

Correct Answer: D
Option (D) is correct. This is an experimental study because one variable (head angle) is manipulated under highly controlled conditions to see if changes in head angle causes any changes in another variable (speech recognition).

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

In this study, speech recognition performance can best be described as which type of variable?

A.Independent
B.Dependent
C.Classification
D.Criterion
E.Predicted

Correct Answer: B
Option (B) is correct. Speech recognition performance is a dependent variable because it is affected by head angle, which is manipulated in this study under highly controlled conditions.

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.

Which of the following best describes the type of research design used in this study?

A.Between-subjects design
B.Within-subjects design
C.Mixed (between- and within-subjects) design
D.Single-subject design
E.Crossover design

Correct Answer: B
Option (B) is correct. This is a within-subjects design because the variable of head angle is being manipulated to determine if speech recognition improves within each subject, with each subject serving as his or her own control.

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

A.fit the patient with a power behind-the-ear hearing aid on a trial basis
B.suggest the patient enroll in speechreading classes
C.try a transcranial CROS hearing-aid with the patient
D.make a referral to another otologist for a second opinion
E.make a referral to a speech-language pathologist for information regarding speech conservation

Correct Answer: C
Option (C) is correct. A transcranial CROS hearing aid reroutes signals from the poor ear to the better ear via bone conduction.

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?

A.500, 1000, and 2000 Hz
B.1000, 2000, and 3000 Hz
C.2000, 3000, and 4000 Hz
D.500, 1000, 2000, and 3000 Hz
E.500, 1000, 2000, and 4000 Hz

Correct Answer: C
Option (C) is correct. OSHA's definition of standard threshold shift involves 2000, 3000, and 4000 Hz only.

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

A.learning a manual communication system
B.obtaining a job that does not require spoken communication
C.obtaining reasonable accommodation for telephone communication at work
D.working with vocational rehabilitation to be considered for a cochlear implant
E.using an assistive listening device that alerts the client that the phone is ringing

Correct Answer: C
Option (C) is correct. The audiologist should counsel the patient about reasonable accommodations in the workplace mandated by the Americans with Disabilities Act.

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?

A.Hearing within normal limits
B.A moderate conductive hearing loss below 500 Hz and above 8000 Hz
C.A hearing loss at frequencies above 8000 Hz
D.A high-frequency sensorineural hearing loss
E.A low-frequency sensorineural hearing loss

Correct Answer: D
Option (D) is correct. Patients with tinnitus often think the tinnitus is the cause of their hearing problems, yet they often have an accompanying high-frequency sensorineural hearing loss. A high-frequency sensorineural hearing loss makes it difficult for the listener to hear soft high-frequency consonant sounds. Thus the hearing problems experienced by the patient are due to the hearing loss, not the tinnitus.

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?

A.Lowering the OSPL90
B.Adding a vent or enlarging the present vent
C.Ordering a new earmold without a helix portion
D.Adding a 680-ohm or 1500-ohm damper to the earhook
E.Widening the earmold bore

Correct Answer: B
Option (B) is correct. A hollow sound indicates that low frequencies are being overemphasized; a vent would help low-frequency sound to escape before being amplified.

When performing identification audiometry for school-age children, which of the following types of signals should be used?

A.Speech stimuli in quiet
B.Speech stimuli in noise
C.Frequency-modulated signals
D.Pure-tone signals
E.Octave bands of noise

Correct Answer: D
Option (D) is correct. Pure-tone signals are the only signals that are specifically recommended for identification audiometry with school-age children.

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?

A.Bilateral otosclerosis
B.Ménière's disease
C.Ototoxicity
D.Pseudohypacusis
E.Multiple sclerosis

Correct Answer: C
Option (C) is correct. Aminoglycoside antibiotics can be ototoxic, and tinnitus and hearing loss are common side effects.

