100+ Free ABS Vascular Surgery Practice Questions

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~80-90% first-time among graduates of ACGME-accredited vascular training (ABS annual statistics) Pass Rate

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Question 1

Score: 0/0

According to USPSTF recommendations, who should receive one-time ultrasound screening for abdominal aortic aneurysm (AAA)?

All men and women aged 50-75

Men aged 65-75 who have ever smoked

Women aged 65-75 who have ever smoked

All first-degree relatives of AAA patients regardless of age

to track

2026 Statistics

Key Facts: ABS Vascular Surgery Exam

~275

Total MCQ Items

ABS Vascular Surgery Qualifying Examination (approximately 250-300)

~8 hr

Total Exam Time

1-day computer-based test including breaks

~17%

Aortic Weight

Largest single domain on 2026 ABS Vascular Surgery content outline

~$1,750-$2,000

2026 Qualifying Exam Fee

ABS (verify current schedule)

5 or 5+2 yr

Training Required

ACGME integrated (0+5) or independent (5+2) vascular training

~80-90%

First-Time Pass Rate

ABS annual statistics (ACGME-trained graduates)

The ABS Vascular Surgery Qualifying Examination is a 1-day computer-based test from the American Board of Surgery Vascular Surgery Board comprising ~250-300 single-best-answer MCQs over ~8 hours at Pearson VUE. Content spans aortic (~17%), peripheral arterial and CLTI (~17%), cerebrovascular (~9%), mesenteric/renal (~6%), venous (~9%), dialysis access (~6%), vascular trauma (~6%), noninvasive vascular lab (~8%), endovascular techniques (~9%), medical management (~6%), lymphatics/vascular malformations (~3%), and perioperative/complications (~4%). The fee is ~$1,750-$2,000; requires completion of ACGME-accredited vascular training (integrated 5-year or independent 5+2 fellowship).

Sample ABS Vascular Surgery Practice Questions

Try these sample questions to test your ABS Vascular Surgery exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to USPSTF recommendations, who should receive one-time ultrasound screening for abdominal aortic aneurysm (AAA)?

A.All men and women aged 50-75

B.Men aged 65-75 who have ever smoked

C.Women aged 65-75 who have ever smoked

D.All first-degree relatives of AAA patients regardless of age

Explanation: USPSTF gives a Grade B recommendation for one-time AAA screening with abdominal ultrasound in men aged 65-75 who have ever smoked. Screening in never-smoking men of this age is Grade C (selective), and routine screening of women has insufficient evidence (I statement) or is not recommended in never-smoking women.

2A 72-year-old man is found to have a 5.6 cm infrarenal AAA on screening ultrasound. He is an acceptable surgical candidate with favorable anatomy. Per SVS 2018 guidelines, what is the recommended management?

A.Surveillance ultrasound in 6 months

B.Elective repair (EVAR or open) is indicated

C.Repeat CTA in 1 year

D.Medical management only with beta blockade

Explanation: SVS guidelines recommend elective repair for infrarenal AAA ≥5.5 cm in men (≥5.0 cm in women), rapid expansion (>0.5 cm/6 months or >1 cm/year), or symptomatic aneurysms. At 5.6 cm, rupture risk exceeds operative risk in an acceptable candidate.

3The EVAR-1 and DREAM trials demonstrated which outcome comparing EVAR to open repair of infrarenal AAA?

A.Higher 30-day mortality with EVAR

B.Lower early mortality with EVAR but loss of survival advantage by 2-4 years

C.No difference in any outcome at any time point

D.Permanent long-term survival advantage with EVAR

Explanation: EVAR-1 and DREAM showed ~2-3% absolute reduction in perioperative mortality with EVAR versus open repair. However, the early survival advantage disappeared by 2-4 years due to reinterventions, endoleaks, and late ruptures. Long-term mortality is equivalent, emphasizing the importance of lifelong imaging surveillance after EVAR.

4Which endoleak type requires the most urgent intervention after EVAR?

