General Surgery
Textbook Exam Questions
Course Introduction
General Surgery is a comprehensive course designed to provide medical students and trainees with foundational knowledge and essential skills in the diagnosis, management, and treatment of surgical conditions affecting various organ systems. The course covers preoperative and postoperative care, principles of aseptic technique, wound healing, trauma management, surgical oncology, and common procedures involving the gastrointestinal tract, hepatobiliary system, endocrine organs, and soft tissues. Through a combination of lectures, hands-on practice, and clinical rotations, students develop critical thinking, technical proficiency, and an understanding of surgical decision-making necessary for patient care in a multidisciplinary team setting.
Recommended Textbook
Alexanders Surgical Procedures 1st Edition by Jane C. Rothrock
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18 Chapters
356 Verified Questions
356 Flashcards
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Chapter 1: Importance of the Surgical Technologist on the Surgical Team
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) How many phases of patient care constitute surgical case management?
A)2
B)3
C)4
D)5
Answer: B
Q2) Professional settings for the surgical technologist can include:
A)Hospital suites and ambulatory surgery centers.
B)Ambulatory surgery centers and PACU
C)Labor and delivery units and for a physician as a private scrub
D)All of the above
Answer: D
Q3) Which of the following involves establishment of high standards, professional conduct, legal rights, and protection of the profession's integrity?
A)Recommended Standards of Practice
B)Position Statements
C)Code of Ethics
D)Guidelines
Answer: C
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Chapter 2: Gastrointestinal Surgery
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) Jeannie Donahue is admitted for the fourth time for treatment and management of her pseudomyxoma peritonei, or peritoneal cancer. She is scheduled for open laparotomy for inspection with lymph node surveillance and frozen sections and peritoneal washings for cytologic examination. Her surgical oncologist has recommended a treatment that may slow the growth of the tumor seedings and prolong her life: intraoperative intraperitoneal hyperthermic chemotherapy. Jeannie's perioperative nurse prepares the OR and instructs the new scrub person on chemotherapy safety precautions. For this procedure, it is imperative that the staff:
A)know how to use the chemo spill kit and where it is stored.
B)have the chemotherapeutic solution in the room before the patient arrives.
C)be able to calculate the formula for body weight in kilograms per meters squared in order to comply with the 7 rights of medication administration.
D)wear full personal protective equipment beyond the sterile scrub attire.
Answer: A
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Chapter 3: Surgery of the Liver, Biliary Tract, Pancreas and Spleen
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) The liver, pancreas, and spleen share many similarities. Select the statement about these organs that is true.
A)All three are solid organs and very vascular.
B)All three are metabolic organs.
C)All three organs have terminal attachments to the duodenum.
D)All of the options are false.
Answer: A
Q2) Matthew Ryan, a 9-year-old boy, is admitted to the emergency department for a sledding accident, when he lost control of his sled and crashed into a tree. He is pale and in pain; his abdomen is tender and firm to palpation. The CT scan suggests rupture of the spleen with internal bleeding. Matthew's scheduled surgery will most probably be a(n):
A)laparoscopic splenic resection with sutured mesh overlay.
B)open splenic lobectomy with vascular ligation.
C)open total splenectomy.
D)open splenic repair with sutured anastomosis and argon plasma coagulation vessel sealing.
Answer: C
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Page 5
Chapter 4: Repair of Hernias
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20 Flashcards
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Sample Questions
Q1) Select the triad of the boundaries of the Hesselbach triangle.
A)Inguinal ligament, rectus abdominis muscle, deep epigastric vessels
B)Rectus abdominis muscle, Cooper ligament, aponeurosis
C)Scarpa's fascia, deep epigastric vessels, external oblique muscle
D)Inguinal ligament, inguinal canal, Cooper ligament
Q2) A group of United Kingdom (UK) researchers undertook an analysis of several research studies comparing the outcomes of laparoscopic versus open incisional hernia repair of patients who had prior laparotomies. They examined surgical time, duration of hospital stay, perioperative complications, postoperative surgical site pain, and recurrence rates in 183 patients whose incisional hernias were repaired by the open approach and 183 repaired by the laparoscopic approach. Based on the results of this study, an appropriate risk reduction strategy for patients with incisional hernias would be to repair incisional hernias:
A)laparoscopically.
B)through an open approach.
C)using either open or laparoscopic approaches for equally good patient outcomes.
D)with the open approach to decrease surgical time.
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Chapter 5: Gynecologic and Obstetric Surgery
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) An example of perineal glands that secrete mucus is:
A)Skene's glands.
