NBME Practice Test

The NBME examination is a critical milestone for medical students worldwide. Success on the NBME exam (Steps 1, 2, and 3) determines residency placement and future career opportunities. Start your preparation early with targeted NBME practice questions. Also explore our nclex practice test. Practice with the free NBME practice test on PracticeTestGeeks (550+ questions with answer explanations).

NBME Exam at a Glance

What changed for NBME in 2026

• Oct 25, 2026: Exam fee (Clinical Science Mastery Series self-assessment) changed to $21 per self-assessment (previously $21 per form).^[1]
• Oct 25, 2026: Number of questions (Clinical Science Mastery Series self-assessment) changed to 50 multiple-choice questions per form (previously 50 questions per form).^[1]
• Oct 25, 2026: Delivery (Clinical Science Mastery Series self-assessment) changed to Online via the MyNBME Examinee Portal (previously Online via MyNBME Examinee Portal).^[1]
• Oct 25, 2026: Validity (Clinical Science Mastery Series self-assessment) changed to Complete within one year of purchase; can pause and resume during that period (previously Complete within one year of purchase).^[1]
• Oct 25, 2026: Exam fee (Comprehensive Basic Science Self-Assessment (CBSSA)) changed to Starts at $62 (previously From $62 per form).^[2]
• Oct 25, 2026: Delivery (Comprehensive Basic Science Self-Assessment (CBSSA)) changed to Online, from any location with a suitable computer and internet (previously Online, any location with a computer and internet).^[2]
• Oct 25, 2026: Validity (Comprehensive Basic Science Self-Assessment (CBSSA)) changed to Performance profile available for 2 years (previously Performance profile available 2 years).^[2]

Free NBME Study Tools

Interactive NBME resources on PracticeTestGeeks, free to start:

• Pathology Test 1 — 20 questions with instant scoring and answer explanations
• NBME flashcards — review key terms and concepts card by card
• NBME study guide — topic-by-topic overview of what the exam covers
• NBME cheat sheet — one-page printable summary for last-minute review

According to National Board of Medical Examiners, “designed for students taking an NBME Clinical Science Subject Exam”^[1]

Worked examples: how to reason through NBME questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: A 32-year-old woman, gravida 2, para 2, develops fever and left lower abdominal pain 3 days after delivery of a full-term male newborn. Abdominal examination shows a tender, palpable mass. Ultrasonography of the mass shows an ovarian vein thrombosis. The thrombus is most likely to extend into which of the following veins?

1. Hemiazygos vein
2. Inferior vena cava
3. Left internal iliac vein
4. Left internal pudendal vein
5. Left renal vein

Answer: E. Left renal vein

Explanation:

The correct answer is the left renal vein. The left ovarian vein drains into the left renal vein, so a thrombus that grows along the vessel extends in that direction.

The inferior vena cava is where the right ovarian vein drains directly, so it would suit a right-sided thrombus, not this left-sided one. The hemiazygos vein drains the posterior chest wall and has no link to the gonadal veins. The left internal iliac vein carries pelvic drainage, not ovarian drainage. The left internal pudendal vein serves the perineum and is a tributary of the internal iliac system, so it is also the wrong territory.

The rule to remember: gonadal veins do not follow the arteries' pattern on both sides. The right drains into the inferior vena cava and the left drains into the left renal vein. Ask which side the vessel is on before you choose.

Example 2

Question: A 72-year-old patient develops confusion, bradycardia, and yellow-green visual disturbances while on a drug for atrial fibrillation. Toxicity from which drug best explains these findings?

1. Amiodarone
2. Digoxin
3. Metoprolol
4. Diltiazem

Answer: B. Digoxin

Explanation:

The correct answer is digoxin. Confusion, a slow heart rate and yellow-green visual disturbance (xanthopsia) in an older patient being treated for atrial fibrillation is the classic digoxin toxicity picture.

