100+ Free BCEMP Practice Questions

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Question 1

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What is the recommended dose of IV/IO epinephrine during adult cardiac arrest per ACLS 2020 guidelines?

0.1 mg every 3-5 minutes

1 mg every 3-5 minutes

10 mg every 3-5 minutes

0.5 mg every 10 minutes

to track

2026 Statistics

Key Facts: BCEMP Exam

150

Total Questions

125 scored + 25 pretest

4h 23m

Total Exam Time

Part 1 + Part 2

500/800

Passing Score

BPS scaled scoring

$600

Exam Fee

BPS 2026 ($300 retake)

2023

First Exam Year

Specialty approved 2019

7 years

Certification Valid

Recertification cycle

The BCEMP exam tests advanced emergency pharmacy practice with 150 multiple-choice items (125 scored) across two sections (Part 1: 100 items in 2h30m; Part 2: 75 items in 1h53m). BPS uses scaled scoring with 500 (on a 200-800 scale) required to pass. Pass rates for recent cohorts are roughly 60-70%. Eligibility requires an active pharmacist license plus one pathway: PGY1 + PGY2 in emergency medicine within 7 years, PGY1 + 2 years EM practice (greater than or equal to 50%), or 4 years EM practice (greater than or equal to 50%). Certification is valid 7 years.

Sample BCEMP Practice Questions

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

1What is the recommended dose of IV/IO epinephrine during adult cardiac arrest per ACLS 2020 guidelines?

A.0.1 mg every 3-5 minutes

B.1 mg every 3-5 minutes

C.10 mg every 3-5 minutes

D.0.5 mg every 10 minutes

Explanation: ACLS 2020 recommends 1 mg IV/IO epinephrine every 3-5 minutes during adult cardiac arrest. Epinephrine is administered as soon as feasible for non-shockable rhythms and after first or second shock for shockable rhythms.

2A patient in refractory ventricular fibrillation has received two shocks and one dose of epinephrine. What is the recommended initial dose of amiodarone?

A.150 mg IV bolus

B.300 mg IV bolus

C.450 mg IV bolus

D.1 mg/kg IV bolus

Explanation: The initial dose of amiodarone in refractory VF/pulseless VT is 300 mg IV/IO push, followed by a second dose of 150 mg if VF/VT persists. Amiodarone is preferred over lidocaine in most ACLS algorithms.

3Which antiarrhythmic is first-line for torsades de pointes?

A.Amiodarone 300 mg IV

B.Lidocaine 1.5 mg/kg IV

C.Magnesium sulfate 1-2 g IV

D.Procainamide 17 mg/kg IV

Explanation: IV magnesium sulfate 1-2 g is first-line therapy for torsades de pointes regardless of the patient's magnesium level. Torsades is a polymorphic VT associated with QT prolongation; magnesium stabilizes the myocardial membrane.

4A hemodialysis patient presents in cardiac arrest with peaked T waves noted before the arrest. Which medication addresses the underlying cause most directly?

A.Sodium bicarbonate 1 mEq/kg

B.Calcium gluconate 3 g IV

C.Regular insulin 10 units IV with D50

D.Albuterol 20 mg nebulized

Explanation: Calcium (gluconate or chloride) is the fastest-acting therapy for cardiac membrane stabilization in hyperkalemia. In a hemodialysis patient with peaked T waves and arrest, empiric calcium is indicated. Insulin/dextrose and albuterol shift K+ intracellularly but act slower.

5What is the correct PALS dose of epinephrine for pediatric cardiac arrest?

A.0.001 mg/kg IV/IO

B.0.01 mg/kg IV/IO (1:10,000)

C.0.1 mg/kg IV/IO (1:1,000)

D.1 mg IV/IO regardless of weight

Explanation: PALS dose of epinephrine for cardiac arrest is 0.01 mg/kg IV/IO (0.1 mL/kg of 1:10,000) every 3-5 minutes. Maximum single dose is 1 mg.

