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100+ Free ACRRM MCQ Practice Questions

Pass your ACRRM MCQ Assessment (FACRRM Fellowship) exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: ACRRM MCQ Exam

125 questions

Single-best-answer multiple-choice questions on the ACRRM MCQ Assessment

ACRRM - Rural Generalist Assessment

3 hours

Time allowed to complete the 125-question MCQ

ACRRM - MCQ and StAMPS Instruction

Single best answer

Each item has a case stem, a lead-in question and four options

ACRRM - Rural Generalist Assessment

Computer-based

MCQ delivered on computer through ACRRM's Risr/Assess system

ACRRM - MCQ and StAMPS Instruction

Modified Angoff

Standard-setting method used to set the pass mark each sitting

ACRRM - Public MCQ assessment reports

No negative marking

Incorrect answers are not penalised on the MCQ

ACRRM - MCQ and StAMPS Instruction

8 domains

Rural Generalist Curriculum domains of rural and remote practice

ACRRM - Rural Generalist Curriculum

100

Free original practice questions in this bank

OpenExamPrep

The ACRRM MCQ Assessment is a summative written exam on the FACRRM Fellowship pathway, set by the Australian College of Rural and Remote Medicine. It uses 125 single-best-answer multiple-choice questions delivered over 3 hours on computer via the Risr/Assess system, with each item presenting a clinical case stem, a lead-in question and four options. There is no negative marking, and the cut score is set for each sitting using the Modified Angoff method, so the pass mark varies with question difficulty. The assessment covers the whole breadth of rural and remote practice, including emergencies, chronic disease, women's health, paediatrics, mental health and Indigenous health. This 100-question bank provides original single-best-answer practice modelled on that format and curriculum.

