10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The NMM/OMM exam has 150 questions and runs 3 hours.
These 10 free NMM/OMM questions are organized by exam domain, so you can see how each part of the Certification in Neuromusculoskeletal Medicine & OMM (NMM/OMM) blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Assessment and diagnosis of conditions presenting with neuromusculoskeletal symptoms 29% of exam
Question 1
Foot drop developed after a 46-year-old spent a weekend kneeling while installing flooring. Four weeks later, examination shows weak great-toe extension, ankle dorsiflexion, ankle inversion, and hip abduction. Distal sensory nerve responses are preserved; needle EMG shows denervation in the corresponding limb myotome and lumbar paraspinal muscles. Despite the apparent compression exposure, where does this pattern localize the lesion?
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Correct answer: A - L5 nerve root
Question 2
"My back hurts too much for this to be just a strain. Shouldn't we get an MRI?" A 38-year-old reports four days of pain after lifting a box, rated 8/10 with bending but improving at rest. There is no leg radiation, weakness, sensory loss, fever, weight loss, trauma, cancer history, or bowel or bladder change. Strength, reflexes, and gait are normal. What is the appropriate imaging decision at this visit?
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Correct answer: B - Defer imaging, start conservative care, and arrange reassessment with clear return precautions.
Question 3
Eight weeks after a wrist fracture that has now healed, an adult reports disproportionate regional pain, touch sensitivity, episodic purple discoloration, swelling, and stiffness. Today, light brushing causes pain and pinprick is excessively painful, but color, temperature, and sweating are symmetric. There is no edema, weakness, motion loss, or trophic change. No prior examination documented additional signs, and no better explanation has been identified. How should the Budapest clinical criteria be applied to this assessment?
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Correct answer: D - They are not fulfilled because the observed abnormalities occupy only one sign category.
Domain 2: Diagnosis and osteopathic manipulative treatment (OMT) of somatic dysfunction 43% of exam
Question 4
At L3, the right transverse process is posterior to the left. This asymmetry disappears in flexion and increases in extension; segmental testing also shows easier right rotation and right sidebending. The patient has no contraindication to treatment and can cooperate with muscle energy. Before the first contraction, how should the physician position L3 for a direct post-isometric relaxation technique?
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Correct answer: C - Extension, left rotation, and left sidebending
Question 5
A sacral examination documents a deep left sulcus and a right inferior lateral angle that is posterior and inferior. Seated flexion is positive on the right. Anterior springing of the sacral base is restricted, and the asymmetry increases in the sphinx position. In conventional sacral torsion nomenclature, which diagnosis accounts for all four findings?
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Correct answer: B - Right-on-left sacral torsion
Question 6
During respiratory motion testing, right ribs 4 through 7 descend freely with expiration but fail to rise normally with inspiration. The adjacent ribs move normally, and cardiopulmonary and fracture screening is reassuring. Using the key-rib convention for a group dysfunction, which rib and corrective respiratory direction should guide a direct treatment?
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Correct answer: D - Rib 4, directed toward inhalation
Question 7
A cranial palpatory description records the sphenoid and occiput rotating in opposite directions about a common anteroposterior axis, with the right greater wing of the sphenoid superior to the left. Which label correctly expresses these findings in traditional sphenobasilar strain nomenclature?
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Correct answer: B - Right torsion
Domain 3: Comprehensive osteopathic management of conditions presenting with neuromusculoskeletal symptoms 13% of exam
Question 8
After six weeks of graded rehabilitation for chronic low-back pain, a patient's past-week PEG ratings change from pain intensity 6, interference with enjoyment 8, and interference with activity 7 to 6, 2, and 4, respectively. The patient is walking farther and has resumed cooking; examination shows no new neurologic deficit. Which assessment best captures the treatment response?
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Correct answer: D - PEG is now 4; reduced interference supports continued goal-directed rehabilitation despite unchanged pain intensity.
Domain 4: Osteopathic manipulative medicine considerations for special populations 5% of exam
Question 9
At 30 weeks' gestation, a patient with mechanical pelvic pain develops brief lightheadedness whenever she lies flat. Symptoms resolve promptly on her left side. Her obstetric clinician has evaluated these episodes and has identified no contraindication to gentle manual care. She is currently asymptomatic with normal vital signs and wishes to proceed. Which modification most directly addresses the positional problem?
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Correct answer: C - Use supported left-lateral positioning and reassess her comfort and vital signs during treatment.
Domain 5: Professional roles and responsibilities 10% of exam
Question 10
The procedure note supports medically necessary OMT of the cervical spine, thoracic spine, rib cage, both shoulders, and right wrist. Several techniques were used on the upper limbs. Lumbar somatic dysfunction was examined and documented but was not treated. Which CPT code matches the OMT service actually performed?
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Correct answer: A - 98926
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