COMSAE FORM 113 PRACTICE EXAM VERSION 3 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Osteopathic Principles, Practice, and Manipulative Treatment
*- Foundational Biomedical Sciences (Anatomy, Physiology, Biochemistry)*
- Pathology and Pathophysiology
*- Pharmacology and Therapeutics*
*- Microbiology and Immunology*
*- Behavioral Science and Public Health*
*- Musculoskeletal System and Somatic Pain*
*- Nervous System and Mental Health*
*- Gastrointestinal System and Nutritional Health*
*- Circulatory and Hematologic Systems*
Introduction
,This comprehensive practice examination is designed to assess readiness for the Comprehensive Osteopathic
Medical Licensing Examination (COMLEX-USA) Level 1. The exam evaluates foundational biomedical
sciences knowledge integrated with osteopathic principles and practice. Candidates will encounter 100
multiple-choice questions featuring both direct knowledge assessments and scenario-based clinical situations
that require application of theory to real-world patient care decisions. The assessment emphasizes critical
thinking, regulatory compliance, ethical professional standards, and evidence-based decision-making
essential for osteopathic medical practice. Success on this exam demonstrates mastery of the competencies
required for safe and effective osteopathic physician practice.
Section One: Questions 1–100
Question 1
A 45-year-old patient presents with chronic lower back pain. Physical examination reveals somatic dysfunction
characterized by tissue texture abnormality, asymmetry, restriction of motion, and tenderness. Which
osteopathic manipulative treatment principle is most directly addressing the underlying pathophysiology?
A. Increasing lymphatic flow to reduce inflammation
B. Restoring optimal body mechanics to enhance physiologic function
C. Stimulating the sympathetic nervous system to reduce pain
D. Decreasing venous congestion in the lumbar region
🟢 Correct answer: B
,🔴 RATIONALE: Osteopathic medicine views structure and function as reciprocally interrelated. OMT aims to
restore optimal body mechanics and enhance physiologic function, which directly addresses somatic
dysfunction's underlying pathophysiology. This holistic approach targets the root cause rather than just
symptoms.
Question 2
Which biochemical pathway is primarily responsible for generating the majority of ATP during aerobic
respiration in human cells?
A. Glycolysis
B. Beta-oxidation
C. Oxidative phosphorylation
D. Citric acid cycle
🟢 Correct answer: C
🔴 RATIONALE: Oxidative phosphorylation in the mitochondrial inner membrane generates approximately
26-28 ATP molecules per glucose molecule, representing the majority of ATP production during aerobic
respiration. Glycolysis produces only 2 ATP, and the citric acid cycle produces 2 ATP directly.
Question 3
A 28-year-old pregnant woman at 34 weeks gestation presents with pretibial edema and mild hypertension.
Blood pressure is 138/88 mmHg. Urinalysis shows no protein. What is the most appropriate initial
management?
, A. Immediate delivery
B. 24-hour urine protein collection
C. Reassurance and close monitoring
D. Start magnesium sulfate
🟢 Correct answer: C
🔴 RATIONALE: This patient has gestational hypertension without proteinuria, which is common in normal
pregnancy. Pretibial edema at 34 weeks without proteinuria is typically physiologic. Reassurance and close
monitoring are appropriate until signs of HELLP syndrome or severe features develop.
Question 4
Which cranial nerve is responsible for both taste to the anterior two-thirds of the tongue and motor innervation
to the muscles of facial expression?
