This is Part 1 of the Physician Assistant
(PA) Program Comprehensive Test Bank
based on the PANCE Content Blueprint
by the National Commission on
Certification of Physician Assistants
(NCCPA).
TABLE OF CONTENTS - PART 1 of 5
Cardiovascular System - Questions 1-20
Dermatologic System - Questions 21-30
Endocrine System - Questions 31-40
Eyes, Ears, Nose, and Throat - Questions 41-50
Gastrointestinal System/Nutrition - Questions 51-60
Genitourinary System - Questions 61-70
Hematologic System - Questions 71-80
Infectious Diseases - Questions 81-90
Musculoskeletal System - Questions 91-100
CARDIOVASCULAR SYSTEM
Q1. A 58-year-old man presents with chest pain radiating to his left arm. ECG shows ST elevation in
leads II, III, and aVF. Which coronary artery is most likely occluded?
Right coronary artery
Left anterior descending artery
Left circumflex artery
Posterior descending artery
,Correct Answer: Right coronary artery
Rationale: Inferior wall myocardial infarction is indicated by ST elevation in leads II, III, and aVF.
The right coronary artery supplies the inferior wall of the heart in most individuals. Occlusion of the
left anterior descending artery would produce ST elevation in V1-V4, indicating anterior wall
infarction. Occlusion of the left circumflex artery would produce ST elevation in I, aVL, V5, and V6,
indicating lateral wall infarction. The posterior descending artery supplies the posterior wall and
would produce reciprocal changes rather than the pattern described.
Q2. A 62-year-old woman presents with chest pain and dyspnea. ECG shows ST elevation in V1-V4.
Which coronary artery is most likely occluded?
Left anterior descending artery
Right coronary artery
Left circumflex artery
Posterior descending artery
Correct Answer: Left anterior descending artery
Rationale: Anterior wall myocardial infarction is indicated by ST elevation in V1-V4. The left
anterior descending artery supplies the anterior wall and septum. Occlusion of the right coronary
artery would produce ST elevation in II, III, and aVF. Occlusion of the left circumflex artery would
produce ST elevation in I, aVL, V5, and V6. The posterior descending artery supplies the posterior
wall.
Q3. A 55-year-old man presents with chest pain. ECG shows ST elevation in I, aVL, V5, and V6. Which
coronary artery is most likely occluded?
Left circumflex artery
Right coronary artery
Left anterior descending artery
Posterior descending artery
Correct Answer: Left circumflex artery
Rationale: Lateral wall myocardial infarction is indicated by ST elevation in I, aVL, V5, and V6.
The left circumflex artery supplies the lateral wall of the heart. Occlusion of the right coronary artery
would produce ST elevation in II, III, and aVF. Occlusion of the left anterior descending artery would
produce ST elevation in V1-V4. The posterior descending artery supplies the posterior wall.
Q4. A 60-year-old man presents with syncope and is found to have a systolic ejection murmur at the
right second intercostal space radiating to the carotids. Which diagnosis is most likely?
,Aortic stenosis
Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Correct Answer: Aortic stenosis
Rationale: Aortic stenosis presents with a systolic ejection murmur at the right second
intercostal space that radiates to the carotids. Mitral regurgitation presents with a holosystolic
murmur at the apex radiating to the axilla. Mitral stenosis presents with a diastolic murmur at the
apex with an opening snap. Aortic regurgitation presents with a diastolic murmur at the left sternal
border.
Q5. A 55-year-old woman presents with fatigue and is found to have a holosystolic murmur at the
apex radiating to the axilla. Which diagnosis is most likely?
Mitral regurgitation
Aortic stenosis
Mitral stenosis
Aortic regurgitation
Correct Answer: Mitral regurgitation
Rationale: Mitral regurgitation presents with a holosystolic murmur at the apex that radiates to
the axilla. Aortic stenosis presents with a systolic ejection murmur at the right second intercostal
space. Mitral stenosis presents with a diastolic murmur at the apex. Aortic regurgitation presents
with a diastolic murmur at the left sternal border.
Q6. A 45-year-old woman presents with dyspnea and is found to have a diastolic murmur at the apex
with an opening snap. Which diagnosis is most likely?
