60 PANCE Practice Questions and
Ansers Updated 2026
34Ayear-oldAfemaleApatientApresentsAtoAtheAERAwithAsharpApleuritic-typeAchestApain.AAnAx-
rayArevealsApericarditis.AOnAmoreAcarefulAquestioning,AtheApatientAadmitsAtoAaApolyarticula
rAarthritisAinvolvingAtheAsmallAjointsAofAherAhands.AHerAobstetricalAhistoryAisApositiveAforA
twoAthirdAtrimesterAspontaneousAabortions.AAtAthisApoint,AyouAwouldAsuspectAwhichAautoim
muneAprocessAasAtheAcauseAofAherAsymptoms:
A
A.ARheumatoidAarthritis
B.ASystemicALupusAErythematosis
C.AWegener'sAgranulomatosis
D.ASjogren'sASyndrome
E.ASclerodermaA-AAnswerAAnswer:AB
40-
60%AofApatientsAwithASLEAhaveAserositisA(pleuritisAandApericarditis).AThat,AcombinedAwithAj
ointApains,AhabitualAABA-AshouldAcauseAyouAtoAorderAanAANA.
48Ayear-
oldAnurse,AwithAaAbodyAmassAindexAofA31,ApresentsAforAanAevaluationAforAbackApain.AShe
ArelatesAthatAhistorically,AsheAhadAaApositiveAPPDAtestAaAyearAagoAandAdidAnotAfollow-
upAasAdirected.ASheAhasArecentlyAbeenAexperiencingAnightAsweatsAandAcoughing.AAnAx-
rayAofAherAlumbarAspineArevealsAosteopeniaAandAcorticalAbreakdownAofAvertebralAbodiesAL4
AandAL5.AWhichAofAtheAfollowingAdiagnosisAisAmostAsuspect?
A
AAcompressionAfracturesAsecondaryAtoAobesity
BAdegenerativeAjointAdisease
CAPottsAdisease
DAcompressionAfracturesAsecondaryAtoAosteoporosis
EAspondylolisthesisA-AAnswerA*Answer:ACAPottsADisease*
Pott'sAdiseaseAisATBAofAtheAspine.ASheAcouldAhaveAanyAofAtheAotherAdiseases;AbutAtheAque
stionAstatesAthatAsheAhadAaApositiveAPPDAandAdidAnotAtakeAmeds...thatAisAtheAclueAthatAs
heAhasAactiveATBAinAtheAspine.
,AA14Amonth-
oldAfemaleAisAbroughtAtoAyourAofficeAwithAaA1AdayAhistoryAofAaAfeverAofA101AdegreesArec
tally.ASuddenly,Atoday,AtheAparentAnotedAsmallAredAspotsAthatAbecameAbumpsAandAareAno
wAblisters.ATheAmajorityAofAtheAlesionsAareAonAtheAthorax.AEachAvesicleAresidesAonAitsAow
nAerythematousAbase.
A.Ashingles.
B.ARamsey-HuntAsyndrome.
C.AerythemaAinfectiosum.
D.AherpesAsimplex,
E.AvaricellaA-AAnswerAAnswer:AE,Avaricella
ThisAisAaAtypicalApresentationAofAvaricellaA(chickenApox)
AA14Amonth-oldAfemaleAisAbroughtAtoAyourAofficeAwithAaA3-
dayAhistoryAofAaAfeverAofA104AdegreesArectally.ASuddenly,Atoday,AtheAfeverAstoppedAandAa
ArashAdeveloped.AExaminationArevealsAaAdiffuse,Afine,AmaculopapularArash.APresently,AtheAc
hildAdoesAnotAappearAill.ATheAmostAlikelyAdiagnosisAis:
A
A.ARubella
B.ARubeola
C.AerythemaAinfectiosumA(Fifth'sAdisease)
D.ARoseola
E.AChickenApoxA-AAnswerAAnswer:AD,ARoseola
ThisAisAtypicalAforARoseola.ARubellaAhasAmildAillnessAwithAaAfineAmacularArash.ARubeolaA(
measles)AisAanAacuteAillness,AtheAchildAisAtoxic,AhasAconjunctivitisAandAKoplikAspots.AFifth's
AdiseaseAhasAmildAillnessAwithAaA"lacey"ArashAonAtheAextremities.AChickenApoxAhasAvesicl
es.
AA14Ayear-
oldAisAexperiencingAaAsevereAasthmaAattack.AAlthoughAheAisAusingAaccessoryAmusclesAtoAbr
eath,AauscultationAofAhisAchestArevealsAnoAaudibleAwheezing.AHisAheartArateAisA160AandAhi
sArespiratoryArateAisA52.AWhichAofAtheAfollowingAarterialAbloodAgasesArepresentsAtheAworst
Aprognosis?