A.Type I (seal zone leak at proximal or distal attachment)

B.Type II (retrograde flow from lumbar or IMA)

C.Type IV (graft porosity)

D.Type V (endotension without demonstrable leak)

Explanation: Type I endoleaks represent direct systemic pressurization of the aneurysm sac from inadequate proximal (Ia) or distal (Ib) seal and carry a high risk of rupture. They require prompt intervention — proximal cuff, palmaz stent, embolization, or conversion. Type III (junctional leaks) are similarly high-risk. Type II are typically observed unless sac expands.

5A patient presents with acute onset tearing chest pain radiating to the back. CTA shows a Stanford type A aortic dissection involving the ascending aorta. What is the appropriate management?

A.Medical management with IV beta blockade and close monitoring

B.Urgent open surgical repair (ascending aortic replacement)

C.TEVAR alone

D.Aortic fenestration

Explanation: Stanford type A dissections (involving the ascending aorta) are surgical emergencies due to risk of tamponade, aortic insufficiency, coronary malperfusion, and rupture — mortality is ~1-2% per hour untreated. Treatment is urgent ascending aortic replacement. Type B (descending only) is typically managed medically unless complicated.

6An uncomplicated Stanford type B aortic dissection should be managed with which first-line therapy?

A.Immediate TEVAR

B.Impulse control — IV beta blockade targeting HR <60 and SBP 100-120

C.Open thoracoabdominal replacement

D.Anticoagulation with heparin

Explanation: Uncomplicated type B dissection is treated with anti-impulse therapy: IV beta blockade (esmolol/labetalol) first to reduce dP/dt, targeting HR <60 and SBP 100-120 mmHg, then add vasodilators. TEVAR is indicated for complicated type B (malperfusion, rupture, refractory pain/hypertension, rapid expansion). INSTEAD/ADSORB suggest TEVAR may improve late remodeling in selected subacute cases.

7The Crawford classification describes thoracoabdominal aortic aneurysms. A Crawford Extent II TAAA extends:

A.From distal to left subclavian to above the renal arteries

B.From distal to left subclavian to below the renal arteries (entire thoracoabdominal)

C.From distal thoracic to above the renals

D.Distal to renal arteries only

Explanation: Crawford I: distal LSCA to above renals. Crawford II: distal LSCA to below renals (entire thoracoabdominal — highest risk for spinal cord ischemia and mortality). Crawford III: distal thoracic to below renals. Crawford IV: entire abdominal (diaphragm to iliac bifurcation).

8Which adjunct has the strongest evidence for reducing spinal cord ischemia during TAAA repair?

A.Routine systemic hypothermia to 28°C

B.Cerebrospinal fluid drainage targeting pressure <10 mmHg

C.High-dose corticosteroids

D.Intraoperative papaverine into the aorta

Explanation: CSF drainage (targeting CSF pressure ≤10 mmHg with MAP ≥80-90) is a Class I recommendation for extent I-III TAAA repair and improves spinal cord perfusion pressure. Other neuroprotective adjuncts include distal aortic perfusion, reimplantation of critical intercostals, moderate hypothermia, and hemoglobin optimization.

9A ruptured AAA patient arrives hypotensive. What is the recommended initial resuscitation strategy?

A.Aggressive crystalloid resuscitation to normal BP

B.Permissive hypotension targeting SBP 70-90 mmHg until proximal control

C.Vasopressors to MAP >90

D.Immediate full-volume resuscitation to CVP >12

Explanation: Permissive (hypotensive) resuscitation with SBP 70-90 mmHg reduces ongoing hemorrhage and clot disruption until proximal aortic control is achieved. Aggressive resuscitation worsens bleeding and mortality. Modern management emphasizes rapid transport, percutaneous EVAR where feasible, and hemostatic resuscitation with balanced blood products.

10Minimum recommended proximal aortic neck length for standard infrarenal EVAR per most current instructions for use (IFU) of commercially available devices is typically:

A.≥4 mm

B.≥10-15 mm with favorable angulation

C.≥30 mm regardless of angulation

D.No minimum

Explanation: Most modern EVAR devices require ≥10-15 mm of infrarenal neck (some as short as 10 mm with suprarenal fixation and active suprarenal barbs) with angulation ≤60°. Inadequate seal zone predicts type Ia endoleak. Short/hostile necks may require fenestrated/branched EVAR, EndoAnchors, or open repair.

