NBC-HIS National Competency Exam (BC-HIS) — Questions and Answers

Question 1: Staying well hydrated and managing blood pressure can support hearing health because the inner ear:

Is unaffected by circulation
Has no blood supply
Depends on good blood flow (Correct answer)
Works better when dehydrated

Correct answer: Depends on good blood flow

The cochlea relies on healthy circulation, so cardiovascular health helps protect hearing.

Question 2: The external components of a cochlear implant system typically include:

A microphone, sound processor, and transmitter coil (Correct answer)
A battery implanted behind the ear
The electrode array and receiver-stimulator only
The cochlea and auditory nerve

Correct answer: A microphone, sound processor, and transmitter coil

The external components consist of a microphone that picks up sound, a sound processor that codes it, and a transmitter coil that sends signals transcutaneously to the internal implant.

Question 3: Electric-acoustic stimulation (EAS) or hybrid cochlear implant systems are designed for patients with:

Residual low-frequency hearing but severe high-frequency hearing loss (Correct answer)
Complete hearing loss in both ears
Only conductive hearing loss
No residual hearing

Correct answer: Residual low-frequency hearing but severe high-frequency hearing loss

EAS systems combine a short electrode cochlear implant (for high-frequency electrical stimulation) with acoustic amplification (for preserved low-frequency residual hearing) in the same ear.

Question 4: The point where the scala vestibuli and scala tympani meet at the cochlear apex is the:

Modiolus
Oval window
Macula
Helicotrema (Correct answer)

Correct answer: Helicotrema

The helicotrema is the apical opening where the two outer cochlear chambers connect.

Question 5: A bone-anchored hearing aid (BAHA) is best suited for patients with which type of hearing loss?

Conductive or mixed hearing loss with ear canal abnormalities (Correct answer)
Profound bilateral sensorineural hearing loss
Central auditory processing disorder
Mild sensorineural hearing loss

Correct answer: Conductive or mixed hearing loss with ear canal abnormalities

BAHA devices bypass the outer and middle ear by conducting sound through bone directly to the cochlea, making them ideal for conductive/mixed hearing loss or when ear canals are absent or blocked.

Question 6: Post-cochlear implant aural rehabilitation is important primarily because:

It prevents device malfunction
The brain needs training to learn to interpret the new electrical signal as meaningful sound (Correct answer)
It is legally required for insurance reimbursement
It replaces the need for device programming sessions

Correct answer: The brain needs training to learn to interpret the new electrical signal as meaningful sound

Auditory rehabilitation following cochlear implantation helps the brain learn to interpret the novel electrical stimulation from the device, maximizing speech perception and communication outcomes.

Question 7: Typically, a cold comes first before an ear infection.

False
Sometimes
True (Correct answer)

Correct answer: True

Colds often cause nasal congestion and inflammation, which can lead to the blockage of the Eustachian tubes. These tubes connect the middle ear to the back of the throat and are vital for drainage and pressure equalization. When blocked, fluid can accumulate in the middle ear, creating an ideal environment for bacteria and viruses to thrive, thus leading to an ear infection.

Question 8: What is the role of the Eustachian tube?

Amplifying high frequencies
Detecting head rotation
Producing endolymph
Equalizing middle ear pressure with the atmosphere (Correct answer)

Correct answer: Equalizing middle ear pressure with the atmosphere

The Eustachian tube connects the middle ear to the nasopharynx and equalizes pressure.

Question 9: The Deaf cultural perspective typically views deafness as:

A temporary condition that can always be treated
A complete barrier to communication
A difference in human experience and a source of cultural identity, not a disability (Correct answer)
A medical condition requiring a cure

Correct answer: A difference in human experience and a source of cultural identity, not a disability

The Deaf cultural perspective, prominent in the US Deaf community, views deafness as a cultural and linguistic identity rather than a medical deficit requiring correction.

Question 10: During pure-tone audiometry, what does the patient's 'hearing threshold' represent?

The loudest sound the patient can tolerate
The frequency at which the patient hears best
The softest sound the patient can detect at least 50% of the time (Correct answer)
The average loudness of normal conversation

Correct answer: The softest sound the patient can detect at least 50% of the time

The hearing threshold is defined as the lowest intensity level at which a patient can correctly detect a pure-tone stimulus at least 50% of the time.

Question 11: The _________ cochlear tube is the ONLY one where perilymph does NOT flow.

scala tympani
scala vestibuli
scala media (Correct answer)

Correct answer: scala media

The cochlea contains three main fluid-filled compartments: the scala vestibuli and scala tympani, both filled with perilymph, and the scala media (or cochlear duct). The scala media is unique because it is the only one filled with endolymph, a fluid with a distinct ionic composition crucial for the function of the organ of Corti.

Question 12: Which fluid fills the cochlear duct (scala media)?

Endolymph (Correct answer)
Plasma
Perilymph
Cerebrospinal fluid

Correct answer: Endolymph

Endolymph, high in potassium, fills the scala media and bathes the hair cells of the organ of Corti.

Question 13: Cochlear ossification following bacterial meningitis creates a surgical urgency for cochlear implantation because:

The auditory nerve degenerates rapidly
Infection spreads to the brain
New bone formation in the cochlea can block the electrode array from being inserted (Correct answer)
Insurance coverage expires quickly

Correct answer: New bone formation in the cochlea can block the electrode array from being inserted

Following meningitis, labyrinthitis ossificans (cochlear ossification) can cause new bone to fill the cochlea, potentially blocking full electrode insertion and compromising cochlear implant outcomes.

Question 14: Which ototoxic medication class is commonly known to cause hearing loss and should be monitored audiologically?

Aminoglycoside antibiotics (Correct answer)
Antihistamines
ACE inhibitors
Beta blockers

Correct answer: Aminoglycoside antibiotics

Aminoglycoside antibiotics (such as gentamicin, tobramycin, and streptomycin) are well-known ototoxic medications that can damage cochlear hair cells, causing sensorineural hearing loss.

Question 15: Damage to the cochlear hair cells typically results in which type of hearing loss?

Sensorineural (Correct answer)
Conductive
Temporary tympanic
Mixed reversible

Correct answer: Sensorineural

Hair cell or auditory nerve damage causes sensorineural hearing loss, which is usually permanent.

Question 16: Fluctuating hearing loss, where hearing ability changes over time, is most associated with which condition?

Ménière's disease (Correct answer)
Presbycusis
Otosclerosis
Noise-induced hearing loss

Correct answer: Ménière's disease

Ménière's disease is characterized by fluctuating sensorineural hearing loss, tinnitus, vertigo, and aural fullness due to excess endolymph in the inner ear.

