COMSAE Phase 2-Form BSA 101 Clinical
Simulation Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2026 Latest Update| Instant
Download PDF
1. A 65-year-old man presents to the emergency department with
crushing substernal chest pain radiating to his left arm, diaphoresis,
and nausea. ECG shows ST-segment elevation 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
Answer: C. Right coronary artery
Rationale: Inferior wall myocardial infarctions are classically caused
by occlusion of the right coronary artery, which supplies the inferior
myocardium through the posterior descending artery in most
individuals. The presentation of chest pain with ST elevation in II, III,
and aVF indicates an inferior STEMI.
2. A 32-year-old woman presents with fatigue, weight gain, cold
intolerance, and constipation. Laboratory studies show elevated TSH
and decreased free T4. Which diagnosis is most likely?
,A. Graves disease
B. Hashimoto thyroiditis
C. Cushing syndrome
D. Addison disease
Answer: B. Hashimoto thyroiditis
Rationale: Hashimoto thyroiditis is an autoimmune destruction of
thyroid tissue causing primary hypothyroidism. Increased TSH with
decreased T4 indicates failure of the thyroid gland to respond
adequately to pituitary stimulation.
3. A patient develops sudden weakness of the right face and arm with
expressive aphasia. Which vascular territory is most likely affected?
A. Right middle cerebral artery
B. Left middle cerebral artery
C. Left posterior cerebral artery
D. Basilar artery
Answer: B. Left middle cerebral artery
Rationale: The dominant hemisphere is usually the left hemisphere.
The middle cerebral artery supplies the lateral frontal and parietal
lobes, affecting face and upper limb motor function and language
centers.
4. A 55-year-old patient with long-standing hypertension develops
progressive renal insufficiency. Renal biopsy shows thickened
glomerular basement membranes and nodular glomerulosclerosis.
What is the most likely underlying condition?
,A. Acute poststreptococcal glomerulonephritis
B. Diabetes mellitus
C. Lupus nephritis
D. Polycystic kidney disease
Answer: B. Diabetes mellitus
Rationale: Diabetic nephropathy causes glomerular basement
membrane thickening and Kimmelstiel-Wilson nodules due to chronic
hyperglycemic injury.
5. A 70-year-old smoker presents with painless hematuria. Imaging
reveals a mass in the urinary bladder. Which tumor type is most
likely?
A. Renal cell carcinoma
B. Transitional cell carcinoma
C. Squamous cell carcinoma
D. Prostate adenocarcinoma
Answer: B. Transitional cell carcinoma
Rationale: Transitional cell carcinoma is the most common bladder
cancer and is strongly associated with cigarette smoking. Painless
hematuria is the classic presentation.
6. A 24-year-old woman presents with fever, pelvic pain, and purulent
cervical discharge. Cervical motion tenderness is noted. Which
organism is commonly responsible?
A. Escherichia coli
B. Chlamydia trachomatis
, C. Candida albicans
D. Human papillomavirus
Answer: B. Chlamydia trachomatis
Rationale: Pelvic inflammatory disease commonly results from
sexually transmitted infections, especially Chlamydia trachomatis and
Neisseria gonorrhoeae.
7. A newborn develops respiratory distress shortly after birth. The
mother had poorly controlled diabetes during pregnancy. Which
neonatal complication is most likely?
A. Respiratory distress syndrome
B. Meconium aspiration
C. Neural tube defect
D. Congenital hypothyroidism
Answer: A. Respiratory distress syndrome
Rationale: Infants of diabetic mothers have delayed fetal lung
maturation due to decreased surfactant production, increasing the
risk of neonatal respiratory distress syndrome.
8. A patient receiving chemotherapy develops neutropenia. Which
complication requires the greatest concern?
A. Hyperkalemia
B. Infection
C. Hypertension
D. Hyperglycemia
Answer: B. Infection
Simulation Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2026 Latest Update| Instant
Download PDF
1. A 65-year-old man presents to the emergency department with
crushing substernal chest pain radiating to his left arm, diaphoresis,
and nausea. ECG shows ST-segment elevation 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
Answer: C. Right coronary artery
Rationale: Inferior wall myocardial infarctions are classically caused
by occlusion of the right coronary artery, which supplies the inferior
myocardium through the posterior descending artery in most
individuals. The presentation of chest pain with ST elevation in II, III,
and aVF indicates an inferior STEMI.
2. A 32-year-old woman presents with fatigue, weight gain, cold
intolerance, and constipation. Laboratory studies show elevated TSH
and decreased free T4. Which diagnosis is most likely?
,A. Graves disease
B. Hashimoto thyroiditis
C. Cushing syndrome
D. Addison disease
Answer: B. Hashimoto thyroiditis
Rationale: Hashimoto thyroiditis is an autoimmune destruction of
thyroid tissue causing primary hypothyroidism. Increased TSH with
decreased T4 indicates failure of the thyroid gland to respond
adequately to pituitary stimulation.
3. A patient develops sudden weakness of the right face and arm with
expressive aphasia. Which vascular territory is most likely affected?
A. Right middle cerebral artery
B. Left middle cerebral artery
C. Left posterior cerebral artery
D. Basilar artery
Answer: B. Left middle cerebral artery
Rationale: The dominant hemisphere is usually the left hemisphere.
The middle cerebral artery supplies the lateral frontal and parietal
lobes, affecting face and upper limb motor function and language
centers.
4. A 55-year-old patient with long-standing hypertension develops
progressive renal insufficiency. Renal biopsy shows thickened
glomerular basement membranes and nodular glomerulosclerosis.
What is the most likely underlying condition?
,A. Acute poststreptococcal glomerulonephritis
B. Diabetes mellitus
C. Lupus nephritis
D. Polycystic kidney disease
Answer: B. Diabetes mellitus
Rationale: Diabetic nephropathy causes glomerular basement
membrane thickening and Kimmelstiel-Wilson nodules due to chronic
hyperglycemic injury.
5. A 70-year-old smoker presents with painless hematuria. Imaging
reveals a mass in the urinary bladder. Which tumor type is most
likely?
A. Renal cell carcinoma
B. Transitional cell carcinoma
C. Squamous cell carcinoma
D. Prostate adenocarcinoma
Answer: B. Transitional cell carcinoma
Rationale: Transitional cell carcinoma is the most common bladder
cancer and is strongly associated with cigarette smoking. Painless
hematuria is the classic presentation.
6. A 24-year-old woman presents with fever, pelvic pain, and purulent
cervical discharge. Cervical motion tenderness is noted. Which
organism is commonly responsible?
A. Escherichia coli
B. Chlamydia trachomatis
, C. Candida albicans
D. Human papillomavirus
Answer: B. Chlamydia trachomatis
Rationale: Pelvic inflammatory disease commonly results from
sexually transmitted infections, especially Chlamydia trachomatis and
Neisseria gonorrhoeae.
7. A newborn develops respiratory distress shortly after birth. The
mother had poorly controlled diabetes during pregnancy. Which
neonatal complication is most likely?
A. Respiratory distress syndrome
B. Meconium aspiration
C. Neural tube defect
D. Congenital hypothyroidism
Answer: A. Respiratory distress syndrome
Rationale: Infants of diabetic mothers have delayed fetal lung
maturation due to decreased surfactant production, increasing the
risk of neonatal respiratory distress syndrome.
8. A patient receiving chemotherapy develops neutropenia. Which
complication requires the greatest concern?
A. Hyperkalemia
B. Infection
C. Hypertension
D. Hyperglycemia
Answer: B. Infection
