100+ Free CGC Practice Questions

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What is the Genetic Information Nondiscrimination Act (GINA) designed to prevent?

Genetic discrimination in health insurance and employment

Direct-to-consumer genetic testing

Unauthorized genetic testing of minors

Patenting of human genes

to track

2026 Statistics

Key Facts: CGC Exam

~200

Exam Questions

ABGC

4 hrs

Time Limit

ABGC

$400

Exam Fee

ABGC

~80-85%

First-Time Pass Rate

Estimated

5 yrs

Recertification Cycle

50 CEUs required

The CGC exam has approximately 200 questions with a 4-hour time limit. It covers genetic testing and genomics (25%), risk assessment and probability (20%), counseling skills and psychosocial support (20%), clinical genetics (25%), and ethics and professional practice (10%). A criterion-referenced scaled score is required to pass. Recertification requires 50 CEUs every 5 years.

Sample CGC Practice Questions

Try these sample questions to test your CGC 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 most appropriate first step when a patient is referred for genetic counseling regarding a family history of breast cancer?

A.Order BRCA1/BRCA2 testing immediately

B.Construct a detailed three-generation pedigree

C.Recommend prophylactic mastectomy

D.Refer directly to an oncologist

Explanation: Constructing a detailed three-generation pedigree is the essential first step in genetic counseling for hereditary cancer. The pedigree identifies patterns of inheritance, affected family members, ages of diagnosis, and cancer types, which informs the risk assessment and determines whether genetic testing is appropriate. Testing should only be ordered after proper counseling, informed consent, and risk assessment.

2Which inheritance pattern is characterized by affected individuals in every generation, with affected fathers never transmitting the condition to sons?

A.Autosomal dominant

B.Autosomal recessive

C.X-linked dominant

D.Mitochondrial

Explanation: X-linked dominant inheritance shows affected individuals in every generation (like autosomal dominant), but affected fathers pass the condition to all daughters and no sons, because fathers give their X chromosome to daughters and their Y chromosome to sons. Affected mothers have a 50% chance of passing the condition to children of either sex.

3What does the term 'penetrance' refer to in genetics?

A.The severity of symptoms in an affected individual

B.The proportion of individuals with a specific genotype who express the expected phenotype

C.The age at which symptoms first appear

D.The number of genes involved in a trait

Explanation: Penetrance refers to the proportion of individuals carrying a particular genotype who actually express the associated phenotype. A condition with 80% penetrance means 80% of individuals with the causative genotype will develop the condition. Reduced penetrance explains why some gene carriers remain unaffected. This concept is important for risk counseling because it affects the probability estimates given to families.

4Which type of genetic test analyzes the protein products of genes rather than DNA directly?

A.Next-generation sequencing

B.Biochemical genetic testing

C.Chromosomal microarray

D.Karyotype analysis

Explanation: Biochemical genetic testing analyzes the protein products of genes, including enzyme activity levels, metabolite concentrations, and protein structure. Examples include measuring enzyme activity for lysosomal storage disorders, amino acid levels for phenylketonuria, and hemoglobin electrophoresis for hemoglobinopathies. This contrasts with molecular testing (DNA analysis) and cytogenetic testing (chromosome analysis).

5What is the primary purpose of nondirectiveness in genetic counseling?

A.To avoid liability for counseling recommendations

B.To empower clients to make autonomous, informed decisions aligned with their own values

C.To reduce the time spent in counseling sessions

D.To ensure the counselor does not need specialized knowledge

Explanation: Nondirectiveness is a core principle of genetic counseling that aims to empower clients to make autonomous, informed decisions consistent with their own values, beliefs, and circumstances. The counselor provides accurate information, explores the client's values, and supports decision-making without imposing personal opinions or recommendations. This approach respects client autonomy and acknowledges the deeply personal nature of genetic decisions.

6A couple who are both carriers of an autosomal recessive condition asks about their risk for having an affected child. What is the recurrence risk for each pregnancy?

A.10%

B.25%

C.50%

D.75%

Explanation: When both parents are carriers (heterozygous) of an autosomal recessive condition, each pregnancy has a 25% (1 in 4) chance of producing an affected child (homozygous), a 50% chance of producing a carrier, and a 25% chance of producing a non-carrier. This risk applies independently to each pregnancy regardless of the outcomes of previous pregnancies.

7What does FISH (fluorescence in situ hybridization) testing detect?

A.Single nucleotide variants in coding regions

B.Specific chromosomal regions using fluorescent DNA probes to identify deletions, duplications, or rearrangements

C.Epigenetic methylation patterns

D.Trinucleotide repeat expansions

Explanation: FISH uses fluorescently labeled DNA probes that bind to specific chromosomal regions to detect targeted deletions, duplications, translocations, and aneuploidies. It can be performed on metaphase or interphase cells, making it useful for rapid aneuploidy screening (e.g., trisomy 21) and detecting known microdeletion syndromes (e.g., 22q11.2 deletion). It does not detect point mutations or small sequence changes.

8What is the standard symbol used to represent a deceased female in a pedigree?