Question 17: The gelatinous structure overlying the hair cells in the cochlea is the:

Tympanic membrane
Basilar membrane
Reissner's membrane
Tectorial membrane (Correct answer)

Correct answer: Tectorial membrane

The tectorial membrane sits atop the stereocilia, bending them as the basilar membrane moves.

Question 18: The FDA approved cochlear implants for children at what minimum age?

5 years
6 months
12 months (Correct answer)
2 years

Correct answer: 12 months

The FDA approved cochlear implantation for children as young as 12 months of age, though some centers implant even younger in exceptional cases, based on evidence supporting early implantation for optimal language outcomes.

Question 19: Receiver-in-canal (RIC) hearing aids differ from traditional BTE aids in that the receiver (speaker) is located:

Underneath the ear
In the main body behind the ear
Inside the ear canal (Correct answer)
On top of the ear

Correct answer: Inside the ear canal

In RIC hearing aids, the receiver is placed directly in the ear canal, connected to the behind-ear unit via a thin wire, which reduces feedback and improves sound quality.

Question 20: Known as the labyrinth?

Outer ear
All of these
Inner ear (Correct answer)
Middle ear

Correct answer: Inner ear

The inner ear is commonly known as the labyrinth due to its complex and intricate structure. It consists of the bony labyrinth and the membranous labyrinth, which house the cochlea for hearing and the vestibular system for balance, forming a maze-like arrangement.

Question 21: Which MRI consideration is important for cochlear implant recipients?

Some implants require magnet removal or special protocols before MRI; patients must consult their implant team (Correct answer)
MRI is completely safe with all cochlear implants at any strength
Only CT scans are ever needed after implantation
MRI is permanently contraindicated for all implant recipients

Correct answer: Some implants require magnet removal or special protocols before MRI; patients must consult their implant team

MRI compatibility varies by implant brand and generation; some devices require magnet removal or head bandaging before scanning, and specific MRI field strengths and protocols must be followed to ensure safety.

Question 22: The 'mapping' or 'programming' sessions after cochlear implant activation are used to:

Teach sign language
Physically adjust the electrode array position
Set the threshold and comfort levels for each electrode to optimize hearing performance (Correct answer)
Decide if additional surgery is needed

Correct answer: Set the threshold and comfort levels for each electrode to optimize hearing performance

MAP programming sessions adjust the minimum (threshold) and maximum (comfort) stimulation levels for each electrode to create a personalized program that provides the best hearing experience.

Question 23: Which audiometric criterion is a key candidacy requirement for cochlear implantation in adults in the US?

Any degree of conductive hearing loss
Single-sided deafness only
Bilateral severe to profound sensorineural hearing loss with limited benefit from hearing aids (Correct answer)
Mild to moderate sensorineural hearing loss

Correct answer: Bilateral severe to profound sensorineural hearing loss with limited benefit from hearing aids

Standard adult cochlear implant candidacy requires bilateral severe to profound sensorineural hearing loss with demonstrated limited benefit from appropriately fit hearing aids.

Question 24: Prolonged exposure to very loud noise damages hearing primarily by:

Rupturing the Eustachian tube
Increasing earwax
Hardening the pinna
Destroying stereocilia on hair cells (Correct answer)

Correct answer: Destroying stereocilia on hair cells

Loud noise shears and destroys the stereocilia of hair cells, causing noise-induced hearing loss.

Question 25: High-frequency audiometry, which tests frequencies above 8,000 Hz (up to 20,000 Hz), is particularly useful for monitoring:

Conductive hearing loss from middle ear disease
Central auditory processing disorders
Early ototoxic hearing loss from chemotherapy or aminoglycoside antibiotics (Correct answer)
Age-related low-frequency hearing loss (presbycusis)

Correct answer: Early ototoxic hearing loss from chemotherapy or aminoglycoside antibiotics

Ototoxic drugs typically damage the basal (high-frequency) region of the cochlea first; high-frequency audiometry detects these ultra-high-frequency losses before they progress into the speech range.

Question 26: Myringotomy with tympanostomy tube placement is a common surgical treatment for:

Acoustic neuroma
Recurrent or chronic otitis media with effusion (glue ear) (Correct answer)
Otosclerosis
Cochlear ossification

Correct answer: Recurrent or chronic otitis media with effusion (glue ear)

Pressure equalization (PE) tubes are surgically inserted through a small myringotomy incision to ventilate the middle ear and drain fluid in children with recurrent or persistent otitis media with effusion.

Question 27: What unit of measurement is used to express hearing thresholds on an audiogram?

Decibels Hearing Level (dB HL) (Correct answer)
Hertz (Hz)
Pascals (Pa)
Decibels Sound Pressure Level (dB SPL)

Correct answer: Decibels Hearing Level (dB HL)

Audiograms use decibels Hearing Level (dB HL), a scale referenced to the average thresholds of young adults with normal hearing, making 0 dB HL the normative baseline.

Question 28: The inner ear's semicircular canals are helpful in?

Balance
Both A & B (Correct answer)
Vibration amplification
Hearing

Correct answer: Both A & B

The semicircular canals are crucial components of the inner ear's vestibular system, which is primarily responsible for detecting head movements and maintaining balance. While the canals themselves directly contribute to balance, the inner ear as a whole also houses the cochlea, the organ responsible for hearing. Therefore, considering the broader functions associated with the inner ear where these canals are located, both balance and hearing are key roles.

Question 29: What is the term for hearing loss that involves both conductive and sensorineural components?

Unilateral hearing loss
Functional hearing loss
Central hearing loss
Mixed hearing loss (Correct answer)

Correct answer: Mixed hearing loss

Mixed hearing loss combines conductive and sensorineural damage in the same ear.

Question 30: Which of the following DOES NOT limit the tympanum and ossicles' ability to move when an overwhelming noise is present?

tensor tympani
stapedius
scala vestibuli (Correct answer)

Correct answer: scala vestibuli

The tensor tympani and stapedius muscles are located in the middle ear and contract in response to loud noises, stiffening the tympanic membrane and ossicles to reduce sound transmission. The scala vestibuli, however, is a fluid-filled chamber within the cochlea of the inner ear and is not involved in limiting the physical movement of the tympanum and ossicles.

Question 31: Sensorineural hearing loss results from damage to which structures?

The inner ear or auditory nerve (Correct answer)
The eardrum only
The ear canal
The outer ear cartilage

Correct answer: The inner ear or auditory nerve

Sensorineural hearing loss involves damage to the cochlea's hair cells or the auditory nerve pathway.

Question 32: On a standard audiogram, what does a flat hearing loss configuration suggest?

