Skip to main content
Sign in Create a free account
Varsity Tutors
Sign in Sign up

Practice Test 6 - USMLE Step 2

20 questions. Answer them in any order, then submit to see your score and every explanation.

  1. A 17-year-old girl at 10 weeks' gestation seeks prenatal care. She lives at home, is financially dependent, and does not want her parents informed of the pregnancy. Local regulations permit minors to consent to prenatal care. The patient also requests laboratory testing for HIV infection. Which of the following best describes the physician's obligation regarding parental notification of the HIV test?
  2. The valvular abnormality in this patient is most likely secondary to which of the following conditions?
  3. A 65-year-old man with metastatic prostate cancer develops spontaneous extensive ecchymoses. Labs: platelets 230,000/µL, PT 12 sec, aPTT 96 sec. aPTT remains prolonged after a 1:1 mixing study with normal plasma. Factor VIII level is 2% (normal 50–150%). What is the best immediate treatment to control this bleeding?
  4. Which of the following is the physician's most appropriate action?
  5. Which of the following is the most appropriate next step in management?
  6. A 70-year-old woman with obesity hypoventilation syndrome presents with lethargy and dyspnea. Vitals: RR 8/min, SpO2 85% on room air. ABG: pH 7.30, PaCO2 60 mm Hg, PaO2 56 mm Hg, HCO3− 25 mEq/L. Chest X-ray shows low lung volumes. Potential causes of hypoxemia include hypoventilation, PE, pneumonia, and heart failure. What is the most likely diagnosis based on the clinical presentation?
  7. History: A 25-year-old woman presents with 2 weeks of lower abdominal pain and abnormal vaginal discharge. She has had multiple partners and reports inconsistent condom use; she did not complete a prior STI antibiotic course because symptoms improved. Presenting issue: She has dyspareunia and irregular spotting. Exam shows cervical motion tenderness and uterine tenderness. Diagnostics: Pregnancy test negative. NAAT pending. Transvaginal US shows no tubo-ovarian abscess. Considerations: She asks whether she should wait for test results before starting therapy. Which of the following is the most appropriate next step in management?
  8. What is the most appropriate next step in her management?
  9. In addition to continuing to treat his sepsis, which of the following is the most important aspect of managing his acute kidney injury (AKI)?
  10. A 16-year-old boy accompanies his 9-year-old sister to her appointment. The sister's pediatrician asks the brother to leave the room for the private portion of the girl's visit. The brother protests, stating he is her legal guardian during their parents' trip abroad. Which of the following best explains the rationale for excluding the brother from his sister's confidential interview?
  11. Which of the following is the most appropriate next step in management?
  12. What is the most appropriate initial response from the physician?
  13. In addition to diuretic therapy, which of the following is the most important intervention for managing his hyponatremia?
  14. A 58-year-old man is in the middle of a typical 8-week cluster period with two 1-hour attacks daily. High-flow oxygen aborts each attack. He has no cardiac history, and blood pressure is 130/80 mm Hg. Which of the following is the most appropriate medication to prevent further attacks during this cluster bout?
  15. Which of the following is the most appropriate next step to establish the diagnosis?
  16. In addition to lifestyle modifications, which of the following is the most immediate therapeutic goal?
  17. A 67-year-old sedentary man with CAD has 1 week of constipation and straining; hard stools; on oxycodone and verapamil; benign exam. Most appropriate initial management?
  18. A 45-year-old man with AR has exertional dyspnea and wide pulse pressure. Exam: early diastolic murmur at LSB; bounding pulses. Echo shows severe AR. Which initial medical therapy can reduce afterload while awaiting surgery if needed?
  19. Which of the following is the most appropriate initial fluid for resuscitation in this patient?
  20. A 30-year-old woman with IBS asks about diet; symptoms worsen with onions, beans, and certain fruits; exam normal. What dietary modification should be recommended?

Practice tests