Mitral stenosis
Aortic stenosis
Mitral regurgitation
Aortic regurgitation
Correct Answer: Mitral stenosis
Rationale: Mitral stenosis presents with a diastolic murmur at the apex with an opening snap.
Aortic stenosis presents with a systolic ejection murmur. Mitral regurgitation presents with a
holosystolic murmur. Aortic regurgitation presents with a diastolic murmur at the left sternal border.
, Q7. A 50-year-old man presents with palpitations and is found to have a diastolic murmur at the left
sternal border with a wide pulse pressure. Which diagnosis is most likely?
Aortic regurgitation
Aortic stenosis
Mitral regurgitation
Mitral stenosis
Correct Answer: Aortic regurgitation
Rationale: Aortic regurgitation presents with a diastolic murmur at the left sternal border and a
wide pulse pressure. Aortic stenosis presents with a systolic ejection murmur. Mitral regurgitation
presents with a holosystolic murmur. Mitral stenosis presents with a diastolic murmur at the apex.
Q8. A 70-year-old man presents with exertional dyspnea and is found to have jugular venous
distension and crackles on lung examination. Which diagnosis is most likely?
Heart failure
Aortic stenosis
Mitral regurgitation
Pericarditis
Correct Answer: Heart failure
Rationale: Heart failure presents with exertional dyspnea, jugular venous distension, and
crackles due to fluid overload. Aortic stenosis presents with a systolic ejection murmur. Mitral
regurgitation presents with a holosystolic murmur. Pericarditis presents with a pericardial friction rub
and chest pain.
Q9. A 40-year-old man presents with sharp chest pain that worsens with inspiration and is relieved
by sitting forward. Which diagnosis is most likely?
Pericarditis
Heart failure
Aortic stenosis
Mitral regurgitation
Correct Answer: Pericarditis
Rationale: Pericarditis presents with sharp chest pain that worsens with inspiration and is
relieved by sitting forward, often with a pericardial friction rub. Heart failure presents with dyspnea
and crackles. Aortic stenosis presents with a systolic ejection murmur. Mitral regurgitation presents
with a holosystolic murmur.
(PA) Program Comprehensive Test Bank
based on the PANCE Content Blueprint
by the National Commission on
Certification of Physician Assistants
(NCCPA).
TABLE OF CONTENTS - PART 1 of 5
Cardiovascular System - Questions 1-20
Dermatologic System - Questions 21-30
Endocrine System - Questions 31-40
Eyes, Ears, Nose, and Throat - Questions 41-50
Gastrointestinal System/Nutrition - Questions 51-60
Genitourinary System - Questions 61-70
Hematologic System - Questions 71-80
Infectious Diseases - Questions 81-90
Musculoskeletal System - Questions 91-100
CARDIOVASCULAR SYSTEM
Q1. A 58-year-old man presents with chest pain radiating to his left arm. ECG shows ST elevation in
leads II, III, and aVF. Which coronary artery is most likely occluded?
Right coronary artery
Left anterior descending artery
Left circumflex artery
Posterior descending artery
,Correct Answer: Right coronary artery
Rationale: Inferior wall myocardial infarction is indicated by ST elevation in leads II, III, and aVF.
The right coronary artery supplies the inferior wall of the heart in most individuals. Occlusion of the
left anterior descending artery would produce ST elevation in V1-V4, indicating anterior wall
infarction. Occlusion of the left circumflex artery would produce ST elevation in I, aVL, V5, and V6,
indicating lateral wall infarction. The posterior descending artery supplies the posterior wall and
would produce reciprocal changes rather than the pattern described.
Q2. A 62-year-old woman presents with chest pain and dyspnea. ECG shows ST elevation in V1-V4.
Which coronary artery is most likely occluded?
Left anterior descending artery
Right coronary artery
Left circumflex artery
Posterior descending artery
Correct Answer: Left anterior descending artery
Rationale: Anterior wall myocardial infarction is indicated by ST elevation in V1-V4. The left
anterior descending artery supplies the anterior wall and septum. Occlusion of the right coronary
artery would produce ST elevation in II, III, and aVF. Occlusion of the left circumflex artery would
produce ST elevation in I, aVL, V5, and V6. The posterior descending artery supplies the posterior
wall.
