WISE MD – SURGERY | CLINICAL SURGICAL 150 PRACTICE
QUESTIONS WITH CORRECT ANSWERS 2025 LATEST UPDATE
COVERING MOST TESTED QUESTIONS
THE WISE MD – SURGERY 2025 EXAM RESOURCE IS STRATEGICALLY DESIGNED
TO PREPARE MEDICAL STUDENTS FOR EVERY PHASE OF SURGICAL CARE—
FROM PATIENT EVALUATION TO POSTOPERATIVE FOLLOW-UP. THIS PRACTICE
SET GUARANTEES STUDENTS A COMPREHENSIVE REVIEW OF THE MOST
TESTED CONCEPTS ON THE 2025 EXAM, BOOSTING EXAM PERFORMANCE AND
CLINICAL CONFIDENCE.
A 49-year-old man is referred for evaluation of a left groin mass found during a routine screening
physical. He has well-controlled hypertension but no other chronic disease or history of prior
surgery. He is 70 in (178 cm) tall and weighs 160 lb (73 kg). On physical examination, blood pressure
is 132/80 mm Hg, pulse is 75/min, and respirations are 16/min and unlabored. With the patient in
supine position, the abdomen is soft and nontender; there is no organomegaly, and no masses are
palpated. No groin or scrotal masses are appreciated, and there is no tenderness to palpation.
Which of the following is the most appropriate next step in management?
a. Reassure the patient that no hernia is present
b. Order computed tomography of the pelvis
c. Have the patient stand up and perform the Valsalva maneuver
d. Advise the patient to return to clinic when the mass is protruding
e. Obtain an ultrasound of the groin - CORRECT ANSWER-c. Have the patient stand up and perform
the Valsalva maneuver
A 49-year-old man is referred for evaluation of a left groin mass found during a routine screening
physical. He has well-controlled hypertension but no other chronic disease or history of prior
surgery. He is 70 in (178 cm) tall and weighs 160 lb (73 kg). On physical examination, blood pressure
is 132/80 mm Hg, pulse is 75/min, and respirations are 16/min and unlabored. With the patient in
supine position, the abdomen is soft and nontender; there is no organomegaly, and no masses are
palpated. No groin or scrotal masses are appreciated, and there is no tenderness to palpation.
Which of the following differentials should be given greatest consideration when choosing the next
step in management?
a. Epididymitis
b. Testicular torsion
c. Indirect or direct inguinal hernia
,d. Direct inguinal hernia but not indirect
e. Indirect inguinal hernia but not direct - CORRECT ANSWER-c. Indirect or direct inguinal hernia
During a routine follow-up appointment for well-controlled dyslipidemia, a 26-year-old man is
evaluated for a lump in his right groin. He first noted the lump one evening approximately 2 months
ago after he helped his fiancé move into a new apartment. The lump was moderately
uncomfortable, with pain concentrated in the groin and upper, inner aspect of his right thigh. The
mass and discomfort subsided by the next morning, but he has had recurrence of mild to moderate
pain during the week, but he is generally asymptomatic in the morning before going to work at his
job at a factory where he stands most of the day. He has no prior surgical history, and his medical
history is otherwise unremarkable. On physical examination, a soft, reducible mass consistent with a
hernia is palpated in the right groin; the left groin appears normal. Which of the following is the
most likely diagnosis?
a. Direct inguinal hernia
b. Hydroce - CORRECT ANSWER-d. Indirect inguinal hernia
uring a routine follow-up appointment for well-controlled dyslipidemia, a 26-year-old man is
evaluated for a lump in his right groin. He first noted the lump one evening approximately 2 months
ago after he helped his fiancé move into a new apartment. The lump was moderately
uncomfortable, with pain concentrated in the groin and upper, inner aspect of his right thigh. The
mass and discomfort subsided by the next morning, but he has had recurrence of mild to moderate
pain during the week, but he is generally asymptomatic in the morning before going to work at his
job at a factory where he stands most of the day. He has no prior surgical history, and his medical
history is otherwise unremarkable. On physical examination, a soft, reducible mass consistent with a
hernia is palpated in the right groin; the left groin appears normal. Which of the following is the
most appropriate next step in management?
