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20Q: The Importance of Cognitive Assessment in Audiology Practice

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1.  In which of the following situations will cognition most impact a patient with hearing loss?
  1. Listening to a single speaker in a quiet, non-reverberant environment.
  2. Listening to pure tones during a routine audiogram test.
  3. Listening to a piano concerto via headphones.
  4. Conversation in a noisy, reverberant restaurant.
2.  Listening in complex auditory environments involves:
  1. selective attention
  2. attention switching
  3. working memory
  4. all of the above
3.  According to the American Psychiatric Association, abnormal cognition is defined as:
  1. More than 2 standard deviations below the norm for IQ compared to age-matched peers.
  2. A decline from a previous level of performance in one or more cognitive domains (such as attention, learning or memory).
  3. Forgetting things around the house like where you put your coat.
  4. More than 2 standard deviations above the norm for IQ compared to age-matched peers.
4.  Mild cognitive impairment (MCI) differs from dementia in that:
  1. With dementia, the patient is still independent in everyday activities, while MCI interferes with independence in daily activities.
  2. MCI is considered part of the normal aging process, while dementia is included in the definition of abnormal cognition.
  3. With MCI, the patient is still independent in everyday activities, while dementia interferes with independence in daily activities.
  4. MCI can be cured with medical treatment and healthy lifestyle, while dementia is treatable, but incurable.
5.  According to the author, which of the following statements best describes how primary care physicians typically address cognitive assessment?
  1. Most primary care physicians conduct formal screenings of cognitive skills annually as it is required by Medicare and Medicaid.
  2. Most primary care physicians refer to neurologists to conduct formal cognitive assessments for patients over age 65.
  3. Most primary care physicians believe cognitive assessments are a waste of time since there is no treatment for cognitive issues.
  4. While assessment of cognitive status is recommended for Medicare patients, oftentimes other medical issues or time constraints preclude formal cognitive screenings in a typical primary care visit.
6.  According to the author, which two cognitive screenings may be appropriate for audiologists to administer?
  1. Wechsler adult intelligence scale (WAIS) & Wechsler Memory Scale
  2. Rey-Osterrieth Figure Test & Wechsler Memory Scale (WMS)
  3. National Adult Reading Test (NART) & Wisconsin Card Sorting Test (WCST)
  4. Montreal Cognitive Assessment (MoCA) & Mini-Cog
7.  If a patient performs poorly on a cognitive screening conducted by an audiologist, the audiologist should:
  1. Schedule the patient for auditory training classes.
  2. Discuss the results with the patient/family and refer to the appropriate provider (primary care physician, geriatrician, psychologist, etc.)
  3. Schedule the patient to return to the audiologist for a full cognitive evaluation.
  4. Make the appropriate cognitive diagnosis and discuss treatment options with the patient/family.
8.  The strongest predictor of communication difficulty in noise according to Akeroyd (2008) is:
  1. Working memory
  2. IQ
  3. Selective Attention
  4. Lexicon
9.  The article mentions these two clinic-friendly options for measuring working memory:
  1. National Adult Reading Test (NART) & Wisconsin Card Sorting Test (WCST)
  2. Reading Span Test & Word Auditory Recognition and Recall Measure
  3. Peabody Picture Vocabulary Test & Working Memory Recall Measure
  4. Hearing in Noise Test & QuickSIN
10.  For patients with low working memory, which of the following hearing aid signal processing/settings would be most advantageous?
  1. turn off digital noise reduction and provide maximum frequency lowering.
  2. turn off digital noise reduction and use omnidirectional microphone setting.
  3. linear, analogy processing with minimal low frequency gain.
  4. effective directional microphone technology, digital noise reduction, slow compression speed.

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