PANCE PREP EXAM |ACTUAL QUESTIONS AND
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
A patient presents with hearing loss involving the right ear. The Weber test lateralizes to
the right ear. The patient notes hearing better when the tuning fork is on the mastoid
during the Rinne test. Which of the following is the likely cause of his hearing loss?
A) Furosemide use
B) Meniere's disease
C) Mumps
D) Otitis media
CORRECT ANSWER
D) Otitis media
Question 2
A 42-year-old man is diagnosed with acute pericarditis complicated by a pericardial
effusion. He suddenly develops dyspnea and orthopnea. On physical exam he is
tachycardic, hypotensive and has distant heart sounds. He is noted to have jugular venous
distension and his lungs are clear to auscultation. Which of the following is an important
physical finding associated with this patients condition?
A) Pulsus alternans
B) Pulsus bisferiens
C) Pulsus paradoxus
D) Pulsus parvus et tardes
CORRECT ANSWER
C) Pulsus paradoxus
1
,Question 3
What is the first line treatment for a pregnant patient with known tick exposure and
erythema migrans?
A) Amoxicillin
B) Azithromycin
C) Cefuroxime
D) Doxycycline
CORRECT ANSWER
A) Amoxicillin (500mg TID x14 days, TOC for lyme disease in pregnancy)
*Cefuroxime can be considered for pts with PCN allergies, Azithromycin can be consider
for pts who can't tolerate amoxicillin or cephalosporins
Question 4
The clinical manifestations of anaphylaxis most often involve which organ system?
A) Cardiovascular
B) Gastrointestinal
C) Respiratory
D) Skin
CORRECT ANSWER
D) Skin
90% of pts report a general feeling of warmth and tingling followed by pruritus; +/-
flushing, urticaria, and angioedema
2
,Question 5
A 50-year-old man with type II diabetes presents for follow up after failing to achieve
glycemic control on metformin alone. You decide to try combination therapy with
dapagliflozin. He asks what side effects are associated with this new medication. What
adverse effect can you tell him might occur?
AConstipation
BHypoglycemia
CUrinary tract infectionCorrect Answer
DWeight gain
CORRECT ANSWER
Question 6
A 42-year-old woman presents to the clinic stating that she has constant feelings of "being
worried." She notes that she has felt this way for over a year and notes that she has
always been a worrier, but the constant thoughts are making it difficult to sleep and
concentrate on her work. She feels restless and irritable most days. Which of the following
medications is the most appropriate for long-term management of her diagnosis?
ABupropionYour Answer
BMethylphenidate
CRisperidone
DVenlafaxineCorrect Answer
CORRECT ANSWER
Question 7
A 24-year-old pregnant woman presents with a rash on her hands with itching that is
worse at night. Physical exam shows excoriations over the web spaces of the hands with
3
, tiny burrows noted. Several members in her household have similar symptoms. Which of
the following is the most appropriate treatment?
AIvermectin
BLindane 1% cream
CPermethrin 5% creamCorrect Answer
DSulfur in petroleum 5%
CORRECT ANSWER
Question 8
A 26-year-old woman with a history of dysmenorrhea and depression presents to the ED
after having a seizure witnessed by her husband. He reports finding her on the bedroom
floor with an empty pill bottle. Which of the following non-steroidal anti-inflammatory
(NSAIDs) medications did she most likely ingest?
ACelecoxib
BIbuprofenYour Answer
CMefenamic acidCorrect Answer
DRofecoxib
CORRECT ANSWER
Question 9
A 75-year-old man presents to his primary physician with excessive fatigue over the past
three months and swollen lymph nodes in his neck. Upon further questioning, he also
reports night sweats and early satiety. On physical exam, there are two palpable lymph
nodes, one along the cervical neck and the other in the inguinal region. Laboratory data
shows a white blood count of 25,000 with a B cell proliferation. The peripheral blood
smear reveals smudge cells. Which of the following is the most likely diagnosis?
