Exposure to loud noises can cause ___.

• A. I only
• B. II only
• C. I and II only
• D. I, II, and III

Answer: (C)

Loud-noise exposure can damage the delicate structures of the inner ear, especially the hair cells in the cochlea that convert sound into neural signals. A brief, intense noise can cause a temporary threshold shift, where hearing is muffled for a while but typically recovers with rest. If exposure is loud or repeated, the damage can be permanent, leading to permanent hearing loss. In this item, the outcomes described as I and II align with these well-established effects, so choosing both together captures the realistic consequences of noise exposure. The third outcome described in the item is not considered a direct or guaranteed consequence in this context, so it isn’t included with I. Therefore, the combination of I and II is the best answer.