PACKRAT 8 (QUESTIONS WITH
COMPLETE SOLUTIONS) A+ RATED
2025/2026
1. 1. HISTORY/PHYSICAL
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 - correct answer ✔✔EXPLANATIONS:
(u) A. See B for explanation.
(c) 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.
(u) C. See B for explanation.
(u) D. See B for explanation.
2. 1. HISTORY/PHYSICAL
Examination of the heart in chronic heart failure frequently reveals
A. S3.
B. splitting of S2.
, C. paradoxical splitting of S2.
D. holosystolic murmur. - correct answer ✔✔EXPLANATIONS:
(c) 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.
(u) B. Splitting of S2usually results from inspiration lengthening the time difference between
closure of the aortic valve and closure of the pulmonic valve.
(u) C. Paradoxical splitting of S2usually results from conditions that either delay the closure of
the aortic valve, such as aortic stenosis, or left bundle branch block, or in conditions that cause
premature closure of the pulmonic valve.
(u) D. Holosystolic murmur occurs as a result of mitral regurgitation or ventricular septal defect.
3. 1. HISTORY/PHYSICAL
Which of the following conditions is most suggestive of an asymptomatic abdominal aortic
aneurysm?
A. abdominal mass
B. hypertension
C. chest pain
D. syncope - correct answer ✔✔EXPLANATIONS:
(c) A. Symptomatic abdominal aortic aneurysm presents with pulsating upper abdominal mass.
(u) B. Hypertension is not suggestive of symptomatic abdominal aortic aneurysm.
(u) C. Abdominal aortic aneurysm presents with midabdominal or lower back pain.
(u) D. Syncope is not common in abdominal aortic aneurysm, unless it ruptures.
4. 1. HISTORY/PHYSICAL
COMPLETE SOLUTIONS) A+ RATED
2025/2026
1. 1. HISTORY/PHYSICAL
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 - correct answer ✔✔EXPLANATIONS:
(u) A. See B for explanation.
(c) 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.
(u) C. See B for explanation.
(u) D. See B for explanation.
2. 1. HISTORY/PHYSICAL
Examination of the heart in chronic heart failure frequently reveals
A. S3.
B. splitting of S2.
, C. paradoxical splitting of S2.
D. holosystolic murmur. - correct answer ✔✔EXPLANATIONS:
(c) 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.
(u) B. Splitting of S2usually results from inspiration lengthening the time difference between
closure of the aortic valve and closure of the pulmonic valve.
(u) C. Paradoxical splitting of S2usually results from conditions that either delay the closure of
the aortic valve, such as aortic stenosis, or left bundle branch block, or in conditions that cause
premature closure of the pulmonic valve.
(u) D. Holosystolic murmur occurs as a result of mitral regurgitation or ventricular septal defect.
3. 1. HISTORY/PHYSICAL
Which of the following conditions is most suggestive of an asymptomatic abdominal aortic
aneurysm?
A. abdominal mass
B. hypertension
C. chest pain
D. syncope - correct answer ✔✔EXPLANATIONS:
(c) A. Symptomatic abdominal aortic aneurysm presents with pulsating upper abdominal mass.
(u) B. Hypertension is not suggestive of symptomatic abdominal aortic aneurysm.
(u) C. Abdominal aortic aneurysm presents with midabdominal or lower back pain.
(u) D. Syncope is not common in abdominal aortic aneurysm, unless it ruptures.
4. 1. HISTORY/PHYSICAL
