ABSA Surgical Assistant Certification Exam Prep 2026/2027 | American Board of
Surgical Assistants | Practice Questions & Comprehensive Review
1. A 45-year-old male is undergoing a laparoscopic cholecystectomy. During the procedure, the surgeon requests a Kitner
dissector. What is the primary function of this instrument in this context?
A) Sharp dissection of the cystic duct
B) Electrocautery of the cystic artery
C) Blunt dissection and peeling of peritoneum off the gallbladder
D) Suturing the cystic duct stump
Correct Answer: C
Explanation: A Kitner dissector, also known as a peanut sponge, is a small cotton-tipped swab used for blunt dissection. In a
cholecystectomy, it is frequently used to gently dissect the peritoneum and connective tissue from the infundibulum of the
gallbladder to expose the critical structures (Calot's triangle).
2. What is the primary purpose of applying a "scrub suit" and "sterile gown" in the surgical environment?
A) To identify the surgical team members
B) To provide a barrier against shedding skin and hair-borne bacteria
C) To keep the surgeon warm in the cold operating room
D) To absorb sweat from the surgical team
Correct Answer: B
Explanation: The primary purpose of surgical attire, including scrub suits and sterile gowns, is to minimize the transfer of
microorganisms from the surgical team's skin and hair to the patient's surgical site, thereby preventing surgical site infections.
3. During a total knee arthroplasty, the surgeon is preparing the femur for the prosthesis. Which power saw blade is most
appropriate for making the distal femoral cut?
A) Sagittal saw blade
B) Reciprocating saw blade
C) Oscillating saw blade
, D) Gigli saw blade
Correct Answer: C
Explanation: An oscillating saw blade is used for cutting bone. It moves in a small arc, minimizing damage to soft tissues. For precise,
flat cuts like the distal femoral cut in a total knee arthroplasty, an oscillating saw is the standard tool.
4. The surgical assistant is preparing the back table for a procedure. Which of the following is a critical step in maintaining the
sterile field?
A) Placing all instruments within 6 inches of the edge of the table
B) Keeping the sterile field dry
C) Turning your back to the sterile field frequently to retrieve supplies
D) Speaking directly over the sterile field
Correct Answer: B
Explanation: A dry sterile field is essential. Moisture can wick bacteria from non-sterile surfaces through the drape or packaging via
capillary action, contaminating the sterile field. The edges of the table are considered non-sterile, and one should never turn their
back on a sterile field.
5. Which of the following anatomical structures is at greatest risk during a thyroidectomy due to its proximity to the thyroid
gland?
A) Vagus nerve (CN X)
B) Recurrent laryngeal nerve
C) Phrenic nerve
D) Hypoglossal nerve (CN XII)
Correct Answer: B
Explanation: The recurrent laryngeal nerve runs in the tracheoesophageal groove, directly posterior to the thyroid gland. It is highly
susceptible to injury during thyroid surgery, which can result in vocal cord paralysis and hoarseness.
6. A patient is experiencing a tension pneumothorax. The surgeon requests an immediate needle decompression. Which
anatomical landmark is used for this emergency procedure?
A) 5th intercostal space, anterior axillary line
B) 2nd intercostal space, midclavicular line
, C) 4th intercostal space, midaxillary line
D) 6th intercostal space, scapular line
Correct Answer: B
Explanation: Needle decompression for a tension pneumothorax is typically performed at the 2nd intercostal space in the
midclavicular line on the affected side. This site allows the needle to enter the pleural space to release trapped air without
penetrating major organs.
7. The surgical assistant is setting up for a procedure and notices the suture packaging is wet. What is the appropriate action?
A) Use the suture as it is still within its sterile packaging
B) Dry the packaging with a sterile towel and open it
C) Discard the suture and obtain a new one
D) Place the suture package in a sterile basin
Correct Answer: C
Explanation: Wet packaging is considered a breach in sterility because moisture can compromise the barrier, allowing bacteria to
travel through the packaging. The suture should be discarded, and a new, dry one should be opened for the sterile field.
8. In the context of electrosurgery, what is the function of the return electrode (grounding pad)?
A) To cut tissue by creating a high-frequency arc
B) To coagulate blood vessels
C) To complete the electrical circuit and disperse current safely
D) To provide suction for smoke evacuation
Correct Answer: C
Explanation: The return electrode is placed on the patient's skin to provide a safe path for the electrical current to return to the
electrosurgical generator. It dissipates the current over a large surface area to prevent burns at the application site.
