Audiologist Prometric exam questions with answers

1. Question 1Auditory and Vestibular Anatomy and Physiologymedium

   Which cells act as the cochlear amplifier through electromotility and generate otoacoustic emissions?

   1. AInner hair cells
   2. BOuter hair cells
   3. CSpiral ganglion cells
   4. DCells of the stria vascularis
   Show answer and explanation▾

   Answer: B. Outer hair cells

   Outer hair cells change length in response to stimulation through the motor protein prestin, amplifying basilar membrane motion; this activity produces OAEs. Inner hair cells are the main sensory receptors sending signals to the auditory nerve.

2. Question 2Electrophysiology and Otoacoustic Emissionshard

   In a neurodiagnostic ABR for asymmetric hearing loss, which finding most suggests a retrocochlear lesion?

   1. AAbsolute wave V latency of 5.6 ms in both ears
   2. BWave V amplitude larger than wave I
   3. CWave V present at 30 dB nHL
   4. DInteraural wave V latency difference above 0.4 ms
   Show answer and explanation▾

   Answer: D. Interaural wave V latency difference above 0.4 ms

   A prolonged interaural wave V latency difference, commonly above about 0.4 ms, raises suspicion of a retrocochlear lesion. A wave V latency of 5.6 ms in both ears at high intensity is within normal limits.

3. Question 3Electrophysiology and Otoacoustic Emissionsmedium

   A 4-month-old needs ear-specific hearing thresholds to fit hearing aids. Which test is most appropriate?

   1. AVisual reinforcement audiometry
   2. BConditioned play audiometry
   3. CSpeech recognition threshold
   4. DFrequency-specific tone-burst ABR
   Show answer and explanation▾

   Answer: D. Frequency-specific tone-burst ABR

   Frequency-specific ABR (or ASSR) estimates ear- and frequency-specific thresholds in infants too young for behavioural testing. VRA usually needs a developmental age of about 6 months or more.

4. Question 4Hearing Aids, Implants and Rehabilitationmedium

   A patient has a mixed loss with a chronically discharging mastoid cavity that prevents use of an air-conduction aid. Which device is most suitable?

   1. ACompletely-in-canal hearing aid
   2. BBone-anchored hearing device
   3. CCochlear implant
   4. DPersonal sound amplifier
   Show answer and explanation▾

   Answer: B. Bone-anchored hearing device

   Bone-anchored devices bypass the outer and middle ear and suit patients with chronic discharge or atresia who cannot wear an aid in the canal. A cochlear implant is for severe-to-profound sensorineural loss with poor aided benefit.

5. Question 5Pure-Tone Audiometry and Maskingeasy

   At 1000 Hz, a patient's air-conduction threshold is 45 dB HL and the masked bone-conduction threshold is 10 dB HL. How should this be described?

   1. ASensorineural loss of 45 dB
   2. BConductive loss, 35 dB air-bone gap
   3. CMixed loss with a 10 dB air-bone gap
   4. DNormal hearing at this test frequency
   Show answer and explanation▾

   Answer: B. Conductive loss, 35 dB air-bone gap

   Normal bone conduction with raised air conduction indicates a conductive loss, and the air-bone gap is 45 - 10 = 35 dB. A sensorineural loss would show bone thresholds close to air thresholds.

6. Question 6Hearing Disordersmedium

   A 50-year-old woke with a 40 dB sensorineural loss at 1, 2 and 4 kHz in one ear. Tympanometry is normal. What is the most appropriate action?

   1. AUrgent same-week ENT referral
   2. BRoutine hearing aid fitting
   3. CRepeat audiogram in 6 months
   4. DEar syringing and review
   Show answer and explanation▾

   Answer: A. Urgent same-week ENT referral

   A loss of 30 dB or more over three consecutive frequencies within 72 hours meets the definition of sudden sensorineural hearing loss, which needs urgent medical assessment and consideration of steroids. Delay reduces the chance of recovery.

7. Question 7Speech Audiometry and Immittancehard

   A patient has a right facial nerve palsy proximal to the stapedius branch, with normal hearing. Which acoustic reflex pattern is expected?

   1. AAbsent whenever the probe is in the right ear
   2. BAbsent whenever the right ear is stimulated
   3. CAbsent only with left contralateral stimulation
   4. DAll reflexes present and normal
   Show answer and explanation▾

   Answer: A. Absent whenever the probe is in the right ear

   The stapedius muscle contraction is measured in the probe ear, so a right efferent (facial nerve) lesion abolishes reflexes recorded from the right ear, whichever ear is stimulated. A pattern of absent reflexes whenever the right ear is stimulated indicates an afferent problem on that side.

