NZREX Clinical

Exam at a glance

Questions

not published

Duration

180 minutes

Pass mark

not published

Sections

12 equally weighted OSCE stations, 3 hours, Auckland; result achieved or not achieved · Prerequisite within 5 years: AMC CAT MCQ, PLAB 1, MCCQE Part I or USMLE Steps 1 and 2 CK

Exam type

Practical

Language

English

Authority

MCNZ

Curriculum

Built from the question bank and updated automatically when new questions are added. 12 modules · 298 questions · Last updated: 30 October 2026

1. 01Acute care and the deteriorating patient27 questions · 9.1 % of the bank

   Chapters

   • Foundations: ABCDE approach and airway basics
   • Foundations: life-threatening chest emergencies
   • Foundations: shock, burns and sepsis

   Sample question

   Sample question1 / 1 · 0 correct

   Five minutes after an IV cefazolin infusion starts, a 25-year-old man on the ward develops generalised urticaria, stridor, wheeze and a blood pressure of 78/40 mmHg. The infusion has been stopped and help has been called. Which drug and route should be given first?

   AAdrenaline 0.5 mg (0.5 mL of 1 mg/mL) intramuscularly into the anterolateral thighBAdrenaline 1 mg as an intravenous bolus given through the existing cannula immediatelyCPromethazine 25 mg intramuscularly, followed by hydrocortisone 200 mg intravenouslyDSalbutamol 5 mg by nebuliser, with oxygen, and observe the response for 15 minutesEAdrenaline 0.5 mg subcutaneously into the upper arm, repeated at 30 minutes

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
2. 02Adult health (medicine): focused history and examination46 questions · 15.4 % of the bank

   Sample question

   Sample question1 / 1 · 0 correct

   A 58-year-old man presents to the emergency department with 40 minutes of central, crushing chest pain radiating to his jaw. He is sweaty and pale. What is the most appropriate immediate step?

   ARequest CT pulmonary angiography urgentlyBGive an oral antacid and reassess laterCRecord a 12-lead ECG within 10 minutesDWait for the first troponin result before actingEArrange a portable chest X-ray before the ECG

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
3. 03Adult health (surgery): surgical and perioperative care28 questions · 9.4 % of the bank

   Chapters

   • Foundations: abdominal anatomy and the acute abdomen
   • Foundations: hernias and the biliary system
   • Foundations: wound healing and perioperative basics

   Sample question

   Sample question1 / 1 · 0 correct

   A 45-year-old woman with no medical problems is booked for an elective laparoscopic cholecystectomy under general anaesthesia at 1300. She asks what she may drink on the morning of surgery. What is the most appropriate advice?

   AClear fluids are allowed until 2 hours before the scheduled timeBNothing by mouth from midnight, including water and tabletsCClear fluids are allowed until 4 hours before the scheduled timeDClear fluids are allowed until she is called to the theatreEOnly sips of water are allowed from 6 hours before surgery

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
4. 04Child health31 questions · 10.4 % of the bank

   Chapters

   • Foundations: the newborn and the transition after birth
   • Foundations: growth and development
   • Foundations: the child's airway, vital signs and resuscitation

   Sample question

   Sample question1 / 1 · 0 correct

   A 3-year-old girl has had 2 days of coryza followed by a barking cough and hoarse voice. She has audible stridor when upset, mild suprasternal recession, is alert and drinking, and has a temperature of 37.8 °C. What is the most appropriate treatment?

   AA single dose of oral dexamethasoneBA 5-day course of oral amoxicillinCNebulised salbutamol every 20 minutesDExamine the throat with a spatula to exclude epiglottitisEChest X-ray before any treatment is given

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
5. 05Chronic disease, older people and palliative care19 questions · 6.4 % of the bank

   Sample question

   Sample question1 / 1 · 0 correct

   An 82-year-old woman with moderate dementia is admitted with aspiration pneumonia. She cannot understand the options for limiting treatment. She has no advance care directive and has not appointed anyone to make decisions for her. Her daughter, her son and her sister each give different views about how aggressive her care should be. What is the most appropriate approach?

   ADecide alone as the treating doctor, because the family members disagree with each otherBAccept the opinion of the eldest child, who is the default decision-maker in every stateCIdentify the legally recognised substitute decision-maker for her state and decide with them on her known valuesDDefer all treatment decisions until her capacity returns after the course of antibioticsEApply to a tribunal or court for approval before giving any further treatment

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
6. 06Communication: counselling, explanation and breaking bad news26 questions · 8.7 % of the bank
7. 07Ethics and professionalism: consent, open disclosure, cultural safety19 questions · 6.4 % of the bank
8. 08Women's health: gynaecology and sexual health19 questions · 6.4 % of the bank

   Chapters

   • Foundations: the menstrual cycle in the ovary, endometrium and cervix
   • Foundations: breast anatomy and lymphatic drainage
9. 09Investigations and data interpretation: pathology, ECG and imaging16 questions · 5.4 % of the bank
10. 10Mental health32 questions · 10.7 % of the bank
11. 11Population health, prevention and immunisation19 questions · 6.4 % of the bank
12. 12Practical skills and procedures16 questions · 5.4 % of the bank

    Chapters

    • Foundations: patient positions and peripheral intravenous cannulas
    • Foundations: urinary catheters and nasogastric tubes

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