SPEX Practice Test - Exam Questions - Block 1 & 2

Sep 25, 2026

Uploaded by Đào

Practice exam material featuring general instructions for selecting the single best response (4–6 options) and answering grouped clinical vignette questions in the presented order. The test is organized into two blocks with item ranges (Block 1: Items 1–43, Block 2: Items 44–86) and specifies timing and selection rules for all items. Sample questions cover multiple clinical scenarios, including oncology-related pulmonary symptoms, congenital/inherited cardiac findings affecting sports participation advice, geriatric discharge counseling and fall prevention, and obstetric painless bleeding after intercourse with gestational age considerations.

LanguageEnglish

CategoryExam

FormatPDF

Pages29

Reading Time1 h 13 min

AccessFree to download

GENERAL INSTRUCTIONS

Test structure: blocks and timing

Sample Questions

Items 1-2

Items 3-4

Items 5-6

Sample SPEX Questions GENERAL INSTRUCTIONS: Read each question carefully and in the order in which it is presented. Then select the one best response option of the choices offered. There may be 4 to 6 response options. More than one option may be partially correct. You must select the ONE BEST answer and fill in the corresponding blank line on the answer sheet. The answer sheet and answer key are provided at the end of Block 2. Some items are grouped together around a clinical vignette as a set or case; be particularly careful to read and answer these cases or sets of items in the order they are presented. The items in this exam are divided into 2 blocks: Block 1 Block 2 Items 1–43 Items 44–86 Block 1 Items 1–43; Time-57 minutes ALL ITEMS REQUIRE SELECTION OF ONE BEST CHOICE. 1. A 14-year-old girl, who has received three courses of chemotherapy for Hodgkin disease, is brought to the office by her father because of worsening cough, shortness of breath, a low-grade fever and fatigue for the past 2 days. No one at home is ill. She says she is taking no medications. Her vaccinations are up-to-date. She attends a private school. Vital signs are temperature 37.1°C (98.8°F), pulse 100/min, respirations 35/min, and blood pressure 110/72 mm Hg. Oxygen saturation on pulse oximetry is 87% while breathing room air. Physical examination discloses a few coarse breath sounds in the lower lobes and retractions. Chest x-ray shows no masses and a mild interstitial pattern. No infiltrates or effusions are noted and heart size is normal. Which of the following is the most appropriate step at this time? (A) Admit the girl to the hospital for high-dose trimethoprim-sulfamethoxazole therapy (B) Begin isoniazid therapy in the girl and test the family for tuberculosis (C) Prescribe ciprofloxacin and schedule a return visit for tomorrow (D) Prescribe oral fluconazole for the girl (E) Schedule a lung biopsy 2. A 14-year-old African American girl comes to the office for the first time for a sports physical examination. She is asymptomatic. Her medical history is unremarkable. Family history shows that her maternal grandmother had a myocardial infarction at age 65 years. Her mother has hypertension that is well controlled with antihypertensive medication. Vital signs are temperature 37.2°C (99.0°F), pulse 86/min, respirations 16/min, and blood pressure 112/74 mm Hg. Height is 165 cm (5 ft 5 in; 75th percentile) and weight is 45 kg (99 lb; 25th percentile) . Physical examination shows a grade 2–3/6 systolic heart murmur at the left sternal border. The second heart sound (S2) is loud with fixed splitting and is heard best in the second left intercostal space. The family is anxious and requests an answer regarding the patient's sports participation. Which of the following is the most appropriate advice to give the patient and her parents? (A) Allow her to participate in all sports (B) Allow her to participate in noncontact sports only (C) Allow her to participate in sports but recommend cardiac catheterization (D) Allow her to participate in sports but recommend echocardiography (E) Prescribe prophylactic antibiotics for use prior to each game Items 3–4 An 81-year-old woman is being prepared for discharge following a 3-week stay in the hospital for repair of a fractured hip that she sustained while gardening. She now ambulates with difficulty using a walker, but she is determined to become independent again and to return to her own home. Her daughter, who is in the room with the patient, says, "I want to take Mother home with me because I'm concerned that she could fall and break her hip again. Mom says she doesn't really want to leave her own home, but she will do what is best." The daughter turns to her mother and says firmly, "Isn't that right, Mom?"The mother says, "Yes, I guess so," averting eye contact with both her daughter and you by looking down toward the floor. 3. Which of the following is the most

FAQs

How should test-takers choose answers on this exam?

Select the one best response option for each question, even if more than one option may be partially correct. Fill in the corresponding blank line on the answer sheet.

How is the exam organized and how long is Block 1?

The exam is divided into 2 blocks. Block 1 contains Items 1–43 with a time limit of 57 minutes, and Block 2 contains Items 44–86.

What should test-takers pay attention to with clinical vignette sets?

Some items are grouped around a clinical vignette as a set or case. Read and answer these cases or sets in the order presented.

Sep 25, 2026

Uploaded by Đào