Free Laser and Surgical Procedures Examination (LSPE) — Surgical Section Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Laser and Surgical Procedures Examination (LSPE) — Surgical Section practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An optometrist closing a lid laceration in thin, friable periocular tissue is concerned that each individual suture will pull through the skin edge. A suture retention device such as a surgical button or suture bolster is available. Under FDA's device classification, what is that device intended to accomplish?

   1. A. Aid wound healing by distributing suture tension over a larger area in the patient
   2. B. Aid wound healing by producing hemostasis through acceleration of the blood clotting process
   3. C. Isolate the site of the surgical incision from microbial and other contamination
   4. D. Remove tissue and control bleeding by the use of high-frequency electrical current

   Answer: A

   Explanation: FDA's classification for this device states that "A suture retention device is a device, such as a retention bridge, a surgical button, or a suture bolster, intended to aid wound healing by distributing suture tension over a larger area in the patient." Spreading the load away from a single bite of friable tissue is exactly the problem described. Each wrong option is the intended use FDA assigns to a different general and plastic surgery device in the same subpart: producing hemostasis by accelerating clotting is the absorbable hemostatic agent and dressing, isolating the incision from contamination is the surgical drape, and removing tissue and controlling bleeding with high-frequency current is the electrosurgical cutting and coagulation device.

   Reference: Subpart E — § 878.4930(a); compare § 878.4490(a), § 878.4370(a) and § 878.4400(a)

2. 2An optometrist is preparing to excise a chalazion of the upper lid. The skin has been cleaned with an alcohol prep pad and a surgical marker is at hand. At what point in the sequence is the chalazion marked?

   1. A. Before the local anesthetic is injected
   2. B. After the anesthetic is injected but before the clamp is applied
   3. C. After the clamp is applied and the lid is everted
   4. D. After the incision has been made and the contents curetted

   Answer: A

   Explanation: The owner's clinical skills evaluation form scores the chalazion steps in order, asking whether the practitioner did "appropriately mark chalazion before injecting?" and only afterwards whether they did "inject 0.3-0.5cc lidocaine 1%/epinephrine 1:200,000 adjacent to chalazion using preloaded syringe?". Marking first matters because infiltration and the subsequent digital massage distort the lid and can make the lesion impossible to localise. Each wrong option is a real, later moment in the same scored sequence: after injection comes the massage to spread anesthesia, then "apply chalazion clamp and appropriately evert eyelid of model?", then the incision and curettage.

   Reference: Surgical LSPE Evaluation Form 2026 — Skill 2 - CHALAZION EXCISION, items 55 to 61

3. 3A patient collapses with anaphylaxis minutes after an injection in the clinic, and epinephrine is drawn up for intramuscular injection. Into which site does FDA labeling direct that it be given?

   1. A. The anterolateral aspect of the thigh
   2. B. The upper outer quadrant of the buttock
   3. C. The deltoid muscle of the upper arm
   4. D. The subcutaneous tissue of the abdominal wall

   Answer: A

   Explanation: The labeling directs that epinephrine be injected intramuscularly or subcutaneously "into the anterolateral aspect" "of the thigh, through clothing if necessary", and states that it "should only be injected into the anterolateral aspect of the thigh". Each wrong option is a real, routinely used parenteral injection site that this labeling nonetheless excludes for this drug: the dorsogluteal buttock site, of which the labeling says "Injection into the buttock may not provide effective treatment of anaphylaxis." and which has been associated with clostridial gas gangrene; the deltoid, the standard intramuscular site for vaccines; and the subcutaneous abdominal wall, a standard site for subcutaneous injections such as insulin. The labeling confines both of its permitted routes, intramuscular and subcutaneous, to the single site it names.

   Reference: Approval [Rx ONLY] — Dosage and Administration 2.1; Warnings and Precautions 5.2

4. 4FDA labeling warns that small doses of local anesthetic injected in the head and neck area, including retrobulbar injection, may produce confusion, convulsions, respiratory depression and cardiovascular effects. Besides intra-arterial injection with retrograde flow to the cerebral circulation, which mechanism does the labeling give for those reactions?

