Chapter 65: Impaired Hearing Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A child who has recurrent otitis media fails a hearing screen at school. The provider suspects which type of hearing loss in this child?

a. Central b. Conductive c. Mixed type d. Sensorineural

ANS: B a. Impedance audiometry b. Pure tone audiogram c. Speech reception test d. Tympanogram

A common cause of conductive loss is fluid in the middle ear as a result of chronic otitis media with effusion. Central hearing loss is related to CNS disorders. Mixed-type hearing loss is related to causes of both conductive and sensorineural hearing loss. Sensorineural hearing loss is caused by damage to the structures in the inner ear, usually caused by infection, barotrauma, or trauma.

2. A result of screening audiogram on a patient is abnormal. Which test may the primary provider perform next to further evaluate the cause of this finding?

ANS: D

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A screening tympanogram may be performed by a primary provider to determine tympanic membrane mobility and may help in identifying the presence of infection, fluid, or changes in middle ear pressure. The other tests are performed by audiologists, not primary care providers.

Multiple Response

1. Which are risk factors for developing hearing loss caused by presbycusis? (Select all that apply.)

a. Diabetes b. GERD c. High blood pressure d. Liver disease e. Smoking

ANS: A, C, E

Presbycusis is a gradual degeneration within the cochlea that accompanies aging. Diabetes, high blood pressure, and smoking may hasten these changes. GERD and liver disease are not associated with an increased rate of changes.