Refresher Course for
Nurses and Medical
Assistants
June 2009
© John Tracy Clinic
Special Instructions
● Be sure to view in “Slide Show”
● Use your mouse to select your answers
● Click anywhere on the slide to
advance to the next question
● Do not use the up/down arrows to
advance
● You may find it useful to refer to your
Quick Reference Guides and other
training materials as necessary
BSC hearing screening in the medical
home is recommended in order to:
● Identify later onset hearing loss
● Identify progressive hearing loss
● Identify children who did not receive
a hearing screening at birth
● All of the above
Partially Correct!
That is one target goal of the BSC
program but it is not the only goal.
Please try again!
Congratulations!
You are correct!
The answer to this question is
ALL OF THE ABOVE
Because we need to catch children
that fit into all of these categories.
BSC should be conducted with:
● All children 0-5 years
● All babies 0-36 months
● Babies under one year only
Sorry!
That answer is incorrect!
Congratulations!
You are correct!
BSC should be conducted at
every WCC
● True
● False
Sorry!
That answer is incorrect!
Congratulations!
You are correct!
Baby Sound Check intervals are:
● 2 months (if not done at birth)
● 6 months
● 12 months
● 24 months
● 36 months
Which BSC tests are given to
ALL babies?
● OAE and Reflexes
● BSC questions and OAE
● Tympanometry and Reflexes
● OAE and Tympanometry
Sorry!
That answer is incorrect!
Congratulations!
You are correct!
In tympanometry, when is a
high frequency probe tone
required?
● For all babies when the OAE refers
● For babies 7 to 36 months
● For babies under 6 months
Sorry!
That answer is incorrect!
Sorry!
That is not the best answer!
Congratulations!
You are correct!
This is necessary to ensure that we are
able to reliably detect middle ear
disorders in young infants when their
ear canals are still developing.
If a child has a PE tube in the right ear, what
testing adjustment(s) do you make for OAEs?
● Hold down the ‘right arrow’ on the
OAE for 3 seconds before
proceeding with test
● Press ‘Shift’ and ‘New Patient’ on the
Tympanometer
● Neither OAE or tympanometry should
be done in the case of PE tubes
Sorry!
That answer is incorrect!
Congratulations!
You are correct!
WOW!!
Since a PE tube affects the OAE signals
in the ear canal, holding down the
button allows the machine to skip the
calibration phase and proceed with
the test.
When the OAE does not go into calibration
mode, but stays on the Volume and Noise
screen, what is the most likely cause?
A. Wax build-up in the probe tip
B. A poor probe fit in the ear canal
C. Both A and B
Partially Correct!
Although true, this is not the best
answer!
Congratulations!
You are correct! Both the probe fit and
wax in the probe tip can prevent the
test from running.
Be sure to try a different size tip and to
check the probe for wax, replacing
the plastic probe tip if necessary,
before re-running the test.
A “Noisy” result on an OAE is most
likely an indicator of what?
● A refer
● Too much internal noise
● Too much chat from the
nurse’s station!
● All of the above
Partially Correct!
The best answer is “ALL of these”.
When the baby’s OAE response is very small,
or close to being absent, factors such as
external noise(chatting), internal noise
(baby’s movements) or probe fit, have a
much greater effect on the test. When the
OAE response is large and robust (as in the
presence of normal hearing), these factors
are less critical
Congratulations!
You are correct!
When the baby’s OAE response is very small,
or close to being absent, factors such as
external noise(chatting), internal noise
(baby’s movements) or probe fit, have a
much greater effect on the test. So be sure
to control for these factors and retest.
When the OAE response is large and robust
(as in the presence of normal hearing),
these factors become much less critical.
What should you do if a 12 mo. old
baby refers on OAE in the left ear?
● REPEAT OAE and do High Frequency
Tympanometry only
● REPEAT left OAE and do left tymps
and reflexes
● REPEAT left OAE and do both left and
right tymps and reflexes
Sorry!
That answer is incorrect!
Congratulations!
You are correct!
By repeating the OAE, we can be confident
that the ‘refer’ is a true result. Additionally,
it is common for middle ear problems to
affect both ears. Tympanometry and reflex
testing can help detect underlying middle
ear problems even before they begin to
affect hearing. So be sure to test both ears,
even if one ear has passed the OAE.
A ‘Yes’ on one of the BSC questions and a
pass on both OAEs means you should:
● Continue to test tympanometry
● Continue to test tympanometry and
reflexes
● Stop testing
Sorry!
That answer is incorrect!
Unless the baby is under 6 months, you would
need to continue to conduct both
tympanometry AND reflexes
Congratulations!
Unless the baby is under 6 months, you would
continue to conduct both tympanometry
AND reflexes
In which situation would you
decide not to conduct BSC?
● If there is drainage present from an ear
● If the child reacts in pain when the ear
is touched
● If a foreign object is lodged in the ear
● All of the above
Sorry!
True, but that is not the best answer!
Congratulations!
You are correct!
How much time should you spend
on BSC if a baby is fussy?
● 5 to 15 mins maximum
● 15 to 30 mins
● As long as it takes to get a result!
Sorry!
That answer is incorrect!
Congratulations!
● You are correct!
What information should be given to
the parent when their baby passes
on the BSC screening?
No referral = copy of results form, hearing
milestones and BSC sticker
What information should be given
to the parent when their baby refers
on their BSC screening?
Fax Referral to JTC. Call while patient still in office to make
appointment. Give parent JTC brochure, referral letter, BSC sticker
and copy of results form
WOW!!
Congratulations!
You have successfully completed the
BSC MA refresher quiz!
Please email smintz@jtc.org to inform us
that you have completed this course. If it
was done in a group, please list all
people in attendance.
Thank You!
TERRIFIC
JOB!!!