B)Bartholin's glands.
C)perineal glands.
D)labial glands.
Q2) When catheterizing the female patient, the urethra must be located. The correct order of the external organs of the vulva listed anterior to posterior is:
A)mons pubis, labia majora, labia minora, urethra, clitoris, vaginal opening.
B)labia majora, labia minora, clitoris, urethra, vaginal opening, mons pubis.
C)mons pubis, labia majora, labia minora, clitoris, urethra, vaginal opening.
D)labia majora, labia minora, urethra, mons pubis, clitoris, vaginal opening.
Q3) Sally Hargraves is a 72-year-old patient with multicentric carcinoma in situ (CIS) of the vulva, without evidence of leukoplakia and pruritus. She has a history of prior papillomavirus infection. Select the most appropriate surgical option.
A)Radical vulvectomy with inguinal lymph node dissection
B)Skinning vulvectomy
C)CO<sub>2</sub> laser surface ablation of the vulvar lesions
D)Simple vulvectomy
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Chapter 6: Genitourinary Surgery
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16 Flashcards
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Sample Questions
Q1) Which action best reflects the movement of urine from the renal pelvis to the bladder?
A)Normal intra-abdominal positive pressure promotes renal drainage.
B)Slight distention of the renal pelvis initiates a wave of peristaltic contractions.
C)Distention of the proximal ureter facilitates gravity drainage through signaling channels.
D)Urine is propelled into the bladder when adrenal hormones bind with ureteral receptor sites.
Q2) Patients having genitourinary surgery are at risk for impaired urinary elimination.
Select the statement that best reflects a desired outcome for an adult patient.
A)The patient will be able to urinate before the bladder exceeds 350 ml of fullness.
B)The patient will regain his or her normal pattern of urinary elimination.
C)The patient will excrete 50 ml of urine per hour.
D)All of the options are desired outcomes.
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Chapter 7: Thyroid and Parathyroid Surgery
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) The primary function of the three thyroid hormones is to regulate:
A)energy metabolism.
B)body growth and development.
C)calcium storage in the bones.
D)the decrease in blood calcium levels.
Q2) Thyroid storm can occur in patients whose hyperthyroidism is partially controlled or untreated. Thyrotoxic crisis can be precipitated by a stressful event, such as surgery. An example of an action(s) the circulator and surgical technologist can take to reduce the risk of thyroid storm is:
A)administer potassium iodide before transfer to the OR.
B)provide a quiet, calm atmosphere and help the patient relax.
C)provide comfort measures, including a cooling blanket.
D)provide a quiet, calm atmosphere and help the patient relax, and provide comfort measures, including a cooling blanket.
Q3) The pyramidal lobe of the thyroid is described as:
A)a small lobe often involved in 30% of cases of thyroid dysfunction.
B)a protrusion of an immature thyroglossal duct cyst overgrowth.
C)a thin upward protrusion of thyroid tissue from the isthmus.
D)a vestige of an embryonic thyroid cyst.
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Page 9
Chapter 8: Breast Surgery
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Ductal ectasia is a benign breast disorder that is difficult to distinguish from cancer, primarily because it presents with:
A)bilateral tenderness, mottled skin patterns of the breast, and fullness.
B)bilateral multicentric nodules and nipple discharge.
C)mottled skin patterns of the breast and edema.
D)a hard and irregular mass, nipple discharge, and enlarged axillary nodes.
Q2) In the past, radical procedures, which involved removal of the affected breast and all axillary and thoracic lymph nodes, were used to treat breast cancer. These procedures did not significantly lower mortality. What factor(s) may have contributed to mortality after these procedures?
A)Distant metastases may have already occurred without adjacent lymph node involvement at the time of its palpable detection.
B)Early pathology techniques for frozen section and histology microexamination could not define margins.
C)Breast cancer was believed to spread by direct extension from its initial site in the breast to adjacent lymph nodes.
D)Tumor size was not usually correlated with involvement of lymph nodes and cancer spread.
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Page 10
Chapter 9: Ophthalmic Surgery
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) Select the appropriate procedure performed for a patient with Fuchs' dystrophy, edema after cataract surgery, or keratoconus (abnormal steepening) of the cornea.
A)Keratoplasty
B)Keratorefraction
C)Laser epithelial keratomileusis
D)Laser-assisted in-situ keratomileusis
Q2) Select the true statement about dacryocystorhinostomy (DCR).
A)A DCR is performed for chronic or recurrent dacryocystitis, which is also called epiphora.