Greater hearing loss in the high frequencies than low frequencies
Equal hearing loss across all tested frequencies (Correct answer)
Greater hearing loss in the low frequencies than high frequencies
Normal hearing at all frequencies

Correct answer: Equal hearing loss across all tested frequencies

A flat audiogram configuration means that hearing thresholds are similar across all tested frequencies, indicating roughly equal degree of hearing loss from low to high frequencies.

Question 33: Which cells in the organ of Corti convert mechanical vibration into electrical signals?

Goblet cells
Hair cells (Correct answer)
Schwann cells
Osteocytes

Correct answer: Hair cells

Hair cells bend their stereocilia in response to vibration and trigger nerve impulses.

Question 34: Speech audiometry primarily evaluates a person's ability to do what?

Balance on one foot
Hear and understand spoken words (Correct answer)
Smell faint odors
See small print

Correct answer: Hear and understand spoken words

Speech audiometry measures word recognition and the softest level at which speech is understood.

Question 35: What is the main purpose of bone conduction testing in an audiological evaluation?

To evaluate the acoustic reflex pathway
To measure how well sound travels through the outer ear canal
To determine the patient's most comfortable listening level
To bypass the outer and middle ear and directly stimulate the cochlea (Correct answer)

Correct answer: To bypass the outer and middle ear and directly stimulate the cochlea

Bone conduction testing uses a vibrating device placed on the mastoid bone or forehead to bypass the outer and middle ear, directly stimulating the cochlea to isolate sensorineural function.

Question 36: Which three tiny bones in the middle ear amplify sound vibrations?

Anvil, hammer, and cochlea
Cochlea, pinna, and tragus
Malleus, incus, and stapes (Correct answer)
Femur, tibia, and fibula

Correct answer: Malleus, incus, and stapes

The malleus, incus, and stapes (hammer, anvil, stirrup) transmit and amplify vibrations to the inner ear.

Question 37: Which strategy involves alerting a communication partner to the specific nature of your hearing difficulty before a conversation begins?

Anticipatory disclosure (Correct answer)
Clarification request
Avoidance strategy
Repair strategy

Correct answer: Anticipatory disclosure

Anticipatory disclosure means proactively informing a communication partner about your hearing loss and specific needs before problems arise, improving communication effectiveness.

Question 38: Which test measures how well the eardrum moves in response to air pressure?

Speech recognition test
Pure-tone audiometry
Weber test
Tympanometry (Correct answer)

Correct answer: Tympanometry

Tympanometry evaluates middle ear function by measuring eardrum mobility under varying pressure.

Question 39: Assertive communication for people with hearing loss includes:

Avoiding all social situations
Pretending to understand when you don't
Disclosing hearing loss and requesting specific accommodations from others (Correct answer)
Depending entirely on hearing aids

Correct answer: Disclosing hearing loss and requesting specific accommodations from others

Assertive communication involves honestly disclosing hearing loss to others and clearly requesting specific accommodations such as face-to-face conversation, slower speech, or reduced background noise.

Question 40: Ototoxic hearing loss is caused by which factor?

Ear infections
Loud noise
Certain medications or chemicals (Correct answer)
Aging

Correct answer: Certain medications or chemicals

Ototoxic hearing loss results from exposure to substances such as certain antibiotics, chemotherapy drugs, or industrial chemicals that damage the inner ear.

Question 41: Sudden sensorineural hearing loss (SSHL) is defined as hearing loss of at least how many decibels over 72 hours?

50 dB
10 dB
30 dB (Correct answer)
20 dB

Correct answer: 30 dB

SSHL is clinically defined as a rapid hearing loss of 30 dB or more affecting at least three consecutive audiometric frequencies within 72 hours.

Question 42: Bilateral cochlear implantation provides which primary benefit over unilateral implantation?

Greater battery life
Reduced surgery time
Improved sound localization and speech understanding in noise (Correct answer)
Lower cost

Correct answer: Improved sound localization and speech understanding in noise

Two cochlear implants provide binaural hearing cues that improve the ability to localize the direction of sounds and understand speech in noisy environments compared to a single implant.

Question 43: Acquired hearing loss differs from congenital hearing loss in that it occurs:

Only from genetic causes
Only from noise exposure
After birth, at any age (Correct answer)
Only in children

Correct answer: After birth, at any age

Acquired hearing loss develops after birth and can occur at any age due to factors such as noise exposure, illness, medications, or aging.

Question 44: Which part of the ear converts sound vibrations into electrical nerve signals?

The cochlea (Correct answer)
The pinna
The eardrum
The eustachian tube

Correct answer: The cochlea

The cochlea contains hair cells that transform fluid vibrations into nerve impulses sent to the brain.

Question 45: Between the _ and the __, the cochlea's basilar membrane can be found.

scala vestibule; scala tympani
scala vestibule; scala media
scala tympani; scala media (Correct answer)

Correct answer: scala tympani; scala media

Within the cochlea, the basilar membrane is a crucial structure that supports the organ of Corti. It is situated between the scala tympani and the scala media. Vibrations transmitted through the fluid cause the basilar membrane to move, which in turn stimulates the hair cells in the organ of Corti.

Question 46: What is a practical way to protect children's hearing when using headphones?

Share earbuds during illness
Use volume-limiting headphones (Correct answer)
Always set volume to maximum
Use headphones only underwater

Correct answer: Use volume-limiting headphones

Volume-limiting headphones cap output at safer decibel levels to protect developing ears.

Question 47: Auditory Neuropathy Spectrum Disorder (ANSD) is characterized by which combination of test findings?

Absent OAEs and normal ABR
Normal OAEs and normal ABR with elevated pure-tone thresholds
Present OAEs and absent or severely abnormal ABR (Correct answer)
Absent OAEs and absent ABR

Correct answer: Present OAEs and absent or severely abnormal ABR

ANSD is defined by the presence of OAEs (indicating intact outer hair cells) combined with an absent or severely distorted ABR, suggesting disrupted neural synchrony rather than cochlear hair cell damage.

Question 48: Acoustic neuroma (vestibular schwannoma) is a benign tumor that grows on which nerve?

The glossopharyngeal nerve
The vestibulocochlear nerve (cranial nerve VIII) (Correct answer)
The trigeminal nerve
The facial nerve

Correct answer: The vestibulocochlear nerve (cranial nerve VIII)

Acoustic neuromas (vestibular schwannomas) grow on the vestibulocochlear nerve (CN VIII), typically on the vestibular branch, causing progressive unilateral sensorineural hearing loss, tinnitus, and balance problems.

Question 49: A cochlear implant is contraindicated in patients who have which condition?

Tinnitus
Age over 65
Absence of cochlear nerve (cochlear nerve aplasia) (Correct answer)
Sensorineural hearing loss

Correct answer: Absence of cochlear nerve (cochlear nerve aplasia)

Absence of a functional cochlear nerve is a contraindication because the implant's electrodes stimulate the auditory nerve; without a nerve to stimulate, the implant cannot convey sound information.