9. A surgeon is performing a bowel resection and asks for a "Babcock" clamp. What is the specific purpose of this instrument?
A) To crush the bowel for closure
B) To occlude blood flow to the mesentery
C) To grasp the bowel gently without crushing it
D) To dissect the mesentery from the bowel
, Correct Answer: C
Explanation: The Babcock clamp is a non-crushing, atraumatic clamp with fenestrated jaws. It is specifically designed to grasp
delicate tissues like the bowel, fallopian tubes, or blood vessels without causing damage.
10. What is the primary physiological effect of the Trendelenburg position on a patient?
A) Decreased venous return to the heart
B) Increased venous return to the heart
C) Decreased intracranial pressure
D) Improved ventilation of the lungs
Correct Answer: B
Explanation: In the Trendelenburg position, the patient is lying supine with the feet elevated higher than the head. Gravity causes
blood to shift from the lower extremities toward the central venous system, thereby increasing venous return to the heart.
11. Which of the following is a Class III (moderate-risk) surgical wound?
A) An elective inguinal hernia repair
B) A clean, penetrating trauma wound less than 4 hours old
C) An incision into the biliary tract with bile spillage
D) An incision into an inflamed, non-purulent appendix
Correct Answer: C
Explanation: Class III or contaminated wounds involve open, fresh, accidental wounds, or procedures with major breaks in sterile
technique or gross spillage from the gastrointestinal or biliary tracts. Entry into the biliary tract with spillage falls into this category.
12. The surgical assistant is preparing to hand a scalpel to the surgeon. What is the correct and safest method?
A) Hand it over with the blade facing the surgeon
B) Place it on the Mayo stand for the surgeon to pick up
C) Hand it with the handle first, blade pointing down and away
D) Toss it gently to the surgeon's hand
Correct Answer: C
Explanation: The safest way to pass a scalpel is with the handle first, and the blade pointed down and away from both the person
giving and receiving it. This technique minimizes the risk of accidental sharp injuries.
Surgical Assistants | Practice Questions & Comprehensive Review
1. A 45-year-old male is undergoing a laparoscopic cholecystectomy. During the procedure, the surgeon requests a Kitner
dissector. What is the primary function of this instrument in this context?
A) Sharp dissection of the cystic duct
B) Electrocautery of the cystic artery
C) Blunt dissection and peeling of peritoneum off the gallbladder
D) Suturing the cystic duct stump
Correct Answer: C
Explanation: A Kitner dissector, also known as a peanut sponge, is a small cotton-tipped swab used for blunt dissection. In a
cholecystectomy, it is frequently used to gently dissect the peritoneum and connective tissue from the infundibulum of the
gallbladder to expose the critical structures (Calot's triangle).
2. What is the primary purpose of applying a "scrub suit" and "sterile gown" in the surgical environment?
A) To identify the surgical team members
B) To provide a barrier against shedding skin and hair-borne bacteria
C) To keep the surgeon warm in the cold operating room
D) To absorb sweat from the surgical team
Correct Answer: B
Explanation: The primary purpose of surgical attire, including scrub suits and sterile gowns, is to minimize the transfer of
microorganisms from the surgical team's skin and hair to the patient's surgical site, thereby preventing surgical site infections.
3. During a total knee arthroplasty, the surgeon is preparing the femur for the prosthesis. Which power saw blade is most
appropriate for making the distal femoral cut?
A) Sagittal saw blade
B) Reciprocating saw blade
C) Oscillating saw blade
, D) Gigli saw blade
Correct Answer: C
Explanation: An oscillating saw blade is used for cutting bone. It moves in a small arc, minimizing damage to soft tissues. For precise,
flat cuts like the distal femoral cut in a total knee arthroplasty, an oscillating saw is the standard tool.
4. The surgical assistant is preparing the back table for a procedure. Which of the following is a critical step in maintaining the
sterile field?
