USMLE two-step (also called double-jump) questions require several cognitive steps to arrive at a correct answer. Finding the correct answer requires you to formulate a proper diagnosis and then select the most appropriate pharmacologic treatment. Note that you get no credit for the intermediate step of diagnosis. The correct answer is found only by reasoning all the way through to the treatment.
Two-Step Practice Question 1
The correct answer is B, atenolol.
Two-Step Practice Question 2
In this next question, you must reason your way to the additional characteristics of the organism in mind by first correctly identifying what the organism is based on the laboratory data. Again, you get no credit for identifying the correct organism but only for “two-stepping” to the additional characteristic.
The correct answer is C, coagulase positive.
Note that you need to make two correct decisions to arrive at the correct answer, hence the name “two-step.” The goal is to guide you away from simple memorization in your learning. Instead, the exam wants you to be able to use the information you have memorized to reason through to a correct answer.
The correct process for answering these questions is not “read, answer,” but “read, think, answer.” You’ll definitely see your share of these two-step (and even three-step) questions on the Step 1 exam.
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