Question 50: The noise reduction rating (NRR) on hearing protection devices represents:

The number of hours the device can be worn safely
The cost rating of the device
An estimate of the noise reduction the device provides in decibels under ideal conditions (Correct answer)
The maximum noise level the device can block completely

Correct answer: An estimate of the noise reduction the device provides in decibels under ideal conditions

The NRR is a measure of the noise reduction provided by a hearing protection device under ideal laboratory conditions; real-world protection is typically lower.

Question 51: Which approach to aural rehabilitation focuses on improving speech perception through structured auditory training exercises?

Auditory training therapy (Correct answer)
Tinnitus retraining therapy
Cognitive behavioral therapy
Vestibular rehabilitation

Correct answer: Auditory training therapy

Auditory training involves systematic exercises to improve the brain's ability to process and interpret sounds, especially speech, often used alongside hearing aid fitting.

Question 52: The eustachian tube helps equalize pressure between the middle ear and which area?

The outer ear canal
The cochlea
The brain
The throat (nasopharynx) (Correct answer)

Correct answer: The throat (nasopharynx)

The eustachian tube connects the middle ear to the nasopharynx to balance air pressure.

Question 53: Which inner ear structures are responsible for detecting linear acceleration and gravity?

Utricle and saccule (Correct answer)
Cochlea
Semicircular canals
Ossicles

Correct answer: Utricle and saccule

The utricle and saccule (otolith organs) sense linear movement and head tilt.

Question 54: The term 'residual hearing preservation' in cochlear implant surgery refers to:

Keeping the device turned off to preserve batteries
Surgical techniques designed to minimize trauma to cochlear structures so remaining acoustic hearing is maintained (Correct answer)
Preserving the hearing in the non-implanted ear
Retaining the ability to use hearing aids after surgery

Correct answer: Surgical techniques designed to minimize trauma to cochlear structures so remaining acoustic hearing is maintained

Residual hearing preservation involves using thin, flexible electrodes and careful surgical technique to minimize cochlear trauma, allowing patients to retain their existing low-frequency acoustic hearing post-implantation.

Question 55: Which test is typically used in newborn hearing screening programs?

Tympanometry
Pure tone audiometry
Speech recognition testing
Otoacoustic emissions (OAE) and/or auditory brainstem response (ABR) (Correct answer)

Correct answer: Otoacoustic emissions (OAE) and/or auditory brainstem response (ABR)

OAE and ABR tests are used in newborn screening because they are objective, non-invasive, and can be performed on sleeping infants without requiring a behavioral response.

Question 56: What does tympanometry primarily assess?

Hair cell function in the cochlea
Mobility of the tympanic membrane and middle ear pressure (Correct answer)
Speech recognition ability in noise
Auditory nerve conduction speed

Correct answer: Mobility of the tympanic membrane and middle ear pressure

Tympanometry measures how the eardrum (tympanic membrane) moves in response to changes in air pressure, providing information about middle ear pressure, fluid, and ossicular chain integrity.

Question 57: Otitis media is also influenced by the adenoids.

Sometimes
False
True (Correct answer)

Correct answer: True

Adenoids are lymphoid tissues located in the nasopharynx, close to the opening of the Eustachian tubes. When these adenoids become enlarged or inflamed, they can obstruct the Eustachian tubes, preventing proper ventilation and drainage of the middle ear. This blockage significantly increases the risk of fluid accumulation and subsequent middle ear infections (otitis media).

Question 58: The stapes is attached to one side of the oval window, while the cochlea's _________ is attached to the other.

scala media
scala tympani
scala vestibuli (Correct answer)

Correct answer: scala vestibuli

The stapes, the innermost ossicle, is attached to the oval window, which is the entry point to the inner ear. On the other side of the oval window, within the cochlea, lies the scala vestibuli. The stapes pushes against the perilymph fluid in the scala vestibuli, initiating the pressure wave that travels through the cochlea.

Question 59: At roughly what sound level (in decibels) can prolonged exposure begin to damage hearing?

85 dB and above (Correct answer)
200 dB only
30 dB and above
10 dB and above

Correct answer: 85 dB and above

Sustained exposure to sounds at or above about 85 decibels can gradually harm the inner ear.

Question 60: An audiologist fitting hearing aids uses which prescription formula to determine appropriate amplification targets?

OSHA 1910.95
ANSI S3.22
DSL or NAL-NL2 (Correct answer)
IEC 60118

Correct answer: DSL or NAL-NL2

DSL (Desired Sensation Level) and NAL-NL2 (National Acoustic Laboratories) are evidence-based prescription formulas used to calculate recommended hearing aid amplification targets based on audiometric thresholds.

Question 61: What does an 'air-bone gap' on an audiogram indicate?

Sensorineural hearing loss only
A difference between air and bone conduction thresholds suggesting a conductive component (Correct answer)
A problem limited to the cochlea
Normal middle ear function

Correct answer: A difference between air and bone conduction thresholds suggesting a conductive component

An air-bone gap exists when air conduction thresholds are poorer than bone conduction thresholds by 10 dB or more, indicating a conductive component (outer or middle ear problem) is present.

Question 62: Otosclerosis causes conductive hearing loss by affecting which structure?

The auditory nerve
The stapes footplate fixation (Correct answer)
Cochlear hair cells
The pinna

Correct answer: The stapes footplate fixation

In otosclerosis, abnormal bone growth fixes the stapes at the oval window, blocking vibration transfer.

Question 63: Ear protection should be double-plugged (wearing both earplugs and earmuffs) when noise exposure exceeds approximately:

105 dBA (Correct answer)
90 dBA
100 dBA
85 dBA

Correct answer: 105 dBA

Double protection (combining earplugs and earmuffs) is recommended when noise levels exceed 105 dBA, as single protection may be insufficient at extremely high noise levels.

Question 64: The basilar membrane responds to high-frequency sounds most strongly at which location?

Apex of the cochlea
Helicotrema
Base of the cochlea (Correct answer)
Round window

Correct answer: Base of the cochlea

The stiff, narrow base of the cochlea is tuned to high frequencies (tonotopic organization).

Question 65: Which cranial nerve carries auditory information to the brain?

Facial (VII)
Vestibulocochlear (VIII) (Correct answer)
Glossopharyngeal (IX)
Trigeminal (V)

Correct answer: Vestibulocochlear (VIII)

The cochlear branch of the vestibulocochlear nerve (CN VIII) transmits sound signals to the brainstem.

Question 66: Presbycusis, the age-related hearing loss, most commonly first affects:

Low frequencies
Only the left ear
High frequencies (Correct answer)
Bone conduction only

Correct answer: High frequencies

Presbycusis typically begins with loss of high-frequency hearing due to hair cell deterioration at the cochlear base.

