ILE Final Exam Study with complete solutions

A first time hearing aid wearer and partner come in for the first follow-up. The partner reports that the patient/client cannot hear the partner while in different rooms and that the patient/client is still having difficulty hearing everything at their favorite restaurant. What should be reviewed with the patient/client and their partner? - ANSWER-Realistic expectations What activity should be completed with a patient/client who wants to purchase hearing instruments because they are having difficulty hearing in a number of different listening environments? - ANSWER-The COSI What do poorer binaural than monaural WR scores indicate? - ANSWER-Degradation Why is masking used? - ANSWER-To eliminate the NTE from TE measurements What criteria determines that the plateau has been reached during masked testing? - ANSWER-When effective masking is applied without a shift in the TE threshold A patient/client with a bilateral profound sensory/neural hearing loss reports little benefit from their new power BTEs. Verification demonstrates significantly limited dynamic ranges; speech mapping meets NAL-R prescriptive fitting targets; and aided SIIs are 2% and 3%. What should be recommended? - ANSWER-Referral to cochlear implant center What is the difference between hearing instrument verification and validation? - ANSWER-Verification is a measure of how well the acoustic goals of fitting the hearing instruments have been met, while validation is a measure of how well the patient/client perceives that the hearing instruments are meeting their needs What is the first thing to do after completing post-fitting validation measures? - ANSWER-Discuss the differences between the patient's/client's pre-fitting and post-fitting validation measures with the patient/client What is the first step to take when a patient/client complains of feedback? - ANSWER-Perform otoscopy What is the benefit of measuring thresholds for all octave and inter-octave frequencies? - ANSWER-The hearing instrument fitting potential is optimized A patient/client with a bilateral severe, sloping sensory/neural loss has worn ITEs for many years but they are providing insufficient gain. The patient/client will only consider new ITE hearing instruments. What feature should be ordered on the new ITE hearing instruments to promote more gain? - ANSWER-Long Canals How much hearing instrument gain is achieved with a 40 dB input signal and a compression ratio of 2:1? - ANSWER-80 db A patient/client complains that the refrigerator and furnace fans sound annoying. Which feature should be adjusted? - ANSWER-Expansion How do speech in noise test results impact hearing instrument fittings? - ANSWER-They can be used for fitting validation and to demonstrate the benefit of directional microphones What is EIN a measure of? - ANSWER-Noise made by the circuit of the hearing instrument In the matrix 118/45/06, what does the middle number refer to? - ANSWER-FOG Why are recorded materials recommended for SRT and WRS? - ANSWER-The impact of technical issues on measurements is minimized What is the IA value for AC pure tone testing with insert earphones? - ANSWER-70 db At the first follow-up visit a patient/client reports a sore ear when wearing a BTE skeleton acrylic earmold. Otoscopy reveals a sore spot in the helix curl. What should be done first to address the problem? - ANSWER-Modify the earmold by grinding and buffing the helix area What should be done to assess the comfort of a new hearing instrument? - ANSWER-Ask the patient how it feels in their ears What is one benefit of using insert earphones? - ANSWER-masking is required less often A patient/client with significant manual dexterity problems insists on being fit with very small hearing instruments. Which strategy should be recommended first to promote the patient's/client's success with their fitting? - ANSWER-Use of a remote control A patient/client with arthritis, macular degeneration and a bilateral moderate to severe hearing loss wears glasses and uses oxygen with tubes that go over their ears. What style of hearing instruments should be recommended? - ANSWER-ITE Why is the bridge-and-brace technique recommended? - ANSWER-To prevent an instrument from forcibly entering the ear canal When following standard precautions for infection control of non-disposable critical items, what should be done first? - ANSWER-A thorough cleaning What is the purpose of measuring pure tone UCLs? - ANSWER-To program the output of the hearing instruments What is an alternative to traditional ALDs? - ANSWER-Gateway devices with additional components A patient/client who is a candidate for a binaural fitting decides to only get one hearing instrument. What is one disadvantage the patient/client will likely face from the monaural fitting? - ANSWER-Poor localization Which fitting visit activity should have the largest impact on the patient/client's successful use of their hearing instruments? - ANSWER-Having the patient/client demonstrate that they can insert and remove the batteries successfully A motivated patient/client who uses premium hearing instruments with noise reduction features activated and consistently utilizes accessories to improve the SNR, still experiences difficulty in background noise. What else could be recommended? - ANSWER-An AR program Which hearing instrument component is a transducer? - ANSWER-Telecoil When should audiometric electroacoustic calibration be completed? - ANSWER-At least annually How are comprehensive fitting objectives and goals established for each patient/client? - ANSWER-By using the audiometric data to describe the functional impact of the hearing loss and considering the patient's/client's responses on a self assessment questionnaire What are prescriptive methods used for? - ANSWER-Determining the acoustic targets for hearing aid verification measures What is the primary goal of completing a thorough and systematic case history prior to every hearing assessment? - ANSWER-To identify issues requiring a medical referral A teacher is having difficulty at work hearing and understanding the students especially when the classroom is noisy, and has concerns that hearing loss is affecting their job performance. Speech-in-noise testing demonstrates a significant breakdown for sentence identification at SNRs of +10 dB and lower. What should be recommended? - ANSWER-Binaural amplification using RIC/RITE hearing instruments with noise suppression and directionality What should be done prior to the hearing instrument fitting to ensure that the hearing instrument is functioning properly? - ANSWER-Measure the performance of the hearing