Amiodarone can slow the heart rate, but its typical problems involve the thyroid, lungs, liver and corneal deposits, not yellow-green vision. Metoprolol causes bradycardia through beta blockade, but it does not produce visual colour change. Diltiazem can also slow the rate and lower blood pressure, yet it does not cause xanthopsia.

The rule to remember: when a rate-control drug stem includes a colour vision change, think of digoxin first. Then look for supporting clues such as nausea, older age or reduced kidney function, which make toxicity more likely.

Example 3

Question: A 60-year-old man has tenderness in the region distally between the tendons of the extensor pollicis longus and extensor pollicis brevis (anatomical snuffbox) after falling on the palm of his right hand. A fracture of which of the following carpal bones is most likely in this patient?

1. Hamate
2. Lunate
3. Scaphoid
4. Trapezium
5. Triquetrum

Answer: C. Scaphoid

Explanation:

The correct answer is the scaphoid. A fall onto an outstretched palm with tenderness in the anatomical snuffbox points to a scaphoid fracture. The scaphoid forms part of the floor of the snuffbox, between the extensor pollicis longus and extensor pollicis brevis tendons.

The hamate sits on the ulnar side of the wrist, away from the snuffbox. The lunate lies in the centre of the proximal row and is tender in the middle of the dorsal wrist. The trapezium is at the base of the thumb and is deeper and more distal. The triquetrum is on the ulnar side as well, so tenderness there would not be in the snuffbox.

The rule to remember: snuffbox tenderness after a fall on the hand is a scaphoid fracture until imaging shows otherwise. This bone has a vulnerable blood supply, so it matters clinically.

How to use these practice tests

Start by working out which official product fits you. If you are preparing for a Clinical Science Subject Exam, read the NBME Clinical Science self-assessment page. If you want a broad basic science check, read the CBSSA page. Decide on a date to sit the paid assessment and work backwards from it.

Before you pay for a self-assessment, use the free sets here to find weak subjects. Pick a single subject set, such as Pathology, Pharmacology or Microbiology, and answer every question before you look at any explanation. Then read each explanation, including those for the options you got right, and write down the rule behind each miss.

Once a subject feels steady, move to a mixed set such as the Basic Science test or the Clinical Science test, so you practise switching between topics as the real exam requires. Keep a running list of missed topics and review it before each session.

Take the official self-assessment only when you can sit through it undisturbed. Afterwards, use the score report and performance profile to decide what to review in the time you have left. Because the Clinical Science self-assessments allow one year to finish, you can pause, but a steady pace usually beats a long break.

NBME Exam Timeline

The NBME examination series (USMLE) follows the medical education curriculum. Here is the typical timeline for taking these exams. Also explore our socra practice test.

1. Complete Basic Sciences - Finish first two years of medical school curriculum covering anatomy, pathology, and pharmacology.
2. Pass USMLE Step 1 - Take the NBME Step 1 exam (Pass/Fail) typically after the second year.
3. Clinical Rotations - Complete core rotations (Internal Medicine, Surgery, etc.) and pass NBME shelf exams.
4. Take USMLE Step 2 CK - Assess clinical knowledge and skills application, usually early in the fourth year.
5. Graduate Medical School - Earn your MD or DO degree.
6. Begin Residency - Start your residency training program.
7. Pass USMLE Step 3 - Complete the final NBME exam for independent medical licensure, usually during intern year.

PLAB and NBME: How These Medical Licensing Exams Compare

The PLAB (Professional and Linguistic Assessments Board) exam is the UK equivalent of the USMLE, and many international medical graduates prepare for both PLAB and NBME-style assessments simultaneously. NBME shelf exams and self-assessments use a similar multiple-choice clinical vignette format that builds the same diagnostic reasoning skills tested on PLAB Part 1. Practicing with NBME question banks strengthens the clinical knowledge base needed for both US and UK licensing pathways.

NBME Subject Exam Score Prediction with SSPO

The SSPO (Subject Score Performance Overview) is a diagnostic tool provided by the NBME that breaks down your shelf exam performance by discipline and content area. Reviewing your SSPO report after each NBME subject exam helps identify specific weak areas in pathophysiology, pharmacology, or clinical management that need targeted review. Students who systematically track their SSPO results across multiple shelf exams can measure improvement over time and adjust their study plans before Step 2 CK.

