Tips on Passing the PANCE and PANRE Exams-Board Vitals

PANCE / PANRE Free Sample Questions

The Physician Assistant National Certifying Exam (PANCE) and Physician Assistant National Recertifying Exam (PANRE) can be intimidating tests. The PANCE is composed of 300 multiple-choice questions completed over five hours, while the PANRE is four hours and composed of 240 multiple-choice questions.

It is important to understand the components of the test and the number of questions to expect from each topic. Be sure to study each topic, but focusing more time on heavier-weighted subjects will yield the best results.

The following is a breakdown of the percentage of exam content on each subject.

– Cardiovascular: 16%
– Pulmonary: 12%
– Gastrointestinal/Nutritional: 10%
– Musculoskeletal: 10%
– Ears/Eyes/Nose/Throat: 9%
– Reproductive: 8%
– Endocrine: 6%
– Genitourinary: 6%
– Neurologic System: 6%
– Psychiatry: 6%
– Dermatology: 5%
– Hematologic: 3%
– Infectious Diseases: 3%

Another way of breaking down the test is below.

– Formulating most likely diagnosis: 18%
– Pharmaceutical therapeutics: 18%
– History taking & physical exams: 16%
– Using laboratory & diagnostic studies: 14%
– Clinical intervention: 14%
– Health maintenance: 10%
– Applying basic science concepts: 10%

The key to doing well on the exam is simple- Practice Questions (and lots of them). Click here for 1400 of them. Whether you chose to do this on your own, through online or printed material, or through a review course is up to you. The format isn’t important, getting used to the style and content of the questions is what really matters.

The following are free sample PANCE questions that are similar to those seen on the tests. This is meant to introduce you to the different question types that I saw on my exam.

Sample Question #1

– A 32 y.o. female is 2 weeks postpartum from an uneventful pregnancy and delivery. She presents to the ED with a severe holocephalic headache, nausea, and vomiting. Examination shows bilateral papilledema but is otherwise unremarkable. Family history is relevant for DVT in her mother and recurrent miscarriages in her sister. Non-contrast CT head is normal. Which of the following tests would be ordered to further evaluate?

A. CT Head w/ Contrast
B. MR Venogram
C. Cerebral Angiogram
D. Trans-Cranial Doppler Ultrasound
E. Lumbar Puncture

– The answer is MR Venogram (B). This question expects you to not only associate given symptoms with a diagnosis, but takes it a step further and requires you to know the next best step to diagnose the problem.

Sample Question #2

– A 23 y.o. female presents to clinic complaining of intermittent throbbing headaches that last several hours and are made worse by light. She endorses occasional vomiting as well. Physical exam is unremarkable and there is no significant past medical history. Which of the following treatments is considered abortive therapy for this patient’s underlying condition?

A. Sumatriptan
B. Gabapentin
C. Amitriptyline
D. Propranolol
E. Diltiazem

– The answer is Sumatriptan (A). This question tests your ability to determine the patient’s underlying diagnosis, and then provide the correct pharmacologic treatment.

Sample Question #3

– A 74 y.o. male with a history of hypertension, type 2 diabetes and prior cigarette use presents for routine follow-up. His blood pressure and hemoglobin A1c are well controlled. His physical exam is unremarkable. Which of the following diagnostic screening tests is most appropriate?

A. Exercise Stress Test w/ EKG
B. Exercise Stress Test w/ Myocardial Perfusion Imaging
C. Abdominal Ultrasound
D. Ankle-Brachial Index
E. Carotid Duplex Ultrasound

– The answer is Abdominal Ultrasound (C). This is the basic format of a health maintenance question. It requires you to review pertinent history and physical examination findings, and then chose an appropriate screening test for the patient.

Sample Question #4

– A 30 y.o. female presents to clinic with chronic fatigue. Physical exam reveals pallor of the mucous membranes and concavity of the fingernails. Lab findings reveal the MCV and MCHC are below normal range; the findings also reveal a low serum Ferritin and an elevated TIBC. The deficient substance in this patient is typically absorbed at which of the following sites?

A. Colon
B. Distal Small Bowel
C. Esophagus
D. Stomach
E. Proximal Small Bowel

– The answer is Proximal Small Bowel (E). This question is a common way that basic anatomy is tested on the exam. A patient’s symptoms are presented, and the test taker is expected to be able to diagnose the disease and understand the anatomy that is associated with that problem.

The information and questions presented above are just a small review. Preparation for a test of this size and scope requires weeks and months of planning and studying. Use all available resources, including books, the internet, your peers, and review courses. The exam, while daunting, is just one more obstacle in the Physician Assistant career path, and one that many before you have overcome.

Good luck and happy studying! Click Here for over 1400 questions that cover all of the question types you’ll need to know for the real exam.