NCCPA Physician Assistant National Certifying Examination Practice Test
PANCE practice questions cover clinical reasoning across common patient presentations, including infectious disease, renal and cardiovascular conditions, neurologic emergencies, pregnancy complications, and pediatric respiratory illness. The practice bank uses case-based prompts that ask you to identify likely diagnoses, interpret clinical findings, choose diagnostic tests, and recognize appropriate medication classes or immediate interventions.
Exam overview
About the NCCPA Physician Assistant National Certifying Examination Exam
Clinical decisions in these cases depend on connecting symptoms, examination findings, and test results to the underlying disease process. You may need to distinguish cellulitis from a drainable abscess, recognize postinfectious glomerular injury from urine and complement findings, or identify a painless chancre as a sign of primary syphilis. Other questions test urgent evaluation, such as selecting noncontrast head CT when acute focal deficits raise concern for intracranial hemorrhage. Medication-focused scenarios involve matching treatment to risk and presentation, including magnesium sulfate for seizure prevention in severe preeclampsia and renin-angiotensin system blockade for albuminuric kidney disease. Imaging choices also matter: ultrasound is commonly used first for suspected gallstones or lower-extremity DVT. Pediatric cases require recognizing characteristic airway findings and assessing severity.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A 33-year-old patient presents with a painful, swollen, erythematous area around a recent skin wound. The patient is febrile, and the redness is spreading, but there is no fluctuance or drainage. Which type of infection is most likely?
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Correct answer: ACellulitis is a diffuse infection of the dermis and subcutaneous tissue, typically producing spreading erythema, warmth, swelling, and tenderness without a discrete collection of pus. A fluctuant collection would instead suggest an abscess.
A 9-year-old child has periorbital puffiness and dark urine two weeks after a sore throat. Blood pressure is elevated, urinalysis shows red blood cell casts, and serum complement C3 is low. Which process most likely explains the kidney findings?
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Correct answer: AThe latency after streptococcal pharyngitis, hematuria with red blood cell casts, edema, hypertension, and low C3 are characteristic of poststreptococcal glomerulonephritis. Immune complexes activate complement and cause glomerular inflammation.
A 58-year-old patient with hypertension and type 2 diabetes has a urine albumin-to-creatinine ratio of 420 mg/g on repeat testing. Which medication class can help slow progression of albuminuric chronic kidney disease?
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Correct answer: AAn ACE inhibitor, or an angiotensin receptor blocker when appropriate, can reduce intraglomerular pressure and albuminuria and slow kidney disease progression in patients with hypertension and albuminuric chronic kidney disease. Kidney function and potassium should be monitored after initiation or dose adjustment.
A 32-year-old patient has a painless genital ulcer with a clean base and firm, nontender regional lymph nodes. Which infection is the most likely cause?
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Correct answer: APrimary syphilis typically causes a painless, indurated chancre with nontender regional lymphadenopathy. Herpes lesions are often painful and vesicular, while chancroid classically causes painful ulcers.
A 72-year-old patient develops sudden right-sided weakness and difficulty speaking 45 minutes ago. Point-of-care glucose is normal. Which initial imaging study is most appropriate to assess for intracranial hemorrhage?
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Correct answer: AUrgent noncontrast head CT is a standard initial study in suspected acute stroke because it can rapidly identify intracranial hemorrhage, which changes immediate treatment decisions.
A 43-year-old patient develops facial swelling, lip enlargement, and difficulty breathing shortly after taking a new medication. There is no urticaria. Which medication class is a common cause of this presentation?
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Correct answer: AACE inhibitors can cause bradykinin-mediated angioedema, which may occur even after prolonged use and often lacks urticaria. Airway assessment and emergency management are priorities when breathing or swallowing is affected; the suspected ACE inhibitor should be discontinued.
A 26-year-old patient at 30 weeks of pregnancy has a blood pressure of 168/112 mm Hg on repeat measurement and reports a severe persistent headache. Which medication is used to reduce the risk of eclamptic seizures in this setting?
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Correct answer: ASevere preeclampsia carries a risk of progression to eclampsia. Magnesium sulfate is used for seizure prophylaxis, alongside urgent assessment and management of severe hypertension and pregnancy.
How to use this practice test
Access is free. The page provides 50 published practice questions, with each session drawing up to 20 random questions from the bank. Complete a session to see your results, then use missed or uncertain items to identify which clinical patterns, diagnostic choices, or treatment decisions need more review.
Preparation tips
- For each case, separate the key discriminating findings from background details; compare fever, fluctuance, urine casts, complement levels, and symptom timing with the likely diagnosis.
- Practice choosing the next diagnostic step by matching the clinical question to the test, such as noncontrast head CT for suspected hemorrhage or ultrasound for suspected gallstones and DVT.
- Review high-risk treatment decisions, including seizure prophylaxis in severe preeclampsia and medication classes that reduce progression of albuminuric chronic kidney disease.
- For pediatric respiratory cases, distinguish croup from more dangerous upper-airway presentations using cough quality, stridor, drooling, and overall appearance.
- After each session, explain why the best answer fits and why the closest alternative does not, focusing on clinical findings rather than memorized labels.