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100+ Free NMLE Integrated Practice Questions

Prepare for the Integrated Chinese-Western Practitioner Licensing Examination (中西医结合执业医师资格考试) exam with instant access — no signup required.

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2026 Statistics

Key Facts: NMLE Integrated Exam

600

Total questions in the Medical Comprehensive Examination (4 units × 150 MCQs)

TCM Qualification Examination Center (tcmtest.org.cn)

360

Fixed national passing score threshold (60% of 600)

National Administration of Traditional Chinese Medicine

4 Units

Exam units administered over 2 testing days (150 min per unit)

NMEC Examination Notice

2 Stages

Examination structure: Practical Skills Exam (June) + Medical Comprehensive Exam (August)

PRC Physician Licensing Regulations

100

High-yield practice questions in this prep bank

OpenExamPrep

The NMLE Integrated Practitioner Exam is China's official 600-question (4 units × 150 MCQs), 2-day computer-based licensing exam with a fixed 360/600 passing cutoff. It tests dual competence in TCM and Western medicine across Internal Medicine (35%), Foundations (20%), Surgery/Ob-Gyn/Pediatrics (25%), and Diagnostics/Pharmacology (20%). Candidates must first pass the Practical Skills Exam (实践技能考试) before taking the Medical Comprehensive Exam (医学综合考试).

