Deck 1: The Physician Assistant National Recertifying Exam (PANRE)

Question 1

A woman with arthritis has Heberden's nodes. Which of the following statements is the most accurate statement about this deformity?

A)Herberden's nodes occur in rheumatoid arthritis
B)Heberden's nodes are located on the distal interphalangeal joints
C)Heberden's nodes are located on the proximal interphalangeal joints
D)Heberden's nodes are associated with ulnar deviation of the wrists

Answer 1

Heberden's nodes are located on the distal interphalangeal joints

Question 2

A patient suspected of osteomyelitis is ordered to have an X-ray of the affected leg to verify the diagnosis. Which of the following is/are the earliest findings of osteomyelitis on an X-ray?

A)Fracture
B)Periosteal elevation
C)Punched-out lesions
D)Sequestrum

Answer 2

Periosteal elevation

Question 3

On assessment, a man diagnosed with gout has urate crystal deposits in the forearms, ears, hands, knees, feet, and Achilles tendon. Which of the following mechanisms is believed to cause gout?

A)A defect in purine metabolism causing the underproduction of uric acid
B)Overproduction of calcium
C)Overproduction of uric acid
D)Increased elimination of uric acid

Answer 3

Overproduction of uric acid

Question 4

A patient sustained Brown-Sequard's syndrome. Laboratory and diagnostic findings reveal that the lesion is located on the left side of the spinal cord. The following functions and sensations are intact in the left side of the body except:

A)Sensations of pain
B)Temperature
C)Proprioception
D)Light touch

Question 5

Spinal cord injury involving the C4 results in the following signs and symptoms except:

A)Complete paralysis of the legs and arms
B)Breathing is possible without a ventilator
C)Finger, wrist, or elbow flexion and extension are possible
D)Shoulder movement is limited

Question 6

A woman presents with paralysis of one side of the face. The patient is diagnosed with Bell's palsy. A lesion in which cranial nerve results in Bell's palsy?

A)Cranial nerve V
B)Cranial nerve VII
C)Cranial nerve X
D)Cranial nerve XI

Question 7

A 12-year-old is scheduled to receive a series of the hepatitis vaccine, but a history of which of the following is a contraindication to hepatitis B vaccine?

A)Pregnancy
B)Anaphylactic reaction to baker's yeast
C)Hypersensitivity to eggs
D)Anaphylactic reaction neomycin

Question 8

The CSF analysis report of a 30-year-old man with meningitis reveals the following findings:
CSF opening pressure = 100 mm H2O
WBC count = 80 per mm3
Cell differential = Predominance of lymphocytes
Protein = 75 mg/dL
CSF-to-serum glucose ratio: = normal to significantly decreased
Which type of meningitis is the most consistent with the results of the CSF analysis?

A)Bacterial meningitis
B)Viral meningitis
C)Fungal meningitis
D)Tubercular meningitis

Question 9

A 34-year-old patient presents with repeated episodes of short-lived memory loss. The patient reports frequent episodes where he wakes up in a different place with no memory of traveling there. The episode is known as:

A)Fugue state
B)Anterograde amnesia
C)Retrograde amnesia
D)Selective amnesia

Question 10

When the pressure within the muscle compartment increases, the following symptoms are expected except:

A)Decreased venous pressure
B)Increased peripheral resistance
C)Decreased arterial circulation
D)Decreased venous circulation

Question 11

A 25-year-old man comes to the office and complains of fever, sore throat, and malaise. Further examination revealed lymphadenopathy and hepatosplenomegay. The patient is diagnosed with infectious mononucleosis. What is the causative agent of this infection?

A)Enteroviruses
B)Paramyxovirus
C)Epstein-Barr
D)Cytomegalovirus

Question 12

The following actions demonstrate the appropriate ways of taking anti-asthma medications except:

A)Zafirlukast is used for maintenance therapy in adults and children over 12 years with asthma.
B)Cromolyn sodium is administered by a metered-dose inhaler to prevent bronchoconstriction in response to cold air and prevent asthma attacks.
C)Beclomethasone is inhaled after albuterol during prophylaxis.
D)Theophylline is used to prevent nocturnal asthma in adults.

Question 13

A bother brings in a 18-month-old child with low-grade fever, rhinorrhea, and wheezing on auscultation. The child is diagnosed to have respiratory syncytial virus, or RSV. which type of precautionary measures should you maintain?

