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ABSA EXAM / AMERICAN BOARD OF SURGICAL
ASSISTANT (ABSA) ACTUAL EXAM 2026/2027 PREP
QUESTIONS COMPLETE ACCURATE EXAM
APPROVED QUESTIONS AND CORRECT VERIFIED
SOLUTIONS WITH DETAILED RATIONALES (100%
CORRECT VERIFIED ANSWERS)
1. During a laparotomy, the surgeon asks the surgical assistant to
identify the structure located posterior to the stomach and extending
horizontally across the posterior abdominal wall. Which structure should
the assistant identify?
A. Transverse colon
B. Pancreas
C. Spleen
D. Duodenum
Answer: B. Pancreas
Rationale: The pancreas lies posterior to the stomach and extends
transversely across the posterior abdominal wall. Its close relationship to
major vascular structures makes accurate anatomic identification
essential during upper-abdominal procedures.
2. A patient undergoing a thyroidectomy develops sudden bleeding from
a vessel near the superior pole of the thyroid gland. Which artery is most
likely involved?
A. Inferior thyroid artery
B. Superior thyroid artery
C. Lingual artery
D. Facial artery
Answer: B. Superior thyroid artery
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Rationale: The superior thyroid artery arises from the external carotid
artery and supplies the superior portion of the thyroid gland. It is closely
associated with the superior thyroid pole and must be carefully
controlled during thyroid surgery.
3. During an appendectomy, the surgical assistant is asked to identify the
typical location of the appendix. Which structure provides the most
reliable landmark?
A. Greater curvature of the stomach
B. Ileocecal junction
C. Splenic flexure
D. Sigmoid colon
Answer: B. Ileocecal junction
Rationale: The appendix arises from the posteromedial aspect of the
cecum near the ileocecal junction. Following the tenia coli toward their
convergence is another useful operative technique for locating the
appendix.
4. During a cholecystectomy, the surgeon is preparing to dissect the
structures within the hepatocystic triangle. Which structure normally
forms the cystic duct, common hepatic duct, and inferior surface of the
liver as the relevant boundaries?
A. Calot/hepatocystic triangle
B. Femoral triangle
C. Hesselbach triangle
D. Carotid triangle
Answer: A. Calot/hepatocystic triangle
Rationale: The hepatocystic triangle is bounded by the cystic duct,
common hepatic duct, and inferior surface of the liver. Careful
identification of biliary anatomy is critical because inadvertent injury to
the common bile duct can cause serious complications.
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5. A patient suddenly develops severe hypotension, tachycardia, and
decreased oxygen saturation during surgery. The surgical assistant
should recognize these findings as potentially representing:
A. Stable postoperative recovery
B. A surgical emergency requiring immediate assessment
C. Normal response to anesthesia
D. Mild dehydration that can be ignored
Answer: B. A surgical emergency requiring immediate assessment
Rationale: Sudden hemodynamic instability during surgery requires
immediate recognition, communication, and coordinated intervention.
The surgical assistant should promptly notify the surgical and anesthesia
teams and assist according to the established emergency protocol.
6. Which action is most appropriate when a surgical assistant identifies a
possible retained surgical item before closure?
A. Remain silent to avoid delaying the procedure
B. Inform the surgeon and initiate the established count/discrepancy
protocol
C. Wait until the patient reaches recovery
D. Document it only after the procedure is completed
Answer: B. Inform the surgeon and initiate the established
count/discrepancy protocol
Rationale: A suspected retained item represents a major patient-safety
concern. The discrepancy must be immediately communicated and
managed according to institutional policy, including appropriate search
and reconciliation procedures.
7. A sterile instrument falls below the level of the sterile field. What is
the appropriate action?
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A. Return it to the sterile field after wiping it with antiseptic
B. Consider it contaminated and remove it from the sterile field
C. Cover it with a sterile towel
D. Use it if it appears visually clean
Answer: B. Consider it contaminated and remove it from the sterile
field
Rationale: An item that falls below the sterile field is considered
contaminated. Simply wiping or covering it does not restore sterility.
8. Which practice is most effective for preventing surgical-site
contamination during preparation of the operative field?
A. Preparing only the incision line
B. Maintaining appropriate aseptic technique throughout preparation and
the procedure
C. Touching sterile equipment with clean gloves
D. Reusing contaminated instruments when they appear clean
Answer: B. Maintaining appropriate aseptic technique throughout
preparation and the procedure
Rationale: Surgical-site safety depends on consistent aseptic technique,
appropriate skin preparation, sterile handling, and maintenance of the
sterile field.
9. A patient develops a rapidly expanding neck hematoma after thyroid
surgery and begins experiencing airway compromise. What is the
priority?
