SAMPLE TEST QUESTIONS
Step 2 Clinical Knowledge (CK)
A Joint Program of the Federation of State Medical Boards of the
United States, Inc., and National Board of Medical Examiners
, This booklet was updated July 2023.
For Public Release
Copyright © 2023 by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical
Examiners® (NBME®). All rights reserved. Printed in the United States of America. The United States Medical Licensing
Examination® (USMLE®) is a joint program of the FSMB and NBME.
, CONTENTS
USMLE Step 2 CK Test Question Formats …………………………………...…………..………. 3
Introduction to USMLE Step 2 CK Sample Test Questions …………………………..….. 9
USMLE Laboratory Values ………………………………...………..…….….………..……………... 10
USMLE Step 2 CK Sample Test Questions……………………………………………..…............ 13
Block 1, Items 1–40 …………………………………………………………………..….......... 13
Block 2, Items 41–80 ……………………………………………..….............................. 29
Block 3, Items 81–120 ……………………………………………..…........................... 47
Answer Form for USMLE Step 2 CK Sample Test Questions………………………..…... 63
Answer Key for USMLE Step 2 CK Sample Test Questions………………………….……. 64
, USMLE STEP 2 CK TEST QUESTION FORMATS
The following are strategies for answering one-best-answer items:
• Read each question carefully. It is important to understand what is being asked.
• Try to generate an answer and then look for it in the response option list.
• Alternatively, read each response option carefully, eliminating those that are clearly incorrect.
• Of the remaining response options, select the one that is most correct.
• If unsure about an answer, it is better to guess since unanswered questions are automatically counted as wrong
answers.
Patient Scenario Formats
Patient scenarios for any Single Item or Sequential Item Set may be provided in either Vignette (paragraph) format, or in
Chart/Tabular format. Test items using the chart/tabular format are designed to resemble patient charts but are not
intended to be an exact representation of a patient chart. Questions written in Chart/Tabular format will contain
relevant patient information in list form, organized in clearly marked sections for ease of review. Familiar medical
abbreviations may be used within Chart/Tabular format questions.
Single-Item Questions
A single patient-centered vignette is associated with one question followed by four or more response options. The
response options are lettered (ie, A, B, C, D, E). A portion of the questions involves interpretation of graphic or pictorial
materials. You are required to select the best answer to the question. Other options may be partially correct, but there is
only ONE BEST answer. This is the traditional, most frequently used multiple-choice question format on the examination.
Example Question 1
A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She has not yet
started dialysis. Examination shows no abnormalities. Her hemoglobin concentration is 9 g/dL, hematocrit is 28%, and
mean corpuscular volume is 94 μm3. A blood smear shows normochromic, normocytic cells. Which of the following is the
most likely cause?
(A) Acute blood loss (F) Microangiopathic hemolysis
(B) Chronic lymphocytic leukemia (G) Polycythemia vera
(C) Erythrocyte enzyme deficiency (H) Sickle cell disease
(D) Erythropoietin deficiency (I) Sideroblastic anemia
(E) Immunohemolysis (J) β-Thalassemia trait
(Answer: D)
3
Step 2 Clinical Knowledge (CK)
A Joint Program of the Federation of State Medical Boards of the
United States, Inc., and National Board of Medical Examiners
, This booklet was updated July 2023.
For Public Release
Copyright © 2023 by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical
Examiners® (NBME®). All rights reserved. Printed in the United States of America. The United States Medical Licensing
Examination® (USMLE®) is a joint program of the FSMB and NBME.
, CONTENTS
USMLE Step 2 CK Test Question Formats …………………………………...…………..………. 3
Introduction to USMLE Step 2 CK Sample Test Questions …………………………..….. 9
USMLE Laboratory Values ………………………………...………..…….….………..……………... 10
USMLE Step 2 CK Sample Test Questions……………………………………………..…............ 13
Block 1, Items 1–40 …………………………………………………………………..….......... 13
Block 2, Items 41–80 ……………………………………………..….............................. 29
Block 3, Items 81–120 ……………………………………………..…........................... 47
Answer Form for USMLE Step 2 CK Sample Test Questions………………………..…... 63
Answer Key for USMLE Step 2 CK Sample Test Questions………………………….……. 64
, USMLE STEP 2 CK TEST QUESTION FORMATS
The following are strategies for answering one-best-answer items:
• Read each question carefully. It is important to understand what is being asked.
• Try to generate an answer and then look for it in the response option list.
• Alternatively, read each response option carefully, eliminating those that are clearly incorrect.
• Of the remaining response options, select the one that is most correct.
• If unsure about an answer, it is better to guess since unanswered questions are automatically counted as wrong
answers.
Patient Scenario Formats
Patient scenarios for any Single Item or Sequential Item Set may be provided in either Vignette (paragraph) format, or in
Chart/Tabular format. Test items using the chart/tabular format are designed to resemble patient charts but are not
intended to be an exact representation of a patient chart. Questions written in Chart/Tabular format will contain
relevant patient information in list form, organized in clearly marked sections for ease of review. Familiar medical
abbreviations may be used within Chart/Tabular format questions.
Single-Item Questions
A single patient-centered vignette is associated with one question followed by four or more response options. The
response options are lettered (ie, A, B, C, D, E). A portion of the questions involves interpretation of graphic or pictorial
materials. You are required to select the best answer to the question. Other options may be partially correct, but there is
only ONE BEST answer. This is the traditional, most frequently used multiple-choice question format on the examination.
Example Question 1
A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She has not yet
started dialysis. Examination shows no abnormalities. Her hemoglobin concentration is 9 g/dL, hematocrit is 28%, and
mean corpuscular volume is 94 μm3. A blood smear shows normochromic, normocytic cells. Which of the following is the
most likely cause?
(A) Acute blood loss (F) Microangiopathic hemolysis
(B) Chronic lymphocytic leukemia (G) Polycythemia vera
(C) Erythrocyte enzyme deficiency (H) Sickle cell disease
(D) Erythropoietin deficiency (I) Sideroblastic anemia
(E) Immunohemolysis (J) β-Thalassemia trait
(Answer: D)
3
