100+ Free ACMSO ACMS Practice Questions

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A hospitalist documents 'patient transferred out of ICU to step-down unit.' 'Step-down unit' (also called intermediate care) provides:

Long-term care for chronically ill patients

The highest intensity of care, equivalent to ICU

Monitoring and care between ICU and general medical-surgical ward

Outpatient rehabilitation services only

to track

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AHDPG MSCE Medical Scribe Certification

Practice Questions100 questions

2026 Statistics

Key Facts: ACMSO ACMS Exam

100

Exam Questions

Multiple-choice + fill-in-the-blank

~2 hrs

Time Limit

ACMSO

70%

Passing Score

ACMSO minimum

20+

Specialties Covered

ACMSO curriculum

$165

Exam Fee

Standalone exam 2026

2–6 wks

Typical Study Time

Self-paced program

The ACMSO Advanced Clinical Medical Scribe Certification exam has 100 questions (multiple-choice and fill-in-the-blank) completed in approximately 2 hours. Passing requires 70% overall. Content covers SOAP notes, EHR mastery (Epic, Cerner, Athena), HIPAA, medical terminology, anatomy, and 20+ medical specialties. No prior clinical experience is required. The program is CPD-accredited and recognized by major healthcare employers. A bundled training + exam package is available from $250.

Sample ACMSO ACMS Practice Questions

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

1A physician asks you to document the reason the patient came in today. Which section of the SOAP note captures this information?

A.Review of Systems (ROS)

B.Chief Complaint (CC)

C.Assessment

D.Physical Exam (PE)

Explanation: The Chief Complaint (CC) is a brief statement, usually in the patient's own words, describing why the patient is seeking care today. It is the first element of the Subjective section of the SOAP note.

2Which acronym helps scribes capture all components of the History of Present Illness (HPI)?

A.HIPAA

B.SOAP

C.OLDCARTS

D.POMR

Explanation: OLDCARTS stands for Onset, Location, Duration, Character, Alleviating factors, Relieving factors, Timing, and Severity. It is the standard mnemonic for documenting a thorough HPI.

3A patient states: 'I've had a dull ache in my lower back for two weeks. It gets worse when I bend forward and improves with ibuprofen.' The scribe should place 'dull ache' under which OLDCARTS element?

A.Location

B.Duration

C.Character

D.Timing

Explanation: Character describes the quality or nature of the symptom — in this case, 'dull ache.' Location would be 'lower back,' Duration would be 'two weeks,' and Timing relates to whether symptoms are constant or intermittent.

4Which section of the SOAP note lists current medications, past surgeries, family history, and social history?

A.Chief Complaint

B.HPI

C.Past Medical History (PMH) / Background

D.Assessment and Plan

Explanation: Past Medical History includes previous diagnoses, hospitalizations, surgeries, current medications, allergies, family history, and social history. These background elements are part of the Subjective section but are distinct from the HPI.

5The Review of Systems (ROS) is best described as:

A.A list of objective findings from physical examination

B.A systematic inquiry of symptoms across body systems reported by the patient

C.The physician's assessment of the working diagnosis

D.A record of vital signs measured at triage

Explanation: The ROS is a systematic questionnaire asking the patient about symptoms in each major body system (constitutional, cardiovascular, respiratory, GI, etc.). It is part of the Subjective section, representing patient-reported symptoms, not physical findings.

6In EHR documentation, a scribe enters 'Patient denies chest pain, shortness of breath, and palpitations.' This entry belongs in which note section?

A.Physical Examination

B.Assessment

C.Review of Systems

D.Plan

Explanation: Denials and affirmations of symptoms across body systems are recorded in the Review of Systems. Cardiovascular system ROS commonly includes chest pain, dyspnea, and palpitations.

7A patient presents with BP 148/92 mmHg, HR 88 bpm, temperature 98.6°F, RR 16, and SpO2 98%. Where does the scribe record these measurements?

A.Subjective — HPI

B.Objective — Vital Signs

C.Assessment

D.Review of Systems

Explanation: Vital signs are objective, measurable data and are recorded in the Objective section of the SOAP note. They are not patient-reported symptoms, so they do not belong in the Subjective section.

8Which EHR system is most widely used in large academic medical centers and hospital systems in the United States?

A.Meditech

B.Athena

C.Epic

D.Allscripts

Explanation: Epic holds the largest market share among U.S. hospital EHR systems, particularly in large academic medical centers. Cerner (now Oracle Health) is the second most common. Meditech and Allscripts are common in smaller facilities.

9Under HIPAA, Protected Health Information (PHI) includes which of the following?

A.De-identified aggregate statistics published in a research journal

B.A patient's name combined with their diagnosis and date of birth

C.The total number of flu cases in a city during one week

D.A physician's personal medical license number

Explanation: PHI is individually identifiable health information. Combining a patient's name with diagnosis and date of birth creates PHI because it links identity to health information. De-identified data and aggregate statistics without individual identifiers are not PHI.

10A medical scribe overhears a patient's diagnosis while working in an emergency department. The scribe may lawfully share this information with:

A.A friend who is a nurse at a different hospital

B.The patient's employer, who is asking about the absence

C.Members of the direct care team treating the patient

D.The media if it involves a public figure

Explanation: HIPAA's Treatment, Payment, and Operations (TPO) exception permits sharing PHI with members of the direct care team without separate patient authorization. Sharing with employers, friends at other facilities, or media would violate HIPAA.

