100+ Free Surgery Shelf Practice Questions
Pass your NBME Clinical Science Subject Examination in Surgery exam on the first try — instant access, no signup required.
A 68-year-old man has painless jaundice, dark urine, weight loss, and a palpable nontender gallbladder. CT shows a mass in the pancreatic head without metastases. What is the most appropriate potentially curative treatment?
Explore More NBME Medical School Assessments
Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.
Key Facts: Surgery Shelf Exam
110
Official Exam Items
NBME Timing Chart
2h45m
Official Testing Time
NBME Timing Chart
20%-25%
GI System Weight
NBME Surgery Outline
50%-60%
Diagnosis Task Weight
NBME Surgery Outline
30%-35%
Management Task Weight
NBME Surgery Outline
100
Practice Questions Here
Open Exam Prep
The official NBME Surgery Subject Exam is a 110-item, 2 hour 45 minute proctored exam. NBME's current public outline lists gastrointestinal disease as the largest system band (20%-25%), with cardiovascular (10%-15%) and respiratory (8%-12%) also prominent. Diagnosis accounts for 50%-60% of physician tasks and pharmacotherapy/intervention/management for 30%-35%.
Sample Surgery Shelf Practice Questions
Try these sample questions to test your Surgery Shelf exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 24-year-old man is brought after a high-speed motor vehicle collision. He is moaning, has blood in the oropharynx, and withdraws to pain. Pulse is 122/min, blood pressure is 104/70 mm Hg, and oxygen saturation is 88% despite a nonrebreather mask. What is the next best step?
2A 31-year-old man has a gunshot wound to the abdomen. He is confused, pulse is 138/min, blood pressure is 78/42 mm Hg, and the abdomen is rigid. Two large-bore IVs are placed and blood is requested. What is the most appropriate next step?
3A 22-year-old man is stabbed in the right chest. He is severely dyspneic with distended neck veins, tracheal deviation to the left, absent right breath sounds, and blood pressure of 82/50 mm Hg. What is the immediate treatment?
4A 67-year-old man has multiple left rib fractures after a fall. A segment of chest wall moves inward during inspiration. He is alert but increasingly tachypneic, and oxygen saturation is 89% on high-flow oxygen. Chest x-ray shows pulmonary contusion. What is the best next step?
5A 19-year-old woman has left upper quadrant pain after a bicycle crash. Blood pressure is 118/74 mm Hg after 1 L crystalloid, pulse is 94/min, and CT shows a contained splenic laceration without contrast extravasation. What is the preferred management?
6A 43-year-old man is hypotensive after a motorcycle crash. He has right upper quadrant tenderness and a positive FAST examination. After transfusion is started, blood pressure remains 76/44 mm Hg. What is the best next step?
7A 35-year-old man has a pelvic fracture after being crushed by a forklift. A pelvic binder is applied. He remains hypotensive after balanced transfusion; FAST is negative. What is the most appropriate next intervention?
8A restrained driver decelerates rapidly in a collision. He has chest pain and a widened mediastinum on chest x-ray but is hemodynamically stable. Which study is most appropriate to evaluate the suspected injury?
9A 28-year-old man falls from a roof and has complete loss of motor function below the umbilicus. During transfer after initial stabilization, his mean arterial pressure falls to 55 mm Hg. Which intervention best helps prevent secondary spinal cord injury?
10A 70-kg man has deep partial-thickness and full-thickness burns over the anterior trunk and both anterior legs after a house fire. Using the Parkland formula, approximately how much lactated Ringer solution should he receive in the first 8 hours from the burn?
About the Surgery Shelf Exam
The NBME Surgery Clinical Science Subject Exam is commonly used at the end of a medical school surgery clerkship. The public NBME outline emphasizes gastrointestinal disease, cardiovascular and respiratory systems, trauma and multisystem processes, breast, endocrine, renal/GU, musculoskeletal overlap, diagnosis, diagnostic testing, management, and perioperative decision-making.
Questions
110 scored questions
Time Limit
2 hours, 45 minutes
Passing Score
School-defined; NBME provides scaled scores and norms
Exam Fee
Institution-dependent (National Board of Medical Examiners (NBME))
Surgery Shelf Exam Content Outline
Gastrointestinal System
Appendicitis, biliary disease, pancreatitis, obstruction, perforation, diverticulitis, colorectal cancer, anorectal disease, hernias, upper and lower GI bleeding, and operative indications.
Cardiovascular and Vascular
Peripheral artery disease, acute limb ischemia, AAA, carotid stenosis, venous disease, vascular trauma, mesenteric ischemia, and perioperative cardiac risk.
Respiratory and Thoracic
Pneumothorax, hemothorax, flail chest, pulmonary embolism, postoperative atelectasis and pneumonia, thoracic trauma, and chest tube management.
Trauma, Critical Care, and Multisystem
ATLS priorities, shock, massive transfusion, solid-organ injury, pelvic fracture, burns, sepsis, fluids, electrolytes, and ICU complications.
Breast, Endocrine, Renal/GU, and Musculoskeletal
Breast cancer workup, thyroid nodules, parathyroid disease, adrenal tumors, urinary tract emergencies, compartment syndrome, open fractures, and septic joints.
Clinical Reasoning Tasks
Most questions require the next best diagnostic step, immediate stabilization priority, operative versus nonoperative management, or recognition of postoperative complications.
How to Pass the Surgery Shelf Exam
What You Need to Know
- Passing score: School-defined; NBME provides scaled scores and norms
- Exam length: 110 questions
- Time limit: 2 hours, 45 minutes
- Exam fee: Institution-dependent
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
Surgery Shelf Study Tips from Top Performers
Frequently Asked Questions
How many questions are on the official NBME Surgery shelf exam?
The NBME Subject Exam Timing Chart lists the Surgery Clinical Science Subject Exam as 110 items with a 2 hour, 45 minute testing time. This site's practice bank contains 100 original practice questions.
What topics are most important for the Surgery shelf?
NBME's public outline lists the gastrointestinal system as the largest band at 20%-25%. Cardiovascular, respiratory, trauma/multisystem processes, perioperative care, breast, endocrine, renal/GU, and musculoskeletal overlap are also tested.
Is the Surgery shelf only operative general surgery?
No. The exam heavily tests clinical diagnosis, triage, stabilization, and management. Students should know trauma priorities, acute abdomen, preoperative and postoperative care, fluids and electrolytes, vascular disease, breast, endocrine, and common orthopedic and urologic emergencies.
Who sets the passing score?
NBME provides equated scores and normative feedback, but medical schools determine how the score is used for clerkship grading, honors cutoffs, remediation, and retakes.
How should I use this qbank?
Work in timed mixed blocks, then review every explanation. For missed questions, identify whether the error was diagnosis, immediate stabilization, test selection, operative indication, or postoperative complication timing.