Reduced visual function that can complicate planning for aural rehabilitation is most likely to be found in patients with hearing losses who present with

A.Ménière's disease
B.Treacher-Collins syndrome
C.erythroblastosis fetalis
D.otitis media
E.diabetes

Correct Answer: E
Option (E) is correct. Diabetes is a major cause of acquired visual impairment; the audiologist should take this fact into consideration when planning rehabilitation for patients with diabetes.

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?

A.Referral for a cochlear implant evaluation
B.Use of digital noise reduction features in the hearing aids
C.Fitting with a personal FM system coupled to the hearing aids
D.Fitting with a personal FM system that uses earbuds
E.An increase in the gain of the hearing aids

Correct Answer: C
Option (C) is correct. An FM system coupled to the child's hearing aids will take advantage of the prescribed amplification for the child's specific hearing loss and assist in improving the signal-to-noise ratio.

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?

A.Informational
B.Person-centered
C.Rational-emotive
D.Directive
E.Behavioral

Correct Answer: A
Option (A) is correct. The audiologist is simply providing information; this is the basis for informational counseling.

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

A.does not have disposable parts
B.is used with multiple patients
C.is used with patients with known infections
D.can survive the heat of sterilization in an autoclave
E.comes into contact with blood or other bodily substances

Correct Answer: E
Option (E) is correct. When audiologic equipment comes into contact with blood or other bodily substances, it requires sterilization rather than disinfection because sterilization is capable of eliminating microbiological organisms.

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?

A.Aided versus unaided single-word recognition scores in quiet
B.The presence of a high-frequency sensorineural hearing loss
C.Self-assessment of listening difficulties
D.Strong motivation to wear a hearing aid
E.Close match between hearing-aid frequency response and prescription specifications

Correct Answer: D
Option (D) is correct. The patient will not adjust successfully to wearing a hearing aid unless he or she feels motivated to accept any perceived inconvenience in return for better communication.

Which of the following is true about an audiologist who bills a CPT code of 92557 for a routine hearing screening?

A.The audiologist is billing appropriately.
B.The audiologist could be charged with fraudulent billing practices.
C.The audiologist should use an ICD code to modify the billing.
D.The audiologist should be reimbursed for the service by all private insurers.
E.The audiologist can bill the code only once per month.

Correct Answer: B
Option (B) is correct. An audiologist who incorrectly codes a procedure can be charged with billing for services not rendered.

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

A.differences in training between the two audiologists
B.a misinterpretation of the tympanogram by one of the audiologists
C.increased cooperation by the infant during one of the measurements
D.the decreased reliability of low-frequency tympanograms on infants
E.the use of tympanometers from different manufacturers for the two tests

Correct Answer: D
Option (D) is correct. The middle-ear system of the infant is mass dominated with a lower resonant frequency, thus a 1000 Hz probe frequency would be more appropriate for detecting changes in middle-ear function than a 226 Hz probe tone.

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?

A.The patient reports experiencing lightheadedness upon standing up abruptly.
B.The patient exhibits ataxia of gait or stance.
C.The patient reports experiencing dizziness and has type B tympanograms.
D.The patient reports having blurred vision and headaches.
E.The patient reports having experienced hearing loss.

Correct Answer: B
Option (B) is correct. Cisplatin is a chemotherapeutic agent. A side effect of cisplatin is ototoxicity, which can cause high-frequency hearing loss followed by bilateral vestibular loss. Clinical signs and symptoms that may suggest bilateral vestibular involvement include visual instability with head movements and ataxia of gait and stance.

Which of the following hearing-aid features would MOST benefit a patient who is having trouble understanding speech in background noise?

A.Compression limiting
B.Directional microphones
C.Feedback cancellation
D.Digital noise reduction
E.Frequency lowering

Correct Answer: B
Option (B) is correct. Directional microphone technology improves the signal-to-noise ratio by suppressing noise in the environment, allowing the speech signal to be received at a higher input level than the noise.

Of the following conditions that can affect children's hearing, which is the most likely cause of acquired sensorineural hearing loss?

