At a 2-month well visit, which finding is expected of a typical infant?MedlinePlus Medical Encyclopedia, "Developmental milestones record - 2 months", Information. Outline: NBME Pediatrics Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
At a 12-month well visit, which skill is expected of a typical child?MedlinePlus Medical Encyclopedia, "Developmental milestones record - 12 months", Information. Outline: NBME Pediatrics Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
The parents of a healthy newborn ask how to lower the risk of sudden infant death syndrome. What does the American Academy of Pediatrics recommend for sleep?MedlinePlus Medical Encyclopedia, "Sudden infant death syndrome", Causes; Prevention. Outline: NBME Pediatrics Subject Exam content outline, General Principles, Including Normal Age-Related Findings and Care of the Well Patient.
Show all 54 questions (51 more)
Immune system 3
A 2-year-old boy has had three pneumonias and many ear infections. His immunoglobulin levels are very low, and flow cytometry shows almost no circulating B lymphocytes. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Agammaglobulinemia", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Immune System.
A 4-year-old boy has had repeated skin abscesses, a lung abscess and infected lymph nodes in the neck. His antibody levels are normal. Which defect explains chronic granulomatous disease?MedlinePlus Medical Encyclopedia, "Chronic granulomatous disease", Causes. Outline: NBME Pediatrics Subject Exam content outline, Immune System.
A 9-year-old girl with selective deficiency of IgA needs surgery. Which complication can follow ordinary blood products or immunoglobulins in this disorder?MedlinePlus Medical Encyclopedia, "Selective deficiency of IgA", opening; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Immune System.
Blood and lymphoreticular system 3
A 3-year-old boy has a swollen, painful knee after a minor fall. His mother's brother has a bleeding disorder. Which clotting factor is lacking in hemophilia A?MedlinePlus Medical Encyclopedia, "Hemophilia A", opening; Causes. Outline: NBME Pediatrics Subject Exam content outline, Blood & Lymphoreticular System.
A pale 2-year-old craves ice and eats dirt. His blood count shows anemia. Which type of anemia is most likely?MedlinePlus Medical Encyclopedia, "Iron deficiency anemia", opening; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Blood & Lymphoreticular System.
Two weeks after a cold, a well-looking 4-year-old has scattered bruises and pinpoint red spots. Her platelet count is very low, and the rest of the blood count is normal. What is the usual course of this disorder in children?MedlinePlus Medical Encyclopedia, "Immune thrombocytopenic purpura (ITP)", Causes; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Blood & Lymphoreticular System.
Behavioral health 1
A 9-year-old girl has daydreamed, missed instructions and left tasks unfinished since first grade, in class and at home. Which medicines are most commonly used for this disorder?MedlinePlus Medical Encyclopedia, "Attention deficit hyperactivity disorder", Treatment. Outline: NBME Pediatrics Subject Exam content outline, Behavioral Health.
Nervous system and special senses 4
A 7-year-old girl has spells of staring and eyelid fluttering that last a few seconds, many times a day. Deep, fast breathing brings one on in the office. Which test is done to check for this seizure type?MedlinePlus Medical Encyclopedia, "Absence seizure", opening; Causes; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Nervous System & Special Senses.
An 18-month-old girl with a temperature of 103.1°F (39.5°C) has a 2-minute seizure of her whole body. An hour later she is playful, and her exam is normal. Which statement to her parents is accurate?MedlinePlus Medical Encyclopedia, "Febrile seizures", Causes. Outline: NBME Pediatrics Subject Exam content outline, Nervous System & Special Senses.
In flash photographs, the left pupil of an 18-month-old boy looks white instead of red, and that eye turns inward. Which diagnosis must be ruled out?MedlinePlus Medical Encyclopedia, "Retinoblastoma", Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Nervous System & Special Senses.
Why are ear infections more common in infants and children than in adults?MedlinePlus Medical Encyclopedia, "Ear infection - acute", Causes. Outline: NBME Pediatrics Subject Exam content outline, Nervous System & Special Senses.
Skin 2
A 5-year-old has blisters around the nose that ooze and form honey-colored crusts. What causes this infection?MedlinePlus Medical Encyclopedia, "Impetigo", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Skin & Subcutaneous Tissue.
A well 2-day-old term infant has small yellow-white bumps surrounded by red skin on the trunk. The rash moves from place to place over hours. What is the appropriate management?MedlinePlus Medical Encyclopedia, "Erythema toxicum", Causes; Symptoms; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Skin & Subcutaneous Tissue.