About the ABS Vascular Surgery Exam

The ABS Vascular Surgery Qualifying Examination validates core knowledge for independent practice in vascular surgery. Content spans aortic disease (infrarenal AAA, TAAA, Stanford A/B dissection, EVAR/TEVAR, endoleaks, Crawford classification, spinal cord protection), peripheral arterial disease and CLTI (ABI/TBI, Rutherford, WIfI, GLASS, BEST-CLI, COMPASS, tibial intervention), cerebrovascular (NASCET/CREST, CEA, TCAR, duplex criteria), mesenteric and renal (acute and chronic mesenteric ischemia, CORAL, MALS), venous disease (DVT/PE, May-Thurner, ATTRACT, IVC filters, CEAP and venous ablation), dialysis access (KDOQI Fistula First, rule of 6s, steal syndrome), vascular trauma (blunt aortic injury, REBOA, extremity trauma, iatrogenic access injury), noninvasive vascular lab (duplex velocity criteria), endovascular techniques (access, IVUS, FEVAR/BEVAR, parallel grafts), medical management (statin, antiplatelet, SGLT2, HIT), lymphatics and ISSVA vascular malformations, and perioperative complications (graft infection, colon ischemia, aortoenteric fistula). Requires completion of ACGME-accredited vascular training (integrated 5-year or independent 5+2).

Questions

275 scored questions

Time Limit

1-day CBT (~8 hours including breaks)

Passing Score

Criterion-referenced scaled score set by the ABS Vascular Surgery Board (modified Angoff standard)

Exam Fee

~$1,750-$2,000 Qualifying Examination fee (ABS 2026 — verify current schedule) (American Board of Surgery — Vascular Surgery Board / Pearson VUE)

ABS Vascular Surgery Exam Content Outline

~17%

Aortic Disease (AAA, TAAA, Dissection)

Infrarenal AAA (USPSTF screening — men 65-75 ever-smokers; SVS thresholds ≥5.5 cm men, ≥5.0 cm women, rapid expansion >0.5 cm/6 mo), ruptured AAA (permissive hypotension SBP 70-90, REBOA), EVAR IFU (neck ≥10-15 mm, angulation ≤60°), endoleaks I-V (Type I urgent, Type II if ≥5 mm sac expansion), fenestrated/branched EVAR, Crawford I-IV TAAA, spinal cord ischemia prevention (CSF drainage ≤10 mmHg), Stanford A (urgent ascending repair) vs B (anti-impulse beta blockade; TEVAR for malperfusion/rupture, INSTEAD/ADSORB for subacute), PETTICOAT, mycotic aneurysm (Salmonella, Staph), post-implantation syndrome, SVS surveillance (CTA 1 mo, duplex annually).

~17%

Peripheral Arterial Disease (Aortoiliac, Infrainguinal, CLTI)

ABI ≤0.90 (TBI when non-compressible, CKD/DM), Rutherford claudication vs CLTI, WIfI (Wound/Ischemia/foot Infection) staging, TASC II, GLASS staging, supervised exercise 35-50 min 3×/wk ×12 wks, cilostazol, high-intensity statin, antiplatelet, COMPASS (rivaroxaban 2.5 mg BID + ASA) and VOYAGER-PAD post-revascularization, BEST-CLI Cohort 1 (bypass with adequate GSV superior to endo for MALE/death), femoropopliteal bypass (vein > prosthetic below knee), drug-coated balloons/stents (paclitaxel safety signal resolved), acute limb ischemia Rutherford I-III (thrombolysis for IIa, surgical thrombectomy for IIb), popliteal entrapment, Leriche syndrome.

~9%

Cerebrovascular (Carotid, Vertebral)

NASCET/ECST/ACAS/ACST: CEA for symptomatic ≥50-70%, asymptomatic ≥60-70% with good life expectancy; CREST (CEA vs CAS equivalent long-term; periprocedural stroke higher with CAS, MI higher with CEA; age <70 favors CAS); CREST-2 asymptomatic; duplex criteria (PSV >230 cm/s, ICA/CCA >4 for ≥70%); CEA technique (patch vs eversion, shunt, cranial nerves — hypoglossal, vagus, marginal mandibular); hyperperfusion syndrome; TCAR with flow reversal; carotid body tumor (Shamblin I-III); FMD; carotid dissection.

