NCCPA PANCE EXAM |ACTUAL QUESTIONS AND
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
For the past three weeks, a 47-year-old man has had the feeling of heaviness in his chest
while pushing his lawn mower. He says he has never been treated for similar symptoms
and has no symptoms now. He smoked one pack of cigarettes daily for 20 years but quit
smoking seven years ago. Findings on physical examination are normal.
Electrocardiography shows no
abnormalities. Which of the following is the most appropriate initial diagnostic study?
A. Coronary arteriography
B. Echocardiography
C. Exercise stress test
D. 24-Hour ambulatory cardiac monitoring
E. Myocardial perfusion scan
CORRECT ANSWER
exercise stress test
exercise stress test, is correct because it is the most appropriate initial step in the workup
of a patient with recent chest pain because the test is noninvasive, inexpensive,
convenient, and sensitive in this type of patient.
The most definitive diagnostic test for a patient with coronary artery disease is Option
(A), coronary arteriography, but this test is not the most appropriate initial test in an
asymptomatic patient with no abnormal findings on electrocardiography. Option (B),
echocardiography, is a valuable tool for examining valvular structures, cardiac size,
ejection fraction, as well as other anatomic features. However, echocardiography is not
routinely indicated for evaluating ischemia resulting from coronary artery disease and is,
therefore, incorrect. Option (D), 24-hour ambulatory cardiac monitoring, is also incorrect.
1
, Twenty-four-hour ambulatory cardiac monitoring is used primarily for evaluating
disturbances of rate and rhythm and it is able to detect ST-segment depression, but it is
less effective than exercise stress testing in confirming a diagnosis of coronary artery
disease in the initial workup of a patient. This patient's electrocardiogram shows no
abnormalities, and therefore, Option (E), myocardial perfusion scan, is incorrect. This
option would only be correct if the results of resting electrocardiography were abnormal,
making it difficult to interpret an exercise stress tes
Question 2
A 32-year-old woman has had a rash on her legs for the past three weeks. There are no
known infectious contacts. One month ago, she had a bladder infection and was treated
with trimethoprim-sulfamethoxazole. Physical examination shows a diffuse rash on the
shins, the left medial ankle, and the right medial calf. The rash is tender, diffuse, and
recurs in the same
areas. A few of the lesions have the appearance of bruising. Which of the following is the
most
likely diagnosis?
A. Erythema multiforme
B. Erythema nodosum
C. Lichen planus
D. Lichen simplex
E. Nummular eczema
CORRECT ANSWER
B. Erythema nodosum
Option (B), erythema nodosum, because this type of rash may be antibiotic-related,
occurs on the lower extremities below the knees, and has the appearance of bruising. All
of these symptoms are present in this clinical scenario. Options (A), erythema
multiforme, and (C), lichen planus, can also result from an allergic reaction to a sulfa
antibiotic, but the presentation of this patient's rash is not consistent with either of
these conditions. Options (D), lichen simplex, and (E), nummular eczema, are chronic
2
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
For the past three weeks, a 47-year-old man has had the feeling of heaviness in his chest
while pushing his lawn mower. He says he has never been treated for similar symptoms
and has no symptoms now. He smoked one pack of cigarettes daily for 20 years but quit
smoking seven years ago. Findings on physical examination are normal.
Electrocardiography shows no
abnormalities. Which of the following is the most appropriate initial diagnostic study?
A. Coronary arteriography
B. Echocardiography
C. Exercise stress test
D. 24-Hour ambulatory cardiac monitoring
E. Myocardial perfusion scan
CORRECT ANSWER
exercise stress test
exercise stress test, is correct because it is the most appropriate initial step in the workup
of a patient with recent chest pain because the test is noninvasive, inexpensive,
convenient, and sensitive in this type of patient.
The most definitive diagnostic test for a patient with coronary artery disease is Option
(A), coronary arteriography, but this test is not the most appropriate initial test in an
asymptomatic patient with no abnormal findings on electrocardiography. Option (B),
echocardiography, is a valuable tool for examining valvular structures, cardiac size,
ejection fraction, as well as other anatomic features. However, echocardiography is not
routinely indicated for evaluating ischemia resulting from coronary artery disease and is,
therefore, incorrect. Option (D), 24-hour ambulatory cardiac monitoring, is also incorrect.
1
, Twenty-four-hour ambulatory cardiac monitoring is used primarily for evaluating
disturbances of rate and rhythm and it is able to detect ST-segment depression, but it is
less effective than exercise stress testing in confirming a diagnosis of coronary artery
disease in the initial workup of a patient. This patient's electrocardiogram shows no
abnormalities, and therefore, Option (E), myocardial perfusion scan, is incorrect. This
option would only be correct if the results of resting electrocardiography were abnormal,
making it difficult to interpret an exercise stress tes
Question 2
A 32-year-old woman has had a rash on her legs for the past three weeks. There are no
known infectious contacts. One month ago, she had a bladder infection and was treated
with trimethoprim-sulfamethoxazole. Physical examination shows a diffuse rash on the
shins, the left medial ankle, and the right medial calf. The rash is tender, diffuse, and
recurs in the same
areas. A few of the lesions have the appearance of bruising. Which of the following is the
most
likely diagnosis?
A. Erythema multiforme
B. Erythema nodosum
C. Lichen planus
D. Lichen simplex
E. Nummular eczema
CORRECT ANSWER
B. Erythema nodosum
Option (B), erythema nodosum, because this type of rash may be antibiotic-related,
occurs on the lower extremities below the knees, and has the appearance of bruising. All
of these symptoms are present in this clinical scenario. Options (A), erythema
multiforme, and (C), lichen planus, can also result from an allergic reaction to a sulfa
antibiotic, but the presentation of this patient's rash is not consistent with either of
these conditions. Options (D), lichen simplex, and (E), nummular eczema, are chronic
2