6A 6-month-old in symptomatic SVT has failed vagal maneuvers. What is the correct first dose of adenosine?

A.0.05 mg/kg rapid IV push

B.0.1 mg/kg rapid IV push

C.0.2 mg/kg rapid IV push

D.6 mg rapid IV push

Explanation: PALS first-dose adenosine for SVT is 0.1 mg/kg (max 6 mg) rapid IV push followed by saline flush. If ineffective, give 0.2 mg/kg (max 12 mg) as the second dose.

7A 65-year-old presents for RSI with a BP of 85/50 and HR 120. Which induction agent is most hemodynamically neutral?

A.Propofol 2 mg/kg

B.Etomidate 0.3 mg/kg

C.Midazolam 0.3 mg/kg

D.Thiopental 5 mg/kg

Explanation: Etomidate 0.3 mg/kg is the most hemodynamically neutral induction agent and is preferred in hemodynamically unstable patients. Ketamine is an alternative that can actually increase BP via sympathetic stimulation.

8Which RSI paralytic is contraindicated in a patient with hyperkalemia of 6.2 mEq/L?

A.Rocuronium

B.Vecuronium

C.Succinylcholine

D.Cisatracurium

Explanation: Succinylcholine causes a transient rise in serum potassium of approximately 0.5 mEq/L and is contraindicated in pre-existing hyperkalemia. It is also contraindicated in malignant hyperthermia, muscular dystrophies, and burns/denervation 24-72 hours or older.

9What is the correct RSI dose of rocuronium when succinylcholine is contraindicated?

A.0.3 mg/kg

B.0.6 mg/kg

C.1.0 mg/kg

D.1.2 mg/kg

Explanation: For RSI, rocuronium 1.2 mg/kg provides intubating conditions in approximately 60 seconds, comparable to succinylcholine. The standard non-RSI dose is 0.6 mg/kg, which takes longer (2-3 minutes).

10A 78 kg patient presents within 3 hours of stroke symptom onset. NIHSS is 14, BP 170/95, no contraindications. What is the correct alteplase dose?

A.0.9 mg/kg with 10% bolus, remainder over 60 min (max 90 mg)

B.0.6 mg/kg over 60 min

C.100 mg over 2 hours

D.0.25 mg/kg single bolus

Explanation: Per 2019 AHA/ASA stroke guidelines, alteplase is dosed at 0.9 mg/kg (max 90 mg) with 10% given as an IV bolus over 1 minute and the remainder infused over 60 minutes. For 78 kg: 70.2 mg total, 7.02 mg bolus, rest over 60 min.

About the BCEMP Exam

The BCEMP certification is the premier board credential for emergency medicine pharmacists, approved by BPS in 2019 with first exam administration in 2023. The exam assesses acute patient care, evidence-based pharmacotherapy for ED conditions, toxicology, medication safety, and operational/disaster readiness. It contains 150 items (125 scored, 25 unscored) delivered in two sections with an optional break.

Questions

150 scored questions

Time Limit

4 hours 23 minutes

Passing Score

500/800 (scaled)

Exam Fee

$600 (Board of Pharmacy Specialties (BPS))

BCEMP Exam Content Outline

45%

Acute Patient Care and Pharmacotherapy

Cardiac arrest/ACLS-PALS, rapid sequence intubation, stroke and STEMI, sepsis/shock, status epilepticus, DKA, hyperkalemia, pulmonary embolism, asthma/anaphylaxis, pain and sedation, trauma resuscitation, obstetric and pediatric emergencies.

20%

Toxicology and Antidote Management

Acetaminophen, salicylates, TCA, beta-blocker/CCB, digoxin, opioids/benzodiazepines, toxic alcohols, iron/lead, anticoagulant reversal (idarucizumab, andexanet, 4F-PCC, vitamin K), cyanide, organophosphate, envenomation.

