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Med-Challenger PA is the most effective, easiest to use Physician Assistant certification board review question bank for the PANCE NCCPA board certification examination. Med-Challenger's physician assistant board reviews with intelligent PA self-assessment provides everything you need to pass physician assistant certification exams and fulfill other PA certification requirements such as AAPA CME credits, all in one powerful, effective, and convenient access point online.

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Our pass-guaranteed physician assistant certification board review courses gets you prepared the PANCE fast, thanks to our constantly updated physician assistant review questions, detailed answer explanations, and intelligent PANCE board exam simulators. Plus, our online PANCE board review course keeps serving you after exams too. PANCE review has never been so easy, effective, or efficient. It's more than just the best PANCE question bank, it's lifelong physician assistant education and AAPA MOC convenience.

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2600+ PANCE Review Questions

High-Yield Physician Assistant exam practice questions mapped to the PANCE exam blueprint.

Using authoritative resources, our physician assistant editors ensure our PANCE review courses are always current and cover the latest NCCPA certification exam blueprint. Med-Challenger's PANCE Board Review course is 100% pass-guaranteed and used by GME programs and healthcare organizations world-wide.

Earn Required CMEs

The MOST CME credits you'll find in any online physician assistant board review.

195

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Physician Assistant Course Information

Physician Assistant Review Course Information

Post-Rotation Exams

Post-Rotation Exam - Allergy/Immunology
Post-Rotation Exam - Cardiology
Post-Rotation Exam - Dermatology
Post-Rotation Exam - EENT
Post-Rotation Exam - Emergency Medicine
Post-Rotation Exam - Family Medicine
Post-Rotation Exam - Geriatrics
Post-Rotation Exam - Internal Medicine
Post-Rotation Exam - OBGYN
Post-Rotation Exam - Orthopedics
Post-Rotation Exam - Pediatrics
Post-Rotation Exam - Psychiatry
Post-Rotation Exam - Surgery
Post-Rotation Exam - Underserved Care
Post-Rotation Exam - Urgent Care

CME Bank - Signs, Symptoms, and Presentations (AAPA Credit)

Abdominal Pain
Acute Pelvic Pain in Women
Acute Vaginal Bleeding
Back Pain
Chest Pain
Confusion
Constipation
Cyanosis
Depressed Consciousness and Coma
Diarrhea
Dizziness and Vertigo
Dyspnea
Fever in the Adult Patient
Gastrointestinal Bleeding
Headache: Initial Approach
Hemoptysis
Jaundice
Nausea and Vomiting
Seizures: Initial Approach
Syncope
Weakness

CME Bank - Allergy/Immunology

Auto-Immune Collagen Vascular Disorders
Drug Allergy
Food Allergy
Hypersensitivity Reactions
Pediatric Allergy and Immunology
Primary Immunodeficiency Disorders
The Immunocompromised / Solid-Organ Transplant Patient

CME Bank - Cardiovascular System

Congenital Heart Disease in the Adult
Congestive Heart Failure
Dysrhythmias/Conduction Defects
Endocarditis
Hypertension
Ischemic Heart Disease
Myocardial Disease
Pediatric Cardiovascular Disease
Pericardial Disease
Valvular Heart Disease
Vascular Disease

CME Bank - Dermatology

Acne/Rosacea
Cancers of the Skin
Cutaneous Infections
Dermatitis (non-infectious)
Maculopapular Lesions
Papular/Nodular Lesions
Pediatric Dermatology
Ulcerative Lesions
Vesicular / Bullous Lesions

CME Bank - EENT (Eyes, Ears, Nose and Throat) System

Eye: Assessment
Eye: Glaucoma
Eye: Inflammation and Infection
Eye: Pharmacology
Eye: Vascular Disorders
Nose: Infection and Inflammation
Oral Cavity: Medical Disorders
Otologic Infections
Otologic Signs, Symptoms, Presentations
Pediatric Eye, Ear, Nose and Throat Disorders
Throat and Soft Tissue Neck: Medical Disorders