A. Observe the patient for several hours
B. Recognize the airway emergency and immediately assist with
surgical/anesthesia intervention
C. Give oral fluids
D. Apply a routine postoperative dressing
ABSA EXAM / AMERICAN BOARD OF SURGICAL
ASSISTANT (ABSA) ACTUAL EXAM 2026/2027 PREP
QUESTIONS COMPLETE ACCURATE EXAM
APPROVED QUESTIONS AND CORRECT VERIFIED
SOLUTIONS WITH DETAILED RATIONALES (100%
CORRECT VERIFIED ANSWERS)
1. During a laparotomy, the surgeon asks the surgical assistant to
identify the structure located posterior to the stomach and extending
horizontally across the posterior abdominal wall. Which structure should
the assistant identify?
A. Transverse colon
B. Pancreas
C. Spleen
D. Duodenum
Answer: B. Pancreas
Rationale: The pancreas lies posterior to the stomach and extends
transversely across the posterior abdominal wall. Its close relationship to
major vascular structures makes accurate anatomic identification
essential during upper-abdominal procedures.
2. A patient undergoing a thyroidectomy develops sudden bleeding from
a vessel near the superior pole of the thyroid gland. Which artery is most
likely involved?
A. Inferior thyroid artery
B. Superior thyroid artery
C. Lingual artery
D. Facial artery
Answer: B. Superior thyroid artery
,2|Page
Rationale: The superior thyroid artery arises from the external carotid
artery and supplies the superior portion of the thyroid gland. It is closely
associated with the superior thyroid pole and must be carefully
controlled during thyroid surgery.
3. During an appendectomy, the surgical assistant is asked to identify the
typical location of the appendix. Which structure provides the most
reliable landmark?
A. Greater curvature of the stomach
B. Ileocecal junction
C. Splenic flexure
D. Sigmoid colon
Answer: B. Ileocecal junction
Rationale: The appendix arises from the posteromedial aspect of the
cecum near the ileocecal junction. Following the tenia coli toward their
convergence is another useful operative technique for locating the
appendix.
4. During a cholecystectomy, the surgeon is preparing to dissect the
structures within the hepatocystic triangle. Which structure normally
forms the cystic duct, common hepatic duct, and inferior surface of the
liver as the relevant boundaries?
A. Calot/hepatocystic triangle
B. Femoral triangle
C. Hesselbach triangle
D. Carotid triangle
Answer: A. Calot/hepatocystic triangle
Rationale: The hepatocystic triangle is bounded by the cystic duct,
common hepatic duct, and inferior surface of the liver. Careful
identification of biliary anatomy is critical because inadvertent injury to
the common bile duct can cause serious complications.
,3|Page
5. A patient suddenly develops severe hypotension, tachycardia, and
decreased oxygen saturation during surgery. The surgical assistant
should recognize these findings as potentially representing:
A. Stable postoperative recovery
B. A surgical emergency requiring immediate assessment
C. Normal response to anesthesia
D. Mild dehydration that can be ignored
Answer: B. A surgical emergency requiring immediate assessment
Rationale: Sudden hemodynamic instability during surgery requires
immediate recognition, communication, and coordinated intervention.
The surgical assistant should promptly notify the surgical and anesthesia
teams and assist according to the established emergency protocol.
6. Which action is most appropriate when a surgical assistant identifies a
possible retained surgical item before closure?
A. Remain silent to avoid delaying the procedure
B. Inform the surgeon and initiate the established count/discrepancy
protocol
C. Wait until the patient reaches recovery
D. Document it only after the procedure is completed
Answer: B. Inform the surgeon and initiate the established
count/discrepancy protocol
Rationale: A suspected retained item represents a major patient-safety
concern. The discrepancy must be immediately communicated and
managed according to institutional policy, including appropriate search
and reconciliation procedures.
7. A sterile instrument falls below the level of the sterile field. What is
the appropriate action?
, 4|Page
A. Return it to the sterile field after wiping it with antiseptic
B. Consider it contaminated and remove it from the sterile field
C. Cover it with a sterile towel
D. Use it if it appears visually clean
Answer: B. Consider it contaminated and remove it from the sterile
field
Rationale: An item that falls below the sterile field is considered
contaminated. Simply wiping or covering it does not restore sterility.
8. Which practice is most effective for preventing surgical-site
contamination during preparation of the operative field?
A. Preparing only the incision line
B. Maintaining appropriate aseptic technique throughout preparation and
the procedure
C. Touching sterile equipment with clean gloves
D. Reusing contaminated instruments when they appear clean
Answer: B. Maintaining appropriate aseptic technique throughout
preparation and the procedure
Rationale: Surgical-site safety depends on consistent aseptic technique,
appropriate skin preparation, sterile handling, and maintenance of the
sterile field.
9. A patient develops a rapidly expanding neck hematoma after thyroid
surgery and begins experiencing airway compromise. What is the
priority?
A. Observe the patient for several hours
B. Recognize the airway emergency and immediately assist with
surgical/anesthesia intervention
C. Give oral fluids
D. Apply a routine postoperative dressing
