Title: HIS-250 Lab Practice Exam
Course: 14FA-HIS-250-H1B1-REAL EAR MEASUREMENTS > Section: Dropbox

Respondus

Q: Which of the following statements is most true about the use of gloves?
- Gloves are considered one-time use and should be disposed of after each use.
- Gloves can be reused as long as they were not contaminated with blood or other bodily fluids.
- Gloves can be cleaned and reused if properly sanitized.
- Gloves can be saved to be used during a different appointment with the same patient.
A: Gloves are considered one-time use and should be disposed of after each use.

Q: Which of the following complaints warrants an immediate referral to an ENT physician?
- History of noise exposure
- Occasional tinnitus
- Acute or chronic dizziness
- History of taking ototoxic medications
A: Acute or chronic dizziness

Q: You perform tympanometry on your patient/client and obtain a Type B tympanogram with a normal ear canal volume. What type of hearing loss would you expect them to have?
- Normal hearing sensitivity
- Conductive hearing loss
- Sensorineural hearing loss
- Mixed hearing loss
A: Conductive hearing loss

Q: A case history is taken prior to testing in order to
- Determine if member is a candidate for a hearing aid
- Determine if a medical referral is needed
- if you know the family of the patient
- Determine communication needs
A: Determine if a medical referral is needed

Q: When obtaining audiometric thresholds, 1000 Hz is tested twice because
- Test/retest reliability needs to be established
- It is the most important speech frequency
- It is the hardest tone to hear
- Both A and B
A: Both A and B

Q: Your patient/client has a mild to moderate sloping high frequency sensorineural hearing loss in her right ear and a more severe hearing loss in the left ear. Speech discrimination scores are 76% for the right ear and 56% for the left ear. She complains that she cannot understand on the phone very well with her left ear, but does fairly well with the right ear. You should
- Fit her with hearing aids in both ears
- Fit her with a hearing aid in the right ear only because her understanding is better in that ear
- Recommend that she follow up in 1 year for further evaluation.
- Refer her to an ENT for further evaluation
A: Refer her to an ENT for further evaluation

Q: When taking an ear impression why might your patient cough?
- Your patient sometimes coughs when they are nervous.
- It’s a normal response to cough due to Arnold’s Reflex
- The patient coughs due to pressure in the ear canal
- Your patient needs to be referred to an ENT
A: It’s a normal response to cough due to Arnold’s Reflex

Q: The easiest way to eliminate the spreading of bacteria from patient to patient is:
- Cleaning
- wash hands after each patient
- Sterilize tools and equipment daily
- All of the above
A: All of the above

Q: Patient/client records should be maintained:
- for the life of the patient
- As required by applicable law
- for three years
- until the warranty expires
A: As required by applicable law

Q: For hand hygiene you should lather antimicrobial soap, scrubbing the palms, backs of hands, and wrists for a minimum of how many seconds?
- 5 seconds
- 10 seconds
- 15 seconds
- 22 seconds
A: 22 seconds

Q: Recruitment is most common in
- Conductive hearing losses
- Central auditory processing disorders
- Sensorineural hearing losses
- Mixed hearing losses
A: Sensorineural hearing losses

Q: A 69 year old male patient/client with normal hearing through 1KHz followed by a precipitous drop in thresholds would do best with
- Non-occluding earmolds
- Skeleton earmolds with select-a-vent
- ITC instruments
- A compression circuit
A: Non-occluding earmolds

Q: Impacted cerumen
- Will not interfere with impression taking
- Should be surgically removed
- Will have little effect on audiometric tests
- Should be removed prior to audiometric testing
A: Should be removed prior to audiometric testing

Q: Your patient/client has a very soft, flaccid outer ear, and he has a moderately sloping loss. What earmold material would work best for his ear texture, AND what type of mold might be a success?
- Acrylic material; canal mold
- Silicone material; open mold
- Acrylic material; skeleton mold
- Silicone material; half shell mold
A: Acrylic material; skeleton mold

Q: Your patient/client is concerned that when their hearing aids are off during the night they will not hear their alarm clock in the morning. What is an assistive device that could help them?
- Alarm clock with a pillow shaker
- Alarm clock with high frequency alarm signal
- Sound signaler that activates bedside lamp to flash
- Telephone wake-up call
A: Alarm clock with a pillow shaker

