COMLEX LEVEL 2–CE PRACTICE EXAM LATEST 2026
UPDATE 100 QUESTIONS AND DETAILED VERIFIED
ANSWERS FROM ACTUAL EXAMS TEST GRADE A+
Question 1
A 45-year-old woman presents with acute low back pain after lifting a heavy
object. Physical examination reveals paraspinal muscle hypertonicity and
tenderness at L4–L5. Which osteopathic manipulative treatment (OMT) technique
is most appropriate in the acute phase?
A. High-velocity, low-amplitude (HVLA)
B. Muscle energy
C. Counterstrain
D. Still technique
E. Facilitated positional release
Answer: C. Counterstrain
Rationale: Counterstrain is a gentle, indirect technique ideal for acute pain and
muscle spasm, reducing nociceptive input without exacerbating tissue injury.
Question 2
A 60-year-old man with hypertension and diabetes presents with crushing
substernal chest pain radiating to the left arm. ECG shows ST 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. Posterior descending artery
E. Diagonal branch
,Answer: C. Right coronary artery
Rationale: ST elevations in leads II, III, and aVF indicate an inferior myocardial
infarction, most commonly due to occlusion of the right coronary artery.
Question 3
A 3-year-old child presents with fever, barking cough, and inspiratory stridor.
Which is the most appropriate initial management?
A. Oral amoxicillin
B. Nebulized epinephrine and dexamethasone
C. Immediate intubation
D. Albuterol nebulization
E. Racemic epinephrine only
Answer: B. Nebulized epinephrine and dexamethasone
Rationale: These findings are consistent with croup. Management includes
corticosteroids for all cases and nebulized epinephrine for moderate to severe
symptoms.
Question 4
A patient with chronic obstructive pulmonary disease (COPD) presents with
worsening dyspnea and purulent sputum. Which organism is most commonly
responsible for acute exacerbations?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Pseudomonas aeruginosa
E. Chlamydophila pneumoniae
,Answer: C. Haemophilus influenzae
Rationale: Haemophilus influenzae is the most common bacterial cause of COPD
exacerbations, followed by Streptococcus pneumoniae and Moraxella catarrhalis.
Question 5
A 28-year-old pregnant woman at 10 weeks’ gestation presents for prenatal care.
Which screening test is recommended at this visit?
A. Group B Streptococcus screening
B. Nonstress test
C. Nuchal translucency ultrasound
D. Amniocentesis
E. Biophysical profile
Answer: C. Nuchal translucency ultrasound
Rationale: First-trimester screening for chromosomal abnormalities includes
nuchal translucency measurement between 11 and 14 weeks’ gestation.
Question 6
A 70-year-old man presents with progressive resting tremor, bradykinesia, and
rigidity. Which neurotransmitter deficiency is responsible for his symptoms?
A. Acetylcholine
B. Dopamine
C. Serotonin
D. GABA
E. Norepinephrine
Answer: B. Dopamine
Rationale: Parkinson disease results from degeneration of dopaminergic neurons
in the substantia nigra pars compacta.
, Question 7
A 25-year-old woman presents with dysuria and urinary frequency. Urinalysis
shows positive nitrites and leukocyte esterase. What is the most appropriate first-
line treatment?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Vancomycin
E. Doxycycline
Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is a first-line therapy for uncomplicated cystitis in
nonpregnant women due to its efficacy and low resistance rates.
Question 8
A patient presents with somatic dysfunction of the thoracic spine characterized by
T4 FRrSr. In which position should the patient be placed for muscle energy
treatment?
A. Flexion, rotation right, sidebending right
B. Extension, rotation left, sidebending left
C. Flexion, rotation left, sidebending left
D. Extension, rotation right, sidebending right
E. Neutral, rotation right, sidebending left
Answer: B. Extension, rotation left, sidebending left
Rationale: Muscle energy requires positioning the patient into the restrictive
barrier. For T4 FRrSr (flexed, rotated right, sidebent right), the restrictive barrier is
extension, rotation left, and sidebending left.
