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Physician Assistant (PANCE) Practice Test
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The material on the PANCE and PANRE is organized by the NCCPA into two dimensions, as indicated in the content blueprint for the examination. - Organ systems and the diseases, disorders and medical assessments physician assistants encounter within those systems; and - The knowledge and skills physician assistants should exhibit when confronted with those diseases, disorders and assessments. Medical Content Categories % Allocation: Cardiovascular System 13% Dermatologic System 5% Endocrine System 7% Eyes, Ears, Nose, and Throat 7% Gastrointestinal System/Nutrition 9% Genitourinary... Show more
Physician Assistant (PANCE) Practice Test
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25 Questions

1. An 18-year-old man is suffering from mumps and what appears to be a urinary tract infection. He has unilateral testicular swelling and a slight fever. A urinalysis study shows pyuria and bacteriuria accompanied by bacterial infection. Which of the following diagnoses is most likely to be accurate?
2. You are treating a 12-year-old male patient with peritonsillar cellulitis and abscess. You’ve administered the basic treatment, but you think he might require a tonsillectomy. Which of the following conditions would be an absolute indication for tonsillectomy?
3. A 25-year-old female presents with pale skin, fatigue, and numbness in her hands and feet. She reports that she exercises three times a week and eats a healthy vegan diet, though she does not take vitamin supplements. You suspect that her diet is depriving her of essential nutrients, which is causing mild megaloblastic anemia and possible nerve damage. Which nutrient is most likely missing from this patient’s diet?
4. An infant has received immunization with PRP-OMP for Haemophilus influenza type b at two and four months. Which of the following would be an appropriate age for the third dose?
5. A pregnant 26-year-old patient in her 16th week presents at the clinic with vaginal bleeding and severe cramping. Upon examination, you find that no membranes have been ruptured, but her cervix is dilated. Which form of spontaneous abortion is she most likely experiencing?
6. A 33-year-old male patient who is known to be a frequent runner arrives with severe pain in the area of his right ankle The patient reported that he was in the middle of a low-stress run when he began to feel the pain developing. The pain is located on the right posterior calf, 2 cm above the insertion of the Achilles tendon. Which of the following diagnoses is most likely to be correct?
7. You are treating a 68-year-old male patient with Parkinson’s disease. Which of the following medications would you prescribe to specifically treat the tremor associated with this condition?
8. A 38-year-old woman has come to the clinic complaining for the first time of sudden, severe stomach pain. She believes she has an ulcer. The examination shows no signs of any type of ulcer and she appears to be in good physical health. She is known to be an honest and upstanding individual and she has a history of anxiety and depression. From which of the following somatoform disorders is the patient most likely suffering?
9. A 23-year-old female patient thought to be suffering from a personality disorder is brought to the clinic. She experiences frequent mood swings and severe bouts of seemingly uncontrollable anger. She has great difficulty with being alone, but cannot maintain normal relationships. She also shows signs of self-mutilation. From what type of personality disorder is the patient most likely suffering?
10. A 47-year-old female patient arrives at the clinic complaining of severe left hip pain. The joint is warm, swollen, tender, and has limited range of movement. You diagnose her with septic arthritis. Diagnostic testing reveals that Staphylococcus aureus is the infecting pathogen. Based on this information, which of the following clinical interventions would be most necessary?
11. During a regular checkup on an 8-year-old child, you note a loud first heart sound with a fixed and widely split second heart sound at the upper left sternal border that does not change with respirations. The patient is otherwise active and healthy. The mostly likely heart lesion to explain these findings is:
12. A 59-year-old male patient arrives at the clinic complaining of abdominal pain. Physical examination shows a herniation of the stomach through the diaphragm. He had no previous abdominal surgeries. Based on these findings, from which type of hernia is the patient suffering?
13. A 46-year-old woman comes to the office complaining of syncope, especially when standing up from a sitting position. The previous week, she was placed on 2 mg of the alpha blocker prazosin twice daily for Raynaud’s disease by her physician. Her other medications are 20 mg of atorvastatin daily and 60 mg of raloxiphene daily. What is likely to be causing the patient’s syncope?
14. A 24-year-old pregnant patient at 34 weeks’ gestation comes to the office complaining of headaches, blurred vision, nausea and vomiting, and swelling in her feet and hands. She has gained 5 pounds since her last appointment a week ago. On physical examination, there is tenderness in the upper right abdomen. Her blood pressure is 140/92. Urinalysis indicates proteinuria. What is the most likely diagnosis?
15. A 48-year-old male patient has severe arthritic knee pain and shows signs of mucocutaneous lesions. He is sexually active and has been previously treated for chlamydial urethritis. His laboratory results return positive for HLA-B27. Of the following diagnoses, which is most likely to be correct?
16. Which of the following immunizations could cause an anaphylactic reaction in an infant with an egg allergy?
17. A 2-year-old boy is brought into the emergency nursing clinic with a complaint of fever for 6 days and development of a limp. On examination, he is found to have an erythematous macular exanthem over his body, ocular conjunctivitis, dry and cracked lips, a red throat, and cervical lymphadenopathy. There is a grade II/VI systolic ejection murmur at the lower left sternal border. A white blood cell count and differential show predominant neutrophils with increased platelets on smear. What is the most likely diagnosis?
18. A 65-year-old female patient is being examined during the summer for a skin condition. Her right exterior forearm exhibits thick, solid, firm plaques and no scaling. She also has a few small lesions and reports a strong desire to scratch the affected area. Lichenification indicates that she has been scratching the area frequently. She has been treated for Atropic dermatitis in the past. Which of the following diagnoses is most likely to be correct?
19. A 74-year-old female patient is seen at the clinic complaining of visual distortions, decreased brightness of colors, and blurriness in her left eye. Examination reveals retinal mottling, serous leaks, and hemorrhages. Which of the following diagnoses is most likely to be correct?
20. An 18-year-old male awoke early and experienced intermittent periumbilical pain throughout the morning. By evening, the pain had become constant and is centered toward the right lower quadrant of the patient’s abdomen. Movement increases the pain. The patient also feels nauseated and has a low-grade fever. The diagnosis is appendicitis. Which of the following is the recommended treatment for appendicitis?
21. A 42-year-old female patient is suffering from an apparent infection that is causing a fever, sore throat, and a general feeling of malaise. Her examination reveals a tenacious gray membrane covering her tonsils and pharynx. The membrane is not affecting her ability to breath. Based on this information, she is diagnosed with diphtheria. What is the first and most important form of treatment for this condition?
22. A 45-year-old businessman comes to the clinic for his routine physical. He states that he is traveling to India in six weeks and asks you if he needs a hepatitis A vaccination. What do you tell him?
23. Which of the following toxidromes would most likely be treated with gastric lavage?
24. A 38-year-old woman comes to the office with red to brownish-gray colored patches on her inner elbows. She reports severe itching, especially at night. There are small, raised bumps that leak fluid and crust over when scratched. Her skin also appears scaly and cracked as well as raw from scratching. What is the most likely diagnosis?
25. A 42-year-old woman comes to the office with pain, slight redness, and edema in the right calf. She had been placed on oral contraceptives for the first time 5 weeks previously by her gynecologist in order to provide contraception and to help regulate her menstrual cycle. The only other medication she is taking is 20 mg atorvastatin (Lipitor) daily for hypercholesterolemia. The patient said she noticed the calf pain three days previously, and thought she had pulled a muscle. The pain intensified, and by the third day, she noticed her lower leg appeared swollen and red. She also reported throbbing pain in her leg when standing. What do you suspect is causing the symptoms in her leg?

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