Unofficial USMLE Step 2 CK practice questions: short patient cases on diagnosis, tests, treatment and prevention.
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Unofficial practice questions, not affiliated with the Federation of State Medical Boards and National Board of Medical Examiners. Bank checked October 10, 2026.
The real exam, as the USMLE program describes it
Length
Sixteen 30-minute blocks in one 9-hour testing session, for anyone testing on or after May 7, 2026. A block holds no more than 20 questions.
Breaks
At least 55 minutes of break time and an optional 5-minute tutorial. Finishing a block early adds to the break time.
Result
Pass or fail, as a recommendation. The percent of items needed varies from form to form; examinees typically must answer approximately 60 percent correctly.
Where
A test center, booked through the scheduling links on the exam page of usmle.org.
A 54-year-old man is scheduled for an elective knee replacement. To obtain informed consent, the surgeon explains the problem, what the operation involves, its risks and how likely it is to work. What else must be explained?MedlinePlus Medical Encyclopedia, Informed consent - adults, What Should Occur During the Informed Consent Process?. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
A 70-year-old woman wants her daughter to make medical decisions for her if she ever cannot. Which document does this?MedlinePlus Medical Encyclopedia, Advance care directives, Other Types of Advance Directives. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
A 78-year-old woman with end-stage heart failure has a do-not-resuscitate order. She is admitted with a painful pneumonia. What does the order tell the team not to do?MedlinePlus Medical Encyclopedia, Do-not-resuscitate order, What is a DNR?. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
Show all 60 questions (57 more)
Ethics, law and patient safety, continued
A patient is harmed by a tenfold dosing error. The hospital forms a team that reconstructs the event from records and interviews and looks for underlying system problems, not individual blame. What is this method called?Agency for Healthcare Research and Quality, PSNet primer, Root Cause Analysis, Background. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
A resident orders the wrong dose of a medicine and the patient needs two extra days in hospital. The patient does not know why. What should the physician do?Agency for Healthcare Research and Quality, PSNet primer, Disclosure of Errors, Background. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
An uninsured man comes to the emergency department of a Medicare-participating hospital with chest pain. Under EMTALA, what must the hospital provide first?Centers for Medicare & Medicaid Services, Emergency Medical Treatment & Labor Act (EMTALA), overview. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
Just before a hernia repair begins, everyone in the operating room stops to review the patient, the procedure and the site together. What is this planned pause called?Agency for Healthcare Research and Quality, PSNet primer, Wrong-Site, Wrong-Procedure, and Wrong-Patient Surgery, Background. Outline: USMLE Step 2 CK, Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety.
Renal, urinary and reproductive systems 6
A 15-year-old boy has sudden severe pain in one testicle, with nausea. The testicle sits high and Doppler ultrasound shows no blood flow. What is the next step?MedlinePlus Medical Encyclopedia, Testicular torsion, Exams and Tests, Treatment. Outline: USMLE Step 2 CK, Renal & Urinary System & Reproductive Systems.
A 24-year-old woman has two days of burning with urination and lower abdominal pressure. She has no fever. Which test can diagnose a bladder infection most of the time?MedlinePlus Medical Encyclopedia, Urinary tract infection - adults, Exams and Tests. Outline: USMLE Step 2 CK, Renal & Urinary System & Reproductive Systems.
A 38-year-old man has passed a calcium oxalate kidney stone and asks how to avoid another. Which advice is the most important?National Institute of Diabetes and Digestive and Kidney Diseases, Eating, Diet, & Nutrition for Kidney Stones, Can I help prevent kidney stones by changing what I eat or drink?. Outline: USMLE Step 2 CK, Renal & Urinary System & Reproductive Systems.
A 42-year-old woman at average risk asks about breast cancer screening. What does the US Preventive Services Task Force recommend?US Preventive Services Task Force, Breast Cancer: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Renal & Urinary System & Reproductive Systems.
A 45-year-old man has swollen legs, protein in the urine, low blood protein and high cholesterol. Which medicines are most often used to keep his blood pressure at goal and reduce protein loss?MedlinePlus Medical Encyclopedia, Nephrotic syndrome, Treatment. Outline: USMLE Step 2 CK, Renal & Urinary System & Reproductive Systems.
A healthy 25-year-old woman comes for a routine visit. Which cervical cancer screening does the US Preventive Services Task Force recommend at her age?US Preventive Services Task Force, Cervical Cancer: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Renal & Urinary System & Reproductive Systems.
