Audiology Praxis Test Questions with Complete Verified Solutions 2024/2025, Exams of Health sciences

Download Audiology Praxis Test Questions with Complete Verified Solutions 2024/2025 and more Exams Health sciences in PDF only on Docsity! Audiology Praxis Test Questions with Complete Verified Solutions 2024/2025 A patient comes to a clinic complaining of short, intense dizzy spells. An audiologist suspects that the patient may have benign paroxysmal positional vertigo (BPPV). Which of the following tests is most appropriate to use to confirm the diagnosis? Dix-Hallpike test 0 dB0 decibels HL is best described by which of the following? 0 dB0 decibels HL on an audiometer represents the minimum audible pressure needed at each frequency for an individual with normal hearing to detect a pure tone. This value varies with frequency due to the anatomic and physiologic properties of the auditory system. An audiologist fit a patient 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 also complains that soft background noise is distracting. To reduce the adverse noise effect, which of the following is the best adjustment for the audiologist to make to the hearing aids? Enable expansion. 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? For individuals with unilateral hearing loss, speech intelligibility improves when the ear with better hearing is closer to the noise source. When this occurs, the signal-to-noise ratio 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. The patient reports one severe attack of true rotary vertigo six months ago and since then fears that another will occur. The patient has limited many activities because quick head movements increase symptoms. Videonystagmography (VNG) results indicate normal saccade, optokinetic, and smooth pursuit testing. A left-beating nystagmus is observed during gaze testing without fixation. Post- headshake nystagmus reveals a left-beating nystagmus. No positioning or positional nystagmus is observed. Bilateral bithermal caloric test results indicate a 50 percent right weakness with no significant directional preponderance. Based on the preceding information, the patient most likely has which of the following? Videonystagmography (VNG) results normally provide site-of-lesion specific information to determine the 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 post-headshake left-beating nystagmus suggests that the lesion is dynamically uncompensated. Research shows that people wait as long as seven years before they seek hearing health care services due to the negative stigma associated with hearing loss. Which of the following is most likely to occur with untreated hearing loss? The consequences of untreated hearing loss include lower signal quality in the brain (leading to a higher cognitive load), a change in the structure of the brain, social disengagement, behavior changes, and health issues like dementia, depression, fatigue, and anxiety. A 65-year-old woman is fitted with her first pair of hearing aids. She and her husband are attending their first audiologic rehabilitation session about communication strategies. She states that she struggles to understand what her husband says "because he uses too many words." Which of the following facilitative strategies would be the most appropriate to improve the situation? Ask the partner to talk in short phrases and take pauses. She should use a message-tailoring strategy that teaches her communication partner to use simple syntax and multiple shorter phrases rather than one longer one. A patient with new hearing aids complains of difficulty understanding speech in noisy environments such as restaurants. The audiologist verifies that the cardioid polar plots with fixed directionality are working appropriately. Which of the following is the most appropriate action for the audiologist to take when counseling the patient? Counseling patients about where to sit in noisy environments will maximize the capability of the directionality feature of the hearing aids. Cardioid microphones in hearing aids pick up sounds with sensitivity from the front and sides but poorly from the rear. It is therefore best to sit or stand with the back to the noise that is interfering with hearing and let the sound come from the front or sides. A 5-year-old child was recently diagnosed with a bilateral, moderately severe sensorineural hearing loss after a bout of meningitis. She had typically developing speech and language before her illness but now has significant difficulty communicating because of her hearing loss. She also has other comorbidities as a result of the meningitis. Knowledge of which of the following would assist other professionals who are working with this child? Use of communication strategies. Knowledge and application of repair and facilitative strategies would assist interprofessional practice Which TWO of the following are accurate statements concerning assessment measures of speechreading ability? Speechreading tests are difficult to administer and assess because of intertalker differences and lack of naturalness. Which TWO of the following measurements are included in a psychoacoustic evaluation of tinnitus? Although speech-in-noise testing and otoacoustic emissions are important when determining the patient's hearing acuity and proceeding with or programming amplification, it is not considered part of the standard test battery for a psychoacoustic evaluation for tinnitus. This evaluation is an important tool to help guide patient counseling, patient education, and baseline information. The psychoacoustic evaluation may include, but is not limited to, a full case history, audiological