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Physician Board Certification

ABIM Adolescent Medicine Initial Certification Examination Practice Test

Adolescent medicine addresses health concerns that emerge during puberty and the transition toward adult care. This practice page’s question bank uses clinical scenarios involving adolescent immunization, nutrition and weight-related counseling, diabetes self-management, mental health, sleep, headache, anemia, and acute joint symptoms.

Exam overview

Exam providerAmerican Board of Internal Medicine
Exam codeNot listed
CategoryPhysician Board Certification

About the ABIM Adolescent Medicine Initial Certification Examination Exam

Clinical decisions in adolescent care often combine symptom assessment with developmental context, confidentiality, prevention, and support for increasing independence. The available question scenarios call for recognizing urgent findings—such as a feverish, severely painful joint with inability to bear weight—and distinguishing these from presentations suitable for an initial outpatient approach. Other items test interpretation of a suspected iron-deficiency pattern, evaluation of possible obstructive sleep apnea, and first-line responses to recurrent headache or panic symptoms. Preventive and longitudinal care also appear: selecting catch-up tetanus vaccination, discussing HPV vaccination, addressing missed insulin doses in school and social settings, and counseling about health behaviors without making weight the sole focus. Use these examples to practice choosing a next step that is clinically appropriate, developmentally responsive, and sensitive to an adolescent’s daily environment.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

A 15-year-old with obesity has elevated liver enzymes on routine testing. The adolescent feels well and has no jaundice. Which general approach is appropriate?

  1. AEvaluate for metabolic dysfunction-associated steatotic liver disease and other causes of liver injury
  2. BAssume the enzyme elevation is harmless and do not repeat or investigate it
  3. CStart long-term antiviral therapy without assessing for viral infection
  4. DRecommend complete fasting until liver enzymes normalize
Show answerCorrect answer: A

Obesity and elevated aminotransferases raise concern for steatotic liver disease, but liver enzyme abnormalities have multiple possible causes. Assessment should include clinical context and appropriate evaluation for metabolic and other hepatic conditions rather than assuming a single diagnosis.

Question 2

A 15-year-old with type 1 diabetes has begun missing insulin doses during school and social activities. Which intervention is most likely to support safer self-management?

  1. ACollaboratively identify barriers and create a practical plan involving the adolescent and appropriate supports
  2. BTransfer all responsibility to the parent without discussing the adolescent's concerns
  3. CUse punishment for each missed dose as the primary intervention
  4. DReduce glucose monitoring so missed doses are less noticeable
Show answerCorrect answer: A

Adolescent diabetes care benefits from collaborative problem-solving that explores practical, emotional, and social barriers. A developmentally appropriate plan can include reminders, discreet supplies, school support, and agreed caregiver involvement while preserving the adolescent's growing autonomy.

Question 3

A 15-year-old who has not received any tetanus-containing vaccine doses is seen for catch-up immunization. Which vaccine series is appropriate for an adolescent with no prior doses?

  1. AA three-dose tetanus, diphtheria, and acellular pertussis-containing series, with one dose as Tdap and subsequent doses as Td or Tdap at appropriate intervals
  2. BOne dose of Tdap only, with no further tetanus-containing vaccine needed
  3. CA single dose of tetanus toxoid without diphtheria or pertussis components
  4. DNo vaccination until adulthood
Show answerCorrect answer: A

Adolescents who are unvaccinated or incompletely vaccinated should receive catch-up tetanus-, diphtheria-, and pertussis-containing vaccination. The schedule generally includes one Tdap dose and additional Td or Tdap doses according to catch-up intervals; verify the current schedule for the individual patient.

Question 4

A 17-year-old with a history of childhood trauma reports recurrent episodes of sudden intense fear, palpitations, shortness of breath, and trembling. The episodes peak within minutes, and the adolescent worries about having another one. Which initial approach is most appropriate?

  1. AAssess for medical and substance-related contributors and evaluate anxiety symptoms, impairment, and safety
  2. BDiagnose a cardiac arrhythmia based on palpitations alone and begin antiarrhythmic medication
  3. CAdvise the adolescent to avoid all school and social activities indefinitely
  4. DDismiss the symptoms because panic episodes are never associated with significant distress
Show answerCorrect answer: A

Episodes resembling panic can occur in anxiety disorders, but assessment should also consider medical conditions, medications, and substances. A careful history should clarify symptoms, triggers, impairment, and safety and guide appropriate evidence-based treatment or referral.

Question 5

A 16-year-old who has never received an HPV vaccine asks whether vaccination is still useful. Which recommendation is most appropriate?

  1. ADo not vaccinate after the onset of sexual activity
  2. BOffer HPV vaccination now, using the age-appropriate catch-up schedule
  3. CWait until an abnormal cervical screening result occurs
  4. DVaccinate only if HPV testing is positive
Show answerCorrect answer: B

Catch-up HPV vaccination is recommended for adolescents who have not completed the series. Vaccination can still provide protection after sexual activity begins and should not be delayed for HPV testing or an abnormal screening result.

Question 6

A 16-year-old with a body mass index in the overweight range asks how to improve health without focusing on weight. Which counseling approach is most appropriate?

  1. ADiscuss sustainable behaviors such as regular meals, enjoyable activity, sleep, and reducing sugary drinks
  2. BRecommend a highly restrictive diet with rapid weight-loss goals
  3. CAvoid discussing nutrition or activity until the adolescent asks again
  4. DSet a specific weight-loss target without assessing the adolescent's goals or context
Show answerCorrect answer: A

Adolescent counseling should be supportive, nonstigmatizing, and centered on health-promoting behaviors rather than restrictive dieting or shame. Collaborative discussion can address eating patterns, physical activity, sleep, and sugary beverages while considering family, access, and emotional context.

Question 7

A 17-year-old reports loud snoring, witnessed pauses in breathing during sleep, and daytime sleepiness. Which next step is most appropriate to evaluate suspected obstructive sleep apnea?

  1. AOrder overnight polysomnography
  2. BBegin stimulant medication for daytime sleepiness
  3. CUse a sleep diary alone to establish the diagnosis
  4. DReassure the patient that snoring is normal in adolescence
Show answerCorrect answer: A

Overnight polysomnography is the standard diagnostic test for suspected obstructive sleep apnea. A history and sleep diary can help characterize symptoms but cannot confirm the diagnosis.

How to use this practice test

The free practice bank contains 50 questions. Each session presents up to 20 random questions, with results shown after you finish. Use a session to identify which clinical decisions need closer review, such as acute joint evaluation, preventive vaccination, or support for chronic-condition self-management.

Preparation tips

  • For acute presentations, separate red flags from stable symptoms; practice identifying when fever, severe joint limitation, or inability to bear weight calls for urgent evaluation.
  • Review adolescent catch-up immunization principles, including how to approach a patient with no prior tetanus-containing doses and an adolescent who has not received HPV vaccine.
  • For chronic-condition scenarios, connect the treatment plan to the adolescent’s actual routines, such as insulin use during school, social activities, and growing responsibility for self-care.
  • Practice interpreting common symptom and laboratory patterns in context, including suspected iron-deficiency anemia, possible sleep apnea, recurrent headache, and panic-like episodes.
  • Use non-stigmatizing counseling strategies that emphasize health behaviors and function when discussing nutrition, overweight, or obesity with adolescents.
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