Cardiovascular system 5
A 58-year-old man is brought in with a heart attack. He is on a monitor with oxygen and an IV line. Unless it would be unsafe for him, which medicine is given to prevent clotting?MedlinePlus Medical Encyclopedia, Heart attack, Treatment, Immediate Treatment. Outline: USMLE Step 2 CK, Cardiovascular System.
A 62-year-old man has sudden tearing chest pain that moves to his back. His blood pressure differs between the arms. Imaging shows a dissection of the ascending aorta. How is it treated?MedlinePlus Medical Encyclopedia, Aortic dissection, Symptoms, Exams and Tests, Treatment. Outline: USMLE Step 2 CK, Cardiovascular System.
A 67-year-old man smoked for 20 years and quit a decade ago. He feels well. Which screening does the US Preventive Services Task Force recommend for him?US Preventive Services Task Force, Abdominal Aortic Aneurysm: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Cardiovascular System.
At a screening visit a 40-year-old man's office blood pressure is 150/94 mm Hg. He has no known hypertension. What does the US Preventive Services Task Force recommend before treatment starts?US Preventive Services Task Force, Hypertension in Adults: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Cardiovascular System.
Two days after a long plane flight, a 48-year-old woman has a red, swollen, tender leg. Which imaging test is often done to diagnose the suspected condition?MedlinePlus Medical Encyclopedia, Deep vein thrombosis, Causes, Exams and Tests. Outline: USMLE Step 2 CK, Cardiovascular System.
Musculoskeletal system and skin 5
A 45-year-old man has a mole with irregular edges and several colors that keeps changing. What is the next step?MedlinePlus Medical Encyclopedia, Melanoma, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Musculoskeletal System/Skin & Subcutaneous Tissue.
A 60-year-old woman has a fever and one swollen knee that became intensely painful over a day and hurts more with movement. Which test matters most?MedlinePlus Medical Encyclopedia, Septic arthritis, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Musculoskeletal System/Skin & Subcutaneous Tissue.
A healthy 66-year-old woman has never had a fracture. What does the US Preventive Services Task Force recommend to prevent osteoporotic fractures?US Preventive Services Task Force, Osteoporosis to Prevent Fractures: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Musculoskeletal System/Skin & Subcutaneous Tissue.
An obese 13-year-old boy has a limp, knee pain and restricted hip movement. Which test can confirm a slipped capital femoral epiphysis?MedlinePlus Medical Encyclopedia, Slipped capital femoral epiphysis, Causes, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Musculoskeletal System/Skin & Subcutaneous Tissue.
Hours after a cast is put on a broken lower leg, a 25-year-old man has pain far greater than the injury explains. Acute compartment syndrome is confirmed. What is the treatment?MedlinePlus Medical Encyclopedia, Compartment syndrome, Symptoms, Treatment. Outline: USMLE Step 2 CK, Musculoskeletal System/Skin & Subcutaneous Tissue.
Behavioral health 5
A 17-year-old girl with anorexia nervosa enters a treatment program to restore her weight. What rate of weight gain is considered a safe goal?MedlinePlus Medical Encyclopedia, Anorexia, Treatment. Outline: USMLE Step 2 CK, Behavioral Health.
A 28-year-old man is found barely breathing, with pinpoint pupils, after injecting heroin. Which medicine reverses the overdose?MedlinePlus Medical Encyclopedia, Heroin overdose, Symptoms, Home Care, What to Expect at the Emergency Room. Outline: USMLE Step 2 CK, Behavioral Health.
A 30-year-old woman comes for a routine visit six weeks after giving birth. She reports no symptoms and has no history of depression. What does the US Preventive Services Task Force recommend?US Preventive Services Task Force, Depression and Suicide Risk in Adults: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Behavioral Health.
A 50-year-old man who drinks heavily is admitted with a broken hip. Three days after his last drink he becomes agitated, tremulous and suddenly confused, and sees things that are not there. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, Delirium tremens, Symptoms. Outline: USMLE Step 2 CK, Behavioral Health.
A malnourished man with alcohol use disorder is admitted with confusion, loss of muscle coordination and abnormal eye movements. Which treatment should be given as soon as possible?MedlinePlus Medical Encyclopedia, Wernicke-Korsakoff syndrome, Symptoms, Treatment. Outline: USMLE Step 2 CK, Behavioral Health.