   1. A. Puncture of the dural sheath of the optic nerve, with the anesthetic diffusing along the subdural space to the midbrain
   2. B. Direct transection of the infraorbital nerve, with the anesthetic tracking along the nerve to the brainstem
   3. C. Absorption across the corneal epithelium, with the anesthetic entering the anterior chamber and then the orbit
   4. D. Compression of the central retinal artery, with the anesthetic held in the orbit under raised pressure

   Answer: A

   Explanation: The labeling states that these reactions may be due to intra-arterial injection of the local anesthetic with retrograde flow to the cerebral circulation, and that they may also be due to puncture of "the dural sheath of the optic nerve during retrobulbar block with diffusion of any local anesthetic along the subdural space to the" midbrain. The optic nerve's dural sheath is continuous with the intracranial subdural space, which is why a needle injury there can deliver drug centrally. The wrong options name real periocular structures and real routes of drug movement, but the labeling attaches none of them to this reaction, and a corneal or vascular-compression route could not deliver anesthetic to the midbrain.

   Reference: label — Warnings and Precautions 5.12, Risk of Adverse Reactions with Use in the Head and Neck Area

5. 5An optometrist is selecting a suture for an adnexal laceration repair and checks the intended use that FDA assigns to the surgical sutures covered by its safety and performance based pathway guidance. What intended use does that guidance state for those sutures?

   1. A. General soft tissue approximation and/or ligation
   2. B. Temporary internal control of bleeding from oozing raw surfaces
   3. C. Isolation of the operative site from microbial contamination
   4. D. Cleaning and maintenance debridement of open wounds

   Answer: A

   Explanation: The guidance states that the sutures within its scope "are intended for general soft tissue approximation and/or ligation, such as use in ophthalmic, cardiovascular, neurological, orthopedic, and dental procedures." An eyelid laceration repair is soft tissue approximation, so a suture cleared on this basis is being used within its labeled purpose. The other options are intended uses FDA assigns to different devices used in the same operative field rather than to sutures: temporary internal hemostasis belongs to the hemostatic sponge and gauze devices, isolating the site belongs to the surgical drape, and debridement of wounds belongs to the low energy ultrasound wound cleaner.

   Reference: FDA Surgical Sutures Performance Criteria — Section III, Scope/Device Description, Intended Use/Indications for Use paragraph

6. 6During a chalazion excision the optometrist has applied the chalazion clamp and everted the eyelid. Which step comes next?

   1. A. Making the incision through the centre of the chalazion
   2. B. Applying digital massage to spread the anesthetic
   3. C. Marking the position of the chalazion on the lid
   4. D. Applying antibiotic ointment to the operated lid

   Answer: A

   Explanation: The evaluation form places the incision immediately after clamping and eversion, asking whether the practitioner did "apply chalazion clamp and appropriately evert eyelid of model?" and then whether they did "move to chalazion model and properly make incision through center of chalazion?". Each wrong option is a real step of the same procedure that belongs at a different point: marking and digital massage are both completed before the clamp goes on, and applying antibiotic ointment comes near the end, after the contents have been removed, the lesion rinsed and hemostasis achieved.

   Reference: Surgical LSPE Evaluation Form 2026 — Skill 2 - CHALAZION EXCISION, items 55 to 67

7. 7An adult weighing 80 kg is being treated for anaphylaxis with a single-dose pre-filled epinephrine auto-injector. Which dose does FDA labeling specify for a patient of this weight?