4
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
A patient presents with hearing loss involving the right ear. The Weber test lateralizes to
the right ear. The patient notes hearing better when the tuning fork is on the mastoid
during the Rinne test. Which of the following is the likely cause of his hearing loss?
A) Furosemide use
B) Meniere's disease
C) Mumps
D) Otitis media
CORRECT ANSWER
D) Otitis media
Question 2
A 42-year-old man is diagnosed with acute pericarditis complicated by a pericardial
effusion. He suddenly develops dyspnea and orthopnea. On physical exam he is
tachycardic, hypotensive and has distant heart sounds. He is noted to have jugular venous
distension and his lungs are clear to auscultation. Which of the following is an important
physical finding associated with this patients condition?
A) Pulsus alternans
B) Pulsus bisferiens
C) Pulsus paradoxus
D) Pulsus parvus et tardes
CORRECT ANSWER
C) Pulsus paradoxus
1
,Question 3
What is the first line treatment for a pregnant patient with known tick exposure and
erythema migrans?
A) Amoxicillin
B) Azithromycin
C) Cefuroxime
D) Doxycycline
CORRECT ANSWER
A) Amoxicillin (500mg TID x14 days, TOC for lyme disease in pregnancy)
*Cefuroxime can be considered for pts with PCN allergies, Azithromycin can be consider
for pts who can't tolerate amoxicillin or cephalosporins
Question 4
The clinical manifestations of anaphylaxis most often involve which organ system?
A) Cardiovascular
B) Gastrointestinal
C) Respiratory
D) Skin
CORRECT ANSWER
D) Skin
90% of pts report a general feeling of warmth and tingling followed by pruritus; +/-
flushing, urticaria, and angioedema
2
,Question 5
A 50-year-old man with type II diabetes presents for follow up after failing to achieve
glycemic control on metformin alone. You decide to try combination therapy with
dapagliflozin. He asks what side effects are associated with this new medication. What
adverse effect can you tell him might occur?
AConstipation
BHypoglycemia
CUrinary tract infectionCorrect Answer
DWeight gain
CORRECT ANSWER
Question 6
A 42-year-old woman presents to the clinic stating that she has constant feelings of "being
worried." She notes that she has felt this way for over a year and notes that she has
always been a worrier, but the constant thoughts are making it difficult to sleep and
concentrate on her work. She feels restless and irritable most days. Which of the following
medications is the most appropriate for long-term management of her diagnosis?
ABupropionYour Answer
BMethylphenidate
CRisperidone
DVenlafaxineCorrect Answer
CORRECT ANSWER
Question 7
A 24-year-old pregnant woman presents with a rash on her hands with itching that is
worse at night. Physical exam shows excoriations over the web spaces of the hands with
3
, tiny burrows noted. Several members in her household have similar symptoms. Which of
the following is the most appropriate treatment?
AIvermectin
BLindane 1% cream
CPermethrin 5% creamCorrect Answer
DSulfur in petroleum 5%
CORRECT ANSWER
Question 8
A 26-year-old woman with a history of dysmenorrhea and depression presents to the ED
after having a seizure witnessed by her husband. He reports finding her on the bedroom
floor with an empty pill bottle. Which of the following non-steroidal anti-inflammatory
(NSAIDs) medications did she most likely ingest?
ACelecoxib
BIbuprofenYour Answer
CMefenamic acidCorrect Answer
DRofecoxib
CORRECT ANSWER
Question 9
A 75-year-old man presents to his primary physician with excessive fatigue over the past
three months and swollen lymph nodes in his neck. Upon further questioning, he also
reports night sweats and early satiety. On physical exam, there are two palpable lymph
nodes, one along the cervical neck and the other in the inguinal region. Laboratory data
shows a white blood count of 25,000 with a B cell proliferation. The peripheral blood
smear reveals smudge cells. Which of the following is the most likely diagnosis?
4
