Free Physician Assistant National Certifying Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Physician Assistant National Certifying Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1At a clinic visit, an adult's properly measured blood pressure is 134/76 mm Hg. Which blood pressure category describes this reading?

   1. A. Normal blood pressure
   2. B. Elevated blood pressure
   3. C. Stage 1 high blood pressure
   4. D. Stage 2 high blood pressure

   Answer: C

   Explanation: NHLBI classifies stage 1 as "130 to 139 systolic pressure OR 80 to 89 diastolic pressure." The systolic value of 134 meets that category even though the diastolic value is below 80; a single reading does not by itself establish a diagnosis.

   Reference: High Blood Pressure - Diagnosis | NHLBI, NIH — Blood Pressure Levels table, High Blood Pressure Stage 1 row

2. 2A patient in the first trimester of pregnancy needs an antithyroid medicine for hyperthyroidism. Which medicine is often used during this period because of the fetal concern with methimazole?

   1. A. Levothyroxine
   2. B. Propylthiouracil
   3. C. Methimazole
   4. D. Propranolol

   Answer: B

   Explanation: NIDDK states, "Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus." Propylthiouracil is the antithyroid choice described for the first three months.

   Reference: Hyperthyroidism (Overactive Thyroid) | NIDDK — How do doctors treat hyperthyroidism?, Antithyroid medicines

3. 3A patient with uncomplicated viral conjunctivitis asks for antibiotic eye drops to speed recovery. Which counseling point best fits the expected course?

   1. A. Antibiotic drops routinely shorten viral conjunctivitis
   2. B. Artificial tears may relieve symptoms while it resolves
   3. C. Steroid drops routinely clear the underlying virus
   4. D. Antifungal drops prevent delayed viral complications

   Answer: B

   Explanation: NEI states, "Viral pink eye, the most common type, usually gets better in 1 to 2 weeks without medicine. Sometimes, it can take 3 weeks or more to heal. Remember, antibiotics don’t help viral pink eye." It also advises, "To help your eyes feel less dry, you can use a type of over-the-counter eye drops called artificial tears." Thus supportive artificial tears can relieve discomfort while the viral condition resolves.

   Reference: Treatment for Pink Eye | National Eye Institute — How long will it take for my pink eye to heal?

4. 4A patient leaks urine only when coughing or jogging, without a preceding urge to void. Which type of urinary incontinence best fits this pattern?

   1. A. Overflow incontinence
   2. B. Urgency incontinence
   3. C. Stress incontinence
   4. D. Reflex incontinence

   Answer: C

   Explanation: NIDDK defines the pattern: "Stress incontinence occurs when movement—coughing, sneezing, laughing, or physical activity—puts pressure on the bladder and causes urine to leak." The patient's cough- and exercise-related leakage matches stress incontinence.

   Reference: Definition & Facts for Bladder Control Problems | NIDDK — What are the types of bladder control problems?; Stress incontinence

5. 5A stable adult has laboratory-confirmed iron-deficiency anemia without ongoing major bleeding. Which treatment most directly replenishes iron stores?

   1. A. Oral iron supplementation
   2. B. Oral folate supplementation
   3. C. Vitamin B12 injections
   4. D. Red blood cell transfusion

   Answer: A

   Explanation: NHLBI states, "Iron supplements, also called iron pills or oral iron, help increase the iron in your body. This is the most common treatment for iron-deficiency anemia." Oral iron directly replaces the missing nutrient in this stable patient.

   Reference: Iron-Deficiency Anemia | NHLBI — How is iron-deficiency anemia treated?

6. 6A patient with knee osteoarthritis wants to increase muscle strength and endurance while reducing stiffness. Which nonpharmacologic intervention directly targets all three goals?

   1. A. Low-impact exercise training
   2. B. Weight-loss dietary counseling
   3. C. Use of a knee support brace
   4. D. Use of a walking aid

   Answer: A

   Explanation: NIAMS states, "Exercising, which can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance." Weight management, braces, and walking aids can be legitimate OA interventions, but they do not directly train both strength and endurance as exercise does.

   Reference: Osteoarthritis: Diagnosis, Treatment, and Steps to Take | NIAMS — Treatment of Osteoarthritis; initial measures

7. 7A patient arrives with sudden aphasia and right-sided weakness. Before a thrombolytic decision, which initial brain imaging procedure is most widely used to exclude intracranial bleeding?

   1. A. Diffusion-weighted brain MRI
   2. B. Noncontrast head CT
   3. C. CT perfusion imaging
   4. D. Catheter cerebral angiography

   Answer: B

   Explanation: NINDS states, "A plain CT of the head and brain is the most widely used imaging procedure to rule out bleeding." Excluding hemorrhage with the initial noncontrast CT informs the thrombolytic decision.

   Reference: Assess and Treat Stroke | NINDS — CT (Computed tomography), lines 164-171

8. 8A patient with asthma develops episodic wheeze and chest tightness and needs a rapid inhaled reliever for acute bronchoconstriction. Which drug class directly opens the airways?

   1. A. Inhaled short-acting beta2 agonist
   2. B. Inhaled corticosteroid controller
   3. C. Oral leukotriene receptor antagonist
   4. D. Injectable anti-inflammatory biologic

   Answer: A

   Explanation: NHLBI states, "Inhaled short-acting beta2-agonists (SABAs) open the airways so air can flow through." The acute wheeze calls for the rapid bronchodilating reliever among these classes.

   Reference: Asthma Treatment and Action Plan | NHLBI — Quick-relief medicines, lines 225-231

9. 9A PA reviews a patient's kidney function after repeated abnormal tests. Which glomerular filtration rate is the upper boundary below which NIDDK says kidney disease may be present?

   1. A. 90 mL/min/1.73 m²
   2. B. 60 mL/min/1.73 m²
   3. C. 30 mL/min/1.73 m²
   4. D. 15 mL/min/1.73 m²

   Answer: B

   Explanation: NIDDK states, "a GFR of less than 60 may mean you have kidney disease." The question asks for the upper boundary of this range, 60; lower values also fall in it.

   Reference: Tests & Diagnosis of Chronic Kidney Disease | NIDDK — Blood test for GFR

10. 10Before an elective procedure, a PA has explained the diagnosis, expected benefit, and risks of treatment. The patient asks about declining every intervention. Which additional risk discussion addresses that choice under AMA consent guidance?

    1. A. Risks of forgoing treatment entirely
    2. B. Risks of receiving the proposed procedure
    3. C. Risks of receiving an alternative procedure
    4. D. Risks of receiving procedural anesthesia

    Answer: A

    Explanation: The AMA requires discussing "the burdens, risks, and expected benefits of all options, including forgoing treatment." This patient is considering no treatment, so the remaining specific discussion is the risk of that choice. The other risk discussions concern receiving an intervention.

    Reference: Informed Consent | AMA Code of Medical Ethics — Opinion 2.1.1, Informed Consent