A 64-year-old woman who has never had heart disease or a stroke asks whether she should start a daily low-dose aspirin to prevent them. What does the US Preventive Services Task Force recommend for adults 60 years or older?US Preventive Services Task Force, Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication, recommendation statement. Outline: NBME Ambulatory Care Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
A 68-year-old man with healthy eyes can see distant road signs clearly but must hold his newspaper at arm's length to read it. What is this common change of aging called?MedlinePlus Medical Encyclopedia, "Aging changes in the senses", Summary. Outline: NBME Ambulatory Care Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
A healthy 52-year-old woman asks whether she is old enough for the shingles vaccine. For which healthy adults is recombinant shingles vaccine recommended, and how is it given?MedlinePlus Medical Encyclopedia, "Recombinant zoster (shingles) vaccine - what you need to know", Information. Outline: NBME Ambulatory Care Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
A healthy 72-year-old man asks for a PSA blood test to screen for prostate cancer. What does the US Preventive Services Task Force recommend for men 70 years and older?US Preventive Services Task Force, Prostate Cancer: Screening, recommendation statement. Outline: NBME Ambulatory Care Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
Show all 50 questions (46 more)
Immune system 1
A 34-year-old woman tells her new physician that she is allergic to an antibiotic because it once gave her nausea. What is true of most side effects of medicines?MedlinePlus Medical Encyclopedia, "Drug allergies", Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Immune System.
Blood and lymphoreticular system 2
A 55-year-old man with long-term alcoholism who eats few vegetables is tired and pale. His blood count shows anemia with abnormally large red blood cells, and his vitamin B12 level is normal. Which deficiency is likely?MedlinePlus Medical Encyclopedia, "Folate-deficiency anemia", Causes. Outline: NBME Ambulatory Care Subject Exam content outline, Blood & Lymphoreticular System.
A 70-year-old woman with rheumatoid arthritis has a mild anemia, and anemia of chronic disease is diagnosed. What is true of treatment for this anemia?MedlinePlus Medical Encyclopedia, "Anemia of chronic disease", Summary; Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Blood & Lymphoreticular System.
Behavioral health 4
A 23-year-old man avoids meetings and parties because he fears being judged by others, and it is holding him back at work. Social anxiety disorder is diagnosed. Which treatment is often tried first?MedlinePlus Medical Encyclopedia, "Social anxiety disorder", Summary; Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Behavioral Health.
A 29-year-old woman who lives where winter nights are long has had a low mood each winter for 3 years, and it lifts every spring. Her physician prescribes light therapy. When is the treatment started?MedlinePlus Medical Encyclopedia, "Seasonal affective disorder", Summary; Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Behavioral Health.
A 38-year-old woman has worried about everyday matters on most days for a year, and generalized anxiety disorder is diagnosed. Besides talk therapy, which medicines, taken every day, may be very helpful?MedlinePlus Medical Encyclopedia, "Generalized anxiety disorder", Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Behavioral Health.
A 45-year-old man who smokes a pack a day has set a date to quit, and his physician prescribes bupropion. When should he start taking it?MedlinePlus Medical Encyclopedia, "Smoking cessation medications", Information. Outline: NBME Ambulatory Care Subject Exam content outline, Behavioral Health.
Nervous system and special senses 2
A 74-year-old woman has cloudy vision, difficulty seeing at night and trouble with glare from headlights. A cataract is found in each eye. What is the only treatment for a cataract?MedlinePlus Medical Encyclopedia, "Cataract - adult", Summary; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Nervous System & Special Senses.
A 77-year-old man has trouble hearing in noisy rooms and understanding people with higher-pitched voices, and it has slowly become worse. What causes age-related hearing loss?MedlinePlus Medical Encyclopedia, "Age-related hearing loss", Causes; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Nervous System & Special Senses.
Skin 4
A 35-year-old man has thick, red, well-defined patches of skin with flaky, silver-white scales. Psoriasis is diagnosed. How is psoriasis treated most of the time?MedlinePlus Medical Encyclopedia, "Psoriasis", Summary; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Skin & Subcutaneous Tissue.
A 67-year-old farmer has a pearly, waxy bump on his nose that has grown slowly and does not hurt. A biopsy shows basal cell skin cancer. What is true of this cancer?MedlinePlus Medical Encyclopedia, "Basal cell skin cancer", Summary; Causes; Symptoms. Outline: NBME Ambulatory Care Subject Exam content outline, Skin & Subcutaneous Tissue.
A 69-year-old man who worked outdoors for 40 years has several small, rough, scaly areas on his scalp and ears. Actinic keratosis is diagnosed. Which cancer do some of these growths become?MedlinePlus Medical Encyclopedia, "Actinic keratosis", Summary; Causes; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Skin & Subcutaneous Tissue.
A 71-year-old woman had shingles on one side of her chest. The blisters healed 3 months ago, but burning pain in the same area has not gone away. What is this pain called?MedlinePlus Medical Encyclopedia, "Shingles", Symptoms; Treatment; Outlook (Prognosis). Outline: NBME Ambulatory Care Subject Exam content outline, Skin & Subcutaneous Tissue.
Musculoskeletal system 4
A 41-year-old runner has pain on the bottom of the heel that is worst when he takes his first steps in the morning and after he has been sitting for a while. What is the likely diagnosis?MedlinePlus Medical Encyclopedia, "Plantar fasciitis", Causes; Symptoms; Outlook (Prognosis). Outline: NBME Ambulatory Care Subject Exam content outline, Musculoskeletal System.
A 45-year-old woman has pain and swelling in the same joints of both hands, with morning stiffness that lasts more than 1 hour. Her rheumatoid factor and anti-CCP antibody tests are positive. Which medicines should be used early in all patients?MedlinePlus Medical Encyclopedia, "Rheumatoid arthritis", Symptoms; Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Musculoskeletal System.
A 58-year-old man has had three attacks this year of sudden pain and swelling in his big toe, and gout is diagnosed. Which medicine is taken daily to decrease the uric acid level in the blood?MedlinePlus Medical Encyclopedia, "Gout", Causes; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Musculoskeletal System.
A 66-year-old woman has pain in both knees that is worse after activity, and her knees are stiff when she wakes up. Osteoarthritis is diagnosed. How long does morning stiffness due to osteoarthritis often last?MedlinePlus Medical Encyclopedia, "Osteoarthritis", Summary; Symptoms. Outline: NBME Ambulatory Care Subject Exam content outline, Musculoskeletal System.
Cardiovascular system 4
A 27-year-old woman has high blood pressure that is hard to control. With a stethoscope over her belly, her physician hears a "whooshing" noise. What is the likely cause of her high blood pressure?MedlinePlus Medical Encyclopedia, "Renovascular hypertension", Summary; Symptoms; Exams and Tests. Outline: NBME Ambulatory Care Subject Exam content outline, Cardiovascular System.
A 30-year-old woman with no symptoms has a heart murmur with an extra sound, a midsystolic click, at a routine visit. An echocardiogram shows mitral valve prolapse. What is true most of the time?MedlinePlus Medical Encyclopedia, "Mitral valve prolapse", Causes; Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Cardiovascular System.
A 62-year-old man has chest pressure whenever he climbs two flights of stairs. It lasts about 5 minutes and is relieved by rest. Which medicine may be used to stop the chest pain?MedlinePlus Medical Encyclopedia, "Stable angina", Summary; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Cardiovascular System.
A 73-year-old woman has swollen legs with a dull ache that gets worse when she stands and better when her legs are raised. Chronic venous insufficiency is diagnosed. Which treatment improves blood flow in the legs?MedlinePlus Medical Encyclopedia, "Venous insufficiency", Causes; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Cardiovascular System.