A
A.ApHA=A7.52;ApC02A=A28;Ap02A=A80
, B.ApHA=A7.44;ApC02A=A38;Ap02A=A70
C.ApHA=A7.60;ApC02A=A18;Ap02A=A60
D.ApH=A7.40;ApC02A=A40;Ap02A=A60
E.ApHA=A7.27;ApC02A-A62;Ap02A=A64A-AAnswerAAnswer:AE.ApHA=A7.27;ApC02A-
A62;Ap02A=A64
ThisApatientAhasAaARRAofA52.AIfAsheAisAventilating,AsheAisAblowingAofAC02A(anAacid)AandA
wouldAbeAalkaloticAandAshouldAhaveAaAlowAC02.AAApHAwhichAisAacidicAwithAaApC02Awhich
AisAelevatedAmeansAthatAsheAisAnoAlongerAventilatingAatAallA(sheAneedsAmechanicalAventila
tionAorAsheAwillAdie).
AA17Ayear-
oldAmaleAisAstabbedAinAtheAanteriorAchestAwithAanAiceApick.AHeAquicklyAbecomesAhypotensi
ve,AtachycardicAandAobtunded.AHisAbreathAsoundsAareAequal,AhisAneckAveinsAareAdistended,
AandAhisAchestAx-rayAisAnormal.AWhatAconditionAisAmostAlikely?
A.ASimpleApneumothorax
B.ATensionApneumothorax
C.APericardialATamponade
D.AaorticAlacerationAdistalAtoAtheAoriginAofAtheAleftAcommonAcarotidAartery
E.AinferiorAvenaAcavaAlacerationA-AAnswerAAnswer:AC,APericardialATamponade
ThisAisAtheAtypicalAclinicalApresentationAofAtamponadeA(hypotension,AJVD).AHeAwasAstabbed
AandAprobablyAhasAaAmediastinalAbleedA(so,AIAthinkAtheAmediastinumAwouldAbeAwidenedAo
nAhisAchestAfilmA—AbutAtheA"normalACXR"AisAwhatArulesAoutAtheApneumothoraxA-
AanotherAcommonAproblemAinAaAstabbingAinjury.
AA22Ayear-
oldAfemaleAcomplainsAofAvaginalAbleedingAforA24Ahours.AHerAlastAmenstrualAcycleAwasAsev
enAweeksAagoASheAhasAhadAanAIUD,AbutAcurrentlyAusesAnoAformAofAcontraception.AHerAHC
GAisApositive.ASheAdeniesAfever,AchillsAandAvaginalAdischarge,ApriorAtoAtheAonsetAofAtheAva
ginalAbleeding.AYouAorderAaApelvicAultrasoundAtoAruleAout:
A.Acervicitis.
B.ApelvicAinflammatoryAdisease.
C.AdysfunctionalAuterineAbleeding.
D.AanAectopicApregnancy.
Ansers Updated 2026
34Ayear-oldAfemaleApatientApresentsAtoAtheAERAwithAsharpApleuritic-typeAchestApain.AAnAx-
rayArevealsApericarditis.AOnAmoreAcarefulAquestioning,AtheApatientAadmitsAtoAaApolyarticula
rAarthritisAinvolvingAtheAsmallAjointsAofAherAhands.AHerAobstetricalAhistoryAisApositiveAforA
twoAthirdAtrimesterAspontaneousAabortions.AAtAthisApoint,AyouAwouldAsuspectAwhichAautoim
muneAprocessAasAtheAcauseAofAherAsymptoms:
A
A.ARheumatoidAarthritis
B.ASystemicALupusAErythematosis
C.AWegener'sAgranulomatosis
D.ASjogren'sASyndrome
E.ASclerodermaA-AAnswerAAnswer:AB
40-
60%AofApatientsAwithASLEAhaveAserositisA(pleuritisAandApericarditis).AThat,AcombinedAwithAj
ointApains,AhabitualAABA-AshouldAcauseAyouAtoAorderAanAANA.
48Ayear-
oldAnurse,AwithAaAbodyAmassAindexAofA31,ApresentsAforAanAevaluationAforAbackApain.AShe
ArelatesAthatAhistorically,AsheAhadAaApositiveAPPDAtestAaAyearAagoAandAdidAnotAfollow-
upAasAdirected.ASheAhasArecentlyAbeenAexperiencingAnightAsweatsAandAcoughing.AAnAx-
rayAofAherAlumbarAspineArevealsAosteopeniaAandAcorticalAbreakdownAofAvertebralAbodiesAL4
AandAL5.AWhichAofAtheAfollowingAdiagnosisAisAmostAsuspect?
A
AAcompressionAfracturesAsecondaryAtoAobesity
BAdegenerativeAjointAdisease
CAPottsAdisease
DAcompressionAfracturesAsecondaryAtoAosteoporosis
EAspondylolisthesisA-AAnswerA*Answer:ACAPottsADisease*
Pott'sAdiseaseAisATBAofAtheAspine.ASheAcouldAhaveAanyAofAtheAotherAdiseases;AbutAtheAque
stionAstatesAthatAsheAhadAaApositiveAPPDAandAdidAnotAtakeAmeds...thatAisAtheAclueAthatAs
heAhasAactiveATBAinAtheAspine.