a. Use of a truss - CORRECT ANSWER-Elective open inguinal hernia repair at the patient's
convenience
During a routine follow-up appointment for well-controlled dyslipidemia, a 26-year-old man is
evaluated for a lump in his right groin. He first noted the lump one evening approximately 2 months
ago after he helped his fiancé move into a new apartment. The lump was moderately
uncomfortable, with pain concentrated in the groin and upper, inner aspect of his right thigh. The
mass and discomfort subsided by the next morning, but he has had recurrence of mild to moderate
pain during the week, but he is generally asymptomatic in the morning before going to work at his
job at a factory where he stands most of the day. He has no prior surgical history, and his medical
history is otherwise unremarkable. On physical examination, a soft, reducible mass consistent with a
hernia is palpated in the right groin; the left groin appears normal. Which of the following is the
most likely source of this patient's pain?
a. Stretching of - CORRECT ANSWER-Compression of the ilioinginal nerve by the hernia
,During a routine physical examination for a new job, a 50-year-old man is found to have a small
inguinal hernia in the right groin. He didn't know he had it. He is asymptomatic, and his medical
history is otherwise unremarkable. His father had successful hernia repair surgery at the age of 52
years. Which of the following is the most appropriate treatment recommendation?
a. Close follow-up of the patient every 6 months for at least 5 years
b. Diagnostic laparoscopy to confirm the diagnosis with plans to repair it if the defect is greater than
1.5 cm
c. Elective laparoscopic inguinal hernia repair at a convenient time
d. Elective open inguinal hernia repair at a convenient time
e. Reassurance of the patient with instructions to return if symptoms develop - CORRECT ANSWER-
Reassurance of the patient with instructions to return if symptoms develop
A 73-year-old man presents with signs and symptoms of a new, mildly symptomatic right inguinal
hernia. During elective open anterior repair of the hernia, the external oblique aponeurosis is
opened in the direction of its fibers. Which of the following can the surgeon expect to find beneath
the external oblique?
a. Superficial inguinal ring
b. Internal oblique aponeurosis
c. Lacunar ligament
d. Femoral canal
e. Spermatic cord - CORRECT ANSWER-Spermatic cord
A 30-year-old woman is evaluated for avone-day history of obstipation and severe nausea with
increasingly bilious emesis. She has no history of previous abdominal surgery. On physical
examination, the abdomen is distended and diffusely tympanitic but without peritoneal signs. A firm
right groin mass is palpated and does not reduce in the supine position or with manual
manipulation. Which of the following is the most likely diagnosis?
a. Pantaloon hernia
b. Hyperemesis gravidarum
c. "Sports hernia"
d. Incarcerated hernia
e. Richter's hernia - CORRECT ANSWER-Incarcerated hernia
When the contents of a hernia sac cannot be returned to their normal anatomic location, the hernia
is said to be incarcerated.
, A 30-year-old woman is evaluated for a one-day history of obstipation and severe nausea with
increasingly bilious emesis. She has no history of previous abdominal surgery. On physical
examination, the abdomen is distended and diffusely tympanitic but without peritoneal signs. A firm
right groin mass is palpated and does not reduce in the supine position or with manual
manipulation. Upon exploration of the inguinal canal, no hernia is found in the indirect or direct
spaces. Which of the following the most appropriate strategy to determine if a femoral hernia is
present?
a. Divide the transversalis fascia to expose the femoral canal
b. Identify the processus vaginalis and follow it to the deep inguinal ring
c. Divide the round ligament to expose the femoral vessels
d. Open the peritoneum to explore the femoral canal
e. Obtain an intra-operative ultrasound to look for a femoral hernia - CORRECT ANSWER-Divide the
transversalis fascia to expose the femoral canal
A 30-year-old woman is evaluated for a one-day history of obstipation and severe nausea with
increasingly bilious emesis. She has no history of previous abdominal surgery. On physical
examination, the abdomen is distended and diffusely tympanitic but without peritoneal signs. A firm
right groin mass is palpated and does not reduce in the supine position or with manual
manipulation. The patient is scheduled to undergo mesh repair of a femoral hernia. During the
procedure, the mesh must be anchored to which of the following anatomic structures?
a. The ileopubic tract (conjoined tendon)
b. The iliac crest
c. The shelving edge of the inguinal ligament
d. The deep inguinal ring
e. The pectineal (Cooper's) ligament - CORRECT ANSWER-The pectineal (Cooper's) ligament
A 21-year-old male college basketball player undergoing evaluation for groin pain is found to have
bilateral reducible inguinal hernias. Which of the following is the most appropriate management?
