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NBC-HIS CERTIFICATION EXAM (2025/2026)
National Board for Certification in Hearing Instrument Sciences
Total Questions: 200
Format: Multiple Choice
Passing Score: 80% (160 correct)
Time Limit: 4 hours
Section 1: Anatomy and Physiology of the Auditory System (Questions 1–35)
1. The tympanic membrane separates which two structures?
A) Outer ear and middle ear
B) Middle ear and inner ear
C) Cochlea and vestibule
D) Eustachian tube and pharynx
Answer: A
Rationale: The tympanic membrane (eardrum) forms the boundary between
the external auditory canal (outer ear) and the middle ear cavity. Sound
waves cause it to vibrate, transmitting energy to the ossicular chain.
,2. The ossicular chain consists of which three bones in correct order?
A) Malleus, incus, stapes
B) Incus, malleus, stapes
C) Stapes, incus, malleus
D) Malleus, stapes, incus
Answer: A
Rationale: The malleus (hammer) attaches to the tympanic membrane, the
incus (anvil) connects to the malleus, and the stapes (stirrup) attaches to the
oval window of the cochlea.
3. Which structure connects the middle ear to the nasopharynx?
A) Cochlea
B) Eustachian tube
C) Semicircular canals
D) Round window
Answer: B
Rationale: The Eustachian tube (auditory tube) equalizes pressure between
the middle ear and the atmosphere. Dysfunction can lead to middle ear
effusion and conductive hearing loss.
4. The organ of Corti is located within which structure?
A) Semicircular canals
B) Vestibule
C) Scala media (cochlear duct)
D) Scala vestibuli
Answer: C
Rationale: The organ of Corti, the sensory organ of hearing, rests on the
basilar membrane within the scala media (cochlear duct) of the cochlea. It
contains inner and outer hair cells.
5. Hair cells responsible for high-frequency hearing are located at which part
of the cochlea?
A) Apex
B) Helicotrema
,C) Base
D) Modiolus
Answer: C
Rationale: The cochlea is tonotopically organized. High frequencies are
processed at the base (near the oval window), while low frequencies are
processed at the apex. This is the basis of place theory.
6. The scala vestibuli and scala tympani are filled with which fluid?
A) Endolymph
B) Perilymph
C) Cerebrospinal fluid
D) Aqueous humor
Answer: B
Rationale: Perilymph, similar in composition to extracellular fluid, fills the
scala vestibuli and scala tympani. Endolymph (high in potassium) fills the
scala media.
7. Which cranial nerve is responsible for hearing?
A) CN VII (Facial)
B) CN V (Trigeminal)
C) CN VIII (Vestibulocochlear)
D) CN IX (Glossopharyngeal)
Answer: C
Rationale: The vestibulocochlear nerve (CN VIII) has two branches: the
cochlear nerve (hearing) and the vestibular nerve (balance). Damage can
cause sensorineural hearing loss and vertigo.
8. The pinna is composed primarily of which tissue?
A) Bone
B) Cartilage
C) Dense connective tissue
D) Fibrocartilage
Answer: B
, Rationale: The pinna (auricle) is made of elastic cartilage covered by skin. Its
shape helps collect sound and provides cues for sound localization.
9. What is the primary function of the stapedius muscle?
A) Amplify sound
B) Dampen loud sounds (acoustic reflex)
C) Equalize pressure
D) Drain the middle ear
Answer: B
Rationale: The stapedius muscle contracts in response to loud sounds
(acoustic reflex), pulling the stapes away from the oval window to reduce
sound transmission and protect the cochlea.
10. The round window is covered by which membrane?
A) Reissner's membrane
B) Basilar membrane
C) Secondary tympanic membrane
D) Tectorial membrane
Answer: C
Rationale: The round window is covered by the secondary tympanic
membrane, which bulges outward to allow fluid displacement within the
cochlea when the stapes pushes the oval window inward.
11. The normal range of human hearing in frequency (Hz) is:
A) 20 Hz – 20,000 Hz
B) 200 Hz – 2,000 Hz
C) 50 Hz – 10,000 Hz
D) 20 Hz – 40,000 Hz
Answer: A
*Rationale: The healthy human ear can detect frequencies from
approximately 20 Hz (low bass) to 20,000 Hz (high treble). Sensitivity is best
in the 500-4000 Hz range, which is critical for speech understanding*.
12. The frequency of a sound wave is perceived as which auditory quality?
A) Loudness