ILE-HIS Exam #1

Question 1

A 45-year old man presents with the following partial audiogram and complaints of a sudden hearing loss in the past week and a feeling of fullness in the left ear.

Which should the hearing care professional suspect as a hearingdisorder?

a. Atresia
b. Serous Otitis Media
c. Ototoxicity
d. Presbycusis

Answer 1

b. Serous Otitis Media

Question 2

A 45-year old man presents with the following partial audiogram and complaints of a sudden hearing loss in the past week and a feeling of fullness in the left ear.

What type of tympanogram would be expected in the right ear?

a. Type B
b. Type C
c. Type A
d. Typa Ad

Answer 2

c. Type A

Question 3

A 45-year old man presents with the following partial audiogram and complaints of a sudden hearing loss in the past week and a feeling of fullness in the left ear.

3. What type of tympanogram would be expected in the left ear?

a. Type B
b. Type A
c. Type As
d. Typa Ad

Answer 3

a. Type B

Question 4

Upon visual inspection of the ear, the HCP notices active drainage in theleft ear, what is the first precautionary measure that should be taken?

a. Replace the speculum with a new speculum prior to using theotoscope
b. Wipe the speculum with an alcohol wipe prior to using theotoscope
c. Refer to a physician without continuing with an otoscopeinspection
d. Put on gloves prior to looking in the ear with the otoscope

Answer 4

d. Put on gloves prior to looking in the ear with the otoscope

Question 5

A 45-year old man presents with the following partial audiogram and complaints of a sudden hearing loss in the past week and a feeling of fullness in the left ear.

What is the best course of action for this patient?

a. Recommend a BTE hearing instrument with closed mold on the leftear
b. Recommend a CROS hearing instrument to improve localization
c. Refer to a physician due to report of sudden hearing loss and active drainage in left ear
d. Continue hearing evaluation to assess speech scores

Answer 5

c. Refer to a physician due to report of sudden hearing loss and active drainage in left ear

Question 6

A patient comes to your office wearing bilateral CIC instruments. Her primary complaint is she hears better with the hearing aids out of her ear. What is a likely result you would find when running probe microphone measures?

a. Her real ear aided response (REAR) curve is lower than her real ear unaided response (REUR) curve
b. Hear real ear unaided response (REUR) curse is lower than her real ear aided response (REAR) curve
c. Her real ear aided response (REAR) matches the NAL-NL2 target at all frequencies and input levels
d. Her real ear aided response (REAR) at a 65 dB input level is below hertarget for loud speech

Answer 6

a. Her real ear aided response (REAR) curve is lower than her real ear unaided response (REUR) curve

Question 7

Which should the hearing careprofessional suspect as a hearing disorder

a. Otosclerosis
b. Cholesteatoma
c. Presbycusis
d. Acoustic Trauma

Answer 7

c. Presbycusis

Question 8

What type of tympanogram would be expected in the left ear?

a. A
b. B
c. C
d. Ad

Answer 8

a. A

Question 9

What is the best hearing aid recommendation for this patient?

a. CIC with a pressure vent
b. RIC with a semi-open dome
c. ITE with a 1 mm vent
d. BiCROS with a non-occluding skeleton mold

Answer 9

b. RIC with a semi-open dome

Question 10

Upon returning to your office for her first week post-fitting check up. Mrs.
Lee is concerned because she is still having some difficulty in noisy
situations. She indicates that most of her trouble occurs when she is
attending brunch with investment club members. What is your first course
of action?

a. Reprogram the hearing aids to increase the highfrequencies
b. Run a front to back probe microphone measurement
c. Ask patient more questions to get a better understanding of the listening environment
d. Read out the data logging feature of the hearing aid to confirmwhere
she is wearing the instruments

Answer 10

c. Ask patient more questions to get a better understanding of the listening environment

Question 11

An 87-year old man and his daughter come to your office for routine check up with his 2 year old power BTE hearing instruments. He does not have any complaints; however the daughter is concerned he is not hearing well when she visits him at his assisted living facility. Which should the hearing care professional recommend to the patient and his daughter?

