PAEA EOC & Summative Exam 2026/2027 – Actual Practice
Questions with Verified Answers & Detailed Rationales |
Comprehensive Physician Assistant Exam Prep | Instant
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1. A 45-year-old male presents with acute onset chest pain radiating to his left arm. He is
diaphoretic and nauseated. Which is the most appropriate initial diagnostic test?
A) Chest X-ray
B) Electrocardiogram (ECG) ✅
C) Echocardiogram
D) Stress test
Answer: B
Rationale: ECG is the first-line test to evaluate suspected acute myocardial infarction and guides
immediate management.
2. A 7-year-old child presents with a barking cough and stridor. Which is the most likely
diagnosis?
A) Epiglottitis
B) Bronchiolitis
C) Croup ✅
D) Asthma exacerbation
Answer: C
Rationale: Barking cough, stridor, and age < 6–7 years are characteristic of viral croup.
3. Which of the following is the first-line treatment for newly diagnosed Type 2
Diabetes Mellitus in adults?
A) Insulin
B) Metformin ✅
C) Sulfonylurea
D) GLP-1 receptor agonist
Answer: B
Rationale: Metformin is recommended as first-line therapy due to efficacy, safety profile, and
cardiovascular benefits.
4. A 32-year-old female presents with amenorrhea, galactorrhea, and headaches. Which lab
test is most important initially?
A) TSH
B) Prolactin ✅
C) LH/FSH
D) Estradiol
,Answer: B
Rationale: Prolactin level should be checked in patients with galactorrhea and amenorrhea to
evaluate for prolactinoma.
5. Which of the following vaccines is contraindicated in pregnancy?
A) Tdap
B) Influenza inactivated
C) MMR ✅
D) COVID-19 mRNA
Answer: C
Rationale: MMR is a live attenuated vaccine and should not be administered during pregnancy.
6. A 60-year-old male with COPD presents with acute shortness of breath. ABG shows
PaCO₂ of 65 mmHg. What is the most appropriate initial management?
A) High-flow oxygen
B) Noninvasive positive-pressure ventilation (NIPPV) ✅
C) Immediate intubation
D) Diuretics
Answer: B
Rationale: NIPPV is first-line for acute hypercapnic respiratory failure in COPD exacerbations
to reduce intubation risk.
7. Which antibiotic is first-line for uncomplicated community-acquired pneumonia in
an otherwise healthy adult?
A) Azithromycin ✅
B) Ceftriaxone
C) Levofloxacin
D) Vancomycin
Answer: A
Rationale: Macrolides are recommended for healthy adults without comorbidities.
8. A patient presents with fever, malaise, and a rash that started on the face and spread to
the trunk. Koplik spots are present. What is the diagnosis?
A) Rubella
B) Measles ✅
C) Varicella
D) Scarlet fever
Answer: B
Rationale: Measles presents with fever, cough, coryza, conjunctivitis, and Koplik spots.
9. Which of the following is first-line therapy for acute otitis media in children?
A) Azithromycin
, B) Amoxicillin ✅
C) Ciprofloxacin
D) Cephalexin
Answer: B
Rationale: High-dose amoxicillin is the first-line antibiotic for uncomplicated acute otitis media
in children.
10. A 24-year-old presents with dysuria, frequency, and urgency. Urine dipstick shows
positive leukocyte esterase and nitrites. What is the most appropriate treatment?
A) Amoxicillin
B) Ciprofloxacin
C) Nitrofurantoin ✅
D) Ceftriaxone
Answer: C
Rationale: Nitrofurantoin is first-line for uncomplicated urinary tract infections in non-pregnant
women.
11. Which of the following is a common side effect of ACE inhibitors?
A) Hyperkalemia ✅
B) Hypokalemia
C) Bradycardia
D) Hypernatremia
Answer: A
Rationale: ACE inhibitors can cause hyperkalemia due to decreased aldosterone production.
12. A patient presents with sudden painless vision loss in one eye. Fundoscopy shows a
cherry-red spot. What is the likely diagnosis?
A) Retinal detachment
B) Central retinal artery occlusion ✅
C) Acute glaucoma
D) Optic neuritis
Answer: B
Rationale: Central retinal artery occlusion presents with sudden painless vision loss and cherry-
red spot on fundoscopy.
