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Physician Assistant (PANCE) Practice Test 2
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Avg score: 76% • Most missed: “A 46-year-old obese male presents in the emergency room with acute myocardial in…”
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 2
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25 Questions

1. Which of the following treatments is recommended for protection of areas of depigmented skin due to vitiligo?
2. A 70-year-old male presents with chest pain and shortness of breath. Physical examination and auscultation reveal low-intensity pulse in the carotid arteries. Chest X-ray shows fluid in the lungs. Echocardiogram reveals a calcified, poorly functioning aortic valve. Which of the following is the correct diagnosis?
3. A 22-year-old female presents to the emergency room with chest trauma, chest pain, and shortness of breath. The examination and chest X-ray reveal a tension pneumothorax. Due to the emergent nature of the situation, what is the first priority of treatment?
4. A 32-year-old male presents, in the summer time, with a spotted tan on the face, chest, and arms. Potassium hydroxide preparation confirms the presence of hyphae and spores on the non-tanning areas of skin. Based on the patient’s presentation and test results, which of the following is the most appropriate diagnosis?
5. A 55-year-old female presents with morning joint stiffness and swelling in the hands, wrists, and ankles that has persisted for approximately 8 weeks. Bloodwork reveals elevated erythrocyte sedimentation rate and C-reactive protein level. Bloodwork was also positive for anti-cyclic citrullinated peptide antibodies. Based on the patient’s presentation and lab results, which of the following is the most appropriate diagnosis?
6. A 44-year-old female presents with dizziness and syncopal episodes when transferring from a sitting to a standing position. Blood pressure in the sitting position is 130/80 mmHg. Blood pressure in the standing position is noted to be 90/50 mmHg. It is noticed that her pulse rate in the sitting position is 80 beats per minute, while it is 105 beats per minute when standing. Based on this information, which of the following is the cause of the patient’s postural hypotension?
7. A 36-year-old female presents with muscle weakness, bone pain, and history of several fractures. Bloodwork reveals a vitamin D deficiency. X-rays reveal generalized decrease in bone density and Looser lines, characteristic of pseudofractures. You diagnose this patient with osteomalacia. Which of the following medications would you prescribe to treat this disorder?
8. A 22-year-old female presents as underweight and emaciated. Physical examination reveals orthostatic hypotension, salivary gland hypertrophy, and dental erosion. The patient states she has a normal appetite but doesn’t eat much because she is afraid of becoming overweight. Lab work reveals hypokalemia, hypochloremia, and elevated blood urea nitrogen. Based on the patient’s history, physical examination, and test results, which of the following is the most appropriate diagnosis?
9. A 23-year-old male presents with fever, headache, and a stiff neck. Physical examination reveals a petechial rash. You suspect meningitis. Which of the following clinical interventions must be performed to confirm the diagnosis?
10. An X-ray of a patient’s hands reveals a lesion on the proximal phalanx of the ring finger. The lesion has a lobular morphology and punctate calcifications are noted. Further analysis revealed that the lesion is composed of hyaline cartilage. This common primary bone neoplasm of the hand is known as:
11. A 60-year-old male presents with shortness of breath, retrosternal chest pain, weakness, fatigue, cyanosis, and syncope. Auscultation of the chest reveals a systolic ejection click. Chest X-ray reveals enlarged pulmonary arteries. Based on the patient’s presentation, history, and test results, which of the following is the most accurate diagnosis?
12. A 48-year-old man presents with a series of severe, unilateral, periorbital headaches lasting from 30 to 90 minutes, several times a day over the past month. Physical exam reveals myosis and ptosis. Patient states his headaches are not relieved by rest. Based on the patient’s presentation and physical examination, which of the following is the most appropriate diagnosis?
13. A newborn infant presents with excessive saliva and choking with attempts to feed. Attempt to drop a nasogastric tube for feedings was unsuccessful. Based on the patient’s presentation, which of the following is the appropriate diagnosis?
14. A 68-year-old male presents with abdominal pain, bloating, belching, weight loss, and intermittent gastrointestinal bleeding. Bloodwork reveals irondeficiency anemia and elevated liver enzymes. Endoscopy reveals a neoplasm near the pylorus. Based on the patient’s presentation and test results, which of the following is the most appropriate diagnosis?
15. Which of the following preventative measures would you advise an individual with pediculosis who is concerned with transmission to others?
16. A 46-year-old female presents with foul smelling, purulent sputum, hemoptysis, and chronic cough. She has had recurrent bouts of pneumonia. Auscultation of the chest reveals localized chest crackles and clubbing. High-resolution CT scan reveals dilated, tortuous airways. Based on the patient’s presentation, history, and test results, which of the following is the most accurate diagnosis?
17. A 44-year-old female hospital worker presents with a productive, bloody cough that has persisted for several weeks. She also complains of fever, night sweats, anorexia, and weight loss. Auscultation of the chest reveals post-tussive rales. Based on the patient’s presentation and physical examination, the most appropriate diagnosis is:
18. A 72-year-old African-American male with a history of alcoholism presents with progressive shortness of breath. Auscultation of the chest reveals S1 gallop, rales, and increased jugular venous pressure. Chest X-ray reveals cardiomegaly with vascular congestion. Echocardiogram reveals dilated left ventricle, low cardiac output, and high diastolic pressure. Based on the patient’s presentation, physical examination, and test results, which of the following is the most appropriate diagnosis?
19. A 46-year-old African-American female presents with a persistent non-specific headache. Physical examination reveals her blood pressure to be 230/130 mmHg. Which of the following refers to the disorder that is characterized by blood pressure readings of this range?
20. A 60-year-old woman presents with sudden, abrupt, right-side facial muscle weakness, along with onesided facial paralysis in which she cannot close her right eye or raise her right brow. Based on the patient’s presentation, which of the following is the most likely diagnosis?
21. A 46-year-old white male presents with dizziness, chest pressure, shortness of breath, and heart palpitations that have occurred over several weeks. EKG is normal with no S-T segment abnormalities. Cholesterol is borderline elevated at 210. Troponin levels are normal at 0.2 ng/mL. D-dimer level is normal at 0.37. Which diagnostic test would you suggest and why?
22. Which of the following forms of childhood-onset idiopathic arthritis is characterized by spiking fevers of 102.2-104 °F with an associated salmonpink maculopapular rash?
23. A 45-year-old businessman who spends a significant amount of time in airplanes complains of recurrent pain in the inner ear during flights. Which of the following disorders is likely the cause of his discomfort?
24. A 62-year-old female who is being treated for gastroesophageal reflux disease (GERD) presents with progressively worsening symptoms of heartburn and regurgitation. The patient is currently being treated with histamine blockers, with no relief of symptoms. Endoscopy reveals severe disease with evidence of erosive gastritis. Which of the following medications would you prescribe to effectively manage this patient’s gastroesophageal reflux disease?
25. A 14-year-old boy presents with blow-out fractures to the orbital floor after being hit with a baseball. Which of the following are critical to prevent further damage from this injury?

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