A.Serous otitis media
B.Otosclerosis
C.Waardenburg syndrome
D.Bacterial meningitis
E.Turner syndrome

Correct Answer: D
Option (D) is correct. Bacterial meningitis can cause profound sensorineural hearing loss in children.

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?

A.The audiologist may be guilty of an ethical violation.
B.The audiologist may be subject to litigation for malpractice.
C.The audiologist should refer the patient elsewhere for another earmold impression.
D.The audiologist should use a different type of earmold impression material.
E.The audiologist should receive additional training in the making of earmolds.

Correct Answer: B
Option (B) is correct. The audiologist received appropriate training for the procedure and is therefore not guilty of unethical practice. However, the mistake can be construed as malpractice.

Which of the following always applies to nystagmus caused by a labyrinthine lesion?

A.It is right-beating on right gaze and left-beating on left gaze.
B.It is pendular when the eyes are closed.
C.It is enhanced with eyes open.
D.It is up-beating on up gaze and down-beating on down gaze.
E.It is suppressed by visual fixation.

Correct Answer: E
Option (E) is correct. Visual fixation always suppresses nystagmus caused by a peripheral lesion, such as a labyrinthine lesion.

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?

A.An audiometric follow-up in one year
B.A trial period of speech-language therapy
C.An evaluation for a mild-gain, ear-level hearing aid
D.A home language-enrichment program
E.A medical referral and speech-language consultation

Correct Answer: E
Option (E) is correct. The recurrent otitis media suggests a medical problem; the child should be referred to a physician for diagnosis of possible middle-ear dysfunction. In addition, speech-language consultation is indicated because of the limited vocabulary knowledge.

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?

A.Administer pure-tone Stenger tests
B.Obtain reflex thresholds
C.Administer a central-auditory-processing test battery
D.Reinstruct the boy and use an ascending-threshold measurement technique
E.Refer the boy for an educational evaluation

Correct Answer: D
Option (D) is correct. There is poor agreement between the pure-tone average and the speech-recognition threshold, accompanied by discrepancy between word recognition scores and pure-tone average, suggesting a nonorganic hearing loss. Using an ascending threshold measurement technique will disrupt the boy's loudness yardstick and provide a better estimate of true organic hearing sensitivity.

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?

A.Decreased hearing in the low frequencies
B.Difficulty swallowing
C.Decreased sensation of taste
D.Decreased hearing in the high frequencies
E.Numbness on one side of her face

Correct Answer: C
Option (C) is correct. The chorda tympani, which is a branch of the facial nerve (VII), is responsible for the sensation of taste in the anterior two-thirds of the tongue. Therefore, when it is damaged or nicked, taste is affected.

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?

A.Referral for another medical evaluation
B.Auditory brainstem response (ABR) testing
C.A routine audiometric evaluation
D.Evaluation for a conventional CROS hearing aid
E.Evaluation for a transcranial CROS hearing aid

Correct Answer: C
Option (C) is correct. The surgery has apparently been successful, the client's report that there has been no subjective improvement warrants further investigation. The follow-up medical evaluation that occurred would normally focus on physical healing and would not include an audiometric evaluation, so the audiologist should conduct a routine audiometric examination to determine the precise level of postsurgical hearing loss.

Which of the following best describes American Sign Language?

A.A language that uses visual gestures to spell individual words
B.A language with its own syntax that relies on visual-gestural symbols
C.A language with English syntax that relies on visual-gestural symbols
D.A language of visual-gestural symbols easily transferable to written English
E.A language of visual-gestural symbols that are comprehensible to anyone who uses a signed language

Correct Answer: B
Option (B) is correct. American Sign Language has its own syntax and relies on visual-gestural symbols.

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?

A.Eustachian tube dysfunction
B.A collapsed canal
C.Otitis media
D.Impacted cerumen
E.A perforated tympanic membrane

Correct Answer: E
Option (E) is correct. The volume of the external canal is large; this suggests the possibility of a perforated membrane, which is even more likely because of the failure to maintain the seal.