20%

Medication Safety and Systems

ED-specific safety (high-alert meds, look-alike/sound-alike), antimicrobial and opioid stewardship, transitions of care, order verification at bedside, discharge prescribing, medication reconciliation in boarding patients.

15%

Emergency Preparedness and Operations

Mass-casualty incident pharmacotherapy, disaster and chempack/SNS utilization, infection outbreak response, ED workflow optimization, pharmacist response to codes and traumas, evidence-based practice and quality improvement.

How to Pass the BCEMP Exam

What You Need to Know

Passing score: 500/800 (scaled)
Exam length: 150 questions
Time limit: 4 hours 23 minutes
Exam fee: $600

Keys to Passing

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

BCEMP Study Tips from Top Performers

1Memorize weight-based ACLS/PALS drug dosing cold - epinephrine, amiodarone, adenosine, atropine, magnesium

2Master RSI induction and paralytic selection including succinylcholine contraindications (hyperkalemia, burns >24-72h, crush, muscular dystrophy, malignant hyperthermia)

3Know tPA/alteplase inclusion/exclusion criteria, dosing (0.9 mg/kg, max 90 mg) and post-tPA BP targets (<180/105)

4Review the full Surviving Sepsis 1-hour bundle: lactate, cultures, broad-spectrum abx, 30 mL/kg crystalloid, norepinephrine as first-line vasopressor

5Drill toxicology antidotes - NAC, sodium bicarb (TCA/salicylates), glucagon/HIET/lipid emulsion (BB/CCB), DigiFab, fomepizole, hydroxocobalamin, pralidoxime

Frequently Asked Questions

What is the BCEMP pass rate?

Recent BCEMP cohorts pass at approximately 60-70%, with better performance among PGY2 emergency medicine residency graduates than the practice-experience pathway. BPS uses scaled scoring from 200-800, with 500 required to pass, which normalizes for question difficulty across forms.

How many questions are on the BCEMP exam?

The BCEMP exam has 150 multiple-choice questions (125 scored, 25 unscored pretest). The exam is split into two parts with an optional 30-minute break: Part 1 has 100 items in 2 hours 30 minutes and Part 2 has 75 items in 1 hour 53 minutes, totaling about 4 hours 23 minutes of testing time.

Who is eligible for the BCEMP exam?

Candidates must hold an active pharmacist license plus ONE of three pathways: (1) PGY1 pharmacy residency plus PGY2 emergency medicine residency completed within the past 7 years, (2) PGY1 pharmacy residency within the past 7 years plus at least 2 years of emergency medicine practice with 50%+ scope, or (3) at least 4 years of practice in a hospital or ED setting with 50%+ scope in emergency medicine.

How much does the BCEMP exam cost?

The BCEMP exam application fee is $600 for initial certification and $300 for retakes within 12 months of a failed attempt. Costs do not include review courses (ACCP/ASHP prep course, High-Yield Med Reviews) or study materials.

When was BCEMP established and when are exams administered?

BPS approved emergency medicine pharmacy as a recognized specialty in 2019 after petition from emergency medicine pharmacists. The first BCEMP examination was administered in 2023. Exams are offered twice annually in spring and fall testing windows at Pearson VUE test centers.

How should I prepare for the BCEMP exam?

Plan 150-250 hours over 3-6 months. High-yield focus areas: ACLS/PALS drug dosing and algorithms, RSI induction/paralytic selection, thrombolytics and stroke care, sepsis bundles with vasopressor choice, status epilepticus protocols, toxicology antidotes, and anticoagulant reversal. Use the ACCP/ASHP Emergency Medicine Pharmacy Preparatory Review Course and practice 1,000+ case-based questions.

How long is BCEMP certification valid?

BCEMP certification is valid for 7 years. Recertification requires either passing the recertification examination OR completing 100 hours of BPS-approved professional development (PDP) modules through organizations like ACCP or ASHP during the 7-year cycle.