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NZREX Cheat Sheet 2026

The 30 highest-yield NZREX facts, distilled from real exam questions. Print it, save it as a PDF, or study it here β€” free, no sign-up.

NZREX exam key facts

  • The NZREX Clinical examination consists of 12 OSCE stations. Source
  • The NZREX Clinical examination lasts for a total duration of 3 hours. Source
  • To pass the NZREX Clinical, a candidate must achieve an overall score greater than the cut score and receive at least seven overall pass or borderline results out of the 12 stations in a single sitting. Source
  • The NZREX Clinical requires an examination fee of NZ$4,966.94 plus a non-refundable application fee of NZ$860.92, inclusive of GST. Source
  • Candidates may sit the NZREX Clinical multiple times provided they meet eligibility requirements each time they apply, but cannot reapply until they have received feedback from their prior attempt. Source
  • A pass in the NZREX Clinical examination is valid for 5 years from the date of the examination. Source
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  1. A patient presents with ptosis, miosis, and anhidrosis on the right side of the face. Which syndrome does this describe? β†’ Horner syndrome
  2. Which of the following is the most common cause of acute pancreatitis in New Zealand? β†’ Gallstones
  3. What does the term 'tikanga Māori' mean in the context of healthcare? β†’ Māori customary values and practices that guide appropriate and respectful behaviour
  4. According to the New Zealand National Immunisation Schedule, which combination vaccine is administered to all infants at 6 weeks of age? β†’ DTaP-IPV-Hib-HepB (Infanrix-hexa)
  5. What is the primary purpose of the 'systems review' component of a clinical history? β†’ To identify symptoms not covered in the presenting complaint that may be relevant
  6. A patient with type 2 diabetes has a new eGFR of 25 mL/min/1.73mΒ². What change should be made to their metformin therapy? β†’ Cease metformin as it is contraindicated at this eGFR
  7. What is the primary legislation that established the current NZ health system structure replacing DHBs in 2022? β†’ Pae Ora (Healthy Futures) Act 2022
  8. A patient has asymmetric reflexes with brisk reflexes on the right and absent reflexes on the left arm. Which type of lesion would cause absent reflexes? β†’ Lower motor neurone lesion
  9. A patient is brought in with a GCS of 8 after a road traffic accident. What is the GCS score threshold typically used to guide intubation? β†’ GCS ≀8
  10. During a NZREX dermatological assessment, what systematic approach should be used to describe a skin lesion? β†’ Site, size, shape, surface, surrounding skin, colour, consistency, and distribution
  11. Which ethical framework best describes the view that the right action is the one that produces the greatest good for the greatest number? β†’ Utilitarianism
  12. A 70-year-old patient presents with confusion. Which validated tool is most appropriate for brief cognitive assessment in the acute setting? β†’ Abbreviated Mental Test Score (AMTS)
  13. Which organisation is responsible for registering and regulating health practitioners in New Zealand? β†’ The relevant Responsible Authority under the HPCA Act 2003 (e.g., Medical Council of NZ)
  14. Which of the following is the recommended first-line antihypertensive for a 50-year-old Māori man with hypertension and no other comorbidities? β†’ ACE inhibitor or angiotensin receptor blocker
  15. Which model of patient communication is most aligned with the NZ Code's emphasis on partnership and shared decision-making? β†’ Collaborative/shared decision-making model
  16. Which article of Te Tiriti o Waitangi affirms Māori rangatiratanga (chieftainship) over their lands, villages, and taonga? β†’ Article 2 (Tino Rangatiratanga)
  17. Which NZ strategy is specifically designed to address the health disparities experienced by Māori? β†’ He Korowai Oranga β€” Māori Health Strategy
  18. Which of the following is a contraindication to the use of metformin? β†’ eGFR below 30 mL/min/1.73mΒ²
  19. Under the New Zealand Medicines Act 1981, which of the following is correctly classified as a Prescription Medicine requiring a valid prescription? β†’ Metoprolol 50mg tablets
  20. A patient describes waking at night with arm pain and paraesthesia that is relieved by shaking the hand. Which nerve is most likely affected? β†’ Median nerve
  21. Which of the three principles of Te Tiriti o Waitangi is represented by the Crown's obligation to actively protect Māori health? β†’ Protection (Tiakitanga)
  22. A patient presents to a NZ ED with anaphylaxis. What is the first-line drug treatment? β†’ Intramuscular adrenaline (epinephrine) 0.5 mg (1:1000) into the anterolateral thigh
  23. Which organisation in New Zealand is responsible for determining which medicines are subsidised on the Pharmaceutical Schedule? β†’ PHARMAC
  24. A patient presents with sudden severe 'thunderclap' headache. What is the most important diagnosis to exclude? β†’ Subarachnoid haemorrhage
  25. Which clinical sign is used to assess for hepatomegaly during abdominal examination? β†’ Begin percussion in the right iliac fossa and move superiorly until dullness is detected
  26. Under the Pae Ora Act 2022, what is the primary function of Health New Zealand (Te Whatu Ora)? β†’ Commission and deliver health services nationally, replacing the 20 DHBs
  27. Which symptom in a patient with haematuria most increases concern for bladder cancer? β†’ Painless macroscopic haematuria
  28. During a respiratory examination in the NZREX, what does increased tactile vocal fremitus on one side suggest? β†’ Consolidation (such as pneumonia) on that side
  29. Which of the following is most consistent with a diagnosis of irritable bowel syndrome (IBS)? β†’ Abdominal pain relieved by defecation, altered stool form, no red flag symptoms
  30. A 28-year-old woman presents at 10 weeks gestation with a urinary tract infection. Which antibiotic is most appropriate? β†’ Nitrofurantoin (avoiding near term)
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How this page was made: written with AI tools and published by Nathan Beja, founder of Practice Test Geeks, who is responsible for its content. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

  1. mcnz.org.nz β€” Test delivery, exam dates, exam format, registration, retake policy, score release, time limit, score validity, passing score, fees Β· verified Oct 2026