instrument and compare the results to the manufacturer's expectations Why should verification be completed at the fitting visit? - ANSWER-To ensure that the hearing instruments will not amplify sound to a level more intense than the patient's/client's tolerance limit for loud sound A patient/client with the above hearing loss complains that hearing loss affects their work and social life. They admit to being very vain and want no one to know that they wear hearing instruments, so their preference is IICs, but they will settle for CICs. Otoscopy revealed very small and tortuous ear canals. Which hearing instrument style should be recommended? - ANSWER-RICs/RITEs with open domes A patient/client reports that their hearing instrument is intermittent. Upon visual inspection the hearing healthcare provider notices corrosion in the battery case. What is a common reason for this problem? - ANSWER-Moisture The patient/client with the above test results is being fit with an RIC hearing instrument. Which dome should be selected? - ANSWER-Occluding double dome Which statement supports patients/clients as they are learning about their new hearing instruments? - ANSWER-See this button here? Pushing it will turn up the volume of your hearing aid What should be achieved before the fitting visit is finished? - ANSWER-The patient/client has successfully inserted and removed their hearing instrument multiple times Which combination of test data can influence the classification of the degree of hearing loss? - ANSWER-PTA and WRs In addition to verifying that the ear canal is clear and without unusual conditions, what is another purpose for otoscopy? - ANSWER-To determine which hearing instrument style is appropriate A patient/client has wireless RICs, but reports difficulty hearing weekly lectures at an auditorium. They feel uncomfortable asking the professor to wear a special device, but did find out that the auditorium has a loop system. What should be done to take advantage of the loop system in the auditorium? - ANSWER-Add a t-coil program A patient/client is having difficulty hearing on their cell phone, in meetings, at school, and at the symphony. Which hearing aid feature will meet their needs? - ANSWER-Multiple Memories A patient/client is very interested in connectivity and does not want to wear a gateway device while speaking hands-free on the phone and listening through their hearing instruments. What wireless technology should be recommended? - ANSWER-2.4 GHz Which patient/client statement indicates that the hearing instrument fitting has been successful? - ANSWER-I'm starting to realize just how many sounds I've missed over the past few years Which hearing instrument component produces gain? - ANSWER-Amplifier A patient/client presents with a progressive bilateral sensory/neural hearing loss that is now profound with significantly reduced WR ability in both ears. The patient/client reports that hearing instruments are no longer providing benefit. What should be recommended? - ANSWER-Cochlear implant consultation A patient/client has unaidable single-sided conductive hearing loss and reports an unsuccessful trial with a CROS fitting. What should be recommended? - ANSWER-Refer for a BAHA Consultation What is the relationship between verification measures and the LTASS? - ANSWER-The results of speech mapping show the relationship between the in situ response of the hearing instrument and the LTASS Why is less gain generally required for a binaural fitting compared to a monaural fitting? - ANSWER-Binaural summation What strategy should family members be encouraged to use when talking with their loved ones who wear hearing instruments? - ANSWER-Face each other when speaking When selecting an appropriate hard earmold material for a patient/client with severe allergies, which material should be ordered? - ANSWER-Polythylene Which hearing instruments requires the least amount of daily maintenance? - ANSWER-semi-implantable A patient's/client's case history reveals unilateral left ear hearing loss of more than 10 years, recent ear pain, and discharge for approximately 2 months. Otoscopy in the left ear shows that the TM is reddish in color and the canal is very moist. In addition, an odor is detected. What should be done next? - ANSWER-Explain the otoscopic findings and immediately refer the patient/client to their physician of choice What is the difference between IA and crossover? - ANSWER-IA involves intracranial sound transmission. Crossover is the intensity of the sound that can be heard in the NTE A patient/client comes in stating that the dome fell off their RIC product. What should be done first? - ANSWER-Perform otoscopy How does interpretation of case history information enable appropriate recommendations? - ANSWER-Challenges in specific listening situations may require specific features or programming considerations What audiometric condition requires a medical referral? - ANSWER-Symmetrical sensory/neural hearing loss with asymmetrical WRs A patient/client who was referred by their ENT, has an asymmetrical sensory/neural hearing loss with very poor binaural WR ability and reports having significant problems hearing and understanding in meetings. What should be recommended? - ANSWER-BiCROS A patient/client who wears a custom product reports that their voice sounds hollow. What should be done? - ANSWER-Enlarge the vent What is considered the single most significant factor in hearing instrument acceptance and use? - ANSWER-Post- Fitting Care Why is speech audiometry performed? - ANSWER-To provide functional information about the impact of the hearing loss What should be done if a hearing healthcare professional makes a home visit to make ear impressions but has forgotten an otoscope? - ANSWER-Return to the office for an otoscope What activity should be completed with a patient/client who is a realtor and is struggling to hear when meeting clients in restaurants? - ANSWER-The QuickSIN test What recommendation should be made for a patient/client who has difficulty hearing on the cell phone? - ANSWER-Connectivity What hearing aid settings should be used to evaluate hearing instrument electroacoustical performance prior to the fitting? - ANSWER-Test mode with FOG Which audiometric frequency contributes the most to speech intelligibility? - ANSWER-2000 For a person who uses hearing instruments, which location should be the easiest for communication? - ANSWER-A room with rugs and drapes Which hearing instrument causes the least amount of occlusion? - ANSWER-IIC Which hearing instrument option should be recommended for a patient/client who finds loud sounds uncomfortable? - ANSWER-Compression