# PANCE practice questions, written from your own PA program notes

> PANCE style questions from your own PA program notes, each quoting its page, for an exam of 300 questions in five blocks of 60 with a passing score of 350.

Markdown copy of https://meduniexam.com/exam/pance (the HTML page), published by MedUni Exam. Published September 27, 2026. Site guide for agents: https://meduniexam.com/llms.txt.

The PANCE is 300 questions in five blocks of 60, and 94 percent of it is organ system medicine. Upload the notes from one system block and you get PANCE style questions from it, each one quoting the line and the page it came from.

[Take the ten question sample exam](https://meduniexam.com/#/sample)

No upload and no account, about a minute. Or [upload a chapter](https://meduniexam.com/#/) and get PANCE style questions from it.

Free: 5,000 verified questions a month. The Exam Pass is $19.99 once for 90 days on the priority models; [get it here](https://meduniexam.com/#/pricing?buy=exam_pass). 14 day refund, in full before you generate.

Launch offer: 5,000 free questions a month with an account, until October 24, 2026.

## PANCE pass rate 2025, passing score, fee, questions and testing windows

PANCE pass rate 2025: 91.5 percent of 13,145 first time test takers and 88.4 percent of all 14,669 exams given, from the NCCPA five year table. How many questions on the PANCE: 300, in five blocks of 60 with 60 minutes a block, and the PANCE fee is USD 550. The PANCE passing score is 350 on a scale of 200 to 800, and the 2026 testing window at Pearson VUE centers closes on December 18, 2026.

| PANCE fact | Number | Applies to |
| --- | --- | --- |
| Questions and time | 300 questions in five blocks of 60, 60 minutes a block, 60 seconds a question | PANCE in 2026, pace computed from 3,600 seconds over 60 questions |
| Appointment length | 6 hours: 5 hours of blocks, 45 minutes of breaks and a 15 minute tutorial | PANCE in 2026, hours added up here |
| Testing window | January 2, 2026 to December 18, 2026 | 2026, Pearson VUE test centers |
| Testing window | January 2, 2027 to December 18, 2027 | 2027, Pearson VUE test centers |
| Results wait | About two weeks after the test date, by email | NCCPA PANCE policies |
| Fee | USD 550 | Paid with the application |
| Pass rate | 91.5 percent of 13,145 first time test takers; 88.4 percent of 14,669 exams given | 2025 |
| Pass rate | 92.4 percent of 12,424 first time test takers; 89.5 percent of 13,860 exams given | 2024 |
| Passing score | 350 on a scale of 200 to 800 | Scaled score; the number of correct answers needed varies from one examinee to another |
| Attempts | 6 attempts in 6 years, no more than once in 90 days and 3 times in a calendar year | Graduates of ARC-PA accredited programs on or after January 1, 2003 |

Source: [NCCPA Become Certified](https://www.nccpa.net/become-certified/), [NCCPA Key Dates](https://www.nccpa.net/key-dates/), [NCCPA Exam Development and Scoring](https://www.nccpa.net/examdevelopmentscoring/), [NCCPA five year PANCE pass rates](https://www.nccpa.net/wp-content/uploads/PANCEPassRates.pdf), [NCCPA PANCE Policies, Procedures and Authorization](https://www.nccpa.net/wp-content/uploads/PANCE-Policy-Procedures-and-Authorization.pdf), checked on September 26, 2026.

## PANCE blueprint 2025: organ system and task percentages

PANCE blueprint, in force since January 2025: 14 organ system categories make up the 94 percent of the exam that is medical content, led by cardiovascular at 11 percent and pulmonary at 9, and professional practice is the other 6 percent. Every medical content question is also coded to one of seven task areas, led by formulating the most likely diagnosis at 18 percent. Up to 8 to 10 percent of the exam covers general surgical topics and 12 to 15 percent pediatric patients, and NCCPA says the allocations may vary slightly on exams.

| Blueprint dimension | Category | Share of the PANCE |
| --- | --- | --- |
| Medical content | Cardiovascular system | 11 percent |
| Medical content | Pulmonary system | 9 percent |
| Medical content | Gastrointestinal system and nutrition | 8 percent |
| Medical content | Musculoskeletal system | 8 percent |
| Medical content | Infectious diseases | 7 percent |
| Medical content | Neurologic system | 7 percent |
| Medical content | Psychiatry and behavioral science | 7 percent |
| Medical content | Reproductive system | 7 percent |
| Medical content | Endocrine system | 6 percent |
| Medical content | Eyes, ears, nose and throat | 6 percent |
| Medical content | Hematologic system | 5 percent |
| Medical content | Renal system | 5 percent |
| Medical content | Dermatologic system | 4 percent |
| Medical content | Genitourinary system | 4 percent |
| Both dimensions | Professional practice | 6 percent |
| Task | Formulating most likely diagnosis | 18 percent |
| Task | History taking and performing physical examination | 16 percent |
| Task | Clinical intervention | 16 percent |
| Task | Pharmaceutical therapeutics | 15 percent |
| Task | Health maintenance, patient education and preventive measures | 11 percent |
| Task | Using diagnostic and laboratory studies | 10 percent |
| Task | Applying basic scientific concepts | 8 percent |

Source: [NCCPA PANCE Blueprint](https://www.nccpa.net/become-certified/pance-blueprint/), checked on September 26, 2026.

