COMLEX-USA Level 2-CE —
Comprehensive Practice Exam Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2027
Q&A | Instant Download Pdf
Question 1
A 64-year-old man presents with crushing substernal chest pain radiating to
his left arm for 45 minutes. ECG shows 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. Left main coronary artery
E. Posterior descending artery
Answer: C. Right coronary artery
,Rationale: Inferior-wall myocardial infarctions produce ST elevations in
leads II, III, and aVF and are most commonly caused by right coronary
artery occlusion.
Question 2
A 27-year-old woman presents with fatigue, weight gain, constipation, and
cold intolerance. Laboratory studies show elevated TSH and decreased free
T4. Which diagnosis is most likely?
A. Graves disease
B. Hashimoto thyroiditis
C. Subacute thyroiditis
D. Toxic multinodular goiter
E. Pituitary adenoma
Answer: B. Hashimoto thyroiditis
Rationale: Primary hypothyroidism with elevated TSH and low free T4 in a
young woman is most commonly caused by autoimmune Hashimoto
thyroiditis.
Question 3
,A 58-year-old man develops sudden right-sided weakness and aphasia. CT of
the head shows no hemorrhage. Symptoms began 90 minutes ago. What is
the most appropriate immediate treatment if there are no
contraindications?
A. Aspirin only
B. Intravenous alteplase
C. Warfarin
D. Heparin infusion
E. Carotid endarterectomy
Answer: B. Intravenous alteplase
Rationale: A patient with an acute ischemic stroke presenting within the
appropriate treatment window should receive IV thrombolysis when
eligible and when intracranial hemorrhage has been excluded.
Question 4
A 22-year-old woman has dysuria, urinary frequency, and suprapubic
discomfort. She has no fever, flank pain, or vaginal discharge. Urinalysis
shows leukocyte esterase and nitrites. What is the most likely diagnosis?
A. Pyelonephritis
B. Acute cystitis
, C. Vaginitis
D. Urethral carcinoma
E. Nephrolithiasis
Answer: B. Acute cystitis
Rationale: Dysuria, frequency, suprapubic discomfort, and bacteriuria
without systemic findings are classic for uncomplicated acute cystitis.
Question 5
A 71-year-old man with COPD presents with worsening dyspnea and
increased sputum production that is purulent. Which treatment is most
appropriate?
A. Inhaled corticosteroid alone
B. Oral antibiotics and systemic corticosteroids
C. Immediate lung transplantation
D. Anticoagulation
E. Diuretics only
Answer: B. Oral antibiotics and systemic corticosteroids
Comprehensive Practice Exam Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2027
Q&A | Instant Download Pdf
Question 1
A 64-year-old man presents with crushing substernal chest pain radiating to
his left arm for 45 minutes. ECG shows 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. Left main coronary artery
E. Posterior descending artery
Answer: C. Right coronary artery
,Rationale: Inferior-wall myocardial infarctions produce ST elevations in
leads II, III, and aVF and are most commonly caused by right coronary
artery occlusion.
Question 2
A 27-year-old woman presents with fatigue, weight gain, constipation, and
cold intolerance. Laboratory studies show elevated TSH and decreased free
T4. Which diagnosis is most likely?
A. Graves disease
B. Hashimoto thyroiditis
C. Subacute thyroiditis
D. Toxic multinodular goiter
E. Pituitary adenoma
Answer: B. Hashimoto thyroiditis
Rationale: Primary hypothyroidism with elevated TSH and low free T4 in a
young woman is most commonly caused by autoimmune Hashimoto
thyroiditis.
Question 3
,A 58-year-old man develops sudden right-sided weakness and aphasia. CT of
the head shows no hemorrhage. Symptoms began 90 minutes ago. What is
the most appropriate immediate treatment if there are no
contraindications?
A. Aspirin only
B. Intravenous alteplase
C. Warfarin
D. Heparin infusion
E. Carotid endarterectomy
Answer: B. Intravenous alteplase
Rationale: A patient with an acute ischemic stroke presenting within the
appropriate treatment window should receive IV thrombolysis when
eligible and when intracranial hemorrhage has been excluded.
Question 4
A 22-year-old woman has dysuria, urinary frequency, and suprapubic
discomfort. She has no fever, flank pain, or vaginal discharge. Urinalysis
shows leukocyte esterase and nitrites. What is the most likely diagnosis?
A. Pyelonephritis
B. Acute cystitis
, C. Vaginitis
D. Urethral carcinoma
E. Nephrolithiasis
Answer: B. Acute cystitis
Rationale: Dysuria, frequency, suprapubic discomfort, and bacteriuria
without systemic findings are classic for uncomplicated acute cystitis.
Question 5
A 71-year-old man with COPD presents with worsening dyspnea and
increased sputum production that is purulent. Which treatment is most
appropriate?
A. Inhaled corticosteroid alone
B. Oral antibiotics and systemic corticosteroids
C. Immediate lung transplantation
D. Anticoagulation
E. Diuretics only
Answer: B. Oral antibiotics and systemic corticosteroids