Sample NMLE Integrated Practice Questions

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

1In Traditional Chinese Medicine (TCM) Five Elements theory (五行学说), when chronic Heart Fire hyperactivity drains Liver Yin, leading to Liver blood deficiency and restlessness, this pathological transmission is termed which of the following relationships?
A.Subjugation / Over-restriction (相乘)
B.Mother disease affecting child (母病及子)
C.Child disease draining mother (子病犯母 / 子盗母气)
D.Reverse restriction / Insult (相侮)
Explanation: In Five Elements theory, Wood generates Fire (Wood is the mother, Fire is the child; Liver belongs to Wood, Heart belongs to Fire). When the child organ (Heart Fire) becomes pathologically hyperactive or deficient and consecutively consumes its mother organ (Liver Wood), it is classified as 'Child disease draining mother' (子病犯母 / 子盗母气).
2A 58-year-old male with chronic coronary heart disease presents with chest tightness, dark purple tongue with petechiae, insomnia, and irritability. In TCM Zang-Fu physiology (藏象学说), the physiological synergy between the Heart and Liver (心肝生理关系) primarily depends on which mechanism?
A.Mutual transformation of congenital essence and acquired essence (先天与后天之精相互资生)
B.Synergistic regulation of blood circulation and emotional activities (血液运行与情志调节的协同)
C.Coordination of water-fluid metabolism and respiration (水液代谢与呼吸运动的协调)
D.Mutual control of ascending clear Yang and descending turbid Yin (清阳上升与浊阴下降的互根)
Explanation: The Heart governs blood and vessels (心主血脉) and houses the Shen/Mind (心藏神), while the Liver stores blood (肝藏血) and governs free coursing/emotions (肝主疏泄). Together, they coordinate blood circulation (Heart drives, Liver stores/regulates volume) and emotional stability (Heart dominates mental clarity, Liver ensures smooth Qi flow).
3The classic TCM physiological dictum stating that 'The Spleen is the source of phlegm production, while the Lung is the storage vessel for phlegm' (脾为生痰之源，肺为贮痰之器) is rooted in which functional connection between the two Zang organs?
A.The Spleen governs transformation and transportation of water-dampness, while the Lung governs diffusion and depurative descent of fluids (脾主运化水湿，肺主宣降水液)
B.The Spleen generates blood while the Lung distributes Qi (脾统血而肺主气)
C.The Spleen warms Kidney Yang while the Lung cools Heart Fire (脾温肾阳而肺清心火)
D.The Spleen governs muscle mass while the Lung governs the skin and body hair (脾主肌肉而肺主皮毛)
Explanation: When Spleen Qi is deficient, its function of transforming and transporting fluids (运化水湿) is impaired, producing internal dampness that congeals into phlegm (生痰之源). Turbid phlegm ascends along channels and accumulates in the Lung, impairing the Lung's diffusion and descending functions (宣发肃降), causing coughing and wheezing (贮痰之器).
4In TCM fundamental theory, Kidney Yin and Kidney Yang (肾阴与肾阳) are regarded as the root of all Yin and Yang in the human body (五脏阴阳之本). What is their fundamental physiological relationship?
A.Kidney Yin is dominant in childhood, while Kidney Yang dominates in old age (幼年阴盛，老年阳盛)
B.Kidney Yin and Kidney Yang are mutually dependent, mutually restricting, and share the same root in Kidney Essence (相互依存、相互制约，同居于命门水火之中)
C.Kidney Yang generates Kidney Qi, while Kidney Yin only moistens the lower burner (肾阳生精，肾阴独化水饮)
D.Kidney Yin is acquired from food essence, while Kidney Yang is exclusively inherited from ancestors (肾阴后天化生，肾阳纯属先天)
Explanation: Kidney Yin (True Yin/元阴) and Kidney Yang (True Yang/元阳) reside together in the Kidney. Kidney Yin moistens, cools, and calms all Zang-Fu organs, whereas Kidney Yang warms, activates, and transforms Qi. They are mutually dependent, restricting, and rooted in the same primordial Kidney Essence (同源互根).
5A patient suffering from chronic menorrhagia presents with pallor, profound fatigue, shortness of breath on exertion, and spontaneous sweating. This clinical picture illustrates which foundational principle regarding Qi and Blood (气血关系)?
A.Qi generates Blood (气能生血)
B.Blood is the mother of Qi (血为气之母)
C.Qi governs and commands Blood, and Qi holds Blood in vessels (气为血之帅，气能统血/摄血)
D.Blood moves Qi through the vessels (血行则气行)
Explanation: Qi acts as the commander of Blood (气为血之帅): it drives blood circulation, generates blood, and holds blood within vessels (气能摄血/统血). When Qi (especially Spleen Qi) is severely deficient, it fails to hold blood, leading to chronic hemorrhage, which in turn leads to further Qi exhaustion.
6Among the Six Exogenous Pathogenic Factors (六淫致病特点), which pathogenic factor is characterized by heaviness, turbidity, stickiness, stagnation, and a tendency to impair the Yang Qi of the Middle Burner and invade lower body parts (重浊、黏滞、趋下)?
A.Wind pathogen (风邪)
B.Cold pathogen (寒邪)
C.Dampness pathogen (湿邪)
D.Dryness pathogen (燥邪)
Explanation: Dampness (湿邪) is an Yin pathogen characterized by heavy and turbid manifestations (heavy limbs, murky discharge), sticky and lingering disease courses (difficult to clear), downward infusion (edema of lower limbs, turbid urine, vaginal discharge), and easy impairment of Spleen Yang.
7During tongue inspection (舌诊) in an integrated medicine clinic, a patient is observed to have a bright red tongue body with a thick, yellow, greasy coating (舌红，苔黄厚腻). This tongue presentation most accurately indicates which pathological pattern?
A.Extreme cold coagulation with Yang deficiency (阳虚寒凝证)
B.Damp-heat accumulation and brewing in the interior (湿热内蕴/内结证)
C.Stomach and Kidney Yin exhaustion (胃肾阴竭证)
D.Spleen Qi deficiency with water inundation (脾虚水泛证)
Explanation: A red tongue body (舌红) indicates interior heat, while a thick, yellow, greasy coating (苔黄厚腻) signifies damp-turbidity and phlegm-heat accumulating internally. Together, this is the classic hallmark of damp-heat brewing in the interior (湿热内蕴).
8A patient presents with hypertension, dizziness, hypochondriac distension, and a pulse that feels taut, straight, and long like a pressed musical string (端直以长，如按琴弦). Which pulse condition is this, and what is its primary clinical significance in TCM?
A.Slippery pulse (滑脉), indicating phlegm-dampness or pregnancy
B.Wiry/String-taut pulse (弦脉), indicating Liver-Gallbladder disorders, pain, or phlegm-retained fluid
C.Soggy pulse (濡脉), indicating Qi-Blood deficiency and dampness
D.Surging pulse (洪脉), indicating extreme exterior cold
Explanation: A pulse that is taut, straight, and long like a pressed musical string is the Wiry pulse (弦脉). It indicates Liver-Gallbladder disorders (肝胆病), Qi stagnation, pain syndromes, phlegm-rheum (痰饮), or arteriosclerosis/hypertension.
9A 72-year-old patient with end-stage heart failure presents with extremely cold extremities, curled-up posture, profuse cold sweats, yet has flushed red cheeks, thirst with a desire for warm drinks, a pale tongue with white coat, and a faint pulse on the verge of expiring (脉微欲绝). In TCM Eight Principles (八纲辨证), this condition is diagnosed as which of the following?
A.True Heat with False Cold (真热假寒 / 阳盛格阴)
B.True Cold with False Heat (真寒假热 / 阴盛格阳)
C.Interior Heat with Exterior Cold (表寒里热)
D.Simultaneous Yang Collapse and Yin Collapse (阴阳俱亡)
Explanation: This patient exhibits True Cold with False Heat (真寒假热), also known as 'Yin exuberance repelling Yang' (阴盛格阳). Severe internal Yin-cold repels the remaining weak Yang Qi to the body surface, producing false heat signs (facial flush, desire for warm sips) while the core signs (cold limbs, pale tongue, faint pulse) confirm genuine extreme Yang deficiency.
10In Zang-Fu syndrome differentiation (脏腑辨证), what is the key clinical distinction between Liver Fire Flaming Upward (肝火炽盛证) and Liver Yang Hyperactivity (肝阳上亢证)?
A.Liver Fire flaming upward is a purely excess heat syndrome (实热证), whereas Liver Yang hyperactivity is an upper-excess with lower-deficiency syndrome rooted in Liver-Kidney Yin deficiency (本虚标实证)
B.Liver Fire causes dizziness, whereas Liver Yang hyperactivity never causes headaches
C.Liver Yang hyperactivity shows a red tongue with thick yellow dry coat, whereas Liver Fire shows a pale tongue
D.Liver Fire affects only females, whereas Liver Yang hyperactivity affects only males
Explanation: Liver Fire Flaming Upward (肝火炽盛) is a pure full-excess heat syndrome characterized by fiery heat signs (burning red eyes, bitter taste, intense headache, constipation, red tongue with dry yellow coat, rapid wiry pulse). In contrast, Liver Yang Hyperactivity (肝阳上亢) is an upper excess / lower deficiency pattern (本虚标实) where underlying Kidney/Liver Yin deficiency fails to anchor Yang, producing dizziness, tinnitus, sore weak lumbar region/knees, and a wiry thin rapid pulse.