Blood and immune systems 4
A 10-year-old with sickle cell anemia has frequent painful crises. Which medicine is used to reduce how often the crises occur and the need for blood transfusions?MedlinePlus Drug Information, Hydroxyurea, Why is this medication prescribed?. Outline: USMLE Step 2 CK, Blood & Lymphoreticular/Immune Systems.
A 34-year-old woman has eaten no animal products for years. She has anemia with numbness and tingling in her feet, and her vitamin B12 level is low. Which other blood test may be done for this anemia?MedlinePlus Medical Encyclopedia, Vitamin B12 deficiency anemia, Symptoms, Exams and Tests, Treatment. Outline: USMLE Step 2 CK, Blood & Lymphoreticular/Immune Systems.
A 62-year-old man is tired. Tests show anemia with low iron stores, and he has seen no bleeding. Which test is ordered to check for a cause of blood loss?MedlinePlus Medical Encyclopedia, Iron deficiency anemia, Exams and Tests. Outline: USMLE Step 2 CK, Blood & Lymphoreticular/Immune Systems.
Minutes after a bee sting, a 19-year-old has trouble breathing, wheezing and a hoarse, whispered voice. Which treatment comes first?MedlinePlus Medical Encyclopedia, Anaphylaxis, Symptoms, Treatment. Outline: USMLE Step 2 CK, Blood & Lymphoreticular/Immune Systems.
Gastrointestinal system 5
A 4-week-old boy vomits forcefully after feedings and is hungry again at once. An olive-shaped mass is felt in the upper belly. Which imaging test may be done first?MedlinePlus Medical Encyclopedia, Pyloric stenosis in infants, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Gastrointestinal System.
A 22-year-old man's pain began around the navel and moved to the right lower abdomen, with nausea and a low fever. Appendicitis is diagnosed and a CT scan shows no abscess. What is the usual management?MedlinePlus Medical Encyclopedia, Appendicitis, Symptoms, Treatment. Outline: USMLE Step 2 CK, Gastrointestinal System.
A 44-year-old woman is in hospital with acute pancreatitis and cannot yet eat by mouth. How is nutrition handled?MedlinePlus Medical Encyclopedia, Acute pancreatitis, Treatment. Outline: USMLE Step 2 CK, Gastrointestinal System.
A 45-year-old man at average risk asks when to begin colorectal cancer screening. What does the US Preventive Services Task Force recommend?US Preventive Services Task Force, Colorectal Cancer: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Gastrointestinal System.
Blood tests and a biopsy of the small intestine confirm celiac disease in a 28-year-old woman. What is the treatment?MedlinePlus Medical Encyclopedia, Celiac disease - sprue, Treatment. Outline: USMLE Step 2 CK, Gastrointestinal System.
Nervous system and special senses 4
A 19-year-old student has a fever, a severe headache, a stiff neck and confusion that came on quickly. Meningitis is suspected. Which test should be done?MedlinePlus Medical Encyclopedia, Meningitis, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Nervous System & Special Senses.
A 48-year-old woman has a sudden headache she calls the worst of her life, and a stiff neck. A subarachnoid hemorrhage is suspected. Which test is done right away?MedlinePlus Medical Encyclopedia, Subarachnoid hemorrhage, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Nervous System & Special Senses.
A 70-year-old woman has sudden weakness on one side. Her stroke comes from a clot of blood. To be effective, a clot-busting medicine must be started within what time of the first symptoms?MedlinePlus Medical Encyclopedia, Stroke, Treatment. Outline: USMLE Step 2 CK, Nervous System & Special Senses.
An 18-month-old with a fever of 103°F has a seizure that stops by itself in two minutes. Afterward the child is drowsy for a short time, and the examination is otherwise normal. What testing is usually needed?MedlinePlus Medical Encyclopedia, Febrile seizures, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Nervous System & Special Senses.
Respiratory system 5
A 2-year-old has had a mild cold and low fever for several days. Tonight she has a hoarse voice and a cough like the bark of a seal. What is the most likely diagnosis?MedlinePlus Medical Encyclopedia, Croup, Symptoms. Outline: USMLE Step 2 CK, Respiratory System.
A 62-year-old woman smoked a pack a day for 30 years and quit 5 years ago. She has no symptoms. What does the US Preventive Services Task Force recommend?US Preventive Services Task Force, Lung Cancer: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Respiratory System.
