Hearing Loss Audiological Testing and Diagnosis Test 2 — Questions and Answers
Question 1: What frequency range is routinely tested in a standard clinical audiogram?
- 20 Hz to 20,000 Hz
- 125 Hz to 4,000 Hz
- 250 Hz to 8,000 Hz (Correct answer)
- 500 Hz to 6,000 Hz
Correct answer: 250 Hz to 8,000 Hz
A standard clinical audiogram tests pure-tone thresholds from 250 Hz to 8,000 Hz, as this range encompasses the frequencies most critical for speech understanding and everyday listening.
Question 2: What is the main purpose of bone conduction testing in an audiological evaluation?
- To measure how well sound travels through the outer ear canal
- To bypass the outer and middle ear and directly stimulate the cochlea (Correct answer)
- To evaluate the acoustic reflex pathway
- To determine the patient's most comfortable listening level
Correct answer: To bypass the outer and middle ear and directly stimulate the cochlea
Bone conduction testing uses a vibrating device placed on the mastoid bone or forehead to bypass the outer and middle ear, directly stimulating the cochlea to isolate sensorineural function.
Question 3: According to ASHA guidelines, what dB HL threshold is generally considered the boundary of normal hearing for adults?
- 10 dB HL
- 20 dB HL
- 25 dB HL (Correct answer)
- 30 dB HL
Correct answer: 25 dB HL
ASHA defines normal hearing as thresholds of 0–25 dB HL; thresholds above 25 dB HL are considered indicative of hearing loss in adults.
Question 4: What does an 'air-bone gap' on an audiogram indicate?
- Sensorineural hearing loss only
- A problem limited to the cochlea
- A difference between air and bone conduction thresholds suggesting a conductive component (Correct answer)
- Normal middle ear function
Correct answer: A difference between air and bone conduction thresholds suggesting a conductive component
An air-bone gap exists when air conduction thresholds are poorer than bone conduction thresholds by 10 dB or more, indicating a conductive component (outer or middle ear problem) is present.
Question 5: Word Recognition Score (WRS) testing measures a patient's ability to:
- Detect speech at threshold in quiet conditions
- Correctly repeat a list of phonetically balanced monosyllabic words presented at a comfortable level (Correct answer)
- Understand sentences in background noise
- Recognize words using only visual cues (lip reading)
Correct answer: Correctly repeat a list of phonetically balanced monosyllabic words presented at a comfortable level
The WRS (also called speech discrimination score) presents phonetically balanced monosyllabic words at a suprathreshold level to assess clarity of hearing, not just loudness.
Question 6: On a standard audiogram, what does a flat hearing loss configuration suggest?
- Equal hearing loss across all tested frequencies (Correct answer)
- Greater hearing loss in the high frequencies than low frequencies
- Greater hearing loss in the low frequencies than high frequencies
- Normal hearing at all frequencies
Correct answer: Equal hearing loss across all tested frequencies
A flat audiogram configuration means that hearing thresholds are similar across all tested frequencies, indicating roughly equal degree of hearing loss from low to high frequencies.
Question 7: Distortion Product Otoacoustic Emissions (DPOAEs) differ from Transient Evoked OAEs (TEOAEs) primarily in that DPOAEs:
- Do not require any stimulus to be presented
- Are elicited by two simultaneous pure tones rather than a click or tone burst (Correct answer)
- Measure the brainstem response rather than cochlear function
- Can only be recorded in infants
Correct answer: Are elicited by two simultaneous pure tones rather than a click or tone burst
DPOAEs are generated when two simultaneous pure tones (f1 and f2) interact in the cochlea and produce a distortion product, allowing frequency-specific assessment of outer hair cell function.
Hearing Loss Audiological Testing and Diagnosis Test 2
What frequency range is routinely tested in a standard clinical audiogram?