Musculoskeletal system 3
A 3-year-old cries and will not use her right arm after her father swung her by the hands. She holds the arm slightly bent. Which injury is most likely?MedlinePlus Medical Encyclopedia, "Nursemaid's elbow", opening; Causes. Outline: NBME Pediatrics Subject Exam content outline, Musculoskeletal System.
A newborn girl, a first child delivered breech, has a clunk in the left hip on exam. Which test confirms the problem at this age?MedlinePlus Medical Encyclopedia, "Developmental dysplasia of the hip", Causes; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Musculoskeletal System.
An obese 13-year-old boy has limped for 2 weeks and has knee pain. His leg is turned outward, and the knee exam is normal. A hip x-ray confirms the diagnosis. What is the treatment?MedlinePlus Medical Encyclopedia, "Slipped capital femoral epiphysis", Causes; Symptoms; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Musculoskeletal System.
Cardiovascular system 4
A 2-year-old boy turns blue when he cries and squats during these spells. He has clubbed fingers. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Tetralogy of Fallot", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Cardiovascular System.
A 6-week-old girl with a murmur is feeding and growing well. An echocardiogram shows a small ventricular septal defect. What should her parents be told?MedlinePlus Medical Encyclopedia, "Ventricular septal defect", Causes. Outline: NBME Pediatrics Subject Exam content outline, Cardiovascular System.
A 14-year-old girl with Turner syndrome has leg cramps with exercise and cold feet. Her blood pressure is lower in the legs than in the arms, and her femoral pulses are weak. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Coarctation of the aorta", Causes; Symptoms; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Cardiovascular System.
A premature infant has a patent ductus arteriosus that needs treatment. Which medicines are often the first choice?MedlinePlus Medical Encyclopedia, "Patent ductus arteriosus", Treatment. Outline: NBME Pediatrics Subject Exam content outline, Cardiovascular System.
Respiratory system 4
A 2-year-old with croup is brought to the emergency department with noisy breathing at rest. Which medicines does the source list for croup treated in the hospital?MedlinePlus Medical Encyclopedia, "Croup", Treatment. Outline: NBME Pediatrics Subject Exam content outline, Respiratory System.
A 3-year-old has poor weight gain, foul-smelling stools that float, salty-tasting skin and repeated lung infections. Which test is the standard for diagnosing the most likely disorder?MedlinePlus Medical Encyclopedia, "Cystic fibrosis", Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Respiratory System.
An unvaccinated 4-year-old has a high fever, drooling and noisy breathing. He sits upright, leaning forward. Which action should be avoided?MedlinePlus Medical Encyclopedia, "Epiglottitis", Symptoms; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Respiratory System.
In January a 4-month-old has a runny nose and then, 3 days later, wheezing and fast breathing. Which virus is the most common cause?MedlinePlus Medical Encyclopedia, "Bronchiolitis", Causes. Outline: NBME Pediatrics Subject Exam content outline, Respiratory System.
Gastrointestinal system 5
A 2-year-old boy passes a large maroon stool without pain. His exam is normal. Which test looks for the most likely source?MedlinePlus Medical Encyclopedia, "Meckel diverticulum", opening; Symptoms; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Gastrointestinal System.
A 5-week-old boy has vomited with force for a week and is losing weight. An ultrasound confirms a narrowed outlet of the stomach. What is the treatment?MedlinePlus Medical Encyclopedia, "Pyloric stenosis in infants", opening; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Gastrointestinal System.
A 5-week-old girl has jaundice that keeps getting worse, dark urine and pale, clay-colored stools. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Biliary atresia", Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Gastrointestinal System.
A 10-month-old boy has bouts of sudden, loud crying with his knees drawn to his chest, then passes a bloody, mucus-like stool. Which procedure can treat the blockage in some cases?MedlinePlus Medical Encyclopedia, "Intussusception - children", Causes; Symptoms; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Gastrointestinal System.
A term newborn has not passed stool by 48 hours and has a swollen belly. A rectal biopsy is planned. What is the underlying defect in Hirschsprung disease?MedlinePlus Medical Encyclopedia, "Hirschsprung disease", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Gastrointestinal System.
Renal and urinary system 4
A 3-year-old girl has her second urinary tract infection with fever. Which test shows whether urine flows backward from the bladder into the ureters?MedlinePlus Medical Encyclopedia, "Urinary tract infection - children", Causes; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Renal & Urinary System.
