100+ Free ABNM Nuclear Medicine Practice Questions

The ABNM Certification Examination is the primary ABMS board-certification exam for nuclear medicine physicians, administered by the American Board of Nuclear Medicine (ABNM). It is a secure, computer-based, single-best-answer multiple-choice examination delivered at Pearson VUE testing centers. Passing the exam, along with ACGME-accredited residency training and active medical licensure, confers ABMS board certification in Nuclear Medicine. The certificate is valid for 10 years, maintained through the ABNM Continuing Certification (CC) program — either the CC exam or CertLink longitudinal assessment.

The ABNM Certification Examination contains 250 multiple-choice questions, delivered at Pearson VUE. Candidates have 4 hours of testing time. All questions are A-type single-best-answer with 4-5 response options — no K-type multiple-select items. The blueprint distributes items across 10 primary categories: Oncology 34% (85 items), Cardiovascular 16% (40), Core 10% (25), Therapy 10% (25), and 5% each (12-13 items) for Endocrine, GI, GU, MSK/Infection-Inflammation, Neurology, and Pulmonary. Secondary classifications include Pediatrics and Correlative Imaging.

The ABNM uses a criterion-referenced scaled passing standard set through a modified Angoff standard-setting process — candidates are measured against a fixed content-expert standard, not curved against peers. Score reports provide pass/fail along with performance by content category. According to the ABNM 2023 Tracers Newsletter (most recent published), the first-time pass rate on the Certification Examination (CE) was 83%. Candidates who fail may take the exam up to 3 times within 7 years of completing residency training.

The 2026 ABNM Certification and Continuing Certification exams are administered October 5-17, 2026 at Pearson VUE testing centers. The application window runs April 1 - May 31 (EDT). The fee structure is $500 non-refundable processing fee (due with application by May 31) plus $2,400 registration fee (due by July 15), totaling $2,900. A $500 late fee applies for applications/payments received after the deadlines. Applications withdrawn after July 15 are not refunded; withdrawals before July 15 receive the $2,400 registration refund but not the $500 processing fee.

Candidates must hold an MD or DO degree and have completed either (1) an ACGME- or RCPSC-accredited Nuclear Medicine residency (typically 3 years), or (2) an approved alternate pathway — e.g., 16 months of Nuclear Medicine training during an ACGME-accredited Diagnostic Radiology residency plus a passed ABR Core Exam; 2 years of ACGME NM plus primary certification by another ABMS board (excluding ABR); or the ABNM alternate pathway (3 years of supervised NM work experience). All candidates must meet NRC 10 CFR 35.390 authorized-user requirements (including 700 hours experience and I-131 case logs) and hold an active, unrestricted medical license.

Oncology (34%) dominates — master FDG PET/CT for lymphoma (Deauville 5-point scale, Lugano), lung cancer, GI malignancy; PSMA PET (Ga-68 PSMA-11, F-18 piflufolastat) for prostate staging/BCR; Ga-68 DOTATATE for GEP-NETs (Krenning score); I-131 MIBG for pheochromocytoma/neuroblastoma; and sentinel node mapping. Cardiovascular (16%) demands fluency in MPI radiopharmaceuticals, cardiac PYP for TTR amyloidosis (Perugini grade + H/CL ratio ≥1.5), FDG PET for cardiac sarcoid (12-hour prep + heparin), and viability. Therapy (10%) emphasizes Lu-177 DOTATATE (4 cycles x 7.4 GBq), Lu-177 PSMA-617 Pluvicto (up to 6 cycles), Ra-223, and I-131 dosing. Core physics (10%) requires memorizing radiopharmaceutical half-lives and NRC 10 CFR 35 authorized-user/medical-event rules.

Memorize these exact values: F-18 = 109.8 minutes (~110 min); Tc-99m = 6.01 hours; I-131 = 8.02 days; I-123 = 13.2 hours; Ga-68 = 67.7 minutes (~68 min); Ga-67 = 78.3 hours (3.26 days); Lu-177 = 6.65 days; Tl-201 = 73 hours (3.04 days); Rb-82 = 76 seconds; N-13 = 9.97 minutes; O-15 = 2.04 minutes; C-11 = 20.4 minutes; Y-90 = 64.1 hours (2.67 days); Ra-223 = 11.4 days; Sm-153 = 46.3 hours; Sr-89 = 50.5 days; In-111 = 67.3 hours. Know that Tc-99m generator Mo-99/Tc-99m breakthrough limit is ≤0.15 µCi Mo-99 per 1 mCi Tc-99m at time of administration (10 CFR 35.204).

Use a structured 6-9 month plan during the final year of residency. Start with radiopharmaceutical physics, half-lives, and NRC 10 CFR 35 authorized-user rules (Core 10%). Then dedicate the largest block to Oncology (34%) — FDG PET interpretation (Deauville, Lugano), PSMA PET, DOTATATE, MIBG, and sentinel node mapping. Next master Cardiovascular (16%) — MPI pharmacology, cardiac PYP for TTR amyloid, FDG sarcoid prep. Follow with Therapy (10%) — Lu-177 PSMA-617/DOTATATE dosing, Ra-223, I-131 — then the 5% categories. Complete the ABNM In-Training Exam (ITE), SNMMI learning resources, and at least one full-length 250-question practice exam before October. Integrate current guidelines: Lugano 2014/RECIL 2017, SNMMI PSMA PET appropriate use, ASNC cardiac PYP consensus (Perugini grade ≥2 + H/CL ≥1.5), and PIOPED II.