a. Physical therapy
b. Laparoscopic hernia repair
c. Elective open inguinal hernia repair with mesh
d. High ligation of the sac
QUESTIONS WITH CORRECT ANSWERS 2025 LATEST UPDATE
COVERING MOST TESTED QUESTIONS
THE WISE MD – SURGERY 2025 EXAM RESOURCE IS STRATEGICALLY DESIGNED
TO PREPARE MEDICAL STUDENTS FOR EVERY PHASE OF SURGICAL CARE—
FROM PATIENT EVALUATION TO POSTOPERATIVE FOLLOW-UP. THIS PRACTICE
SET GUARANTEES STUDENTS A COMPREHENSIVE REVIEW OF THE MOST
TESTED CONCEPTS ON THE 2025 EXAM, BOOSTING EXAM PERFORMANCE AND
CLINICAL CONFIDENCE.
A 49-year-old man is referred for evaluation of a left groin mass found during a routine screening
physical. He has well-controlled hypertension but no other chronic disease or history of prior
surgery. He is 70 in (178 cm) tall and weighs 160 lb (73 kg). On physical examination, blood pressure
is 132/80 mm Hg, pulse is 75/min, and respirations are 16/min and unlabored. With the patient in
supine position, the abdomen is soft and nontender; there is no organomegaly, and no masses are
palpated. No groin or scrotal masses are appreciated, and there is no tenderness to palpation.
Which of the following is the most appropriate next step in management?
a. Reassure the patient that no hernia is present
b. Order computed tomography of the pelvis
c. Have the patient stand up and perform the Valsalva maneuver
d. Advise the patient to return to clinic when the mass is protruding
e. Obtain an ultrasound of the groin - CORRECT ANSWER-c. Have the patient stand up and perform
the Valsalva maneuver
A 49-year-old man is referred for evaluation of a left groin mass found during a routine screening
physical. He has well-controlled hypertension but no other chronic disease or history of prior
surgery. He is 70 in (178 cm) tall and weighs 160 lb (73 kg). On physical examination, blood pressure
is 132/80 mm Hg, pulse is 75/min, and respirations are 16/min and unlabored. With the patient in
supine position, the abdomen is soft and nontender; there is no organomegaly, and no masses are
palpated. No groin or scrotal masses are appreciated, and there is no tenderness to palpation.
Which of the following differentials should be given greatest consideration when choosing the next
step in management?
a. Epididymitis
b. Testicular torsion
c. Indirect or direct inguinal hernia
,d. Direct inguinal hernia but not indirect
e. Indirect inguinal hernia but not direct - CORRECT ANSWER-c. Indirect or direct inguinal hernia
During a routine follow-up appointment for well-controlled dyslipidemia, a 26-year-old man is
evaluated for a lump in his right groin. He first noted the lump one evening approximately 2 months
ago after he helped his fiancé move into a new apartment. The lump was moderately
uncomfortable, with pain concentrated in the groin and upper, inner aspect of his right thigh. The
mass and discomfort subsided by the next morning, but he has had recurrence of mild to moderate
pain during the week, but he is generally asymptomatic in the morning before going to work at his
job at a factory where he stands most of the day. He has no prior surgical history, and his medical
history is otherwise unremarkable. On physical examination, a soft, reducible mass consistent with a
hernia is palpated in the right groin; the left groin appears normal. Which of the following is the
most likely diagnosis?
a. Direct inguinal hernia
b. Hydroce - CORRECT ANSWER-d. Indirect inguinal hernia
uring a routine follow-up appointment for well-controlled dyslipidemia, a 26-year-old man is
evaluated for a lump in his right groin. He first noted the lump one evening approximately 2 months
ago after he helped his fiancé move into a new apartment. The lump was moderately
uncomfortable, with pain concentrated in the groin and upper, inner aspect of his right thigh. The
mass and discomfort subsided by the next morning, but he has had recurrence of mild to moderate
pain during the week, but he is generally asymptomatic in the morning before going to work at his
job at a factory where he stands most of the day. He has no prior surgical history, and his medical
history is otherwise unremarkable. On physical examination, a soft, reducible mass consistent with a
hernia is palpated in the right groin; the left groin appears normal. Which of the following is the
most appropriate next step in management?