A)Airborne precautions
B)Droplet precautions
C)Standard precautions
D)Contact precautions

Question 14

A 38-year-old man who sustained a lung contusion 24 hours ago presents with dyspnea, tachypnea, and anxiety. Progressive respiratory distress develops, though oxygen has been administered. Based on these findings, it is most likely that the patient is diagnosed with:

A)Atelectasis
B)Bronchiectasis
C)Acute respiratory distress syndrome
D)Respiratory failure

Question 15

A male patient demonstrates difficulty getting up from a seated position without using his arms. Muscle pain and proximal muscle weakness are reported by the patient, as well. No rashes are observed. Testing reveals elevated CPK and aldose with abnormal electromyogram. The patient is mostly likely diagnosed with:

A)Dermatomyositis
B)Polymyositis
C)Crest syndrome
D)Eosinophilic fasciitis

Question 16

A female patient visits the office to receive a rubella vaccine. Before giving the vaccine, the nurse would instruct the patient to:

A)Use contraceptives for the next 3 months
B)Come back to the center 72 hours later to monitor the injection site
C)Avoid eggs
D)Monitor for signs of encephalopathy

Question 17

The total lung capacity is the total volume of the lungs. The total volume of the lungs depend on the following values:

A)Tidal volume, inspiratory reserve volume, residual volume
B)Tidal volume, expiratory reserve volume, residual volume
C)Tidal volume, inspiratory capacity, expiratory reserve volume, residual volume
D)Vital capacity, residual volume

Question 18

Which of the following is closely associated with rape victims?

A)Depersonalization
B)Sublimation
C)Projection
D)Depression

Question 19

A 19-year-old comes to the office to be screened for tuberculosis. The patient works in a long-term care facility. She says that she lives with a friend who was diagnosed with tuberculosis 2 months ago and is currently on treatment. The PPD test is administered and the patient returns 48 hours after the test to have the result read. The site of the test is reddened and raised about 7 mm. This PPD would be read as having which of the following results?

A)Negative
B)Positive
C)Indeterminate
D)Needs to be redone

Question 20

A newly admitted patient presents with altered behavior and changes in mood. Upon closer inspection, the patient also has muscle rigidity which progressed to choreiform movements. What is the best diagnosis for this?

A)Huntington's disease
B)Syndenham's chorea
C)Parkinson's disease
D)Dyskinetic syndrome

Question 21

An HIV-positive woman is 8 weeks pregnant. To prevent maternal-fetal HIV transmission, zidovudine (AZT) is administered. Which of the following shows the appropriate way and schedule of administrating this medication to pregnant women?

A)The mother is administered with zidovudine orally beginning at 8 weeks gestation until 6 months after the delivery. The neonate should take the medication for 6 months.
B)The mother is administered with zidovudine orally beginning at 14 weeks gestation and intravenously during labor. The neonate should take the medication after birth for 6 weeks and in its syrup form.
C)The mother is administered with zidovudine orally beginning at 14 weeks gestation and intravenously during labor. The neonate should take the medication beginning at 6 weeks of life until their second birthday.
D)The mother is administered with zidovudine orally beginning at 28 weeks gestation. The child and the mother take the zidovudine syrup after birth.

Question 22

The woman gave birth 3 days ago. Which type of lochia is expected during the assessment of the postpartum mother?

A)Lochia rubra
B)Lochia serosa
C)Lochia rubra.
D)Thick, cottage-cheeselike

Question 23

On assessment, a patient who sustained a head injury is not able to obey simple responses consistently, but is able to localize painful stimuli. The patient engaged in confused conversation. Eye-opening is not spontaneous, but response to sound is evident. The patient's score on the Glasgow Coma Scale is ________ .

A)13
B)12
C)10
D)9

Question 24

A woman presents with a firm, round and painless sore in the vagina. The lesion appeared 2 weeks before the consult. The most likely diagnosis is:

A)Herpes
B)Syphillis
C)Gonorrhea
D)Neisseria

Question 25

A child diagnosed with acute epiglottiditis is prescribed with ampicillin. Which of the following side effects is expected with ampicillin therapy?

A)Erythematous rash
B)Epigastric pain
C)Diarrhea
D)Fever

Question 26

To determine the fetal lung maturity, which of the following tests is performed?

A)Alpha-fetoprotein screening
B)Chorionic villus sampling
C)Amniocentesis
D)Fern test

Question 27

A pregnant woman is scheduled for contraction stress test. The result revealed a negative contraction stress test. Which of the following statements best describes the results of the test?

