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Audiology Review: Preparing for the Praxis and Comprehensive Examinations
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12
Cluing
For the Praxis, clues may be intentional or unintentional hints you can detect by consciously matching
concepts, words, or semantic styles in the question stem that signal the correct answer. With practice,
examinees can develop the skill of recognizing clues through focusing, attending to detail, and making
a conscious effort to find a clue. The following example contains a clue that may or may not be obvious
to you.
A 64-year-old patient with a unilateral, flat, moderate mixed hearing loss was fit with a single
invisible-in-the-canal hearing aid. She reports having trouble tracking the talker when in a group of
colleagues or friends. The patient’s complaint is most likely linked to which of the following?
A. Disrupted outer ear resonance
Poor processing of interaural timing cues
B.
C.
Differences in sound quality between ears
Diminished frequency selectivity
D.
Using cluing, you should recognize the correct answer as (B). The patient’s reported problem
implies difficulty in using spatial cues for sound localization, which the patient described as “tracking
the talker.” Interaural timing differences are important for spatial listening; notice the similarity of
concepts in the words spatial and tracking. You should expect few questions with obvious clues on the
Praxis. However, the skill of cluing may be useful for intelligent guessing, as well as for changing to the
correct answer when you recheck the exam.
Guessing
The Praxis test makers encourage guessing since it is likely to increase your score, although you should
not plan for guessing to be your general approach. Rather, guessing should always be used to assist
in selecting the correct answer when you experience uncertainty or difficulty in making your final
answer selection. There are two types of guesses: random guess and intelligent guess. This section will
distinguish the two and make suggestions for when each should be employed.
If you know nothing about the question content, the rule is simple: Make a random guess. A
multiple-choice question is always a game of chance. Since Praxis questions contain four answer options,
even a random guess has a 25% chance of being correct. Intelligent guessing will increase this to a
greater probability. So, the best guessing strategy is to avoid random guessing since it has the least probability of being correct. Intelligent guessing is an essential skill for multiple-choice exams. Several
effective strategies can be useful for intelligent guessing on questions for which you have partial
knowledge.
Elimination
Of course, if you know the answer, guessing as a strategy is unnecessary. But most Praxis questions are
not the verbatim recall type wherein the answer is automatic or immediately recognized. The reasoning
skills discussed above performed on the answer options enable you to rule in options that are likely to
be correct. Conversely, the process of elimination rules out untenable options to narrow the possibilities, thereby increasing the probability of a correct intelligent guess. The following are strategies that
can be useful for eliminating incorrect options.
CHAPTER 1 Test-Taking Strategies
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True/False Strategy. The true/false strategy was demonstrated previously as a quick method
for answering negative stem and grouping questions. Recall that this strategy required marking
each option with T if it is true and F if it is false. The true/false strategy should always be
used to help eliminate incorrect answers. This variation requires you to first use your scratch
paper to write down the letter options A, B, C, D. Then, as you read through each option on
the computer screen, make a T beside an option if it is acceptable and an F beside all other
options to be eliminated. This will allow visual tracking of your decisions, so you won’t need
to reread each option. Finally, in deciding upon your answer, select the one that is marked
with T.
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Avoid Extremes. Avoiding semantic extremes in the wording of the answer options is an
age-old strategy used widely. The presence of negative words in the options (e.g., no, nothing,
not, never, and none) as well as extremes such as never, always, only, and completely is a signal
to avoid that option. Other extreme words contain negative prefixes such as unimportant,
impossible, and unlikely. Avoiding extremes can also entail eliminating the lowest and highest
values in a numerical sequence, as well as avoiding (A) and (D) in making a random guess.
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Avoid Both Opposites. Akin to avoiding extremes, avoiding both opposites is a useful strategy
for intelligent guessing. Be warned, however, that this strategy is not absolute. Using inherent
knowledge together with this strategy is always advisable.
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Avoid Absurd Answers. Absurd answers are not difficult to recognize, especially if they cause
you to chuckle or are unscientific or unethical. It is wise to first eliminate the absurd option
then choose among the remaining options.
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Beware Negative Statements. Except in rare cases, answer options presented as negative
statements are almost always a clue that they should be eliminated.
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Distrust Unfamiliar Terminology. When you encounter an answer option you do not
recognize, there is a good probability that it is not correct. An example might be a totally
unfamiliar word, syndrome, or condition. Yet, there is a proclivity for examinees under stress
to select that unknown option. However, this tendency should be avoided.