Q3. A 55-year-old man presents with chest pain. ECG shows ST elevation in I, aVL, V5, and V6. Which
coronary artery is most likely occluded?
Left circumflex artery
Right coronary artery
Left anterior descending artery
Posterior descending artery
Correct Answer: Left circumflex artery
Rationale: Lateral wall myocardial infarction is indicated by ST elevation in I, aVL, V5, and V6.
The left circumflex artery supplies the lateral wall of the heart. Occlusion of the right coronary artery
would produce ST elevation in II, III, and aVF. Occlusion of the left anterior descending artery would
produce ST elevation in V1-V4. The posterior descending artery supplies the posterior wall.
Q4. A 60-year-old man presents with syncope and is found to have a systolic ejection murmur at the
right second intercostal space radiating to the carotids. Which diagnosis is most likely?
,Aortic stenosis
Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Correct Answer: Aortic stenosis
Rationale: Aortic stenosis presents with a systolic ejection murmur at the right second
intercostal space that radiates to the carotids. Mitral regurgitation presents with a holosystolic
murmur at the apex radiating to the axilla. Mitral stenosis presents with a diastolic murmur at the
apex with an opening snap. Aortic regurgitation presents with a diastolic murmur at the left sternal
border.
Q5. A 55-year-old woman presents with fatigue and is found to have a holosystolic murmur at the
apex radiating to the axilla. Which diagnosis is most likely?
Mitral regurgitation
Aortic stenosis
Mitral stenosis
Aortic regurgitation
Correct Answer: Mitral regurgitation
Rationale: Mitral regurgitation presents with a holosystolic murmur at the apex that radiates to
the axilla. Aortic stenosis presents with a systolic ejection murmur at the right second intercostal
space. Mitral stenosis presents with a diastolic murmur at the apex. Aortic regurgitation presents
with a diastolic murmur at the left sternal border.
Q6. A 45-year-old woman presents with dyspnea and is found to have a diastolic murmur at the apex
with an opening snap. Which diagnosis is most likely?
Mitral stenosis
Aortic stenosis
Mitral regurgitation
Aortic regurgitation
Correct Answer: Mitral stenosis
Rationale: Mitral stenosis presents with a diastolic murmur at the apex with an opening snap.
Aortic stenosis presents with a systolic ejection murmur. Mitral regurgitation presents with a
holosystolic murmur. Aortic regurgitation presents with a diastolic murmur at the left sternal border.
, Q7. A 50-year-old man presents with palpitations and is found to have a diastolic murmur at the left
sternal border with a wide pulse pressure. Which diagnosis is most likely?
Aortic regurgitation
Aortic stenosis
Mitral regurgitation
Mitral stenosis
Correct Answer: Aortic regurgitation
Rationale: Aortic regurgitation presents with a diastolic murmur at the left sternal border and a
wide pulse pressure. Aortic stenosis presents with a systolic ejection murmur. Mitral regurgitation
presents with a holosystolic murmur. Mitral stenosis presents with a diastolic murmur at the apex.
Q8. A 70-year-old man presents with exertional dyspnea and is found to have jugular venous
distension and crackles on lung examination. Which diagnosis is most likely?
Heart failure
Aortic stenosis
Mitral regurgitation
Pericarditis
Correct Answer: Heart failure
Rationale: Heart failure presents with exertional dyspnea, jugular venous distension, and
crackles due to fluid overload. Aortic stenosis presents with a systolic ejection murmur. Mitral
regurgitation presents with a holosystolic murmur. Pericarditis presents with a pericardial friction rub
and chest pain.
Q9. A 40-year-old man presents with sharp chest pain that worsens with inspiration and is relieved
by sitting forward. Which diagnosis is most likely?
Pericarditis
Heart failure
Aortic stenosis
Mitral regurgitation
Correct Answer: Pericarditis
Rationale: Pericarditis presents with sharp chest pain that worsens with inspiration and is
relieved by sitting forward, often with a pericardial friction rub. Heart failure presents with dyspnea
and crackles. Aortic stenosis presents with a systolic ejection murmur. Mitral regurgitation presents
with a holosystolic murmur.
