IHS Patient Counseling and Rehabilitation 5 — Questions and Answers
Question 1: A patient with severe hearing loss who relies heavily on lipreading should be counseled that lipreading alone provides approximately what percentage of speech intelligibility?
- 60–70%
- 85–95%
- 25–30% (Correct answer)
- 5–10%
Correct answer: 25–30%
Visual speech cues alone yield only about 25–30% intelligibility because many phonemes look identical on the lips (visemes); auditory input is essential for accurate speech understanding.
Question 2: Which of the following best defines 'auditory training' in the context of aural rehabilitation?
- Fitting a patient with the most powerful hearing aid available
- Structured listening practice designed to improve the auditory system's ability to interpret sound (Correct answer)
- Teaching a patient to read lips without audio input
- Measuring a patient's pure-tone thresholds over time
Correct answer: Structured listening practice designed to improve the auditory system's ability to interpret sound
Auditory training uses systematic listening exercises to strengthen the brain's ability to process and discriminate speech and environmental sounds.
Question 3: A 78-year-old patient with cognitive decline has difficulty remembering hearing aid battery changes. The MOST appropriate counseling solution is:
- Prescribe a more powerful behind-the-ear aid
- Recommend rechargeable hearing aids and involve a family caregiver in the routine (Correct answer)
- Discontinue hearing aid use until cognition improves
- Schedule weekly clinic visits for battery replacement
Correct answer: Recommend rechargeable hearing aids and involve a family caregiver in the routine
Rechargeable hearing aids eliminate the need to manage small batteries, and caregiver involvement compensates for the patient's memory challenges.
Question 4: When a patient's communication partner asks how they can better support someone with hearing loss, the clinician should advise them to:
- Speak louder and exaggerate mouth movements
- Face the listener, speak at a natural pace, and rephrase rather than repeat if misunderstood (Correct answer)
- Always write down everything they say
- Avoid complex topics to reduce listening effort
Correct answer: Face the listener, speak at a natural pace, and rephrase rather than repeat if misunderstood
Natural clear speech, good visual access, and rephrasing with different words are evidence-based strategies that improve communication without patronizing the listener.
Question 5: Which statement BEST reflects the person-centered counseling model in audiological rehabilitation?
- The clinician sets treatment goals based on audiometric results alone
- Goals are collaboratively identified based on the patient's priorities and lifestyle needs (Correct answer)
- The patient's family determines the rehabilitation plan
- Treatment follows a standardized protocol regardless of individual circumstances
Correct answer: Goals are collaboratively identified based on the patient's priorities and lifestyle needs
Person-centered care prioritizes the patient's own goals, values, and life context over clinician-driven or standardized protocols.
Question 6: A patient who works in a noisy manufacturing environment with hearing loss should be counseled that the primary purpose of hearing protection in that setting is to:
- Improve speech understanding with coworkers
- Prevent further noise-induced hearing loss from occurring (Correct answer)
- Amplify important warning signals
- Replace the need for hearing aids while at work
Correct answer: Prevent further noise-induced hearing loss from occurring
Hearing protection in high-noise workplaces primarily prevents additional noise-induced threshold shift, not to improve communication.
Question 7: A patient reports that their new hearing aids help in quiet but not during phone calls. The BEST immediate counseling step is to:
- Recommend a more expensive hearing aid model
- Demonstrate the telecoil or Bluetooth streaming feature and practice phone use in session (Correct answer)
- Advise the patient to stop using the phone
- Refer immediately to an ENT specialist
Correct answer: Demonstrate the telecoil or Bluetooth streaming feature and practice phone use in session
Most modern hearing aids include telecoil or Bluetooth connectivity specifically to improve telephone use; patient education and in-session practice are the first steps.
IHS Patient Counseling and Rehabilitation 5
A patient with severe hearing loss who relies heavily on lipreading should be counseled that lipreading alone provides approximately what percentage of speech intelligibility?