,PANCE Physician Assistant Exam 2026 | Comprehensive Test Bank |
Questions And Answers
TABLE OF CONTENTS
1. Cardiovascular System — Q1–Q22
2. Dermatologic System — Q23–Q30
3. Endocrine System — Q31–Q42
4. Eyes, Ears, Nose, and Throat — Q43–Q54
5. Gastrointestinal System/Nutrition — Q55–Q70
6. Genitourinary System — Q71–Q78
7. Hematologic System — Q79–Q88
8. Infectious Diseases — Q89–Q102
9. Musculoskeletal System — Q103–Q118
10. Neurologic System — Q119–Q132
11. Psychiatry/Behavioral Science — Q133–Q146
12. Pulmonary System — Q147–Q164
13. Renal System — Q165–Q174
14. Reproductive System — Q175–Q188
15. Professional Practice — Q189–Q200
1. CARDIOVASCULAR SYSTEM
Q1. A 64-year-old man develops crushing substernal chest pain with
diaphoresis and nausea. The ECG shows ST-segment elevation in
leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Right coronary artery
B) Left circumflex artery
C) Left anterior descending artery
D) Left main coronary artery
Correct Answer: A) Right coronary artery
,Rationale: ST elevation in II, III, and aVF indicates an inferior myocardial
infarction, most commonly caused by right coronary artery occlusion.
Q2. A patient with atrial fibrillation develops sudden aphasia and
right-sided weakness. What is the most likely mechanism of the
neurologic event?
A) Cerebral vasospasm
B) Cardioembolism
C) Venous thrombosis
D) Hypoperfusion from bradycardia
Correct Answer: B) Cardioembolism
Rationale: Atrial fibrillation promotes atrial thrombus formation that can
embolize to the cerebral circulation.
Q3. A 72-year-old patient has dyspnea, orthopnea, pulmonary
crackles, and an elevated jugular venous pressure. Which diagnosis
is most likely?
A) Stable angina
B) Pericarditis
C) Acute decompensated heart failure
D) Deep-vein thrombosis
Correct Answer: C) Acute decompensated heart failure
Rationale: Pulmonary congestion, orthopnea, and elevated venous pressure
are classic findings of decompensated heart failure.
Q4. Which physical examination finding is most characteristic of
severe aortic stenosis?
A) Diastolic murmur at the apex
B) Opening snap
C) Continuous machinery murmur
D) Harsh systolic ejection murmur radiating to the carotids
Correct Answer: D) Harsh systolic ejection murmur radiating to the carotids
Rationale: Aortic stenosis produces a crescendo-decrescendo systolic
murmur that classically radiates to the carotid arteries.
Q5. Which patient is most likely experiencing stable angina?
, A) Chest discomfort predictably triggered by exertion and relieved by rest
B) Chest pain occurring at rest with rising troponin
C) Sudden pleuritic chest pain with hemoptysis
D) Sharp pain worsened by inspiration and relieved by leaning forward
Correct Answer: A) Chest discomfort predictably triggered by exertion and
relieved by rest
Rationale: Stable angina results from predictable myocardial oxygen-
demand ischemia during exertion.
Q6. A patient has hypotension, muffled heart sounds, and distended
neck veins. Which diagnosis should be suspected?
A) Left-sided heart failure
B) Cardiac tamponade
C) Aortic stenosis
D) Pulmonary edema
Correct Answer: B) Cardiac tamponade
Rationale: Hypotension, muffled heart sounds, and jugular venous
distention are classic features of tamponade.
Q7. Which finding is most consistent with infective endocarditis?
A) New murmur with fever and positive blood cultures
B) Isolated hypertension
C) Pleuritic chest pain with a normal cardiac examination
D) Bilateral pedal edema without fever
Correct Answer: A) New murmur with fever and positive blood cultures
Rationale: Infective endocarditis commonly presents with fever,
bacteremia, and valvular involvement producing a new or changing murmur.
Q8. Which ECG finding is characteristic of atrial fibrillation?
A) Regular rhythm with prolonged PR interval
B) Sawtooth flutter waves
C) Irregularly irregular rhythm without discrete P waves
D) Wide-complex regular tachycardia
Correct Answer: C) Irregularly irregular rhythm without discrete P waves
Rationale: Atrial fibrillation produces chaotic atrial activity and an
irregularly irregular ventricular response.