evaluation, tinnitus pitch matching, tinnitus loudness masking, minimum masking level evaluation, residual inhibition assessment, and subjective patient questionnaires. Diagnostic audiometers generally provide one-third-octave noise bands for use in masking pure tones. Which of the following best explains why one-third-octave noise bands are used? They are wider than critical bands. Narrow bands of masking noise on audiometers should be wider than a critical band because they provide more effective masking for the frequency being tested without requiring higher overall intensity. A 92-year-old resident of a skilled nursing facility reports that binaural hearing aids are not improving the resident's ability to understand what coresidents and caregivers are saying, particularly in the common activity room. Which of the following is the best way to address the resident's concern? An FM system. Patients who are residents of care facilities and do not benefit as expected from binaural hearing aids can benefit from FM systems, which improve the signal-to-noise ratio in noisy environments, such as common activity rooms. To which of the following patients would it be most appropriate to recommend a full vestibular evaluation? A 62-year-old female who denies vertigo but states she often veers when she walks and loses her balance when she turns her head quickly. This patient reports symptoms that could suggest either an otolith or semicircular canal dysfunction. An audiometer attenuator is set to 0 dB0 decibels HL. Which of the following is true about the sound pressure level output at the earphone? It is lowest at mid-frequencies. The sound pressure level necessary to achieve 0 dB0 decibels hearing level is greatest at low frequencies, lessens in the middle frequencies, and then increases at high frequencies. Tinnitus pitch matching is most useful when the tinnitus assessed is described as A single or overlapping tone. Tinnitus pitch matching is useful with tonal tinnitus. A patient in the early stages of Ménière's disease will have an increase in the amount of endolymph in the inner ear. Audiometric assessment is likely to show sensorineural hearing loss that primarily affects which of the following frequency ranges? 250-2000 Hz. 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. For someone sitting 20 meters from a concert stage, the average intensity is 65 dB65 decibels SPL. Which of the following best indicates the average sound-pressure level at a seat 10 meters from the stage? 71 db SPL. According to the inverse square law, the sound intensity decreases by 6 dB6 decibels when the distance from a sound source doubles. Conversely, the sound intensity increases by 6 dB6 decibels when the distance to the sound source is halved. Which TWO of the following types of medications are considered to be in the family of ototoxic medications? Diuretics and cancer medications have been shown to cause ototoxicity. The cochlear implant signal-processing strategy in which brief pulses are presented to each electrode in a nonoverlapping sequence is known as 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 are the tests recommended for monitoring hearing when there is concern about ototoxicity? Ultrahigh-frequency thresholds are recommended as ototoxicity may initially be observed in the higher frequencies (10K Hz10 thousand hertz, 12K Hz12 thousand hertz, 14K Hz14 thousand hertz). Moreover, since ototoxicity affects outer hair cells initially, otoacoustic emissions are a sensitive measure of outer hair cell function. A 23-month-old child was seen in an audiology clinic. The child presented with a chronic history of upper respiratory infections, middle ear infections, diminished vocabulary, and delayed speech-sound development. She had pressure-equalization (PE) tubes placed when she was 19 months old, and audiologic testing was attempted but was unsuccessful in the ENT office post- surgery. She is the daughter of bilingual parents who divide their conversational speech between English and Spanish in the home environment. The child was cooperative for otoscopy, and PE tubes were observed bilaterally, with subsequent large volumes confirmed by tympanometry. Which of the following tests is most likely to be performed next? Otoacoustic Emissions. Since the child is cooperative for otoscopy and tympanometry, she will likely be cooperative for otoacoustic emission (OAE) testing, which will provide important information to the parents. 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 Hzhertz? At 9 months old, a typically developing child can provide reliable responses to all octave band frequencies, and VRA is the most valid and reliable method. A neurodiagnostic auditory brainstem response (ABR) evaluation using different stimulus (click) repetition rates is performed on an adult with a suspected vestibular schwannoma. Which of the following is the most likely outcome if the patient has a vestibular schwannoma when the ABR stimulus (click) repetition rate is increased from 21.121.1 per second to 89.189.1 per second? Decreased waveform amplitudes, increased wave V latencies, and shortened, prolonged wave I-V interpeak latencies. Increasing the stimulus repetition rate results in decreased amplitudes, longer absolute latencies, and prolonged interpeak latencies. 