Question 9
UPDATE 100 QUESTIONS AND DETAILED VERIFIED
ANSWERS FROM ACTUAL EXAMS TEST GRADE A+
Question 1
A 45-year-old woman presents with acute low back pain after lifting a heavy
object. Physical examination reveals paraspinal muscle hypertonicity and
tenderness at L4–L5. Which osteopathic manipulative treatment (OMT) technique
is most appropriate in the acute phase?
A. High-velocity, low-amplitude (HVLA)
B. Muscle energy
C. Counterstrain
D. Still technique
E. Facilitated positional release
Answer: C. Counterstrain
Rationale: Counterstrain is a gentle, indirect technique ideal for acute pain and
muscle spasm, reducing nociceptive input without exacerbating tissue injury.
Question 2
A 60-year-old man with hypertension and diabetes presents with crushing
substernal chest pain radiating to the left arm. ECG shows ST 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. Posterior descending artery
E. Diagonal branch
,Answer: C. Right coronary artery
Rationale: ST elevations in leads II, III, and aVF indicate an inferior myocardial
infarction, most commonly due to occlusion of the right coronary artery.
Question 3
A 3-year-old child presents with fever, barking cough, and inspiratory stridor.
Which is the most appropriate initial management?
A. Oral amoxicillin
B. Nebulized epinephrine and dexamethasone
C. Immediate intubation
D. Albuterol nebulization
E. Racemic epinephrine only
Answer: B. Nebulized epinephrine and dexamethasone
Rationale: These findings are consistent with croup. Management includes
corticosteroids for all cases and nebulized epinephrine for moderate to severe
symptoms.
Question 4
A patient with chronic obstructive pulmonary disease (COPD) presents with
worsening dyspnea and purulent sputum. Which organism is most commonly
responsible for acute exacerbations?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Pseudomonas aeruginosa
E. Chlamydophila pneumoniae
,Answer: C. Haemophilus influenzae
Rationale: Haemophilus influenzae is the most common bacterial cause of COPD
exacerbations, followed by Streptococcus pneumoniae and Moraxella catarrhalis.
Question 5
A 28-year-old pregnant woman at 10 weeks’ gestation presents for prenatal care.
Which screening test is recommended at this visit?
A. Group B Streptococcus screening
B. Nonstress test
C. Nuchal translucency ultrasound
D. Amniocentesis
E. Biophysical profile
Answer: C. Nuchal translucency ultrasound
Rationale: First-trimester screening for chromosomal abnormalities includes
nuchal translucency measurement between 11 and 14 weeks’ gestation.
Question 6
A 70-year-old man presents with progressive resting tremor, bradykinesia, and
rigidity. Which neurotransmitter deficiency is responsible for his symptoms?
A. Acetylcholine
B. Dopamine
C. Serotonin
D. GABA
E. Norepinephrine
Answer: B. Dopamine
Rationale: Parkinson disease results from degeneration of dopaminergic neurons
in the substantia nigra pars compacta.
, Question 7
A 25-year-old woman presents with dysuria and urinary frequency. Urinalysis
shows positive nitrites and leukocyte esterase. What is the most appropriate first-
line treatment?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Vancomycin
E. Doxycycline
Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is a first-line therapy for uncomplicated cystitis in
nonpregnant women due to its efficacy and low resistance rates.
Question 8
A patient presents with somatic dysfunction of the thoracic spine characterized by
T4 FRrSr. In which position should the patient be placed for muscle energy
treatment?
A. Flexion, rotation right, sidebending right
B. Extension, rotation left, sidebending left
C. Flexion, rotation left, sidebending left
D. Extension, rotation right, sidebending right
E. Neutral, rotation right, sidebending left
Answer: B. Extension, rotation left, sidebending left
Rationale: Muscle energy requires positioning the patient into the restrictive
barrier. For T4 FRrSr (flexed, rotated right, sidebent right), the restrictive barrier is
extension, rotation left, and sidebending left.
Question 9
