100+ Free ABPS Urgent Care Practice Questions

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~75-85% first-time pass rate (BCUCM periodic statistics) Pass Rate

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Question 1

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A 58-year-old man presents with 2 hours of substernal chest pain. HEART score calculation includes which five components?

History, ECG, Age, Risk factors, Troponin

Hypertension, ECG, Angina, Risk, Time

Headache, ECG, Age, Rhythm, Temperature

History, Echo, Age, Race, Troponin

to track

2026 Statistics

Key Facts: ABPS Urgent Care Exam

~200

Total MCQ Items

BCUCM Urgent Care Medicine Certification Examination

~4 hr

Total Exam Time

Computer-based test at Pearson VUE

~11%

MSK Weight (tied largest)

BCUCM 2026 content outline

~$2,500

2026 Exam Fee

ABPS/BCUCM (verify current schedule)

Prior Board

Eligibility

Primary specialty board certification (EM/FM/IM/Peds) required

~75-85%

First-Time Pass Rate

BCUCM periodic statistics

The ABPS Urgent Care Medicine Certification Examination is a computer-based test from the Board of Certification in Urgent Care Medicine (BCUCM) comprising ~200 single-best-answer MCQs over ~4 hours at Pearson VUE. Content spans MSK (~11%), skin/wounds (~11%), respiratory (~10%), HEENT (~10%), cardiovascular (~10%), pediatrics (~8%), GU/OB (~7%), neurologic (~7%), psychiatric (~5%), practice management (~5%), GI (~5%), toxicology (~4%), procedures (~4%), and public health/immunizations (~3%). Fee is ~$2,500; requires MD/DO with primary specialty board certification (commonly EM, FM, IM, or Peds) and documented urgent care practice hours.

Sample ABPS Urgent Care Practice Questions

Try these sample questions to test your ABPS Urgent Care exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man presents with 2 hours of substernal chest pain. HEART score calculation includes which five components?

A.History, ECG, Age, Risk factors, Troponin

B.Hypertension, ECG, Angina, Risk, Time

C.Headache, ECG, Age, Rhythm, Temperature

D.History, Echo, Age, Race, Troponin

Explanation: HEART = History, ECG, Age, Risk factors, Troponin. Each is scored 0-2 (max 10). Low-risk (0-3) = <2% MACE at 6 weeks and can be discharged with outpatient follow-up; moderate (4-6) = admit/observe; high (7-10) = early invasive strategy.

2A 72-year-old woman with DM presents with fatigue, nausea, and dyspnea without chest pain. ECG shows new T-wave inversions V2-V4. Best next step in urgent care?

A.Reassurance and return if chest pain develops

B.Prescribe omeprazole and follow up in 1 week

C.Activate EMS for ED transfer for possible atypical MI

D.Order outpatient stress test in 2 weeks

Explanation: Women, elderly, and diabetics frequently present with atypical ACS symptoms (fatigue, dyspnea, nausea, epigastric discomfort). New ECG changes mandate immediate EMS transfer — urgent care cannot fully rule out MI.

3A stable 65-year-old with new-onset atrial fibrillation (HR 135, BP 128/78) in urgent care. First-line rate-control strategy?

A.IV amiodarone bolus

B.Immediate synchronized cardioversion

C.Oral or IV beta-blocker (metoprolol) or diltiazem

D.Digoxin 0.25 mg PO

Explanation: For stable AF with RVR, AHA guidelines recommend rate control with beta-blockers (metoprolol 2.5-5 mg IV) or non-dihydropyridine CCBs (diltiazem 0.25 mg/kg IV). Cardioversion is reserved for unstable patients. Digoxin is second-line and slower.

4Hypertensive emergency is distinguished from hypertensive urgency by:

A.BP > 200/120 alone

B.Presence of acute end-organ damage (e.g., stroke, ACS, pulmonary edema, AKI)

C.Requirement for 3 medications

D.Age over 65

Explanation: Hypertensive emergency = severe HTN (usually >180/120) WITH acute end-organ damage (encephalopathy, stroke, MI, aortic dissection, pulmonary edema, AKI, eclampsia). Urgency = elevated BP without end-organ injury; treat gradually as outpatient.

5According to the San Francisco Syncope Rule (CHESS), which finding is NOT one of the five high-risk criteria?

