COMLEX-USA Level 3 Practice Examination Newest
2025 – 2026 Questions From Actual Exams Complete
100 Questions And Correct Detailed Answers
(Verified Answers) |Already Graded A+||Brand New!!
Content covered (most tested areas on COMLEX-USA Level 3):
Clinical Decision-Making • Emergency Medicine • Family Medicine • Internal
Medicine • Preventive Medicine • Pediatrics • Obstetrics & Gynecology •
Psychiatry • OMT Principles • Ethics and Patient Safety • Infectious Disease •
Cardiology • Pulmonary Medicine • Endocrinology • Gastroenterology
1. A 62-year-old man presents with sudden onset crushing substernal chest pain radiating to
the left arm. ECG shows ST elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A. Left anterior descending artery
B. Circumflex artery
C. Right coronary artery
D. Left main coronary artery
Answer: C. Right coronary artery
Inferior wall myocardial infarctions with ST elevations in leads II, III, and aVF most
commonly result from occlusion of the right coronary artery.
2. A 5-year-old boy presents with fever, sore throat, and a sandpaper-like rash on the trunk.
Strawberry tongue is noted. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Kawasaki disease
D. Rubella
Answer: B. Scarlet fever
Scarlet fever is caused by Group A Streptococcus producing erythrogenic toxin leading to a
characteristic sandpaper rash and strawberry tongue.
3. A 30-year-old woman at 36 weeks’ gestation presents with severe headache, blood
pressure 170/110 mmHg, and proteinuria. What is the most appropriate initial
medication?
,A. Magnesium sulfate
B. Oxytocin
C. Methyldopa
D. Labetalol
Answer: A. Magnesium sulfate
Magnesium sulfate is administered to prevent seizures in patients with severe preeclampsia.
4. A patient presents with sudden unilateral facial droop, inability to close the eye, and loss
of forehead wrinkles on the same side. What is the most likely diagnosis?
A. Bell palsy
B. Stroke involving internal capsule
C. Myasthenia gravis
D. Multiple sclerosis
Answer: A. Bell palsy
Bell palsy is a lower motor neuron lesion of the facial nerve causing complete unilateral facial
paralysis including the forehead.
5. A 58-year-old diabetic patient presents with confusion, glucose 38 mg/dL. What is the
immediate treatment?
A. Insulin
B. Oral metformin
C. IV dextrose
D. Glucagon suppression
Answer: C. IV dextrose
Severe symptomatic hypoglycemia requires immediate administration of intravenous dextrose.
6. A 24-year-old woman presents with dysuria and urinary frequency. Urinalysis reveals
leukocyte esterase and nitrites. What is the most common causative organism?
A. Staphylococcus saprophyticus
B. Proteus mirabilis
C. Escherichia coli
D. Klebsiella pneumoniae
Answer: C. Escherichia coli
E. coli accounts for approximately 80–90% of uncomplicated urinary tract infections.
, 7. A 70-year-old smoker presents with chronic cough and hemoptysis. Imaging reveals a
central lung mass. Which type of lung cancer is most likely?
A. Adenocarcinoma
B. Small cell carcinoma
C. Squamous cell carcinoma
D. Large cell carcinoma
Answer: C. Squamous cell carcinoma
Squamous cell carcinoma commonly arises centrally in the lung and is strongly associated
with smoking.
8. A newborn presents with projectile vomiting and palpable olive-shaped mass in the
abdomen. What is the most likely diagnosis?
A. Duodenal atresia
B. Pyloric stenosis
C. Intussusception
D. Hirschsprung disease
Answer: B. Pyloric stenosis
Hypertrophic pyloric stenosis presents with projectile non-bilious vomiting and an olive-
shaped abdominal mass.
9. A patient presents with fever, nuchal rigidity, and photophobia. Lumbar puncture shows
neutrophils, high protein, low glucose. Diagnosis?
A. Viral meningitis
B. Tuberculous meningitis
C. Bacterial meningitis
D. Fungal meningitis
Answer: C. Bacterial meningitis
Bacterial meningitis typically shows neutrophilic predominance, elevated protein, and
decreased glucose in CSF.
