PACKRAT EXAM AND PRACTICE
EXAM 2026 TEST BANK| 2 VERSIONS
(VERSION A & B) WITH COMPLETE
1300 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY
GRADED A+| PACKRAT EXAM PREP 2
(MOST RECENT!!)
1. Which of the following conditions would cause a positive Kussmaul's sign on
physical examination?
A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis ✓
Rationale: Kussmaul's sign is an increase (rather than the normal decrease) in central
venous pressure during inspiration. It is most often caused by severe right-sided heart
failure and is a frequent finding in patients with constrictive pericarditis or right
ventricular infarction. Left ventricular failure causes backup into the left atrium and
pulmonary system. Pulmonary edema affects pulmonary pressures. Coarctation of the
aorta affects outflow from the heart.
2. Anginal chest pain is most commonly described as which of the following?
, A. Pain changing with position or respiration
B. A sensation of discomfort ✓
C. Tearing pain radiating to the back
D. Pain lasting for several hours
Rationale: Myocardial ischemia is often experienced as a sensation of discomfort lasting
5-15 minutes, described as dull, aching, or pressure. Pain changing with position or
respiration suggests pericarditis. Tearing pain radiating to the back represents aortic
dissection. Pain lasting several hours is more suggestive of myocardial infarction.
3. Eliciting a history from a patient presenting with dyspnea due to early heart
failure, the severity of the dyspnea should be quantified by:
A. Amount of activity that precipitates it ✓
B. How many pillows they sleep on at night
C. How long it takes the dyspnea to resolve
D. Any associated comorbidities
Rationale: The amount of activity that precipitates dyspnea should be quantified in the
history. Orthopnea or paroxysmal nocturnal dyspnea can be quantified by how many
pillows a patient needs. The duration of dyspnea or associated comorbidities does not
help quantify severity.
4. A patient presents with complaints of progressive bilateral lower extremity
edema. Which of the following historical findings would be most suggestive of a
systemic而非localized process?
A. Cyanotic changes to the lower extremities when standing
B. Long history of coronary artery disease
C. History of recent surgical procedure of the lower extremities
D. History of orthopnea ✓
Rationale: Orthopnea is a sign of heart failure, which is a systemic而非localized process.
Recent surgical procedures or cyanotic changes with standing suggest localized venous
processes. Coronary artery disease is a risk factor but not specifically suggestive.
, 5. A 62-year-old male complains of aching and heaviness in his lower extremities
that has progressed over the last 10 years. Physical examination reveals multiple
tortuous veins in the bilateral lower extremities without associated edema or stasis
dermatitis. Which of the following is the most likely diagnosis?
A. Arterial insufficiency
B. Varicose veins ✓
C. Chronic venous insufficiency
D. Deep vein thrombosis
Rationale: Dull aching heaviness or a feeling of fatigue brought on by periods of
standing is the most common complaint of patients presenting initially with varicose
veins. Stasis dermatitis and edema suggest chronic venous insufficiency.
6. A 22-year-old male received a stab wound in the chest an hour ago. The
diagnosis of pericardial tamponade is strongly supported by the presence of:
A. Pulmonary edema
B. Wide pulse pressure
C. Distended neck veins ✓
D. An early diastolic murmur
Rationale: Cardiac compression from tamponade manifests with distended neck veins
and cold, clammy skin. Narrow pulse pressure (not wide) is seen with cardiac
tamponade. Wide pulse pressure occurs with aortic insufficiency or hyperthyroidism.
Diastolic murmurs suggest valvular disease.
7. Cardiac nuclear scanning is done to detect:
A. Electrical conduction abnormalities
B. Valvular abnormalities
C. Ventricular wall dysfunction ✓
D. Coronary artery patency/occlusion
, Rationale: Visualization of the cardiac wall can be done with cardiac nuclear scanning to
determine hypokinetic areas from akinetic areas. EKG detects electrical conduction
abnormalities. Echocardiogram detects valvular abnormalities and wall motion. Cardiac
catheterization assesses patency or occlusion.
8. A 72-year-old male with a new diagnosis of congestive heart failure and atrial
fibrillation develops episodes of hemodynamic compromise secondary to
increased ventricular rate. A decision to perform elective cardioversion is made
and the patient is anticoagulated with heparin. Which test should be ordered to
assess for atrial or ventricular mural thrombi?
A. Electrocardiogram
B. Chest x-ray
C. Transesophageal Echocardiogram ✓
D. C-reactive protein
Rationale: Transesophageal echocardiography allows for determination of mural
thrombi that may have resulted from atrial fibrillation. EKG and chest x-ray cannot
visualize mural thrombi. C-reactive protein identifies inflammation, not thrombi.
9. A patient with episodic palpitations and dizziness is suspected of having a
cardiac arrhythmia. Which of the following non-invasive tests would be the most
appropriate to order to detect the arrhythmia?
A. Holter monitor ✓
B. Cardiac catheterization
C. Stress testing
D. Cardiac nuclear scanning
Rationale: Holter monitoring is a non-invasive test that provides continuous monitoring
of the heart's electrical activity to detect rhythm disturbances that correlate with patient
symptoms. Cardiac catheterization, stress testing, and nuclear scanning assess coronary
artery disease.
