Free International Licensing Examination for Hearing Healthcare Professionals Practice Questions

Sample Practice Questions

Try these 10 sample questions from the International Licensing Examination for Hearing Healthcare Professionals practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A specialist lifts a small flake of cerumen from the entrance of a patient's ear canal with a stainless steel wax loop. Afterward the loop shows no visible blood or drainage. Before the same loop is used on another patient, how must it be processed?

   1. A. Cleaned of gross contamination and then sterilized before it is used again
   2. B. Cleaned of gross contamination and then soaked in a hospital-grade disinfectant
   3. C. Cleaned of gross contamination and then wiped with a rubbing alcohol pad
   4. D. Cleaned of gross contamination in an ultrasonic machine and then air dried

   Answer: A

   Explanation: The processing level for an instrument in the hearing clinic is set by what the instrument can do to tissue, not by whether contamination happens to be visible on it. The American Academy of Audiology guideline states: "Objects that are capable of breaking the skin (i.e. curettes, wax loops) must be sterilized prior to re-use regardless of contamination." A wax loop is such an object, so the absence of visible blood does not lower the requirement. Disinfection, whether by soak or by wipe, is the level reserved for items that do not break the skin, and cleaning alone is only the preparatory step: "Cleaning is an important precursor to disinfecting and sterilizing as gross contamination must first be removed before these procedures will be effective."

   Source: Audiology Today — American Academy of Audiology Guideline, Infection Control in Audiological Practice, sections 'Cleaning' and 'Sterilization'

2. 2An adult's pure-tone average in the right ear is 48 dB HL. Using the classification of degree that ASHA publishes, how is that degree described?

   1. A. Moderate
   2. B. Mild
   3. C. Moderately severe
   4. D. Severe

   Answer: A

   Explanation: Degree of loss is read off a fixed table of hearing level ranges, so the answer follows directly once the range containing 48 dB HL is identified. ASHA publishes the ranges as "Normal -10 to 15 Slight 16 to 25 Mild 26 to 40 Moderate 41 to 55 Moderately severe 56 to 70 Severe 71 to 90 Profound 91+", attributing the classification to Clark. A pure-tone average of 48 dB HL falls in the 41 to 55 band and is therefore moderate. Mild ends at 40, moderately severe begins at 56, and severe begins at 71, so each of those labels would misstate the band by at least one step.

   Source: CHSA | Degree of Hearing Loss — ASHA, Degree of Hearing Loss, table of degree and hearing loss range

3. 3A device rests behind the ear and a thin wire carries the signal down to a speaker sitting in the ear canal itself. Which style is being described?

   1. A. A receiver-in-canal instrument
   2. B. A behind-the-ear instrument with tubing
   3. C. An in-the-canal custom instrument
   4. D. A bone conduction sound processor

   Answer: A

   Explanation: What distinguishes this style is that the receiver has been moved out of the case and into the canal, with only a wire between them. ASHA states: "A receiver-in-canal/receiver-in-the-ear (RIC/RITE) hearing aid hooks over the top of the ear and rests behind the ear with a thin wire connecting the hearing aid to a speaker or receiver in the ear canal. The receiver can be affixed to a dome or custom earmold." In a conventional behind-the-ear fitting the receiver stays in the case and sound travels down acoustic tubing instead of along a wire; an in-the-canal instrument houses everything in a custom shell within the canal; and a bone conduction processor delivers vibration to the skull rather than sound to the canal.

   Source: Hearing Aids For Adults — ASHA Practice Portal, Hearing Aids For Adults, subsection on hearing aid styles

4. 4New instruments have arrived from the manufacturer and quality control is beginning. What does ASHA say may be done before electroacoustic analysis is started?

   1. A. A listening check of each instrument
   2. B. A real-ear measurement in each ear
   3. C. A programming session at the target
   4. D. A functional gain run in the sound field

   Answer: A

   Explanation: Quality control begins with the quickest test that can reveal a gross defect, and only then moves to instrumented measurement. ASHA states: "Upon receipt of the device(s) from the manufacturer, quality control measures are taken to rule out any defects. Listening checks may be completed prior to initiating electroacoustic analysis (EAA)." A listening check catches intermittency, circuit noise and dead receivers in seconds. Real-ear measurement, programming to target and functional gain testing all occur later in the process, once the instrument has been shown to be working and is on the patient.

   Source: Hearing Aids For Adults — ASHA Practice Portal, Hearing Aids For Adults, Fitting and Verification, subsection 'Quality Control'

5. 5Aural rehabilitation is defined as reducing the deficits caused by hearing loss through a combination of four things. Which four?

   1. A. Sensory management, instruction, perceptual training and counseling
   2. B. Sensory management, instruction, perceptual training and medical referral
   3. C. Sensory management, device selection, perceptual training and counseling
   4. D. Hearing conservation, instruction, perceptual training and counseling

   Answer: A

   Explanation: The definition is deliberately broader than fitting a device, because a device alone leaves communication problems unresolved. ASHA quotes the definition as "the reduction of hearing-loss-induced deficits of function, activity, participation, and quality of life through a combination of sensory management, instruction, perceptual training, and counseling." Sensory management covers the amplification itself, instruction covers use and care, perceptual training covers auditory and speechreading work, and counseling covers adjustment. Device selection is one part of sensory management rather than a separate component, and medical referral and hearing conservation belong to other parts of practice.

