Free Surgical First Assistant Certifying Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Surgical First Assistant Certifying Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1After applying an alcohol-based surgical hand preparation with persistent activity, what should the first assistant do before donning sterile gloves?

   1. A. Dry the hands and forearms with a sterile towel.
   2. B. Allow the hands and forearms to dry completely.
   3. C. Rinse the hands and forearms with sterile water.
   4. D. Wash the hands and forearms with plain soap.

   Answer: B

   Explanation: CDC states, "After application of the alcohol-based product as recommended, allow hands and forearms to dry before donning sterile gloves." Complete drying is the next step; towel drying, rinsing, or washing would alter the prescribed preparation.

   Reference: Clinical Safety: Hand Hygiene for Healthcare Workers — Follow hand hygiene recommendations for surgery

2. 2Using SBAR to relay a patient's deterioration, the assistant explains what the current findings suggest is wrong. Which component of SBAR is being communicated?

   1. A. Situation
   2. B. Background
   3. C. Assessment
   4. D. Recommendation

   Answer: C

   Explanation: AHRQ states, "Assessment reports what the person communicating the SBAR thinks the problem is." The assistant is interpreting findings, rather than supplying history or requesting an action.

   Reference: TeamSTEPPS Tool: SBAR — Using SBAR effectively, Assessment

3. 3The assistant reviews the pathology of a tumor arising from epithelial cells lining an organ. Which broad malignant-tumor category corresponds to this tissue of origin?

   1. A. Sarcoma
   2. B. Carcinoma
   3. C. Lymphoma
   4. D. Myeloma

   Answer: B

   Explanation: NCI explains that carcinomas "are formed by epithelial cells". Sarcoma, lymphoma, and myeloma arise from different tissue or cell lineages.

   Reference: What Is Cancer? — Types of Cancer, Carcinoma

4. 4While positioning a supine patient, the team notices that an armboard would abduct the shoulder beyond 90 degrees. Which structure is particularly threatened by this positioning?

   1. A. Brachial plexus
   2. B. Sacral plexus
   3. C. Lumbar plexus
   4. D. Coccygeal plexus

   Answer: A

   Explanation: AST instructs, "to avoid brachial plexus injury, the arms should not be abducted more than 90". Excessive shoulder abduction threatens the brachial plexus, rather than a plexus supplying the pelvis or lower limb.

   Reference: AST Standards of Practice for Surgical Positioning — Standard of Practice VIII, nerve protection, C(2)

5. 5The surgeon gives an instruction, and the first assistant repeats it accurately. Which participant must confirm the repeat-back to complete the communication loop?

   1. A. The surgeon who issued the instruction
   2. B. The assistant who repeated the instruction
   3. C. The circulator who heard the exchange
   4. D. The technologist who observed the exchange

   Answer: A

   Explanation: AHRQ states, "The original sender of the information completes the loop". The surgeon is the sender and must validate that the assistant received the intended instruction. Repeating, witnessing, or documenting the message does not substitute for sender confirmation.

   Reference: TeamSTEPPS Tool: Check-Back (or Repeat-Back) — Other examples of effective check-backs, falling blood pressure example

6. 6A lung lesion removed from a patient with breast cancer contains the same cancer-cell type as the breast primary. How should the assistant understand its disease origin?

   1. A. A primary pulmonary adenocarcinoma
   2. B. A primary pleural mesothelioma
   3. C. A primary pulmonary lymphoma
   4. D. A metastatic breast carcinoma

   Answer: D

   Explanation: NCI states, "Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer." Its location in lung does not make it a new lung primary.

   Reference: What Is Cancer? — When Cancer Spreads

7. 7The first assistant is preparing to participate in the surgical time-out. When should this verification occur in relation to the operation?

   1. A. Immediately before induction of general anesthesia.
   2. B. Immediately before transport into the operating room.
   3. C. Immediately before starting the surgical incision.
   4. D. Immediately before application of the sterile drapes.

   Answer: C

   Explanation: The Universal Protocol states, "Conduct a time-out immediately before starting the invasive procedure or making the incision." Earlier checkpoints do not replace this final verification.

   Reference: The Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery — Perform a time-out, first bullet

8. 8The first assistant positions a local smoke-evacuation inlet during electrosurgery. What maximum distance from the surgical site does NIOSH specify for effective capture?

   1. A. 2 inches
   2. B. 4 inches
   3. C. 6 inches
   4. D. 8 inches

   Answer: A

   Explanation: NIOSH states, "The smoke evacuator or room suction hose nozzle inlet must be kept within 2 inches of the surgical site to effectively capture airborne contaminants generated by these surgical devices." Two inches is the maximum stated separation; the larger listed distances exceed it.

   Reference: Control of Smoke From Laser/Electric Surgical Procedures — Page 2, Work Practices

9. 9A tumor specimen contains cells that closely resemble the normal tissue from which they arose. Which differentiation term fits this histological appearance?

   1. A. Well differentiated
   2. B. Moderately differentiated
   3. C. Poorly differentiated
   4. D. Undifferentiated

   Answer: A

   Explanation: NCI states, "Cells that look more normal might be called well-differentiated". This describes cellular resemblance to normal tissue, rather than the extent of spread.

   Reference: Tumor Grade — How tumor grade is determined

10. 10A first assistant selects the smallest urinary catheter bore that will provide adequate drainage for an operative patient. What injury is this selection intended to minimize?

    1. A. Bladder neck and urethral trauma
    2. B. Renal pelvic and calyceal trauma
    3. C. Ureteral and renal hilar trauma
    4. D. Prostatic and seminal duct trauma

    Answer: A

    Explanation: CDC recommends the smallest bore consistent with good drainage "to minimize bladder neck and urethral trauma." This concerns structures contacted by urethral catheterization, rather than the upper urinary tract or seminal ducts.

    Reference: Summary of Recommendations: Guideline for Prevention of Catheter-Associated Urinary Tract Infections — II.F, Proper Techniques for Urinary Catheter Insertion