IHS Patient Counseling and Rehabilitation 4 ā Questions and Answers
Question 1: A hearing aid wearer complains that their own voice sounds 'hollow' or 'like talking in a barrel.' This phenomenon is called:
- Recruitment
- The occlusion effect (Correct answer)
- Loudness discomfort
- Tinnitus masking
Correct answer: The occlusion effect
The occlusion effect occurs when the ear canal is blocked, causing low-frequency bone-conducted vocal energy to resonate in the occluded space.
Question 2: Which of the following is the BEST example of an 'anticipatory strategy' for a patient with hearing loss?
- Asking a speaker to repeat themselves after missing information
- Requesting a quiet table near the wall when making a restaurant reservation (Correct answer)
- Turning up hearing aid volume during a meeting
- Asking a colleague to write down what was said
Correct answer: Requesting a quiet table near the wall when making a restaurant reservation
Anticipatory strategies are proactiveātaken before a communication situationāto optimize listening conditions before any breakdown occurs.
Question 3: A patient with tinnitus reports that it is most bothersome at bedtime in a quiet room. The MOST appropriate rehabilitation recommendation is:
- Advise the patient to sleep with earplugs
- Recommend low-level background sound (a fan, nature sounds, or a sound machine) at night (Correct answer)
- Suggest increasing hearing aid volume before bed
- Recommend referral for MRI immediately
Correct answer: Recommend low-level background sound (a fan, nature sounds, or a sound machine) at night
Sound enrichment reduces the contrast between tinnitus and silence, making tinnitus less perceptually prominent and improving sleep.
Question 4: During group aural rehabilitation, a patient becomes emotional when discussing the impact of hearing loss on family relationships. The facilitator should FIRST:
- Redirect the group to the next topic immediately
- Acknowledge the patient's feelings and allow brief sharing before refocusing (Correct answer)
- Excuse the patient from the group session
- Provide written handouts to distract from the emotion
Correct answer: Acknowledge the patient's feelings and allow brief sharing before refocusing
Acknowledging emotions validates the patient's experience and fosters group cohesion before gently returning to the structured curriculum.
Question 5: The TELEGRAM approach to communication strategies emphasizes that T stands for:
- Testing the hearing aid before speaking
- Topicāinforming the listener about the subject before speaking (Correct answer)
- Tone of voice adjustment
- Turning toward the listener
Correct answer: Topicāinforming the listener about the subject before speaking
In the TELEGRAM approach, T = Topic: announcing the conversation topic helps the listener with hearing loss use contextual cues to follow along.
Question 6: A patient with unilateral hearing loss (normal hearing in one ear) is MOST likely to report difficulty with:
- Understanding speech in quiet one-on-one settings
- Localizing the direction of sound and hearing in background noise (Correct answer)
- Hearing low-pitched environmental sounds
- Understanding speech at close range
Correct answer: Localizing the direction of sound and hearing in background noise
Binaural hearing is essential for sound localization and the head shadow benefit; unilateral loss eliminates these advantages in noisy environments.
Question 7: When evaluating hearing aid benefit during a rehabilitation follow-up, the HHIE (Hearing Handicap Inventory for the Elderly) measures:
- Pure-tone thresholds before and after amplification
- The patient's perceived social and emotional impact of hearing loss (Correct answer)
- Word recognition score improvement
- Insertion gain across frequencies
Correct answer: The patient's perceived social and emotional impact of hearing loss
The HHIE is a self-report questionnaire assessing the social and emotional consequences of hearing impairment, not audiometric measures.
IHS Patient Counseling and Rehabilitation 4
A hearing aid wearer complains that their own voice sounds 'hollow' or 'like talking in a barrel.' This phenomenon is called: