Unofficial family medicine shelf practice: office cases from the well-baby visit to care after 80, prevention included.
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Unofficial practice questions, not affiliated with NBME (the National Board of Medical Examiners). Bank checked October 15, 2026.
The real exam, as NBME describes it
Physician task
Diagnosis, with foundational science, 40 to 50%; pharmacotherapy, intervention and management 25 to 30%; health maintenance, prevention, surveillance 20 to 25%
Site of care
Ambulatory 100%
Patient age
Birth to 17, 15 to 20%; 18 to 65, 55 to 65%; 66 and older, 15 to 20%
A 28-year-old woman with no record of MMR vaccination comes for a routine visit and says that she might be pregnant. What does the vaccine information statement say about MMR vaccine in pregnancy?MedlinePlus Medical Encyclopedia, "MMR (measles, mumps, and rubella) vaccine - what you need to know", Information. Outline: NBME Family Medicine Modular Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
A 72-year-old woman who lives in her own home has fallen twice this year. Which intervention does the US Preventive Services Task Force recommend to prevent falls in adults like her?US Preventive Services Task Force, Falls Prevention in Community-Dwelling Older Adults: Interventions, recommendation statement. Outline: NBME Family Medicine Modular Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
A healthy 24-year-old man comes for a routine visit and reports no risk factors. For which infection does the US Preventive Services Task Force recommend screening in adolescents and adults aged 15 to 65 years?US Preventive Services Task Force, Human Immunodeficiency Virus (HIV) Infection: Screening, recommendation statement. Outline: NBME Family Medicine Modular Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
A sexually active 19-year-old woman with no symptoms comes for a checkup. Which screening does the US Preventive Services Task Force recommend for all sexually active women 24 years or younger?US Preventive Services Task Force, Chlamydia and Gonorrhea: Screening, recommendation statement. Outline: NBME Family Medicine Modular Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
Show all 48 questions (44 more)
Immune system 2
A 26-year-old woman has itchy raised welts on her arms and trunk an hour after eating shrimp. Her breathing is normal, and her throat is not swollen. Which medicine may her provider suggest?MedlinePlus Medical Encyclopedia, "Hives", Summary; Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Immune System.
A 31-year-old teacher has sneezing, an itchy nose and watery eyes every spring when plant pollen is in the air. Which is the most effective treatment for allergic rhinitis?MedlinePlus Medical Encyclopedia, "Allergic rhinitis", Summary; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Immune System.
Blood and lymphoreticular system 1
At a 9-month well visit, a mother says she switched her son from formula to cow's milk 3 months ago. He is pale, and a blood test shows anemia with low iron stores. Why does drinking cow's milk lead to anemia?MedlinePlus Medical Encyclopedia, "Anemia caused by low iron - infants and toddlers", Causes; Exams and Tests; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Blood & Lymphoreticular System.
Behavioral health 4
A 44-year-old man has had a low mood for a month, with loss of interest in activities he once enjoyed, trouble sleeping and trouble concentrating. He has no thoughts of suicide. Which antidepressants are typically used?MedlinePlus Medical Encyclopedia, "Major depression", Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Behavioral Health.
A 47-year-old man says that he drinks 4 beers every evening and asks whether that is too much. Long-term risks of drinking are more likely for a man who has more than how many drinks?MedlinePlus Medical Encyclopedia, "Alcohol use disorder", Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Behavioral Health.
A 50-year-old woman who smokes a pack of cigarettes a day wants to quit and asks which form of nicotine replacement is best. Which statement is correct?MedlinePlus Medical Encyclopedia, "Nicotine replacement therapy", Information. Outline: NBME Family Medicine Modular Subject Exam content outline, Behavioral Health.
A 72-year-old man has had trouble falling asleep for 3 months. He drinks coffee through the day and watches television in bed. Which talk therapy may help him gain control over his sleep?MedlinePlus Medical Encyclopedia, "Insomnia", Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Behavioral Health.
Nervous system and special senses 2
A 28-year-old swimmer has itching and pain in one ear, with yellow drainage. The pain gets worse when the outer ear is pulled. What is needed in most cases?MedlinePlus Medical Encyclopedia, "Swimmer's ear", Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Nervous System & Special Senses.
A 35-year-old office worker has dull, pressure-like headaches that feel like a tight band around her head. She now takes ibuprofen 5 days a week. What may this lead to?MedlinePlus Medical Encyclopedia, "Tension headache", Summary; Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Nervous System & Special Senses.
Skin 2
An 8-month-old boy has a dry, itchy rash on his face and scalp, and atopic dermatitis is diagnosed. Besides keeping his skin moist with ointment, which medicine will probably be prescribed at first?MedlinePlus Medical Encyclopedia, "Atopic dermatitis", Causes; Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Skin & Subcutaneous Tissue.
An 18-year-old woman has cystic acne with scarring, and isotretinoin is being considered. Why must she not be pregnant while she takes it?MedlinePlus Medical Encyclopedia, "Acne", Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Skin & Subcutaneous Tissue.
Musculoskeletal system 4
A 13-year-old boy who plays soccer has a painful swelling over the bump on the upper shinbone, just below the knee. Osgood-Schlatter disease is diagnosed. What usually happens to it?MedlinePlus Medical Encyclopedia, "Osgood-Schlatter disease", Summary; Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Musculoskeletal System.
A 20-year-old woman twists her ankle playing soccer. The ankle is swollen, and a sprain is diagnosed. A sprain is an injury to which structures around a joint?MedlinePlus Medical Encyclopedia, "Sprains", Summary; First Aid. Outline: NBME Family Medicine Modular Subject Exam content outline, Musculoskeletal System.
A 45-year-old carpenter has pain on the outside of his elbow that is worse when he uses a screwdriver. Tennis elbow is diagnosed. What is the first step in treatment?MedlinePlus Medical Encyclopedia, "Tennis elbow", Summary; Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Musculoskeletal System.
A 67-year-old man strained his lower back lifting furniture 2 days ago. He has no weakness or numbness in his legs. What should he be told about rest?MedlinePlus Medical Encyclopedia, "Low back pain - acute", Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Musculoskeletal System.
Cardiovascular system 4
A 30-year-old woman who smokes says that in cold weather her fingers turn white, then blue, and then red as they warm. Which steps may help control this condition?MedlinePlus Medical Encyclopedia, "Raynaud phenomenon", Summary; Causes; Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Cardiovascular System.
A 42-year-old woman has blood pressure readings of about 134/84 mm Hg at several visits. She has no other diseases or risk factors for heart or kidney disease. What may her provider recommend?MedlinePlus Medical Encyclopedia, "High blood pressure in adults - hypertension", Summary; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Cardiovascular System.
A 66-year-old man with diabetes still has a high LDL cholesterol level after changing his diet and exercising. Which kind of medicine lowers cholesterol and has been proven to reduce the chance of heart disease?MedlinePlus Medical Encyclopedia, "High blood cholesterol levels", Causes; Exams and Tests; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Cardiovascular System.
A 70-year-old man faints after standing in one place for a long time at a parade and wakes within a minute. Fainting is a brief loss of consciousness due to what?MedlinePlus Medical Encyclopedia, "Fainting", Summary; Causes; Home Care. Outline: NBME Family Medicine Modular Subject Exam content outline, Cardiovascular System.
Respiratory system 4
A 7-year-old boy with asthma coughs and wheezes several nights a week and uses only a quick-relief inhaler. Which kind of long-term control medicine, taken every day, is usually the first choice?MedlinePlus Medical Encyclopedia, "Asthma in children", Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Respiratory System.
A 40-year-old woman with a lingering cold asks when to suspect a sinus infection. The symptoms of acute sinusitis in adults very often follow a cold that does not get better, or gets worse, after how long?MedlinePlus Medical Encyclopedia, "Sinusitis", Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Respiratory System.
A healthy 33-year-old man has had a chest cold with a cough for 5 days, and acute bronchitis is diagnosed. What is true of antibiotics for acute bronchitis caused by a virus?MedlinePlus Medical Encyclopedia, "Acute bronchitis", Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Respiratory System.
An 8-year-old girl has a sore throat and a fever, and her rapid strep test is positive. Amoxicillin is prescribed. For how long should the antibiotic be taken?MedlinePlus Medical Encyclopedia, "Strep throat", Exams and Tests; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Respiratory System.
Gastrointestinal system 4
A 3-year-old girl who goes to day care has had vomiting and watery diarrhea for a day. Which virus is the leading cause of gastroenteritis in children?MedlinePlus Medical Encyclopedia, "Viral gastroenteritis (stomach flu)", Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Gastrointestinal System.
A 24-year-old man has bloating, gas and diarrhea after he drinks milk. Which test for lactose intolerance is most commonly done?MedlinePlus Medical Encyclopedia, "Lactose intolerance", Summary; Symptoms; Exams and Tests. Outline: NBME Family Medicine Modular Subject Exam content outline, Gastrointestinal System.
A 29-year-old woman has had cramping abdominal pain with changes in her bowel movements, on and off for a year. Which feature fits irritable bowel syndrome?MedlinePlus Medical Encyclopedia, "Irritable bowel syndrome", Summary; Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Gastrointestinal System.