In audiometric testing, a false-positive response means that the

A.signal was not presented and the patient did not respond
B.signal was not presented and the patient responded
C.signal was presented and the patient responded
D.signal was presented and the patient did not respond
E.patient is feigning a hearing loss

Correct Answer: B
Option (B) is correct. A false-positive response is one in which a response occurs in the absence of a stimulus, such as when a patient responds even though no signal has been presented.

A type of otoacoustic emission that requires the use of two oscillators and two attenuators is known as

A.spontaneous otoacoustic emission
B.transient evoked otoacoustic emission
C.stimulus-driven otoacoustic emission
D.fine-structure otoacoustic emission
E.distortion-product otoacoustic emission

Correct Answer: E
Option (E) is correct. Distortion-product otoacoustic emissions occur when the ear is stimulated simultaneously by two different pure tones. Two oscillators and two attenuators are required to generate and control these signals.

Click-evoked otoacoustic emissions are most likely to be recorded from the ears of which of the following individuals?

A.A person with a profound hearing loss
B.A person with severe presbycusis
C.A person with an upper brainstem lesion
D.A person with otitis media
E.A person who has ingested large quantities of aminoglycosides

Correct Answer: C
Option (C) is correct. Upper brainstem lesions do not always interfere with otoacoustic emissions, so otoacoustic emissions can be recorded from the ears of persons with upper brainstem lesions.

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?

A.Performing threshold testing of the child using behavioral observation audiometry
B.Referring the child for an auditory evoked brainstem evaluation
C.Scheduling the child to return at 6 months of age so visual reinforcement audiometry can be performed
D.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
E.Testing the child using visual reinforcement audiometry

Correct Answer: B
Option (B) is correct. An auditory evoked brainstem evaluation is the only reliable measure for estimating hearing sensitivity in infants less than 6 months of age.

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?

A.He was justified in leaving because there is customarily no charge for follow-up visits.
B.He should have called the patients to let them know there would be a charge for their follow-up visits.
C.He can be charged with patient abandonment.
D.He should report the owner to the licensure board.
E.He should inform the patients that they can be seen in a neighboring community.

Correct Answer: C
Option (C) is correct. The audiologist's actions leave the patients with no other audiologist present to perform follow-up procedures, which could lead to charges of patient abandonment.

The absence of an acoustic reflex threshold at 2000 Hz in the left ear is most likely the result of

(R: WNL thresholds; type A tymp; SRT-10; WRS 96%)
(L: WNL sloping to profound snhl after 1k Hz; type A tymps; SRT-30; WRS-20%)

A.differences in interaural attenuation between ears
B.a possible brainstem lesion
C.the beginning of a possible middle-ear lesion
D.variations in probe placement from one ear to the other
E.a possible mixed hearing loss

Correct Answer: B
Option (B) is correct. Brainstem lesions are likely to result in absent reflexes.

(R: WNL thresholds; type A tymp; SRT-10; WRS 96%) (present AR contra at 2k)
(L: WNL sloping to profound snhl after 1k Hz; type A tymps; SRT-30; WRS-20%; absent AR contra at 2k)

If this hearing test and audiology exam represent the initial point of entry, the audiologist should

A.offer the patient a trial with an osseointegrated cochlear stimulator
B.have the patient complete a hearing handicap scale to determine the extent of his communication problems
C.obtain a complete family case history
D.offer aural rehabilitation classes
E.refer the patient for a complete otological evaluation

Correct Answer: E
Option (E) is correct. Based on the audiogram, which shows an asymmetrical audiometric configuration, it is necessary to rule out a brainstem lesion, such as an acoustic neuroma; for a complete evaluation, the audiologist should refer the patient to an otologist.

