COMLEX-USA Level 1

Exam at a glance

Questions

320

Duration

480 minutes

Pass mark

not published

Sections

Foundational biomedical sciences in osteopathic context

Exam type

Written

Language

English

Authority

NBOME

Curriculum

Built from the question bank and updated automatically when new questions are added. 10 modules · 635 questions · Last updated: 30 October 2026

1. 01Behavioral health and psychiatry50 questions · 7.9 % of the bank

   Sample question

   Sample question1 / 1 · 0 correct

   A 34-year-old man has 6 weeks of low mood, poor sleep, low energy and loss of interest. He has no suicidal ideation. What is the best first-line medication?

   ALorazepamBLithiumCHaloperidolDSertralineEPhenelzine

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
2. 02Cardiovascular system54 questions · 8.5 % of the bank

   Chapters

   • Foundations: anatomy of the heart
   • Foundations: conduction system and cardiac cycle
   • Foundations: circulation and blood vessels

   Sample question

   Sample question1 / 1 · 0 correct

   A 79-year-old man fainted while climbing stairs. Examination shows a harsh crescendo-decrescendo systolic murmur at the right upper sternal border radiating to the carotids and a soft S2. What is the most likely diagnosis?

   ACalcific aortic stenosisBMitral regurgitationCVentricular septal defectDMitral valve prolapseEAortic regurgitation

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
3. 03Endocrine system and metabolism49 questions · 7.7 % of the bank

   Chapters

   • Foundations: endocrine glands and feedback control
   • Foundations: the thyroid in the neck and endocrine emergencies

   Sample question

   Sample question1 / 1 · 0 correct

   A 45-year-old woman started levothyroxine for hypothyroidism. When should TSH be rechecked?

   AIn 1 weekBIn 6 monthsCIn 6–8 weeksDIn 1 yearEOnly if symptoms recur

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
4. 04Ethics, law, patient safety and population health92 questions · 14.5 % of the bank

   Sample question

   Sample question1 / 1 · 0 correct

   A 16-year-old asks for treatment of a sexually transmitted infection and does not want her parents informed. What should the physician do?

   ANotify her parentsBRefuse treatment without consentCTreat her confidentiallyDReport to policeEWait until she is 18

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
5. 05Gastrointestinal system and nutrition90 questions · 14.2 % of the bank

   Chapters

   • Foundations: the digestive tract, digestion and absorption
   • Foundations: peptic ulcer disease and upper GI bleeding

   Sample question

   Sample question1 / 1 · 0 correct

   A 26-year-old woman has bloating, diarrhea and iron deficiency anemia. She eats a normal diet including bread. Which test is the best initial screen?

   AStool cultureBColonoscopyCHydrogen breath test after a lactose loadDFecal calprotectin aloneETissue transglutaminase IgA with total IgA

   Keys: 1–5 or A–E to choose, Enter to check and continue, F to mark.

   MarkCheck answer
6. 06Neurology and musculoskeletal system54 questions · 8.5 % of the bank

   Chapters

   • Foundations: brain anatomy and clinical localisation
   • Foundations: reflexes, the spinal cord and upper versus lower motor neuron signs
   • Foundations: the skeleton, spine and pelvis
   • Foundations: shoulder, wrist and hand
   • Foundations: hip fractures, knee and ankle ligaments
7. 07Obstetrics, women's health and pediatrics47 questions · 7.4 % of the bank

   Chapters

   • Foundations: female pelvic anatomy
   • Foundations: placenta, pregnancy physiology and fetal circulation
   • Foundations: labour and the fetal skull
   • Foundations: the newborn and the transition after birth
   • Foundations: growth and development
   • Foundations: the child's airway, vital signs and resuscitation
8. 08Osteopathic principles and practice (OPP/OMT)97 questions · 15.3 % of the bank

   Chapters

   • Foundations: the skeleton, spine and pelvis
   • Foundations: shoulder, wrist and hand
   • Foundations: hip fractures, knee and ankle ligaments
9. 09Renal and genitourinary system50 questions · 7.9 % of the bank

   Chapters

   • Foundations: structure and function of the kidney
   • Foundations: fluids and electrolytes
   • Foundations: the male urinary tract, prostate and testis
10. 10Respiratory system52 questions · 8.2 % of the bank

    Chapters

    • Foundations: anatomy of the respiratory tract
    • Foundations: alveoli and gas exchange
    • Foundations: mechanics and control of breathing

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From registration to licence

The usual steps with NBOME. Details can change; check the current rules with NBOME before you register.

1. Check eligibility and collect your documents (degree, experience, good standing).
2. Create an account with NBOME and submit the application.
3. Receive the exam eligibility and book a date with the test centre.
4. Sit the exam. Results usually come within days.
5. After passing: complete licensing (for example primary source verification) and receive your licence.

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