Question 67: The safe listening time at 100 dB exposure according to WHO guidelines is approximately:

8 hours
15 minutes (Correct answer)
1 hour
4 hours

Correct answer: 15 minutes

At 100 dB, safe listening time is approximately 15 minutes per day according to WHO guidelines, as louder sounds require exponentially shorter exposure times.

Question 68: American Sign Language (ASL) is classified as:

An international sign system
A form of finger spelling only
A fully developed natural language with its own grammar, syntax, and vocabulary (Correct answer)
A simplified version of English grammar

Correct answer: A fully developed natural language with its own grammar, syntax, and vocabulary

ASL is a complete, natural language with its own distinct grammar and syntax that differs significantly from English, used primarily by the Deaf community in the United States and Canada.

Question 69: Which structure of the inner ear is responsible for converting sound vibrations into nerve signals?

The eustachian tube
The pinna
The cochlea (Correct answer)
The eardrum

Correct answer: The cochlea

The cochlea transforms mechanical sound vibrations into electrical signals sent to the brain.

Question 70: What is the primary goal of auditory brainstem implants (ABIs)?

To replace damaged eardrums
To provide hearing sensation to patients without a functional cochlear nerve by stimulating the brainstem (Correct answer)
To amplify residual hearing
To treat middle ear disorders

Correct answer: To provide hearing sensation to patients without a functional cochlear nerve by stimulating the brainstem

ABIs bypass both the cochlea and auditory nerve, electrically stimulating the cochlear nucleus in the brainstem, providing hearing sensation to patients who are not cochlear implant candidates due to absent or non-functional auditory nerves.

Question 71: Why is 'masking' used during audiological testing?

To calibrate the audiometer before testing begins
To reduce the patient's anxiety during testing
To prevent the non-test ear from responding to stimuli intended for the test ear (Correct answer)
To enhance the test ear's sensitivity to pure tones

Correct answer: To prevent the non-test ear from responding to stimuli intended for the test ear

Masking introduces a noise stimulus into the non-test ear to prevent it from detecting sounds meant for the test ear via cross-hearing (sound crossing the skull), ensuring accurate threshold measurements.

Question 72: Tympanoplasty is a surgical procedure that repairs which structure?

The auditory nerve
The eardrum (tympanic membrane) and/or ossicular chain (Correct answer)
The Eustachian tube
The cochlea

Correct answer: The eardrum (tympanic membrane) and/or ossicular chain

Tympanoplasty repairs perforations in the tympanic membrane and may also include reconstruction of the ossicular chain (ossiculoplasty) to restore hearing.

Question 73: Environmental manipulation as a communication strategy refers to:

Switching between hearing devices
Adjusting hearing aid settings remotely
Modifying the physical setting to improve listening conditions (e.g., reducing background noise, improving lighting) (Correct answer)
Changing one's attitude toward hearing loss

Correct answer: Modifying the physical setting to improve listening conditions (e.g., reducing background noise, improving lighting)

Environmental manipulation involves taking steps to optimize listening conditions, such as moving to a quieter location, sitting with back to noise, or improving lighting for speechreading.

Question 74: Cued Speech is a visual communication system that uses:

Handshapes near the mouth to differentiate sounds that look alike on the lips (Correct answer)
Written cards held up during conversation
Only hand signs representing concepts
Facial expressions alone

Correct answer: Handshapes near the mouth to differentiate sounds that look alike on the lips

Cued Speech uses eight handshapes in four positions near the mouth to make all English phonemes visually distinct, supplementing speechreading.

Question 75: Which vitamin or mineral deficiency has been linked to increased risk of hearing problems?

Folate (vitamin B9) (Correct answer)
Surplus calcium
Too much sodium only
Excess vitamin A

Correct answer: Folate (vitamin B9)

Low folate levels have been associated with a higher risk of age-related hearing loss in studies.

Question 76: What frequency range is routinely tested in a standard clinical audiogram?

20 Hz to 20,000 Hz
125 Hz to 4,000 Hz
500 Hz to 6,000 Hz
250 Hz to 8,000 Hz (Correct answer)

Correct answer: 250 Hz to 8,000 Hz

A standard clinical audiogram tests pure-tone thresholds from 250 Hz to 8,000 Hz, as this range encompasses the frequencies most critical for speech understanding and everyday listening.

Question 77: What is the main purpose of the ossicles' lever action and area ratio?

Reducing sound to protect the brain
Filtering out low frequencies
Amplifying and matching impedance to fluid (Correct answer)
Generating earwax

Correct answer: Amplifying and matching impedance to fluid

The ossicles boost sound pressure to overcome the impedance of inner ear fluid.

Question 78: Chronic middle ear infections (otitis media) can lead to which type of hearing loss?

Profound sensorineural loss only
Conductive hearing loss (Correct answer)
Central auditory processing disorder
No hearing loss at all

Correct answer: Conductive hearing loss

Fluid and inflammation from otitis media impair sound conduction through the middle ear.

Question 79: Anticipatory strategies in communication involve:

Preparing ahead of time by learning vocabulary and context for upcoming conversations (Correct answer)
Avoiding difficult listening situations
Waiting passively for others to speak clearly
Asking for captions at all times

Correct answer: Preparing ahead of time by learning vocabulary and context for upcoming conversations

Anticipatory strategies involve preparing before communication by researching topics, reading agendas, or asking to receive materials in advance to improve comprehension.

Question 80: Which three tiny bones make up the ossicular chain of the middle ear?

Hammer, cochlea, anvil
Cochlea, utricle, saccule
Malleus, incus, stapes (Correct answer)
Stapes, pinna, tragus

Correct answer: Malleus, incus, stapes

The malleus, incus, and stapes form the ossicular chain that conducts vibrations.

Question 81: Word Recognition Score (WRS) testing measures a patient's ability to:

Understand sentences in background noise
Detect speech at threshold in quiet conditions
Correctly repeat a list of phonetically balanced monosyllabic words presented at a comfortable level (Correct answer)
Recognize words using only visual cues (lip reading)

Correct answer: Correctly repeat a list of phonetically balanced monosyllabic words presented at a comfortable level

The WRS (also called speech discrimination score) presents phonetically balanced monosyllabic words at a suprathreshold level to assess clarity of hearing, not just loudness.

Question 82: What does the term 'tinnitus' refer to?

Loss of balance only
A type of hearing aid
Inflammation of the throat
Ringing or buzzing in the ears (Correct answer)

Correct answer: Ringing or buzzing in the ears

Tinnitus is the perception of sound, such as ringing or buzzing, without an external source.

