NCCPA Physician Assistant National Recertifying Examination Practice Test
PANRE practice focuses on clinical decision-making across adult and pediatric medicine, including cardiovascular emergencies, endocrine and neurologic disorders, respiratory illness, pregnancy complications, and common infections. The question bank samples patient assessment, interpretation of diagnostic findings, recognition of urgent conditions, and selection of initial treatment in varied clinical presentations.
Exam overview
About the NCCPA Physician Assistant National Recertifying Examination Exam
Clinical reasoning involves connecting symptoms, examination findings, and test results to a likely diagnosis and an appropriate next step. Scenarios may call for recognizing inferior-wall ST elevation, assessing diabetic foot infection, identifying eclampsia, or responding to acute limb ischemia and a suspected ruptured abdominal aortic aneurysm. Other questions test distinguishing asthma by reversible airflow obstruction, selecting therapy for uncomplicated cystitis, recognizing croup, and interpreting findings that suggest achalasia. Medication decisions require attention to the clinical context—for example, seizure prevention in eclampsia or treatment of Parkinson motor symptoms. Strong performance depends on prioritizing stabilization when a presentation is immediately dangerous, choosing suitable initial tests, and distinguishing a first-line intervention from later evaluation or management.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A 58-year-old with crushing chest pain has ST-segment elevation in leads II, III, and aVF. Which coronary artery is most commonly responsible for this pattern?
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Correct answer: BInferior-wall ST-segment elevation is most commonly caused by occlusion of the right coronary artery, although a left circumflex occlusion can also produce this pattern depending on coronary dominance.
A patient with type 2 diabetes presents with a painful, warm, swollen foot and fever. Which initial imaging study is generally most appropriate to assess for gas or bony changes?
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Correct answer: APlain radiographs are a useful initial study for diabetic foot infection because they can show soft-tissue gas, foreign bodies, and established bony destruction. A normal early radiograph does not exclude osteomyelitis; MRI is more sensitive when suspicion remains.
A 32-year-old at 34 weeks of pregnancy has a generalized tonic-clonic seizure. Her blood pressure is 170/112 mm Hg, and urine testing shows proteinuria. Which medication should be given to prevent recurrent seizures?
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Correct answer: AEclampsia is a seizure occurring in the setting of preeclampsia. Magnesium sulfate is the preferred medication to prevent recurrent eclamptic seizures; maternal stabilization and management of severe hypertension and delivery planning are also urgent priorities.
A 76-year-old with atrial fibrillation who is not taking anticoagulation develops abrupt pain and pallor in one leg. The foot is cool, and distal pulses are absent. What is the most appropriate immediate treatment while urgent vascular evaluation is arranged?
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Correct answer: AAcute limb ischemia requires urgent vascular assessment. Unless contraindicated, intravenous unfractionated heparin is started promptly to limit thrombus propagation while definitive management is planned.
A 63-year-old with Parkinson disease has resting tremor, bradykinesia, and rigidity. Which medication is commonly used to improve these motor symptoms?
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Correct answer: ALevodopa is converted to dopamine in the brain and improves Parkinson motor symptoms. Carbidopa reduces peripheral conversion of levodopa, allowing more of it to reach the central nervous system and reducing some peripheral adverse effects.
A 3-year-old has a barking cough, hoarseness, and inspiratory stridor that worsens at night. Which pathogen most commonly causes this illness?
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Correct answer: BParainfluenza viruses are the most common cause of croup, which presents with a barking cough, hoarseness, and inspiratory stridor due to upper-airway inflammation.
A 28-year-old presents with episodic wheezing, cough, and chest tightness. Spirometry shows airflow obstruction that improves substantially after inhaled bronchodilator administration. Which finding best supports asthma?
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Correct answer: BAsthma is characterized by variable respiratory symptoms and variable expiratory airflow limitation. Significant improvement in airflow after bronchodilator use supports reversible obstruction.
How to use this practice test
Access is free. The PANRE practice bank contains 50 published questions; each session presents up to 20 random questions. Complete a session to see your results, then use missed or uncertain items to identify clinical concepts and decision steps for focused review.
Preparation tips
- For acute presentations, state the immediate threat and first action before considering definitive testing or long-term treatment; practice with shock, acute coronary syndromes, and limb ischemia.
- Review ECG localization by leads and connect inferior ST elevation with the relevant coronary anatomy and associated clinical risks.
- Contrast common respiratory and urinary presentations using their distinguishing findings, such as bronchodilator reversibility in asthma and uncomplicated cystitis without systemic or flank symptoms.
- Rehearse obstetric emergency management by linking severe hypertension, proteinuria, and seizure to eclampsia and seizure-prevention treatment.
- For imaging and diagnostic questions, identify what the test is intended to detect; distinguish plain-film assessment for gas or bony change from evaluation of esophageal motility disorders.