A)Good heart rate variability with no late or variable decelerations from uterine contractions
B)Fetal heart rate tracing is not sufficient for adequate interpretation
C)There were fetal heart rate decelerations, but with less than 50% of the contractions
D)Late or variable fetal heart rate decelerations with 50% or more of the contractions in the absence of uterine hyperstimulation

Question 28

Children become burned by accident all the time. What is the most common type of burn?

A)Chemical
B)Direct fire
C)Scalding
D)Electrical

Question 29

The nurse is assessing the visual acuity of a client using the Snellen chart. The examination reveals that the client has a visual acuity of 20/120. The client asks the nurse what it means. Which of the following responses by the nurse is the most accurate?

A)"You are legally blind."
B)"You have perfect vision."
C)"What you can read at 20 feet what can be read at 120 feet by an eye with perfect vision"
D)"What you can read at 120 feet what can read what a healthy eye can read at 20 feet."

Question 30

A patient is prescribed with levothyroxine sodium (Synthroid). On assessment, the patient demonstrates intolerance to cold, bradycardia, weakness, and dry skin and hair. The patient gained weight since the last assessment. Based on these findings, which of the following prescriptions is ordered?

A)Decrease the dose of levothyroxine
B)Increase the dose of levothyroxine
C)Maintain the dose of levothyroxine
D)Change the medication

Question 31

An 8-year-old boy is brought by the mother to the office because she suspects that her child has a problem with hearing. On examination, the child says that ringing and roaring type of constant tinnitus fill both of his ears. The boy also reported hearing loud sounds when chewing. Pinkish discoloration of the tympanic membrane is also noted. Rinne test is negative. The child is most likely diagnosed with:

A)Otosclerosis
B)Mastoiditis
C)Presbycusis
D)Labyrinthitis

Question 32

A 12-year-old girl is scheduled for a series of diagnostic exams for the ear. On the Weber test, the girl says that she can hear the sound longer in the left ear than in the right ear. Based on the given information, which of the following interpretations is true?

A)The results of the patient's Weber test are normal.
B)The term lateralization is applied to the right ear.
C)The patient has a conductive hearing loss in the right or she can have sensorineural hearing loss in the other ear.
D)The patient has a conductive hearing loss in the left ear or she can have a sensorineural hearing loss n the other ear.

Question 33

When the cardiac output decreases, the body compensates by which of the following mechanisms?

A)The Frank-Starling mechanism decreases the preload to sustain cardiac performance
B)Myocardial atrophy
C)Epinephrine and norepinephrine cause vasoconstriction
D)Activation of the RAAS to retain water and excrete sodium

Question 34

A patient presents signs of flushing and pulsating of the nail beds (Quincke pulse). He was also noted to have a bounding radial pulse. These typical findings are related to which of the following cardiovascular disorders?

A)Tricuspid regurgitation
B)Coarctation of the aorta
C)Thoracic aortic aneurysm
D)Aortic regurgitation

Question 35

The following manifestations are usually observed in patients with endocarditis except:

A)Small, whitish spots seen on the retina
B)Small, non-tender, purplish-red, macular lesions on the palms of the hands and soles of the feet
C)Purplish-red hemorrhagic spots on the trunk, conjunctiva, and mucus membranes
D)Transitory pink, non-pruritic, macular lesions on trunk or inner aspect of upper arms or thighs

Question 36

When assessing a child with tetralogy of Fallot, which of the following assessment findings is expected?

A)Poor growth and development
B)Higher increase in blood pressures in the upper extremities than with the lower extremities
C)Clubbing of fingers and toes
D)Machine-like murmur

Question 37

The patient sustained second-degree burns on the lower left leg. On assessment, the burned area consists of large blisters with mottled base and broken skin. A wet, shiny, and weeping surface is observed. What is the burn depth of this patient?

A)Deep full-thickness
B)Full-thickness
C)Partial-thickness superficial burn
D)Superficial thickness burn

Question 38

Pulmonary complications are associated with burns of which of the following body parts?

A)Head, chest
B)Head, neck, and chest
C)Neck and chest
D)Head, neck

Question 39

All of the following are ECG findings of premature atrial contractions, except:

A)P waves may be present
B)The QRS is usually narrow
C)Extra P waves may be hidden within the QRS complex or T waves
D)P waves are invariably absent

Question 40

A patient sustained full-thickness burns on the upper left arm. Which of the following best describes the extent of full-thickness burns?

