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According to the NCIHC National Code of Ethics, what is the healthcare interpreter's PRIMARY obligation during an interpreted encounter?

To render messages accurately and completely between parties

To explain medical concepts to the patient in simplified terms

To ensure the provider follows hospital policy

To advocate for the patient's preferred treatment

to track

2026 Statistics

Key Facts: CHI Exam

Languages Available

Spanish, Arabic, Mandarin

100

CoreCHI Questions

85 scored + 15 pretest

450/600

CoreCHI Passing Score

Scaled scoring system

$533

Total Exam Cost

Application + CoreCHI + CHI

12 months

CHI Exam Window

After passing CoreCHI

4 years

Certification Validity

Renewal required

CHI certification requires passing the CoreCHI written exam (100 MCQs, 450/600 to pass) plus the CHI bilingual oral performance exam within 12 months. CoreCHI tests 5 domains: Professional Responsibility & Ethics (23%), Managing the Interpreting Encounter (24%), Healthcare Terminology (25%), U.S. Health Systems (13%), and Cultural Responsiveness (15%). The CHI performance exam tests consecutive interpreting (70%), simultaneous interpreting (17%), sight translation (11%), and written translation (2%). Available in Spanish, Arabic, and Mandarin only. NCCA-accredited (CHI-Spanish since 2012).

Sample CHI Practice Questions

Try these sample questions to test your CHI exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the NCIHC National Code of Ethics, what is the healthcare interpreter's PRIMARY obligation during an interpreted encounter?

A.To render messages accurately and completely between parties

B.To explain medical concepts to the patient in simplified terms

C.To ensure the provider follows hospital policy

D.To advocate for the patient's preferred treatment

Explanation: The NCIHC National Code of Ethics identifies accuracy and completeness as the first and foremost ethical principle for healthcare interpreters. The interpreter must convey the meaning of all messages faithfully, without additions, omissions, or distortions. Advocacy, simplification, and policy enforcement are not the interpreter's primary role. Exam Tip: Accuracy is the cornerstone principle — when in doubt on ethics questions, the answer that preserves the original message is usually correct.

2A patient tells the interpreter in private that they are not taking their medication as prescribed but asks the interpreter not to tell the doctor. What should the interpreter do?

A.Keep the information confidential as the patient requested

B.Report the patient to the hospital compliance department

C.Inform the doctor privately after the session ends

D.Encourage the patient to share this information with the doctor during the encounter

Explanation: The interpreter should encourage the patient to disclose the information directly to the provider. The interpreter cannot act as an independent medical advisor or keep clinically relevant information from the provider, but should respect patient autonomy by encouraging voluntary disclosure rather than breaking confidence unilaterally. Exam Tip: The correct approach respects both confidentiality and patient safety — encourage the patient to speak, rather than speaking for them.

3Which mode of interpreting involves the interpreter rendering the message in the target language while the speaker is still talking?

A.Summarization

B.Consecutive interpreting

C.Simultaneous interpreting

D.Sight translation

Explanation: Simultaneous interpreting requires the interpreter to listen and speak at the same time, rendering the message in the target language while the source language speaker continues talking. Consecutive interpreting involves waiting for the speaker to pause before interpreting. Sight translation involves reading a written document aloud in the target language. Summarization is not a recognized professional interpreting mode. Exam Tip: The CHI performance exam tests consecutive (70%), simultaneous (17%), and sight translation (11%) — know the definitions of each mode.

4During a medical appointment, the provider uses the term 'myocardial infarction.' The patient's language does not have a direct medical equivalent. What is the interpreter's BEST approach?

A.Interpret the concept using a culturally appropriate explanation that preserves the medical meaning

B.Ask the provider to use a simpler term

C.Skip the term and continue interpreting

D.Use the English term and move on

Explanation: When a direct equivalent does not exist in the target language, the interpreter should convey the concept accurately using a culturally and linguistically appropriate explanation that preserves the medical meaning. Skipping or using the English term would leave the patient uninformed. While asking the provider to simplify is acceptable in some situations, the interpreter should first attempt to convey the concept. Exam Tip: Healthcare terminology questions often test your ability to manage terms without direct equivalents — concept interpretation is the preferred strategy.

5What does HIPAA stand for, and why is it relevant to healthcare interpreters?

A.Healthcare Interpreter Professional Accountability Act — it certifies medical interpreters

B.Health Information Processing and Access Act — it regulates electronic health records

C.Health Insurance Portability and Accountability Act — it governs patient privacy and confidentiality of health information

D.Hospital Interpreting Policies and Accreditation Act — it sets standards for interpreter services

Explanation: HIPAA (Health Insurance Portability and Accountability Act) establishes national standards for protecting patient health information. Healthcare interpreters have access to protected health information (PHI) during encounters and must comply with HIPAA's confidentiality requirements. Interpreters should never disclose patient information outside the professional context. Exam Tip: HIPAA is a frequently tested topic — remember that interpreters are bound by the same confidentiality standards as other healthcare team members.