Q: You are performing a first fit with a BTE and custom earmold with a 2.44mm vent. Although you have run your feedback reduction they are still getting a lot of feedback. You do not want to reduce any gain in the high frequencies. What should you do?
- Make a new earmold as it must be a poor fit issue
- Tell them they will get used to the feedback
- Use vent plugs to reduce the vent size until feedback is reduced
- Fill their vent with glue so that they do not get feedback
A: Use vent plugs to reduce the vent size until feedback is reduced

Q: After otoscopic examination of the right ear, you should
- Perform otoscopy on the left ear
- Wipe off speculum and perform otoscopy on the left ear
- Change speculum and perform otoscopy on the left ear
- Otoscopy on the left ear is not necessary, only one ear is required
A: Change speculum and perform otoscopy on the left ear

Q: Your patient/client is a current long-time hearing aid wearer. She says that her hearing aids are not giving her the volume she needs.  She’s wearing an open fit style behind the ear instrument. After retesting her hearing you discover, her low frequencies have dropped considerably since she was initially fit. Her hearing loss has changed from a moderate high frequency hearing loss to a moderate flat hearing loss. What is the recommendation?
- Advise her that it is time for a new set of hearing aids, as these will no longer provide her with enough volume
- Turn the instruments up to give her more volume
- Advise her that with the change in hearing custom earmolds would be most appropriate
- Counsel her on how to use the volume control appropriately
A: Advise her that with the change in hearing custom earmolds would be most appropriate

Q: During the otoscopic examination of the ear canal you notice wax in the ear canal and you can’t see one small section of the  tympanic membrane. What do you do next?
- Remove the wax
- Refer to the doctor for removal
- Proceed with testing
- Go on break
A: Proceed with testing

Q: Bracketing refers to
- Descending in 10 dB steps; ascending in 5 dB steps
- Descending in 15 dB steps; ascending in 10 dB steps
- Descending in 5 dB steps; ascending in 10 dB steps
- Descending in 5 dB steps; ascending in 5 dB steps
A: Descending in 10 dB steps; ascending in 5 dB steps

Q: Narrow band noise is
- Actually a variation of sprectral noise
- Produced by selective warble pulses
- Considered more effective for pure tone masking
- Considered more effective for speech masking
A: Considered more effective for pure tone masking

Q: Your patient/client has been referred to you by his ENT physician to obtain amplification. He recently experienced a sudden sensorineural hearing loss in his right ear and had 8% WRS in that ear. His left ear has a mild to moderate sensorineural hearing loss from 1-8K Hz, with normal hearing in the low frequencies and has 84% WRS. What type hearing aid would you recommend for him based on his hearing loss?
- A high power BTE for the right ear with a full shell earmold; no hearing aid for the left ear
- A high power BTE for the right ear with a full shell earmold; an open fit BTE for the left ear
- A CROS open fit hearing aid
- A BiCROS open fit hearing aid
A: A BiCROS open fit hearing aid

Q: Inter-octaves should be tested when there is a
- 15 dB HL difference between adjoining octaves
- 20 dB HL difference between adjoining octaves
- 25 dB HL difference between adjoining octaves
- 30 dB HL difference between adjoining octaves
A: 15 dB HL difference between adjoining octaves

Q: A good test environment means:
- A distracting environment
- Complex instructions to the patient
- A properly calibrated audiometer
- A lack of excess ambient noise
A: A lack of excess ambient noise

Q: You’re patient/client is in a wheelchair because she has severe osteoarthritis. She has never worn hearing aids before because she doesn’t think that her hearing is all that bad. After a complete test you discover she has a binaural sensorineural severe flat loss with great sensitivity to noise. Her TV blares. Her binaural discrimination is 80%. What would you recommend that would serve the needs of this client and her family?
- A set of RITEs because they are easy to fit and most of your client’s prefer them
- A set of large BTEs and custom earmolds because of her severe hearing loss
- A set of CICs
- A set of power ITEs that have remote and TV streamer capability
A: A set of power ITEs that have remote and TV streamer capability

Q: An infection of the middle ear is called
- Otosclerosis
- Otitis media
- Otitis externa
- Exostosis
A: Otitis media