   Source: Aural Rehabilitation for Adults — ASHA Practice Portal, Aural Rehabilitation for Adults, definition section

6. 6A clinic decides to use a hydrogen peroxide solution for cold sterilization of the instruments it reuses. At what minimum concentration does hydrogen peroxide act as a sterilant rather than only as a disinfectant?

   1. A. 2 percent
   2. B. 3 percent
   3. C. 7.5 percent
   4. D. 10 percent

   Answer: C

   Explanation: Concentration is what separates a sterilant from a disinfectant for this chemistry. The American Academy of Audiology guideline states: "Hydrogen peroxide is only a sterilant in a concentration of 7.5% or greater." A 3 percent solution is the familiar drugstore strength and works only as a disinfectant, and 2 percent is the working concentration of the other approved cold sterilant, glutaraldehyde, not of hydrogen peroxide. The guideline adds that because hydrogen peroxide is "safer to use and dispose of than the glutaraldehyde products, it is the recommended cold sterilant for audiology practices."

   Source: Audiology Today — American Academy of Audiology Guideline, Infection Control in Audiological Practice, section 'Sterilization'

7. 7A patient's thresholds average 62 dB HL in the left ear. Which label does the published classification of degree assign to that ear?

   1. A. Moderately severe
   2. B. Moderate
   3. C. Severe
   4. D. Profound

   Answer: A

   Explanation: The moderately severe band sits between the moderate and severe bands and is easy to skip when the classification is recalled as a five-step rather than a seven-step scale. ASHA's published ranges read "Normal -10 to 15 Slight 16 to 25 Mild 26 to 40 Moderate 41 to 55 Moderately severe 56 to 70 Severe 71 to 90 Profound 91+". A 62 dB HL average falls inside 56 to 70 and is therefore moderately severe. Moderate stops at 55, severe does not begin until 71, and profound does not begin until 91.

   Source: CHSA | Degree of Hearing Loss — ASHA, Degree of Hearing Loss, table of degree and hearing loss range

8. 8Among custom in-the-ear instruments, which style is described as filling most of the bowl-shaped area of the outer ear?

   1. A. The full shell
   2. B. The half shell
   3. C. The in-the-canal
   4. D. The completely-in-the-canal

   Answer: A

   Explanation: Custom instruments form a size series, and this question asks which end of that series occupies the concha. ASHA states: "An in-the-ear (ITE) custom-made hearing aid sits in the ear canal and can vary in size. The smallest fits completely in the canal (CIC) and is almost, if not completely, invisible. The largest version is a full shell that fills most of the bowl-shaped area of the outer ear." The larger the shell the more room there is for a larger receiver, larger battery and user controls, which is why size is a selection variable and not only a cosmetic one. The half shell and in-the-canal styles fall between the two extremes described.

   Source: Hearing Aids For Adults — ASHA Practice Portal, Hearing Aids For Adults, subsection on hearing aid styles

9. 9Coupler measurements are run on a new instrument in the test box. What are those measured values compared against?

   1. A. The manufacturer's published specifications for that brand and model, within stated tolerances
   2. B. The prescriptive targets generated for the patient's audiogram, within stated tolerances
   3. C. The values obtained from the patient's previous instruments, within stated tolerances
   4. D. The average values published for that class of instrument, within stated tolerances

   Answer: A

   Explanation: Electroacoustic analysis asks whether this particular device performs as its maker says it should, which is a question about the device rather than about the patient. ASHA states: "Coupler measures of gain, frequency response, equivalent input noise, maximum output, battery drain, telecoil function, and distortion should conform to the manufacturer’s published specifications (within stated tolerances) for the given brand and model." Prescriptive targets are matched later, in the patient's ear, and comparing against a previous instrument or a class average would not establish whether this unit is faulty.

   Source: Hearing Aids For Adults — ASHA Practice Portal, Hearing Aids For Adults, Fitting and Verification, subsection 'Electroacoustic Analysis (Test Box)'

10. 10A patient asks what causes his hearing loss, how the audiogram is read and what the treatment options are. Which category of counselling do those questions call for?

    1. A. Informational counseling, which educates about the disorder and the rationale for treatment
    2. B. Personal adjustment counseling, which addresses the emotional acceptance of the disorder
    3. C. Group counseling, which uses shared experience to build acceptance of the disorder
    4. D. Referral counseling, which prepares the patient for a consultation with another profession

    Answer: A

    Explanation: The two categories are distinguished by what they act on: knowledge or feelings. ASHA states: "Informational counseling focuses on providing education to the person with hearing loss (and/or related disorders) and their care partners about the disorder, associated symptoms, prevention and wellness, and the rationale for specific treatment interventions." The other category is defined alongside it: "Personal adjustment counseling focuses on the person’s psychological, social, and emotional acceptance of hearing loss and/or related disorders." The questions in the scenario are all requests for knowledge, so they fall to the informational category, though in practice the two are provided together.

    Source: Aural Rehabilitation for Adults — ASHA Practice Portal, Aural Rehabilitation for Adults, Treatment, subsection 'Counseling'