About the ACMSO ACMS Exam

The ACMSO Advanced Clinical Medical Scribe Certification validates competency in clinical documentation, EHR navigation, HIPAA compliance, medical terminology, anatomy, and multi-specialty scribing. The exam consists of 100 multiple-choice and fill-in-the-blank questions completed in approximately 2 hours. Content spans SOAP note structure, HPI and ROS documentation, Epic/Cerner/Athena EHR workflows, emergency department scribing, and patient case scenarios across 20+ medical specialties. A minimum passing score of 70% is required; the Medical Note Writing and HIPAA components require 85%. The program is accredited by CPD Standards Office and recognized for AMA/ANCC continuing professional development credit.

Questions

100 scored questions

Time Limit

~2 hours

Passing Score

70% (approximately 70/100 correct)

Exam Fee

$165–$499 (American College of Medical Scribe Organizations (ACMSO) — online proctored)

ACMSO ACMS Exam Content Outline

~15%

Medical Terminology & Abbreviations

Prefixes, suffixes, combining forms, body system terminology, clinical shorthand (PRN, SOAP, NPO, SOB, etc.), medication abbreviations, and specialty-specific language.

~15%

Anatomy & Physiology

Major organ systems, anatomical planes and directional terms, cardiovascular and respiratory physiology, renal function, electrolyte regulation, endocrine system, and GI anatomy.

~25%

Clinical Documentation & SOAP Notes

Chief Complaint, HPI (OLDCARTS), Past Medical History, Review of Systems, physical exam documentation, objective data (vital signs, labs, imaging), Assessment and Plan structure, scope of practice, and documentation ethics.

~20%

EHR Mastery

Epic SmartPhrases, Cerner Medication Manager, Athena navigation, problem list management, allergy documentation, audit trails, order entry support, and multi-platform workflows.

~10%

HIPAA & Privacy Compliance

PHI definition and 18 identifiers, minimum necessary standard, TPO exceptions, breach notification, patient rights (right of access), workforce obligations, and de-identification.

~5%

ICD-10-CM & CPT Basics

Common ICD-10 code categories (E11, I10, K35, etc.), E/M coding levels (99213), procedure codes, multi-diagnosis documentation, and code specificity for documentation support.

~10%

Specialty & Emergency Documentation

ED triage (ESI), RSI documentation, cardiology (EF, ASCVD risk), neurology (GCS, MMSE), OB/GYN (TPAL, labor terminology), dermatology, orthopedics, psychiatry (PHQ-9, SI/HI), gastroenterology, nephrology, and telehealth-specific requirements.

How to Pass the ACMSO ACMS Exam

What You Need to Know

Passing score: 70% (approximately 70/100 correct)
Exam length: 100 questions
Time limit: ~2 hours
Exam fee: $165–$499

Keys to Passing

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

ACMSO ACMS Study Tips from Top Performers

1Master SOAP note structure: know what belongs in each section (Subjective, Objective, Assessment, Plan) before the exam

2Practice OLDCARTS for HPI documentation — it covers the majority of HPI-related questions

3Know the 18 HIPAA identifiers cold and be able to distinguish PHI from de-identified data

4Learn Epic SmartPhrases and basic navigation; Epic is the most commonly tested EHR platform

5Study ICD-10 code categories for the most common conditions: hypertension (I10), diabetes (E11), GERD (K21), UTI (N39.0)

6Review medical terminology prefixes, suffixes, and combining forms — at least 15 questions test terminology

7Understand the scribe's scope of practice: document what the physician says, never add clinical opinion

8Study specialty-specific documentation patterns: cardiology (EF, ejection fraction), ED (ESI triage, RSI), OB/GYN (TPAL notation)

9Practice differentiating ROS from physical exam — patient-reported symptoms go in ROS; physician-observed findings go in PE

10Review HIPAA breach notification rules and the four-factor assessment for potential breach risk

Frequently Asked Questions

What is the ACMSO Advanced Clinical Medical Scribe Certification?

The ACMSO Advanced Clinical Medical Scribe Certification is an online, CPD-accredited credential offered by the American College of Medical Scribe Organizations (ACMSO). It validates competency in clinical documentation, EHR navigation, HIPAA, medical terminology, anatomy, and multi-specialty scribing workflows for healthcare settings.

How many questions are on the ACMSO certification exam?

The ACMSO certification exam consists of 100 questions in multiple-choice and fill-in-the-blank formats. The exam is typically completed within approximately 2 hours and must be passed with a minimum score of 70%.

What is the passing score for the ACMSO medical scribe exam?

The overall ACMSO certification exam passing score is 70% (70 out of 100 correct). Component exams within the program — specifically the Medical Note Writing and HIPAA exams — require a minimum score of 85%. Two attempts are included.

What does the ACMSO certification exam cover?

The ACMSO exam covers medical terminology, anatomy and physiology, SOAP note documentation (HPI, ROS, physical exam, assessment and plan), EHR platforms (Epic, Cerner, Athena, Meditech), HIPAA compliance, ICD-10/CPT basics, and clinical documentation across 20+ medical specialties including emergency medicine, cardiology, neurology, OB/GYN, psychiatry, and gastroenterology.

Do I need prior medical experience to take the ACMSO certification?

No. ACMSO explicitly states that no prior scribe experience, clinical licensure, or specific academic degree is required. The program is designed for pre-health students, career changers, and healthcare administrative workers. Completion of ACMSO's training program is strongly recommended before sitting for the exam.

How much does the ACMSO certification cost?

The standalone ACMSO certification exam costs $165. Bundled training and exam packages range from $250 to $499, depending on the included courses (core scribing, specialty certifications, EHR training, CMAA exam prep). Check acmso.org for current pricing.

Is the ACMSO certification recognized by employers?

ACMSO certification is recognized by hospitals, physician practices, urgent care centers, and specialty clinics for medical scribe hiring. The program is CPD-accredited and affiliated with NHA (National Healthcareer Association) for the optional CMAA add-on credential. Employers in competitive markets may also look for AHDPG CMSP certification as a complementary credential.