112+ Free NPLEX I Practice Questions

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NABNE NPLEX Part II Clinical Sciences

Practice Questions100 questions

2026 Statistics

Key Facts: NPLEX I Exam

200

Multiple-Choice Items

NABNE

5 hours

Total Testing Time

NABNE (two 2.5-hour sections)

2 GEAs

Both Must Be Passed

NABNE Part I Blueprint

2x / year

Administrations

NABNE (typically August and February)

CNME

Required Program Accreditation

NABNE Eligibility

Prometric

Testing Center

NABNE Exam Administration

NPLEX Part I contains 200 questions delivered in two same-day 100-question sessions of 2.5 hours each, with a scheduled one-hour break. Approximately 60% tests Structure/Function and 40% tests Disease/Dysfunction, with about 40 questions from each of five specific exam areas. NABNE does not use a fixed score of 75 for Part I: administration-specific Angoff cut scores apply, and candidates must demonstrate competence in both GEAs in the same administration or retake the entire examination.

Sample NPLEX I Practice Questions

Try these sample questions to test your NPLEX I exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 112+ question experience with AI tutoring.

1Which cranial nerve provides parasympathetic innervation to the smooth muscle of the gastrointestinal tract down to the splenic flexure?

A.Vagus nerve (CN X)

B.Glossopharyngeal nerve (CN IX)

C.Facial nerve (CN VII)

D.Accessory nerve (CN XI)

Explanation: The vagus nerve (CN X) supplies parasympathetic fibers to the gut from the esophagus distally to the splenic flexure of the colon. Beyond the splenic flexure, parasympathetic input comes from the pelvic splanchnic nerves (S2-S4). CN IX innervates the parotid gland and pharynx, and CN VII supplies the submandibular, sublingual, and lacrimal glands.

2A patient has a lesion of the recurrent laryngeal nerve on the left side. Which structure is most likely responsible if the lesion occurs in the thorax?

A.Arch of the aorta

B.Right subclavian artery

C.Thyroid gland

D.Brachiocephalic trunk

Explanation: The left recurrent laryngeal nerve loops under the arch of the aorta at the level of the ligamentum arteriosum, making it vulnerable to thoracic pathology such as aortic aneurysms or left-sided lung tumors. The right recurrent laryngeal nerve instead loops under the right subclavian artery in the neck.

3Which layer of the epidermis contains the highest density of keratohyalin granules?

A.Stratum granulosum

B.Stratum basale

C.Stratum spinosum

D.Stratum corneum

Explanation: Keratohyalin granules, which contain profilaggrin and are essential for keratin cross-linking, are the defining feature of the stratum granulosum. The stratum basale contains proliferating keratinocytes, the stratum spinosum features desmosome-rich cells, and the stratum corneum contains terminally keratinized dead cells.

4A patient cannot abduct their arm past 15 degrees. Damage to which nerve is most likely responsible?

A.Suprascapular nerve

B.Axillary nerve

C.Long thoracic nerve

D.Musculocutaneous nerve

Explanation: The supraspinatus muscle initiates the first 15 degrees of shoulder abduction and is innervated by the suprascapular nerve. Beyond 15 degrees, the deltoid (axillary nerve) takes over. Long thoracic nerve damage causes scapular winging, and musculocutaneous nerve lesions affect forearm flexion and lateral forearm sensation.

5Which structure passes through the foramen ovale of the sphenoid bone?

A.Mandibular division of the trigeminal nerve (V3)

B.Maxillary division of the trigeminal nerve (V2)

C.Ophthalmic division of the trigeminal nerve (V1)

D.Middle meningeal artery

Explanation: The mandibular division (V3) of the trigeminal nerve exits the skull through the foramen ovale. V2 passes through the foramen rotundum, V1 exits through the superior orbital fissure, and the middle meningeal artery enters through the foramen spinosum.

6The posterior cruciate ligament (PCL) of the knee prevents which primary motion?

A.Posterior displacement of the tibia on the femur

B.Anterior displacement of the tibia on the femur

C.Lateral rotation of the tibia

D.Varus angulation of the knee

Explanation: The PCL attaches the posterior intercondylar area of the tibia to the medial femoral condyle and prevents posterior translation of the tibia relative to the femur (tested by the posterior drawer sign). The ACL prevents anterior tibial translation (anterior drawer sign).

7Which region of the adrenal gland produces aldosterone?

A.Zona glomerulosa

B.Zona fasciculata

C.Zona reticularis

D.Adrenal medulla

Explanation: The outermost zona glomerulosa of the adrenal cortex synthesizes aldosterone, regulated primarily by angiotensin II and potassium. The zona fasciculata produces cortisol, the zona reticularis produces androgens such as DHEA, and the medulla produces catecholamines. A useful mnemonic is GFR: Glomerulosa/Fasciculata/Reticularis make Salt/Sugar/Sex.

8The ligament of Treitz marks the anatomical boundary between which two regions?

A.Duodenum and jejunum

B.Jejunum and ileum

C.Stomach and duodenum

D.Ileum and cecum

Explanation: The ligament of Treitz (suspensory ligament of the duodenum) marks the duodenojejunal flexure, which is the clinical boundary between upper and lower GI bleeding. Bleeding proximal to this ligament is typically upper GI; bleeding distal to it is lower GI.

9A patient with a stroke loses sensation on the right side of the body and the left side of the face. Where is the lesion most likely located?

A.Left lateral medulla

B.Right lateral medulla

C.Right cerebral cortex

D.Left internal capsule

Explanation: Lateral medullary (Wallenberg) syndrome from posterior inferior cerebellar artery occlusion causes ipsilateral facial sensory loss (involving the spinal trigeminal nucleus) and contralateral body sensory loss (involving the already-crossed spinothalamic tract). A left-sided lesion therefore produces right body and left face sensory loss.