Q: When giving instructions during testing, it is important to
- Make sure the patient/client can understand the test instructions
- Never provide what the test stimulus will be like
- Only give the instructions one time
- Make sure that the patient/client cannot see your face
A: Make sure the patient/client can understand the test instructions

Q: You are fitting a new BTE. The instrument and shell mold have been properly inserted and the volume is adjusted to a comfortable listening level. The patient/client complains that her own voice has an echo, but says that yours is OK. What is the first adjustment you would try?
- Occlude the mold
- Reduce the low frequency response
- Reduce the gain of all frequencies
- Shorten the canal on the earmold
A: Reduce the low frequency response

Q: The slope of the hearing loss can determine a successful fitting. A most favorable slope is  a
- Gradually falling
- Deep saucer shape
- Sharp drop in the lower frequencies
- Irregular dips and peaks
A: Gradually falling

Q: The best tool to determine hearing threshold levels is
- The tympanogram
- The audiogram
- The Weber test
- OAE
A: The audiogram

Q: You are fitting a first-time wearer, and initially select “First Fit, New User.” The member reports than sound is loud but not clear, and you observe that he misses much of your conversation. What would you do next?
- Counsel that understanding will be expected to increase with time and use
- Increase the high frequency response
- Run Real Ear and adjust instruments accordingly
- Select another hearing instrument and start the fitting over
A: Run Real Ear and adjust instruments accordingly

Q: A pure conductive hearing loss will show
- All bone conduction thresholds within normal limits
- All air conduction thresholds are better than bone conduction thresholds
- Some bone conduction thresholds within normal limits
- Both A and B
A: All bone conduction thresholds within normal limits

Q: An audiogram with less loss at the high and low frequencies than in the middle frequency region is classified as a
- Sandwich bite
- Rising curve
- Reverse curve
- Cookie bite
A: Cookie bite

Q: Your patient came in with 4 year old ITEs for cleaning. She said they had not been cleaned for a long time and she cannot hear as well as she used to. What would you do?
- Clean hearing aids and give them back to your patient/client
- Clean hearing aids and then demonstrate to her how she can do maintenance cleanings at home, as well as schedule her for an updated hearing evaluation
- Tell her they need to go in for repair since you can’t see the receiver
- Tell her that you cannot help her as they are no longer under warranty
A: Clean hearing aids and then demonstrate to her how she can do maintenance cleanings at home, as well as schedule her for an updated hearing evaluation

Q: Why do we look for a PTA/SRT discrepancy?
- To make sure they are repeating words at threshold levels
- To verify pure tone thresholds and check for malingering or possible misunderstanding of instructions during pure tones
- To determine appropriate level for WRS testing
- None of the above
A: To verify pure tone thresholds and check for malingering or possible misunderstanding of instructions during pure tones

Q: A person with a mild hearing impairment
- May have difficulty hearing faint and/or distant speech
- Would understand conversational speech only if it were loud
- May show articulation problems in their speech
- Do not rely on hearing as their primary avenue of communication
A: May have difficulty hearing faint and/or distant speech

Q: You patient/client comes in for her to follow up visit and reports she can hear people at a distance, but do not those at her table when shes at a restaurant. What is the best action to do?
- Reduce venting
- Change her microphones to directional in a specific program for speech in noise
- Reduce compression
- Reduce the  noise reduction algorithm
A: Change her microphones to directional in a specific program for speech in noise

Q: You have just completed a complete audiogram and the results indicate a unilateral sensorineural hearing loss. Although the hearing loss was not reported as a sudden hearing loss in the last 90 days your best course of action is
- Fit the worse ear only with amplification
- Fit with a  CROS hearing aid
- Refer to an ENT
- Discuss the test results and plan to retest them in one year
A: Refer to an ENT

Q: You receive a phone call from a client’s daughter wanting to discuss her mother’s recent hearing test results and your recommendations for her regarding hearing aids because she was not able to be at her appointment. What is your next course of action?
- Explain her test results and how she could benefit from hearing aids
- Verify in you records that you have written consent from your client to discuss her protected health information with the caller before discussing anything
- Document in the client’s record that you discussed PHI with the caller and the date/time of discussion
- Both B and C
A: Both B and C