B)A dacrolithotripsy is attempted if the DCR is unsuccessful.
C)DCR establishes a new passageway for tear drainage into the nasal cavity.
D)The passageway is usually restored with the use of ultrasonic lacrimal probes.
Q3) To accommodate near and distant focus, the lens changes shape and focus by relaxation and tightening of the zonular fibers. What physiologic change of the normal aging process is typically corrected with bifocals?
A)Cataracts
B)Presbyopia
C)Glaucoma
D)Astigmatism
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Page 11
Chapter 10: Otorhinolaryngologic Surgery
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) A nasal polypectomy is the removal of polyps from the nasal cavity. Nasal polyps are benign, grapelike clusters of mucous membrane and connective tissue. When the polyps become large, they obstruct the free passage of air, make breathing difficult, and cause a change in speech quality. Nasal polypectomies are typically performed endoscopically with the use of microdebriders, which remove the polyps by their mechanism of _______________ the polyp and suctioning the tissue.
A)ultrasonic cavitating
B)morcellating
C)radiofrequency ablating
D)laser vaporizing
Q2) The nasal turbinates increase the turbulence of the airflow through the nose to humidify the air. The turbinates also serve another function to the accessory sinuses by:
A)filtering inspired air and preventing sinusitis.
B)acting as drainage passageways.
C)giving resonance to the voice.
D)trapping particle matter before it reaches the nasopharynx.
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Chapter 11: Orthopedic Surgery
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Revision arthroplasty may be indicated if the patient's original knee replacement wears out or loosens, or fails as a result of repeated dislocation, infection, or trauma. Total joint revision can be a very demanding and complicated procedure. Attention to detail, anticipation, and preparation are essential. Following the induction of anesthesia, the surgeon performs an exam under anesthesia (EUA) to determine the approach. The most difficult aspect of revision surgery is that there is:
A)considerable scar tissue and edema.
B)a significant challenge ahead with postoperative pain management.
C)no clear-cut sequence of events.
D)polymethyl methacrylate (PMMA) bone cement that must be drilled out.
Q2) Osteoporosis is one of the most common and serious of bone diseases and is responsible for more than 2 million fractures a year. Osteoporosis-related fractures most commonly occur in the hip, spine, and wrist, but any bone can be affected. The excessive reduction of total bone mass in osteoporosis is due to the loss of:
A)calcified matrix and collagenous fibers.
B)exercise and weight-bearing physical activity.
C)estrogen and testosterone.
D)calcium or vitamin D.
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Chapter 12: Neurosurgery
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which of the following is the anatomical bloodless plane that contains loose areolar tissue and permits mobility of the scalp?
A)Subarachnoid space
B)Galea aponeurotica
C)Subgaleal space
D)Diploe table
Q2) Which of the following is the tissue most often responsible for spinal nerve root compression in patients with herniated intervertebral disks?
A)Annulus fibrosis
B)Nucleus pulposus
C)Posterior longitudinal ligament
D)Spinous process
Q3) Which surgical specialist might be asked to assist in providing exposure for the neurosurgeon in a transsphenoidal hypophysectomy (TSH) procedure?
A)Cardiothoracic surgeon
B)Neuroradiologist
C)Orthopedic surgeon
D)Otorhinolaryngologist
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14
Chapter 13: Plastic and Reconstructive Surgery
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Sample Questions
Q1) Replantation is an attempt to reattach a completely amputated digit or other body part. Revascularization is the procedure performed on incomplete amputations, when the part remains attached to the body by skin, artery, vein, or nerve. Good candidates for replantation are those with the following amputations:
A)almost any body part of a child.
B)proximal portion of the hand at palm level.
C)distal to middle foot.
D)distal to middle thigh.
Q2) Josh Tremain, a 28-year-old firefighter, sustained significant full-thickness burns when he fell through the roof of a burning building while fighting an explosive fire. What surgical treatments may Josh need before he is discharged from the burn center to home?
A)Debridement and monitoring of full-thickness skin regeneration
B)Debridement, allograft placement during initial healing, and later split-thickness (ST) and full-thickness (FT) skin grafting
C)Allograft and xenograft placement as temporary dressings until secondary granulation begins
D)Tangential excision of the burn wound with antibiotic-soaked dressings
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Chapter 14: Thoracic Surgery
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Sample Questions
Q1) Pleurodesis is undertaken as a treatment for malignant pleural effusion and for unresolved spontaneous pneumothorax. The endpoint goal of a pleurodesis is to:
A)prevent accumulation of pleuritic secretions.
B)bond the parietal pleura to the lung.