A 69-year-old man has heartburn that gets worse when he lies down at night. Raising the head of the bed has helped a little. Which medicines decrease the amount of acid produced in the stomach?MedlinePlus Medical Encyclopedia, "Gastroesophageal reflux disease", Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Gastrointestinal System.
Renal and urinary system 2
A family physician reviews which patients without urinary symptoms need a urine culture as a screening test. For which of these patients is the culture done even without symptoms?MedlinePlus Medical Encyclopedia, "Asymptomatic bacteriuria", Causes; Exams and Tests; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Renal & Urinary System.
A healthy 32-year-old woman has her third bladder infection in a year and asks why women get urinary tract infections more often than men do. What is the reason?MedlinePlus Medical Encyclopedia, "Urinary tract infection - adults", Causes; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Renal & Urinary System.
Pregnancy and childbirth 2
A 27-year-old woman who is 7 weeks pregnant has nausea every morning but keeps fluids down. Until when does morning sickness most often continue?MedlinePlus Medical Encyclopedia, "Morning sickness", Considerations; Home Care. Outline: NBME Family Medicine Modular Subject Exam content outline, Pregnancy, Childbirth, & the Puerperium.
A 31-year-old woman had gestational diabetes in her first pregnancy, and her blood sugar went back to normal after delivery. For how long afterward should she be closely followed for signs of diabetes?MedlinePlus Medical Encyclopedia, "Gestational diabetes", Outlook (Prognosis). Outline: NBME Family Medicine Modular Subject Exam content outline, Pregnancy, Childbirth, & the Puerperium.
Female reproductive system and breast 2
A 30-year-old woman has a gray vaginal discharge that smells fishy. Bacterial vaginosis is diagnosed, and an antibiotic is prescribed. She asks what she can do to keep it from coming back. Which step helps prevent bacterial vaginosis?MedlinePlus Medical Encyclopedia, "Bacterial vaginosis - aftercare", Symptoms; Preventing Bacterial Vaginosis. Outline: NBME Family Medicine Modular Subject Exam content outline, Female Reproductive System & Breast.
A 33-year-old woman has bloating, breast tenderness and headaches before each period, and they go away soon after it starts. Premenstrual syndrome is suspected. What should she keep for at least 3 months?MedlinePlus Medical Encyclopedia, "Premenstrual syndrome", Symptoms; Exams and Tests; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Female Reproductive System & Breast.
Male reproductive system 1
A 68-year-old man has a slow start to his urine stream and gets up 3 times a night to urinate. An enlarged prostate is diagnosed. Which medicines lower the levels of hormones produced by the prostate?MedlinePlus Medical Encyclopedia, "Enlarged prostate", Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Male Reproductive System.
Endocrine system 4
A 10-year-old boy has had 2 weeks of great thirst, frequent urination and weight loss, and his blood sugar is very high. Type 1 diabetes is diagnosed. Which treatment will he need?MedlinePlus Medical Encyclopedia, "Type 1 diabetes", Causes; Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Endocrine System.
A 36-year-old woman has a body mass index of 32 at her yearly visit. Which weight class is this?MedlinePlus Medical Encyclopedia, "Obesity", Exams and Tests. Outline: NBME Family Medicine Modular Subject Exam content outline, Endocrine System.
A 48-year-old man has a waist of 42 inches, a blood pressure of 134/86 mm Hg and a fasting blood sugar of 108 mg/dL. Metabolic syndrome is likely when a person has at least how many of its five signs?MedlinePlus Medical Encyclopedia, "Metabolic syndrome", Exams and Tests. Outline: NBME Family Medicine Modular Subject Exam content outline, Endocrine System.
A 52-year-old man with obesity and a family history of diabetes asks what result on the hemoglobin A1C test means that he has diabetes. At which result is diabetes diagnosed?MedlinePlus Medical Encyclopedia, "Type 2 diabetes", Exams and Tests. Outline: NBME Family Medicine Modular Subject Exam content outline, Endocrine System.
Multisystem disorders 2
A 19-year-old college wrestler has a fever, a sore throat, swollen lymph nodes in his neck and a swollen spleen, and his monospot test is positive. What should he avoid while his spleen is swollen?MedlinePlus Medical Encyclopedia, "Mononucleosis", Causes; Exams and Tests; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Multisystem Processes & Disorders.
A week after a hike in tall grass, a 34-year-old man has a fever, a headache and a flat red "bull's eye" spot on his thigh where a tick was attached. What is this rash called?MedlinePlus Medical Encyclopedia, "Lyme disease", Causes; Symptoms; Treatment. Outline: NBME Family Medicine Modular Subject Exam content outline, Multisystem Processes & Disorders.