CME Bank - Endocrinology, Metabolism, and Nutrition

Adrenal Disorders
Diabetes Mellitus
Disorders of Calcium Metabolism and Bone
Hypoglycemia
Lipid Disorders
Obesity
Thyroid Disorders
Pediatric Endocrine Disorders

CME Bank - Gastroenterology/Nutritional System

Biliary Tract Disease
Colonic and Anorectal Disease
Esophageal Disorders
Liver Disease
Pancreatic Disease
Pediatric Gastrointestinal Disorders
Small Intestinal Disease
Stomach or Duodenum

CME Bank - Genitourinary System

Acute Renal Failure
Chronic Kidney Disease
Glomerular Disorders
Nephrolithiasis
Pediatric Nephrology and Urology
Penile Disorders
Prostate Disorders
Sexually Transmitted Infections - Male
Testicular Disorders
Urinary Incontinence
Urinary Tract Infections
Water and Electrolyte Balance

CME Bank - Hematology and Oncology

Anemia
Bone Tumors
Breast Cancer
Coagulopathies
Disseminated Intravascular Coagulation
Gastrointestinal or Hepatic Cancer
Gynecologic Cancer
Hematologic Malignancies
Lung Cancer
Management of Malignant Pain
Neoplasms of the Head and Neck
Oncologic Emergencies
Pediatric Hematology and Oncology
Sickle Cell Disease
Transfusion Medicine (Principles and Complications)
Urological Cancer

CME Bank - Infectious Diseases

Coronavirus (SARS-COV-2, COVID-19)
COVID-19 During Pregnancy
Diphtheria, Pertussis, Tetanus
Meningococcemia, Pneumococcemia
MRSA, VRE, ESBL
Tuberculosis
Parasitic Infections
Pediatric Infectious Diseases
Sepsis Syndromes
Systemic Fungal Infections
Tick-Borne Illnesses
Hantavirus HIV and AIDS
Influenza, Mononucleosis, Herpes
Rabies

CME Bank - Musculoskeletal System

Bone and Joint Infections
Crystal-Induced Arthropathy
Deep Soft Tissue Infections
Disorders of Muscles
Infectious, Inflammatory, and Reactive Arthritis
Neck and Back Pain
Osteoarthritis Rheumatoid Arthritis
Sports Injuries / Trauma
Systemic Lupus Erythematosus
Systemic Sclerosis Vasculitis
Pediatric Rheumatology and Musculoskeletal Disorders

CME Bank - Neurological System

Central Nervous System Disorders: Delirium and Dementia
Central Nervous System Disorders: Demyelinating/Inflammatory Diseases
Central Nervous System Disorders: Diseases of Movement Control
Central Nervous System Disorders: Seizures
Central Nervous System Disorders: Spinal Cord Syndromes
Central Nervous System Infections
Cerebrovascular Accidents: Epidemiology and Presentation
Cerebrovascular Accidents: Initial Work-Up
Cerebrovascular Accidents: Preventive Care
Cerebrovascular Accidents: Treatment
Headache: Cervical Neck Vessels, Subarachnoid, and Venous Emergencies
Headache: Cluster, Migraine, and Tension
Headache: Less Common Etiologies
Neurologic Assessment
Pediatric Neurologic Disorders
Peripheral Nervous System Disorders: Neuromuscular Junction Disease
Peripheral Nervous System Disorders: Neuropathies
Selected Cranial Nerve Disorders

CME Bank - Psychiatry/Behavioral System

Affective Disorders
Antidepressants
Anxiety Disorders
Anxiolytics
Dissociative Disorders
Eating Disorders
Factitious Disorders and Malingering
Geriatric Psychology
Obsessive-Compulsive Disorder
Pediatric Psychiatric Disorders
Personality Disorders
Psychiatric Assessment
Psychological Factors Affecting Medical Disorders
Schizophrenia
Somatoform Disorders
Substance Abuse
Suicidal Behavior
Thought Disorders

CME Bank - Pulmonary System

Asthma and Other Obstructive Lung Disease
Interstitial Lung Disease
Lower Respiratory Tract Infections
Occupational and Environmental Lung Disease
Pediatric Respiratory Disorders
Pleural Disease
Pulmonary Vascular Disease
Sleep Medicine
Upper Respiratory Tract Infections

CME Bank - Reproductive System

Acute Complications of Pregnancy
Chronic Medical Illness During Pregnancy
Contraception
General Approach to the Pregnant Patient
Gynecological Assessment
Menopause and Hormonal Therapy
Screening and Regular Health Care in Adult Women
Sexual Assault Sexually Transmitted Infections: Female

Sample Question 1

How is the mini-mental state examination (MMSE) useful?