a. Consider purchasing new hearing instruments with bettertechnology
b. Recommend purchasing an FM system with external microphone
c. Give daughter communication strategies to assist with better communication
d. Reprogram the hearing aids to increase the highfrequencies

Answer 11

c. Give daughter communication strategies to assist with better communication

Question 12

Germicidal disposable cloths should be used for which of the following purposes?

a. Disinfection of counters in the testing room
b. Sterilization of otoscope specula
c. General cleaning of hands
d. Removal of all blood-borne pathogens

Answer 12

a. Disinfection of counters in the testing room

Question 13

When conducting masking to establish the true air conduction thresholds for the poorer ear, which ear would be considered the non-test ear?

a. Right ear
b. Left ear
c. They are both the non-test ear
d. Neither are the non-test ear

Answer 13

b. Left ear

Question 14

Which air conduction frequencies need to be masked to establish true thresholds for the poorer ear?

a. All frequencies
b. 250Hz, 500 Hz, 1000 Hz, 2000 Hz & 3000 Hz
c. 500 Hz, 1000 Hz, 2000 Hz & 3000 Hz
d. 500 Hz, 2000 Hz & 3000 Hz

Answer 14

d. 500 Hz, 2000 Hz & 3000 Hz

Question 15

Which bone conduction frequencies need to be masked to establish true
thresholds for the poorer ear? Select all that apply

a. 500 Hz
b. 1000 Hz
c. 2000 Hz
d. 4000 Hz

Answer 15

All of the above

Question 16

What type of signal do you use when performing a Speech Reception Threshold test?

a. Phonetically balanced single syllable words
b. Warble tone
c. Two-syllable spondee words
d. Phonetically balanced two-syllable words

Answer 16

c. Two-syllable spondee words

Question 17

Mr. Samson purchased hearing aids from you three months ago. He comes in to see you today because his left hearing aid does not seem to be loud enough.

What is the first thing you should do?

a. Perform probe microphone measures
b. Listen to the hearing instrument
c. Reprogram the hearing instrument with more gain
d. Reinstruct on using the volume control

Answer 17

b. Listen to the hearing instrument

Question 18

After removing a complete impression from your patient’s ear, what is the first thing you should do?

a. Visually inspect the quality of the impression
b. Inspect the ear canal with the otoscope
c. Use hand sanitizer to decontaminate your hands
d. Ask the patient if he is ok

Answer 18

b. Inspect the ear canal with the otoscope

Question 19

What is the best hearing aid solution for Mrs.Sanchez?

a. Omnidirectional Open fit BTE with open tip
b. Power BTE with directional microphones and a skeleton earmold andpressure
c. RIC BTE with directional microphones and custom canal with lock ear mold and 2mm select-a -vent
d. In-the-ear custom with omnidirectional microphones and a 1 mmvent

Answer 19

d. In-the-ear custom with omnidirectional microphones and a 1 mmvent

Question 20

What expectations would you want to establish regarding hearing aid
performance with Mrs. Sanchez?

a. If she uses her hearing aids everyday she will perform as well asher
peers
b. She will be able to understand 80% of speech based on her test
results
c. She will only be able to hear in quiet and should consider an ALDif
she wants to hear better in noisy situations
d. She will still have difficulty in noise even with her hearing aids,but
she will do better with good communication strategies.

Answer 20

d. She will still have difficulty in noise even with her hearing aids,but
she will do better with good communication strategies.