A 4-year-old boy has puffy eyelids and swollen legs. His urine has a large amount of protein, and his blood albumin is low. Which treatment cures the most likely disease in most children?MedlinePlus Medical Encyclopedia, "Minimal change disease", Causes; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Renal & Urinary System.
A 7-year-old boy has rust-colored urine and a swollen face. He had a sore throat that was not treated. How long after a throat infection does poststreptococcal glomerulonephritis usually develop?MedlinePlus Medical Encyclopedia, "Poststreptococcal glomerulonephritis (GN)", Causes. Outline: NBME Pediatrics Subject Exam content outline, Renal & Urinary System.
Five days after eating an undercooked hamburger, a 3-year-old with bloody diarrhea becomes pale and passes almost no urine. Tests show hemolytic anemia and kidney failure. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Hemolytic-uremic syndrome", Causes. Outline: NBME Pediatrics Subject Exam content outline, Renal & Urinary System.
Newborn and congenital disorders 4
A boy born at 30 weeks has grunting, nasal flaring and fast, shallow breathing within minutes of birth. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Neonatal respiratory distress syndrome", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Disorders of the Newborn & Congenital Disorders.
A breastfed 4-day-old term infant is placed under blue lights for a high bilirubin level. What should happen to breastfeeding?MedlinePlus Medical Encyclopedia, "Newborn jaundice", Treatment. Outline: NBME Pediatrics Subject Exam content outline, Disorders of the Newborn & Congenital Disorders.
A formula-fed infant born at 28 weeks develops a swollen belly, feeding problems and blood in the stool on day 10. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, "Necrotizing enterocolitis", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Disorders of the Newborn & Congenital Disorders.
A newborn with upward slanting eyes, a single crease in each palm and low muscle tone vomits green fluid on the first day. Which blockage is linked with this genetic condition?MedlinePlus Medical Encyclopedia, "Down syndrome", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Disorders of the Newborn & Congenital Disorders.
Female reproductive system 2
A 5-year-old girl has vulvar itching and a foul-smelling discharge. There is no sign of injury, and cultures grow only common skin and bowel germs. Which factor most likely contributed?MedlinePlus Medical Encyclopedia, "Vulvovaginitis", Causes. Outline: NBME Pediatrics Subject Exam content outline, Female Reproductive System.
A healthy 15-year-old has crampy lower abdominal pain with each period. Her exam is normal. Which medicine is tried first?MedlinePlus Medical Encyclopedia, "Painful menstrual periods", Causes; Home Care. Outline: NBME Pediatrics Subject Exam content outline, Female Reproductive System.
Male reproductive system 1
A 14-year-old boy wakes with sudden, severe pain in one testicle. Torsion is suspected. Within what time does surgery save most of the testicle?MedlinePlus Medical Encyclopedia, "Testicular torsion", Treatment. Outline: NBME Pediatrics Subject Exam content outline, Male Reproductive System.
Endocrine system 4
A 3-week-old has lasting jaundice, a hoarse cry, a thick tongue that sticks out, constipation and poor muscle tone. Which medicine is usually given?MedlinePlus Medical Encyclopedia, "Neonatal hypothyroidism", Symptoms; Treatment; Outlook. Outline: NBME Pediatrics Subject Exam content outline, Endocrine System.
A 6-year-old girl has breast development and pubic hair. Before which age do these changes count as precocious puberty in girls?MedlinePlus Medical Encyclopedia, "Precocious puberty", Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Endocrine System.
A 14-month-old who is breastfed only and takes no supplements has bowlegs and bumps along the ribcage. A lack of which nutrient is most likely?MedlinePlus Medical Encyclopedia, "Rickets", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Endocrine System.
A newborn girl has ambiguous genitals. At 10 days she is vomiting and dehydrated. Which enzyme is missing in most people who have congenital adrenal hyperplasia?MedlinePlus Medical Encyclopedia, "Congenital adrenal hyperplasia", Causes. Outline: NBME Pediatrics Subject Exam content outline, Endocrine System.
Multisystem disorders 6
A 2-year-old lives in a house built in 1950 with peeling paint. He is irritable and constipated. Which test helps identify whether there is a problem?MedlinePlus Medical Encyclopedia, "Lead poisoning", Where Found; Exams and Tests. Outline: NBME Pediatrics Subject Exam content outline, Multisystem Processes & Disorders.
A 3-year-old has had a fever for 6 days with red eyes, cracked lips and a rash. Kawasaki disease is diagnosed. Why must treatment start right away?MedlinePlus Medical Encyclopedia, "Kawasaki disease", Treatment. Outline: NBME Pediatrics Subject Exam content outline, Multisystem Processes & Disorders.