Question 83: Auricle is a component of

Heart
Inner ear
Outer ear (Correct answer)
Middle ear

Correct answer: Outer ear

The auricle, also known as the pinna, is the visible, external part of the ear. It is a component of the outer ear, responsible for collecting sound waves from the environment and directing them into the ear canal towards the tympanic membrane.

Question 84: Which of the following is damaged by an inner ear infection in a patient?

cochlea (Correct answer)
ossicles
tympanic membrane

Correct answer: cochlea

The cochlea is the primary auditory organ located in the inner ear, responsible for converting sound vibrations into electrical signals. Infections of the inner ear, such as labyrinthitis, directly affect the cochlea and vestibular system, leading to symptoms like hearing loss and dizziness. The ossicles and tympanic membrane are part of the middle ear.

Question 85: The Pure Tone Average (PTA) is calculated by averaging hearing thresholds at which three frequencies?

1000, 2000, and 4000 Hz
250, 500, and 1000 Hz
2000, 4000, and 8000 Hz
500, 1000, and 2000 Hz (Correct answer)

Correct answer: 500, 1000, and 2000 Hz

The classic PTA averages thresholds at 500, 1000, and 2000 Hz because these frequencies are most critical for understanding speech; the PTA should correlate closely with the SRT.

Question 86: Which surgical procedure is used to treat otosclerosis that has fixed the stapes bone?

Myringotomy
Stapedectomy or stapedotomy (Correct answer)
Tympanoplasty
Cochleostomy

Correct answer: Stapedectomy or stapedotomy

Stapedectomy (removing the stapes) or stapedotomy (creating a small hole in the stapes footplate) replaces the fixed stapes with a prosthesis, restoring sound conduction and improving conductive hearing loss.

Question 87: A cochlear implant differs from a hearing aid primarily in that it:

Bypasses damaged hair cells and directly stimulates the auditory nerve with electrical signals (Correct answer)
Treats only conductive hearing loss
Is worn externally only
Amplifies sound mechanically

Correct answer: Bypasses damaged hair cells and directly stimulates the auditory nerve with electrical signals

Unlike hearing aids that amplify acoustic sound, cochlear implants bypass damaged cochlear hair cells and directly stimulate the auditory nerve via an electrode array inserted into the cochlea.

Question 88: Which of the following is not a component of the inner ear?

Cochlea
Tympanic membrane (Correct answer)
Semi circular canal
Vestibule

Correct answer: Tympanic membrane

The inner ear consists of the cochlea, vestibule, and semicircular canals, which are crucial for hearing and balance. The tympanic membrane, or eardrum, is located at the boundary between the outer ear and the middle ear, and therefore is not a component of the inner ear itself.

Question 89: Why are mammalian cochlear hair cells generally unable to regenerate after loss?

They do not divide once mature (Correct answer)
They are constantly replaced
They are made of bone
They lack a blood supply entirely

Correct answer: They do not divide once mature

Mature mammalian hair cells are post-mitotic and do not regenerate, making the loss permanent.

Question 90: According to OSHA regulations, employers are required to implement a hearing conservation program when employee noise exposure reaches:

100 dBA as an 8-hour time-weighted average
75 dBA as an 8-hour time-weighted average
95 dBA as an 8-hour time-weighted average
85 dBA as an 8-hour time-weighted average (Correct answer)

Correct answer: 85 dBA as an 8-hour time-weighted average

OSHA's Hearing Conservation Standard (29 CFR 1910.95) requires a hearing conservation program for workers exposed to noise at or above 85 dBA as an 8-hour TWA (the action level).

Question 91: According to ASHA guidelines, what dB HL threshold is generally considered the boundary of normal hearing for adults?

20 dB HL
25 dB HL (Correct answer)
30 dB HL
10 dB HL

Correct answer: 25 dB HL

ASHA defines normal hearing as thresholds of 0–25 dB HL; thresholds above 25 dB HL are considered indicative of hearing loss in adults.

Question 92: Which term describes the fatigue experienced by people with hearing loss from the extra cognitive effort required to understand speech?

Tinnitus-induced fatigue
Sensorineural fatigue
Peripheral auditory fatigue
Listening effort fatigue (Correct answer)

Correct answer: Listening effort fatigue

Listening effort fatigue (also called auditory fatigue or cognitive fatigue) occurs because people with hearing loss must expend significantly more cognitive resources to decode speech than those with normal hearing.

Question 93: A hearing aid's compression feature is designed to:

Physically compress the size of the device
Compress the frequency range to a narrower band
Increase battery efficiency
Reduce amplification for loud sounds while still amplifying soft sounds to a comfortable level (Correct answer)

Correct answer: Reduce amplification for loud sounds while still amplifying soft sounds to a comfortable level

Compression automatically adjusts the gain of a hearing aid to make soft sounds audible while preventing loud sounds from becoming uncomfortably amplified.

Question 94: What is the primary purpose of the Speech Recognition Threshold (SRT) test?

To assess auditory processing in the brainstem
To determine how well a patient understands speech in background noise
To measure the lowest intensity at which a patient can correctly identify 50% of spondee words (Correct answer)
To evaluate the patient's ability to discriminate between phonemes

Correct answer: To measure the lowest intensity at which a patient can correctly identify 50% of spondee words

The SRT is the lowest hearing level (dB HL) at which a patient can correctly repeat spondee (two-syllable, equal-stress) words 50% of the time, confirming pure-tone average results.

Question 95: What does an audiogram graphically display?

The shape and structure of the inner ear
The electrical activity of the auditory nerve
The pressure levels inside the middle ear
A person's hearing thresholds across different frequencies (Correct answer)

Correct answer: A person's hearing thresholds across different frequencies

An audiogram is a graph that plots a person's hearing thresholds (the softest sounds they can detect) at various test frequencies, typically from 250 Hz to 8000 Hz.

Question 96: Unilateral hearing loss means the person has hearing loss in how many ears?

One ear only (Correct answer)
Both ears equally
No ears
Both ears unequally

Correct answer: One ear only

Unilateral hearing loss refers to hearing loss in only one ear, while the other ear maintains normal or near-normal hearing.

Question 97: Which condition is characterized by abnormal bone growth in the middle ear causing conductive hearing loss?

Ménière's disease
Acoustic neuroma
Otitis media
Otosclerosis (Correct answer)

Correct answer: Otosclerosis

Otosclerosis is an abnormal bone remodeling disorder that typically affects the stapes, causing it to become fixed and unable to transmit sound properly.

Question 98: Which audiological test measures the brain's electrical response to sound and does not require a behavioral response from the patient?

Auditory Brainstem Response (ABR) (Correct answer)
Visual Reinforcement Audiometry (VRA)
Pure-tone audiometry
Speech discrimination testing

Correct answer: Auditory Brainstem Response (ABR)

The ABR records electrical potentials generated along the auditory pathway from the cochlea to the brainstem using scalp electrodes, requiring no voluntary response from the patient.