Q: Sensorineural hearing loss could be caused by all of the following except
- History of ear infections
- Exposure to loud sounds
- Poor eating habits
- Ototoxic medications
A: Poor eating habits

Q: Hearing loss may be LEAST often attributed to
- ototoxic drugs
- Noise exposure
- the aging process
- acoustic trauma
A: acoustic trauma

Q: Ototoxic medications cause
- Damage to the spiral ganglia
- Eustachian tube dysfunction
- Damage to the outer hair cells
- Damage to the stria vascular
A: Damage to the outer hair cells

Q: Your client/patient has had their BTE and earmold hearing aid for 6 months. She reports that in the last week it has started squealing and she has to turn the volume down to stop the problem. You check her ear canal and she has no cerumen or debris in the canal. What should you do stop the squealing?
- Rerun the feedback management
- Decrease the gain in the high frequencies
- Check the tubing for a crack and retube the earmold
- Decrease the gain of all frequencies so that she doesn’t have to turn down the volume
A: Check the tubing for a crack and retube the earmold

Q: Medications causing hearing loss:
- Are known as ototoxic
- may depend on dosage and frequency of use
- may affect different patient differently
- are predominantly antibiotics
A: Are known as ototoxic

Q: What frequencies are used to calculate HF-Average Full-On Gain?
- 500, 1500, 2000 Hz
- 500, 1000, 2000 Hz
- 1000, 1600, 2500 Hz
- 1000, 2000, 5000 Hz
A: 1000, 1600, 2500 Hz

Q: Presbycusis is
- A mixed loss
- An abnormally shaped ear canal
- Hearing loss due to age and loss of nerve capacity
- Both A and C
A: Hearing loss due to age and loss of nerve capacity

Q: A traditional telecoil in a hearing aid allows the patient/client to hear
- Over the telephone along with room conversation
- Over the telephone, but excluding room conversation
- Better in noisy listening environments
- Over the telephone on all telephones, including cell phones
A: Over the telephone, but excluding room conversation

Q: Your client has recently had a stroke and has a mild to moderate sensorineural hearing loss bilaterally. Which style of hearing aid are they most likely to be able to handle the best due to their current limited dexterity?
- CIC
- ITE
- RIC
- BTE
A: ITE

Q: Style selection should ideally be decided by
- The dispenser, the client, and family
- The dispenser only
- The client alone
- The family alone
A: The dispenser, the client, and family

Q: The otoblock must be
- Seen at the first bend of the canal
- The same diameter as the aperture
- Square in the canal; not skewed
- Placed using the otoscope
A: Square in the canal; not skewed

Q: Your patient/client is a nurse practitioner and is a first-time hearing aid user who has a mild to moderate sensorineural hearing loss. She is having trouble hearing her patients and nursing staff, and has to use a stethoscope throughout the day. Which style of hearing aid, if any, would you recommend?
- Fit him with BTE hearing aids with then tube and an open dome
- Fit her with ITE hearing aids
- Fit her with deep-fit CIC aids
- Tell her that hearing aids cannot be used with a stethoscope
A: Fit her with deep-fit CIC aids

Q: Which would be most appropriate for a client with a profound hearing loss?
- BTEs, skeleton mold, acrylic material, short canal
- BTEs, full shell mold, silicone material and long canal
- BTEs, half shell mold acrylic material
- BTEs, thin tube, double dome
A: BTEs, full shell mold, silicone material and long canal

Q: Which is NOT a required step in taking an ear impression?
- Inspect ear with otoscope
- Lubricate the otoblock
- Brace the patient/client’s head to prevent movement
- Keep the tip in the material while filling the ear
A: Lubricate the otoblock

Q: What are the reasons for using an otoblock when taking an ear impression?
- To ensure that impression material does not encroach on the tympanic membrane
- It can be used to make minimal canal length impressions
- It can be used as a handle to remove the impression from the ear
- All of the above
A: To ensure that impression material does not encroach on the tympanic membrane

Q: What is wrong with this impression?
- Underfilled canal
- Underfilled helix
- Otoblock too small
- Voids
A: Underfilled canal

Q: Why must impression material be mixed until it is a consistent color?
- So it can cure properly
- So it looks good
- So it will flow through the syringe easily
A: So it can cure properly

