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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. A 65-year-old woman comes to the clinic with a 101°F fever, diarrhea of three days’ duration, and abdominal cramps. The patient takes simvastatin, 20 mg daily; metoprolol, 50 mg daily; and a daily aspirin. What is the most likely diagnosis?
2. Which of the following symptoms would a patient experiencing metabolic acidosis be most likely to present?
3. A 75-year-old female patient is brought to the clinic by her daughter, who believes she may be suffering from a degenerative mental disorder. Although she has a strong memory and awareness, the patient exhibits frequent bouts of extreme euphoria, apathy, and disinhibition. She also frequently displays several primitive reflexes like the palmomental reflex and the palmar grasp. She has no history of strokes. Based on her condition, what is the patient’s most likely diagnosis?
4. A 53-year-old female comes to the office complaining of vaginal dryness, itchiness, and irritation. She also states that sexual intercourse is painful. She says she previously enjoyed intercourse with her husband, and would like to have pleasurable sex with him again. The patient is postmenopausal and has vaginal atrophy. She was previously given topical estrogen vaginal creams, but she did not like the “messiness” of them. What alternative treatment would you suggest to help relieve her vaginal atrophy?
5. A 53-year-old patient is brought to the emergency room after an abrupt and severe illness has lasted for several hours. He is experiencing abdominal pain, diarrhea, and tenesmus. He has a 102.3°F fever and his stool contains some blood and mucus and his abdomen is tender to the touch. His blood culture does not show any sign of Salmonella entrica. Which of the following diagnoses is most likely to be correct?
6. A 17-year-old male patient presents with a high fever, persistent headache, vomiting, and a stiff neck. He has also developed a petechial rash. You diagnose him with bacterial meningitis. Based on the patient’s symptoms, which of the following pathogens is most likely to be the cause of the patient’s condition?
7. A 73-year-old female patient presents at the clinic with nervous tingling, poor coordination, edema, weakness, and cardiac dysfunction. You believe she may be suffering from a nutritional deficiency. Which of the following vitamins is the patient most likely lacking?
8. 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?
9. Which of the following is the predominant presenting feature of acute thrombocytopenia?
10. A 19-year-old female presents with a complaint of an itchy rash on the skin between her fingers. She reports that the itching is intense at night and that she is often awakened by her dorm roommate, who tells her that she is scratching her hands in her sleep. Upon examination of the rash, red bumps, small blisters, and thin red lines are discovered. Laboratory results reveal the presence of Sarcoptes scabiei and mite eggs. Which of the following treatments would be most appropriate for this patient’s condition?
11. A diabetic 56-year-old male patient arrives at the hospital with apparent muscular weakness on the left side of his face. He reports waking up in the morning with a pronounced pain in his left ear and then discovered that he was unable to move any part of the left side of his face. His general health is otherwise normal and unremarkable. Based on this information, which of the following diagnoses is most likely to be correct?
12. A 40-year-old male is suffering from an anorectal abscess causing anal swelling, erythema, and difficulty with defecation. Which of the following treatments would be most appropriate in this case?
13. A 24-year-old male comes to the office complaining of pain in the cheekbones, upper teeth, and under the eyes. The pain worsens when the patient is upright and improves when he is reclining. He also complains of halitosis. He has clear nasal discharge, and a fever of 100.5°F. What is the most likely diagnosis?
14. 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?
15. A 35-year-old male patient arrives at the clinic complaining of severe pain on the left side of his scrotum. Examination reveals swelling and a fluidic buildup primarily around the left testicle. There are no signs of extraordinary scrotal masses. Based on this information, which of the following diagnoses is most likely to be correct?
16. An 80-year-old male comes to the office complaining of a frequent need to urinate, especially at night. He also complains of difficulty starting urination and holding back urine flow. He also reports occasional burning on urination, hematuria, and pain in his lower back, hips, and upper thighs. A digital rectal exam of the prostate shows it to be enlarged, hard, and lumpy. The patient’s prostatespecific antigen (PSA) result is 9.0 ng/mL. What test would you most likely order next?
17. 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?
18. A 40-year-old female comes to the office complaining of swelling at the base of her neck, rapid heartbeat, increased appetite, sudden weight loss, nervousness, tremor, irregular menstruation, and insomnia. Her resting pulse is 102. She has had one period in the last three months and has lost 10 pounds. She states she is only sleeping about three hours a night. What is the most likely diagnosis?
19. 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?
20. A 51-year-old man comes to the office for his annual physical. The patient’s only complaint is arthritic-type pain in his left knee. What routine procedure would you order to test for possible cardiovascular disease?
21. A 57-year-old female patient who recently quit smoking presents at the clinic with bloody, pusfilled diarrhea, abdominal cramping, and tenesmus. Examination reveals continuous inflammation of the colon. Based on this information, which of the following diagnoses is most likely to be correct?
22. A 10-year-old boy is brought to the clinic by his mother after sustaining a head injury during soccer practice. He was shoved by another player, fell, and hit his head on the ground. He has dizziness and a headache. He had ringing in the ears for a few minutes after it happened and felt dazed afterward, but did not lose consciousness. Initial neurologic exam checking vision, coordination, hearing, reflexes, memory, and concentration are normal. The patient has some difficulty with balance. You suspect a mild concussion. What test should you order first?
23. An obese 40-year-old male comes to the office complaining of heartburn. He also states that he experiences dysphagia when eating certain foods, such as bread and meat. He also has a chronic dry cough, sometimes with wheezing. What is the most likely diagnosis?
24. Which of the following symptoms would suggest a B6 pyridoxine deficiency?
25. A complete blood count (CBC) for a 27-year-old female suffering from fatigue and headaches resulting from microcytic anemia reveals a mean corpuscular volume (MCV) of less than 80 fL. The woman has no family history of thalassemia. Which of the following is most likely the cause of her anemia?

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