Question 1

The signs and symptoms of goiter, amenorrhea, decreased fertility, decreased libido, weight loss, and hand and eye tremors would substantiate a diagnosis of which disease?

Accepted Answer

All of the symptoms mentioned are clinical manifestations of hyperthyroidism. Clinical findings for risk for decreased cardiac output in patients with hyperthyroidism include hypertension, tachycardia, dysrhythmias, and palpitations.

Question 2

When a patient has acromegaly, which of the following changes in appearance a physician assistant would NOT expect to identify?

Accepted Answer

As a result of hypersecretion of growth hormone in a patient with acromegaly, bone and connective tissue continue to grow. The forehead enlarges, the maxilla lengthens, the tongue enlarges, and the voice deepens. The cheekbones also enlarge, and soft-tissue structures such and the nose, lips, cheeks, and flesh above the eyebrows thickens.

Question 3

Which of the following infectious agents cause the most nosocomial infections?

Accepted Answer

Bacteria are the number one cause of nosocomial or hospital-acquired infections. Prevention of transmission of bacteria and other infectious agents can be accomplished through frequent hand washing, disinfection, and cleaning as well as disposing of trash and linens appropriately.

Question 4

Which of the following factors increases the risk of cardiovascular disease in women using oral contraceptives?

Accepted Answer

Smoking increases the risk of cardiovascular disease and thrombi in women using oral contraceptives.

Question 5

Benign prostatic hypertrophy commonly produces which sign or symptom?

Accepted Answer

Benign prostatic hypertrophy may cause changes in the urination pattern, such as hesitancy, incontinence with dribbling, reduced caliber and forced urine stream, and urine retention.

Question 6

Which of the following actions produces the first heart sound (S1)?

Accepted Answer

Mitral and tricuspid valve closing produces S1 marking the beginning of systole or ventricular contraction.

Question 7

Which of the following statements best defines a transient ischemia attack?

Accepted Answer

A transient ischemia attack is a neurological deficit that resolves in 24 hours with no sequelae. Deficits that resolve in 72 hours are a reversible ischemic neurological deficit (RIND).

Question 8

Parkinson's disease is a chronic, progressive motor disorder caused by the loss of which of the following?

Accepted Answer

Destruction of the dopaminergic neurons in substantia regia reduces the amount of neurotransmitter dopamine.

Question 9

Which of the following are the most classic manifestations of Parkinson's disease?

Accepted Answer

Tremor of Parkinson's disease is known as pill rolling (nonintentional) tremors; muscle movement is slowed and stiff. Rigidity causes the loss of facial expression and forward tilt of the body for posture.

Question 10

Myasthemia Gravis is a rare, chronic disease that affects the deficit of which neurotransmitter?

Accepted Answer

Acetylocholine, a neurotransmitter, decreases the number of acetylcholine reception post-synaptic membrane.

Question 11

Which of the following is the major neurotransmitter responsible for sleep?

Accepted Answer

Serotonin is responsible for sleep. Serotonin is thought to decrease the activity of the RAS (reticular activating system), thereby inducing and sustaining sleep.

Question 12

Which is the most effective intervention for a patient diagnosed with an obsessive compulsive disorder?

Accepted Answer

Obsessive compulsive disorder is an anxiety disorder. Exercise will release emotional energy, limit time for the maladaptive behavior and direct the patient's attention outward.

Question 13

Which of the following risk factors is acute appendicitis usually associated with?

Accepted Answer

Appendicitis is an inflammation of the appendix caused by either obstructive fecalith or decreased circulation to the appendix.

Question 14

Which of the following pathological processes causes esophageal varices?

Accepted Answer

Esophageal varices results from increased portal hypertension. In portal hypertension, the liver cannot accept all of the fluid from the portal vein. The excess fluid will back flow to the vessels with lesser pressure, such as esophageal veins or rectal veins causing esophageal varices or hemorrhoids.

Question 15

Which of the following complications of colitis is more serious?

Accepted Answer

Bowel in colitis is very friable, which predisposes risk of perforation leading to peritonitis. A patient with colitis does have bleeding but not as great a risk as perforation.

Question 16

Which of the following interventions will help lessen the effect of GERD (acid reflux)?

Accepted Answer

Elevation of the head of the bed allows gravity to assist in decreasing the backflow of acid into the esophagus. Fluid does not flow uphill.

Question 17

Which of the following foods should be avoided by patients who are prone to develop heartburn as a result of gastroesophgeal reflux disease (GERD)?

Accepted Answer

Ingestion of chocolate can reduce lower esophageal sphincter (LES) pressure leading to reflux and clinical symptoms of GERD. All of the other foods do not affect LES pressure.

Question 18

Which of the following could present a nutritional problem for a patient diagnosed with scleroderma?

Accepted Answer

A patient with scleroderma often suffers from increased acid secretion and esophageal reflux. This could pose a significant nutritional problem.

Question 19

Which of the following should be included in a plan of care for a patient who is lactose intolerant?

Accepted Answer

Patients who are lactose intolerant can digest frozen yogurt. Yogurt products are formed by bacterial action, and this action assists in the digestion of lactose. The freezing process further stops bacterial action so that limited lactase activity remains.

Question 20

Which structure of the heart is enlarged in the patient with cor-pulmonale?

Accepted Answer

The right ventricle is enlarged in the patient with cor-pulmonale, not the other cardiac structures.

Quiz 1: Physician Assistant