STEP 2 CK Test Question Formats

Single One Best Answer Questions

This is the traditional, most frequently used multiple-choice format. It consists of a statement or question followed by three to twenty-six options that are in alphabetical or logical order. The response options in this format are lettered (eg, A, B, C, D, E). Examinees are required to select the best answer to the question. Other options may be partially correct, but there is only ONE BEST answer.

Strategies for Answering Single One Best Answer Test Questions

  • 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 option list.
  • Alternatively, read each option carefully, eliminating those that are clearly incorrect.
  • Of the remaining 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.

Example Item 1

1. A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She is not yet on 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?

  1. Acute blood loss
  2. Chronic lymphocytic leukemia
  3. Erythrocyte enzyme deficiency
  4. Erythropoietin deficiency
  5. Immunohemolysis
  6. Microangiopathic hemolysis
  7. Polycythemia vera
  8. Sickle cell disease
  9. Sideroblastic anemia
  10. ß-Thalassemia trait

(Answer D)

Matching Sets

This format consists of a series of questions related to a common topic. All matching sets contain set-specific instructions, a list of lettered response options, and at least two questions. There will be between four and twenty-six response options. Each set is preceded by a box that indicates the number of questions in the set associated with the response options that follow. Examinees are directed to select one answer for each question in the set. Questions will be presented one at a time, with instructions and response options repeated for each subsequent question.

Strategies for Answering Matching Sets

  • Begin each set by reading through the option list to become familiar with the available responses.
  • Read each question carefully.
  • Within a set, some options may be used several times, while other options may not be used at all. Respond to each question independently.
  • For matching sets with large numbers of options, try to generate an answer to the question and then locate the answer in the option list. This is more efficient than considering each option individually.

The response options for items 2-3 are the same. You will be required to select one answer for each item in the set.

Example Items 2-3: Matching set

  1. Chronic lymphocytic leukemia
  2. Drug reaction
  3. Hodgkin disease
  4. Infectious mononucleosis
  5. Metastatic carcinoma
  6. Sarcoidosis
  7. Systemic lupus erythematosus
  8. Toxoplasmosis
  9. Tuberculosis
  10. Tularemia

For each patient with lymphadenopathy, select the most likely diagnosis.

2. A previously healthy 30-year-old man has had fever, night sweats, pruritus, and an enlarging lump above his left clavicle for 3 weeks. Examination shows a 3-cm, nontender, rubbery, supraclavicular lymph node. An x-ray of the chest shows mediastinal lymphadenopathy.

(Answer C)

3. A 41-year-old woman comes to the physician for a follow-up examination. She has taken aspirin for chronic headaches and phenytoin for a seizure disorder for 2 years. Examination shows mild epigastric tenderness and bilateral, 3-cm, nontender axillary lymph nodes. A lymph node biopsy shows hyperplasia.

(Answer B)