Respiratory system 4
A 25-year-old woman with asthma works with her physician on a plan to manage it at home. Which lung function reading should she know how to take and what it means?MedlinePlus Medical Encyclopedia, "Asthma", Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Respiratory System.
A 54-year-old man with obesity snores loudly and is sleepy all day, and his wife has seen him stop breathing in his sleep. What is needed to confirm obstructive sleep apnea?MedlinePlus Medical Encyclopedia, "Obstructive sleep apnea - adults", Causes; Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Respiratory System.
A 70-year-old woman with COPD comes for a follow-up visit. She still smokes half a pack of cigarettes a day. What will happen to her disease if she does not stop smoking?MedlinePlus Medical Encyclopedia, "Chronic obstructive pulmonary disease (COPD)", Treatment; Outlook (Prognosis); Prevention. Outline: NBME Ambulatory Care Subject Exam content outline, Respiratory System.
In flu season, a 67-year-old man with diabetes has had a fever, body aches and a cough since yesterday, and his flu test is positive. When do antiviral medicines for the flu work better?MedlinePlus Medical Encyclopedia, "Flu", Treatment; Prevention. Outline: NBME Ambulatory Care Subject Exam content outline, Respiratory System.
Gastrointestinal system 4
A 40-year-old man who injected street drugs years ago has a positive test for hepatitis C virus and feels well. What is true of the newer antiviral medicines for hepatitis C?MedlinePlus Medical Encyclopedia, "Hepatitis C", Causes; Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Gastrointestinal System.
A 46-year-old truck driver with constipation has itching around the anus and painless bright red blood on the toilet paper. Hemorrhoids are seen. Which of these may cause hemorrhoids?MedlinePlus Medical Encyclopedia, "Hemorrhoids", Causes; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Gastrointestinal System.
A 50-year-old woman with obesity who does not drink alcohol has no symptoms, and tests done for another reason show a buildup of fat in her liver. Which more severe form of this disease can cause cirrhosis?MedlinePlus Medical Encyclopedia, "Nonalcoholic fatty liver disease", Summary; Causes; Symptoms. Outline: NBME Ambulatory Care Subject Exam content outline, Gastrointestinal System.
A 60-year-old woman who takes naproxen every day for knee pain has burning pain in the upper abdomen, and an endoscopy shows a stomach ulcer. Tests for H pylori are negative. Which kind of medicine will she likely need to take for 8 weeks?MedlinePlus Medical Encyclopedia, "Peptic ulcer", Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Gastrointestinal System.
Renal and urinary system 3
A 59-year-old woman with type 2 diabetes has a urine microalbumin test that is too high on two measurements. Which blood pressure medicines will be prescribed to protect her kidneys from more damage?MedlinePlus Medical Encyclopedia, "Diabetes and kidney disease", Causes; Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Renal & Urinary System.
A 68-year-old man has kidney function that has slowly worsened over 3 years, and chronic kidney disease is diagnosed. Which are the two most common causes of chronic kidney disease?MedlinePlus Medical Encyclopedia, "Chronic kidney disease", Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Renal & Urinary System.
A 72-year-old woman has sudden, strong urges to urinate and often loses urine before she can reach the toilet. Urge incontinence is diagnosed. With what does managing it most often begin?MedlinePlus Medical Encyclopedia, "Urge incontinence", Summary; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Renal & Urinary System.
Female reproductive system and breast 1
A 52-year-old woman whose periods have become rare has severe hot flashes and night sweats that keep her from sleeping. Which treatment may help if such symptoms are severe?MedlinePlus Medical Encyclopedia, "Menopause", Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Female Reproductive System & Breast.
Male reproductive system 1
A 63-year-old man with diabetes and angina, who carries nitroglycerin, asks for sildenafil for erection problems. Why should he not use it?MedlinePlus Medical Encyclopedia, "Erection problems", Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Male Reproductive System.