C)achieve permanent pneumothorax.
D)cause adherence of the pleural layers.
Q2) Video-assisted thoracic surgery (VATS) is a minimally invasive operative technique that has evolved over the past decade. It uses an endoscopic approach to visualize the thoracic cavity for diagnosis of pleural disease or treatment of pleural and lung conditions. In the adult, the surgeon creates a 2- to 3-cm incision between the ________ intercostal spaces for insertion of the 10- or 12-mm trocar. The trocar sites can also be used for insertion of a ____________.
A)fourth and sixth; robotic EndoWrist grasper
B)fifth and seventh; chest tube
C)fifth and seventh; zero-degree scope
D)sixth and eighth; video camera
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Chapter 15: Vascular Surgery
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Sample Questions
Q1) Patients with chronic venous insufficiency (CVI) are not typically treated surgically as often as patients with arterial disease because:
A)CVI is not life-threatening or limb-threatening.
B)venous surgery contributes to thromboembolism.
C)surgical interventions for venous valves have not been refined.
D)All of the options are correct.
Q2) Varicose veins are enlarged and distended veins that are visible and palpable beneath the skin. Secondary varicose veins are believed to be a result of insufficiency of the deep venous system. The primary objective of varicose vein surgery, for the patient with secondary disease, is to prevent:
A)thromboemboli, claudication, and unsightly blue clusters of veins.
B)ulceration, edema, pain, and fatigue.
C)venospasm, phlebitis, and vascular sacculations.
D)vasculitis, pitting edema, and sclerosed vein clusters.
Q3) What drug is used to reverse the effects of heparin?
A)Prostigmine
B)Protonics hydrochloride
C)Protamine sulfate
D)Prothrombin
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Page 17
Chapter 16: Cardiac Surgery
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Sample Questions
Q1) Patients with chronic, severe angina who cannot be revascularized with either coronary bypass surgery or PCI may be appropriate candidates for laser transmyocardial revascularization (TMR). Channels are created in the left ventricular wall with laser energy (e.g., CO , holmium:yttrium-aluminum-garnet [Ho:YAG]). What relevant intervention must accompany this procedure?
A)Prep the patient for possible emergency coronary artery bypass.
B)Prepare for insertion of a ventricular assist device.
C)Employ laser safety precautions.
D)Prepare provisions for an endoscopic or robot-assisted approach.
Q2) Select the diagnostic test that represents an invasive cardiac study.
A)Resting MUGA
B)Exercise MUGA
C)Cardiac function
D)Electrophysiology studies
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18
Chapter 17: Pediatric Surgery
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Sample Questions
Q1) An orchiopexy is the surgical placement and fixation of the testicle in a normal anatomic position in the scrotal sac. If the testis fails to descend into the scrotum during gestation, it is considered undescended. Which statement regarding indications for orchiopexy is true?
A)The normal path of the testis becomes obstructed.
B)The testis is strangulated by contraction of the cremaster muscle.
C)All testes that are undescended after 1 year require surgical placement in the scrotum.
D)Retractile testes require surgical or hormonal treatment.
Q2) Much like the adult population, many traditional "open" pediatric surgical procedures are being replaced by minimally invasive surgery (MIS) procedures. Because the field of pediatric MIS is relatively new, surgeons are at an advantage because they are able to combine virtual reality techniques and robotics with the most current technology and instrumentation. Select all of the MIS procedures commonly performed in pediatric patients from the options listed below.
A)Living-related donor kidney transplant
B)Gastric fundoplication
C)Correction of pectus excavatum
D)Closure of patent ductus arteriosus
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Chapter 18: Trauma Surgery
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18 Verified Questions
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Sample Questions
Q1) What statement regarding level I and level II trauma centers best describes the difference between the two types of centers?
A)A level I trauma center is staffed 24 hours/7 days, while a level II has many support services that are open and staffed 8 hours/5 days.
B)A level I trauma center has a transplant program, while a level II is only able to complete organ procurements.
C)A level I trauma center provides care for every type of injury, while a level II lacks some specialized resources.
D)A level I trauma center requires trauma certification and 8 hours of annual trauma education for all staff, while a level II does not.
Q2) What special consideration should the perioperative team be alert to in order to prevent a negative surgical outcome in bariatric trauma patients?
A)They may have decreased self-esteem and suffer from societal prejudice.
B)They are at risk for retained foreign bodies related to the size of the abdominal cavity.
C)Several persons will be needed to position the patient.
D)They may not be able to fit into the CT or MRI scanner.
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Page 20