~9%

Venous Disease (DVT, Varicose, IVC Filter)

DVT/PE (Wells, D-dimer, duplex; apixaban/rivaroxaban first-line), May-Thurner (left iliac vein compression — stenting), phlegmasia cerulea dolens, ATTRACT (no routine CDT benefit; iliofemoral subgroup signal), CaVenT, IVC filters (PREPIC — retrievable, retrieve when no longer needed), CEAP C0-C6, venous reflux (>0.5 s superficial, >1 s deep), thermal ablation (RFA, EVLA), VenaSeal (cyanoacrylate), MOCA, phlebectomy, post-thrombotic syndrome, venous ulcer compression therapy.

~9%

Endovascular Techniques

Common femoral access with micropuncture/ultrasound, percutaneous EVAR with ProGlide preclose, radial/brachial alternatives, sheaths/wires/catheters, heparinization (ACT >250), IVUS for sizing (TEVAR, iliac veins), CO2 angiography for CKD, contrast-induced nephropathy mitigation, covered stents (Viabahn), drug-coated technology (DCB/DES), atherectomy, re-entry devices, parallel grafts (chimney/snorkel/sandwich), fenestrated/branched endografts, EndoAnchors for hostile neck, embolization materials (coils, plugs, glue, Onyx).

~8%

Noninvasive Vascular Lab

ABI, TBI, segmental pressures, PVR, treadmill testing, arterial duplex velocity criteria (PSV ratios for native/bypass/stent/EVAR surveillance), carotid duplex NASCET cutoffs (50%, 70%, near-occlusion), venous duplex for DVT (compressibility, augmentation, phasicity), reflux criteria, dialysis access surveillance (<600 mL/min or >50% stenosis), TCD for vasospasm, ICAVL/IAC accreditation, emboli monitoring during CEA.

~6%

Mesenteric & Renal

Acute mesenteric ischemia (embolic SMA — atrial fibrillation source; thrombotic — chronic atherosclerosis; NOMI — low-flow states; mesenteric venous thrombosis — hypercoagulable) — lactate, CTA, open embolectomy/bypass vs endo, bowel resection; chronic mesenteric ischemia (postprandial pain, food fear, weight loss — stenting vs bypass); median arcuate ligament syndrome (celiac compression by diaphragm); CORAL (renal artery stenting no benefit over medical therapy in atherosclerotic); FMD (balloon angioplasty effective).

~6%

Dialysis Access

KDOQI Fistula First, ESKD Life-Plan; preferred AVF order — radiocephalic > brachiocephalic > brachiobasilic transposition > AVG > tunneled catheter (avoid subclavian — central stenosis); vein mapping (≥2.5 mm vein, ≥2 mm artery); maturation rule of 6s (≥6 mm diameter, ≤6 mm deep, ≥600 mL/min by 6 weeks); stenosis surveillance (low flow, high venous pressure); steal syndrome management (DRIL, RUDI, PAI, banding); ischemic monomelic neuropathy (urgent ligation); high-output heart failure; HeRO graft for central venous occlusion; endoAVF (WavelinQ, Ellipsys).

~6%

Vascular Trauma

Hard signs (pulsatile bleeding, expanding hematoma, bruit/thrill, absent pulse, ischemia) — OR; soft signs — CTA/ABI; penetrating neck zones I/II/III (I and III — angiography; II — traditionally explored, increasingly selective with CTA); blunt thoracic aortic injury SVS grades I-IV (TEVAR first-line for grade III pseudoaneurysm/IV transection); extremity arterial injury — temporary shunt then vein interposition; mangled extremity (MESS), fasciotomy (compartment pressure >30 mmHg or delta P <30); REBOA zones 1/2/3 (zone 1 supraceliac, zone 3 infrarenal for pelvic hemorrhage); iatrogenic femoral pseudoaneurysm (ultrasound-guided thrombin).