Endocrine system 5
A 44-year-old woman has fatigue and a slightly enlarged thyroid gland, and her thyroid autoantibody test is positive. What causes chronic thyroiditis (Hashimoto disease)?MedlinePlus Medical Encyclopedia, "Chronic thyroiditis (Hashimoto disease)", Summary; Causes; Exams and Tests. Outline: NBME Ambulatory Care Subject Exam content outline, Endocrine System.
A 57-year-old man with type 2 diabetes for 12 years is told after an eye exam that he has diabetic retinopathy. Which part of the eye has diabetes damaged?MedlinePlus Medical Encyclopedia, "Diabetes and eye disease", Summary; Causes; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Endocrine System.
A 65-year-old man with diabetes for 15 years has tingling and burning in his toes and feet. At the office visit, with which instrument is loss of feeling in the feet checked?MedlinePlus Medical Encyclopedia, "Diabetes and nerve damage", Symptoms; Exams and Tests. Outline: NBME Ambulatory Care Subject Exam content outline, Endocrine System.
A 66-year-old woman who went through menopause at 50 has a DEXA scan that shows osteoporosis. Which are the main medicines used to prevent and treat osteoporosis in postmenopausal women?MedlinePlus Medical Encyclopedia, "Osteoporosis", Summary; Exams and Tests; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Endocrine System.
A 70-year-old woman who takes insulin for diabetes feels shaky and sweaty before lunch and checks her glucose monitor. Below which reading is blood sugar considered low?MedlinePlus Medical Encyclopedia, "Low blood sugar", Summary; Causes; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Endocrine System.
Multisystem disorders 3
A 28-year-old man has a small, painless open sore on his penis and enlarged lymph nodes in the groin. Primary syphilis is diagnosed. Which antibiotic is used to treat it?MedlinePlus Medical Encyclopedia, "Syphilis", Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Multisystem Processes & Disorders.
A 39-year-old woman has had widespread pain for a year, with fatigue, sleep problems and tender muscles. Fibromyalgia is diagnosed. Which medicines are approved by the FDA specifically for treating it?MedlinePlus Medical Encyclopedia, "Fibromyalgia", Summary; Symptoms; Treatment. Outline: NBME Ambulatory Care Subject Exam content outline, Multisystem Processes & Disorders.
A 56-year-old woman has had dry eyes and a dry mouth for a year, and her anti-Ro/SSA antibody test is positive. In Sjogren syndrome, which glands are destroyed?MedlinePlus Medical Encyclopedia, "Sjogren syndrome", Summary; Causes; Exams and Tests. Outline: NBME Ambulatory Care Subject Exam content outline, Multisystem Processes & Disorders.
Biostatistics and epidemiology 3
A health department reports how many county residents were newly diagnosed with diabetes during one year, leaving out everyone diagnosed in earlier years. Which measure is limited to new cases only?CDC, Principles of Epidemiology in Public Health Practice, 3rd edition (archived), Lesson 3, Section 2: Morbidity Frequency Measures. Outline: NBME Ambulatory Care Subject Exam content outline, Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Lit..
In one flu season, 10% of the unvaccinated patients of a clinic and 4% of its vaccinated patients get the flu. What is the vaccine effectiveness?CDC, Principles of Epidemiology in Public Health Practice, 3rd edition (archived), Lesson 3, Section 6: Measures of Public Health Impact. Outline: NBME Ambulatory Care Subject Exam content outline, Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Lit..
Researchers record which of 2,000 clinic patients take a daily vitamin and which do not, then track everyone for 10 years to see who develops heart disease. The researchers only observe; they assign nothing. Which study design is this?CDC, Principles of Epidemiology in Public Health Practice, 3rd edition (archived), Lesson 1, Section 7: Analytic Epidemiology. Outline: NBME Ambulatory Care Subject Exam content outline, Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Lit..
