100+ Free Pediatrics Shelf Practice Questions
Pass your NBME Clinical Science Subject Examination in Pediatrics exam on the first try — instant access, no signup required.
A 9-year-old has 2 months of polyuria, polydipsia, weight loss, and fatigue. Random glucose is 310 mg/dL, and urine ketones are small. What long-term therapy is required?
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Key Facts: Pediatrics Shelf Exam
110
Official Exam Items
NBME Timing Chart
2h45m
Official Testing Time
NBME Timing Chart
55%-60%
Diagnosis Task Weight
NBME Pediatrics Outline
65%-70%
Ambulatory Care Weight
NBME Pediatrics Outline
20%-25%
Emergency Department Site Weight
NBME Pediatrics Outline
100
Practice Questions Here
Open Exam Prep
The official NBME Pediatrics Subject Exam is a 110-item, 2 hour 45 minute proctored exam. NBME's current public outline lists diagnosis as the largest physician-task band at 55%-60%, management/prevention at 20%-25%, ambulatory care at 65%-70% of site of care, emergency department care at 20%-25%, and inpatient care at 12%-16%.
Sample Pediatrics Shelf Practice Questions
Try these sample questions to test your Pediatrics Shelf exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A term newborn delivered by scheduled cesarean section has tachypnea and mild retractions 1 hour after birth. Oxygen saturation is 93% on room air. Chest radiograph shows hyperinflation with fluid in the interlobar fissures. The mother was afebrile and membranes ruptured at delivery. What is the most appropriate management?
2A male infant born at 29 weeks gestation develops grunting, nasal flaring, and increasing oxygen requirement shortly after birth. Chest radiograph shows diffuse reticulogranular opacities and low lung volumes. Which intervention directly treats the underlying pathophysiology?
3A 12-hour-old newborn has temperature instability, poor feeding, lethargy, and respiratory distress. The mother had intrapartum fever and unknown group B Streptococcus status. What is the best next step?
4A 36-hour-old newborn has jaundice. The mother is blood type O positive and the infant is A positive. Total bilirubin is above the phototherapy threshold, direct bilirubin is normal, and direct antiglobulin testing is positive. What is the most likely cause of the jaundice?
5A premature infant who recently started enteral feeds develops abdominal distention, temperature instability, and bloody stools. Abdominal radiograph shows pneumatosis intestinalis. What is the best initial management?
6A 5-week-old infant has persistent jaundice, dark urine, and pale stools. Laboratory testing shows elevated direct bilirubin. What is the most important next step?
7A large-for-gestational-age newborn of a mother with poorly controlled diabetes becomes jittery 2 hours after birth. Bedside glucose is 32 mg/dL. What mechanism best explains this finding?
8A newborn has cyanosis that worsens during feeding and improves when crying. A catheter cannot be passed through either nostril. What is the immediate priority?
9A 3-week-old infant has poor feeding, constipation, prolonged jaundice, a large posterior fontanelle, and an umbilical hernia. Newborn screen shows elevated TSH. What is the best treatment?
10After a difficult shoulder delivery, a newborn holds the right arm adducted, internally rotated, and extended at the elbow. The Moro reflex is absent on that side, but grasp is intact. Which nerve roots are injured?
About the Pediatrics Shelf Exam
The NBME Pediatrics Clinical Science Subject Exam is commonly used near the end of a medical school pediatrics clerkship. The public NBME outline emphasizes ambulatory pediatric diagnosis and management across newborn care, growth and development, prevention, infectious disease, respiratory, gastrointestinal, cardiovascular, renal/urologic, endocrine, hematology-oncology, adolescent medicine, emergencies, ethics, and social science topics.
Questions
110 scored questions
Time Limit
2 hours, 45 minutes
Passing Score
School-defined; NBME provides scaled scores and norms
Exam Fee
Institution-dependent (National Board of Medical Examiners (NBME))
Pediatrics Shelf Exam Content Outline
Newborn, Congenital, and Multisystem Care
Respiratory distress, prematurity, neonatal sepsis, jaundice, congenital anomalies, newborn screening, feeding, child abuse, toxicology, shock, and emergency stabilization.
GI, Nutrition, Renal, and Endocrine
Pyloric stenosis, intussusception, malrotation, celiac disease, dehydration, rickets, UTIs, nephrotic and nephritic syndromes, HUS, DKA, CAH, thyroid disease, growth, and puberty.
Respiratory and Cardiovascular
Bronchiolitis, asthma, pneumonia, croup, epiglottitis, foreign body aspiration, cystic fibrosis, OSA, congenital heart disease, murmurs, cyanosis, heart failure, and syncope.
Infectious Disease and Hematology-Oncology
AOM, GAS pharyngitis, Kawasaki disease, meningitis, congenital infections, Lyme disease, pertussis, sickle cell complications, iron deficiency, ITP, leukemia, Wilms tumor, and bleeding disorders.
Growth, Development, Prevention, and Adolescent Medicine
Well-child care, immunizations, lead screening, safe sleep, obesity, language delay, autism screening, confidentiality, contraception, STIs, depression, suicidality, ADHD, eating disorders, and dysmenorrhea.
Clinical Reasoning Tasks
Most items require diagnosis, next best diagnostic test, first-line therapy, prevention, counseling, emergency stabilization, or disposition in ambulatory and emergency settings.
How to Pass the Pediatrics Shelf Exam
What You Need to Know
- Passing score: School-defined; NBME provides scaled scores and norms
- Exam length: 110 questions
- Time limit: 2 hours, 45 minutes
- Exam fee: Institution-dependent
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
Pediatrics Shelf Study Tips from Top Performers
Frequently Asked Questions
How many questions are on the official NBME Pediatrics shelf exam?
The NBME Subject Exam Timing Chart lists the Pediatrics Clinical Science Subject Exam as 110 items with a 2 hour, 45 minute testing time. This site's practice bank contains 100 original practice questions.
What topics are most important for the Pediatrics shelf?
NBME's public outline is broad, with multisystem processes, GI, renal, endocrine, respiratory, cardiovascular, newborn/congenital care, infectious disease, hematology, neurologic, behavioral, and prevention topics. Diagnosis is the largest task band.
Is the Pediatrics shelf mostly outpatient pediatrics?
Yes, the NBME outline lists ambulatory care as the largest site-of-care band at 65%-70%, but emergency department and inpatient care are also represented. Students should be ready for preventive care, common clinic problems, and urgent stabilization.
Who sets the passing score?
NBME provides equated scores and normative feedback, but medical schools determine how the score is used for clerkship grading, honors cutoffs, remediation, and retakes.
How should I use this qbank?
Work in timed mixed blocks, then review each explanation. For missed questions, label the error as diagnosis, test selection, prevention, management, emergency priority, or ethics/confidentiality.