ABSA SURGICAL ASSISTANT CERTIFICATION (SA-C)
EXAMINATION COMPLETE PRACTICE QUESTION BANK
– 300 QUESTIONS WITH DETAILED SOLUTIONS
LATEST UPDATE 2026/2027
SECTION 1 – PERIOPERATIVE CARE (PREOPERATIVE)
Questions 1–30
Question 1
A patient scheduled for an elective inguinal hernia repair reports taking their
daily 81 mg aspirin this morning. The surgical assistant should anticipate which
action?
A) Proceed with surgery as planned
B) Notify the surgeon, as aspirin is often withheld 5 to 7 days before surgery
due to bleeding risk
C) Administer vitamin K to reverse the aspirin effect
D) Give a platelet transfusion before incision
Answer: B
Rationale: Aspirin irreversibly inhibits cyclooxygenase and platelet aggregation
for the life of the platelet (7–10 days). Elective surgery is typically postponed
or aspirin is stopped per protocol to reduce bleeding risk. Vitamin K does not
reverse aspirin, and platelet transfusion is not routine.
Question 2
The surgical assistant is performing a preoperative verification. Which three
elements must be confirmed according to the Universal Protocol?
A) Patient age, diagnosis, and insurance
B) Correct patient, correct procedure, and correct surgical site
C) Surgeon name, anesthesia type, and OR number
D) Blood type, allergies, and medications
Answer: B
Rationale: The preoperative "time out" is a critical patient safety protocol
requiring verification of the correct patient identity, planned procedure, and
surgical site. This is a required Joint Commission Universal Protocol element
performed immediately before incision.
Question 3
What is the primary responsibility of the surgical assistant during the
1
,preoperative phase?
A) Obtaining informed consent from the patient
B) Performing the surgical procedure independently
C) Assisting with patient assessment, positioning, and skin preparation
D) Administering anesthesia
Answer: C
Rationale: The surgical assistant's preoperative responsibilities include
assisting with patient assessment, proper positioning for the procedure, and
skin preparation (prepping) to reduce infection risk. Informed consent is the
surgeon's duty, and the assistant does not independently perform surgery or
administer anesthesia.
Question 4
A patient with a history of penicillin allergy is scheduled for surgery. The
surgeon orders cefazolin for surgical prophylaxis. The surgical assistant should:
A) Administer the cefazolin as ordered
B) Notify the surgeon of the allergy and suggest an alternative like clindamycin
C) Give a test dose of penicillin first
D) Proceed with cefazolin but monitor closely
Answer: B
Rationale: Cephalosporins have cross‑reactivity with penicillins (about 1–3%).
In a patient with a documented penicillin allergy, an alternative such as
clindamycin or vancomycin is usually recommended. The surgeon should be
notified
to change the antibiotic order.
Question 5
Which laboratory value is most important to review before surgery to assess
bleeding risk?
A) White blood cell count
B) Serum sodium
C) Platelet count
D) Blood urea nitrogen
Answer: C
Rationale: Platelet count is essential to evaluate hemostatic function.
Thrombocytopenia (low platelets) increases bleeding risk. WBC, sodium, and BUN
are not direct indicators of bleeding risk.
2
,Question 6
The preoperative checklist includes verifying that the patient has:
A) Eaten a light breakfast
B) Signed an informed consent form
C) Brought their own medications
D) Showered the night before
Answer: B
Rationale: Informed consent is a legal and ethical requirement; it must be
obtained and documented before surgery. Patients are typically NPO, do not
bring
their own medications, and showering is encouraged but not a checklist item.
Question 7
When positioning a patient for a thyroidectomy, which position is most
appropriate?
A) Supine with arms tucked
B) Supine with a shoulder roll and neck extended (hyperextension)
C) Prone
D) Lateral decubitus
Answer: B
Rationale: For thyroidectomy, the patient is placed supine with a shoulder roll
to hyperextend the neck, allowing better exposure of the anterior neck. Arms are
usually tucked, but the key position is neck extension.