The MMSE is a test for the patient’s level of consciousness.
The MMSE is a test of cognitive function.
The MMSE has high sensitivity and specificity for Alzheimer dementia.
The MMSE is a test for depression.
The MMSE helps distinguish between impairment based on organic compared with psychiatric causes.

The MMSE is a tool to evaluate cognitive function. Although most cognitive impairment is organic, the test is not designed to diagnose pseudodementia that may accompany depression.

The MMSE can be easily and relatively rapidly performed in any primary care setting. It consists of a series of questions and tasks that test orientation, memory, attention, calculation, recall, and language. The maximum score is 30. Patients who score lower than 9 have severe cognitive impairment, those who score between 10 and 20 have moderate impairment, and those who score 21 to 29 have mild impairment.

References:

Jelcic N, Agostini M, Meneghello F, et al. Feasibility and efficacy of cognitive telerehabilitation in early Alzheimer's disease: a pilot study. Clin Interv Aging. 2014;9:1605-1611.

Marx JA, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed., 2014.

Sample Question 2

An 11-year-old girl is brought for evaluation because her parents don't think she is achieving her potential in school. Her grades have been mostly C’s with occasional B’s. Her current teacher enjoys her and reports that she gets along well with her classmates. In fact, her socializing interferes with her getting her work done. Both the parents and her teacher feel that she frequently doesn't pay attention and makes many careless mistakes. While she is easily distracted, she gets her assignments done, but it takes longer to do them. She loves to draw and is quite artistic. Her parents report that she has had similar problems since second grade. Based on the information provided, what should be suspected?

ADHD - combined type
ADHD - predominantly hyperactive-impulsive type
depression
inattentive problem that may be ADHD
hyperactive-impulsive problem

The symptoms suggest inattentiveness, but the diagnosis of the inattentive form of ADHD cannot be made without further, comprehensive evaluation.

 

Reference:

American Psychiatric Association. Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Association, Arlington, VA 2013. p.59.

Sample Question 3

A 24-year-old electrician must enter narrow spaces as part of his regular daily work. However, he has experienced increasing claustrophobia to this requirement. What pharmacologic treatment is appropriate for this patient?

Bupropion
Serotonin–norepinephrine reuptake inhibitor
Desipramine
Selective serotonin reuptake inhibitor (SSRI)
Benzodiazepine

Correct!

If the situation that triggers the phobia is a frequent occurrence like the claustrophobia seen in this case, then the phobia may be treated with an SSRI. The SSRI dose for the treatment of phobia is usually at the lower end of the therapeutic range. A treatment trial should last at least 6-8 weeks, thus allowing time for the medication to achieve its full effect.

References:
Alamy S, Wei Zhang, Varia I, Davidson JR, Connor KM. Escitalopram in specific phobia: results of a placebo-controlled pilot trial. J Psychopharmacol (Oxford). 2008;22(2):157-161.

Benjamin J, Ben-Zion IZ, Karbofsky E, Dannon P. Double-blind placebo-controlled pilot study of paroxetine for specific phobia. Psychopharmacology (Berl). 2000;149(2):194-196.

Sample Question 4

A 17-year-old woman presents with fatigue and increased dyspnea on exertion. Her past medical history includes sickle cell disease from which she has 1 painful crisis per year. She takes folic acid and depo-provera. She does not smoke, drink, or use drugs. She is a senior in high school.

Her temperature is 37.1, heart rate is 112, blood pressure 114/86, respiratory rate 12, and oxygen saturation 97% on room air. Her conjunctivae are pale. Her heart is tachycardic but regular. Her lungs are clear, and her abdomen is non-tender. Her spleen is not palpable.