A.CHF history

B.Hematocrit < 30%

C.Age > 65

D.Systolic BP < 90

Explanation: CHESS = CHF history, Hematocrit <30%, ECG abnormal, Shortness of breath, Systolic BP <90. Age is NOT a CHESS criterion (though it is in other rules). Any positive CHESS = high-risk for serious outcome at 7 days.

6A 45-year-old with calf swelling and pain. Wells DVT score is 1 (moderate risk). What is the appropriate next step in urgent care?

A.Start empiric rivaroxaban without testing

B.Obtain D-dimer; if negative, DVT excluded

C.Discharge home with NSAIDs

D.Immediate thrombolysis

Explanation: Wells score ≤1 (DVT unlikely) + negative D-dimer excludes DVT. If D-dimer positive OR Wells ≥2, order compression ultrasound. Empiric anticoagulation is not indicated without confirmation unless imaging is delayed and clinical suspicion is high.

7The PERC rule allows you to exclude PE without further testing if the patient has a low pre-test probability AND:

A.D-dimer is negative

B.All 8 PERC criteria are negative

C.Chest X-ray is normal

D.Troponin is negative

Explanation: PERC: age <50, HR <100, SaO2 ≥95%, no hemoptysis, no estrogen use, no prior DVT/PE, no unilateral leg swelling, no recent surgery/trauma. All 8 negative + low clinical pre-test probability = PE effectively ruled out without D-dimer.

8A 28-year-old with sharp chest pain worse when supine, improved by leaning forward. ECG shows diffuse concave ST elevations with PR depressions. Most likely diagnosis?

A.STEMI

B.Acute pericarditis

C.Early repolarization

D.Pulmonary embolism

Explanation: Pericarditis: pleuritic chest pain, positional (worse supine, better leaning forward), friction rub, diffuse concave ST elevations, PR depression (except aVR, V1 where PR is elevated). Treat with NSAIDs + colchicine 0.5 mg BID x 3 months.

9A 22-year-old presents with palpitations and regular narrow-complex tachycardia at 180 bpm, BP 110/70, alert. First-line treatment in urgent care?

A.Synchronized cardioversion

B.IV amiodarone 150 mg

C.Vagal maneuvers (Valsalva), then adenosine 6 mg rapid IV push

D.IV metoprolol 5 mg

Explanation: Stable SVT: try vagal maneuvers (modified Valsalva improves success). If ineffective, adenosine 6 mg rapid IV push, followed by 12 mg if needed. Cardioversion is reserved for unstable patients.

10In an asthma exacerbation, which peak expiratory flow (PEF) range indicates severe exacerbation requiring aggressive therapy and likely ED transfer?

A.>80% of personal best

B.60-80% of personal best

C.40-60% of personal best

D.<40% of personal best

Explanation: PEF severity: mild >70%, moderate 40-69%, severe <40%, life-threatening <25%. Severe exacerbations require continuous beta-agonists, systemic steroids, O2, and ED transfer if inadequate response after 1 hour.

About the ABPS Urgent Care Exam

The ABPS Urgent Care Medicine Certification Examination, administered by the Board of Certification in Urgent Care Medicine (BCUCM) under the American Board of Physician Specialties, validates core knowledge for independent urgent care practice. Content spans musculoskeletal injuries and fracture recognition (Ottawa ankle/knee rules, Salter-Harris, splinting), skin/soft tissue/wound care (laceration repair, digital block with epinephrine, bite wounds, cellulitis/abscess/MRSA, burns), respiratory (asthma, GOLD 2026 COPD, pneumonia with CURB-65, bronchiolitis per AAP, PE with Wells/PERC, Paxlovid), HEENT (AAP AOM, Centor-McIsaac pharyngitis, epistaxis, dental, BPPV with Dix-Hallpike/Epley), cardiovascular (HEART score chest pain, ECG recognition, AF/SVT), pediatrics (Holliday-Segar fluids, fever, intussusception, nursemaid's), GU/OB (UTI, torsion, CDC 2021 STI, ectopic), neurologic (stroke, migraine, concussion SCAT-5, Bell's palsy), psychiatric (PHQ-9, CIWA, buprenorphine), toxicology (acetaminophen/NAC, TCA, CO), procedures, practice management with 2021 E/M coding, and public health including CDC 2026 immunizations and rabies PEP. Eligibility requires MD/DO with unrestricted license and prior primary specialty certification.