For a fuller set of questions on this topic, see our nbme practice exams resource.

For a fuller set of questions on this topic, see our free nbme practice exams resource.

For a fuller set of questions on this topic, see our nbme questions and answers pdf resource.

For a fuller set of questions on this topic, see our nbme test resource.

Expect to spend over $2,500 on exam fees alone, not including study resources like UWorld, First Aid, or NBME practice tests.

Ready to Pass Your NBME Exam?

Start practicing with our free questions today. Get comfortable with the format, identify your weak areas, and boost your score.

Related Medical Practice Tests

If you are preparing for a career in medical, you may also find these related practice tests helpful:

Prepare for the USMLE - United States Medical Licensing Examination — the United States Medical Licensing Examination for medical school graduates seeking to practice medicine in the US.

Prepare for the MCAT - Medical College Admission Test — the Medical College Admission Test required for admission to medical schools in the US and Canada.

Prepare for the PLAB 1 - Professional and Linguistic Assessments Board Part 1 — the PLAB Part 1 exam for international medical graduates seeking to practice in the United Kingdom.

Prepare for the PLAB 2 - Professional and Linguistic Assessments Board Part 2 — the PLAB Part 2 clinical assessment for international doctors applying for UK medical registration.

Prepare for the PANCE Test — the Physician Assistant National Certifying Exam for PA program graduates entering clinical practice.

Pros and Cons at a Glance

Sample NBME Practice Questions

Try these questions from our free NBME practice tests. The correct answer and an explanation follow each question.

1. A 16-year-old boy is undergoing evaluation for jaundice. Laboratory studies show normal hepatic enzyme activities, a negative direct antiglobulin (Coombs) test, increased mean corpuscular hemoglobin concentration, and increased osmotic fragility of erythrocytes. Which of the following types of erythrocyte is most likely to be seen on a peripheral blood smear?

   • A. Ovalocyte
   • B. Schistocyte
   • C. Spherocyte
   • D. Target cell
   • E. Teardrop cell

Answer: C. Spherocyte

The combination of jaundice, normal hepatic enzymes, negative Coombs test, increased mean corpuscular hemoglobin concentration (MCHC), and increased osmotic fragility is highly characteristic of hereditary spherocytosis. This genetic disorder causes red blood cells to be spherical, rigid, and more fragile, leading to their premature destruction in the spleen. Spherocytes are the hallmark finding on a peripheral blood smear in this condition.

Answer: A. Acid-fast stain

Mycobacteria contain mycolic acids that bind carbol-fuchsin and resist decolorization with acid-alcohol, making them acid-fast positive.

Answer: A. B lymphocytes

Epstein-Barr virus (EBV) infects B lymphocytes via CD21 (complement receptor 2); the atypical lymphocytes seen on smear are reactive cytotoxic T cells responding to infected B cells.

Answer: B. Autoimmune hemolytic anemia

A positive direct Coombs test confirms autoantibodies coating the red cells, consistent with autoimmune hemolytic anemia.

Take the full NBME practice test

Sources & last verified

1. National Board of Medical Examiners — number of questions, exam fee, validity, delivery (official source). “with 50 multiple-choice questions per form” Verified Oct 25, 2026 · source checked Oct 19, 2026.
2. National Board of Medical Examiners — exam fee, validity, delivery, eligibility (official source). “Price starts at $62” Verified Oct 25, 2026 · source checked Oct 19, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.

Official Resources

• National Board of Medical Examiners (NBME) — the official body that develops NBME subject exams, self-assessments, and co-sponsors the USMLE.
• NBME Self-Assessments — the official page where students purchase and take NBME practice exams that predict Step performance.
• United States Medical Licensing Examination (USMLE) — the official USMLE site covering Step 1, Step 2 CK, and Step 3 content, eligibility, and scoring.