Based on the results of all the audiological tests, the site of lesion for the left-ear thresholds is most likely

(R: WNL thresholds; type A tymp; SRT-10; WRS 96%) (present AR contra at 2k)
(L: WNL sloping to profound snhl after 1k Hz; type A tymps; SRT-30; WRS-20%; absent AR contra at 2k)

A.related to Ménière's disease
B.retrocochlear in origin
C.a function of cochlear hydrops
D.related to chronic ear infections
E.related to familial hearing loss

Correct Answer: B
Option (B) is correct. The unilateral hearing loss, the poor word recognition score, and the disagreement between the SRT and the PTA in the left ear are all indicative of a retrocochlear pathology.

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?

A.An acoustic neuroma
B.Cholesteatoma
C.Glomus jugulare tumor
D.Otosclerosis
E.A squamous cell carcinoma

Correct Answer: C
Option (C) is correct. A low-pitched, pulsating tinnitus synchronous with the heartbeat and acoustic immittance fluctuations are symptoms of glomus jugulare tumors, vascular growths originating from the glomus bodies. These tumors sometimes expand into the middle ear, causing hearing loss by putting the pressure of a pulsating jugular vein on the ossicles.

In a clinical-decision analysis, sensitivity of a screening test refers to

A.the incidence of false positive results in patients who do not have the disorder
B.the accuracy of the test in correctly rejecting patients without the disorder
C.the predictive value of negative results
D.the accuracy of the test in correctly identifying patients with the disorder
E.the incidence of false negative results in patients who have the disorder

Correct Answer: D
Option (D) is correct. "Sensitivity" refers to the accuracy of the test to correctly identify those patients who have the disorder of interest.

Among children with nonsyndromic clefts of the lip and palate, which of the following types of hearing loss is most common?

A.Sensorineural
B.Congenital
C.Mixed
D.Central auditory
E.Conductive

Correct Answer: E
Option (E) is correct. A cleft lip and palate are often associated with abnormalities of the muscles that open the eustachian tube. Eustachian tube dysfunction results in negative middle-ear pressure, leading to otitis media, which in turn can cause conductive hearing loss.

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?

A.Low compression threshold, low compression ratio
B.High compression threshold; high compression ratio
C.Low compression threshold; high compression ratio
D.High compression threshold, low compression ratio
E.Variable compression ratio; high compression threshold

Correct Answer: A
Option (A) is correct. WDRC provides gain adjustment across a wide range of input levels. It provides additional gain for low input levels with a low compression threshold and provides gradual increases in gain as input levels increase using a 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?

A.Congenital conductive hearing losses
B.Skull base fracture and congenital atresia
C.Diabetes and thyroid disease
D.Migraine, benign paroxysmal vertigo of childhood (BPVC), otitis media, viral infection, and head trauma
E.Pediatric patients usually only experience vestibular disorders that are viral in nature, and they usually exhibit spontaneous recovery.

Correct Answer: D
Option (D) is correct. Migraine, benign paroxysmal vertigo of childhood (BPVC), otitis media, viral infection, and head trauma are all common medical conditions that are associated with pediatric balance disorders and may require further vestibular assessment and medical referral for treatment.

Which of the following is the most valid method of monitoring a 5-year-old child's progress in aural rehabilitation?

A.Having the child report his or her own perceptions of change
B.Periodically administering probes of treatment targets in naturalistic contexts
C.Using questionnaires to be answered by the child's parents
D.Having teachers report on the child's classroom performance
E.Administering a norm-referenced test at the end of each session

Correct Answer: B
Option (B) is correct. Administering probes of treatment targets in a variety of modes in naturalistic contexts will give an objective assessment of the child's progress and is likely to provide valid results.

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?

A.Referring the patient to a Spanish-speaking otolaryngologist
B.Rescheduling the patient for a time when a Spanish-speaking interpreter is available
C.Administering an English word recognition test and scoring it as accurately as possible based on the patient's responses in English
D.Administering an English SRT and word recognition test, recording the responses, and having a Spanish-speaking friend score the responses
E.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

Correct Answer: B
Option (B) is correct. Given that the audiologist does not speak Spanish, a Spanish-speaking interpreter would be the most effective solution to assist the audiologist with speech-recognition testing.