Question 99: Which of the following is specifically aided by having two ears?

The directional nature of sound (Correct answer)
Multiple noises occurring at once
Different sound kinds
The volume of the noises

Correct answer: The directional nature of sound

Having two ears (binaural hearing) is essential for sound localization, which is the ability to determine the direction from which a sound originates. The brain uses subtle differences in the arrival time and intensity of sound waves at each ear to pinpoint the sound source, providing a crucial sense of spatial awareness.

Question 100: Congenital hearing loss refers to hearing loss that is present at which time?

Due to noise exposure
Birth or shortly after (Correct answer)
Adolescence
After age 65

Correct answer: Birth or shortly after

Congenital hearing loss is present at or shortly after birth and can be caused by genetic factors, infections during pregnancy, or birth complications.

Question 101: Directional microphone technology in hearing aids primarily helps users:

Focus on sounds coming from in front while reducing sounds from behind (Correct answer)
Hear sounds from all directions equally
Amplify only low-frequency sounds
Eliminate feedback

Correct answer: Focus on sounds coming from in front while reducing sounds from behind

Directional microphone systems improve speech understanding in noise by focusing amplification on sounds in front of the listener and attenuating noise coming from other directions.

Question 102: Reissner's membrane separates which two cochlear compartments?

Scala tympani and scala media
Scala vestibuli and scala tympani
Middle ear and inner ear
Scala vestibuli and scala media (Correct answer)

Correct answer: Scala vestibuli and scala media

Reissner's (vestibular) membrane divides the scala vestibuli from the scala media.

Question 103: After cochlear implant surgery, the device is typically activated (first turned on) after:

1 year post-surgery
2–4 weeks post-surgery to allow healing (Correct answer)
Immediately in the operating room
6 months post-surgery

Correct answer: 2–4 weeks post-surgery to allow healing

Cochlear implant activation is typically scheduled 2–4 weeks after surgery to allow the surgical site to heal before the external processor is fitted and programmed.

Question 104: Which everyday habit best protects against noise-induced hearing loss?

Avoiding all hearing tests
Wearing earplugs at loud venues (Correct answer)
Listening to music at maximum volume
Cleaning ears daily with swabs

Correct answer: Wearing earplugs at loud venues

Using earplugs or earmuffs in loud environments reduces the sound energy reaching the cochlea.

Question 105: Real Ear Measurement (REM) in hearing aid fitting verifies:

Cosmetic appearance of the device
Durability of the hearing aid
Actual amplification delivered to the eardrum in the patient's ear canal (Correct answer)
Battery life of the device

Correct answer: Actual amplification delivered to the eardrum in the patient's ear canal

REM uses a probe microphone placed near the eardrum to verify that the hearing aid is delivering the prescribed amplification targets in the individual's unique ear canal.

Question 106: Meningitis can cause sensorineural hearing loss because the infection can damage which structure?

The cochlea and auditory nerve through inflammation and bacterial toxins (Correct answer)
The pinna
The eardrum
The ossicular chain

Correct answer: The cochlea and auditory nerve through inflammation and bacterial toxins

Bacterial meningitis can cause permanent sensorineural hearing loss by damaging the cochlea through direct bacterial invasion, toxin release, and inflammatory processes spreading from the meninges.

Question 107: Otoacoustic Emissions (OAE) testing is used primarily to assess which structure?

The tympanic membrane
The Eustachian tube
The outer hair cells of the cochlea (Correct answer)
The auditory cortex

Correct answer: The outer hair cells of the cochlea

OAEs are sounds generated by the outer hair cells (OHCs) of the cochlea in response to stimulation; absent OAEs indicate outer hair cell damage or dysfunction.

Question 108: Outer hair cells differ from inner hair cells mainly because they:

Send most signals to the brain
Amplify and sharpen cochlear vibrations (Correct answer)
Equalize pressure
Produce endolymph

Correct answer: Amplify and sharpen cochlear vibrations

Outer hair cells provide active amplification (the cochlear amplifier), while inner hair cells send most afferent signals.

Question 109: Which structure helps equalize pressure between the middle ear and the throat?

The cochlea
The ossicles
The eustachian tube (Correct answer)
The auditory nerve

Correct answer: The eustachian tube

The eustachian tube connects the middle ear to the back of the throat and balances air pressure.

Question 110: Hearing loss caused by untreated chronic otitis media (middle ear infections) in children is primarily which type?

Auditory neuropathy
Central auditory processing disorder
Temporary or fluctuating conductive hearing loss (Correct answer)
Permanent sensorineural hearing loss

Correct answer: Temporary or fluctuating conductive hearing loss

Chronic otitis media typically causes fluctuating or temporary conductive hearing loss due to middle ear fluid and pressure changes, though chronic untreated cases can occasionally lead to permanent damage.

Question 111: A blockage of the ear canal by impacted cerumen causes which type of hearing loss?

Conductive (Correct answer)
Sensorineural
Retrocochlear
Central

Correct answer: Conductive

Anything blocking sound transmission through the outer or middle ear produces conductive hearing loss.

Question 112: The occlusion effect in hearing aids refers to:

Sound distortion at high volumes
A hollow or booming quality in one's own voice caused by a blocked ear canal (Correct answer)
Feedback from the amplifier
Battery drain issues

Correct answer: A hollow or booming quality in one's own voice caused by a blocked ear canal

The occlusion effect occurs when a hearing aid or earmold blocks the ear canal, causing low-frequency bone-conducted sounds (like one's own voice) to resonate and sound hollow or boomy.

Question 113: High potassium concentration in endolymph is critical because it:

Lubricates the eardrum
Stiffens the ossicles
Drives hair cell depolarization (Correct answer)
Produces earwax

Correct answer: Drives hair cell depolarization

Potassium influx through opened stereocilia channels depolarizes hair cells to trigger signals.

Question 114: The semicircular canals primarily detect what type of motion?

Sound frequency
Air pressure
Rotational (angular) acceleration (Correct answer)
Linear acceleration

Correct answer: Rotational (angular) acceleration

The three semicircular canals sense angular acceleration as the head rotates.

Question 115: The acoustic (stapedius) reflex test measures:

Neural transmission speed from cochlea to cortex
Eustachian tube opening pressure
The contraction of the stapedius muscle in response to a loud sound (Correct answer)
Cochlear outer hair cell function at threshold

Correct answer: The contraction of the stapedius muscle in response to a loud sound

The acoustic reflex is an involuntary contraction of the stapedius muscle triggered by loud sounds (typically 70–100 dB above threshold), detected via changes in middle ear impedance.

