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PACKRAT 1 - Exam Questions With Solutions (Verified)
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PACKRAT 1 - Exam Questions With Solutions (Verified)A patient with hypovolemic shock would most likely exhibit which of the
following signs?
A. increased CVP; decreased BP; increased pulse rate
B. decreased CVP; decreased BP; increased pulse rate
C. increased CVP; increased BP; decreased pulse rate
D. decreased CVP; increased BP; decreased pulse rate Right Ans - B.
Hypovolemic shock is a condition with a decrease in the amount of circulating
blood volume in the intravascular system. A decrease in the amount of
circulating volume will result in a decrease in the CVP pressure which is an
indirect measurement of the amount of blood in the right ventricle. Less blood
in the
vascular system means decreased blood pressure. Since there is less blood in
the circulation, the body
will attempt to compensate for this by increasing the number of contractions
(pulse rate) and the force of those contractions due to increased sympathetic
stimulation.
Examination of the heart in chronic heart failure frequently reveals
A. S3.
B. splitting of S2.
C. paradoxical splitting of S2.
D. holosystolic murmur. Right Ans - A. S3 occurs as a result of the left
ventricle becoming stiff and interfering with blood entering the left ventricle
during filling. As the left ventricle loses its compliance, there is impaired filling
which results in less blood entering the left ventricle, increased left ventricle
filling pressures, and left ventricular failure. Contraction of the left ventricle is
not initially affected, but becomes affected with time.
Which of the following conditions is most suggestive of an asymptomatic
abdominal aortic aneurysm?
A. abdominal mass
B. hypertension
C. chest pain
D. syncope Right Ans - A. Symptomatic abdominal aortic aneurysm
presents with pulsating upper abdominal mass.
,Post-infarction syndrome (Dressler's syndrome) occurs after acute
myocardial infarction presenting as
A. ventricular aneurysm.
B. pericarditis and pleuritis.
C. cardiac tamponade.
D. pleural effusion and rash. Right Ans - B. Dressler's syndrome is the
occurrence of pericarditis and pleuritis several days to weeks following an MI.
The typical physical examination finding of scarlet fever is which of the
following?
A. slapped cheek appearance
B. strawberry tongue
C. Koplik's spots
D. honey-crusted lesions Right Ans - B. Scarlet fever presents with fever,
chills, sore throat, and a generalized fine papular rash with a sandpaper
texture which begins on the chest. "Strawberry tongue" is also noted.
In myxedema, the patient commonly complains of which of the following?
A. tremors
B. palpitation
C. cold intolerance
D. eructation Right Ans - C. Myxedema is the result of hypothyroidism. Cold
intolerance is associated with hyopthyroidism
along with constipation and fatigue.
Which of the following signs or symptoms differentiates acute sinusitis from
viral rhinitis?
A. fever
B. rhinorrhea
C. facial pain
D. swollen nasal mucous membranes Right Ans - C. Frontal headache,
swollen nasal mucous membranes, rhinorrhea and fever may all be signs of
viral rhinitis, along with sneezing and a scratchy throat. Sinusitis usually
follows a viral rhinitis, but in addition to the above symptoms, it will include
pain and tenderness over the involved sinus.
Which of the following is most commonly seen in viral croup?
A. drooling
,B. wheezing
C. sputum production
D. inspiratory stridor Right Ans - D. Viral croup typically presents with
barking cough and stridor.
A patient has double vision when he turns his eyes to the right. Examination
shows that he cannot move his right eye laterally. Which of the following
cranial nerves is involved?
A. optic
B. oculomotor
C. trochlear
D. abducens Right Ans - D. The abducens nerve affects lateral eye
movement, and if paralyzed will cause double vision with lateral gaze.
When palpating a patient's abdomen at the level of the left costal margin, the
physician assistant feels the edge of the spleen. To confirm findings, which of
the following is appropriate?
A. Roll the patient onto the right side and palpate for the spleen edge.
B. Roll the patient onto the left side and palpate for the spleen edge.
C. Have the patient get into the knee-chest position.
D. Have the patient sit upright and palpate in the left costal vertebral angle.
Right Ans - A. By rolling the patient onto the right side, gravity may bring the
spleen forward and medial so that it is in a palpable location.
Which of the following is a finding in vitamin A deficiency?
A. decreased proprioception
B. night blindness
C. hair loss
D. bleeding Right Ans - B. Night blindness is the earliest symptom of
vitamin A deficiency.
The physician assistant would suspect food poisoning from Staphylococcus
aureus in a patient who
presents with
A. ingestion of mayonnaise-based salads 48 hours earlier.
B. bloody diarrhea with mucus for one week.
C. abdominal cramps and vomiting.
D. high fever. Right Ans - C. Abdominal cramps, nausea, vomiting, and
watery diarrhea typically last 1-2 days with
, Staphylococcal food poisoning.
The most common location of bleeding seen in patients with von Willebrand's
disease is the
A. mucosal surfaces.
B. spleen.
C. joint spaces.
D. muscle groups. Right Ans - A. Von Willenbrand's disease most commonly
presents with mucosal bleeding such as epistaxis, gingival bleeding, and
menorrhagia.
Which of the following physical findings suggest pernicious anemia?
A. splenomegaly and hepatomegaly
B. petechiae and ecchymosis
C. loss of position and vibratory sensation
D. cheilosis and koilonychia Right Ans - C. Loss of position and vibratory
sensation are common neurologic findings in pernicious anemia.
Which of the following is the most common early presenting sign in patients
with Alzheimer's disease?
A. change in personality
B. loss of memory
C. multiple physical complaints
D. depressed mood Right Ans - B. The presence of memory impairment is
the most common sign of Alzheimer's disease. Changes occur first with short-
term memory.
The most frequent finding in a person presenting with a brain abscess is
A. nuchal rigidity.
B. headache.
C. seizures.
D. vomiting. Right Ans - B. Headache occurs in over 70% of patients with a
brain abscess.
A 28-year-old female presents on examination with enlarged ovaries
bilaterally. The possible diagnosis of polycystic ovarian syndrome is enhanced
by finding which of the following?
A. hirsutism
B. gynecomastia
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