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

A.binaural completely-in-the canal hearing aids
B.receiver-in-the-ear (RITE) aids with an open ear fitting
C.binaural behind-the-ear aids with occluding earmolds
D.in-the-ear aids with no venting
E.an assistive listening device

Correct Answer: B
Option (B) is correct. Given that this patient does not have a low-frequency hearing loss, a RITE hearing aid with an open ear fitting will allow low-frequency sounds to enter without being amplified. As a result, the emphasis of amplification will be in the high frequencies.

Which of the following is considered to be the best AI-DI for a directional microphone performing in noise?

A.-5 dB
B.-3 dB
C.0 dB
D.3 dB
E.5 dB

Correct Answer: E
Option (E) is correct. The AI-DI is a single number that represents the ratio of the microphone output for signals from the front to those sounds originating from all other directions. It is weighted by the articulation index. The larger the number the better the AI-DI.

A VNG/ENG test shows a caloric response yielding a left unilateral weakness. Which of the following statements about the results is most accurate?

A.It suggests a right peripheral vestibular disorder of the labyrinth.
B.It is of no real interpretive value
C.It suggests a nonspecific (nonlocalizing) vestibular disorder.
D.It suggests a left peripheral vestibular disorder of either the labyrinth or the VIIIth nerve.
E.It suggests a central vestibular disorder.

Correct Answer: D
Option (D) is correct. A unilateral weakness indicates a disorder of the labyrinth or the VIIIth nerve on the same side as the weakness.

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?

A.Tympanometry
B.Reflex-decay test
C.The Stenger test
D.Acoustic reflex testing
E.The distorted-speech test

Correct Answer: C
Option (C) is correct. A very large difference in sensitivity between two ears in an adult is easily verified by the Stenger test.

Which of the following would be the most appropriate acoustic modifications for an earmold when fitting a precipitously sloping high-frequency sensorineural hearing loss?

A.2 mm sound bore, standard tubing, no vent
B.3 mm sound bore, Libby horn, narrow vent
C.4 mm sound bore, Libby horn, no vent
D.2 mm sound bore, Libby horn, wide vent
E.4 mm sound bore, long tubing, narrow vent

Correct Answer: D
Option (D) is correct. Acoustic modification should emphasize high-frequency amplification and de-emphasize low-frequency amplification. A short sound bore, a flared horn (Libby), and a wide vent is the best combination to achieve that goal.

Which of the following tests most directly predicts the presence of a conductive hearing loss?

A.Rinne
B.Weber
C.Schwabach
D.Stenger
E.Bone conduction using forehead placement

Option (A) is correct. The Rinne test is the tuning-fork test that most directly predicts the presence of a conductive hearing loss, because it compares air-conduction to bone-conduction reception of the sound.

Which of the following individuals should be referred to a speech-language pathologist?

A.A 2-month-old male with no expressive vocabulary
B.An 18-month-old female with no expressive vocabulary
C.A 24-month-old male who is starting to put words together in sentences
D.A 24-month-old female who is starting to put words together in sentences
E.A 42-month-old female who is able to tell stories

Correct Answer: B
Option (B) is correct. An 18-month-old child should have a spoken vocabulary of about 50 words.

An audiologist sees his professor entering a hotel room on a Saturday with a woman who is not his wife. He should

A.discuss the matter with the professor
B.do nothing since it did not occur with a patient and was not in the work setting
C.report the matter to the licensure board as a potential ethics violation
D.report the matter to the department head
E.report the matter to the dean

Correct Answer: B
Option (B) is correct. The matter does not impact the practice of audiology nor does it impact the academic training of the audiologist.

A common medication known to be ototoxic is

A.ibuprofen
B.Benadryl
C.cough syrup
D.melatonin
E.high dosage vitamin C

Correct Answer: A
Option (A) is correct. Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to be ototoxic. Ibuprofen is an NSAID.

