NCCPA Surgical Principles 5

Question 1

Which of the following is the MOST appropriate prophylaxis for venous thromboembolism in a patient after major abdominal surgery?

Accepted Answer

Low-molecular-weight heparin plus sequential compression devices

Answer

Combined pharmacologic (LMWH) and mechanical (sequential compression devices) prophylaxis is the most effective VTE prevention strategy after major abdominal surgery.

Question 2

A patient presents with hypotension, distended neck veins, and muffled heart sounds after a stab wound to the chest. The IMMEDIATE intervention is:

Accepted Answer

Emergent pericardiocentesis

Answer

Beck's triad (hypotension, distended neck veins, muffled heart sounds) indicates cardiac tamponade, requiring emergent pericardiocentesis or pericardial window.

Question 3

The 'open abdomen' technique is indicated in which of the following scenarios?

Accepted Answer

Damage control laparotomy with abdominal compartment syndrome risk

Answer

The open abdomen is used after damage control surgery when abdominal compartment syndrome is anticipated, allowing deferred fascial closure after resuscitation.

Question 4

Which of the following hernias carries the HIGHEST risk of strangulation?

Accepted Answer

Femoral hernia

Answer

Femoral hernias have the highest strangulation rate due to the narrow, rigid femoral ring that tightly constricts herniated contents.

Question 5

When performing a splenectomy, which structure MUST be identified and preserved to prevent postoperative complications?

Accepted Answer

Tail of the pancreas

Answer

The tail of the pancreas lies in close proximity to the splenic hilum; inadvertent injury leads to pancreatic fistula or pseudocyst formation.

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

NCCPA Surgical Principles 5