100+ Free NPLEX II Practice Questions

The Part II Core Clinical Science Examination is an integrated case-based exam consisting of approximately 80 case clusters (~400 total items) administered over 3 consecutive days in 3 sections (one section per day, ~3.5 hours each). Each case begins with a clinical summary followed by 5 items covering diagnosis, lab selection, therapeutic intervention, and patient management. The exam is delivered at Prometric testing centers.

NPLEX Part II uses a criterion-referenced passing standard — there is no fixed percentage. You must demonstrate concurrent competence in all four General Exam Areas: (1) Diagnosis, (2) Materia Medica, (3) Other Modalities, and (4) Medical Interventions. A panel of licensed NDs sets the passing threshold using the modified Angoff method. You must pass every area — strength in one area cannot compensate for failure in another.

The NPLEX Part II Core Clinical Science Examination application fee is US$1,315 per attempt as of 2026, paid to NABNE. Each Clinical Elective Examination (Minor Surgery, Acupuncture, Elective Pharmacology, Parenteral Medicine) costs an additional US$335. Transcripts are $30 and manual scoring review is $70 for Part II CCSE.

To sit for NPLEX Part II, you must have graduated (or be within 60 days of graduation) from a CNME-accredited naturopathic medical program in the US or Canada, and you must have passed NPLEX Part I (Biomedical Science Examination). Applications are submitted through the NABNE applicant portal. The application period for August administration is typically April 1 – May 1; for February administration it is October 1 – November 1.

Based on the most recent (2022) practice analysis, the CCSE blueprint is: Diagnosis (34–35%) including clinical diagnosis (20%), lab/imaging (12–13%), and research interpretation (2–3%); Materia Medica (19–20%) including botanical medicine (12.5%) and homeopathy (6.5%); Other Modalities (28–29%) including clinical nutrition (10–11%), physical medicine (8–9%), and health psychology (8–9%); Medical Interventions (20%) including emergency medicine, procedures, public health, and pharmacology.

NABNE offers four Clinical Elective Examinations taken in addition to the core CCSE: (1) Minor Surgery, (2) Acupuncture, (3) Elective Pharmacology, and (4) Parenteral Medicine. Each elective is $335 and is required only in jurisdictions that license NDs to perform those procedures. For example, Oregon and Washington require the Minor Surgery exam for full scope of practice. Verify with your state/province licensing board which electives you need.

Most candidates begin focused review 4–6 months before the exam, building on clinical years of the ND program. Prioritize case-based practice questions that integrate diagnosis, materia medica, and treatment planning. Master the NPLEX Part II Blueprint and Study Guide's lists of required conditions, orthopedic tests, lab tests, botanical medicines, homeopathic remedies, and the CCSE drug list. Take full-length practice exams to build stamina for the 3-day format.

NPLEX Part II is administered twice yearly: in early February and early August. Exams are delivered at Prometric testing centers across the US and Canada. Score reports are released approximately 8 weeks after the exam. The CCSE spans 3 consecutive days (one section each day). Plan travel and lodging accordingly, as test centers may not be in your home city.