Biostatistics and epidemiology 1
A clinic tries a new screening test on 300 people who are known not to have a disease. The test is negative in 270 of them. What is the specificity of the test?CDC, Principles of Epidemiology in Public Health Practice, 3rd edition (archived), Glossary, "specificity". Outline: NBME Family Medicine Modular Subject Exam content outline, Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Lit..
Social sciences 3
A 16-year-old girl asks her family physician for care that she does not want her parents to know about, and the law does not let her consent to it alone. By the AMA Code of Medical Ethics, what should the physician do about her parents?AMA Code of Medical Ethics, Opinion 2.2.2, Confidential Health Care for Minors. Outline: NBME Family Medicine Modular Subject Exam content outline, Social Sciences.
A 62-year-old woman waiting for biopsy results tells her physician that she does not want to hear the details and asks that her husband be told instead. By the AMA Code of Medical Ethics, what should the physician do?AMA Code of Medical Ethics, Opinion 2.1.3, Withholding Information from Patients. Outline: NBME Family Medicine Modular Subject Exam content outline, Social Sciences.
The electronic record in a family practice shows a drug warning on almost every prescription. An 81-year-old man is harmed after his physician clicks past a warning about a real interaction. What is this desensitization to safety alerts called?AHRQ Patient Safety Network, Patient Safety Primer, Alert Fatigue. Outline: NBME Family Medicine Modular Subject Exam content outline, Social Sciences.
How this list was compiled: Our own questions, written to the content outline of the Family Medicine Modular Subject Exam that NBME publishes (https://www.nbme.org/institutions/assess-learn/subject-exams/clinical-science/family-medicine-modular/, read 2026-10-15). Its eighteen 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 3-7%, Musculoskeletal System 5-10%, Cardiovascular System 5-10%, Respiratory System 5-10%, Gastrointestinal System 5-10%, Renal & Urinary System 1-5%, Pregnancy, Childbirth & the Puerperium 1-5%, Female Reproductive System & Breast 1-5%, Male Reproductive System 1-5%, Endocrine System 5-10%, Multisystem Processes & Disorders 1-5%, Biostatistics, Epidemiology/Population Health & Interpretation of the Medical Literature 1-5%, Social Sciences 5-10%. The bank holds 4, 2, 1, 4, 2, 2, 4, 4, 4, 4, 2, 2, 2, 1, 4, 2, 1 and 3 questions in that order, 48 in all; every case is set in the office, eight patients are under 18 and eight 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; three screening questions rest on recommendation statements of the US Preventive Services Task Force, the statistics question on the CDC course Principles of Epidemiology in Public Health Practice, and the three social sciences questions on the AMA Code of Medical Ethics and the AHRQ Patient Safety Network. Licence: Questions, choices and explanations are original work of this site.
How it works
This free NBME practice test for family medicine has 48 short office cases of our own for the Family Medicine Modular 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 family medicine shelf covers
NBME's Family Medicine Modular content outline, read October 15, 2026, lists 18 systems, pregnancy among them. The exam is given as the Core alone, with the Chronic Care module, or with Chronic Care and Musculoskeletal; the outline says the musculoskeletal share rises with that module.
How the cases are built
Eight of the 48 patients are children and eight are 66 or older, close to the outline's shares. Screening cases quote the US Preventive Services Task Force; most others name the MedlinePlus article and section behind the answer.
Timed practice
Each form of the real exam allows a minute and a half an item, so the timed round here is 40 cases in 60 minutes.
Ages that decide answers: HIV screening from 15 to 65, chlamydia and gonorrhea screening for sexually active women 24 or younger, fall-prevention exercise from 65.
Questions and answers
How many questions are on the NBME family medicine shelf exam?
It depends on the modules given. NBME's timing chart (July 2021) gives Core 90 items in 2 hours 15 minutes, Core with Chronic Care 100 items in 2 hours 30 minutes, and all three modules 110 items in 2 hours 45 minutes.
Are these real NBME family medicine shelf questions?
No. All 48 cases were written for this page from NBME's public content outline and the public sources named on each answer. NBME's sample items and self-assessments were not opened, and nothing was reworded from a question bank or a review book.
What should a family medicine shelf study guide cover?
Eight areas carry 5 to 10% each in NBME's outline: general principles and well care, behavioral health, musculoskeletal, cardiovascular, respiratory, gastrointestinal, endocrine and social sciences. Skin carries 3 to 7%, and each of the other nine 1 to 5%.
Is there a free NBME CMS practice test for family medicine?
Not from NBME. Its Clinical Science Mastery Series (CMS) self-assessments, Family Medicine among them, cost $21 a form of 50 multiple-choice questions, by NBME's site on October 15, 2026. This page is free, unofficial and not a CMS form.