A 64-year-old man who has smoked for 40 years has a cough and shortness of breath that worsens with mild activity. Which is the typical test for the suspected lung disease?MedlinePlus Medical Encyclopedia, Chronic obstructive pulmonary disease (COPD), Causes, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Respiratory System.
A tall, thin 22-year-old man has sudden sharp chest pain and shortness of breath. Breath sounds are absent on the right, and a chest x-ray shows a large pneumothorax. What is the treatment?MedlinePlus Medical Encyclopedia, Collapsed lung (pneumothorax), Causes, Exams and Tests, Treatment. Outline: USMLE Step 2 CK, Respiratory System.
Five days after hip surgery, a 55-year-old man has sudden sharp chest pain and shortness of breath. Which imaging test can help show where a blood clot in the lungs is located?MedlinePlus Medical Encyclopedia, Pulmonary embolus, Causes, Exams and Tests. Outline: USMLE Step 2 CK, Respiratory System.
Multisystem processes 4
A 3-year-old has had a high fever for six days, with red eyes without drainage, cracked red lips, a strawberry tongue and red, swollen palms. What is the standard treatment?MedlinePlus Medical Encyclopedia, Kawasaki disease, Symptoms, Treatment. Outline: USMLE Step 2 CK, Multisystem Processes & Disorders.
A 19-year-old swallowed a large amount of acetaminophen. Which antidote counteracts its effects?MedlinePlus Medical Encyclopedia, Acetaminophen overdose, What to Expect at the Emergency Room. Outline: USMLE Step 2 CK, Multisystem Processes & Disorders.
A 44-year-old man has a body mass index of 33 and asks for help with his weight. What does the US Preventive Services Task Force recommend that clinicians do?US Preventive Services Task Force, Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions, Recommendation Summary. Outline: USMLE Step 2 CK, Multisystem Processes & Disorders.
A 70-year-old woman with a urinary infection becomes confused, and her blood pressure drops. Sepsis is diagnosed. How should antibiotics be given?MedlinePlus Medical Encyclopedia, Sepsis, Symptoms, Treatment. Outline: USMLE Step 2 CK, Multisystem Processes & Disorders.
Endocrine system 3
A 16-year-old with type 1 diabetes has vomiting, deep rapid breathing and fruity-smelling breath. Ketones are found in her urine. What is the goal of treatment?MedlinePlus Medical Encyclopedia, Diabetic ketoacidosis, Symptoms, Treatment. Outline: USMLE Step 2 CK, Endocrine System.
A 45-year-old woman feels cold and tired and is constipated. Tests confirm an underactive thyroid. Which medicine is most commonly used?MedlinePlus Medical Encyclopedia, Hypothyroidism, Symptoms, Treatment. Outline: USMLE Step 2 CK, Endocrine System.
Screening finds prediabetes in a 45-year-old man with obesity. Besides metformin, which interventions does the Task Force statement say have shown efficacy in preventing or delaying diabetes?US Preventive Services Task Force, Prediabetes and Type 2 Diabetes: Screening, Practice Considerations, Preventive Interventions. Outline: USMLE Step 2 CK, Endocrine System.
Pregnancy and childbirth 3
A 26-year-old woman plans to become pregnant. Which daily supplement does the US Preventive Services Task Force recommend?US Preventive Services Task Force, Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication, Recommendation Summary. Outline: USMLE Step 2 CK, Pregnancy, Childbirth & the Puerperium.
A 27-year-old woman has missed a period and has mild one-sided pelvic cramping with abnormal vaginal bleeding. An ectopic pregnancy is suspected. Which tests will be done?MedlinePlus Medical Encyclopedia, Ectopic pregnancy, Symptoms, Exams and Tests. Outline: USMLE Step 2 CK, Pregnancy, Childbirth & the Puerperium.
A 29-year-old woman at 37 weeks of pregnancy has blood pressure of 152/96 mm Hg and protein in her urine. Preeclampsia is diagnosed. What will her provider most likely recommend?MedlinePlus Medical Encyclopedia, Preeclampsia, Exams and Tests, Treatment. Outline: USMLE Step 2 CK, Pregnancy, Childbirth & the Puerperium.
Biostatistics and medical literature 2
A screening test is positive in 90 people who have a disease and in 45 people who do not. What is its predictive value positive in this group?CDC, Principles of Epidemiology in Public Health Practice, third edition (archived), Glossary, predictive value positive. Outline: USMLE Step 2 CK, Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature.