A)Burn involves the muscle and bone. Pain is absent.
B)Large blisters are evident, with wet, shiny, and weeping surfaces.
C)The burned area is deep red, black, white, yellow, or brown.
D)Mild to severe erythema, from pink to red, without blisters.

Question 41

A patient diagnosed with a peptic ulcer is prescribed with sucralfate. Which of the following instructions should be given to the patient to ensure that the medication is taken appropriately?

A)Sucralfate is taken with meals
B)Sucralfate should be administered together with an antacid
C)Sucralfate should be administered two hours apart from warfarin sodium
D)Sucralfate can cause diarrhea; increased fiber intake is recommended

Question 42

You are assessing a 32-year-old male client. On scrotal examination, the you palpate a smooth nodule. Which of the following should you do?

A)Document the findings as normal
B)Call in the physician
C)Darken the room and transilluminate the scrotum
D)Assist the client to Sim's position

Question 43

A patient with a history of alcoholism has been diagnosed with liver cirrhosis. Which of the following laboratory test helps in the diagnosis of this condition?

A)Shortened prothrombin time
B)Decreased alkaline phosphatase levels
C)Increased lipase levels
D)Increased bilirubin levels

Question 44

Which of the following statements accurately describes anemia?

A)Anemia is an abnormally low level of circulating red blood cells.
B)Anemia is an abnormally low hemoglobin concentration.
C)Anemia does not result from blood loss.
D)A and B.

Question 45

A patient is taken in the emergency vehicle due to a vehicular accident. He is in the early stage of shock. Which of the following characteristic is not true about early stages of shock?

A)It is considered compensated
B)The body is maintaining perfusion to vital organs
C)Increased total peripheral resistance
D)Metabolic acidosis

Question 46

A patient with gastroesophageal reflux disease is prescribed with magnesium hydroxide. Which of the following is the most common side effect of this antacid?

A)Diarrhea
B)Constipation
C)Abdominal pain
D)Nausea

Question 47

A female patient with a peptic ulcer is scheduled for vagotomy. The purpose of this surgical procedure is to:

A)Enhance gastric emptying
B)Remove the ulcer and a portion of cells that produce hydrochloric acid
C)Avoid or prevent stimulation for hydrochloric acid secretion
D)Decrease pyloric obstruction

Question 48

A patient presents with signs of fluid overload, changes in level of consciousness, hypertension, weight gain, and tachycardia. Which of the following is the most likely diagnosis of these symptoms?

A)Diabetes insipidus
B)Syndrome of inappropriate antidiuretic hormone
C)Addison's disease
D)Cushing's disease

Question 49

A patient was diagnosed with Diabetes Mellitus 7 years ago. The patient correctly states which of the following is not a complication of his disease?

A)Atherosclerosis
B)Neuropathy
C)Glaucoma
D)Hypotension

Question 50

A patient comes to the office presenting with paroxysmal or sustained hypertension, severe headaches, palpitations, flushing, heat intolerance, and hyperglycemia. Further laboratory results reveal that the patient's levels of epinephrine and norepinephrine are excessive. Based on these findings, the patient is most likely diagnosed with:

A)Hypothyroidism
B)Hyperthyroidism
C)Pheochromocytoma
D)Addison's disease

Question 51

Which of the following laboratory findings support the diagnosis of hypoparathyroidism?

A)Serum calcium = 10.0 mg/dL; Serum potassium = 5.5 mg/dL
B)Serum calcium = 8.7 mg/dL; Serum potassium = 3.0 mg/dL
C)Serum calcium = 11.0 mg/dL; Serum phosphorus =2.0 mg/dL
D)Serum calcium = 7.5 mg/dL; Serum phosphorus = 5.5 mg/dL

Question 52

Which of the following is not a typical sign and symptom of renal cell carcinoma?

A)Abdominal mass
B)Hematuria
C)Flank pain
D)Oliguria

Question 53

A patient is scheduled to undergo needle biopsy of the kidney. Which of the following is an important consideration before letting the patient undergo this procedure?

A)Adequate fasting for at least 8 hours prior to procedure
B)Establish an IV line for hydration
C)Monitoring vital signs
D)Ensure that coagulation studies have been carried out

Question 54

The clinical feature of interstitial cystitis includes all of the following, except:

A)Continuous bladder pain
B)Nocturia
C)Frequent urinary urgency
D)Bacterial infection