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Taking the Praxis
General Procedure
This general process for taking the Praxis will discuss mental and psychological preparation and behaviors for successful performance. The following is a recommended approach to taking the Praxis.
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Assume an active, rather than passive, approach to each question. The answers will not be
readily apparent. Put your mind to work to figure out the answer.
n
Take each question at face value. Don’t overthink the question by trying to find subtleties,
tricks, or hidden meanings.
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Establish a quick yet comfortable pace as you move through each question. Because guessing is
recommended, answer every question, guessing if you must.
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When you encounter a question that you know nothing about, take a random guess. Some
examinees prefer to use the same letter for every guess. This strategy is as good as any.
Audiology Review: Preparing for the Praxis and Comprehensive Examinations
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If you think you know the answer but do not immediately find it among the options, use
elimination. If you can, eliminate all but two and use intelligent guessing. Flag these questions
to return to when you complete the exam.
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If you know the material within the question, flag it if:
You have a memory block.
The question takes more time than it should.
You do not grasp the meaning.
The question appears to be ambiguous.
The implication of a chart, graph, or audiogram is not apparent.
You disagree with the answer options.
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If there is time remaining when you complete the exam, return to the questions you flagged.
Do not start at the beginning and attempt to redo the entire exam in sequence.
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If there is time remaining after you return to the questions you flagged, check the exam from
the beginning checking for errors. But do not change the answer unless it is clearly an error.
Combatting Test Anxiety
Test anxiety is that unsettling, unpleasant, discomforting feeling experienced in anticipation of or
during an exam. Some examinees respond to test anxiety as a positive force, resulting in enhanced
performance. However, extremely elevated levels of anxiety can cause distress, confusion, fear, physical
malaise, and worry, resulting in ineffective coping strategies that diminish performance. The following
are tips to combat test anxiety.
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Distrust myths heard about the Praxis. Read all the information about the test from the
American Speech-Language-Hearing Association (ASHA) and Educational Testing Service
(ETS).
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Don’t focus on past failure. Adopt an attitude of confidence.
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Don’t trust the reports of others. Each individual experiences the Praxis differently.
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Avoid toxic people. Avoid negative, test-anxious acquaintances.
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Begin preparation well in advance. Being prepared will boost confidence and ease anxiety.
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Visit the student counseling center. Professionals can provide useful coping strategies.
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Don’t cram. Relax the night before. Get your usual hours of sleep.
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Do warm-up exercises before the exam. Do puzzles or word games unrelated to audiology.
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Avoid drugs and other stimulants. These may dull knowledge and induce fatigue during
the exam.
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Write down mnemonic devices and memory joggers on scratch paper. Do this in the first minute
to help combat memory blocks and thus ease anxiety.
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Take brief relaxation breaks. To refresh your brain cells.
n
Use anxiety to your advantage. The adrenaline boost from a little anxiety can be beneficial to
performance.
CHAPTER 1 Test-Taking Strategies
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As a final thought, confidence is the antithesis of test anxiety. Indeed, the more you can utilize these
and other strategies to bolster confidence, the less you will experience debilitating test anxiety.
Pacing Yourself
For the Praxis, you have 150 minutes to complete 120 questions. The main goal is to complete the
exam with time to recheck questions you guessed and flagged for review. Thus, it is important to set
your pace early so that you do not worry whether you will finish or rush to finish at the end. The
following is a recommended strategy to set your pace.
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Establish a rapid, yet comfortable and efficient pace for the first several questions. Your pace
must be comfortable to ensure accuracy. DO NOT speed read the questions.
n
After 15 minutes, check the number of questions completed. You should have completed
at least 20 questions. (To ensure completion with time to recheck, as a rule of thumb, the
number of questions completed should be slightly more than the minutes lapsed.)
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If you have not reached 20 questions, don’t panic. Hasten your speed for short verbatim
recall questions, avoiding the temptation to speed read. Remember that random guessing on
unknown questions will save time.
n
Continue working until 30 minutes have lapsed. You should have completed at least
40questions.
If you have answered 40 questions at this point, your pace is on target for completion. If you have not
reached 40 questions, determine the reason. You may still be able to complete the exam. However, you
must alter your behavior, or risk not being able to return to the flagged questions. The following timing
strategies assist in setting a healthy pace.