Investigators enroll 100 people with a rare cancer and 200 people without it, then ask about past exposure to a solvent. Which measure of association is the measure of choice for this study design?CDC, Principles of Epidemiology in Public Health Practice, third edition (archived), Lesson 3, Section 5, Odds ratio. Outline: USMLE Step 2 CK, Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature.
Care of the well patient 2
A healthy 30-year-old man with no risk factors has a routine visit. For which infection does the US Preventive Services Task Force recommend screening in adults aged 18 to 79 years?US Preventive Services Task Force, Hepatitis C Virus Infection in Adolescents and Adults: Screening, Recommendation Summary. Outline: USMLE Step 2 CK, Human Development.
At a two-week checkup, new parents ask how to lay their baby down to sleep to lower the risk of sudden infant death syndrome. What is the advice?MedlinePlus Medical Encyclopedia, Sudden infant death syndrome, Prevention. Outline: USMLE Step 2 CK, Human Development.
How this list was compiled: Our own questions, written to the Step 2 CK content outline and specifications of the USMLE program (https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications, read 2026-10-10). Its systems and their ranges: Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety 10-15%, Renal & Urinary System & Reproductive Systems 7-13%, Cardiovascular System 6-12%, Musculoskeletal System/Skin & Subcutaneous Tissue 6-12%, Behavioral Health 5-10%, Blood & Lymphoreticular/Immune Systems 5-10%, Gastrointestinal System 5-10%, Nervous System & Special Senses 5-10%, Respiratory System 5-10%, Multisystem Processes & Disorders 4-8%, Endocrine System 3-7%, Pregnancy, Childbirth & the Puerperium 3-7%, Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature 3-5%, Human Development 2-4%; and the Nutrition discipline, 15-20%, whose questions are also coded to a system. The bank holds 7, 6, 5, 5, 5, 4, 5, 4, 5, 4, 3, 3, 2 and 2 questions in that order, 60 in all, and 9 of them also carry the Nutrition topic. Every fact was read on 2026-10-10 in the public source the question names: the MedlinePlus Medical Encyclopedia and MedlinePlus Drug Information (National Library of Medicine), the recommendation statements of the US Preventive Services Task Force, the PSNet primers of the Agency for Healthcare Research and Quality, the Centers for Medicare & Medicaid Services, the National Institute of Diabetes and Digestive and Kidney Diseases and the archived CDC course Principles of Epidemiology in Public Health Practice. The predictive value answer is arithmetic on the numbers in the question. Licence: Questions, choices and explanations are original work of this site.
How it works
This free USMLE Step 2 CK practice test has 60 short patient cases of our own. It is unofficial, not affiliated with or endorsed by the Federation of State Medical Boards (FSMB) or the National Board of Medical Examiners (NBME).
Read the full guide
What the exam covers
The Step 2 CK content outline on usmle.org, read October 10, 2026, gives each system a range: ethics, professionalism and patient safety 10 to 15%, renal and reproductive 7 to 13%, cardiovascular 6 to 12%, down to human development at 2 to 4%. The 60 questions follow those shares; nine are on nutrition, 15 to 20% of the outline.
Timing
Since May 7, 2026 the real exam is sixteen 30-minute blocks of no more than 20 questions. Exam mode asks 40 questions in 60 minutes: two blocks at that pace.
Where the answers come from
Each USMLE Step 2 CK practice test question names the public page behind its answer: the MedlinePlus encyclopedia, US Preventive Services Task Force statements, AHRQ patient safety primers and others.
Screening questions follow the Task Force statement in force on the date checked. Open the source link if your course teaches a newer one.
Questions and answers
Is a Step 2 practice test the same as Step 2 CK?
Yes. The USMLE program lists three Step exams today: Step 1, Step 2 CK and Step 3. So a USMLE Step 2 practice test means Clinical Knowledge, and this page covers that exam only.
Are these real Step 2 CK questions?
No. The exam's owners publish their own sample questions on usmle.org. This is a separate bank: none of its questions repeats or rewords one of theirs, and none comes from a review book.
How many questions are on Step 2 CK?
Sixteen 30-minute blocks, each with no more than 20 questions, in one 9-hour session with at least 55 minutes of break time. That is the format since May 7, 2026, by the Step 2 CK page on usmle.org.
What is a passing score on Step 2 CK?
Step 2 CK reports a three-digit score with a pass or fail outcome, and usmle.org posts the current minimum passing score. Examinees usually need about 60 percent of items right, a share that varies by form. A result here forecasts nothing.