NBOME COMLEX-USA Level 2-CE Practice Test
Build your confidence for NBOME COMLEX-USA Level 2-CE. Practice the concepts, understand the answers, and strengthen your knowledge one question at a time.
Try a sample questionExam overview and details
The COMLEX-USA Level 2-Cognitive Evaluation (Level 2-CE) is a pivotal, high-stakes examination administered by the National Board of Osteopathic Medical Examiners (NBOME) for osteopathic medical students and graduates. This comprehensive, one-day computer-based assessment rigorously evaluates a candidate's medical knowledge and clinical decision-making skills across the spectrum of clinical disciplines essential for osteopathic medical practice. Successfully passing Level 2-CE is a mandatory requirement for graduation from COCA-accredited colleges of osteopathic medicine and for progression into graduate medical education (GME). The exam's content integrates osteopathic principles and practice with foundational clinical sciences, testing the application of knowledge in patient-centered scenarios. Earning a passing score validates a candidate's readiness for supervised patient care and is a critical component of the licensure pathway for Doctors of Osteopathic Medicine (DOs), serving as a standardized benchmark of clinical competence recognized by residency programs and state medical boards nationwide.
Sample Questions
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A 70-year-old man with COPD and diabetes has fever, cough, and a right lower lobe infiltrate. Oxygen saturation is 95%, blood pressure is stable, and he can take oral medication. He was not hospitalized recently. Which outpatient regimen is most appropriate?
A 64-year-old man with prior MI has dyspnea on exertion. Echocardiogram shows LVEF 30%. He takes maximally tolerated sacubitril-valsartan and metoprolol succinate. eGFR is 52 mL/min/1.73 m2 and potassium is 4.3 mEq/L. Which addition improves survival?
A 64-year-old woman has 2 days of fever, right flank pain, nausea, and dysuria. She has type 2 diabetes and a history of calcium oxalate stones. Temperature is 38.8 C, heart rate is 112/min, and urinalysis shows pyuria and nitrites. CT shows a 7-mm obstructing proximal ureteral stone with hydronephrosis. Which next step is most appropriate?
A 31-year-old resident has 5 days of sleeping 2 hours nightly, pressured speech, risky online spending, and grandiose plans to open three clinics. He was started on sertraline 3 weeks ago for depression. He denies substance use. What is the best next step?
A 72-year-old man with type 2 diabetes is confused and dehydrated. Glucose is 890 mg/dL, serum osmolality is 338 mOsm/kg, pH is 7.36, bicarbonate is 22 mEq/L, and ketones are minimal. Which initial therapy is most important?
Exam insights and study advice
Achieving a competitive score on the COMLEX-USA Level 2-CE is fundamentally important for career trajectory and professional recognition. It is a primary metric used by residency program directors during the Electronic Residency Application Service (ERAS) match process to assess and compare candidates' clinical knowledge. A strong performance demonstrates your preparedness for the rigors of residency, directly influencing your candidacy for competitive specialties and programs. Furthermore, passing Level 2-CE is a non-negotiable step toward obtaining medical licensure, as it fulfills a core requirement for the three-level COMLEX-USA sequence mandated by state licensing boards. This certification is not merely an academic hurdle; it is a professional credential that signifies your commitment to the standards of osteopathic medicine and your capability to provide safe, effective patient care.