Q: Why do we use vents in custom earmolds, in addition to providing pressure relief?
- To reduce occlusion
- For high frequency reduction
- For low frequency reduction
- To enhance natural high frequencies
A: To reduce occlusion

Q: You remove this impression from your patient/client’s ear. You see several voids. What would you try to correct when you take another impression of that same canal?
- Place otoblock just past second bend
- Use smaller otoblock
- Keep tip in material while filling concha bowl and upper
- All of the above
A: All of the above

Q: You patient/client comes to your office today for her follow up appointment and you notice the hearing aids are not working. What do you check first?
- That the batteries are good
- That the hearing aids are not wet
- That the patient does not have wax impaction
- Perform aided sound field testing.
A: That the batteries are good

Q: Why is it important to look behind the pinna before taking an ear impression?
- Gives suggestion of canal angle
- Presence of excessive ear debris
- Could indicate sign of surgery that they forgot to tell you about
- Placement of bone oscillator for bone conduction testing
A: Could indicate sign of surgery that they forgot to tell you about

Q: Which does not need to be considered when performing the first programming of a hearing aid?
- Patient/client’s age
- Patient/client’s gender
- Patient/client’s previous experience
- Patient/client’s hearing aid battery size
A: Patient/client’s gender

Q: It is recommended that the fit of a hearing aid be verified. What does this mean?
- Make sure that the hearing aid fits comfortable in the canal
- Make sure that the patient/client signs they are taking the hearing aid home with them
- Perform real ear test of hearing aid settings
- Complete COSI assessment
A: Perform real ear test of hearing aid settings

Q: High frequencies can be enhanced by what earmold adjustment?
- A smaller diameter bore
- Longer tubing
- Smaller I.D. tubing
- Larger I.D. tubing
A: A smaller diameter bore

Q: Limiting the output of a hearing aid becomes necessary when
- The low frequencies are not well understood
- The patient/client’s tolerance decreases
- The frequency range becomes wider
- The harmonic distortion increases
A: The patient/client’s tolerance decreases

Q: Which of the following is a validation measure that could be used to assess a patient’s improvement with hearing aids?
- COSI
- ANSI
- FOG
- REAG
A: COSI

Q: Your patient/client has just been fit with her first set of hearing aids. She has had a significant hearing loss for many years. She lives alone and does not leave her home very often. What are some ways that she can acclimate to her hearing aids on her own?
- Read aloud to herself
- Watch television muted, used closed captions only
- Wear her hearing aids for one hour a day
- Wear her hearing aids while she is sleeping
A: Read aloud to herself

Q: Your patient/client was fit with receiver-in-the-ear hearing aids. He has a sloping high frequency hearing loss with 70% word recognition scores. You would use which of the following tests to verify his fitting?
- REM
- APHAB
- Pure tone testing with insert phones
- Pure tone sound field testing
A: REM

Q: Your patient/client is 92 and is in a nursing home. You do an in-service and his appointment is set by his daughter who is 71. He was non-responsive to questions by the Hearing Aid Dispenser and all questions were answered by his daughter. What would you do next?
- Finish all questions on the intake form with his daughter, perform otoscopy, and then put insert phones on him, establish MCL and give him testing instructions via insert phones.
- Inform his daughter that amplification will not help someone who is non-responsive.
- Raise your voice to the point of getting a response to questions from him.
- Ask his daughter what she would like to accomplish today.
A: Finish all questions on the intake form with his daughter, perform otoscopy, and then put insert phones on him, establish MCL and give him testing instructions via insert phones.

Q: You perform real ear verification on your patient/client the day of their hearing aid fitting. There is no difference in the aided gain versus the unaided gain. What are two reasons this could occur?
- Battery door not completely closed on hearing aid
- Probe tube pinched when hearing aid was placed in the ear canal
- Hearing aid is set too loud and must be in compression
- Both A and B
A: Both A and B

Q: The hearing aid test box
- Allows a comparison of an instrument’s performance with its specification
- Is used directly to make adjustments on hearing aid circuits
- Is only used with analogue hearing aids
- Provides unrepeatable subjective data
A: Allows a comparison of an instrument’s performance with its specification

Q: For which speech test do you never need to apply masking?
- UCL
- MCL
- SRT
- WRS
A: UCL