~6%

Medical Management & Risk Factor Optimization

High-intensity statin (LDL <70, <55 very-high-risk ASCVD), antiplatelet (ASA 81 mg; DAPT post-CAS/stent), COMPASS vascular dose rivaroxaban 2.5 mg BID + ASA for stable atherosclerosis, VOYAGER-PAD after lower extremity revascularization, smoking cessation (varenicline, NRT, bupropion), A1c individualized <7%, SGLT2 inhibitors (empagliflozin/canagliflozin — CV benefit), BP <130/80 (ACC/AHA), HIT (4Ts score — argatroban or bivalirudin), protamine for heparin reversal, DOAC peri-procedural interruption.

~4%

Perioperative Care & Complications

Cardiac risk (RCRI, ACS-NSQIP risk calculator), beta-blocker continuation, selective stress testing, neuraxial vs general anesthesia for EVAR, postoperative surveillance, contrast allergy premedication (steroid + H1/H2 blockade), AKI prevention, colon ischemia after aortic repair (bloody diarrhea — sigmoidoscopy, resection for transmural), aortic graft infection (MAGIC criteria, explant + NAIS/rifampin-soaked/cryopreserved reconstruction), aortoenteric fistula (UGI bleed after prior aortic surgery — duodenum is classic).

~3%

Lymphatics & Vascular Malformations

Primary lymphedema (Milroy — FLT4/VEGFR3; Meige late-onset), secondary lymphedema (post-mastectomy, filariasis), ISL staging (0-III), compression garments, manual lymphatic drainage, LVA, VLNT; ISSVA classification — infantile hemangioma (GLUT1+, propranolol), NICH/RICH (GLUT1−), capillary malformation (port-wine — GNAQ, Sturge-Weber), venous malformation (TIE2/PIK3CA), lymphatic malformation (PIK3CA — sirolimus), AVM (Schobinger staging), Klippel-Trenaunay, Parkes-Weber.

How to Pass the ABS Vascular Surgery Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by the ABS Vascular Surgery Board (modified Angoff standard)
Exam length: 275 questions
Time limit: 1-day CBT (~8 hours including breaks)
Exam fee: ~$1,750-$2,000 Qualifying Examination fee (ABS 2026 — verify current schedule)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABS Vascular Surgery Study Tips from Top Performers

1AAA repair thresholds — high-yield: elective infrarenal repair for diameter ≥5.5 cm in men, ≥5.0 cm in women, rapid expansion (>0.5 cm/6 months or >1 cm/year), symptomatic (pain, tenderness, embolization), or ruptured. USPSTF screens men 65-75 who have ever smoked (Grade B), selective in never-smoking men (Grade C). Women ruptures at smaller sizes — lower threshold. EVAR-1/DREAM/OVER: early EVAR mortality benefit converges with open by 2-4 years due to reinterventions.

2Endoleak types after EVAR — memorize these cold: Type I (seal zone leak — Ia proximal, Ib distal) URGENT treat; Type II (retrograde flow from lumbar/IMA) observe unless ≥5 mm sac expansion, then transarterial/translumbar embolization; Type III (junctional or fabric tear) URGENT; Type IV (graft porosity, historical); Type V (endotension without demonstrable leak). Ruptured/expanding sac is never normal — image and treat.

3Crawford TAAA classification and spinal cord protection: Crawford I — distal LSCA to above renals; II — distal LSCA to below renals (entire thoracoabdominal, highest SCI risk); III — distal thoracic to below renals; IV — entire abdominal aorta (diaphragm to iliac bifurcation). CSF drainage to ≤10 mmHg with MAP ≥80-90 is Class I for I-III. Other adjuncts: distal aortic perfusion, moderate hypothermia, intercostal reimplantation, hemoglobin optimization.

4Carotid thresholds — NASCET (using distal normal ICA diameter): symptomatic ≥70% clear benefit; symptomatic 50-69% modest benefit (men more than women); asymptomatic ≥60-70% benefit in good-risk patients with ≥5 years life expectancy (ACAS/ACST). Duplex PSV >230 cm/s with ICA/CCA ratio >4 suggests ≥70% stenosis. CREST: CEA and CAS equivalent long-term; CAS higher periprocedural stroke, CEA higher MI; CAS favored in younger patients, CEA in older (>70).