A. Cranial nerve VII (Facial nerve)
B. Cranial nerve IX (Glossopharyngeal nerve)
C. Cranial nerve V (Trigeminal nerve)
D. Cranial nerve X (Vagus nerve)
🟢 Correct answer: A
🔴 RATIONALE: The facial nerve (CN VII) has multiple branches: the chorda tympani provides taste to the
anterior 2/3 of the tongue, and the motor root innervates muscles of facial expression. CN IX provides taste to
the posterior 1/3, CN V provides general sensation to the anterior 2/3, and CN X provides taste to the epiglottis.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Osteopathic Principles, Practice, and Manipulative Treatment
*- Foundational Biomedical Sciences (Anatomy, Physiology, Biochemistry)*
- Pathology and Pathophysiology
*- Pharmacology and Therapeutics*
*- Microbiology and Immunology*
*- Behavioral Science and Public Health*
*- Musculoskeletal System and Somatic Pain*
*- Nervous System and Mental Health*
*- Gastrointestinal System and Nutritional Health*
*- Circulatory and Hematologic Systems*
Introduction
,This comprehensive practice examination is designed to assess readiness for the Comprehensive Osteopathic
Medical Licensing Examination (COMLEX-USA) Level 1. The exam evaluates foundational biomedical
sciences knowledge integrated with osteopathic principles and practice. Candidates will encounter 100
multiple-choice questions featuring both direct knowledge assessments and scenario-based clinical situations
that require application of theory to real-world patient care decisions. The assessment emphasizes critical
thinking, regulatory compliance, ethical professional standards, and evidence-based decision-making
essential for osteopathic medical practice. Success on this exam demonstrates mastery of the competencies
required for safe and effective osteopathic physician practice.
Section One: Questions 1–100
Question 1
A 45-year-old patient presents with chronic lower back pain. Physical examination reveals somatic dysfunction
characterized by tissue texture abnormality, asymmetry, restriction of motion, and tenderness. Which
osteopathic manipulative treatment principle is most directly addressing the underlying pathophysiology?
A. Increasing lymphatic flow to reduce inflammation
B. Restoring optimal body mechanics to enhance physiologic function
C. Stimulating the sympathetic nervous system to reduce pain
D. Decreasing venous congestion in the lumbar region
🟢 Correct answer: B
,🔴 RATIONALE: Osteopathic medicine views structure and function as reciprocally interrelated. OMT aims to
restore optimal body mechanics and enhance physiologic function, which directly addresses somatic
dysfunction's underlying pathophysiology. This holistic approach targets the root cause rather than just
symptoms.
Question 2
Which biochemical pathway is primarily responsible for generating the majority of ATP during aerobic
respiration in human cells?
A. Glycolysis
B. Beta-oxidation
C. Oxidative phosphorylation
D. Citric acid cycle
🟢 Correct answer: C
🔴 RATIONALE: Oxidative phosphorylation in the mitochondrial inner membrane generates approximately
26-28 ATP molecules per glucose molecule, representing the majority of ATP production during aerobic
respiration. Glycolysis produces only 2 ATP, and the citric acid cycle produces 2 ATP directly.
Question 3
A 28-year-old pregnant woman at 34 weeks gestation presents with pretibial edema and mild hypertension.
Blood pressure is 138/88 mmHg. Urinalysis shows no protein. What is the most appropriate initial
management?
, A. Immediate delivery
B. 24-hour urine protein collection
C. Reassurance and close monitoring
D. Start magnesium sulfate
🟢 Correct answer: C
🔴 RATIONALE: This patient has gestational hypertension without proteinuria, which is common in normal
pregnancy. Pretibial edema at 34 weeks without proteinuria is typically physiologic. Reassurance and close
monitoring are appropriate until signs of HELLP syndrome or severe features develop.
Question 4
Which cranial nerve is responsible for both taste to the anterior two-thirds of the tongue and motor innervation
to the muscles of facial expression?
A. Cranial nerve VII (Facial nerve)
B. Cranial nerve IX (Glossopharyngeal nerve)
C. Cranial nerve V (Trigeminal nerve)
D. Cranial nerve X (Vagus nerve)
🟢 Correct answer: A
🔴 RATIONALE: The facial nerve (CN VII) has multiple branches: the chorda tympani provides taste to the
anterior 2/3 of the tongue, and the motor root innervates muscles of facial expression. CN IX provides taste to
the posterior 1/3, CN V provides general sensation to the anterior 2/3, and CN X provides taste to the epiglottis.
