Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 123–134)

1. The prevalence of mild sensorineural hearing loss is 9 to 15% for persons older than...

   • 15 years

   • 25 years

   • 35 years

   • 45 years

   • None of the above

2. It is estimated that ____ million individuals in the United States have tinnitus.

   • 10

   • 40

   • 50

   • 70

   • None of the above

3. Please select the recommendation that is not mentioned in the American Academy of Otolaryngology, Head, and Neck Surgery's Clinical Practice Guideline: Tinnitus for those with primary significant tinnitus and sensorineural hearing loss.

   • A complete history and physical examination

   • A complete audiologic evaluation

   • Education/ counseling

   • Sound therapy as primary therapy, with hearing aids as an “option”

   • None of the above

4. Which statements is/are true regarding the cohort of patients with MSNHL with significant tinnitus and/or hyperacusis?

   • No patient under 40 years of age obtained hearing aids

   • They represented approximately two-thirds of all the patients that presented to the tinnitus and sound sensitivity clinic

   • Two-thirds had hearing aid treatment; one-third used cellphone apps only

   • A and B

   • All of the above

5. Sound therapy using Tinnitus Retraining Therapy involves setting the neutral sound at a “mixing point” with the tinnitus such that it:

   • Completely masks the tinnitus

   • Just covers it, but that it can still be heard

   • Is effective in achieving habituation

   • B and C

   • None of the above

   Article Two (pp. 135–145)

6. Which of the following was not identified by the World Health Organization (WHO, 2004) as a barrier to addressing global hearing healthcare needs?

   • Poor infrastructure for hearing screening and diagnostic assessment

   • Lack of physical resources for identification of hearing loss

   • Insufficient number of trained professionals

   • Lack of resources for managing hearing loss

   • Insufficient hearing aid distribution channels

7. Which of the following groups first outlined hearing healthcare objectives from a public health perspective in 2009?

   • U.S. Department of Health and Human Services

   • National Institute on Deafness and other Communication Disorders (NIDCD)

   • President's Council of Advisors on Science and Technology (PCAST)

   • National Academies of Sciences, Engineering, and Medicine (NASEM)

   • U.S. Congress

8. Which of the following is recommended for measurement of health-related quality of life (HRQoL) and hearing aids?

   • Disease-specific HRQoL measures (e.g., Hearing Handicap Inventory)

   • Generic HRQoL measures (e.g., WHO-DAS II)

   • Generic and disease-specific HRQoL measures

   • Probe microphone measurement

   • Measures of hearing aid satisfaction (e.g., International Outcome Inventory for Hearing Aids)

9. Which of the following has not been suggested for increasing transparency in hearing healthcare?

   • Provision of a copy of hearing-related data (e.g., audiogram)

   • Provision of programming profile for hearing aids

   • Unbundling of hearing aid costs

   • Visible posting of products dispensed

   • Encouraging consumer choice within the hearing healthcare system

10. Historically, health utilities have been used to drive change in insurance coverage for:

    • Tinnitus maskers

    • Cochlear implants

    • Auditory brainstem implants

    • OTC hearing aids

    • Speech in noise testing

    Article Three (pp. 146–157)

11. Position statements of the American Academy of Audiology and the American Speech-Language-Hearing Association regarding over-the-counter hearing aids state that they should only be used for adults with _________ hearing loss.

    • Mild

    • Moderate

    • Severe

    • A and B

    • None of the above

12. Which of the following is not consistent with the electroacoustic capabilities of over-the-counter hearing aids?

    • Low total harmonic distortion

    • Low equivalent input noise levels

    • Adequate high frequency gain

    • Excessive resonant peaks on the Saturation Sound Pressure Level-90 curves

    • B and C

13. For which configuration of hearing loss would OTC devices have the most difficulty meeting gain and output targets?

    • Downward sloping high-frequency

    • Upward sloping

    • Flat

    • B and C

    • None of the above

14. What is/are some of the way(s) that studies on over-the-counter hearing aids lack external validity?

    • Field studies typically do not involve a direct-to-consumer service-delivery models

    • Humes and colleagues dispensed premium advanced digital hearing aids

    • Study samples represented patient populations that would access over-the-counter devices

    • A and B

    • None of the above

15. What of the following factors have studies on over-the-counter hearing aids given little consideration?

    • Electroacoustic capabilities

    • Cost

    • Patient outcomes

    • Cosmetic appeal

    • None of the above

    Article Four (pp. 158–171)

16. Untreated sensorineural hearing loss has been associated with:

    • Social isolation

    • Depression

    • Anxiety

    • Lower self-efficacy

    • All of the above

17. Which of the following statement(s) is/are true?

    • The prevalence of mild sensorineural hearing loss depends on the definition used

    • The prevalence of mild hearing loss among those over 15 years of age is about 30%

    • The MarkeTrak VIII study found that 43% of persons who self-reported as having a mild were told by healthcare professional to wait before seeking amplification and 25% were told that hearing aids would not help

    • A and C

    • None of the above

18. Which of the following outcome measures has the following subscales: Positive Effects, Service & Cost, Negative Features, and Personal Image?