## Organ systems are 94 percent of the PANCE, so practice one system at a time

The PANCE content blueprint in force since January 2025 gives 94 percent of the exam to medical content in 14 organ system categories and 6 percent to professional practice. Cardiovascular is the largest at 11 percent, then pulmonary at 9, and gastrointestinal and nutrition and musculoskeletal at 8 each. If your program taught the didactic year in organ system blocks, those notes line up with the blueprint already: upload the cardiology block and the questions come from cardiology, each with the page it quotes.

The blueprint has a second dimension. Every medical content question is also coded to a task, and formulating the most likely diagnosis is the largest at 18 percent, then history taking and physical examination and clinical intervention at 16 each, and pharmaceutical therapeutics at 15. The recipe below asks for items in those task shapes. Two slices cut across the systems: up to 8 to 10 percent of the exam covers general surgical topics and 12 to 15 percent focuses on pediatric patients, so a set built only from adult medicine notes leaves both out.

## One question, as it arrives

A patient who suffered a myocardial infarction 4 days ago now presents with acute dyspnea and a new holosystolic murmur. Based on the typical timeline for complications, what is the most likely mechanism of this new murmur?

1. **A.** Cardiac tamponade
2. **B.** Atrial fibrillation
3. **C.** Acute mitral regurgitation correct answer
4. **D.** Ventricular free wall rupture
5. **E.** Ventricular fibrillation

PAGE 6: "papillary muscle rupture causing acute mitral regurgitation, typically 3 to 5 days after infarction"

double-checked

One of the 14 cardiology questions behind the [sample exam](https://meduniexam.com/#/sample), printed with the quote and the page number it cites. It is cardiology because the sample handout is the one file every visitor can try; a question written from your own file comes back in the same shape, with the same two checks. Take the sample exam and you are asked this question with this quote. On your own file the same two checks run: the quote has to be in the stored text of the page it cites, and a second model from a different family has to pick the same option from that quote alone.

**Every question you see passed two checks, and 62 percent of the drafts written since September 14, 2026 did not.** Counted from this site's own database, as of September 27, 2026, refreshed twice an hour. A question fails when its quote is not on the page it cites, when a second model picks a different answer, when it breaks a writing rule or when it repeats one already written. [Each check, with its own rate](https://meduniexam.com/stats/rejections.md).

**Exam Pass, $19.99 once.** 90 days of the priority models for your PANCE block, with the downloads and an unlimited tutor. Nothing renews. [Get the Exam Pass](https://meduniexam.com/#/pricing?buy=exam_pass) Start on the free plan first if you like: 5,000 verified questions a month with an account, 1,000 as a guest.

## A practice recipe for PANCE

Ask for 20 questions from one organ system and set a 20 minute timer, the PANCE pace of 60 questions in a 60 minute block.

Paste this into the extra instructions box on the generate form, or let the button carry it there:

Write single best answer items with five options from the uploaded material. Open each stem with a patient: age, sex, the presenting complaint and the one history, examination or laboratory finding that decides the answer. Ask for the most likely diagnosis, the next diagnostic study, the best clinical intervention or the drug of choice, in the words the source uses. Where the source covers a child or a surgical condition, keep that detail in the stem.

[Use this recipe in the generate form](https://meduniexam.com/#/?recipe=pance)

The extra instructions box overrides the general guidance the model is given, so the wording above is followed on every question in the set.

## What this cannot do

- This is not an NCCPA item pool and it has no connection to NCCPA. It writes items in PANCE style from the file you upload.
- Professional practice is 6 percent of the PANCE and rarely sits in clinical lecture notes. It is only covered if you upload material on it.
- The surgery slice (up to 8 to 10 percent) and the pediatrics slice (12 to 15 percent) come only from surgical and pediatric notes you upload. A set built from adult medicine notes will not produce them.
- The task dimension is not weighted automatically. Ask for diagnosis, management or pharmacotherapy items in the extra instructions, and the set follows what your file supports.