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 admittance 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 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. A 60-year-old man has bilateral, moderate-to-severe, precipitously sloping sensorineural hearing impairment. During the hearing-aid trial period, he is extremely dissatisfied because he constantly reports that /s/forward slash, s, forward slash, /f/forward slash, f, forward slash, and /sh/forward slash, sh, forward slash sounds are not clear. Which of the following is the best method of addressing his concern? Deactivating frequency lowering and performing probe microphone verification by measuring REAR. The best option is to deactivate frequency lowering in the hearing-aid settings and perform Real-Ear Aided Response (REAR). This process will allow the audiologist to rapidly identify maximum audible output across the frequency range and determine whether high-frequency sounds are inaudible or appropriate per the prescription targets. An audiologist is using a tracking procedure to assess a patient's progress in communicating under audition-plus-vision conditions. The materials used are articles from popular magazines. Data are collected for fifteen 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 the patient's scores? Authorial vocabulary or syntax. 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, which are all factors that affect word-per-minute scores. audiologist explained the situation to the patient and made an appropriate referral for follow-up medical care. Which of the following statements about the situation is most accurate? The audiologist may be subject to litigation for malpractice. The audiologist should have received appropriate training for the procedure so that it is always performed correctly. The mistake could be construed as malpractice. Which of the following always applies to nystagmus caused by a labyrinthine lesion? It is suppressed by visual fixation. Visual fixation always suppresses nystagmus caused by a peripheral lesion, such as a labyrinthine lesion. A patient presents to an audiologist eight weeks after surgery to repair a fistula in the round window in the left ear. The patient reports that the surgeon had, at the time of the patient's release, pronounced the procedure successful. The patient has not noticed any change in hearing since the operation. Which of the following actions should the audiologist take after reviewing the patient's previous test results? Conducting a follow-up audiometric evaluation. The follow-up medical evaluation that occurred would normally focus on physical healing and would not include an audiometric evaluation. The audiologist should conduct a routine audiometric examination to determine the precise level of postsurgical hearing loss and compare the new results to previous results. A 13-year-old child presents the following audiometric results: normal acoustic immittance battery, pure-tone average of 50 dB50 decibels HL bilaterally, bilateral speech-recognition thresholds of 20 dB20 decibels HL, and word-recognition scores of 100 percent bilaterally at 50 dB50 decibels HL. Which of the following is the most appropriate next step for the audiologist to take? Reinstructing the child and using an ascending-threshold measurement technique. 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 child's loudness yardstick and provide a better estimate of true organic hearing sensitivity. A patient had recent surgery for otosclerosis in the right ear. The ENT indicated that the procedure was successful. However, the surgeon nicked the chorda tympani. Which of the following is the patient most likely to report? Decreased sensation of taste. The chorda tympani, which is a branch of the facial nerve (cranial 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. 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 Hzhertz. Based on these findings, the audiologist should first recommend which of the following? A medical referral and speech-language consultation. 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 child's limited vocabulary knowledge. A newborn did not pass the hearing screening while in the hospital, and a test for cytomegalovirus (CMV) was ordered. The baby was found to have congenital CMV and at 4 weeks was diagnosed by auditory brainstem response (ABR) with a severe to profound sensorineural hearing loss bilaterally. The parents want to pursue bilateral cochlear implants. Having the parents make an appointment as soon as possible for a cochlear implant evaluation. Even though the child is 1 month of age, the cochlear implant evaluation and process can start right away, because the child does not need to be 12 months of age to receive a cochlear implant. In audiometric testing, a false-negative response means that the signal was presented and the patient did not respond. A false-negative response is a response that occurs when a stimulus is presented, but the patient does not respond. Distortion-product otoacoustic emissions (DPOAEs) and transient-evoked otoacoustic emissions (TEOAEs) provide similar information, but they differ in which of the following ways? DPOAEs arise from two sources of generation, and TEOAEs arise from a single source of generation. Which of the following lists the most appropriate set of acoustic modifications for an earmold when fitting a patient with a precipitously sloping high-frequency sensorineural hearing loss? Libby horn, 2 mm2 millimeter sound bore, wide vent. Acoustic modification should emphasize high- frequency amplification and de-emphasize low-frequency amplification. A flared horn (Libby), a short sound bore, and a wide vent is the best combination to achieve that goal. An 8-week-old infant born at home is brought to an audiology clinic by the parents, who report that the child appears to respond inconsistently 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 Hz1000 hertz at 90 dB90 decibels HL. Which of the following additional steps should be taken to rule out a significant hearing loss? Performing an auditory brainstem response evaluation. An auditory brainstem response would rule out auditory neuropathy and is the only reliable measure for estimating hearing sensitivity in infants less than 6 months of age. Which of the following types of speech recognition materials is most useful to rule out a lesion affecting the VIIIth nerve? Open-set, monosyllabic, phonetically balanced word lists, administered at several intensity levels. 