Sample ACRRM MCQ Practice Questions

Try these sample questions to test your ACRRM MCQ 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 to a rural emergency department with 40 minutes of central crushing chest pain radiating to the left arm. His ECG shows 2 mm ST elevation in leads II, III and aVF. The nearest catheter laboratory is a 4-hour flight away. What is the most appropriate immediate reperfusion strategy?
A.Administer fibrinolytic therapy as soon as possible
B.Arrange urgent retrieval for primary PCI without other treatment
C.Give aspirin only and observe for 12 hours
D.Withhold reperfusion until troponin returns elevated
Explanation: This is an inferior STEMI. When primary PCI cannot be delivered within 120 minutes, guidelines recommend fibrinolysis within 30 minutes of arrival, then transfer for angiography. Rural generalists must be able to deliver pharmacological reperfusion when PCI is not rapidly accessible.
2A 3-year-old child presents at 2 am with a barking cough, inspiratory stridor at rest and mild chest wall recession. He is alert, pink and able to speak. What is the most appropriate first-line treatment?
A.Oral or nebulised corticosteroid (e.g. dexamethasone)
B.Intravenous antibiotics
C.Nebulised salbutamol
D.Immediate intubation
Explanation: This is moderate croup. A single dose of corticosteroid, such as oral dexamethasone, is first-line and reduces severity and the need for return visits. Nebulised adrenaline is added for severe croup with stridor and marked recession at rest.
3A 24-year-old woman is brought to a remote clinic after a bee sting with rapidly developing facial swelling, widespread urticaria, wheeze and a blood pressure of 80/50 mmHg. What is the most appropriate immediate treatment?
A.Intramuscular adrenaline 0.5 mg into the lateral thigh
B.Intravenous hydrocortisone
C.Oral antihistamine and observation
D.Nebulised salbutamol alone
Explanation: This is anaphylaxis with airway, breathing and circulatory involvement. Intramuscular adrenaline (0.5 mg of 1:1000 for an adult) into the lateral thigh is the first and most important treatment and should be given without delay, then repeated every 5 minutes if needed.
4A 55-year-old Aboriginal man with type 2 diabetes has an HbA1c of 9.2% despite maximal metformin. He has an eGFR of 70 mL/min/1.73m2 and established cardiovascular disease. Which add-on agent best addresses both glycaemic control and his cardiovascular risk?
A.An SGLT2 inhibitor
B.A sulfonylurea
C.Acarbose
D.A short-acting insulin secretagogue
Explanation: In type 2 diabetes with established cardiovascular disease, an SGLT2 inhibitor (or a GLP-1 receptor agonist) is preferred as add-on therapy because it lowers glucose and reduces cardiovascular and renal events. His eGFR is adequate to start one.
5A 30-year-old woman at 34 weeks gestation presents with a blood pressure of 165/110 mmHg, headache and 3+ proteinuria. What is the most appropriate first-line antihypertensive to give acutely while arranging transfer?
A.Oral or IV labetalol
B.Oral atenolol
C.Sublingual nifedipine immediate-release crushed
D.An ACE inhibitor
Explanation: This is severe pre-eclampsia. Labetalol (oral or intravenous) is a recommended first-line agent for acute severe hypertension in pregnancy. Oral immediate-release nifedipine capsules (swallowed, not sublingual) and hydralazine are alternatives, and magnesium sulfate is given for seizure prophylaxis.
6A 19-year-old man presents to a rural clinic saying he feels hopeless and has thought about ending his life. He has a specific plan and access to firearms on the family property. What is the most appropriate immediate management priority?
A.Ensure his immediate safety, including means restriction, and arrange urgent mental health assessment
B.Prescribe an SSRI and review in two weeks
C.Reassure him and provide a crisis line number to call if needed
D.Refer him to a psychologist with a routine appointment in a month
Explanation: A patient with active suicidal ideation, a specific plan and access to lethal means is at high risk. Immediate management focuses on ensuring safety, restricting access to means such as firearms, not leaving him alone, and arranging urgent mental health assessment or admission.
7A 6-month-old infant presents in winter with 3 days of coryza, now with a wheeze, fine crackles, mild work of breathing and oxygen saturation of 94% in air. He is feeding at about 70% of normal. What is the most appropriate management?
A.Supportive care with observation, feeding support and oxygen if saturations fall
B.Nebulised salbutamol and oral prednisolone
C.Intravenous antibiotics
D.Nebulised adrenaline as a routine ongoing treatment
Explanation: This is bronchiolitis, which in Australia is managed supportively. Evidence does not support routine bronchodilators, corticosteroids or antibiotics. Care focuses on monitoring, maintaining hydration and feeding, and providing supplemental oxygen if saturations drop, typically below 90 to 92%.
8A 45-year-old woman from a remote community presents with fever, painful migrating large-joint arthritis and a new early diastolic murmur. She had a sore throat several weeks ago. Which condition must be excluded as a priority in this population?
A.Acute rheumatic fever
B.Osteoarthritis
C.Gout
D.Reactive arthritis from a sexually transmitted infection
Explanation: Migratory polyarthritis, fever, recent streptococcal infection and carditis (a new murmur) are major and minor features suggesting acute rheumatic fever, which remains common in Aboriginal and Torres Strait Islander communities and can cause rheumatic heart disease. The Jones criteria guide diagnosis.
9A 70-year-old man presents with sudden left-sided weakness and facial droop that began 90 minutes ago. A CT brain shows no haemorrhage. He has no contraindications to thrombolysis. The nearest stroke unit is reached by a 3-hour road transfer. What is the most appropriate next step?
A.Discuss thrombolysis with a stroke service via telehealth and treat within the time window if appropriate
B.Give aspirin immediately and arrange routine transfer
C.Wait for symptom resolution before any treatment
D.Give therapeutic enoxaparin immediately
Explanation: For acute ischaemic stroke within the time window with a normal CT and no contraindications, thrombolysis may be appropriate. Rural generalists frequently use telestroke services to make this decision; aspirin is delayed until haemorrhage is excluded and thrombolysis has been considered or given.
10A 28-year-old woman requests contraception. She is a migraine sufferer with aura and smokes 10 cigarettes a day. Which contraceptive method is contraindicated?
A.Combined oral contraceptive pill
B.Progestogen-only pill
C.Copper intrauterine device
D.Etonogestrel implant
Explanation: Migraine with aura is a contraindication (UK/WHO Medical Eligibility Criteria category 4) to combined hormonal contraception because of the increased risk of ischaemic stroke from the oestrogen component. Progestogen-only and non-hormonal options are safe.

About the ACRRM MCQ Exam

The ACRRM Multiple Choice Question (MCQ) Assessment is a summative written examination on the pathway to Fellowship of the Australian College of Rural and Remote Medicine (FACRRM). It tests core generalist applied knowledge, recall and reasoning across all areas of rural and remote practice, and is usually attempted in the second half of core generalist training. The assessment consists of 125 single-best-answer multiple-choice questions delivered over 3 hours on computer through ACRRM's Risr/Assess assessment management system. Each item is typically a clinical case stem with a brief targeted lead-in question and four options, from which the candidate selects the single best option; case stems may include images. There is no negative marking, and the pass mark is set for each sitting using the Modified Angoff method so it varies with the difficulty of the question set. The MCQ assesses the breadth of the Rural Generalist Curriculum, including emergency and acute care, undifferentiated presentations, chronic disease, women's health and obstetrics, paediatrics, mental health, and Aboriginal and Torres Strait Islander health.

Assessment

125 single-best-answer multiple-choice questions, each typically a clinical case stem with a brief lead-in and four options. Stems may include text and images. The assessment samples core generalist knowledge across all areas of rural and remote practice.

Time Limit

3 hours (180 minutes) for 125 questions, delivered on computer through ACRRM's Risr/Assess assessment management system at approved venues.

Passing Score

No fixed percentage pass mark. The cut score is set for each sitting using the Modified Angoff standard-setting method, so the pass mark varies with question difficulty. There is no negative marking for incorrect answers.

