IHS - International Hearing Society Hearing Instrument Selection Questions and Answers — Questions and Answers
Question 1: A 78-year-old client has a severe-to-profound sensorineural hearing loss and significant dexterity issues due to arthritis. They also desire a simple, easy-to-handle device. Which hearing instrument style would be the most appropriate initial recommendation?
- Completely-In-Canal (CIC)
- In-The-Canal (ITC)
- Behind-The-Ear (BTE) with a custom earmold (Correct answer)
- Receiver-In-Canal (RIC) with a stock dome
Correct answer: Behind-The-Ear (BTE) with a custom earmold
A Behind-The-Ear (BTE) style instrument is larger, making it easier to handle for individuals with dexterity limitations. Paired with a custom earmold, it can provide the necessary power and acoustic seal for a severe-to-profound hearing loss, unlike smaller custom or RIC styles which may not be powerful enough or are more difficult to manage.
Question 2: A client presents with a unilateral hearing loss, where the right ear has no usable hearing (profound loss) and the left ear has normal hearing. The client's primary complaint is difficulty hearing conversations on their right side. Which of the following is the most suitable amplification strategy?
- A traditional hearing aid on the right ear
- A contralateral routing of signals (CROS) system (Correct answer)
- Bilateral hearing aids
- A bone-anchored hearing aid on the left side
Correct answer: A contralateral routing of signals (CROS) system
A CROS system is specifically designed for unilateral hearing loss where one ear is unaidable. It uses a microphone on the poorer ear to pick up sound and wirelessly transmit it to a receiver on the normal-hearing ear, allowing the user to perceive sounds from their deaf side.
Question 3: During the hearing instrument selection process, which of the following is an objective measure used to confirm that the hearing aid's amplification levels are appropriate for the client's specific hearing loss in their own ear canal?
- Client Oriented Scale of Improvement (COSI)
- Aided soundfield testing
- Real Ear Measurement (REM) (Correct answer)
- Hearing Handicap Inventory for the Elderly (HHIE)
Correct answer: Real Ear Measurement (REM)
Real Ear Measurement (REM), also known as probe microphone measurement, is the gold standard objective verification tool. It measures the sound pressure level in the ear canal to ensure the hearing aid's output matches the prescribed targets for that individual's hearing loss and ear acoustics. The other options are subjective validation tools that measure perceived benefit.
Question 4: Which of the following is considered an FDA 'red flag' condition that requires medical referral before a hearing aid can be dispensed to an adult client, unless they sign a medical waiver?
- Gradual, bilateral high-frequency hearing loss
- A history of tinnitus for more than 5 years
- Recruitment and difficulty hearing in noise
- Visible evidence of significant cerumen accumulation (Correct answer)
Correct answer: Visible evidence of significant cerumen accumulation
The FDA has established specific contraindications, often called 'red flags,' that necessitate a medical evaluation before fitting hearing aids. Visible evidence of significant cerumen accumulation or a foreign body in the ear canal is one of these eight red flags. The other options are common symptoms associated with hearing loss but are not on the specific FDA list requiring mandatory medical referral.
Question 5: When selecting an earmold material for a pediatric patient with a severe hearing loss, which material is generally preferred for safety and to ensure a good acoustic seal in a growing ear?
- Hard acrylic
- Soft silicone (Correct answer)
- Polyethylene
- Hard vinyl
Correct answer: Soft silicone
Soft, flexible materials like silicone are highly recommended for pediatric patients. They are gentle on sensitive, growing ears, reduce the risk of injury during physical activity, and provide an excellent acoustic seal, which is critical for high-gain fittings to prevent feedback. Hard materials are generally not recommended for children due to safety concerns.
Question 6: A primary goal of the initial needs assessment, using tools like the Client Oriented Scale of Improvement (COSI), before selecting a hearing instrument is to:
- Determine the exact make and model of the hearing aid.
- Objectively verify the hearing aid's electroacoustic performance.
- Measure the real-ear-to-coupler difference (RECD).
- Identify and prioritize the client's specific listening goals and difficulties. (Correct answer)
Correct answer: Identify and prioritize the client's specific listening goals and difficulties.
The initial needs assessment is a crucial part of the selection process focused on the patient's subjective experience. Tools like the COSI are used to quantify and prioritize the client's specific communication problems and listening goals, which then guide the selection of appropriate technology and features.
IHS - International Hearing Society Hearing Instrument Selection Questions and Answers
A 78-year-old client has a severe-to-profound sensorineural hearing loss and significant dexterity issues due to arthritis.
They also desire a simple, easy-to-handle device.
Which hearing instrument style would be the most appropriate initial recommendation?