## Format facts, and where each one comes from

- PANCE consists of five blocks of 60 questions with 60 minutes to complete each block, plus a total of 45 minutes for breaks between blocks and 15 minutes for a tutorial, which makes a six hour appointment. Source: [https://www.nccpa.net/become-certified/](https://www.nccpa.net/become-certified/)
- The content blueprint for all PANCE administrations from January 2025 gives medical content 94 percent of the exam and professional practice 6 percent, and every medical content question is also coded to one of seven task areas. Source: [https://www.nccpa.net/become-certified/pance-blueprint/](https://www.nccpa.net/become-certified/pance-blueprint/)
- Up to 8 to 10 percent of the exam covers general surgical topics, and 12 to 15 percent of questions focus on conditions in pediatric patients; the percentages may vary slightly on exams. Source: [https://www.nccpa.net/become-certified/pance-blueprint/](https://www.nccpa.net/become-certified/pance-blueprint/)
- PANCE is scored on a scale of 200 to 800, and the passing standard is 350. Source: [https://www.nccpa.net/examdevelopmentscoring/](https://www.nccpa.net/examdevelopmentscoring/)
- A never certified graduate of an ARC-PA accredited program may take PANCE six times within six years of completing the program, and no more than once in any 90 day period or three times in a calendar year. Source: [https://www.nccpa.net/become-certified/](https://www.nccpa.net/become-certified/)
- The application costs USD 550, and the exam is given at more than 300 Pearson VUE testing centers. Source: [https://www.nccpa.net/become-certified/](https://www.nccpa.net/become-certified/)

Format checked on September 26, 2026. These pages are reviewed once a quarter by the person who runs MedUni Exam, and the review is what moves the date above. If a number here is out of date, write to [support@meduniexam.com](mailto:support@meduniexam.com) and it gets fixed.

## What it costs in PANCE units

During the launch offer, a free account gets 5,000 verified questions a month and a guest workspace gets 1,000, at no cost.

The Exam Pass, $19.99 once, is one payment that puts the priority models on your jobs for 90 days and then stops on its own.

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Paid through Stripe, which shows the total before you pay. One payment, nothing renews, and the [refund policy](https://meduniexam.com/refund-policy.md) gives you 14 days, in full before you generate. A 500 question pack at $5.99 and the Pro subscription are on the [pricing page](https://meduniexam.com/pricing.md).

Works in any language, and quality varies by language: the questions come out in the language of your document, or in the one you pick from a list of every living language. [What works in your language, and what does not](https://meduniexam.com/for/any-language.md).

## Questions students ask

### Is this a PANCE question bank?

No. It has no connection to NCCPA and holds no PANCE items. It writes PANCE style questions from the notes you upload, and each one prints the line and the page it came from.

### How many questions are on the PANCE?

Three hundred, in five blocks of 60 with 60 minutes a block, so one minute a question. The source is linked in the format facts above.

### What is the PANCE passing score?

Three hundred and fifty, on a scale of 200 to 800. It is a scaled score, so the number of correct answers needed varies from one examinee to another.

### Can it cover pediatrics and surgery?

From pediatric and surgical notes, yes. Upload them as their own documents and the questions come from those pages. On the exam the two slices are up to 8 to 10 percent and 12 to 15 percent.

[Upload a chapter](https://meduniexam.com/#/)

[How the checks work](https://meduniexam.com/how-it-works.md)

No account needed to try it. Registering keeps your library, grades and review queue across devices.

[All exams](https://meduniexam.com/exam.md) · [USMLE Step 1](https://meduniexam.com/exam/usmle-step-1.md) · [Real generated questions](https://meduniexam.com/sample.md)

## Related pages

- [How Many Questions: Step 1, NCLEX, MCAT, PLAB](https://meduniexam.com/blog/how-many-questions-are-on-each-medical-exam.md): The question count, the testing time and the computed pace for the eleven exams on this site, from USMLE Step 1 at about 280 questions to PLAB 1 at 180, each row naming the exam owner's document it came from, checked on September 21 and 26, 2026.
- [How Many Times You Can Take the NCLEX, Step 1, MCAT, PLAB 1](https://meduniexam.com/blog/how-many-times-can-you-take-step-1-nclex-mcat-and-plab-1.md): The attempt limit for all eleven exams in one table: the NCLEX eight a year, four per USMLE Step, seven MCAT attempts in a lifetime, five NAPLEX attempts, five PLAB 1 attempts with the fifth by application, six at MRCP Part 1.
- [USMLE Step 1 questions from your own file](https://meduniexam.com/exam/usmle-step-1.md): Step 1 style single best answer questions generated from a student's own pathology and physiology material, with the format facts and the limits stated.
- [PowerPoint to quiz: questions from your slides](https://meduniexam.com/for/lecture-slides.md): Uploading PowerPoint decks: what is read, what is not, and why the questions cite slide numbers.
- [Turn lecture notes into exam questions](https://meduniexam.com/for/lecture-notes-to-exam-questions.md): Getting good questions out of slide decks and handouts, and which question type to ask for.