A.An empty circle with a diagonal line through it

B.A filled circle

C.An empty square with a diagonal line through it

D.A diamond with a diagonal line through it

Explanation: In standard pedigree nomenclature, females are represented by circles and males by squares. A diagonal line through the symbol indicates that the individual is deceased. A filled (solid) symbol indicates the individual is affected with the condition being tracked. An empty circle with a diagonal line represents a deceased, unaffected female.

9Which prenatal diagnostic procedure can be performed earliest in pregnancy?

A.Amniocentesis

B.Chorionic villus sampling (CVS)

C.Cordocentesis

D.Maternal serum screening

Explanation: Chorionic villus sampling (CVS) can be performed at 10-13 weeks of gestation, making it the earliest invasive prenatal diagnostic procedure. Amniocentesis is typically performed at 15-20 weeks. Cordocentesis (percutaneous umbilical blood sampling) is performed after 18-20 weeks. Maternal serum screening is non-invasive and not diagnostic; it provides risk estimates that may lead to diagnostic testing.

10What is the purpose of informed consent in genetic testing?

A.To protect the laboratory from lawsuits

B.To ensure the patient understands the test, its implications, limitations, and possible outcomes before agreeing to testing

C.To satisfy insurance company requirements

D.To document the patient's medical history

Explanation: Informed consent for genetic testing ensures that patients understand what the test will analyze, the possible results (positive, negative, variant of uncertain significance), the implications for themselves and family members, limitations of the test, privacy considerations, and their right to decline testing. It is an ethical and legal requirement that respects patient autonomy and supports shared decision-making.

About the CGC Exam

The CGC certification demonstrates expertise in genetic counseling including genetic testing interpretation, pedigree analysis, risk assessment, psychosocial counseling techniques, clinical genetics across prenatal, cancer, and pediatric specialties, variant interpretation, ethical issues in genomic medicine, and patient-centered care.

Questions

100 scored questions

Time Limit

4 hours

Passing Score

Criterion-referenced scaled score

Exam Fee

$400 (ABGC (American Board of Genetic Counseling))

CGC Exam Content Outline

25%

Genetic Testing & Genomics

Test selection and interpretation, ACMG variant classification, NGS technologies, cytogenetics, pharmacogenomics, and emerging genomic tools

20%

Risk Assessment & Probability

Pedigree analysis, Bayesian calculations, Hardy-Weinberg equilibrium, polygenic risk scores, and risk communication strategies

20%

Counseling Skills & Psychosocial

Psychosocial counseling, empathic responding, nondirectiveness, cultural competence, motivational interviewing, and grief support

25%

Clinical Genetics

Prenatal genetics, cancer predisposition syndromes, pediatric genetics, adult-onset conditions, inheritance patterns, and reproductive options

10%

Ethics & Professional Practice

Informed consent, GINA, confidentiality, duty to warn, testing of minors, secondary findings, research ethics, and scope of practice

How to Pass the CGC Exam

What You Need to Know

Passing score: Criterion-referenced scaled score
Exam length: 100 questions
Time limit: 4 hours
Exam fee: $400

Keys to Passing

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

CGC Study Tips from Top Performers

1Practice Bayesian risk calculations extensively — these probability questions appear frequently and require comfort with conditional probability and pedigree analysis

2Know the ACMG/AMP 5-tier variant classification system cold — understand the criteria for pathogenic, likely pathogenic, VUS, likely benign, and benign classifications

3Study cancer genetics syndromes thoroughly (HBOC/BRCA, Lynch syndrome, Li-Fraumeni, Cowden) including inheritance, screening guidelines, and management recommendations

4Review psychosocial counseling frameworks — be prepared for questions about empathic responding, nondirectiveness, cultural competence, and handling emotional reactions

5Understand ethical issues including GINA limitations, testing of minors, duty to warn vs. confidentiality, and management of secondary findings from genomic sequencing

Frequently Asked Questions

What is the CGC certification?

The CGC (Certified Genetic Counselor) credential is awarded by the ABGC to genetic counselors who demonstrate competency in genetic counseling practice. It covers genetic testing interpretation, risk assessment using pedigree analysis and probability calculations, psychosocial counseling techniques, clinical genetics across multiple specialties, and ethical issues in genomic medicine. CGC certification is required for practice in most clinical settings.

How many questions are on the CGC exam?

The CGC certification exam contains approximately 200 multiple-choice questions with a 4-hour time limit. The questions cover five content domains: genetic testing and genomics (25%), risk assessment and probability (20%), counseling skills and psychosocial issues (20%), clinical genetics (25%), and ethics and professional practice (10%). The exam uses a criterion-referenced passing standard.

What are the prerequisites for the CGC exam?

Candidates must hold a master's degree from an ACGC-accredited genetic counseling program. Programs include supervised clinical training with documented case experiences across multiple genetics specialties. The exam is typically taken within the first year after program completion. Currently, there are approximately 50 accredited programs in the United States and Canada.

How should I study for the CGC exam?

Effective CGC exam preparation includes reviewing clinical genetics across prenatal, cancer, pediatric, and adult specialties, practicing Bayesian risk calculations and pedigree analysis, studying ACMG variant classification criteria and testing methodologies, reviewing counseling skills frameworks, and understanding ethical and legal issues in genetic counseling. Most candidates study 3-6 months. Focus on clinical scenarios that integrate multiple content areas.