6A healthcare interpreter notices that a provider is not making eye contact with the patient and is only addressing the interpreter. What should the interpreter do?

A.Politely remind the provider to speak directly to the patient

B.Stop interpreting until the provider corrects the behavior

C.Tell the patient that the provider is being rude

D.Continue interpreting without addressing the issue

Explanation: The interpreter should manage the communication dynamics of the encounter by politely reminding the provider to speak directly to the patient. This is part of the interpreter's role in managing the interpreting encounter. The interpreter should not ignore the issue, make judgments about the provider's behavior, or refuse to interpret. Exam Tip: Managing the flow of communication is a key competency — interpreters facilitate direct provider-patient interaction.

7Which organization developed the National Standards of Practice for Interpreters in Health Care, published in 2005?

A.JCAHO (Joint Commission on Accreditation of Healthcare Organizations)

B.AMA (American Medical Association)

C.NCIHC (National Council on Interpreting in Health Care)

D.CCHI (Certification Commission for Healthcare Interpreters)

Explanation: The National Council on Interpreting in Health Care (NCIHC) developed and published the National Standards of Practice for Interpreters in Health Care in 2005, following the publication of the National Code of Ethics in 2004. CCHI was founded in 2009 to administer certification exams. The AMA and Joint Commission are healthcare organizations but did not develop interpreter-specific standards. Exam Tip: Know the difference between NCIHC (ethics/standards development) and CCHI (certification administration).

8An interpreter is assigned to interpret for a patient who is a close family friend. What is the MOST appropriate action?

A.Interpret but avoid eye contact with the patient to maintain professionalism

B.Decline the assignment and request a different interpreter

C.Ask the patient's permission before proceeding

D.Proceed with the assignment since you know the patient well

Explanation: The interpreter should decline the assignment due to a conflict of interest. A personal relationship with the patient can compromise the interpreter's objectivity, impartiality, and the patient's willingness to share sensitive health information. The NCIHC Code of Ethics addresses impartiality and professional boundaries. Exam Tip: Any pre-existing personal relationship is a potential conflict of interest — the safest course is to recuse yourself.

9During consecutive interpreting, a provider delivers a lengthy explanation lasting over three minutes without pausing. What should the interpreter do?

A.Summarize the key points rather than interpreting verbatim

B.Signal the patient that the information will be provided later

C.Interrupt politely and ask the provider to pause so the message can be interpreted accurately

D.Wait until the provider finishes and attempt to interpret everything from memory

Explanation: The interpreter should politely intervene and ask the provider to pause at regular intervals so the message can be interpreted accurately and completely. Waiting too long risks loss of information, and summarizing is not an acceptable interpreting practice as it violates the principle of accuracy and completeness. Exam Tip: Consecutive interpreting requires manageable segments — the interpreter is responsible for managing the flow of communication.

10What is 'sight translation' in the context of healthcare interpreting?

A.Reading a written document in one language and orally rendering it in another language

B.Translating a document from one written language to another written language

C.Providing a written summary of an interpreted encounter

D.Interpreting what the patient appears to mean based on visual cues

Explanation: Sight translation involves the interpreter reading a written document in the source language and orally rendering it in the target language. This is commonly used for consent forms, discharge instructions, and medication labels. It differs from written translation (written-to-written) and from consecutive/simultaneous interpreting (oral-to-oral). Exam Tip: Sight translation accounts for approximately 11% of the CHI performance exam — practice reading documents aloud in the target language.

About the CHI Exam

The CHI (Certified Healthcare Interpreter) is CCHI's bilingual performance certification for healthcare interpreters of Spanish, Arabic, and Mandarin. It requires passing two exams: the CoreCHI knowledge exam (100 multiple-choice questions) and the CHI bilingual performance exam testing consecutive interpreting, simultaneous interpreting, sight translation, and written translation skills.

