COMLEX Level 2–style Exam Newest
With Complete Questions And Correct
Detailed Answers| Brand New
Version!2026 2027
1. A 62-year-old man presents with sudden onset
chest pain radiating to his back. Blood pressure is
unequal between arms. What is the most likely
diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Tension pneumothorax
Rationale: Tearing chest pain radiating to the back
with unequal arm blood pressures is classic for aortic
dissection.
2. A patient with chronic alcoholism presents with
confusion, ophthalmoplegia, and ataxia. What is
the most appropriate initial treatment?
A. Glucose infusion
B. Thiamine
, C. Folic acid
D. Pyridoxine
Rationale: Thiamine must be given before glucose to
prevent worsening Wernicke encephalopathy.
3. A newborn has a continuous machine-like murmur.
Which medication is used for closure?
A. Indomethacin
B. Prostaglandin E1
C. Furosemide
D. Digoxin
Rationale: Indomethacin inhibits prostaglandins and
promotes closure of a patent ductus arteriosus.
4. A patient presents with hyperreflexia, agitation,
and diaphoresis after starting a new
antidepressant. What is the diagnosis?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Malignant hyperthermia
D. Acute dystonia
,Rationale: Serotonin syndrome presents with
hyperreflexia, clonus, and autonomic instability.
5. A 28-year-old woman presents with right lower
quadrant pain and fever. What is the most likely
diagnosis?
A. Acute appendicitis
B. Ovarian torsion
C. Ectopic pregnancy
D. Endometriosis
Rationale: RLQ pain with fever and leukocytosis is
classic for appendicitis.
6. Which nerve is injured in surgical neck fractures of
the humerus?
A. Radial nerve
B. Axillary nerve
C. Median nerve
D. Ulnar nerve
Rationale: The axillary nerve wraps around the
surgical neck of the humerus.
, 7. A patient presents with moon facies, purple striae,
and hypertension. What hormone is elevated?
A. Cortisol
B. Aldosterone
C. ACTH only
D. Growth hormone
Rationale: These findings are classic for Cushing
syndrome due to excess cortisol.
8. What organism is most commonly associated with
peptic ulcer disease?
A. Helicobacter pylori
B. Escherichia coli
C. Staphylococcus aureus
D. Campylobacter jejuni
Rationale: H. pylori causes chronic gastritis and peptic
ulcer disease.
9. A diabetic patient presents with fruity breath and
Kussmaul respirations. What acid-base disorder is
present?
A. Metabolic acidosis
B. Respiratory acidosis
With Complete Questions And Correct
Detailed Answers| Brand New
Version!2026 2027
1. A 62-year-old man presents with sudden onset
chest pain radiating to his back. Blood pressure is
unequal between arms. What is the most likely
diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Tension pneumothorax
Rationale: Tearing chest pain radiating to the back
with unequal arm blood pressures is classic for aortic
dissection.
2. A patient with chronic alcoholism presents with
confusion, ophthalmoplegia, and ataxia. What is
the most appropriate initial treatment?
A. Glucose infusion
B. Thiamine
, C. Folic acid
D. Pyridoxine
Rationale: Thiamine must be given before glucose to
prevent worsening Wernicke encephalopathy.
3. A newborn has a continuous machine-like murmur.
Which medication is used for closure?
A. Indomethacin
B. Prostaglandin E1
C. Furosemide
D. Digoxin
Rationale: Indomethacin inhibits prostaglandins and
promotes closure of a patent ductus arteriosus.
4. A patient presents with hyperreflexia, agitation,
and diaphoresis after starting a new
antidepressant. What is the diagnosis?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Malignant hyperthermia
D. Acute dystonia
,Rationale: Serotonin syndrome presents with
hyperreflexia, clonus, and autonomic instability.
5. A 28-year-old woman presents with right lower
quadrant pain and fever. What is the most likely
diagnosis?
A. Acute appendicitis
B. Ovarian torsion
C. Ectopic pregnancy
D. Endometriosis
Rationale: RLQ pain with fever and leukocytosis is
classic for appendicitis.
6. Which nerve is injured in surgical neck fractures of
the humerus?
A. Radial nerve
B. Axillary nerve
C. Median nerve
D. Ulnar nerve
Rationale: The axillary nerve wraps around the
surgical neck of the humerus.
, 7. A patient presents with moon facies, purple striae,
and hypertension. What hormone is elevated?
A. Cortisol
B. Aldosterone
C. ACTH only
D. Growth hormone
Rationale: These findings are classic for Cushing
syndrome due to excess cortisol.
8. What organism is most commonly associated with
peptic ulcer disease?
A. Helicobacter pylori
B. Escherichia coli
C. Staphylococcus aureus
D. Campylobacter jejuni
Rationale: H. pylori causes chronic gastritis and peptic
ulcer disease.
9. A diabetic patient presents with fruity breath and
Kussmaul respirations. What acid-base disorder is
present?
A. Metabolic acidosis
B. Respiratory acidosis
