COMSAE PHASE II FORM 114 PRACTICE TEST QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT DOWNLOAD PDF
, CORE DOMAINS
1. Osteopathic Principles, Practice, and Manipulative Treatment
2. Osteopathic Patient Care and Procedural Skills
3. Foundational Biomedical Sciences Knowledge Base
4. Practice-Based Learning and Improvement in Osteopathic Medical Practice
5. Interpersonal and Communication Skills in Osteopathic Medicine
6. Professionalism in the Practice of Osteopathic Medicine
7. Systems-Based Practice in Osteopathic Medicine
8. Nervous System and Mental Health Clinical Presentations
,9. Musculoskeletal System Clinical Presentations
0. Gastrointestinal and Respiratory System Clinical Presentations
INTRODUCTION
This practice exam is designed to assess your mastery of the competencies required for osteopathic medical
practice as outlined in the COMLEX-USA Level 2-CE content framework. The assessment evaluates
foundational knowledge, clinical decision-making skills, and the application of osteopathic principles across
diverse patient presentations. The test consists of 100 multiple-choice and scenario-based questions that
mirror the structure and difficulty of the actual COMSAE Phase II examination. Emphasis is placed on real-
world clinical application, regulatory compliance, ethical standards, and critical thinking in patient care
decision-making. Success on this exam demonstrates readiness for clinical practice and proficiency in
osteopathic patient care across all major competency domains.
SECTION ONE: QUESTIONS 1–100
, Question 1
A 24-year-old male presents with acute low back pain following a weightlifting session. He reports pain
localized to the lumbar region with no radicular symptoms. Palpation reveals increased tone and tenderness in
the paraspinal muscles. Which osteopathic manipulative treatment (OMT) technique is most appropriate for
this acute musculoskeletal condition?
A. High-velocity low-amplitude (HVLA) thrust to the lumbar spine
B. Myofascial release technique
C. Cranial osteopathic technique
D. Distraction technique
🟢 B. Myofascial release technique
🔴 RATIONALE: Myofascial release is the most appropriate technique for acute musculoskeletal pain with
muscle hypertonicity, as it gently addresses tissue tension without the forceful nature of HVLA. In acute
conditions with significant muscle spasm, myofascial release provides effective treatment while minimizing risk
of further injury.
Question 2
A 45-year-old female with type 2 diabetes presents for routine follow-up. Her HbA1c is 8.2%. She reports
difficulty adhering to her medication regimen due to cost concerns. Which systems-based practice approach is
most appropriate?
A. Refer to social work for medication assistance programs
B. Increase her insulin dose to improve control
C. Discontinue metformin and start newer agent
D. Tell her to prioritize medications over other expenses
🟢 A. Refer to social work for medication assistance programs
🔴 RATIONALE: Systems-based practice involves recognizing and utilizing healthcare system resources to
address patient barriers. Referencing social work for medication assistance directly addresses the cost barrier
while maintaining appropriate care, aligning with the 5% competency domain for systems-based practice.
ANSWERS) PLUS RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT DOWNLOAD PDF
, CORE DOMAINS
1. Osteopathic Principles, Practice, and Manipulative Treatment
2. Osteopathic Patient Care and Procedural Skills
3. Foundational Biomedical Sciences Knowledge Base
4. Practice-Based Learning and Improvement in Osteopathic Medical Practice
5. Interpersonal and Communication Skills in Osteopathic Medicine
6. Professionalism in the Practice of Osteopathic Medicine
7. Systems-Based Practice in Osteopathic Medicine
8. Nervous System and Mental Health Clinical Presentations
,9. Musculoskeletal System Clinical Presentations
0. Gastrointestinal and Respiratory System Clinical Presentations
INTRODUCTION
This practice exam is designed to assess your mastery of the competencies required for osteopathic medical
practice as outlined in the COMLEX-USA Level 2-CE content framework. The assessment evaluates
foundational knowledge, clinical decision-making skills, and the application of osteopathic principles across
diverse patient presentations. The test consists of 100 multiple-choice and scenario-based questions that
mirror the structure and difficulty of the actual COMSAE Phase II examination. Emphasis is placed on real-
world clinical application, regulatory compliance, ethical standards, and critical thinking in patient care
decision-making. Success on this exam demonstrates readiness for clinical practice and proficiency in
osteopathic patient care across all major competency domains.
SECTION ONE: QUESTIONS 1–100
, Question 1
A 24-year-old male presents with acute low back pain following a weightlifting session. He reports pain
localized to the lumbar region with no radicular symptoms. Palpation reveals increased tone and tenderness in
the paraspinal muscles. Which osteopathic manipulative treatment (OMT) technique is most appropriate for
this acute musculoskeletal condition?
A. High-velocity low-amplitude (HVLA) thrust to the lumbar spine
B. Myofascial release technique
C. Cranial osteopathic technique
D. Distraction technique
🟢 B. Myofascial release technique
🔴 RATIONALE: Myofascial release is the most appropriate technique for acute musculoskeletal pain with
muscle hypertonicity, as it gently addresses tissue tension without the forceful nature of HVLA. In acute
conditions with significant muscle spasm, myofascial release provides effective treatment while minimizing risk
of further injury.
Question 2
A 45-year-old female with type 2 diabetes presents for routine follow-up. Her HbA1c is 8.2%. She reports
difficulty adhering to her medication regimen due to cost concerns. Which systems-based practice approach is
most appropriate?
A. Refer to social work for medication assistance programs
B. Increase her insulin dose to improve control
C. Discontinue metformin and start newer agent
D. Tell her to prioritize medications over other expenses
🟢 A. Refer to social work for medication assistance programs
🔴 RATIONALE: Systems-based practice involves recognizing and utilizing healthcare system resources to
address patient barriers. Referencing social work for medication assistance directly addresses the cost barrier
while maintaining appropriate care, aligning with the 5% competency domain for systems-based practice.