8. Question 8Vestibular, Tinnitus, Infection Control and Ethicseasy

   How should foam insert earphone tips be managed between patients?

   1. ADiscard them after single use
   2. BWipe with a dry tissue and reuse
   3. CRinse in tap water and reuse
   4. DReuse for the same day only
   Show answer and explanation▾

   Answer: A. Discard them after single use

   Foam insert tips are single-use items that cannot be adequately cleaned and must be discarded after each patient. Wiping or rinsing does not decontaminate porous foam.

9. Question 9Paediatric Audiology and Newborn Screeningmedium

   Which behavioural test is most suitable for a typically developing 12-month-old?

   1. AConditioned play audiometry
   2. BConventional pure-tone audiometry
   3. CVisual reinforcement audiometry
   4. DSpeech recognition testing with word lists
   Show answer and explanation▾

   Answer: C. Visual reinforcement audiometry

   Visual reinforcement audiometry suits developmental ages from about 6 months to 2 years, using a head turn rewarded by a visual stimulus. Conditioned play audiometry usually needs a developmental age of about 2.5 years or more.

10. Question 10Pure-Tone Audiometry and Maskingmedium

    What minimum interaural attenuation is assumed for bone-conduction testing when deciding whether to mask?

    1. A40 dB
    2. B55 dB
    3. C0 dB
    4. D70 dB
    Show answer and explanation▾

    Answer: C. 0 dB

    A bone vibrator stimulates both cochleae almost equally, so interaural attenuation is taken as 0 dB and masking is needed whenever there is a meaningful air-bone gap in the test ear. The 40 dB value applies to supra-aural earphones.

11. Question 11Speech Audiometry and Immittancemedium

    A patient's pure-tone average is 15 dB HL in each ear, but the speech recognition threshold is 40 dB HL. What does this suggest?

    1. ATypical cochlear hearing loss
    2. BPossible non-organic hearing loss
    3. CRetrocochlear pathology
    4. DNormal test variability
    Show answer and explanation▾

    Answer: B. Possible non-organic hearing loss

    The SRT should agree with the pure-tone average within about 10 dB. A large mismatch, especially an SRT much worse than the PTA, raises suspicion of non-organic loss or test error.

12. Question 12Speech Audiometry and Immittancemedium

    A child with grommets has a flat tympanogram and an ear canal volume of 2.8 mL. What does this indicate?

    1. AThe grommet is blocked
    2. BMiddle ear effusion behind the tube
    3. CThe probe is against the canal wall
    4. DThe grommet is patent
    Show answer and explanation▾

    Answer: D. The grommet is patent

    A flat trace with a large ear canal volume means the probe is measuring both canal and middle ear space, which shows a patent grommet or perforation. A blocked tube would give a normal canal volume.

13. Question 13Speech Audiometry and Immittancemedium

    A 35-year-old with a conductive loss and a Carhart notch has a tympanogram with normal pressure but very low peak compliance. What type is this?

    1. AType Ad
    2. BType C
    3. CType B
    4. DType As
    Show answer and explanation▾

    Answer: D. Type As

    Type As has normal peak pressure with reduced compliance, consistent with a stiff system such as otosclerosis. Type Ad shows abnormally high compliance, seen with ossicular discontinuity.

14. Question 14Vestibular, Tinnitus, Infection Control and Ethicsmedium

    During the right Dix-Hallpike test, a patient has brief vertigo with upbeating, torsional nystagmus after a few seconds' delay. What is the treatment of choice?

    1. AEpley canalith repositioning manoeuvre
    2. BBrandt-Daroff exercises only
    3. CLong-term vestibular sedative drugs
    4. DLempert (barbecue) roll manoeuvre
    Show answer and explanation▾

    Answer: A. Epley canalith repositioning manoeuvre

    This is right posterior canal BPPV, best treated with the Epley manoeuvre. The Lempert roll manoeuvre is for horizontal canal BPPV.

15. Question 15Vestibular, Tinnitus, Infection Control and Ethicsmedium

    An adult with chronic, bothersome tinnitus asks which treatment has the strongest evidence for reducing distress. What should the audiologist advise?

    1. AOral antidepressants for all patients
    2. BIntratympanic steroid injection
    3. CCognitive behavioural therapy
    4. DGinkgo biloba supplements
    Show answer and explanation▾

    Answer: C. Cognitive behavioural therapy

    Cognitive behavioural therapy has the best evidence for reducing tinnitus distress and improving quality of life. Ginkgo biloba is not recommended, and antidepressants are not routinely recommended for tinnitus itself.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.