The Final Step PANCE Exam| Latest Update
2026/2027 |A Comprehensive Review of 1200
Multichoice Practice Questions Covering Full Scope of
the Exam| Each Question Includes the Correct Answer
with a Detailed Clinical Explanation| Guaranteed Pass
Introduction
This comprehensive question bank has been meticulously developed from "The
Final Step PANCE Exam Review" study material, covering the essential medical
knowledge required for Physician Assistant National Certifying Examination
(PANCE) success. The questions span multiple medical disciplines including
Orthopedics/Rheumatology, Neurology, Psychiatry/Behavioral Health, Cardiology,
Dermatology, Endocrinology, ENT, Urology/Nephrology, Hematology/Oncology,
Infectious Disease, Obstetrics/Gynecology, Ophthalmology, Pulmonology,
Gastroenterology, and Pediatrics.
Each question is designed to test clinical reasoning, diagnostic skills, and treatment
knowledge that PAs will encounter in practice. The multiple-choice format mimics
the actual PANCE examination structure, with detailed rationales provided for
correct answers to enhance learning and retention. This resource is ideal for self-
assessment, group study, or structured review courses, ensuring thorough
preparation for certification and clinical practice.
,Questions 1-100: Orthopedics and Rheumatology
1. At what age should DEXA scans be ordered for males?
A. 60 years
B. 65 years
C. 70 years
D. 75 years
Correct Answer: C
Rationale: DEXA scans are recommended for males at age 70 to screen for
osteoporosis. This is later than females because males typically have higher peak
bone mass and do not experience the rapid bone loss associated with menopause.
2. At what age should DEXA scans be ordered for females?
A. 55 years
B. 60 years
C. 65 years
D. 70 years
Correct Answer: C
Rationale: DEXA scans are recommended for females at age 65. The earlier
screening age compared to males is due to the accelerated bone loss that occurs
after menopause.
3. A DEXA score of -1.5 standard deviations indicates which condition?
A. Normal bone density
B. Osteopenia
C. Osteoporosis
D. Severe osteoporosis
Correct Answer: B
Rationale: Osteopenia is defined as a DEXA score between 1 and 2.4 standard
,deviations below the mean. This indicates lower than normal bone density but not
yet at the osteoporotic level.
4. A DEXA score of -2.8 standard deviations indicates which condition?
A. Normal bone density
B. Osteopenia
C. Osteoporosis
D. Osteomalacia
Correct Answer: C
Rationale: Osteoporosis is defined as a DEXA score of 2.5 standard deviations or
greater below the mean. A score of -2.8 meets this criterion.
5. What fracture is the number one cause of compartment syndrome?
A. Femoral shaft fracture
B. Tibial shaft fracture
C. Humeral shaft fracture
D. Radial shaft fracture
Correct Answer: B
Rationale: Tibial shaft fractures are the most common cause of compartment
syndrome due to the limited space within the fascial compartments of the lower leg
and the high energy mechanisms often involved.
6. A patient's lab work shows positive Smith antibody and positive double-
stranded DNA antibody. What is the most likely diagnosis?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Scleroderma
D. Polymyositis
, Correct Answer: B
Rationale: Positive Smith antibody and double-stranded DNA antibody are highly
specific for systemic lupus erythematosus (SLE). These autoantibodies are part of
the diagnostic criteria for lupus.
7. Where are Bouchard's nodes found?
A. Distal interphalangeal joints
B. Proximal interphalangeal joints
C. Metacarpophalangeal joints
D. Wrist joints
Correct Answer: B
Rationale: Bouchard's nodes are found at the proximal interphalangeal (PIP)
joints. The mnemonic "B = Before" helps remember that Bouchard's nodes are
proximal to (before) Heberden's nodes.
8. What will an X-ray show in acute osteomyelitis?
A. Bone destruction
B. Periosteal elevation
C. Nothing (normal appearance)
D. Lytic lesions
Correct Answer: C
Rationale: X-rays appear normal in acute osteomyelitis. Bone destruction and
other changes are typically seen only in chronic osteomyelitis, usually after 10-14
days of infection.