Preview Strategy
The preview strategy is useful with a particular question format. The preview strategy is recommended
only when the question stem is lengthy, but the answer options are composed of one-word or singleline phrases. It is a practice for saving time with lengthy questions that have one-word or short phrases
as options. This strategy is useful because it allows a quick preview of the options. The strategy is
exercised as follows:
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Take a quick glance at the question, noting whether the question stem is lengthy. Also notice
whether the answer options are one word or short phrases.
n
If the answer options are lengthy, answer the question as usual.
n
If the answer options are one word or short phrases, scan the options. If none are familiar,
make a random guess and select any answer immediately.
n
If the answers are familiar, glance at them quickly to gain a sense of the question topic.
n
Return to the question and read it thoroughly.
n
As you reread the options, if you recognize the correct answer, select it without reviewing the
other options and move to the next question.
n
If you need to reread all the options, use elimination or reasoning skills to select the best
answer.
Audiology Review: Preparing for the Praxis and Comprehensive Examinations
https://t.me/medicina_free
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Single-Letter Strategy
If you run out of time, there is an effective strategy for guessing on questions you have not reached.
This is done to gain a few additional points. The single-letter strategy is effective only when you have
not completed the exam and have several questions remaining. This strategy requires that you continue
working until the final minute. In the final minute, choose any letter and mark the same letter for all
remaining questions, that is, mark all the options with (A), for example. It does not matter which letter
you choose, (A), (B), (C), or (D), as long as you mark every question with that same letter.
For this strategy to be effective, it is important to avoid randomly selecting different options
for each question because this will not lead to scoring additional points. As a demonstration of this
principle, consider, for example, that you have 15 questions remaining. There is a good probability
that (B) is the answer for two or three of those questions. Marking all questions with (B) ensures that
you will get those two or three questions correct. Note that this single-letter strategy is effective only
for a group of final unanswered questions. The strategy is not particularly useful when you must make
a random guess on individual questions.
Practice Questions
Complete the practice questions as if you were taking the actual Praxis. Allow no more than 10 minutes
and note whether you finish or if you require more time. If you know the information, mark your
answer, and proceed to the next question. If you must think through the question or guess, decide on
the answer using the test-taking strategies described in this chapter.
1. A 48-year-old male has been referred for an audiological evaluation by his physician. The patient
is experiencing hearing loss with vertigo and nystagmus. Medical history indicates that he has
recently experienced head trauma resulting in a longitudinal fracture of the temporal bone.
Which of the following would be the expected audiological finding?
A. Cochlear hearing loss
B. Retrocochlear hearing loss
C. Conductive hearing loss
D. Mixed hearing loss
2. Which of the following individuals is the most appropriate candidate for a cochlear implant?
A. A 50-year-old woman who has tinnitus
B. A 3-year-old boy who has acquired a profound bilateral hearing loss following a case of
meningitis
C. A 6-year-old girl who has moderate sensorineural hearing loss due to viral infection
D. A 45-year-old woman who has been diagnosed with Meniere’s disease
CHAPTER 1 Test-Taking Strategies
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3. The pure-tone audiogram of a 38-year-old female diagnosed with bilateral otosclerosis exhibits
a 40 dB air-bone gap. Which of the following will probably reflect the acoustic immittance
results?
A.
Type C tympanogram; low static compliance; absent acoustic reflexes
Type As tympanogram; low static compliance; present acoustic reflexes
B.
C.
Type As tympanogram; low static compliance; absent acoustic reflexes
Type B tympanogram; normal static compliance; elevated acoustic reflexes
D.
4. A patient has come to an ASHA-certified audiologist for a hearing aid fitting. In counseling
regarding appropriate expectations, which of the following statements by the audiologist to the
patient is not in accordance with the ASHA Code of Ethics?
“You will hear some sounds that you have not heard before.”
A.
B.
“Your voice may sound different.”
“Using your hearing aid guarantees that your hearing will return to normal.”
C.
D. “It may still be difficult to hear people talking in another room.”
5. In the battery of immittance tests, which of the following is most likely to be affected by the
cognitive effects of aging?
III. Tympanometry
III. Static admittance values
III. Acoustic reflex thresholds
IV. Acoustic reflex decay tests
A. I, II, and IV
B. III and IV
C. All are affected
D. None are affected
6. Otoacoustic emissions (OAE) testing has been found to be most successful in identifying which
of the following types of lesions?
A. Cochlear
B. Retrocochlear
C. VIIIth nerve
Temporal lobe
D.
7. The typical immittance pattern for a left-sided facial paralysis where a VIIth cranial nerve lesion
is located medial to the stapedial muscle will include which of the following when measured
from the left ear?