Questions

100 scored questions

Time Limit

2 hours (CoreCHI written); varies (CHI oral performance)

Passing Score

450/600 scaled score (CoreCHI)

Exam Fee

$40 application + $191 CoreCHI + $302 CHI performance (CCHI (Certification Commission for Healthcare Interpreters))

CHI Exam Content Outline

23%

Professional Responsibility and Interpreter Ethics

Codes of ethics, standards of practice, ethical dilemmas, scope of practice, confidentiality, impartiality, role boundaries, and professional development

24%

Managing the Interpreting Encounter

Communication protocols, interpreting modes, managing flow, pre-session/post-session briefings, self-monitoring, and transparency

25%

Healthcare Terminology

Medical prefixes/suffixes, body systems, pharmacology terms, surgical terminology, abbreviations, and terminology management strategies

13%

U.S. Health Systems

Title VI, Executive Order 13166, HIPAA, Medicare/Medicaid, language access laws, LEP rights, and healthcare organizational structures

15%

Cultural Responsiveness

Cultural mediation, cultural humility, culture-bound syndromes, health beliefs, and culturally responsive interpreting practices

How to Pass the CHI Exam

What You Need to Know

Passing score: 450/600 scaled score (CoreCHI)
Exam length: 100 questions
Time limit: 2 hours (CoreCHI written); varies (CHI oral performance)
Exam fee: $40 application + $191 CoreCHI + $302 CHI performance

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CHI Study Tips from Top Performers

1Master the NCIHC Code of Ethics 9 principles — they are the framework for all ethics questions on the CoreCHI exam

2Build healthcare terminology vocabulary systematically — learn prefixes, suffixes, and root words rather than memorizing individual terms

3Practice scenario-based ethical decision-making — most CoreCHI questions present real-world situations requiring critical thinking

4Study U.S. healthcare system basics including Title VI, Executive Order 13166, HIPAA, and Medicare/Medicaid

5For the CHI performance exam, practice consecutive interpreting with medical dialogues in both directions

6Practice sight translation by reading English medical documents aloud in your target language

Frequently Asked Questions

What is the CHI certification?

The CHI (Certified Healthcare Interpreter) is CCHI's language-specific bilingual performance certification for healthcare interpreters of Spanish, Arabic, and Mandarin. It requires passing two exams: the CoreCHI written knowledge exam (100 multiple-choice questions in English) and the CHI bilingual performance exam. The CHI-Spanish certification has been NCCA-accredited since 2012.

What are the eligibility requirements for CHI certification?

To be eligible for CHI certification, you must: be at least 18 years old, have a U.S. high school diploma (or equivalent), complete at least 40 hours of healthcare interpreter training, and demonstrate dual language proficiency in English and your target language (Spanish, Arabic, or Mandarin). You must also pay a $40 application fee.

What is tested on the CoreCHI exam?

The CoreCHI is a 100-question multiple-choice exam in English covering 5 domains: Professional Responsibility and Interpreter Ethics (23%), Managing the Interpreting Encounter (24%), Healthcare Terminology (25%), U.S. Health Systems (13%), and Cultural Responsiveness (15%). Of the 100 questions, 85 are scored and 15 are unscored pretest items. The passing scaled score is 450 out of 600.

What is tested on the CHI performance exam?

The CHI performance exam is a bilingual oral exam testing healthcare interpreting skills in Spanish, Arabic, or Mandarin. It contains 8 items across 4 domains: Consecutive Interpreting (70%), Simultaneous Interpreting (17%), Sight Translation (11%), and Written Translation (2%). Items include bi-directional healthcare conversations, monolingual simultaneous passages, sight translation of English documents, and written translation.

How long do I have to pass the CHI after passing CoreCHI?

You must take and pass the CHI bilingual performance exam within 12 months of passing the CoreCHI exam. If you do not pass within this timeframe, your CoreCHI score expires and you must retake the CoreCHI exam before attempting the CHI again.

How much does CHI certification cost in total?

The total cost for CHI certification is approximately $533: a $40 application fee, $191 for the CoreCHI exam, and $302 for the CHI performance exam. If you need to retake either exam, additional fees apply. Certification is valid for 4 years, with renewal requiring 32 hours of continuing education and a renewal fee.

What is the difference between CHI, CoreCHI, and CoreCHI-P?

CoreCHI is the knowledge-based certification (written exam only, available for all languages). CoreCHI-P adds a monolingual English-to-English (ETOE) performance component for interpreters of languages other than Spanish, Arabic, and Mandarin. CHI is the highest-level bilingual performance certification, available only for Spanish, Arabic, and Mandarin interpreters.

How should I prepare for the CoreCHI exam?

Focus on the five exam domains proportionally: Healthcare Terminology (25%), Managing the Interpreting Encounter (24%), Professional Responsibility and Interpreter Ethics (23%), Cultural Responsiveness (15%), and U.S. Health Systems (13%). Study the NCIHC Code of Ethics and Standards of Practice, build medical vocabulary, and practice scenario-based critical thinking. Use free practice questions to test your readiness.

How do I maintain my CHI certification?

CHI certification is valid for 4 years. To renew, you must complete 32 hours of continuing education in healthcare interpreting (minimum 4 hours performance-based), complete 40 hours of work experience as a medical interpreter, and pass an interactive ethics training. You must also pay a renewal fee.