About the NMLE Integrated Exam

The Integrated Chinese-Western Practitioner Licensing Examination (中西医结合执业医师资格考试) is the statutory qualifying examination administered by the National Administration of Traditional Chinese Medicine (NATCM) and National Medical Examination Center (NMEC) under the PRC Physician Law. Candidates must demonstrate proficiency in both Traditional Chinese Medicine (TCM theory, diagnostics, herbal formulas, acupuncture) and Western clinical medicine (internal medicine, surgery, ob/gyn, pediatrics, diagnostics, pharmacology). Practice emphasizes the hallmark methodology of integrated medicine: combining Western disease identification (辨病) with TCM syndrome differentiation (辨证) to deliver evidence-based, holistic patient care.

Questions

600 scored questions

Time Limit

8 hours total for the comprehensive exam (4 units × 120 minutes across two days), plus the separate practical-skills examination

Passing Score

360 / 600 (60% fixed national standard)

Exam Fee

RMB 160–300 depending on provincial test center (National Administration of Traditional Chinese Medicine / TCM Qualification Examination Center (国家中医药管理局中医师资格认证中心 / tcmtest.org.cn))

NMLE Integrated Exam Content Outline

20%

Integrated TCM-Western Foundations (中西医基础理论)

TCM Basic Theory (Yin-Yang, Five Elements, Zang-Fu organ manifestations, Qi-Blood-Fluids, Pathogenesis, Meridians and Collaterals), TCM Diagnostics (Inspection, Auscultation/Olfaction, Inquiry, Palpation, Eight Principles, Pattern Differentiation), Western Pathophysiology, Health Law (《中华人民共和国医师法》, 《中医药法》), and Medical Ethics.

35%

Integrated Clinical Internal Medicine (中西医结合内科学)

Cardiovascular (Hypertension, CAD, Heart Failure, Arrhythmias), Respiratory (COPD, Bronchial Asthma, Pneumonia), Gastrointestinal (Peptic Ulcer, Cirrhosis, Pancreatitis), Renal (Glomerulonephritis, Nephrotic Syndrome, CKD), Endocrine/Metabolic (Diabetes Mellitus, Thyroid disorders), Hematology (Anemia, Leukemia), Neurology (CVD, Parkinson's), and Rheumatology with integrated pattern differentiation and formula selection.