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. The clinical-decision matrix shown displays data for screening auditory brainstem response (ABR) test outcomes compared to conventional ABR test outcomes (serving as the gold standard) with the same population of 336 ears. What is the calculated specificity of screening ABR? 97%. Specificity refers to the accuracy of the ABR test to correctly identify those patients who do not have the disorder of interest, where specificity equals true negatives (307) divided by true negatives plus false positives (307 + 11307 plus 11) times 100. Which THREE of the following tests are included in CPT code 92557, which is a comprehensive audiological evaluation? Air Conduction, Bone Conduction, and Speech. 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? Rescheduling the patient for a time when a Spanish-speaking interpreter is available. Given that the audiologist does not speak Spanish, securing the services of a Spanish-speaking interpreter would be the most effective solution to assist the audiologist with speech-recognition testing. An audiologist is selecting hearing aids for a new hearing-aid user who works full time in a loud environment, according to the case history, and finds listening in this environment to be very tiring. Which of the following features would be most appropriate to include in the new hearing aids to specifically address the user's concern? Digital noise reduction. Digital noise reduction reduces the level of amplification provided by the hearing aids in noisy environments, which provides the patient with more comfort in dealing with noise and with ease of listening. Which of the following tests would yield the most important information in the audiological evaluation of an adult with an average unmasked air-conduction threshold of 90 dB90 decibels HL in one ear and normal sensitivity in the other ear? The Stenger test. A large difference in sensitivity in the ears of an adult is easily verified by the Stenger test. Otoacoustic emissions can often be recorded from the ears of a patient with Upper brainstem lesions do not always interfere with otoacoustic emissions, so otoacoustic emissions can be recorded from the ears of patients with upper brainstem lesions. A 55-year-old patient is having trouble understanding others speaking in group situations at work and in the cafeteria at lunchtime. The patient's audiometric results indicate normal hearing in both ears and that word recognition in quiet is at 96%96 percent bilaterally. Which of the following tests should also be conducted? Speech-in-noise. The audiologist needs to address the patient's chief complaint of difficulty understanding speech in noisy situations, such as large-group meetings and busy cafeterias. According to the Program for Infants and Toddlers with Disabilities (Part C of IDEA), an infant or toddler with a hearing loss is entitled to which of the following? Documentation in writing of an Individualized Family Service Plan. Part C of IDEA, PL 99-45, specifies that an Individualized Family Service Plan (IFSP) be developed that lists in detail the early-intervention services that the child through age 2 and the family will receive. Which of the following is the most sensitive measure of VIIItheighth-nerve dysfunction? Auditory brainstem response test. The ABR test is objective and sensitive, and it can determine whether the VIIItheighth 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? Administer threshold tests in areas where ambient noise levels conform to the regulations published in the Federal Register. 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. 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, which of the following must occur? The wife must sign a HIPAA form listing individuals who may have access to her records. According to the HIPAA, medical records cannot be released to anyone without written permission. During mapping sessions (programming of the device) for cochlear implant recipients, audiologists may adjust several parameters. What is the most important aspect of the programming to adjust? Stimulus levels. Cochlear implants (CI) are typically programmed for each patient based on auditory perceptions in response to electrical stimuli. When a patient's device is initially activated, stimulation levels can change frequently while the patient is learning to listen with the cochlear implant. Stimulation levels can increase during the beginning of a patient's CI experience, but eventually a plateau is reached and stimulation levels hover in a certain clinical unit range. Test-retest variability in a client's suprathreshold and word-recognition score is influenced by both the number of test items or words and the initial suprathreshold word-recognition score. The largest test-retest variability can be expected to occur with which of the following combinations of number of test items or words and initial suprathreshold word-recognition score? Number of words: 25 Word Rec Score: 50%. Variability depends on the number of test items or words that are used, as well as on the patient's true recognition ability, since scores in the middle of the