Practice Test 8 - USMLE Step 3
20 questions. Answer them in any order, then submit to see your score and every explanation.
- In addition to optimizing her asthma medications, what is the most important long-term management recommendation for this patient?
- Stable angina on metoprolol; resting HR 54. Which calcium channel blocker should be avoided?
- What is the most appropriate recommendation regarding cervical cancer screening?
- A 32-year-old G2P2 is brought to the clinic by her husband 3 weeks postpartum. He states she has been crying frequently, has a poor appetite, and has been expressing feelings of being an inadequate mother. The patient reports, "I feel overwhelmed and can't seem to connect with the baby." She denies any thoughts of harming herself or the infant. She has profound difficulty sleeping, even when the baby is asleep. These symptoms have been present for the past 10 days.
- Which of the following interventions is most critical for ensuring a safe transition home and preventing adverse events for this patient?
- During a 4-month well-child visit, the mother of an infant expresses hesitation about proceeding with the recommended vaccinations. She says, 'I saw a post online from a doctor who said that natural immunity from getting sick is stronger and safer than vaccine-induced immunity.' Which of the following is the most appropriate response to address this specific concern?
- This patient's immediate postoperative mortality risk is best described by the presence of which of the following conditions?
- What is the most appropriate recommendation regarding zoster vaccination?
- To reduce asthma ED visits in low-income children, which approach is most effective?
- Which of the following is the most appropriate initial management for her nocturnal agitation?
- A 40-year-old woman with rheumatoid arthritis on methotrexate and adalimumab is followed by rheumatology and PCP. Background: Recurrent sinus infections; wants pregnancy in 1 year. Current status/Plan: Disease controlled; needs vaccine updates and contraception counseling; labs every 3 months. Team: PCP, rheumatologist, pharmacist, OB/GYN. Coordination: Rheumatology adjusts DMARDs; PCP manages preventive care and infection screening. Transition plan: Shared care plan in EHR. How should communication be handled between the multidisciplinary team to prevent complications during ongoing coordinated care?
- Which of the following is the most appropriate medication to initiate during this hospitalization?
- Which of the following is the most appropriate way to frame the prognostic discussion with the family?
- Stable CAD, atorvastatin 80, myalgia, CK normal. Best next step?
- What is the most appropriate approach to screening for latent tuberculosis infection in this patient?
- What is the most appropriate next step in the management of his thrombocytopenia?
- Which of the following is the most effective response to this parent's concern?
- A 62-year-old man has CKD stage 4 for 7 years from diabetes; he follows dietary counseling and takes insulin, losartan 100 mg daily, amlodipine 10 mg daily, and furosemide 40 mg daily. He reports worsening restless legs and fatigue for 1 year. BP is 138/80 mm Hg. Exam shows pallor. Labs: creatinine 3.3 mg/dL, eGFR 19 mL/min/1.73 m², Hgb 9.6 g/dL, ferritin 380 ng/mL, transferrin saturation 14%, Ca 8.7 mg/dL, phosphate 4.8 mg/dL. Renal ultrasound shows chronic changes only. What is the next best step in managing this patient's CKD?
- History & Lifestyle: 70-year-old man with hypertension for routine follow-up. • Meds: metoprolol and lisinopril; adherent. • BMI 27; eats balanced diet. • Quit smoking 30 years ago; 10 pack-years total. Family History: Noncontributory. Preventive Care Review: Received PCV13 years ago; no PPSV23 or PCV20 documented. No immunocompromising conditions or cochlear implant. What is the next best step in preventive care for this patient?
- Which of the following is the most appropriate advice regarding her medication?