,AA14Amonth-
oldAfemaleAisAbroughtAtoAyourAofficeAwithAaA1AdayAhistoryAofAaAfeverAofA101AdegreesArec
tally.ASuddenly,Atoday,AtheAparentAnotedAsmallAredAspotsAthatAbecameAbumpsAandAareAno
wAblisters.ATheAmajorityAofAtheAlesionsAareAonAtheAthorax.AEachAvesicleAresidesAonAitsAow
nAerythematousAbase.
A.Ashingles.
B.ARamsey-HuntAsyndrome.
C.AerythemaAinfectiosum.
D.AherpesAsimplex,
E.AvaricellaA-AAnswerAAnswer:AE,Avaricella
ThisAisAaAtypicalApresentationAofAvaricellaA(chickenApox)
AA14Amonth-oldAfemaleAisAbroughtAtoAyourAofficeAwithAaA3-
dayAhistoryAofAaAfeverAofA104AdegreesArectally.ASuddenly,Atoday,AtheAfeverAstoppedAandAa
ArashAdeveloped.AExaminationArevealsAaAdiffuse,Afine,AmaculopapularArash.APresently,AtheAc
hildAdoesAnotAappearAill.ATheAmostAlikelyAdiagnosisAis:
A
A.ARubella
B.ARubeola
C.AerythemaAinfectiosumA(Fifth'sAdisease)
D.ARoseola
E.AChickenApoxA-AAnswerAAnswer:AD,ARoseola
ThisAisAtypicalAforARoseola.ARubellaAhasAmildAillnessAwithAaAfineAmacularArash.ARubeolaA(
measles)AisAanAacuteAillness,AtheAchildAisAtoxic,AhasAconjunctivitisAandAKoplikAspots.AFifth's
AdiseaseAhasAmildAillnessAwithAaA"lacey"ArashAonAtheAextremities.AChickenApoxAhasAvesicl
es.
AA14Ayear-
oldAisAexperiencingAaAsevereAasthmaAattack.AAlthoughAheAisAusingAaccessoryAmusclesAtoAbr
eath,AauscultationAofAhisAchestArevealsAnoAaudibleAwheezing.AHisAheartArateAisA160AandAhi
sArespiratoryArateAisA52.AWhichAofAtheAfollowingAarterialAbloodAgasesArepresentsAtheAworst
Aprognosis?
A
A.ApHA=A7.52;ApC02A=A28;Ap02A=A80
, B.ApHA=A7.44;ApC02A=A38;Ap02A=A70
C.ApHA=A7.60;ApC02A=A18;Ap02A=A60
D.ApH=A7.40;ApC02A=A40;Ap02A=A60
E.ApHA=A7.27;ApC02A-A62;Ap02A=A64A-AAnswerAAnswer:AE.ApHA=A7.27;ApC02A-
A62;Ap02A=A64
ThisApatientAhasAaARRAofA52.AIfAsheAisAventilating,AsheAisAblowingAofAC02A(anAacid)AandA
wouldAbeAalkaloticAandAshouldAhaveAaAlowAC02.AAApHAwhichAisAacidicAwithAaApC02Awhich
AisAelevatedAmeansAthatAsheAisAnoAlongerAventilatingAatAallA(sheAneedsAmechanicalAventila
tionAorAsheAwillAdie).
AA17Ayear-
oldAmaleAisAstabbedAinAtheAanteriorAchestAwithAanAiceApick.AHeAquicklyAbecomesAhypotensi
ve,AtachycardicAandAobtunded.AHisAbreathAsoundsAareAequal,AhisAneckAveinsAareAdistended,
AandAhisAchestAx-rayAisAnormal.AWhatAconditionAisAmostAlikely?
A.ASimpleApneumothorax
B.ATensionApneumothorax
C.APericardialATamponade
D.AaorticAlacerationAdistalAtoAtheAoriginAofAtheAleftAcommonAcarotidAartery
E.AinferiorAvenaAcavaAlacerationA-AAnswerAAnswer:AC,APericardialATamponade
ThisAisAtheAtypicalAclinicalApresentationAofAtamponadeA(hypotension,AJVD).AHeAwasAstabbed
AandAprobablyAhasAaAmediastinalAbleedA(so,AIAthinkAtheAmediastinumAwouldAbeAwidenedAo
nAhisAchestAfilmA—AbutAtheA"normalACXR"AisAwhatArulesAoutAtheApneumothoraxA-
AanotherAcommonAproblemAinAaAstabbingAinjury.
AA22Ayear-
oldAfemaleAcomplainsAofAvaginalAbleedingAforA24Ahours.AHerAlastAmenstrualAcycleAwasAsev
enAweeksAagoASheAhasAhadAanAIUD,AbutAcurrentlyAusesAnoAformAofAcontraception.AHerAHC
GAisApositive.ASheAdeniesAfever,AchillsAandAvaginalAdischarge,ApriorAtoAtheAonsetAofAtheAva
ginalAbleeding.AYouAorderAaApelvicAultrasoundAtoAruleAout:
A.Acervicitis.
B.ApelvicAinflammatoryAdisease.
C.AdysfunctionalAuterineAbleeding.
D.AanAectopicApregnancy.