13. Which medication is first-line for acute asthma exacerbation?
A) Albuterol ✅
B) Salmeterol
C) Fluticasone
D) Montelukast
Questions with Verified Answers & Detailed Rationales |
Comprehensive Physician Assistant Exam Prep | Instant
PDF Download
1. A 45-year-old male presents with acute onset chest pain radiating to his left arm. He is
diaphoretic and nauseated. Which is the most appropriate initial diagnostic test?
A) Chest X-ray
B) Electrocardiogram (ECG) ✅
C) Echocardiogram
D) Stress test
Answer: B
Rationale: ECG is the first-line test to evaluate suspected acute myocardial infarction and guides
immediate management.
2. A 7-year-old child presents with a barking cough and stridor. Which is the most likely
diagnosis?
A) Epiglottitis
B) Bronchiolitis
C) Croup ✅
D) Asthma exacerbation
Answer: C
Rationale: Barking cough, stridor, and age < 6–7 years are characteristic of viral croup.
3. Which of the following is the first-line treatment for newly diagnosed Type 2
Diabetes Mellitus in adults?
A) Insulin
B) Metformin ✅
C) Sulfonylurea
D) GLP-1 receptor agonist
Answer: B
Rationale: Metformin is recommended as first-line therapy due to efficacy, safety profile, and
cardiovascular benefits.
4. A 32-year-old female presents with amenorrhea, galactorrhea, and headaches. Which lab
test is most important initially?
A) TSH
B) Prolactin ✅
C) LH/FSH
D) Estradiol
,Answer: B
Rationale: Prolactin level should be checked in patients with galactorrhea and amenorrhea to
evaluate for prolactinoma.
5. Which of the following vaccines is contraindicated in pregnancy?
A) Tdap
B) Influenza inactivated
C) MMR ✅
D) COVID-19 mRNA
Answer: C
Rationale: MMR is a live attenuated vaccine and should not be administered during pregnancy.
6. A 60-year-old male with COPD presents with acute shortness of breath. ABG shows
PaCO₂ of 65 mmHg. What is the most appropriate initial management?
A) High-flow oxygen
B) Noninvasive positive-pressure ventilation (NIPPV) ✅
C) Immediate intubation
D) Diuretics
Answer: B
Rationale: NIPPV is first-line for acute hypercapnic respiratory failure in COPD exacerbations
to reduce intubation risk.
7. Which antibiotic is first-line for uncomplicated community-acquired pneumonia in
an otherwise healthy adult?
A) Azithromycin ✅
B) Ceftriaxone
C) Levofloxacin
D) Vancomycin
Answer: A
Rationale: Macrolides are recommended for healthy adults without comorbidities.
8. A patient presents with fever, malaise, and a rash that started on the face and spread to
the trunk. Koplik spots are present. What is the diagnosis?
A) Rubella
B) Measles ✅
C) Varicella
D) Scarlet fever
Answer: B
Rationale: Measles presents with fever, cough, coryza, conjunctivitis, and Koplik spots.
9. Which of the following is first-line therapy for acute otitis media in children?
A) Azithromycin
, B) Amoxicillin ✅
C) Ciprofloxacin
D) Cephalexin
Answer: B
Rationale: High-dose amoxicillin is the first-line antibiotic for uncomplicated acute otitis media
in children.
10. A 24-year-old presents with dysuria, frequency, and urgency. Urine dipstick shows
positive leukocyte esterase and nitrites. What is the most appropriate treatment?
A) Amoxicillin
B) Ciprofloxacin
C) Nitrofurantoin ✅
D) Ceftriaxone
Answer: C
Rationale: Nitrofurantoin is first-line for uncomplicated urinary tract infections in non-pregnant
women.
11. Which of the following is a common side effect of ACE inhibitors?
A) Hyperkalemia ✅
B) Hypokalemia
C) Bradycardia
D) Hypernatremia
Answer: A
Rationale: ACE inhibitors can cause hyperkalemia due to decreased aldosterone production.
12. A patient presents with sudden painless vision loss in one eye. Fundoscopy shows a
cherry-red spot. What is the likely diagnosis?
A) Retinal detachment
B) Central retinal artery occlusion ✅
C) Acute glaucoma
D) Optic neuritis
Answer: B
Rationale: Central retinal artery occlusion presents with sudden painless vision loss and cherry-
red spot on fundoscopy.
13. Which medication is first-line for acute asthma exacerbation?
A) Albuterol ✅
B) Salmeterol
C) Fluticasone
D) Montelukast