Question 8
A patient is on warfarin therapy for atrial fibrillation. The surgical assistant
knows that warfarin should typically be stopped how many days before elective
surgery?
A) 1 day
B) 2–3 days
C) 5–7 days
D) 10–14 days
Answer: C
Rationale: Warfarin has a half‑life of about 40 hours. It is usually held for
5–7 days to allow normalization of INR. Bridging with heparin may be considered
depending on the risk of thromboembolism.
Question 9
3
, What is the primary purpose of the preoperative skin prep?
A) To remove hair completely
B) To reduce the microbial count on the skin
C) To warm the skin for better circulation
D) To numb the incision area
Answer: B
Rationale: The skin prep (e.g., with chlorhexidine or iodine) reduces the
resident and transient skin flora, decreasing the risk of surgical site
infection. Hair removal is only done when necessary (clipping, not shaving) and
warming is not the goal.
Question 10
Which of the following is a contraindication to the use of an electrocautery
grounding pad?
A) Patient has a pacemaker
B) Patient has a hip prosthesis
C) Patient has a history of diabetes
D) Patient is over 65 years old
Answer: A
Rationale: Patients with pacemakers require special precautions with
electrocautery (avoid current pathways near the generator). The grounding pad
should be placed as far from the pacemaker as possible, and the device may need
to be reprogrammed. Prostheses and diabetes are not contraindications.
Question 11
The surgical assistant notes that the patient's preoperative ECG shows sinus
bradycardia with a heart rate of 52 bpm. The patient is asymptomatic. What is
the appropriate action?
A) Notify the anesthesiologist immediately
B) Proceed with surgery as planned
C) Administer atropine
D) Cancel the surgery
Answer: A
Rationale: Although sinus bradycardia in a well‑conditioned athlete may be
normal, the anesthesiologist should be informed so they can evaluate the
patient's overall hemodynamic status and determine if any intervention is needed
before or during anesthesia. The assistant does not independently treat.
4
EXAMINATION COMPLETE PRACTICE QUESTION BANK
– 300 QUESTIONS WITH DETAILED SOLUTIONS
LATEST UPDATE 2026/2027
SECTION 1 – PERIOPERATIVE CARE (PREOPERATIVE)
Questions 1–30
Question 1
A patient scheduled for an elective inguinal hernia repair reports taking their
daily 81 mg aspirin this morning. The surgical assistant should anticipate which
action?
A) Proceed with surgery as planned
B) Notify the surgeon, as aspirin is often withheld 5 to 7 days before surgery
due to bleeding risk
C) Administer vitamin K to reverse the aspirin effect
D) Give a platelet transfusion before incision
Answer: B
Rationale: Aspirin irreversibly inhibits cyclooxygenase and platelet aggregation
for the life of the platelet (7–10 days). Elective surgery is typically postponed
or aspirin is stopped per protocol to reduce bleeding risk. Vitamin K does not
reverse aspirin, and platelet transfusion is not routine.
Question 2
The surgical assistant is performing a preoperative verification. Which three
elements must be confirmed according to the Universal Protocol?
A) Patient age, diagnosis, and insurance
B) Correct patient, correct procedure, and correct surgical site
C) Surgeon name, anesthesia type, and OR number
D) Blood type, allergies, and medications
Answer: B
Rationale: The preoperative "time out" is a critical patient safety protocol
requiring verification of the correct patient identity, planned procedure, and
surgical site. This is a required Joint Commission Universal Protocol element
performed immediately before incision.
Question 3
What is the primary responsibility of the surgical assistant during the
1
,preoperative phase?
A) Obtaining informed consent from the patient
B) Performing the surgical procedure independently
C) Assisting with patient assessment, positioning, and skin preparation
D) Administering anesthesia
Answer: C
Rationale: The surgical assistant's preoperative responsibilities include
assisting with patient assessment, proper positioning for the procedure, and
skin preparation (prepping) to reduce infection risk. Informed consent is the
surgeon's duty, and the assistant does not independently perform surgery or
administer anesthesia.