9. What is the best imaging modality to diagnose osteomyelitis?
A. X-ray
B. Bone scan or MRI
C. CT scan
D. Ultrasound
2026/2027 |A Comprehensive Review of 1200
Multichoice Practice Questions Covering Full Scope of
the Exam| Each Question Includes the Correct Answer
with a Detailed Clinical Explanation| Guaranteed Pass
Introduction
This comprehensive question bank has been meticulously developed from "The
Final Step PANCE Exam Review" study material, covering the essential medical
knowledge required for Physician Assistant National Certifying Examination
(PANCE) success. The questions span multiple medical disciplines including
Orthopedics/Rheumatology, Neurology, Psychiatry/Behavioral Health, Cardiology,
Dermatology, Endocrinology, ENT, Urology/Nephrology, Hematology/Oncology,
Infectious Disease, Obstetrics/Gynecology, Ophthalmology, Pulmonology,
Gastroenterology, and Pediatrics.
Each question is designed to test clinical reasoning, diagnostic skills, and treatment
knowledge that PAs will encounter in practice. The multiple-choice format mimics
the actual PANCE examination structure, with detailed rationales provided for
correct answers to enhance learning and retention. This resource is ideal for self-
assessment, group study, or structured review courses, ensuring thorough
preparation for certification and clinical practice.
,Questions 1-100: Orthopedics and Rheumatology
1. At what age should DEXA scans be ordered for males?
A. 60 years
B. 65 years
C. 70 years
D. 75 years
Correct Answer: C
Rationale: DEXA scans are recommended for males at age 70 to screen for
osteoporosis. This is later than females because males typically have higher peak
bone mass and do not experience the rapid bone loss associated with menopause.
2. At what age should DEXA scans be ordered for females?
A. 55 years
B. 60 years
C. 65 years
D. 70 years
Correct Answer: C
Rationale: DEXA scans are recommended for females at age 65. The earlier
screening age compared to males is due to the accelerated bone loss that occurs
after menopause.
3. A DEXA score of -1.5 standard deviations indicates which condition?
A. Normal bone density
B. Osteopenia
C. Osteoporosis
D. Severe osteoporosis
Correct Answer: B
Rationale: Osteopenia is defined as a DEXA score between 1 and 2.4 standard
,deviations below the mean. This indicates lower than normal bone density but not
yet at the osteoporotic level.
4. A DEXA score of -2.8 standard deviations indicates which condition?
A. Normal bone density
B. Osteopenia
C. Osteoporosis
D. Osteomalacia
Correct Answer: C
Rationale: Osteoporosis is defined as a DEXA score of 2.5 standard deviations or
greater below the mean. A score of -2.8 meets this criterion.
5. What fracture is the number one cause of compartment syndrome?
A. Femoral shaft fracture
B. Tibial shaft fracture
C. Humeral shaft fracture
D. Radial shaft fracture
Correct Answer: B
Rationale: Tibial shaft fractures are the most common cause of compartment
syndrome due to the limited space within the fascial compartments of the lower leg
and the high energy mechanisms often involved.
6. A patient's lab work shows positive Smith antibody and positive double-
stranded DNA antibody. What is the most likely diagnosis?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Scleroderma
D. Polymyositis
, Correct Answer: B
Rationale: Positive Smith antibody and double-stranded DNA antibody are highly
specific for systemic lupus erythematosus (SLE). These autoantibodies are part of
the diagnostic criteria for lupus.
7. Where are Bouchard's nodes found?
A. Distal interphalangeal joints
B. Proximal interphalangeal joints
C. Metacarpophalangeal joints
D. Wrist joints
Correct Answer: B
Rationale: Bouchard's nodes are found at the proximal interphalangeal (PIP)
joints. The mnemonic "B = Before" helps remember that Bouchard's nodes are
proximal to (before) Heberden's nodes.
8. What will an X-ray show in acute osteomyelitis?
A. Bone destruction
B. Periosteal elevation
C. Nothing (normal appearance)
D. Lytic lesions
Correct Answer: C
Rationale: X-rays appear normal in acute osteomyelitis. Bone destruction and
other changes are typically seen only in chronic osteomyelitis, usually after 10-14
days of infection.
9. What is the best imaging modality to diagnose osteomyelitis?
A. X-ray
B. Bone scan or MRI
C. CT scan
D. Ultrasound