A. Normal tympanogram, normal static compliance, absent acoustic reflexes
B. Normal tympanogram, normal static compliance, normal acoustic reflexes
C. Abnormal tympanogram, abnormal static compliance, absent acoustic reflexes
D. Normal tympanogram, normal static compliance, elevated acoustic reflexes
Audiology Review: Preparing for the Praxis and Comprehensive Examinations
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8. Sudden hearing loss can result from all of the following except
A.
Viral labyrinthitis
Vascular occlusion
B.
C.
Genetic disposition
Ototoxic drug ingestion
D.
9. A 47-year-old man is referred for auditory brainstem response (ABR) testing. The referral
indicates that he is suspected of having a bilateral functional hearing loss. Medical history
indicates that a new medication has been prescribed. Which of the following is a likely
observation of ABR testing?
A.
All waves will be delayed
Delayed wave I–V interpeak latency
B.
A single wave (V) will be identified
C.
D.
Results will not be affected by medication
10. A patient is referred to an ASHA certified and licensed audiologist for central auditory
processing disorder (CAPD) testing. The audiologist has never administered a CAPD test.
According to the ASHA Code of Ethics, which of the following should be the appropriate
action?
A. Refer the patient to another audiologist with experience in CAPD testing.
B. Delegate the testing to an assistant and provide supervision.
C. Refuse to schedule the patient.
D. Administer the CAPD test and request consultation from an experienced audiologist.
Answers
After completing the practice questions, check the accuracy of your answers. For incorrect answers, use
the answer explanations for knowledge of the question content as well as the recommended reasoning
skill, which is bolded.
1. (C) Creating. Use your creativity to anticipate the impact of a longitudinal temporal bone
fracture on the hearing process. Longitudinal fracture to the temporal bone will result in
ossicular and tympanic membrane injury, thus disrupting sound transmission to the cochlea,
producing a conductive hearing loss.
2. (B) Comparing. The key word most in the question stem renders this a comparison question.
A cochlear implant will restore nerve conduction in the cochlea for an individual with a permanent sensorineural hearing loss. Compare the effect on hearing of each of the conditions listed in
the options. (B) is the option that would result in a permanent sensorineural hearing loss.
3. (C) Creating/Grouping. In otosclerosis, stapes fixation often reduces the mobility of the
middle ear system, leading to limited tympanic membrane mobility (Type As). Using creativity,
conclude that immittance results will reflect a Type As tympanogram with low static immittance
CHAPTER 1 Test-Taking Strategies
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and absent acoustic reflexes. Using this knowledge together with grouping, eliminate options
(A), (B), and (D).
4. (C) Values/Critiquing. Critique each option using your academic knowledge and sense of
professional values. Ethically, as well as in accordance with the ASHA Code of Ethics, an
audiologist must not guarantee the results of a treatment or procedure. Therefore, (C) is correct.
5. (D) Grouping/Critiquing. Using the true/false strategy, each of the Roman numeral options
is deemed as false, revealing (D) as the correct answer. Since the immittance test battery is
composed of physiological measurements, cognitive symptoms of aging will not affect the test
results.
6. (A) Verbatim Recall. OAE is successful in identifying lesions within the cochlea that affect
outer hair cell function.
7. (A) Grouping/Elimination. Marking each with T or F, use the true/false strategy for each of
the three elements of option (A); then mark the same in all the other options. When measured
from the left ear, a VIIth cranial nerve lesion before the stapedial muscle point of innervation
will prevent reflex action, resulting in absent acoustic reflexes, which is marked as T, so (B) and
(D) should be eliminated. Finally, (C) should also be eliminated since tympanogram and static
compliance measurements will be normal.
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8. (D) Negative Stem/Critiquing. Use the true/false strategy as you critique each option, marking
it as T or F. Ototoxic drug ingestion results in gradual onset of hearing loss, so (D) should be
marked F since it is false, thereby identifying (D) as the correct answer.
9. (D) Creating. Using the specific information in the question, creativity should be used to
anticipate the ABR test results. The ABR test provides information on the ability of the
peripheral auditory system to transmit information to the auditory nerve and beyond. As such,
it does not assess the patient’s hearing, and thus the results will not be affected by the patient’s
medication.
10. (A) Values. Using the values of the profession, as well as knowledge of the ASHA Code of
Ethics, the only acceptable action is (A). An audiologist must be able to competently provide
clinical services or refer the patient to another audiologist to ensure that competent service is
provided.
Acknowledgment
The author acknowledges the contributions of editors Jeremy Donai and Katharine Fitzharris in the
production of this chapter.
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Section II
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Foundational Knowledge
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