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Physician Assistant Certification

NCCPA Cardiovascular and Thoracic Surgery CAQ Examination Practice Test

Cardiovascular and thoracic surgery practice involves perioperative assessment, postoperative monitoring, and recognition of complications affecting the heart, lungs, vessels, and surgical access sites. Clinical decisions may require interpreting hemodynamic changes, evaluating chest-tube findings, identifying threatened limb perfusion, or selecting an initial diagnostic study for suspected venous thrombosis.

Exam overview

Exam providerNational Commission on Certification of Physician Assistants
Exam codeNot listed
CategoryPhysician Assistant Certification

About the NCCPA Cardiovascular and Thoracic Surgery CAQ Examination Exam

The practice bank samples decisions that connect bedside findings with urgent surgical care. Questions address cardiac output assessment and arterial-line troubleshooting, along with signs of graft or circulatory compromise after cardiac surgery. Other scenarios involve pulmonary embolism, deep venous thrombosis, acute limb ischemia, persistent air leak, and chylous drainage after thoracic procedures. Preoperative planning includes assessing anatomy around a prior sternotomy, while perioperative device management includes reducing electrocautery interference with pacemakers. These situations call for prioritizing physiologic instability, choosing appropriate diagnostic or monitoring steps, and recognizing when findings warrant urgent intervention. The questions provide exposure to these clinical patterns; they do not establish official exam domains or their relative emphasis.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

A patient develops unilateral leg swelling and tenderness several days after a major operation. The patient is hemodynamically stable and has no chest symptoms. Which test is generally the initial imaging study to evaluate for lower-extremity deep venous thrombosis?

  1. ACompression duplex ultrasonography
  2. BPlain radiography of the leg
  3. CVentilation-perfusion scan
  4. DArterial angiography
Show answerCorrect answer: A

Compression duplex ultrasonography is the usual initial imaging test for suspected lower-extremity deep venous thrombosis. It evaluates venous compressibility and blood flow without ionizing radiation.

Question 2

A patient with a newly placed coronary artery bypass graft has a rising lactate level and cool extremities despite adequate blood pressure. Which bedside hemodynamic measure most directly estimates cardiac output?

  1. ACentral venous pressure alone
  2. BPulmonary artery thermodilution cardiac output
  3. CPulse pressure variation alone
  4. DSystemic vascular resistance alone
Show answerCorrect answer: B

Pulmonary artery thermodilution can provide a direct estimate of cardiac output when a pulmonary artery catheter is in place. Lactate elevation and cool extremities raise concern for impaired perfusion, but no single hemodynamic measurement should replace assessment of the whole clinical picture.

Question 3

A patient with a large pulmonary embolism has persistent hypotension despite initial supportive care. In the absence of a major contraindication, which treatment is generally considered for this high-risk presentation?

  1. ASystemic thrombolysis
  2. BAspirin alone
  3. CObservation with outpatient follow-up
  4. DRoutine inhaled bronchodilator therapy
Show answerCorrect answer: A

Persistent hypotension from pulmonary embolism indicates high-risk disease. Systemic thrombolysis is generally considered when bleeding risk permits; catheter-based or surgical embolectomy may be alternatives when thrombolysis is contraindicated or unsuccessful.

Question 4

A patient with a persistent chylous leak after thoracic surgery has milky chest-tube drainage that increases after meals. Which dietary modification is commonly used as part of initial conservative management?

  1. AHigh-fat diet to increase caloric intake
  2. BLow-fat diet enriched with medium-chain triglycerides
  3. CHigh-protein diet with unrestricted long-chain fats
  4. DClear liquids only until the leak stops
Show answerCorrect answer: B

Reducing long-chain dietary fats and using medium-chain triglycerides can reduce lymphatic flow through the thoracic duct because medium-chain triglycerides are absorbed largely into the portal circulation. Nutritional support and monitoring of drainage are important; persistent or high-output leaks may need additional treatment.

Question 5

A patient with a new arteriovenous dialysis fistula has a continuous thrill and bruit. Which finding would most strongly suggest the access is not functioning adequately despite these signs?

  1. AA palpable thrill along the fistula
  2. BA continuous bruit over the anastomosis
  3. CFailure of the fistula to mature sufficiently for reliable cannulation
  4. DMild bruising shortly after surgery
Show answerCorrect answer: C

A thrill and bruit indicate blood flow through the access but do not establish that it has matured enough for effective dialysis cannulation. Maturation is assessed clinically and, when needed, with imaging based on flow, diameter, and depth. A nonmaturing access needs evaluation for correctable causes.

Question 6

A patient has a persistent air leak after pulmonary resection, and the chest tube is functioning correctly. Which finding most directly indicates that the leak is continuing?

  1. ABubbling in the water-seal chamber during expiration or coughing
  2. BA stable, small amount of serous fluid in the collection chamber
  3. CA patent tube with no visible movement in the water-seal chamber
  4. DA dry dressing at the insertion site
Show answerCorrect answer: A

Bubbling in the water-seal chamber indicates air passing through the drainage system and may reflect an ongoing air leak. The pattern and clinical context help distinguish a patient leak from a system leak.

Question 7

A patient with a prior median sternotomy is scheduled for repeat cardiac surgery. Which imaging approach is especially useful for assessing the relationship of the right ventricle and great vessels to the posterior surface of the sternum before re-entry?

  1. AComputed tomography of the chest
  2. BPlain abdominal radiography
  3. CCarotid duplex ultrasonography
  4. DVentilation-perfusion scanning
Show answerCorrect answer: A

Chest CT can define the proximity of cardiac structures, bypass grafts, and great vessels to the sternum. This information can help the surgical team plan safer re-entry in patients undergoing repeat sternotomy.

How to use this practice test

Access is free. The bank contains 50 published practice questions, and each session presents up to 20 random questions. Submit a session to see results, then use missed or uncertain items to identify clinical decisions and findings that need more focused review.

Preparation tips

  • For postoperative hemodynamic scenarios, distinguish blood pressure from measures that estimate cardiac output, and connect lactate trends and peripheral perfusion to the clinical picture.
  • Review evaluation and escalation principles for venous thromboembolism, including suspected leg DVT and hemodynamically unstable pulmonary embolism.
  • Compare chest-tube findings associated with persistent air leak and chylous drainage, including how meal-related output can inform conservative management.
  • Practice recognizing acute limb ischemia findings that indicate threatened but potentially salvageable tissue and the need for urgent revascularization.
  • Review re-entry imaging after median sternotomy, arterial-line waveform troubleshooting, and precautions for pacemakers during monopolar electrocautery.
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