A 4-month-old who was given honey has constipation, sagging eyelids, a weak suck and a floppy body. What is the main treatment?MedlinePlus Medical Encyclopedia, "Infant botulism", Causes; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Multisystem Processes & Disorders.
A 6-year-old has a sore throat, a strawberry tongue and a red rash on the neck and chest that feels like sandpaper. Why are antibiotics given?MedlinePlus Medical Encyclopedia, "Scarlet fever", Symptoms; Treatment. Outline: NBME Pediatrics Subject Exam content outline, Multisystem Processes & Disorders.
A 9-month-old has 3 days of high fever. On day 4 the fever falls and a pink rash appears on the trunk. Which virus is the cause?MedlinePlus Medical Encyclopedia, "Roseola", Causes; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Multisystem Processes & Disorders.
A week after a cold, a 6-year-old boy has purple spots on his buttocks and lower legs, belly pain and sore knees. His platelet count is normal. Besides the skin, joints and intestines, which organ can be affected?MedlinePlus Medical Encyclopedia, "IgA vasculitis - Henoch-Schonlein purpura", opening; Symptoms. Outline: NBME Pediatrics Subject Exam content outline, Multisystem Processes & Disorders.
Social sciences 1
A 13-year-old who understands the choice refuses an elective procedure that her parents want. Delay carries no serious risk. What does the AMA Code of Medical Ethics advise?AMA Code of Medical Ethics, Opinion 2.2.1, Pediatric Decision Making. Outline: NBME Pediatrics Subject Exam content outline, Social Sciences, including consent and physician-patient relationship.
How this list was compiled: Our own questions, written to the content outline of the Pediatrics Subject Exam that NBME publishes (https://www.nbme.org/institutions/assess-learn/subject-exams/clinical-science/pediatrics/, read 2026-10-12). Its seventeen systems and their ranges: General Principles 3-7%, Immune System 3-7%, Blood & Lymphoreticular System 3-7%, Behavioral Health 1-5%, Nervous System & Special Senses 5-10%, Skin & Subcutaneous Tissue 1-5%, Musculoskeletal System 3-7%, Cardiovascular System 5-10%, Respiratory System 5-10%, Gastrointestinal System 8-12%, Renal & Urinary System 5-10%, Disorders of the Newborn & Congenital Disorders 5-10%, Female Reproductive System 3-7%, Male Reproductive System 1-5%, Endocrine System 5-10%, Multisystem Processes & Disorders 10-15%, Social Sciences 1-5%. The bank holds 3, 3, 3, 1, 4, 2, 3, 4, 4, 5, 4, 4, 2, 1, 4, 6 and 1 questions in that order, 54 in all. Every fact was read on 2026-10-12 in the MedlinePlus Medical Encyclopedia (National Library of Medicine) article the question names; the one question on assent rests on the AMA Code of Medical Ethics. Licence: Questions, choices and explanations are original work of this site.
How it works
This free pediatrics NBME shelf practice test has 54 short cases of our own for the Pediatrics Subject Exam, newborn to teenager. 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 pediatrics shelf covers
NBME's Pediatrics Subject Exam content outline, read October 12, 2026, lists 17 systems. Behavioral health, skin, the male reproductive system and social sciences carry the least, 1 to 5% each. The 54 cases follow the outline's shares.
How the cases are built
Each case gives an age and a few findings, then asks for the diagnosis, the test or the treatment. Every answer names the article and section it rests on, from MedlinePlus in all but one.
The timed test
The timed test here is 40 cases on a 60-minute clock, the minute and a half a case that NBME's timing chart allows.
Age is a clue: pyloric stenosis near 3 weeks, intussusception from 5 months to 3 years, slipped capital femoral epiphysis from 11 to 15.
Questions and answers
How many questions are on the NBME pediatrics shelf exam?
110 items with 2 hours 45 minutes to answer them, by NBME's Subject Examination Timing Chart (July 2021). On a web exam a tutorial comes first and adds 15 minutes.
Are these real NBME pediatrics shelf questions?
No. The 54 cases were written for this page from the public content outline and public health pages. No NBME sample item, self-assessment or review book was opened, used or reworded.
Which topics carry the most weight on the pediatrics shelf?
By the outline: multisystem processes and disorders 10 to 15%, the gastrointestinal system 8 to 12%, then six systems at 5 to 10% each: nervous, cardiovascular, respiratory, renal, endocrine, and newborn and congenital disorders.