Question 21

In the past three months your client has been in to see you 4 times with a
complaint of a dead hearing aid. All 4 times there has been cerumen
impacted in the receiver of the hearing instrument. What should you do
first for this client?

a. Send the aid to the manufacturer for entire rework
b. Schedule routine appointments to clean the instruments for the client
c. Reinstruct the client on how to properly clean the instruments at
home
d. Send the client home with a dri-aid kit

Answer 21

c. Reinstruct the client on how to properly clean the instruments at home

Question 22

When visually inspecting the ear with the otoscope, what conditionwould
contraindicate taking an ear impression?

a. Typanosclerosis
b. A collapsing ear canal
c. Larger than normal ear canal
d. Excessive cerumen

Answer 22

d. Excessive cerumen

Question 23

Based on the audiometric data below, what else needs to be performed for this evaluation to be considered complete?

a. Binaural SRT
b. Pure-tone air-conduction threshold at 6000 Hz in the right and left ears
c. Pure-tone air-conduction threshold at 1500 Hz in the right and left ears
d. Monaural QuickSIN

Answer 23

c. Pure-tone air-conduction threshold at 1500 Hz in the right and left ears

Question 24

What is the ideal presentation level for conducting word recognition testing?

a. At the patient’s MCL
b. At the patient’sUCL
c. At the patient’s SRT
d. At 20dB above the patient’s MCL

Answer 24

a. At the patient’s MCL

Question 25

Which of the following is an example of a validation method for validating your client’s fitting?

a. ANSI measurements
b. Hearing Instrument Test box
c. Client Oriented Scale of Improvement(COSI)
d. Probe Microphone Measurement

Answer 25

d. Probe Microphone Measurement

Question 26

How do individuals with hearing loss typically learn they have ahearing
loss?

a. They suddenly wake up one day not hearingwell
b. They slowly come to the realization in selfreflection
c. Via an online self assessment orscreening
d. Family and loved ones inform them of their hearing loss

Answer 26

d. Family and loved ones inform them of their hearing loss

Question 27

Which is a common initial behavior displayed by individuals with hearing
loss?

a. Acceptance
b. Withdrawal
c. Courage
d. Curiosity

Answer 27

b. Withdrawal

Question 28

Upon otoscopic examination, the hearing care professional notices a surgically modified ear resulting in a larger than normal ear canal. What should the professional do prior to making an ear impression?

a. Refer to a physician to make the impression
b. Use multiple otoblocks to fill the ear canal
c. Fit with BTE with a non-custom earmold since an impression cannot be madesafely
d. Use the largest possible single otoblock and carefully insert impression material to avoid a blow by

Answer 28

b. Use multiple otoblocks to fill the ear canal

Question 28

Your client is in the office for an initial hearing evaluation. He reports he has experienced a hearing loss for the past 10 years. He has a history of noise exposure and tinnitus in his right ear. He indicates he hears better in his left ear, which is the ear he also uses on the telephone. Which ear should you begin your pure tone air conduction threshold testing?

a. Right ear
b. Left ear
c. Either ear, there is no preference
d. The ear with the best word recognition score

Answer 28

b. Left ear

Question 28

Where should the otoblock be positioned when making an ear impression?

a. At the second bend
b. Just past the second bend
c. Between the first and second bend
d. At the aperture of the ear canal

Answer 28

b. Just past the second bend

Question 29

Your patient has a symmetrical severe to profound flat sensory/neural hearing loss with word recognition scores of 36% in the right ear, 40% in the left ear and 44%binaurally. He wears bilateral super power BTEs with full shell earmolds with pressure vents. He is complaining that both hearing aids have begun to whistle in the past week. He has not had his hearing aids checked for two years. What is the first thing a hearing care
professional should do?

a. Remake the earmolds
b. Retube the earmolds
c. Reduce the high frequencies
d. Conduct an otoscopic inspection

Answer 29

d. Conduct an otoscopic inspection

Question 30

When performing probe microphone measures, the response for an 80 dB input indicates the hearing aid is exceeding the client’s frequency specific loudness discomfort levels.

What is the first action the hearing care professional should take?

a. Reduce the MPO of the hearing instrument
b. Increase the compression ratio
c. Decrease the compression kneepoint
d. Reduce overall gain

Answer 30

b. Increase the compression ratio

Question 31

One year ago you fit your client with top of the line binaural in-the-canal hearing instruments. During his last visit six months ago he stated everything was working well and his hearing instruments were meeting his expectations. During his visit today, he informs you he is not happy with his hearing aids and they have never worked for him.