distribution are more variable. While performing tympanometry on a patient, an audiologist obtains a seal on the patient's test ear, which has a large external canal, but the seal is lost intermittently whenever the patient swallows. Which of the following is the most likely cause of the problem? A perforated tympanic membrane. The volume of the external canal is large; the scenario suggests the possibility of a perforated membrane, which is even more likely because of the ear's failure to maintain the seal. An absent stapedial acoustic reflex can result from which of the following? Bell's palsy. Absent reflexes have been observed in individuals with facial nerve paralysis. Two audiologists in private practice together discuss hearing aid pricing and verbally agree on fee-for-service prices. During the second quarter, business slows down, so Audiologist B decides to discount hearing aids by 20 percent. Two patients who are friends are fitted with identical hearing aids, one by Audiologist A and one by Audiologist B. Through conversation, the friends discover that the one who bought from Audiologist B paid 20 percent less. The individuals complain to their respective audiologists and threaten to report them to the licensure board and to ASHA. Which of the following best describes this situation? Although the practice is not illegal, it can be construed as unethical. The agreement was verbal, and it is not illegal to modify prices for audiological services. It is doubtful that a lawsuit would result in damages beyond a refund of the non-discounted hearing aid price. The practice is not illegal but does raise ethical issues in terms of holding the welfare of the patient paramount and also in terms of maintaining harmonious relationships with other professionals. A 76-year-old patient with a primary complaint of hearing loss reports experiencing an unsteady gait and needs assistance walking and climbing stairs. Which of the following would be the most appropriate course of action to take with this patient? Screen the patient for risk of falls. Further information is needed to determine if a referral or assessment is needed. Which of the following is the primary reason for limiting a hearing aid's OSPL 90 to a lower level when it is worn by a child than when it is worn by an adult? 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. The sound pressure level (SPL) at the eardrum is a function of the volume of the external auditory meatus: the smaller the volume, the greater the sound pressure. An OSPL 90 set to a level appropriate for adults may produce an undesirably high maximum SPL in a child. Which of the following are the most common medical conditions associated with pediatric balance disorders that may require further vestibular assessment and medical referral for treatment? Migraine and benign paroxysmal vertigo of childhood (BPVC). Migraine and benign paroxysmal vertigo of childhood (BPVC) are the most common medical conditions associated with pediatric balance disorders and may require further vestibular assessment and medical referral for treatment. A 55-year-old sound engineer who works at a local television news company visits an audiologist. He recently obtained receivers in the ears (RITEs) from another audiologist, but he still experiences listening difficulty. His recent audiogram is within normal limits, from 250 Hz250 hertz to 750 Hz750 hertz, progressively sloping to severe impairment at 8 kHz8 kilohertz in both ears. To address his reported listening difficulties, the audiologist reviews his hearing-aid settings and creates a new multichannel expansion program. Also completed was on-ear speech mapping at increasing input levels (50 dB50 decibels SPL to 80 dB80 decibels SPL). Which of the following responses to this adjustment would the patient be most likely to report? Reporting increased difficulty hearing low-level, high-frequency speech sounds. Low-level environmental noise or internal noise generated by the hearing instrument should be less audible when expansion is activated. What auditory skill involves becoming aware of and learning to attend to sounds? Detection. Once a baby is born, the sounds of the outside world come in loud and clear unless there is a hearing loss. The baby learns to attend and respond to the human voice, the barking of a dog, and other sounds. A stimulus-response table is being maintained to record results of a hearing screening. The trials in which a listener reports hearing a stimulus when a stimulus is not present are recorded in the table as false alarms. Experts in childhood hearing screenings found that frequent and thorough screener training, control of instrument calibration, and rigid ambient-noise control reduced false‐positive rates from a range of 40%-90%40 percent to 90 percent down to a more acceptable level of 20%-30%20 percent to 30 percent. A 35-year-old male is scheduled for vestibular testing. In reviewing his case history, an audiologist finds that he is status post mastoid obliteration with surgical ear canal closure following cholesteatoma removal on his right ear two years ago. He did have residual dizziness following his surgery, requiring him to attend vestibular rehabilitation for twelve weeks postoperatively. Which of the following test batteries is the audiologist most likely to recommend for the patient (assuming the audiologist does not have the ability to do bone-conducted VEMPs) ? Rotary chair, vHIT, oculomotor testing. While all the vestibular tests shown could provide beneficial information, rotary chair, vHIT, and oculomotor testing are the only tests that can be performed on someone with a surgically closed canal.