Her white blood cell count is 4400 per microliter, hemoglobin is 3.2 mg/dl, mean corpuscular volume is 56 femtoliters, and platelet count is 134,000 per microliter. Her reticulocyte count is 0.

What is the most likely diagnosis?

Acute splenic sequenstration
Aplastic crisis due to parvovirus B19
Acute hyper hemolytic crisis
Paroxysmal nocturnal hemoglobinuria
Acute vaso-occlusive crisis

Acute aplastic crisis in sickle cell disease is characterized by a sudden worsening in hemoglobin due to loss of bone marrow production of red cells. Because red cell life span is already compromised by hemolysis due to sickling, severe anemia can result if erythropoiesis is interrupted even for a few days. Causes of acute aplastic crisis include parvovirus B19, EBV, and bacteremia. The crisis can last up to 2 weeks and generally resolves spontaneously. The absence of a reticulocytosis distinguishes acute aplastic crisis from splenic sequestration and hemolytic crises.

Reference:
Janz Glen et al. Anemia, Polycythemia, and White Blood Cell Disorders. In: Marx JA, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed., 2009

Sample Question 5

A 63-year-old man with a history of alcohol use disorder and severe hypertension, who intermittently adheres to his medication regimen, presents to you with headache, nausea, vomiting, stiff neck, and imbalance. He tells you that the symptoms came on suddenly.

His blood pressure is 210/104 mm Hg. Findings on emergent computed tomography of the head show acute blood in the posterior fossa as well as blood in the fourth ventricle.

When he returns from the imaging department, he is completely obtunded and his respirations are depressed. He is intubated and placed on mechanical ventilation.

Of the following, which represents the most appropriate next step in the management of this patient's condition?

Emergent placement of ventricular drain
Withdrawal of support/comfort care
Emergent neurosurgical consultation for evacuation of hemorrhage
Emergent placement of intracranial pressure monitor

Educational Objective:

Describe different therapeutic options for patients with certain risk factors.

Key Point: 

Patients with cerebellar hemorrhage who are deteriorating or experiencing brain stem compression and/or hydrocephalus from ventricular obstruction should undergo emergent surgical evacuation of the clot.

Explanation:

Initial treatment with drain placement alone for cerebellar hemorrhage is not recommended.

Guidelines favor initial aggressive care over withdrawal of care because of concerns that initial prognostic estimates by physicians are often overly pessimistic for patients with brain-stem herniation.

Reference:

Hemphill JC III, Greenberg SM, Anderson CS, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(7):2032-2060.

Target Audience

Med-Challenger Physician Assistant is intended for practitioners of acute and primary care or clinicians otherwise involved in the diagnosis and treatment of acute, emergent, or chronic medical problems.

Educational Objectives

The objective of the Challenger academic continuing medical education programs is to provide an interactive review of the knowledge base of acute care and primary care medicine as appropriate by medical specialty. After completing this course, the participating clinician should be better equipped to:

Confidently manage the broad spectrum of acute and chronic medical problems encountered in the practice of medicine.
Formulate appropriate differential diagnoses for patients presenting with acute medical problems of uncertain etiology.
Efficiently initiate therapeutic and diagnostic procedures for patients presenting with acute and chronic medical disorders.
Cope effectively with the uncertainty that is inherent in the initial treatment of acute and chronic disorders.
Handle efficiently the spectrum of common disorders involving all organ systems. In particular, the physician will be better equipped to diagnose and treat acute and chronic: cardiovascular disorders; diseases of the eye, ear, nose, throat, skin and soft tissues; endocrinologic disorders; traumatic and environmental injuries; gastrointestinal diseases; gynecologic and obstetric disorders; hematologic and oncologic problems; immunologic, allergic and rheumatologic diseases; infectious diseases; life-threatening signs and symptoms; musculoskeletal disorders; pulmonary diseases; and intoxications and poisonings.
Demonstrate mastery of the knowledge and cognitive skills required to achieve objectives 1-5 by scoring at least 80% on all topics studied for CME credit.

Faculty

Mark W. Perdue, PA-C
Clinical Assistant Professor
University of Oklahoma (Tulsa)
Tulsa, OK

Joint Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of National Association for Continuing Education and Challenger Corporation.