5BEST-CLI (NEJM 2022) interpretation — high-yield trial: Cohort 1 (adequate single-segment greater saphenous vein) showed open bypass significantly reduced the composite of major adverse limb event or death vs endo (42.6% vs 57.4%, HR 0.68). Cohort 2 (no adequate GSV) showed no significant difference. Bottom line: bypass-first with adequate autologous vein in suitable CLTI patients. Combine with WIfI staging and GLASS anatomic staging for revascularization decisions.

Frequently Asked Questions

What is the ABS Vascular Surgery Qualifying Examination?

The ABS Vascular Surgery Qualifying Examination is the written component of initial certification administered by the American Board of Surgery Vascular Surgery Board. Candidates must pass the Qualifying (Written) Examination before sitting for the Certifying (Oral) Examination. Content spans the full scope of vascular surgery — aortic disease, peripheral arterial disease and CLTI, cerebrovascular, mesenteric and renal, venous disease, dialysis access, vascular trauma, noninvasive vascular laboratory, endovascular techniques, medical management, lymphatics, and perioperative care.

Who is eligible to take the ABS Vascular Surgery Qualifying Examination?

Candidates must complete ACGME-accredited vascular surgery training — either the integrated pathway (5-year integrated vascular surgery residency, 0+5) or the independent pathway (completion of an ACGME-accredited general surgery residency plus 2 years of ACGME-accredited vascular surgery fellowship, 5+2). A valid unrestricted medical license is required, and the program director must attest to satisfactory performance and professionalism.

What is the format of the ABS Vascular Surgery Qualifying Exam?

The Qualifying Examination is a 1-day computer-based test administered at Pearson VUE test centers. It comprises approximately 250-300 single-best-answer multiple-choice questions over roughly 8 hours including breaks. Items include clinical vignettes, duplex/CTA/angiography images, and management decisions. The exam is blueprinted to the ABS Vascular Surgery content outline.

How much does the 2026 ABS Vascular Surgery Qualifying Exam cost?

The 2026 Qualifying Examination fee is approximately $1,750-$2,000 — always verify the current schedule on the ABS website. Candidates also pay a separate Certifying (Oral) Examination fee (~$1,700-$2,000) after passing the Qualifying Exam. Cancellation and refund policies follow the ABS schedule with decreasing refunds as the exam date approaches. Retakes require full re-registration and fee payment within the allowed qualification window.

When is the 2026 exam administered?

The ABS Vascular Surgery Qualifying Examination is typically offered once annually. Applications generally open early in the year with a deadline several months before the test. Candidates schedule specific appointments with Pearson VUE after application approval. Exact 2026 dates should be confirmed on the ABS Vascular Surgery certification page.

How is the exam scored?

The ABS uses criterion-referenced scaled scoring with the passing standard set by subject-matter experts using the modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports include domain-level feedback. Candidates must pass the Qualifying Examination before becoming eligible to take the Certifying (Oral) Examination.

What are the highest-yield topics?

Highest-yield topics include AAA screening and SVS repair thresholds, endoleak types and EVAR IFU, Crawford TAAA classification and CSF drainage for spinal cord protection, Stanford A/B dissection management (urgent ascending repair vs anti-impulse beta blockade, TEVAR for complicated type B), BEST-CLI bypass-vs-endo interpretation, WIfI and GLASS staging, carotid stenosis thresholds (NASCET) and CREST interpretation, duplex velocity criteria for carotid and bypass surveillance, KDOQI Fistula First with the rule of 6s, blunt aortic injury SVS grades and TEVAR indications, COMPASS and VOYAGER-PAD antithrombotic regimens, and ISSVA classification of vascular anomalies.

How should I study for this exam?

Use a structured 12-18 month plan layered on training. Map to the ABS Vascular Surgery content outline: begin with aortic disease and endovascular fundamentals, then PAD/CLTI and cerebrovascular/mesenteric, then venous, dialysis access, trauma, and vascular lab, and finally medical management, vascular malformations, and perioperative care. Integrate Rutherford's Vascular Surgery, Cronenwett and Johnston, the SVS Clinical Practice Guidelines, VESAP modules, the RPVI exam content for duplex criteria, and landmark trials (EVAR-1, DREAM, OVER, NASCET, CREST, BEST-CLI, COMPASS, CORAL, ATTRACT). Complete 2-3 full-length timed mock exams.