25%

Integrated Surgery, Ob/Gyn & Pediatrics (中西医结合外妇儿科)

Integrated Surgery (Acute abdomen, Appendicitis, Cholelithiasis, Intestinal Obstruction, Breast & Thyroid disease, Peripheral vascular disease, Anorectal disorders); Obstetrics & Gynecology (Dysmenorrhea, Abnormal uterine bleeding, Pelvic inflammatory disease, Ectopic pregnancy, Gestational hypertension); Pediatrics (Pediatric pneumonia, Diarrheal diseases, Nephrotic syndrome, Infectious diseases, and Growth/Development).

20%

Integrated Diagnostics, Pharmacology & Western Therapeutics (西医诊断与药理学)

Clinical Diagnostics (Symptomatology, Physical Examination, 12-lead ECG interpretation, Laboratory hematology/biochemistry/microbiology, Radiological and Ultrasound imaging), Clinical Pharmacology (Antibiotics, Antihypertensives, Cardiovascular agents, Hypoglycemics, Glucocorticoids, NSAIDs), and Emergency Resuscitation.

How to Pass the NMLE Integrated Exam

What You Need to Know

  • Passing score: 360 / 600 (60% fixed national standard)
  • Exam length: 600 questions
  • Time limit: 8 hours total for the comprehensive exam (4 units × 120 minutes across two days), plus the separate practical-skills examination
  • Exam fee: RMB 160–300 depending on provincial test center

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

NMLE Integrated Study Tips from Top Performers

1Master the dual-table mapping of Western diseases to their corresponding classic TCM syndromes (证型) and representative formulas (代表方剂).
2Memorize first-line Western drug choices alongside classic Chinese patent medicines and herbal decoctions for internal medicine emergencies (e.g., Acute Heart Failure, Diabetic Ketoacidosis, Hypertensive Crisis).
3Focus heavily on high-yield ECG interpretations (MI waveforms, STEMI localization, Atrial Fibrillation, AV blocks) and key laboratory lab panels (liver function, renal function, cardiac biomarkers, ABG).
4Drill A2-type clinical case vignettes, carefully identifying tongue and pulse signs (舌脉) to pinpoint the exact TCM syndrome differentiation.
5Review the PRC Physician Law (《医师法》) and regulations concerning informed consent, emergency medical care, prescription writing rules, and reporting of statutory infectious diseases (甲类/乙类传染病).
6Practice timed computer-based mock exams (150 questions in 150 minutes per unit) to build stamina and speed for the 600-question two-day examination.

Frequently Asked Questions

What is the structure of the Integrated Chinese-Western Practitioner Licensing Examination?

The examination comprises two sequential stages: (1) Practical Skills Examination (实践技能考试) held in June, which evaluates clinical skills, acupuncture points, physical exams, and clinical case analysis; and (2) Medical Comprehensive Examination (医学综合笔试/机考) held in August, consisting of 4 units with 150 MCQs each (600 MCQs total over 2 days).

What is the passing score for the Medical Comprehensive Examination?

Under national regulations from the National Administration of Traditional Chinese Medicine and National Medical Examination Center, the passing score for the Integrated Practitioner exam is fixed at 360 points out of 600 (60%).

What are the four MCQ question formats used in the exam?

The exam utilizes: A1 Type (Single-sentence best choice testing definitions and key concepts), A2 Type (Clinical vignette/case summary best choice), A3 Type (Multi-question case cluster based on an evolving clinical vignette), and B1 Type (Matching questions where multiple items share a common set of 5 lettered options).

What does Integrated Medicine (中西医结合) clinical methodology entail?

Integrated Medicine combines Western pathological disease diagnosis (辨病, e.g., Coronary Heart Disease / Angina Pectoris) with TCM syndrome pattern differentiation (辨证, e.g., Heart Blood Stasis / 气虚血瘀证), providing synchronized Western pharmacological/interventional therapy alongside evidence-guided Chinese herbal formulas (e.g., Buyang Huanwu Decoction 补阳还五汤) and acupuncture.

How long is the qualification certificate valid after passing?

The Physician Qualification Certificate (医师资格证书) awarded upon passing does not expire. To engage in clinical practice, doctors must register with local health commissions to obtain a Physician Practice License (医师执业证书) and undergo regular physician assessments (定期考核) every two years.