Questions

200 scored questions

Time Limit

Computer-based testing at Pearson VUE (~4 hours)

Passing Score

Criterion-referenced scaled score set by BCUCM (modified Angoff standard)

Exam Fee

~$2,500 certification examination fee (ABPS/BCUCM 2026 — verify current schedule) (American Board of Physician Specialties (ABPS) — Board of Certification in Urgent Care Medicine (BCUCM) / Pearson VUE)

ABPS Urgent Care Exam Content Outline

~11%

Musculoskeletal

Ankle, knee, wrist, shoulder, and finger injuries; fracture recognition (Salter-Harris in pediatrics, scaphoid, boxer's, Jones, Lisfranc, Maisonneuve); Ottawa ankle/knee rules and Pittsburgh knee rules; splinting (posterior slab, sugar-tong, thumb spica, volar/dorsal); nursemaid's elbow, patellar and shoulder dislocation reduction; low back pain red flags (cauda equina, infection, malignancy); septic arthritis vs gout vs pseudogout; compartment syndrome.

~11%

Skin, Soft Tissue & Wound Care

Laceration repair (simple interrupted, mattress, running; absorbable vs nonabsorbable; removal timing by site); digital block with epinephrine (2022 safety evidence supports low-concentration epi in fingers/toes); bite wounds (amoxicillin-clavulanate); cellulitis vs abscess and MRSA (TMP-SMX, doxycycline, clindamycin); I&D; impetigo, herpes zoster; burns (Parkland, referral criteria); foreign body removal; paronychia, felon, subungual hematoma trephination.

~10%

Respiratory

Asthma exacerbation (SABA, steroids, magnesium), GOLD 2026 COPD (LABA/LAMA/ICS, antibiotics for purulent sputum), community-acquired pneumonia (CURB-65 disposition), bronchiolitis (AAP supportive care, no routine bronchodilators/steroids), croup (dexamethasone, racemic epi), pertussis (azithromycin), PE risk stratification with Wells and PERC, pneumothorax recognition, COVID-19 outpatient with Paxlovid (nirmatrelvir-ritonavir) for high-risk.

~10%

HEENT, Eye & Dental

AOM (AAP — amoxicillin 80-90 mg/kg/day first-line; high-dose amox-clav for failure or recent antibiotic exposure), otitis externa (topical fluoroquinolone), pharyngitis (Centor-McIsaac for GAS, rapid strep/culture), sinusitis, epistaxis (Kiesselbach, silver nitrate, packing, topical tranexamic acid), dental avulsion/fracture, conjunctivitis, corneal abrasion and FB removal, orbital vs preseptal cellulitis, acute angle-closure glaucoma, BPPV with Dix-Hallpike and Epley.

~10%

Cardiovascular

Chest pain with HEART score (low-risk urgent care disposition), ECG recognition (STEMI, LBBB/Sgarbossa, Wellens, de Winter, hyperkalemia, pericarditis), ACS recognition and transfer, hypertensive urgency vs emergency, atrial fibrillation with RVR, SVT (vagal, adenosine), syncope (San Francisco Syncope Rule), heart failure exacerbation, DVT evaluation with Wells and D-dimer, PERC for PE.

~8%

Pediatrics

Fever without source by age, vital signs by age, Holliday-Segar fluid calculation (4-2-1 rule), dehydration assessment, ORT vs IV fluids, AAP bronchiolitis and AOM guidance, croup, pharyngitis in children, intussusception, pyloric stenosis, testicular torsion, Kawasaki recognition, child abuse red flags (sentinel injuries, pattern bruising, retinal hemorrhage), pediatric analgesia and procedural sedation, nursemaid's elbow reduction.

~7%

Genitourinary & Obstetric

Uncomplicated UTI (nitrofurantoin, TMP-SMX, fosfomycin), pyelonephritis, epididymitis, testicular torsion (time-sensitive surgical referral), renal colic and stone size disposition, vaginitis, PID (CDC — ceftriaxone + doxycycline ± metronidazole), CDC 2021 STI (gonorrhea — ceftriaxone 500 mg IM; chlamydia — doxycycline 100 mg BID × 7 days), first-trimester bleeding, ectopic recognition, pregnancy-safe medications, Rh alloimmunization and anti-D.

~7%

Neurologic

Headache red flags (thunderclap, focal, elderly new-onset, immunosuppressed), migraine abortive therapy (triptans, metoclopramide, ketorolac), stroke (FAST/BEFAST, last known normal, transfer for thrombolysis/thrombectomy), TIA (ABCD2), seizure evaluation, Bell's palsy (prednisone, consider valacyclovir), concussion (SCAT-5, return-to-play progression), vertigo central vs peripheral with HINTS and Dix-Hallpike/Epley.