Exam Fee

ACRRM sets MCQ enrolment fees annually and publishes them on its assessment dates, enrolments and fees page; the fee is subject to change each year. Confirm the current fee with ACRRM before enrolling. (Australian College of Rural and Remote Medicine (ACRRM))

ACRRM MCQ Exam Content Outline

20%

Undifferentiated presentations and primary care

Diagnosis and safe management of common and undifferentiated presentations in general practice, including history, examination, rational investigation, red flags and follow-up planning in a rural context.

18%

Emergency and acute care

Recognition and initial management of medical and surgical emergencies, including resuscitation, trauma, sepsis, acute coronary syndrome, stroke, anaphylaxis, asthma and toxicology, often before retrieval or transfer.

16%

Chronic disease management

Long-term, guideline-based management of diabetes, hypertension, cardiovascular disease, COPD, asthma, chronic kidney disease, heart failure and multimorbidity in primary care.

10%

Women's health and obstetrics

Antenatal and intrapartum care, postpartum haemorrhage, pre-eclampsia, contraception, cervical screening, and common menstrual, menopausal and gynaecological presentations.

10%

Paediatrics and child health

Assessment of the febrile and unwell child, croup, bronchiolitis, dehydration, growth and development, immunisation and common acute and chronic paediatric conditions.

8%

Mental health

Assessment and management of depression, anxiety, psychosis, suicide and self-harm risk, substance use and acute behavioural disturbance, including the Mental Health Act in rural settings.

8%

Aboriginal and Torres Strait Islander health

Culturally safe care, chronic disease burden, acute rheumatic fever and rheumatic heart disease, health checks, and social and structural determinants of health in Indigenous communities.

10%

Procedural, pharmacology and population health

Rural procedural context, safe prescribing and pharmacology, drug interactions and adverse effects, preventive care, screening, immunisation, and population and public health.

How to Pass the ACRRM MCQ Exam

What You Need to Know

  • Passing score: No fixed percentage pass mark. The cut score is set for each sitting using the Modified Angoff standard-setting method, so the pass mark varies with question difficulty. There is no negative marking for incorrect answers.
  • Assessment: 125 single-best-answer multiple-choice questions, each typically a clinical case stem with a brief lead-in and four options. Stems may include text and images. The assessment samples core generalist knowledge across all areas of rural and remote practice.
  • Time limit: 3 hours (180 minutes) for 125 questions, delivered on computer through ACRRM's Risr/Assess assessment management system at approved venues.
  • Exam fee: ACRRM sets MCQ enrolment fees annually and publishes them on its assessment dates, enrolments and fees page; the fee is subject to change each year. Confirm the current fee with ACRRM before enrolling.

Keys to Passing

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

ACRRM MCQ Study Tips from Top Performers

1Map your study to the eight domains of the ACRRM Rural Generalist Curriculum so you cover emergency, chronic disease, paediatrics, women's health, mental health and Indigenous health systematically rather than by chance.
2Practise reading the lead-in question first, then the stem, so you focus on what is actually being asked before weighing the four options for the single best answer.
3Because the pass mark is set by the Modified Angoff method and there is no negative marking, always commit to an answer for every question rather than leaving any blank.
4Use current Australian guidelines (RACGP/ACRRM, Therapeutic Guidelines, the Australian Immunisation Handbook and ANZCOR) so your management choices reflect what is examinable in an Australian rural context.
5Drill emergency and time-critical management - resuscitation doses, sepsis recognition, anaphylaxis and trauma - because rural generalists must act before retrieval or transfer.
6Review ACRRM's public MCQ assessment reports to understand how questions are structured and the breadth of content sampled across rural and remote practice.

Frequently Asked Questions

How many questions are on the ACRRM MCQ and how long is it?

The ACRRM MCQ has 125 single-best-answer multiple-choice questions delivered over 3 hours (180 minutes) on computer through ACRRM's Risr/Assess assessment management system.

What format are the ACRRM MCQ questions?

Each item is typically a clinical case stem with a brief lead-in question and four options, from which you choose the single best answer. Stems may include text and images, and there is no negative marking.

How is the ACRRM MCQ pass mark set?

There is no fixed percentage pass mark. The cut score is set for each sitting using the Modified Angoff standard-setting method, so it varies depending on the difficulty of that question set.

When in training is the MCQ taken?

The MCQ is a summative assessment usually undertaken in the second half of core generalist training, as part of the pathway to Fellowship of ACRRM (FACRRM).

What does the ACRRM MCQ cover?

It tests core generalist applied knowledge across all areas of rural and remote practice, including emergencies, undifferentiated presentations, chronic disease, women's health and obstetrics, paediatrics, mental health and Aboriginal and Torres Strait Islander health.

Are these official ACRRM practice questions?

No. These are original OpenExamPrep questions modelled on the MCQ format and the Rural Generalist Curriculum. ACRRM publishes official public MCQ assessment reports and handbooks separately.