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

A.conductive impairment in the right ear
B.VIIIth-nerve pathology on the right side
C.VIIIth-nerve pathology on the left side
D.VIIth-nerve pathology on the right side
E.VIIth-nerve pathology on the left side

Correct Answer: E
Option (E) is correct. The acoustic reflex relies on the stimulus being carried to the stapedial muscle by the VIIth nerve. The absence of any reflex in the left ear suggests that there is a VIIth-nerve pathology preventing measurable reflex contraction on the left side

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?

A.No hearing loss
B.A transient sensorineural hearing loss
C.A permanent sensorineural hearing loss
D.A conductive hearing loss
E.A torn and painful auricle

Correct Answer: C
Option (C) is correct. A head injury that leads to a fracture through the cochlea causes fluid drainage and damage to the hair cells, which creates irreversible sensorineural hearing loss.

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

A.cross the midline with an object
B.visually track objects laterally
C.localize sounds and objects from above
D.babble
E.point to different body parts

Correct Answer: B
Option (B) is correct. Six-month-old infants can be expected to be able to track objects laterally with their eyes, and this skill is essential for visual reinforcement audiometry (VRA).

Click-evoked auditory brainstem response (ABR) thresholds are generally most closely correlated with behavioral thresholds for frequencies of

A.1000 Hz only
B.250-500 Hz
C.500-1000 Hz
D.2000-4000 Hz
E.6000-8000 Hz

Correct Answer: D
Option (D) is correct. The correlation between ABR and behavioral thresholds is greatest at frequencies between 2000 and 4000 Hz.

Which of the following is an effective way to eliminate the cochlear microphonic from the electrocochleographic response?

A.Increasing the distance between the transducer and the electrode sites
B.Using insert earphones to eliminate artifact
C.Using ipsilateral masking to enhance the compound action potential
D.Lowering the intensity of the stimulus
E.Using alternating polarity clicks

Correct Answer: E
Option (E) is correct. The cochlear microphonic response can create noise that makes it difficult to interpret the electrocochleographic response waves. The polarity of the cochlear microphonic response (but not the polarity of the electrocochleographic response) varies with the stimulus, so when polarity of the clicks used as stimuliis alternates, the cochlear microphonic response is cancelled out, and an electrocochleographic response wave can be obtained.

Functional gain of a hearing aid is best defined as the difference between which of the following?

A.Aided and unaided word-recognition scores
B.Input at the hearing-aid microphone and output into an HA-2 coupler
C.Aided and unaided ear-canal signal levels
D.Aided and unaided sound-field thresholds
E.Input at the hearing-aid microphone and output into the ear canal

Correct Answer: D
Option (D) is correct. Functional gain is the amount of improvement that the hearing aid brings to the wearer's hearing levels — more precisely, the difference in decibels between aided and unaided sound-field thresholds.

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?

A.Tympanometry
B.Acoustic-reflex thresholds
C.A word-recognition test
D.Speech-awareness or speech-recognition thresholds
E.Most-comfortable loudness levels

Correct Answer: D
Option (D) is correct. Individuals with traumatic brain injuries are more likely to respond to speech than they are to respond to pure tones. Speech-awareness tests have a high correlation with pure-tone thresholds at certain frequencies. If the speech-awareness threshold is lower than the pure-tone threshold, it is probable that the speech threshold is closer to the true threshold and that the pure-tone threshold is not accurate.

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?

A.Central Institute for the Deaf (CID) W-1
B.Central Institute for the Deaf (CID) W-22
C.Phonetically Balanced Kindergarten Test (PB-K)
D.Northwestern University Test No.6 (NU6)
E.Word Intelligibility by Picture Identification (WIPI)

Correct Answer: E
Option (E) is correct. The WIPI is the only test listed that is both appropriate for young children and requires no verbal participation by the child.

Which of the following is a VNG/ENG test designed to determine whether nystagmus will occur with a specific rapid body maneuver?