The National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

AMA Credit - The National Association for Continuing Education designates this enduring activity for a maximum of 215.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA Credit - Earn up to 20 AAPA-approved CME credits (annual requirements)

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About the NCCPA Certification Exam (PANCE)

What you need to know to prepare for the PANCE.

The content blueprint for PANCE is based on information provided from certified physician assistants who participate in profession-wide practice analysis studies. Certified PAs are involved throughout the exam development process, including: reviewing results of the practice analysis, writing questions that appear on PANCE, reviewing exams before they are administered, reviewing performance data for exam questions, and developing recommendations for the passing standard. Certified PAs work with NCCPA to continuously review the content included on PANCE to ensure it is relevant and current, as the practice of medicine changes and treatment guidelines are revised or new ones introduced.

If you graduate from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessors, you can take the Physician Assistant National Certifying Examination® (PANCE) for certification. The multiple-choice exam assesses basic medical and surgical knowledge. You will need to submit an application and payment in advance and can choose from over 200 testing sites.

You may schedule your exam anytime (depending on testing center availability) except during the end-of-year holiday window.
You can register 90 days prior to your expected program completion date.
You must submit an application and payment in advance to take PANCE.
You may only take PANCE once in any 90-day period or three times in a calendar year
You have 180 days from the beginning of your exam timeframe to take the exam.

PANCE Exam Blueprint

What's covered on the Physician Assistant National Certifying Examination?

NCCPA publishes a content blueprint of the material that will appear on the exam. The content blueprint provides guidance on the information assessed on the Physician Assistant National Certifying Exam (PANCE).

The PA certification examination is categorized in two dimensions:

Knowledge of the diseases and disorders physician assistants encounter; and
Knowledge and skills related to tasks physician assistants perform when treating patients.

This is how we determine which material appears in exam simulations.

MEDICAL CONTENT CATEGORIESPercent Allocation

Cardiovascular System13%
Dermatologic System5%
Endocrine System7%
Eyes, Ears, Nose, and Throat7%
Gastrointestinal System/Nutrition9%
Genitourinary System (Male and Female)5%
Hematologic System5%
Infectious Diseases6%
Musculoskeletal System8%
Neurologic System7%
Pulmonary System10%
Psychiatry/Behavioral Science6%
Renal System5%
Reproductive System (Male and Female)7%

TASK CATEGORIESPercent Allocation

History Taking and Performing Physical Examination17%
Using Diagnostic and Laboratory Studies12%
Formulating Most Likely Diagnosis18%
Health Maintenance, Patient , Education, and Preventive Measures10%
Clinical Intervention14%
Pharmaceutical Therapeuticsm14%
Applying Basic Scientific Concepts10%
Profesional Practice5%

What is the format of the PANCE Exam?

What's the NCCAP PANCE Exam format?

Our exams are administered in multiple blocks of test questions. You may answer the questions within a block in any order, and you may review and change responses within a block of questions during the time allotted for that section. However, after you exit a block of test questions, or after time expires for that block, you won't be allowed to review its questions or change your answers.

The five-hour PANCE exam includes 300 multiple-choice questions administered in five blocks of 60 questions with 60 minutes to complete each block. There is a total of 45 minutes allotted for breaks between blocks and you will be responsible for managing your break time. You will have 15 minutes to complete the PANCE tutorial.

PANCE exam sample questions...

NCCPA provides several sample questions on its site. You can also get more free PANCE board review questions when you subscribe to Med-Challenger's Medical Education Blog - or when you start a free trial of Med-Challenger PANCE/PANRE BOARD REVIEW.

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Passed the PANRE and plan on keeping this. It's a gold mine for PAs. Other reviews just don't do everything Med-Challenger does.
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Medical Education Blog

Our Medical Education Blog offers practice pearls, guideline news, and diagnostic challenges from our clinician authors.

Physician Assistant Learning Management System Helps PA Programs Educate Students and Physician Assistant Staff Improve Knowledge Quality More Effectively

November 23, 2021

Wound Management and Controversies of Dog Bites to the Face – Clinical Patient Case of the Week

November 22, 2021

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