Question 116: What is the sound frequency range of human can hear?

20Hz-20kHz (Correct answer)
200Hz-2kHz
20kHz
More than 20kHz

Correct answer: 20Hz-20kHz

The typical range of sound frequencies that a healthy human ear can perceive is from approximately 20 Hertz (Hz) to 20,000 Hertz (20 kHz). Frequencies below 20 Hz are infrasound, and those above 20 kHz are ultrasound, both generally inaudible to humans.

Question 117: How often should adults over 50 generally have their hearing checked if they notice no problems?

About every few years (Correct answer)
Every single week
Never, unless deaf
Only once in a lifetime

Correct answer: About every few years

Periodic screenings every few years help catch gradual hearing changes early in older adults.

Question 118: The hearing organ is thought to be the organ of Corti. What location is it in?

scala tympani
scala media (Correct answer)
scala vestibuli

Correct answer: scala media

The organ of Corti, often referred to as the 'hearing organ,' is located within the scala media (or cochlear duct) of the cochlea. This highly specialized structure contains the hair cells that are responsible for transducing mechanical sound vibrations into electrical signals that are sent to the brain for interpretation.

Question 119: FM systems used in classrooms work by:

Generating captions on a screen
Using vibration to convey sound
Transmitting the teacher's voice directly to the student's hearing device via radio frequency (Correct answer)
Amplifying all sounds in the room equally

Correct answer: Transmitting the teacher's voice directly to the student's hearing device via radio frequency

FM systems use radio frequency transmission to send the speaker's voice directly to the listener's hearing device, reducing the impact of distance and background noise.

Question 120: Custom-molded musician earplugs differ from standard foam earplugs in that they:

Block all sound completely
Are disposable and inexpensive
Only protect against very loud sounds
Attenuate all frequencies relatively equally to preserve sound quality and music fidelity (Correct answer)

Correct answer: Attenuate all frequencies relatively equally to preserve sound quality and music fidelity

Musician earplugs use specially designed filters to attenuate sound uniformly across frequencies, preserving the tonal quality of music while still reducing harmful volume levels.

Question 121: Universal Newborn Hearing Screening (UNHS) programs primarily use which two tests?

ABR and tympanometry
DPOAE and acoustic reflex testing
Pure-tone audiometry and SRT
OAE and ABR (or AABR) (Correct answer)

Correct answer: OAE and ABR (or AABR)

UNHS programs rely on OAE testing and Automated Auditory Brainstem Response (AABR) because both are objective, fast, and do not require behavioral responses from newborns.

Question 122: The main component of the ear affected by otitis media is the eustachian tube.

True (Correct answer)
Sometimes
False

Correct answer: True

The Eustachian tube is a critical component in the development of otitis media. Its primary function is to ventilate the middle ear and drain any fluid. When this tube becomes blocked due to inflammation or swelling, fluid gets trapped in the middle ear, creating a breeding ground for infection and inflammation characteristic of otitis media.

Question 123: In a noisy restaurant, a person with hearing loss would benefit MOST from which seating strategy?

Sitting with their back to the room noise and the speaker facing the light (Correct answer)
Sitting near the kitchen for sound signals
Sitting at the highest table available
Sitting in the center of the room

Correct answer: Sitting with their back to the room noise and the speaker facing the light

Positioning with back to the noise source and ensuring good lighting on the speaker's face optimizes both the signal-to-noise ratio and speechreading conditions.

Question 124: What is the primary function of the pinna (auricle)?

Amplifying nerve signals
Producing earwax
Collecting and funneling sound waves (Correct answer)
Maintaining balance

Correct answer: Collecting and funneling sound waves

The pinna gathers sound waves and directs them into the ear canal toward the eardrum.

Question 125: Which vaccination prevents a major infectious cause of congenital hearing loss in the US?

Influenza vaccine
Hepatitis B vaccine
Varicella vaccine
MMR (measles, mumps, rubella) vaccine (Correct answer)

Correct answer: MMR (measles, mumps, rubella) vaccine

The MMR vaccine prevents rubella (German measles), which when contracted during pregnancy can cause congenital rubella syndrome, including sensorineural hearing loss.

Question 126: The hierarchy of controls for occupational noise hazards places which control method as most effective?

Administrative controls (job rotation)
Warning signs
Personal protective equipment (PPE)
Engineering controls (noise source reduction) (Correct answer)

Correct answer: Engineering controls (noise source reduction)

Engineering controls are the most effective in the hierarchy, addressing noise at the source (e.g., quieter machinery, enclosures, vibration dampening) rather than relying on human behavior.

Question 127: Which communication mode involves using both speech and signing simultaneously?

Total communication / Simultaneous Communication (SimCom) (Correct answer)
Auditory-verbal therapy
Oral communication
Bilingual-bicultural approach

Correct answer: Total communication / Simultaneous Communication (SimCom)

Simultaneous Communication (SimCom), used within Total Communication approaches, involves using spoken language and a signed system at the same time.

Question 128: Distortion Product Otoacoustic Emissions (DPOAEs) differ from Transient Evoked OAEs (TEOAEs) primarily in that DPOAEs:

Can only be recorded in infants
Measure the brainstem response rather than cochlear function
Do not require any stimulus to be presented
Are elicited by two simultaneous pure tones rather than a click or tone burst (Correct answer)

Correct answer: Are elicited by two simultaneous pure tones rather than a click or tone burst

DPOAEs are generated when two simultaneous pure tones (f1 and f2) interact in the cochlea and produce a distortion product, allowing frequency-specific assessment of outer hair cell function.

Question 129: Which medication used in chemotherapy is known to be highly ototoxic and causes high-frequency hearing loss?

Ibuprofen
Cisplatin (Correct answer)
Amoxicillin
Metformin

Correct answer: Cisplatin

Cisplatin, a platinum-based chemotherapy drug, is highly ototoxic and causes permanent sensorineural hearing loss, particularly at high frequencies, in a significant percentage of patients.

Question 130: A behind-the-ear (BTE) hearing aid is typically recommended for which patient population?

Children and those with severe to profound hearing loss (Correct answer)
Patients with single-sided deafness only
Adults with mild hearing loss only
Adults who want the smallest device

Correct answer: Children and those with severe to profound hearing loss

BTE hearing aids are recommended for children because they can be reprogrammed as needs change, and for those with severe to profound hearing loss due to their greater amplification capacity.

NBC-HIS National Competency Exam (BC-HIS)

The National Competency Exam (NCE) assesses the practical knowledge and decision-making skills required to become a Board Certified Hearing Instrument Specialist, covering patient assessment, audiological testing, hearing instrument prescription, fitting and servicing, and counseling.

130

Questions

105 min

Time Limit

70%

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