A.Epley
B.Dix-Hallpike
C.Bárány
D.Gaze
E.Spontaneous nystagmus

Correct Answer: B
Option (B) is correct. In the Dix-Hallpike test, the audiologist has the patient sit on a table then quickly lie back and hang his or her head over the edge of the table to see if nystagmus occurs as a result of the movement.

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?

A.Signed Exact English
B.Total communication
C.Oral/aural communication
D.Rochester method
E.Simultaneous communication

Correct Answer: C
Option (C) is correct. Jonathon had already begun to learn oral speech and language prior to experiencing the hearing loss, and the family has no known ties to Deaf culture. The fact that Jonathon is responding well to amplification and that the family appears to be willing to be very involved in his rehabilitation, auditory-verbal therapy is a good choice for a communication mode.

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?

A.Caloric
B.Sinusoidal rotary
C.Pseudorandom rotary
D.Dynamic posturography
E.Fistula

Correct Answer: A
Option (A) is correct. The caloric test affects only one ear at a time.

Which of the following types of speech recognition materials is most useful to rule out a lesion affecting the VIIIth nerve?

A.Closed-set monosyllabic and bisyllabic words that vary in stress pattern
B.Closed-set sentences approximating natural syntax, administered in varying intensity levels as in an ongoing message
C.Open-set, monosyllabic, phonetically balanced word lists that are representative of the patient's language
D.Open-set, monosyllabic, phonetically balanced word lists, administered at several intensity levels
E.A closed-set test that requires a picture-pointing response

Correct Answer: D
Option (D) is correct. Speech understanding may be affected in a patient with a suspected retrocochlear lesion. Administering a performance-intensity function and then calculating rollover would be an appropriate step before referring the patient for more objective tests to rule out a retrocochlear lesion.

According to PL 99-457, a child under 2 years of age who has a hearing loss is entitled to

A.be fitted with binaural hearing aids
B.have ABR testing
C.be enrolled in a center-based habilitation program
D.have a written Individualized Family Service Plan
E.be provided with total communication training

Correct Answer: D
Option (D) is correct. PL 99-457 specifies that a plan be developed but does not specify the types of services to be delivered.

Which of the following is the most sensitive measure of VIIIth-nerve dysfunction?

A.Otoacoustic emissions
B.Auditory brainstem response (ABR)
C.Speech recognition testing
D.Performance intensity-phonetically balanced (PI-PB) function
E.Acoustic reflex decay testing

Correct Answer: B
Option (B) is correct. The ABR test is objective and sensitive, and it can determine whether the VIIIth nerve is functioning properly.

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?

A.Test at the end of the work shift in order to record the observed temporary threshold shift (TTS)
B.Test at all frequencies in octaves between 250 and 8000 Hz and also at 3000 Hz and 6000 Hz
C.Include acoustic immittance measures in the hearing-test battery
D.Test only those employees whose daily noise dose exceeds maximum permissible noise levels
E.Administer threshold tests in areas where ambient noise levels conform to the regulations published in the Federal Register

Correct Answer: E
Option (E) is correct. The test will not be valid if the background noise is too high, because the noise will mask signals at hearing levels needed for accurate hearing threshold measures. OSHA provides a table of maximum allowable octave-band sound-pressure levels for audiometric test rooms.

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?

A.Treatment with ingestion of cisplatin
B.An Apgar score of 7 at one minute after birth
C.Family history of neurofibromatosis type II
D.Treatment with aminoglycosides
E.Treatment with loop diuretics

Correct Answer: B
Option (B) is correct. An Apgar score of 7 at one minute after birth is normal. The other answers are all associated with a risk for hearing impairment.

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

A.husband to accompany his wife to the evaluation.
B.wife to give verbal permission over the phone.
C.wife to sign a HIPAA form listing individuals who may have access to her records.
D.husband to speak to the referring physician for the results.
E.wife and husband to make a second appointment for a consultation.

Correct Answer: C
Option (C) is correct. According to the HIPAA, medical records cannot be released to anyone without written permission.