COMSAE Phase 1 (Level 1) Practice
Examination Questions With Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
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1. A 65-year-old man presents with crushing substernal chest pain
radiating to his left arm. An ECG demonstrates ST-segment elevations
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
Correct Answer: C. Right coronary artery
Rationale: Inferior wall myocardial infarctions produce ST-segment
elevations in leads II, III, and aVF. The right coronary artery supplies
the inferior wall in most individuals. Occlusion commonly causes
inferior MI and may be associated with bradycardia due to SA or AV
nodal involvement.
,2. Which electrolyte abnormality is most commonly associated with
peaked T waves on electrocardiography?
A. Hypocalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Rationale: Hyperkalemia causes characteristic ECG changes including
peaked T waves, prolonged PR interval, widened QRS complexes, and
eventually a sine-wave pattern. Prompt recognition is essential
because severe hyperkalemia can lead to fatal arrhythmias.
3. A patient with diabetes mellitus develops diabetic ketoacidosis.
Which laboratory finding is most likely present?
A. Elevated serum bicarbonate
B. Metabolic alkalosis
C. Increased anion gap metabolic acidosis
D. Respiratory acidosis
Correct Answer: C. Increased anion gap metabolic acidosis
Rationale: Diabetic ketoacidosis results from accumulation of
ketoacids, producing an increased anion gap metabolic acidosis.
Typical findings include hyperglycemia, ketonemia, dehydration, and
low bicarbonate levels.
,4. Which cranial nerve is primarily responsible for facial expression?
A. Trigeminal nerve
B. Facial nerve
C. Glossopharyngeal nerve
D. Vagus nerve
Correct Answer: B. Facial nerve
Rationale: The facial nerve (CN VII) innervates the muscles of facial
expression. Damage may result in facial weakness, inability to close
the eye, and loss of forehead movement on the affected side.
5. A deficiency of vitamin B12 is most likely to cause which
hematologic abnormality?
A. Microcytic anemia
B. Normocytic anemia
C. Macrocytic anemia
D. Hemolytic anemia
Correct Answer: C. Macrocytic anemia
Rationale: Vitamin B12 deficiency impairs DNA synthesis, producing
megaloblastic macrocytic anemia characterized by large red blood
cells and hypersegmented neutrophils. Neurologic deficits may also
occur.
, 6. Which organism is the most common cause of community-acquired
pneumonia?
A. Pseudomonas aeruginosa
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Legionella pneumophila
Correct Answer: C. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae remains the leading cause of
community-acquired pneumonia. Patients commonly present with
fever, productive cough, pleuritic chest pain, and lobar consolidation
on imaging.
7. The hormone primarily responsible for lowering blood glucose
levels is:
A. Glucagon
B. Cortisol
C. Epinephrine
D. Insulin
Correct Answer: D. Insulin
Rationale: Insulin promotes cellular glucose uptake and storage while
suppressing hepatic glucose production. It is the primary hormone
responsible for lowering blood glucose concentrations.
Examination Questions With Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A 65-year-old man presents with crushing substernal chest pain
radiating to his left arm. An ECG demonstrates ST-segment elevations
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
Correct Answer: C. Right coronary artery
Rationale: Inferior wall myocardial infarctions produce ST-segment
elevations in leads II, III, and aVF. The right coronary artery supplies
the inferior wall in most individuals. Occlusion commonly causes
inferior MI and may be associated with bradycardia due to SA or AV
nodal involvement.
,2. Which electrolyte abnormality is most commonly associated with
peaked T waves on electrocardiography?
A. Hypocalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Rationale: Hyperkalemia causes characteristic ECG changes including
peaked T waves, prolonged PR interval, widened QRS complexes, and
eventually a sine-wave pattern. Prompt recognition is essential
because severe hyperkalemia can lead to fatal arrhythmias.
3. A patient with diabetes mellitus develops diabetic ketoacidosis.
Which laboratory finding is most likely present?
A. Elevated serum bicarbonate
B. Metabolic alkalosis
C. Increased anion gap metabolic acidosis
D. Respiratory acidosis
Correct Answer: C. Increased anion gap metabolic acidosis
Rationale: Diabetic ketoacidosis results from accumulation of
ketoacids, producing an increased anion gap metabolic acidosis.
Typical findings include hyperglycemia, ketonemia, dehydration, and
low bicarbonate levels.
,4. Which cranial nerve is primarily responsible for facial expression?
A. Trigeminal nerve
B. Facial nerve
C. Glossopharyngeal nerve
D. Vagus nerve
Correct Answer: B. Facial nerve
Rationale: The facial nerve (CN VII) innervates the muscles of facial
expression. Damage may result in facial weakness, inability to close
the eye, and loss of forehead movement on the affected side.
5. A deficiency of vitamin B12 is most likely to cause which
hematologic abnormality?
A. Microcytic anemia
B. Normocytic anemia
C. Macrocytic anemia
D. Hemolytic anemia
Correct Answer: C. Macrocytic anemia
Rationale: Vitamin B12 deficiency impairs DNA synthesis, producing
megaloblastic macrocytic anemia characterized by large red blood
cells and hypersegmented neutrophils. Neurologic deficits may also
occur.
, 6. Which organism is the most common cause of community-acquired
pneumonia?
A. Pseudomonas aeruginosa
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Legionella pneumophila
Correct Answer: C. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae remains the leading cause of
community-acquired pneumonia. Patients commonly present with
fever, productive cough, pleuritic chest pain, and lobar consolidation
on imaging.
7. The hormone primarily responsible for lowering blood glucose
levels is:
A. Glucagon
B. Cortisol
C. Epinephrine
D. Insulin
Correct Answer: D. Insulin
Rationale: Insulin promotes cellular glucose uptake and storage while
suppressing hepatic glucose production. It is the primary hormone
responsible for lowering blood glucose concentrations.