What is the first course of action the hearing care professional should take?

a. Review the documentation and post fitting validation survey from his priorvisits
b. Retest the client’s hearing immediately
c. Return the hearing instruments and reorder new hearinginstruments
d. Listen to the hearing instruments and assess whether they are functioning properly

Answer 31

d. Listen to the hearing instruments and assess whether they are functioning properly

Question 32

Upon initial delivery of a binaural set of standard BTE instruments with
skeleton earmolds you learn your client is frequently working in the garden and walks 5 miles a day. How should you counsel your client to care for her new hearing instruments?

a. Do not wear the instruments when working outside
b. Wear her hair up to limit the amount of moisture exposure to the
instruments
c. Store the instruments in a dry-aid kit at night
d. Immediately exchange the instruments for custom in-the-earmodels

Answer 32

c. Store the instruments in a dry-aid kit at night

Question 33

A hearing care professional just completed a hearing evaluation with a 52 year old female, high school science teacher. The results indicate a mild to moderate sensory/neural hearing loss in the left ear. The right ear exhibited a moderate low frequency SNHL. Her word recognition scores are 88% in the left ear and 60% in the right ear. She reports roaring tinnitus in her right ear. She indicates she noticed a significant change in her hearing when the tinnitus and aural fullness began three days ago along with experiencing some dizziness. Her tympanograms are Type A in both ears. What is the likely cause of the client’s hearing loss?

a. Meniere’s Disease
b. Otosclerosis
c. Acoustic Trauma
d. Acoustic neuroma

Answer 33

a. Meniere’s Disease

Question 34

Based on the audiogram below, what would lead the hearing care professional to question the validity of the results?

a. The 100% word recognition scores in the presence of a moderateto
profound sensorineural hearing loss
b. The large difference between the client’s PTA and SRT in bothears
c. The -1dB QuickSIN score in the presence of a moderate toprofound
sensorineural hearing loss
d. The higher than average UCL results

Answer 34

b. The large difference between the client’s PTA and SRT in bothears

Question 35

A client with 2-week-old, multi-program, in-the-ear hearing instruments with directional microphones and telecoils with 2 mm select-a-vents, returns to your office complaining that he still cannot hear on the phone and the instruments constantly whistle when he puts the receiver to his ear. Which is the first course of action the hearing care professional should take?

a. Reinstruct on using the appropriate program when using thetelephone
b. Run a feedback manager to reduce feedback on the phone
c. Reduce the high frequencies to reduce feedback on thephone
d. Reduce the vent size to eliminate feedback

Answer 35

a. Reinstruct on using the appropriate program when using the telephone

Question 36

Mr. Gold is a 67-year-old retired autoworker and US veteran. He is attending the appointment with his wife. He currently wears 7-year-old CICs bilaterally. Both he and his wife report that he is not hearing well with his current hearing instruments. He would like to learn about new
technology so he can hear better. His main concerns are with his wife when they travel in the RV, understanding in restaurants and during his monthly Lodge meetings. His wife’s main complaint is that he cannot hear at all. What is the best hearing aid recommendation for this client?

a. CICs with a pressure vent
b. Standard BTEs with a skeleton mold and medium select-a-vent
c. RICs with a closed dome
d. Standard BTEs with a slim tube and canal lock earmold with a small select-a-vent

Answer 36

c. RICs with a closed dome

Question 37

Prior to assessing the functionality of Mr.Gold’s current CIC, what precautions should the hearing care professional take?

a. Have the patient place the instruments in a small single-use papercup
b. Wash hands prior to handling the hearing instruments
c. Have the patient wipe the instruments with a germicidal wipe prior to handing over the hearing instruments
d. Place the hearing instruments into a tray containing cold sterilant prior to handing the hearing instruments