    • IOI-HA

    • MARS-HA

    • SADL

    • HHIE

    • None of the above

19. The average self-reported hours per day hearing aid use for the sample was around ___ hours/day.

    • 4

    • 6

    • 8

    • 10

    • None of the above

20. On what MARS-HA subscale did the hearing aid wearers score as having the least confidence?

    • Basic Handling

    • Advanced Handling

    • Adjustment

    • Aided Listening

    • None of the above

    Article Five (pp. 172–209)

21. Which of the following is/ are possible symptoms of hidden hearing loss?

    • Normal audiometric thresholds

    • Tinnitus

    • Difficulty understanding speech in background noise

    • Hyperacusis

    • All of the above

22. Which of the following has hidden hearing loss not been referred to as?

    • King-Kopetzky syndrome

    • Auditory disability with normal hearing

    • Obscure auditory dysfunction

    • Sensorineural hearing loss

    • None of the above

23. Which of the following factors implicated in causing cochlear synaptopathy has/have been considered the most in the studies included in this systematic review?

    • Ototoxic medications

    • Noise

    • Age

    • B and C

    • None of the above

24. Which of the following does not show promise in measuring cochlear synaptopathy in human models of hearing?

    • SP/AP ratio

    • Amplitude of wave I of the auditory brainstem response

    • Speech understanding in noise with temporal distortion (reverberation and/or time compression)

    • Pure-tone audiometry from .25 to 8 kHz

    • None of the above

25. Which of the following is the least effective for identifying hidden hearing loss and/or cochlear synaptopathy?

    • Electrocochleography

    • Amplitude of ABR Wave I

    • Otoacoustic emissions

    • Self-assessment questionnaires

    • None of the above

    Article Six (pp. 210–220)

26. The prevalence of hearing loss in adolescents and young adults is:

    • Increasing

    • Decreasing

    • Staying approximately the same

    • None of the above

27. With hidden hearing loss, noise-exposed ears that showed no audiometric threshold shift had as much as a _____ loss of the synapses connecting inner hair cells to auditory nerve fibers.

    • 30%

    • 40%

    • 50%

    • 60%

28. Which is not one of the five influencing factors for change in the Health Belief model?

    • Perceived severity

    • Susceptibility

    • Benefits

    • Barriers

    • Cost

29. Which of the following is not true regarding the Health Behavior Change model?

    • Fear is used to motivate patients to make behavioral health changes

    • Five key factors influence patients to make lifestyle changes

    • Both statements are false

    • Neither statement is false

30. After the Adopt-A-Band program, there was an immediate increase in:

    • Concern for MIHL

    • Self-efficacy in its prevention

    • Intention to wear MEs

    • All of the above

    Article Seven (pp. 221–226)

31. What audiologic measure(s) did Barbee and colleagues find to have the most promise in possibly identifying individuals with cochlear synaptopathy?

    • Auditory brainstem response wave I amplitude

    • Acoustic reflexes

    • Summating potential-to-action potential ratio

    • A and C

    • None of the above

32. What questions should audiologists be asking themselves when patients present with normal hearing, yet have complaints such as not being able to hear well in noise and/or tinnitus?

    • Do patients have an extensive history of exposure to excessive noise or other ototoxic agents?

    • Do patients need counseling regarding the importance of hearing protection devices?

    • Should patients' hearing sensitivity be monitored over time?

    • Should patients be referred to tinnitus specialists?

    • All of the above

33. Which of the following individuals is doing ground-breaking work on fitting mild-gain hearing aids on individuals with normal audiometric hearing, but difficulty in understanding speech in noise?

    • Roup

    • Liberman

    • Seever

    • Jilla

    • None of the above

34. Kimball and colleagues found that about ___ of the patients in their tinnitus specialty clinic had slight-to-mild hearing losses.

    • ¼

    • ½

    • ¾

    • all

    • None of the above

35. Which of the following was not a finding of Johnson and colleagues for advanced digital technology hearing aid wearers with mild sensorineural hearing loss?

    • They wore their hearing aids 10 hours a day

    • They received benefit from their devices

    • They were satisfied with their hearing instruments

    • There was a high return-for-credit rate

    • None of the above