   1. A. 0.3 mg
   2. B. 0.15 mg
   3. C. 0.5 mg
   4. D. 1 mg

   Answer: A

   Explanation: The labeling sets the dose by weight band: "Patients greater than or equal to 30 kg (66 lbs): 0.3 mg" and "Patients 15 to 30 kg (33 lbs-66 lbs): 0.15 mg". At 80 kg the patient falls in the higher band. The wrong options are doses in the same unit and the same order of magnitude; 0.15 mg is the real dose for the lighter band, and the labeling supplies only the 0.3 mg and 0.15 mg single-dose presentations, adding that another formulation should be considered if a dose lower than 0.15 mg is deemed necessary.

   Reference: Approval [Rx ONLY] — Dosage and Administration 2.1 and 2.2; Dosage Forms and Strengths

8. 8An optometrist is checking that infiltrating lidocaine hydrochloride injection before a lid procedure falls within the product's labelled use. What indication does FDA labeling state for lidocaine hydrochloride injection?

   1. A. Production of local or regional anesthesia or analgesia for surgical, diagnostic and therapeutic procedures
   2. B. Production of surface anesthesia of the male and female urethra during instrumentation
   3. C. Production of corneal anesthesia of short duration for tonometry and gonioscopy
   4. D. Production of localized temporary anesthesia of the ocular surface for short procedures

   Answer: A

   Explanation: The injection labeling states that the product "is indicated in adult and pediatric patients" "for the production of local or regional anesthesia or analgesia for surgery, dental," and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. A lid procedure is a surgical procedure requiring local anesthesia. Each wrong option is the real labelled indication of a different anesthetic preparation: urethral surface anesthesia belongs to lidocaine 2% jelly, corneal anesthesia of short duration for tonometry and gonioscopy to proparacaine 0.5% ophthalmic solution, and localized temporary surface anesthesia to tetracaine 0.5% ophthalmic solution.

   Reference: label — Indications and Usage

9. 9A patient presents with an adnexal laceration. Before the optometrist begins the repair, the history is reviewed and the pertinent clinical findings are identified. In the sequence of a lid suturing procedure, what is the practitioner expected to do with those pertinent clinical findings at that moment?

   1. A. Point them out as the indication to perform the procedure
   2. B. Record them as the patient's disposition after treatment
   3. C. Deliver them to the patient as post-operative home care instructions
   4. D. Use them to confirm the patient's allergies and current ocular medications

   Answer: A

   Explanation: The owner's clinical skills evaluation form for this section scores whether the practitioner did "review history and point out pertinent clinical findings as indication to perform the procedure" as one of the opening steps of the suturing skill. Establishing the indication is therefore what the findings are used for at that point. The wrong options are other scored steps of the same procedure that occur at different moments and serve different purposes: stating "patient disposition post-treatment" belongs to the post-operative note, giving "proper post-operative home care instructions including medication" belongs to post-operative patient education, and confirming "allergies, ocular medications, systemic medications, and visual acuities" is a separate pre-operative documentation item.

   Reference: Surgical LSPE Evaluation Form 2026 — Skill 1 - SUTURING, items 3, 10, 43 and 42

10. 10Bleeding persists from the bed of an excised lid lesion, and the optometrist reaches for a thermal cautery unit rather than a radiofrequency electrosurgical cautery apparatus. By what means does a thermal cautery unit coagulate tissue?

    1. A. Heat conducted through a wire tip
    2. B. A high frequency electric current at the tip
    3. C. A galvanic electrical current applied to the tissue
    4. D. A cryogenic probe that freezes the tissue

    Answer: A

    Explanation: FDA's classification states that a thermal cautery unit is "intended for use during ocular surgery to coagulate tissue or arrest bleeding by heat conducted through a wire tip", so the tip itself carries the heat and no current passes through the patient. Each wrong option is the working mechanism FDA assigns to a different ophthalmic device in the same regulation: high frequency electric current is the radiofrequency electrosurgical cautery apparatus, galvanic current is the ophthalmic electrolysis unit, and freezing is the cryophthalmic unit.

    Reference: Part 886 — § 886.4115(a); compare § 886.4100(a), § 886.4250(a) and § 886.4170