Answer 37

c. Have the patient wipe the instruments with a germicidal wipe prior to handing over the hearing instruments

Question 38

What should the hearing care professional suspect as a cause of thishearing loss?

a. Acoustic Trauma
b. Acoustic Neuroma
c. Noise Induced
d. Ototoxicity

Answer 38

c. Noise Induced

Question 39

How should the hearing care professional counsel Mrs. Gold to improve communication?

a. Get Mr. Gold’s attention before beginning aconversation
b. Mr. Gold will always struggle and she will just need to accept his inability to hear her
c. Counseling with the wife is not needed as this is an issue with Mr.Gold
d. Encourage Mrs. Gold to write important items down prior to beginning a conversation

Answer 39

a. Get Mr. Gold’s attention before beginning a conversation

Question 40

After placing the bone oscillator on the right ear and presenting the tone at 45 dB at 1000 Hz, the patient reports she heard the signal on the left side. The hearing care professional can assume what phenomenon just occurred?

a. Over masking
b. Masking dilemma
c. Interaural attenuation
d. Crossover hearing

Answer 40

d. Crossover hearing

Question 41

A client comes to your office with his wife for an initial hearing evaluation. Results indicate a bilateral moderate flat sensorineural hearing loss. His wife reports he is having a lot of difficulty hearing and she often has to repeat. She has also noticed he needs the TV a lot louder than she does to hear the television program. The client reports that he does not have a problem and everyone mumbles and there is too much background noise on TV programs these days. What common behavior of individuals with hearing loss is the client displaying?

a. Denial
b. Withdrawal
c. Anger
d. Avoidance

Answer 41

a. Denial

Question 42

After placing the otoblock in the ear prior to making an ear impression, what is the next step the hearing care professional should perform?

a. Inject the impressionmaterial using the proper bridge and brace technique
b. Wash hands with a alcohol-based hand sanitizer
c. Release the pinna and visually inspect that the otoblock is no longer visible
d. Inspect the ear with an otoscope looking for gaps between the block and thecanal

Answer 42

d. Inspect the ear with an otoscope looking for gaps between the block and the canal

Question 43

A client returns with is 3-week-old instruments with automatic, directional
microphones and is complaining that the instruments do not seem to be
helping in background noise. What is the first action the hearing care
professional should take?

a. Re-instruct the client on using the program button to activate the
directional microphone
b. Remind the client that due to his hearing loss he will continue to
struggle in noise
c. Review the client’s testresults and re-counsel on good communication strategies in noise
d. Reprogram the instrument so it is always in directional microphone
mode

Answer 43

c. Review the client’s testresults and re-counsel on good communication strategies in noise

Question 44

Speech mapping differs from Real Ear Measurements in whatway?

a. It is measured using a probe microphone and referencemicrophone
b. The goal is to demonstrate output for soft, medium and loud sounds
c. It requires an unaided response
d. It demonstrates insertion gain

Answer 44

b. The goal is to demonstrate output for soft, medium and loud sounds

Question 45

What information cannot be obtained from speech mapping results?

a. Whether or not LDL’s are exceeded with the current hearing aidfitting
b. Output of hearing aids in response to soft, medium and loud inputs
c. Insertion Gain
d. Audibility of speech sounds according to long-term average speech spectrum

Answer 45

a. Whether or not LDL’s are exceeded with the current hearing aid fitting

Question 46

Speech mapping is a type of?

a. Validation test
b. Speech test
c. Verification test
d. Audiometric Test

Answer 46

a. Validation test

Question 47

Which of the following provides the most accurate information ofhearing
aid performance?

a. Functional gain testing
b. 2cc output curve in programming software
c. Probe tube measurement using live speech mapping
d. Ling 6 test

Answer 47

c. Probe tube measurement using live speech mapping

Question 48

How are speech mapping results typically represented?

a. dB HL
b. dB L
c. dB SPL
d. DB A

Answer 48

c. dB SPL