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The BC-A exam has 225 questions and runs 4 hours.
These 10 free BC-A questions are organized by exam domain, so you can see how each part of the Board Certified Audiologist blueprint is tested. Reveal the answer and explanation under each question.
Acoustic-reflex testing in an adult with normal pure-tone thresholds and tympanograms gives this pattern: Probe left: reflexes present with stimulation of either ear. Probe right: reflexes absent with stimulation of either ear. The pattern is reproducible with stable seals. Which part of the reflex arc is most likely impaired?
Correct answer: B - Right facial nerve stapedius motor pathway
During a free-field demonstration, a point-source talker produces 58 dB SPL at a listener 4 m away. Background noise measures 54 dB SPL at both 4 m and 2 m. On this listening task, the patient requires an SNR of at least +8 dB. The listener moves to 2 m while the talker's vocal output remains unchanged. What does the acoustic prediction indicate?
Correct answer: C - The SNR rises to approximately +10 dB, exceeding the task criterion by 2 dB.
For ear-specific right-ear air-conduction testing at 1,000 Hz, an 85-dB-HL tone will be presented through an insert earphone. The left-ear air-conduction threshold is 55 dB HL and its masked bone-conduction threshold is 10 dB HL. Use 60 dB of interaural attenuation for the insert earphones in this test. Which statement correctly addresses the risk of a crossover response?
Correct answer: D - Masking is needed because the 25-dB-HL crossover level exceeds the left-ear bone-conduction threshold.
Six weeks after bilateral tympanostomy-tube placement, a 6-year-old has no pain or drainage and air-conduction thresholds of 10-15 dB HL in both ears. Both tubes remain seated on otoscopy. The 226-Hz tympanograms are flat, with equivalent ear-canal volumes of 3.4 and 3.7 mL. Stable seals and repeated measurements exclude a probe leak. How should these findings be documented?
Correct answer: A - Findings consistent with patent tubes; continue the planned postoperative surveillance.
A 49-year-old describes a blocked left ear that began on awakening 36 hours ago after a cold. Otoscopy is clear and tympanograms are normal. Compared with an audiogram obtained two months earlier, left air- and masked bone-conduction thresholds have worsened by 40 dB at 1, 2, and 3 kHz, without an air-bone gap. There is no focal neurologic symptom. The patient already has an otology appointment in three weeks. How should the audiologist handle that interval?
Correct answer: A - Contact the otology service for urgent assessment today rather than wait for the scheduled visit.
A patient hears their own voice and footsteps unusually loudly in the left ear and experiences brief vertigo during loud sounds or straining. Audiometry shows a left low-frequency air-bone gap, including a masked bone-conduction threshold of -5 dB HL at 500 Hz. Otoscopy and tympanometry are normal, and acoustic reflexes are present. Which condition belongs at the top of the otologic differential?
Correct answer: C - Superior semicircular canal dehiscence
At a hearing-aid follow-up, a patient reports that quiet conversation is still difficult, although ordinary conversation and loud sounds are comfortable. Real-ear measurements show output 8 dB below the prescribed targets at 2-4 kHz for a 55-dB-SPL speech input. Responses to 65- and 80-dB-SPL inputs match their targets, and maximum output remains within measured comfort limits. Probe placement, acoustic coupling, and available gain are satisfactory. Which adjustment most directly addresses the remaining deficit?
Correct answer: C - Increase soft-input gain in the affected channels, then reverify responses at all three input levels.
A CROS user has an unaidable right ear and normal hearing in the left ear. The device helps when a talker is on the right. At a restaurant, however, speech arriving from the left becomes harder to understand when a loud group is seated on the right. Muting the right transmitter improves understanding without changing the receiver placement. Device checks are normal. Which advice addresses this specific difficulty?
Correct answer: D - Use the routing control selectively; transmitting right-sided noise can worsen this listening arrangement.
An audiologist reviews an unprotected work shift under the NIOSH recommendation of 85 dBA for 8 hours with a 3-dB exchange rate. Exposure consists of 2 hours at 88 dBA and 1.5 hours at 91 dBA; the remaining time contributes negligible dose. Which conclusion should guide the hearing-loss prevention plan?
Correct answer: D - The dose is 125%; the combined exposure warrants measures to reduce the daily noise dose.
A well-baby nursery infant passed the left ear but not the right ear during inpatient hearing screening and rescreening. At the single outpatient rescreening session at 3 weeks of age, the right ear passes and the left ear does not. Testing conditions and recording quality are satisfactory. The parents ask whether hearing is now cleared because each ear has passed at least once. What should happen next?
Correct answer: B - Arrange diagnostic audiology for both ears now, with completion by 3 months of age.
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