Question 4
A patient with a history of penicillin allergy is scheduled for surgery. The
surgeon orders cefazolin for surgical prophylaxis. The surgical assistant should:
A) Administer the cefazolin as ordered
B) Notify the surgeon of the allergy and suggest an alternative like clindamycin
C) Give a test dose of penicillin first
D) Proceed with cefazolin but monitor closely
Answer: B
Rationale: Cephalosporins have cross‑reactivity with penicillins (about 1–3%).
In a patient with a documented penicillin allergy, an alternative such as
clindamycin or vancomycin is usually recommended. The surgeon should be
notified
to change the antibiotic order.
Question 5
Which laboratory value is most important to review before surgery to assess
bleeding risk?
A) White blood cell count
B) Serum sodium
C) Platelet count
D) Blood urea nitrogen
Answer: C
Rationale: Platelet count is essential to evaluate hemostatic function.
Thrombocytopenia (low platelets) increases bleeding risk. WBC, sodium, and BUN
are not direct indicators of bleeding risk.
2
,Question 6
The preoperative checklist includes verifying that the patient has:
A) Eaten a light breakfast
B) Signed an informed consent form
C) Brought their own medications
D) Showered the night before
Answer: B
Rationale: Informed consent is a legal and ethical requirement; it must be
obtained and documented before surgery. Patients are typically NPO, do not
bring
their own medications, and showering is encouraged but not a checklist item.
Question 7
When positioning a patient for a thyroidectomy, which position is most
appropriate?
A) Supine with arms tucked
B) Supine with a shoulder roll and neck extended (hyperextension)
C) Prone
D) Lateral decubitus
Answer: B
Rationale: For thyroidectomy, the patient is placed supine with a shoulder roll
to hyperextend the neck, allowing better exposure of the anterior neck. Arms are
usually tucked, but the key position is neck extension.
Question 8
A patient is on warfarin therapy for atrial fibrillation. The surgical assistant
knows that warfarin should typically be stopped how many days before elective
surgery?
A) 1 day
B) 2–3 days
C) 5–7 days
D) 10–14 days
Answer: C
Rationale: Warfarin has a half‑life of about 40 hours. It is usually held for
5–7 days to allow normalization of INR. Bridging with heparin may be considered
depending on the risk of thromboembolism.
Question 9
3
, What is the primary purpose of the preoperative skin prep?
A) To remove hair completely
B) To reduce the microbial count on the skin
C) To warm the skin for better circulation
D) To numb the incision area
Answer: B
Rationale: The skin prep (e.g., with chlorhexidine or iodine) reduces the
resident and transient skin flora, decreasing the risk of surgical site
infection. Hair removal is only done when necessary (clipping, not shaving) and
warming is not the goal.
Question 10
Which of the following is a contraindication to the use of an electrocautery
grounding pad?
A) Patient has a pacemaker
B) Patient has a hip prosthesis
C) Patient has a history of diabetes
D) Patient is over 65 years old
Answer: A
Rationale: Patients with pacemakers require special precautions with
electrocautery (avoid current pathways near the generator). The grounding pad
should be placed as far from the pacemaker as possible, and the device may need
to be reprogrammed. Prostheses and diabetes are not contraindications.
Question 11
The surgical assistant notes that the patient's preoperative ECG shows sinus
bradycardia with a heart rate of 52 bpm. The patient is asymptomatic. What is
the appropriate action?
A) Notify the anesthesiologist immediately
B) Proceed with surgery as planned
C) Administer atropine
D) Cancel the surgery
Answer: A
Rationale: Although sinus bradycardia in a well‑conditioned athlete may be
normal, the anesthesiologist should be informed so they can evaluate the
patient's overall hemodynamic status and determine if any intervention is needed
before or during anesthesia. The assistant does not independently treat.
4
