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100+ Free Family Medicine Shelf Practice Questions

NBME Clinical Science Subject Exam: Family Medicine Modular practice questions are available now; exam metadata is being verified.

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A 52-year-old painter has lateral shoulder pain worse with overhead activity. Strength is mildly reduced because of pain, passive range of motion is preserved, and Hawkins test is positive. There is no trauma. What is the best initial management?

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2026 Statistics

Key Facts: Family Medicine Shelf Exam

100%

Ambulatory Site of Care

NBME Family Medicine Modular Outline

40%-50%

Diagnosis Task Weight

NBME Family Medicine Modular Outline

20%-25%

Health Maintenance and Prevention Task Weight

NBME Family Medicine Modular Outline

90/100/110

Official Items by Module Option

NBME Timing Chart

15%-20%

Pediatric Age Band

NBME Family Medicine Modular Outline

55%-65%

Adult Age Band

NBME Family Medicine Modular Outline

15%-20%

Older Adult Age Band

NBME Family Medicine Modular Outline

100

Practice Questions Here

Open Exam Prep

For the Family Medicine shelf, prioritize outpatient decision-making: preventive screening, immunizations, common acute complaints, chronic cardiometabolic care, pediatric and adolescent visits, prenatal red flags, contraception, abnormal uterine bleeding, geriatrics, behavioral health, substance use, musculoskeletal injuries, dermatology, patient safety, and follow-up planning.

Sample Family Medicine Shelf Practice Questions

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

1A 46-year-old man with no family history of colorectal cancer asks when he should begin screening. He has no rectal bleeding, weight loss, inflammatory bowel disease, or prior polyps. What is the most appropriate recommendation?
A.Begin average-risk colorectal cancer screening now
B.Begin screening at age 50 only if symptoms develop
C.Order CT abdomen and pelvis annually
D.Perform colonoscopy every year starting now
Explanation: Average-risk adults should begin colorectal cancer screening at age 45. Acceptable options include colonoscopy, stool-based testing, CT colonography, and flexible sigmoidoscopy at guideline-specified intervals.
2A 36-year-old patient with a cervix had a normal Pap test 3 years ago and has never had an abnormal result. HPV vaccination was completed in adolescence. What cervical cancer screening approach is appropriate?
A.No further screening is needed because the patient was vaccinated
B.Primary high-risk HPV testing every 5 years is an acceptable option
C.Annual Pap testing is required until menopause
D.Screening should be done only if pelvic pain occurs
Explanation: For average-risk patients ages 30 to 65 with a cervix, options include primary high-risk HPV testing every 5 years, cotesting every 5 years, or cytology alone every 3 years. HPV vaccination does not eliminate screening.
3A 41-year-old woman with no breast symptoms and no family history of breast or ovarian cancer asks about mammography. She has normal breast examination findings. What is the best recommendation?
A.Wait until age 50 to discuss mammography
B.Order breast MRI as the initial screening test
C.Offer biennial screening mammography beginning now
D.Perform annual diagnostic ultrasound only
Explanation: Average-risk women should be offered biennial screening mammography beginning at age 40. MRI is reserved for selected high-risk patients, and ultrasound is not the primary average-risk screening test.
4A 62-year-old man has a 35-pack-year smoking history and quit 8 years ago. He has no cough, hemoptysis, or weight loss. What screening test should be offered?
A.Annual chest radiography
B.Sputum cytology every 6 months
C.No lung cancer screening because he quit smoking
D.Annual low-dose CT of the chest
Explanation: Adults ages 50 to 80 with at least a 20-pack-year history who currently smoke or quit within the past 15 years should receive annual low-dose CT screening if they are healthy enough for treatment.
5A 67-year-old man comes for a wellness visit. He smoked one pack per day for 20 years but quit at age 50. He has no abdominal pain and no prior abdominal imaging. Which screening test is indicated?
A.One-time abdominal aortic aneurysm ultrasound
B.Annual abdominal CT angiography
C.No screening because he quit more than 15 years ago
D.Serum D-dimer measurement
Explanation: Men ages 65 to 75 who have ever smoked should receive one-time ultrasound screening for abdominal aortic aneurysm. The lung cancer quit-time rule does not apply to AAA screening.
6A 29-year-old pregnant patient at 28 weeks' gestation received all routine childhood vaccines and had Tdap 3 years ago after a laceration. Which immunization is recommended now?
A.MMR vaccine today
B.Tdap during this pregnancy
C.Varicella vaccine today
D.Delay all vaccines until after delivery
Explanation: Tdap is recommended during every pregnancy, preferably at 27 to 36 weeks, to maximize passive pertussis antibody transfer to the infant.
7A 54-year-old man with type 2 diabetes has LDL cholesterol of 104 mg/dL and no known cardiovascular disease. Blood pressure is controlled and he does not smoke. What lipid therapy is recommended?
A.Start ezetimibe only if LDL exceeds 190 mg/dL
B.Avoid statins because there is no prior myocardial infarction
C.Start at least moderate-intensity statin therapy
D.Use niacin as first-line primary prevention
Explanation: Adults ages 40 to 75 with diabetes should receive at least moderate-intensity statin therapy for primary prevention, with intensity adjusted for overall ASCVD risk.
8A 44-year-old woman has office blood pressures of 148/92 and 146/94 mm Hg at two visits. She is anxious in clinic and asks whether she truly has hypertension. What is the best next step?
A.Start three antihypertensive medications immediately
B.Diagnose white coat hypertension without additional data
C.Order renal artery angiography
D.Confirm with validated home or ambulatory blood pressure monitoring
Explanation: Hypertension should be confirmed with accurate repeated measurements, ideally including home or ambulatory blood pressure monitoring, before long-term treatment decisions unless severe end-organ damage is present.
9A 52-year-old woman has an A1c of 6.7% on repeat testing. She is asymptomatic, has BMI 34 kg/m2, normal kidney function, and no contraindications to medication. What is the best initial management?
A.Lifestyle modification plus metformin
B.Insulin glargine immediately
C.No treatment until A1c exceeds 8.5%
D.Pancreatic CT scan
Explanation: New type 2 diabetes with mild hyperglycemia is usually managed initially with lifestyle intervention and metformin when tolerated. Additional agents are individualized for comorbidities and glycemic goals.
10A 58-year-old man with COPD asks about vaccines. He received influenza vaccine this season and completed COVID vaccination. Which additional vaccine is most appropriate if he has not previously received it?
A.Live intranasal influenza vaccine
B.Pneumococcal vaccination according to current adult schedule
C.BCG vaccine
D.No additional vaccines because COPD is not an indication
Explanation: Adults with chronic lung disease should receive pneumococcal vaccination according to the current adult schedule, along with annual influenza and other age-appropriate immunizations.

About the Family Medicine Shelf Practice Questions

Verified exam format metadata for NBME Clinical Science Subject Exam: Family Medicine Modular is pending. The practice questions above remain available while official exam length, timing, passing score, fee, and administrator details are reviewed.