~5%

Gastrointestinal

Abdominal pain differential by quadrant, Alvarado score for appendicitis, biliary colic and cholecystitis, diverticulitis, gastroenteritis (oral rehydration), GERD, peptic ulcer, GI bleeding red flags and transfer, hernia, hemorrhoids and anorectal complaints, constipation and disimpaction in pediatrics, foreign body ingestion including button batteries.

~5%

Psychiatric & Behavioral

Depression screening (PHQ-9), suicide risk assessment (Columbia), anxiety and panic, acute agitation management, alcohol withdrawal (CIWA, benzodiazepines, thiamine before glucose — Wernicke prevention), opioid use disorder (buprenorphine initiation, naloxone), substance-use screening, intimate partner violence screening, involuntary hold criteria.

~5%

Practice Management & Documentation

2021 CMS evaluation and management coding (time-based vs MDM), documentation standards, informed consent, EMTALA applicability in urgent care vs ED, patient transfer and handoff, against medical advice, HIPAA, telemedicine, quality and patient safety, risk management, discharge instructions and return precautions, Beers 2023 criteria for older adults.

~4%

Toxicology & Environmental

Acetaminophen overdose (Rumack-Matthew nomogram, N-acetylcysteine), salicylate toxicity, TCA overdose (sodium bicarbonate for QRS widening), beta-blocker/CCB (glucagon, calcium, high-dose insulin), opioid (naloxone), carbon monoxide (hyperbaric indications), methanol/ethylene glycol (fomepizole), heat illness, hypothermia and frostbite, envenomations, marine injuries, lightning.

~4%

Procedures

Laceration repair and tissue adhesives, digital block with epinephrine (2022 evidence), incision and drainage, foreign body removal, joint aspiration and reduction, splinting (posterior slab, sugar-tong, thumb spica), subungual hematoma trephination, paronychia/felon drainage, eye irrigation, ear/nose FB removal, nasal packing, mallet finger splinting, Thompson test for Achilles rupture, point-of-care ultrasound basics.

~3%

Public Health, Prevention & Immunizations

CDC 2026 immunization schedules for adults and children, Tdap in pregnancy 27-36 weeks, Shingrix for adults ≥50, HPV 9-valent, influenza and COVID-19 annual updates, rabies post-exposure prophylaxis (RIG + HDCV days 0/3/7/14; day 21-28 added in immunocompromised), tetanus prophylaxis and TIG, travel medicine basics, reportable diseases, STI screening and partner notification.

How to Pass the ABPS Urgent Care Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by BCUCM (modified Angoff standard)
Exam length: 200 questions
Time limit: Computer-based testing at Pearson VUE (~4 hours)
Exam fee: ~$2,500 certification examination fee (ABPS/BCUCM 2026 — verify current schedule)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABPS Urgent Care Study Tips from Top Performers

1HEART score for chest pain (History, ECG, Age, Risk factors, Troponin): 0-3 low risk (consider outpatient with shared decision-making), 4-6 moderate (observation and serial testing), 7-10 high (ACS pathway). Use only after ACS is not already established and after standard workup; urgent care role is identifying low-risk patients safe for outpatient follow-up versus patients needing ED transfer.

2Ottawa ankle rules (X-ray indicated if pain in malleolar zone AND bone tenderness at posterior edge/tip of lateral or medial malleolus OR inability to bear weight both immediately and in ED for 4 steps) and Ottawa knee rules (age ≥55, isolated patella tenderness, fibular head tenderness, inability to flex to 90°, or inability to bear weight both immediately and in ED). Pittsburgh knee rules are an alternative with higher specificity.

3CDC 2021 STI Treatment Guidelines: Gonorrhea — ceftriaxone 500 mg IM × 1 (1 g if ≥150 kg); treat for chlamydia if not excluded with doxycycline 100 mg PO BID × 7 days (azithromycin 1 g × 1 for pregnancy or adherence concerns). PID outpatient — ceftriaxone 500 mg IM × 1 + doxycycline 100 mg BID × 14 days ± metronidazole 500 mg BID × 14 days. Expedited partner therapy per state law.

4Rabies post-exposure prophylaxis in a previously UNVACCINATED patient: wound cleansing + human rabies immunoglobulin (HRIG) 20 IU/kg infiltrated at wound site (remainder IM distant from vaccine) + HDCV/PCEC vaccine 1 mL IM on days 0, 3, 7, 14 (day 21-28 dose added for immunocompromised). Previously vaccinated — vaccine on days 0 and 3, NO HRIG. Always consult local public health for bat, skunk, raccoon, fox exposures.