Social sciences 1
A physician's adult brother, who lives in the same city, asks her to become his regular doctor and manage his high blood pressure. By the AMA Code of Medical Ethics, what is the general rule?AMA Code of Medical Ethics, Opinion 1.2.1, Treating Self or Family. Outline: NBME Ambulatory Care Subject Exam content outline, Social Sciences.
How this list was compiled: Our own questions, written to the content outline of the Ambulatory Care Subject Exam that NBME publishes (https://www.nbme.org/institutions/assess-learn/subject-exams/clinical-science/ambulatory-care/, read 2026-10-15). Its seventeen systems and their ranges: General Principles 5-10%, Immune System 1-5%, Blood & Lymphoreticular System 1-5%, Behavioral Health 5-10%, Nervous System & Special Senses 1-5%, Skin & Subcutaneous Tissue 5-10%, Musculoskeletal System 5-10%, Cardiovascular System 5-10%, Respiratory System 5-10%, Gastrointestinal System 5-10%, Renal & Urinary System 3-8%, Female Reproductive System & Breast 1-5%, Male Reproductive System 1-5%, Endocrine System 8-12%, Multisystem Processes & Disorders 5-10%, Biostatistics, Epidemiology/Population Health & Interpretation of the Medical Literature 3-8%, Social Sciences 1-5%. The bank holds 4, 1, 2, 4, 2, 4, 4, 4, 4, 4, 3, 1, 1, 5, 3, 3 and 1 questions in that order, 50 in all; every case is set in the office, every patient is an adult, and sixteen are 66 or older, as the outline shares them. Every clinical fact was read on 2026-10-15 in the MedlinePlus Medical Encyclopedia (National Library of Medicine) article the question names; two screening questions rest on recommendation statements of the US Preventive Services Task Force, the three statistics questions on the CDC course Principles of Epidemiology in Public Health Practice, and the ethics question on the AMA Code of Medical Ethics. Licence: Questions, choices and explanations are original work of this site.
How it works
This free ambulatory medicine NBME practice test has 50 short office cases of our own for the Ambulatory Care Subject Exam. It is unofficial: the National Board of Medical Examiners (NBME) is not affiliated with this site and has not endorsed it.
Read the full guide
What the ambulatory care shelf covers
NBME's Ambulatory Care Subject Exam content outline, read October 15, 2026, sets every item in the office: no ward and no emergency department. Its 17 systems include biostatistics and reading the medical literature, which get three of the 50 cases here.
How the cases are built
These are the long-term problems of an adult clinic: diabetes and its harm to eyes, nerves and kidneys, blood pressure, joints, skin, mood and sleep. Sixteen patients are 66 or older. Each answer names the public page and section it was read in.
Timed practice
The timed round is 40 cases in 60 minutes, the real exam's pace of a minute and a half an item.
A contrast to know cold: morning stiffness of 30 minutes or less points to osteoarthritis, and stiffness of more than 1 hour to rheumatoid arthritis.
Questions and answers
How many questions are on the NBME ambulatory care shelf exam?
NBME's Subject Examination Timing Chart (July 2021) lists Ambulatory Care at 110 items in 2 hours 45 minutes. A web exam starts with a tutorial that adds 15 minutes.
Is there a free NBME practice test for ambulatory medicine?
Not from NBME. Its paid self-assessments, the Clinical Science Mastery Series, listed eight content areas on October 15, 2026, and Ambulatory Care was not one of them. This free page is unofficial: 50 cases of our own.
Are these real NBME ambulatory care questions?
No. Each case was written for this page from the public content outline and the public source named on its answer. NBME's sample items were not opened, and no question bank or review book was used or reworded.
Which topics carry the most weight on the ambulatory care shelf?
The endocrine system, at 8 to 12% of items. Eight areas follow at 5 to 10% each: general principles, behavioral health, skin, musculoskeletal, cardiovascular, respiratory, gastrointestinal and multisystem disorders. Renal and biostatistics carry 3 to 8% each.