EXAM 2026 TEST BANK| 2 VERSIONS
(VERSION A & B) WITH COMPLETE
1300 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY
GRADED A+| PACKRAT EXAM PREP 2
(MOST RECENT!!)
1. Which of the following conditions would cause a positive Kussmaul's sign on
physical examination?
A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis ✓
Rationale: Kussmaul's sign is an increase (rather than the normal decrease) in central
venous pressure during inspiration. It is most often caused by severe right-sided heart
failure and is a frequent finding in patients with constrictive pericarditis or right
ventricular infarction. Left ventricular failure causes backup into the left atrium and
pulmonary system. Pulmonary edema affects pulmonary pressures. Coarctation of the
aorta affects outflow from the heart.
2. Anginal chest pain is most commonly described as which of the following?
, A. Pain changing with position or respiration
B. A sensation of discomfort ✓
C. Tearing pain radiating to the back
D. Pain lasting for several hours
Rationale: Myocardial ischemia is often experienced as a sensation of discomfort lasting
5-15 minutes, described as dull, aching, or pressure. Pain changing with position or
respiration suggests pericarditis. Tearing pain radiating to the back represents aortic
dissection. Pain lasting several hours is more suggestive of myocardial infarction.
3. Eliciting a history from a patient presenting with dyspnea due to early heart
failure, the severity of the dyspnea should be quantified by:
A. Amount of activity that precipitates it ✓
B. How many pillows they sleep on at night
C. How long it takes the dyspnea to resolve
D. Any associated comorbidities
Rationale: The amount of activity that precipitates dyspnea should be quantified in the
history. Orthopnea or paroxysmal nocturnal dyspnea can be quantified by how many
pillows a patient needs. The duration of dyspnea or associated comorbidities does not
help quantify severity.
4. A patient presents with complaints of progressive bilateral lower extremity
edema. Which of the following historical findings would be most suggestive of a
systemic而非localized process?
A. Cyanotic changes to the lower extremities when standing
B. Long history of coronary artery disease
C. History of recent surgical procedure of the lower extremities
D. History of orthopnea ✓
Rationale: Orthopnea is a sign of heart failure, which is a systemic而非localized process.
Recent surgical procedures or cyanotic changes with standing suggest localized venous
processes. Coronary artery disease is a risk factor but not specifically suggestive.
, 5. A 62-year-old male complains of aching and heaviness in his lower extremities
that has progressed over the last 10 years. Physical examination reveals multiple
tortuous veins in the bilateral lower extremities without associated edema or stasis
dermatitis. Which of the following is the most likely diagnosis?
A. Arterial insufficiency
B. Varicose veins ✓
C. Chronic venous insufficiency
D. Deep vein thrombosis
Rationale: Dull aching heaviness or a feeling of fatigue brought on by periods of
standing is the most common complaint of patients presenting initially with varicose
veins. Stasis dermatitis and edema suggest chronic venous insufficiency.
6. A 22-year-old male received a stab wound in the chest an hour ago. The
diagnosis of pericardial tamponade is strongly supported by the presence of:
A. Pulmonary edema
B. Wide pulse pressure
C. Distended neck veins ✓
D. An early diastolic murmur
Rationale: Cardiac compression from tamponade manifests with distended neck veins
and cold, clammy skin. Narrow pulse pressure (not wide) is seen with cardiac
tamponade. Wide pulse pressure occurs with aortic insufficiency or hyperthyroidism.
Diastolic murmurs suggest valvular disease.
7. Cardiac nuclear scanning is done to detect:
A. Electrical conduction abnormalities
B. Valvular abnormalities
C. Ventricular wall dysfunction ✓
D. Coronary artery patency/occlusion
, Rationale: Visualization of the cardiac wall can be done with cardiac nuclear scanning to
determine hypokinetic areas from akinetic areas. EKG detects electrical conduction
abnormalities. Echocardiogram detects valvular abnormalities and wall motion. Cardiac
catheterization assesses patency or occlusion.
8. A 72-year-old male with a new diagnosis of congestive heart failure and atrial
fibrillation develops episodes of hemodynamic compromise secondary to
increased ventricular rate. A decision to perform elective cardioversion is made
and the patient is anticoagulated with heparin. Which test should be ordered to
assess for atrial or ventricular mural thrombi?
A. Electrocardiogram
B. Chest x-ray
C. Transesophageal Echocardiogram ✓
D. C-reactive protein
Rationale: Transesophageal echocardiography allows for determination of mural
thrombi that may have resulted from atrial fibrillation. EKG and chest x-ray cannot
visualize mural thrombi. C-reactive protein identifies inflammation, not thrombi.
9. A patient with episodic palpitations and dizziness is suspected of having a
cardiac arrhythmia. Which of the following non-invasive tests would be the most
appropriate to order to detect the arrhythmia?
A. Holter monitor ✓
B. Cardiac catheterization
C. Stress testing
D. Cardiac nuclear scanning
Rationale: Holter monitoring is a non-invasive test that provides continuous monitoring
of the heart's electrical activity to detect rhythm disturbances that correlate with patient
symptoms. Cardiac catheterization, stress testing, and nuclear scanning assess coronary
artery disease.