5AAP AOM: amoxicillin 80-90 mg/kg/day divided BID × 5-10 days is first-line for most children. Use high-dose amoxicillin-clavulanate (90 mg/kg/day amoxicillin component) for treatment failure at 48-72 hours, recent amoxicillin within 30 days, concurrent purulent conjunctivitis, or recurrent AOM. Observation option (no antibiotic for 48-72 hr with follow-up) is appropriate for ≥2 years with nonsevere unilateral AOM and reliable follow-up.

Frequently Asked Questions

What is the ABPS Urgent Care Medicine Certification Examination?

The ABPS Urgent Care Medicine Certification Examination is administered by the Board of Certification in Urgent Care Medicine (BCUCM) under the American Board of Physician Specialties. It validates breadth of knowledge across the urgent care practice scope including musculoskeletal, skin and wound care, respiratory, HEENT, cardiovascular, pediatrics, genitourinary/obstetric, neurologic, psychiatric, toxicology, procedures, practice management, and public health/immunizations.

Who is eligible to take the ABPS Urgent Care exam?

Candidates must be MD or DO physicians with a valid unrestricted medical license and hold primary specialty board certification — most commonly Emergency Medicine (ABEM/AOBEM), Family Medicine (ABFM/AOBFP), Internal Medicine, or Pediatrics — from ABMS, ABPS, or AOA. BCUCM also requires documented urgent care practice hours over a qualifying period and compliance with continuing medical education requirements.

What is the format of the ABPS Urgent Care exam?

The ABPS Urgent Care exam is a computer-based examination administered at Pearson VUE test centers comprising approximately 200 single-best-answer multiple-choice questions over about 4 hours. Items commonly include clinical vignettes, ECG strips, radiographic images, and clinical photographs. The exam is blueprinted to the BCUCM content outline spanning the full scope of adult and pediatric urgent care medicine.

How much does the 2026 ABPS Urgent Care exam cost?

The 2026 certification examination fee is approximately $2,500 — always verify the current schedule on the ABPS/BCUCM website. Candidates also pay application and Continuous Certification fees. Cancellation and refund policies follow the ABPS schedule with decreasing refunds as the exam date approaches. Retakes require re-registration and full fee payment within the allowed qualification window.

When is the 2026 exam administered?

BCUCM typically offers the Urgent Care Medicine certification exam during defined testing windows through Pearson VUE. Applications open in advance with submission deadlines several months before the testing window. Candidates schedule specific appointments with Pearson VUE after application approval. Confirm 2026 testing windows and application deadlines on the ABPS/BCUCM examinations page.

How is the exam scored?

BCUCM uses criterion-referenced scaled scoring with a passing standard set by subject-matter experts using the modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports include domain-level feedback for identifying areas of strength and improvement.

What are the highest-yield topics?

Highest-yield topics include HEART score for chest pain disposition, Ottawa ankle/knee rules, Centor-McIsaac for strep pharyngitis, Wells and PERC for PE/DVT, CURB-65 for pneumonia, GOLD 2026 COPD management, CDC 2021 STI treatment (ceftriaxone 500 mg IM for gonorrhea; doxycycline 100 mg BID × 7 days for chlamydia), AAP AOM (amoxicillin 80-90 mg/kg), Holliday-Segar pediatric fluids, rabies post-exposure prophylaxis (RIG + HDCV days 0/3/7/14), tetanus prophylaxis, Paxlovid for high-risk outpatient COVID, Shingrix ≥50, digital block with epinephrine 2022 evidence, Dix-Hallpike and Epley for BPPV, Rumack-Matthew with NAC for acetaminophen, SCAT-5 concussion, 2021 E/M coding, and Beers 2023 criteria.

How should I study for this exam?

Use a structured 3-6 month plan layered on active urgent care practice. Map study to the BCUCM content outline: start with MSK/wound/procedures, then respiratory/cardiac/HEENT, then pediatrics/GU/neuro/psych, then toxicology/public health/practice management. Integrate The Journal of Urgent Care Medicine, urgent care textbooks, AAP/CDC/ACEP guidelines, and high-volume MCQ practice. Complete 2 full-length timed mock exams. Drill clinical decision rules (HEART, Ottawa, Centor, Wells, CURB-65, PERC, SCAT-5).