Questions And Answers
TABLE OF CONTENTS
1. Cardiovascular System — Q1–Q22
2. Dermatologic System — Q23–Q30
3. Endocrine System — Q31–Q42
4. Eyes, Ears, Nose, and Throat — Q43–Q54
5. Gastrointestinal System/Nutrition — Q55–Q70
6. Genitourinary System — Q71–Q78
7. Hematologic System — Q79–Q88
8. Infectious Diseases — Q89–Q102
9. Musculoskeletal System — Q103–Q118
10. Neurologic System — Q119–Q132
11. Psychiatry/Behavioral Science — Q133–Q146
12. Pulmonary System — Q147–Q164
13. Renal System — Q165–Q174
14. Reproductive System — Q175–Q188
15. Professional Practice — Q189–Q200
1. CARDIOVASCULAR SYSTEM
Q1. A 64-year-old man develops crushing substernal chest pain with
diaphoresis and nausea. The ECG shows ST-segment elevation in
leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Right coronary artery
B) Left circumflex artery
C) Left anterior descending artery
D) Left main coronary artery
Correct Answer: A) Right coronary artery
,Rationale: ST elevation in II, III, and aVF indicates an inferior myocardial
infarction, most commonly caused by right coronary artery occlusion.
Q2. A patient with atrial fibrillation develops sudden aphasia and
right-sided weakness. What is the most likely mechanism of the
neurologic event?
A) Cerebral vasospasm
B) Cardioembolism
C) Venous thrombosis
D) Hypoperfusion from bradycardia
Correct Answer: B) Cardioembolism
Rationale: Atrial fibrillation promotes atrial thrombus formation that can
embolize to the cerebral circulation.
Q3. A 72-year-old patient has dyspnea, orthopnea, pulmonary
crackles, and an elevated jugular venous pressure. Which diagnosis
is most likely?
A) Stable angina
B) Pericarditis
C) Acute decompensated heart failure
D) Deep-vein thrombosis
Correct Answer: C) Acute decompensated heart failure
Rationale: Pulmonary congestion, orthopnea, and elevated venous pressure
are classic findings of decompensated heart failure.
Q4. Which physical examination finding is most characteristic of
severe aortic stenosis?
A) Diastolic murmur at the apex
B) Opening snap
C) Continuous machinery murmur
D) Harsh systolic ejection murmur radiating to the carotids
Correct Answer: D) Harsh systolic ejection murmur radiating to the carotids
Rationale: Aortic stenosis produces a crescendo-decrescendo systolic
murmur that classically radiates to the carotid arteries.
Q5. Which patient is most likely experiencing stable angina?
, A) Chest discomfort predictably triggered by exertion and relieved by rest
B) Chest pain occurring at rest with rising troponin
C) Sudden pleuritic chest pain with hemoptysis
D) Sharp pain worsened by inspiration and relieved by leaning forward
Correct Answer: A) Chest discomfort predictably triggered by exertion and
relieved by rest
Rationale: Stable angina results from predictable myocardial oxygen-
demand ischemia during exertion.
Q6. A patient has hypotension, muffled heart sounds, and distended
neck veins. Which diagnosis should be suspected?
A) Left-sided heart failure
B) Cardiac tamponade
C) Aortic stenosis
D) Pulmonary edema
Correct Answer: B) Cardiac tamponade
Rationale: Hypotension, muffled heart sounds, and jugular venous
distention are classic features of tamponade.
Q7. Which finding is most consistent with infective endocarditis?
A) New murmur with fever and positive blood cultures
B) Isolated hypertension
C) Pleuritic chest pain with a normal cardiac examination
D) Bilateral pedal edema without fever
Correct Answer: A) New murmur with fever and positive blood cultures
Rationale: Infective endocarditis commonly presents with fever,
bacteremia, and valvular involvement producing a new or changing murmur.
Q8. Which ECG finding is characteristic of atrial fibrillation?
A) Regular rhythm with prolonged PR interval
B) Sawtooth flutter waves
C) Irregularly irregular rhythm without discrete P waves
D) Wide-complex regular tachycardia
Correct Answer: C) Irregularly irregular rhythm without discrete P waves
Rationale: Atrial fibrillation produces chaotic atrial activity and an
irregularly irregular ventricular response.
