COMLEX-USA Level 1 ACTUAL EXAM ALL QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+

COMLEX-USA Level 1 ACTUAL EXAM ALL QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+ Question 1 A 45-year-old male presents with chronic low back pain that worsens with sitting and improves with walking. Examination reveals a positive standing flexion test on the left and a seated flexion test on the right. Which of the following is the most likely diagnosis? A) Left sacroiliac joint dysfunction B) Bilateral sacroiliac joint dysfunction C) Right sacroiliac joint dysfunction D) Lumbar facet syndrome Answer: B) Bilateral sacroiliac joint dysfunction Rationale: A positive standing flexion test on one side and a positive seated flexion test on the opposite side indicates bilateral sacroiliac joint dysfunction. The standing flexion test assesses the hamstring and lumbosacral junction while the seated flexion test isolates the sacroiliac joint by eliminating hamstring tension. Discordant findings suggest dysfunction at both SI joints. Question 2 Which of the following cranial nerves is most commonly affected in patients with hypertension presenting with episodic headaches and diaphoresis? A) CN V B) CN VII C) CN IX D) CN X Answer: C) CN IX Rationale: Glossopharyngeal neuralgia (CN IX) can present with episodic severe headaches, hypertension, and diaphoresis. This condition involves irritation of the glossopharyngeal nerve and can cause paroxysmal pain in the throat, ear, and tongue base, often triggered by swallowing or talking, and may be associated with syncope due to vagal stimulation. Question 3 A patient presents with right-sided flank pain, fever, and dysuria. Urinalysis reveals leukocyte esterase and nitrites. What is the most appropriate next step in management? A) Oral ciprofloxacin B) Intravenous ceftriaxone C) Renal ultrasound D) CT abdomen with contrast Answer: A) Oral ciprofloxacin Rationale: This presentation is consistent with acute pyelonephritis in an outpatient setting. For uncomplicated pyelonephritis, oral fluoroquinolones such as ciprofloxacin are first-line therapy. Intravenous antibiotics are reserved for patients who are severely ill, unable to tolerate oral intake, or have suspected sepsis. Imaging is not routinely required for uncomplicated pyelonephritis. Question 4 A 28-year-old female with a history of systemic lupus erythematosus presents with acute onset of shortness of breath and pleuritic chest pain. ECG shows diffuse ST-segment elevations. Which of the following is the most likely diagnosis? A) Acute myocardial infarction B) Pericarditis C) Pulmonary embolism D) Costochondritis Answer: B) Pericarditis Rationale: Lupus erythematosus is associated with pericarditis, which presents with pleuritic chest pain that improves with leaning forward and diffuse ST-segment elevations on ECG. The pain is typically positional. Myocardial infarction is less likely in this young patient without cardiac risk factors. Pulmonary embolism would present with tachycardia, hypoxia, and possibly a S1Q3T3 pattern. Costochondritis is a diagnosis of exclusion without ECG changes. Question 5 Which osteopathic treatment modality involves placing the patient in a position of ease away from the restrictive barrier and applying a high-velocity, low-amplitude thrust? A) Muscle energy B) Counterstrain C) HVLA D) Myofascial release Answer: C) HVLA Rationale: High-velocity, low-amplitude (HVLA) technique involves taking the joint to its restrictive barrier and then applying a rapid, short-distance thrust. This is a direct technique used to restore motion to a restricted joint. Muscle energy uses the patient's voluntary muscle contractions. Counterstrain uses a position of ease away from the barrier. Myofascial release involves sustained pressure into soft tissue restrictions. Question 6 A 62-year-old male with a 40-pack-year smoking history presents with hemoptysis and weight loss. Chest X-ray shows a right hilar mass. Which of the following is the most appropriate next diagnostic step? A) Sputum cytology B) CT-guided biopsy C) Bronchoscopy with biopsy D) PET scan Answer: C) Bronchoscopy with biopsy Rationale: A central hilar mass with hemoptysis in a patient with significant smoking history is highly suspicious for lung cancer. Bronchoscopy with biopsy is the preferred initial diagnostic procedure for central lesions because it provides tissue diagnosis and allows for direct visualization. Sputum cytology has low sensitivity. CT-guided biopsy is more appropriate for peripheral lesions. PET scan is a staging tool, not diagnostic. Question 7 A patient presents with acute onset of severe headache, photophobia, and nuchal rigidity. Lumbar puncture reveals elevated opening pressure, cloudy CSF with elevated protein, low glucose, and many neutrophils. Which of the following is the most likely causative organism? A) Neisseria meningitidis B) Streptococcus pneumoniae C) Listeria monocytogenes D) Haemophilus influenzae Answer: B) Streptococcus pneumoniae Rationale: Acute bacterial meningitis with cloudy CSF, elevated protein, low glucose, and neutrophilic pleocytosis is most commonly caused by Streptococcus pneumoniae in adults. Neisseria meningitidis is more common in adolescents and young adults. Listeria monocytogenes is more common in elderly, immunocompromised, and neonates. Haemophilus influenzae is more common in unvaccinated children. Question 8 Which cranial nerve is tested by having a patient shrug their shoulders against resistance? A) CN IX B) CN X C) CN XI D) CN XII Answer: C) CN XI