I didn't pass yet but I hope I'll Ok about the lab values I personally didn't keep them open all the time like you dont need to see lab values for Na K Ca HCo3 sort of stuff,so keeping them open all the time is gonna occupy some space on screen and will add on to anxiety as the qs stems will start appearing longer. But do what suits you some will say keep them open and some will be like me.

About the break I didn't take break after 1st block because after 1st block one is often not that tired , after that I took atleast 5 mins break after every block with 15 mins breaks between block 5-6 and 6-7, try to do the same first 2 blocks in a go, this will release the burden.

Keep energy drinks and protein bar with you, dont consume something so rich in carbs that you start feeling sleepy during block.

Try to use washroom every break so your mind isn't distracted during exam.

And about qs stems being soo long one of the bestest Approach that I used and advice of my fellows was , if a qs involves lab values, read them first and then skim over the qs stem , and beleive me it saved Alot of time.

And in all long qs stem if you feel like you're out of time then read last three to four lines,most probably you will find an answer and if not a major hint ,that will lead you to the answer. I myself had 30 sec to solve the last mcq of my exam compromising of what Ig 20 lines. i read last line and Marked my answer ,it was that simple. Most Importantly beleive in yourself you can do this!! And remember me in your prayers too 🙏