a. Use of a truss - CORRECT ANSWER-Elective open inguinal hernia repair at the patient's
convenience
During a routine follow-up appointment for well-controlled dyslipidemia, a 26-year-old man is
evaluated for a lump in his right groin. He first noted the lump one evening approximately 2 months
ago after he helped his fiancé move into a new apartment. The lump was moderately
uncomfortable, with pain concentrated in the groin and upper, inner aspect of his right thigh. The
mass and discomfort subsided by the next morning, but he has had recurrence of mild to moderate
pain during the week, but he is generally asymptomatic in the morning before going to work at his
job at a factory where he stands most of the day. He has no prior surgical history, and his medical
history is otherwise unremarkable. On physical examination, a soft, reducible mass consistent with a
hernia is palpated in the right groin; the left groin appears normal. Which of the following is the
most likely source of this patient's pain?
a. Stretching of - CORRECT ANSWER-Compression of the ilioinginal nerve by the hernia
,During a routine physical examination for a new job, a 50-year-old man is found to have a small
inguinal hernia in the right groin. He didn't know he had it. He is asymptomatic, and his medical
history is otherwise unremarkable. His father had successful hernia repair surgery at the age of 52
years. Which of the following is the most appropriate treatment recommendation?
a. Close follow-up of the patient every 6 months for at least 5 years
b. Diagnostic laparoscopy to confirm the diagnosis with plans to repair it if the defect is greater than
1.5 cm
c. Elective laparoscopic inguinal hernia repair at a convenient time
d. Elective open inguinal hernia repair at a convenient time
e. Reassurance of the patient with instructions to return if symptoms develop - CORRECT ANSWER-
Reassurance of the patient with instructions to return if symptoms develop
A 73-year-old man presents with signs and symptoms of a new, mildly symptomatic right inguinal
hernia. During elective open anterior repair of the hernia, the external oblique aponeurosis is
opened in the direction of its fibers. Which of the following can the surgeon expect to find beneath
the external oblique?
a. Superficial inguinal ring
b. Internal oblique aponeurosis
c. Lacunar ligament
d. Femoral canal
e. Spermatic cord - CORRECT ANSWER-Spermatic cord
A 30-year-old woman is evaluated for avone-day history of obstipation and severe nausea with
increasingly bilious emesis. She has no history of previous abdominal surgery. On physical
examination, the abdomen is distended and diffusely tympanitic but without peritoneal signs. A firm
right groin mass is palpated and does not reduce in the supine position or with manual
manipulation. Which of the following is the most likely diagnosis?
a. Pantaloon hernia
b. Hyperemesis gravidarum
c. "Sports hernia"
d. Incarcerated hernia
e. Richter's hernia - CORRECT ANSWER-Incarcerated hernia
When the contents of a hernia sac cannot be returned to their normal anatomic location, the hernia
is said to be incarcerated.
, A 30-year-old woman is evaluated for a one-day history of obstipation and severe nausea with
increasingly bilious emesis. She has no history of previous abdominal surgery. On physical
examination, the abdomen is distended and diffusely tympanitic but without peritoneal signs. A firm
right groin mass is palpated and does not reduce in the supine position or with manual
manipulation. Upon exploration of the inguinal canal, no hernia is found in the indirect or direct
spaces. Which of the following the most appropriate strategy to determine if a femoral hernia is
present?
a. Divide the transversalis fascia to expose the femoral canal
b. Identify the processus vaginalis and follow it to the deep inguinal ring
c. Divide the round ligament to expose the femoral vessels
d. Open the peritoneum to explore the femoral canal
e. Obtain an intra-operative ultrasound to look for a femoral hernia - CORRECT ANSWER-Divide the
transversalis fascia to expose the femoral canal
A 30-year-old woman is evaluated for a one-day history of obstipation and severe nausea with
increasingly bilious emesis. She has no history of previous abdominal surgery. On physical
examination, the abdomen is distended and diffusely tympanitic but without peritoneal signs. A firm
right groin mass is palpated and does not reduce in the supine position or with manual
manipulation. The patient is scheduled to undergo mesh repair of a femoral hernia. During the
procedure, the mesh must be anchored to which of the following anatomic structures?
a. The ileopubic tract (conjoined tendon)
b. The iliac crest
c. The shelving edge of the inguinal ligament
d. The deep inguinal ring
e. The pectineal (Cooper's) ligament - CORRECT ANSWER-The pectineal (Cooper's) ligament
A 21-year-old male college basketball player undergoing evaluation for groin pain is found to have
bilateral reducible inguinal hernias. Which of the following is the most appropriate management?
a. Physical therapy
b. Laparoscopic hernia repair
c. Elective open inguinal hernia repair with mesh
d. High ligation of the sac