10Which type of epithelium lines the trachea and most of the bronchial tree?

A.Pseudostratified ciliated columnar with goblet cells

B.Simple squamous

C.Stratified squamous keratinized

D.Simple cuboidal

Explanation: The conducting airways from the trachea through the larger bronchi are lined by pseudostratified ciliated columnar epithelium with goblet cells. The mucociliary escalator traps and removes inhaled particles. Simple squamous epithelium lines the alveoli (type I pneumocytes).

About the NPLEX I Exam

NPLEX Part I is NABNE's Biomedical Science Examination. It has 200 one-best-answer multiple-choice questions arranged as 50 four-question case clusters and integrates five specific exam areas across 11 weighted body systems. Licensing and registration authorities—not NABNE—determine how NPLEX results apply to licensure.

Questions

200 scored questions

Time Limit

5 hours (two 2.5-hour sections)

Passing Score

Administration-specific Angoff cut scores; both GEAs must be passed

Exam Fee

See NABNE fees page (NABNE)

NPLEX I Exam Content Outline

Approximately 60%

Structure/Function GEA

Anatomy, Physiology, and Biochemistry & Genetics; the exam has approximately 40 questions from each of these three specific exam areas

Approximately 40%

Disease/Dysfunction GEA

Microbiology & Immunology and Pathology; the exam has approximately 40 questions from each of these two specific exam areas

12% / 8% / 12% / 6% / 8% / 6% / 10% / 10% / 8% / 10% / 10%

Eleven body-system domains

Cardiovascular, endocrine, gastrointestinal, hematopoietic, immunological, integumentary, musculoskeletal, neurological, pulmonary and upper respiratory, reproductive, and urinary systems, in that order

How to Pass the NPLEX I Exam

What You Need to Know

Passing score: Administration-specific Angoff cut scores; both GEAs must be passed
Exam length: 200 questions
Time limit: 5 hours (two 2.5-hour sections)
Exam fee: See NABNE fees page

Keys to Passing

Work through all 112 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

NPLEX I Study Tips from Top Performers

1Integrate across disciplines — NPLEX I items often weave anatomy, physiology, and pathology into a single vignette, so study by organ system rather than one subject at a time

2Master the two general exam areas (GEAs) equally — you must pass both Structure/Function and Disease/Dysfunction independently, so do not neglect pathology or microbiology in favor of your strengths

3Build differential diagnoses from histology and morphology — Robbins Basic Pathology images show up in NPLEX style vignettes, so practice pattern recognition

4Drill metabolic pathways as regulated cycles — glycolysis, TCA, gluconeogenesis, urea cycle, beta-oxidation, and the electron transport chain each have rate-limiting enzymes and classic inborn errors worth memorizing

5Use active recall and spaced repetition — flashcards for enzyme names, cranial nerves, bugs-drugs, and cytokines give the highest yield per hour of study

6Take full-length timed practice exams every 2-3 weeks in the final month — the 5-hour, two-session structure demands endurance training, not just content mastery

7Review NABNE's official NPLEX Study Guide early — it is included with your application fee and contains the exact content blueprint and sample items

8Form a study group for immunology and microbiology — bug-by-bug and pathway-by-pathway recitation with peers consolidates details that are hard to retain solo

Frequently Asked Questions

What is the NPLEX Part I exam?

NPLEX Part I is the Biomedical Science Examination administered by NABNE. It contains 200 multiple-choice questions that integrate anatomy, physiology, biochemistry and genetics, microbiology and immunology, and pathology across 11 body systems. Each licensing or registration authority decides how NPLEX results apply to licensure.

How is the NPLEX Part I exam structured?

Part I is delivered in two sections on the same day: a morning session of 100 items (2.5 hours) and an afternoon session of 100 items (2.5 hours), with a 1-hour break between sections. Total testing time is 5 hours. Items are multiple-choice with single best answers, often presented as short clinical vignettes focused on biomedical basis rather than diagnosis or treatment. The exam is administered at Prometric testing centers.

What is the passing score for NPLEX Part I?

NABNE publishes no predetermined percentage or scaled score for Part I. It uses the Angoff method to establish administration-specific cut scores. Candidates must demonstrate competence in both Structure/Function and Disease/Dysfunction during the same administration; failing either GEA means retaking the entire exam.

Who is eligible to take NPLEX Part I?

Applicants must be currently enrolled in, on approved leave from, or graduated from an approved naturopathic medical program and must have completed that program's biomedical science coursework requirements. Graduates more than five years out must contact NABNE about additional eligibility requirements.

How much does NPLEX Part I cost?

Fees can change by administration and service. Check NABNE's current fee schedule and applicant portal before applying rather than relying on an older quoted amount.

When is NPLEX Part I offered?

NPLEX Part I is offered twice yearly, typically in August and February, at Prometric testing centers throughout the US and Canada. Application and registration deadlines fall several months before each administration. Check the NABNE Important Dates page for the current exam schedule and registration windows.

What happens if I fail NPLEX Part I?

If you do not pass either or both GEAs, NABNE requires you to retake the entire Part I examination in a subsequent administration. A passing GEA is not banked for a later attempt; follow the current re-examination application and eligibility process.

How should I study for NPLEX Part I?

Start with NABNE's current Part I blueprint and competency list, then review each competency from your biomedical-science coursework. Practice integrating all five specific exam areas within the 11 body systems and rehearse the two-session, case-cluster format. NABNE does not publish a recommended number of study hours or months.