A) Placing all instruments within 6 inches of the edge of the table
B) Keeping the sterile field dry
C) Turning your back to the sterile field frequently to retrieve supplies
D) Speaking directly over the sterile field
Correct Answer: B
Explanation: A dry sterile field is essential. Moisture can wick bacteria from non-sterile surfaces through the drape or packaging via
capillary action, contaminating the sterile field. The edges of the table are considered non-sterile, and one should never turn their
back on a sterile field.
5. Which of the following anatomical structures is at greatest risk during a thyroidectomy due to its proximity to the thyroid
gland?
A) Vagus nerve (CN X)
B) Recurrent laryngeal nerve
C) Phrenic nerve
D) Hypoglossal nerve (CN XII)
Correct Answer: B
Explanation: The recurrent laryngeal nerve runs in the tracheoesophageal groove, directly posterior to the thyroid gland. It is highly
susceptible to injury during thyroid surgery, which can result in vocal cord paralysis and hoarseness.
6. A patient is experiencing a tension pneumothorax. The surgeon requests an immediate needle decompression. Which
anatomical landmark is used for this emergency procedure?
A) 5th intercostal space, anterior axillary line
B) 2nd intercostal space, midclavicular line
, C) 4th intercostal space, midaxillary line
D) 6th intercostal space, scapular line
Correct Answer: B
Explanation: Needle decompression for a tension pneumothorax is typically performed at the 2nd intercostal space in the
midclavicular line on the affected side. This site allows the needle to enter the pleural space to release trapped air without
penetrating major organs.
7. The surgical assistant is setting up for a procedure and notices the suture packaging is wet. What is the appropriate action?
A) Use the suture as it is still within its sterile packaging
B) Dry the packaging with a sterile towel and open it
C) Discard the suture and obtain a new one
D) Place the suture package in a sterile basin
Correct Answer: C
Explanation: Wet packaging is considered a breach in sterility because moisture can compromise the barrier, allowing bacteria to
travel through the packaging. The suture should be discarded, and a new, dry one should be opened for the sterile field.
8. In the context of electrosurgery, what is the function of the return electrode (grounding pad)?
A) To cut tissue by creating a high-frequency arc
B) To coagulate blood vessels
C) To complete the electrical circuit and disperse current safely
D) To provide suction for smoke evacuation
Correct Answer: C
Explanation: The return electrode is placed on the patient's skin to provide a safe path for the electrical current to return to the
electrosurgical generator. It dissipates the current over a large surface area to prevent burns at the application site.
9. A surgeon is performing a bowel resection and asks for a "Babcock" clamp. What is the specific purpose of this instrument?
A) To crush the bowel for closure
B) To occlude blood flow to the mesentery
C) To grasp the bowel gently without crushing it
D) To dissect the mesentery from the bowel
, Correct Answer: C
Explanation: The Babcock clamp is a non-crushing, atraumatic clamp with fenestrated jaws. It is specifically designed to grasp
delicate tissues like the bowel, fallopian tubes, or blood vessels without causing damage.
10. What is the primary physiological effect of the Trendelenburg position on a patient?
A) Decreased venous return to the heart
B) Increased venous return to the heart
C) Decreased intracranial pressure
D) Improved ventilation of the lungs
Correct Answer: B
Explanation: In the Trendelenburg position, the patient is lying supine with the feet elevated higher than the head. Gravity causes
blood to shift from the lower extremities toward the central venous system, thereby increasing venous return to the heart.
11. Which of the following is a Class III (moderate-risk) surgical wound?
A) An elective inguinal hernia repair
B) A clean, penetrating trauma wound less than 4 hours old
C) An incision into the biliary tract with bile spillage
D) An incision into an inflamed, non-purulent appendix
Correct Answer: C
Explanation: Class III or contaminated wounds involve open, fresh, accidental wounds, or procedures with major breaks in sterile
technique or gross spillage from the gastrointestinal or biliary tracts. Entry into the biliary tract with spillage falls into this category.
12. The surgical assistant is preparing to hand a scalpel to the surgeon. What is the correct and safest method?
A) Hand it over with the blade facing the surgeon
B) Place it on the Mayo stand for the surgeon to pick up
C) Hand it with the handle first, blade pointing down and away
D) Toss it gently to the surgeon's hand
Correct Answer: C
Explanation: The safest way to pass a scalpel is with the handle first, and the blade pointed down and away from both the person
giving and receiving it. This technique minimizes the risk of accidental sharp injuries.
