View Answer

D

30. Which of the following statements about laparoscopic surgery is true?

A Due to the minimally invasive nature of laparoscopy, preoperative evaluation of patients is less critical than for laparotomy.

B Routine use of orogastric tubes and urinary catheters is unnecessary during advanced laparoscopic procedures.

C The abdomen is always prepared and draped for potential laparotomy.

D Antithromboembolic pumps are not needed during laparoscopic procedures, as the risk of deep venous thrombosis is less than for laparotomy.

E Spinal anesthesia is sufficient for most advanced laparoscopic procedures.

View Answer

C

31. Which of the following physiologic changes occurs as a result of carbon dioxide pneumoperitoneum?

A Decreased pulmonary compliance due to diaphragm elevation and increased abdominal pressure

B Metabolic alkalosis from systemic absorption of carbon dioxide

C Increased cardiac output as a result of increased venous return

D Decreased systemic vascular resistance

E Decreased mean arterial pressure

View Answer

A

32. A 32-year-old woman undergoes a laparoscopic cholecystectomy for biliary colic. Forty-eight hours after the operation, she complains of fever and right upper quadrant pain. Laboratory studies reveal an elevated white blood cell count as well as an elevated total bilirubin. Which of the following is not part of the initial management?

A CT scan of the abdomen

B Hydroxy iminodiacetic acid (HIDA) biliary scan

C Surgical exploration

D Endoscopic retrograde cholangiopancreatography (ERCP)

E Broad spectrum antibiotics

View Answer

C

33. Which of the following is true about pediatric hernias?

A The incidence is roughly equal in males and females, with males becoming more common as age increases.

B Congenital pediatric hernias are bilateral 50% of the time.

C Inguinal hernias often close spontaneously in children, and repair should be delayed until 2 years of age.

D Incarcerated hernias in children should never be reduced. Emergency repair is mandatory.

E Right-sided inguinal hernias are twice as common as left-sided inguinal hernias.

View Answer

E

34. A victim of a motor vehicle accident who was thrown from the vehicle is brought to the emergency department. The patient is unconscious and hypotensive. He is found to have a dilated left pupil,

decreased breath sounds over the right chest, a moderately distended abdomen, an unstable pelvis, and severe bruises over the thighs. After resuscitation with 2 L of crystalloid and 2 units of type-specific packed red blood cells, the patient remains hypotensive with a systolic blood pressure in the low 80s. What is the least likely explanation for this patient's hypotension?

A External blood loss

B Bleeding into the chest

C Retroperitoneal bleeding

D Severe closed head injury

E Femoral fractures

View Answer

D

35. An adult male is brought to the emergency department for evaluation and treatment following injury in a house fire. The patient was found in a closed room. He has singed facial hair and full-thickness burns over approximately 30% of his body surface area. All of the following are important in his initial stabilization and treatment except which?

A Endotracheal intubation

B Intravenous fluid resuscitation

C Insertion of a ureteral catheter

D Tetanus toxoid administration

E Systemic antibiotics