10. A 65-year-old man has progressive resting tremor, rigidity, and bradykinesia. Diagnosis?
A. Parkinson disease
B. Huntington disease
C. ALS
D. Essential tremor
2025 – 2026 Questions From Actual Exams Complete
100 Questions And Correct Detailed Answers
(Verified Answers) |Already Graded A+||Brand New!!
Content covered (most tested areas on COMLEX-USA Level 3):
Clinical Decision-Making • Emergency Medicine • Family Medicine • Internal
Medicine • Preventive Medicine • Pediatrics • Obstetrics & Gynecology •
Psychiatry • OMT Principles • Ethics and Patient Safety • Infectious Disease •
Cardiology • Pulmonary Medicine • Endocrinology • Gastroenterology
1. A 62-year-old man presents with sudden onset crushing substernal chest pain radiating to
the left arm. ECG shows ST elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A. Left anterior descending artery
B. Circumflex artery
C. Right coronary artery
D. Left main coronary artery
Answer: C. Right coronary artery
Inferior wall myocardial infarctions with ST elevations in leads II, III, and aVF most
commonly result from occlusion of the right coronary artery.
2. A 5-year-old boy presents with fever, sore throat, and a sandpaper-like rash on the trunk.
Strawberry tongue is noted. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Kawasaki disease
D. Rubella
Answer: B. Scarlet fever
Scarlet fever is caused by Group A Streptococcus producing erythrogenic toxin leading to a
characteristic sandpaper rash and strawberry tongue.
3. A 30-year-old woman at 36 weeks’ gestation presents with severe headache, blood
pressure 170/110 mmHg, and proteinuria. What is the most appropriate initial
medication?
,A. Magnesium sulfate
B. Oxytocin
C. Methyldopa
D. Labetalol
Answer: A. Magnesium sulfate
Magnesium sulfate is administered to prevent seizures in patients with severe preeclampsia.
4. A patient presents with sudden unilateral facial droop, inability to close the eye, and loss
of forehead wrinkles on the same side. What is the most likely diagnosis?
A. Bell palsy
B. Stroke involving internal capsule
C. Myasthenia gravis
D. Multiple sclerosis
Answer: A. Bell palsy
Bell palsy is a lower motor neuron lesion of the facial nerve causing complete unilateral facial
paralysis including the forehead.
5. A 58-year-old diabetic patient presents with confusion, glucose 38 mg/dL. What is the
immediate treatment?
A. Insulin
B. Oral metformin
C. IV dextrose
D. Glucagon suppression
Answer: C. IV dextrose
Severe symptomatic hypoglycemia requires immediate administration of intravenous dextrose.
6. A 24-year-old woman presents with dysuria and urinary frequency. Urinalysis reveals
leukocyte esterase and nitrites. What is the most common causative organism?
A. Staphylococcus saprophyticus
B. Proteus mirabilis
C. Escherichia coli
D. Klebsiella pneumoniae
Answer: C. Escherichia coli
E. coli accounts for approximately 80–90% of uncomplicated urinary tract infections.
, 7. A 70-year-old smoker presents with chronic cough and hemoptysis. Imaging reveals a
central lung mass. Which type of lung cancer is most likely?
A. Adenocarcinoma
B. Small cell carcinoma
C. Squamous cell carcinoma
D. Large cell carcinoma
Answer: C. Squamous cell carcinoma
Squamous cell carcinoma commonly arises centrally in the lung and is strongly associated
with smoking.
8. A newborn presents with projectile vomiting and palpable olive-shaped mass in the
abdomen. What is the most likely diagnosis?
A. Duodenal atresia
B. Pyloric stenosis
C. Intussusception
D. Hirschsprung disease
Answer: B. Pyloric stenosis
Hypertrophic pyloric stenosis presents with projectile non-bilious vomiting and an olive-
shaped abdominal mass.
9. A patient presents with fever, nuchal rigidity, and photophobia. Lumbar puncture shows
neutrophils, high protein, low glucose. Diagnosis?
A. Viral meningitis
B. Tuberculous meningitis
C. Bacterial meningitis
D. Fungal meningitis
Answer: C. Bacterial meningitis
Bacterial meningitis typically shows neutrophilic predominance, elevated protein, and
decreased glucose in CSF.
10. A 65-year-old man has progressive resting tremor, rigidity, and bradykinesia. Diagnosis?
A. Parkinson disease
B. Huntington disease
C. ALS
D. Essential tremor
