,ABSA Surgical Assistant Certification Exam Prep 2026/2027
About the ABSA Surgical Assistant (SA-C) Certification
The American Board of Surgical Assistants (ABSA) SA-C certification validates the knowledge
and skills required for competent surgical assisting practice . The exam covers perioperative
patient care, surgical anatomy, sterile technique, instrumentation, hemostasis, wound closure,
and management of intraoperative emergencies . This guide provides practice questions
modeled on the exam format .
Practice Questions with Detailed Rationales
Perioperative Care & Patient Safety
Q1. During the preoperative "time out," which action is the highest priority?
A) Confirm that all surgical instruments are sterilized
B) Verify the correct patient, procedure, and surgical site
C) Ensure the operating room temperature is appropriate
D) Check that the surgeon's preference card is available
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 .
Q2. Which finding in a preoperative patient scheduled for open abdominal aortic aneurysm
repair should be reported immediately?
A) Hemoglobin of 12.5 g/dL
B) Serum potassium of 3.8 mEq/L
C) Abnormal ECG showing ST-segment elevation
D) Blood pressure of 135/85 mmHg
Answer: C
Rationale: ST-segment elevation on ECG suggests acute myocardial ischemia or injury. This is a
critical finding requiring immediate physician notification and potential postponement of
elective surgery. Normal potassium is 3.5-5.0 mEq/L; the other values are within acceptable
ranges .
,Q3. When positioning a patient for a thyroidectomy, which position provides optimal surgical
exposure while minimizing complications?
A) Supine with a roll under the knees
B) Reverse Trendelenburg with a shoulder roll
C) Prone with head fixation
D) Lateral decubitus with kidney rest
Answer: B
Rationale: Reverse Trendelenburg with a shoulder roll provides optimal surgical exposure for
thyroidectomy. The shoulder roll extends the neck, allowing better access to the thyroid gland
while minimizing complications .
Q4. Which anatomical landmark is most useful for locating the recurrent laryngeal nerve
during a thyroidectomy?
A) The carotid artery
B) The tracheoesophageal groove
C) The thyroid ima artery
D) The sternocleidomastoid muscle
Answer: B
Rationale: The recurrent laryngeal nerve runs in the tracheoesophageal groove. Its
identification is critical to prevent vocal cord paralysis. The carotid artery is a lateral landmark;
the thyroid ima artery is an anomalous vessel; the sternocleidomastoid is a superficial
landmark .
Q5. In which position is the sacrum at greatest risk for pressure injury?
A) Supine
B) Prone
C) Lateral decubitus
D) Lithotomy
Answer: A
Rationale: The sacrum bears the greatest weight in the supine position and is the most
common site for pressure ulcer development. Heels and occiput are also at risk but less so. The
sciatic nerve is at risk in the lithotomy position .
, Q6. Which nerve is most vulnerable to injury when a patient is placed in the lateral decubitus
position without adequate axillary roll placement?
A) Sciatic nerve
B) Radial nerve
C) Brachial plexus
D) Femoral nerve
Answer: C
Rationale: In the lateral decubitus position, if an axillary roll is omitted or placed improperly,
the body weight compresses the chest wall against the support, stretching and injuring the
brachial plexus running through the axilla .
Q7. During lithotomy positioning, what complication requires vigilance?
A) Corneal transplant rejection
B) Lower-extremity nerve and pressure injury
C) Wrist fracture
D) Dental implant failure
Answer: B
Rationale: Lithotomy positioning places the lower extremities in a position that can cause nerve
compression and pressure injuries. The sciatic and common peroneal nerves are particularly at
risk .
Sterile Technique & Asepsis
Q8. Which statement regarding surgical mask use is NOT correct?
A) Masks should be changed between cases
B) Masks are worn to protect both patient and surgical team
C) Ties may be tied crisscross on top of the head
D) Masks should cover both nose and mouth completely
Answer: C
Rationale: Mask ties must be properly secured—the upper ties should be tied at the crown of
the head and lower ties at the neck. Tying them crisscross on top of the head does not provide
a secure fit and compromises the seal .
About the ABSA Surgical Assistant (SA-C) Certification
The American Board of Surgical Assistants (ABSA) SA-C certification validates the knowledge
and skills required for competent surgical assisting practice . The exam covers perioperative
patient care, surgical anatomy, sterile technique, instrumentation, hemostasis, wound closure,
and management of intraoperative emergencies . This guide provides practice questions
modeled on the exam format .
Practice Questions with Detailed Rationales
Perioperative Care & Patient Safety
Q1. During the preoperative "time out," which action is the highest priority?
A) Confirm that all surgical instruments are sterilized
B) Verify the correct patient, procedure, and surgical site
C) Ensure the operating room temperature is appropriate
D) Check that the surgeon's preference card is available
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 .
Q2. Which finding in a preoperative patient scheduled for open abdominal aortic aneurysm
repair should be reported immediately?
A) Hemoglobin of 12.5 g/dL
B) Serum potassium of 3.8 mEq/L
C) Abnormal ECG showing ST-segment elevation
D) Blood pressure of 135/85 mmHg
Answer: C
Rationale: ST-segment elevation on ECG suggests acute myocardial ischemia or injury. This is a
critical finding requiring immediate physician notification and potential postponement of
elective surgery. Normal potassium is 3.5-5.0 mEq/L; the other values are within acceptable
ranges .
,Q3. When positioning a patient for a thyroidectomy, which position provides optimal surgical
exposure while minimizing complications?
A) Supine with a roll under the knees
B) Reverse Trendelenburg with a shoulder roll
C) Prone with head fixation
D) Lateral decubitus with kidney rest
Answer: B
Rationale: Reverse Trendelenburg with a shoulder roll provides optimal surgical exposure for
thyroidectomy. The shoulder roll extends the neck, allowing better access to the thyroid gland
while minimizing complications .
Q4. Which anatomical landmark is most useful for locating the recurrent laryngeal nerve
during a thyroidectomy?
A) The carotid artery
B) The tracheoesophageal groove
C) The thyroid ima artery
D) The sternocleidomastoid muscle
Answer: B
Rationale: The recurrent laryngeal nerve runs in the tracheoesophageal groove. Its
identification is critical to prevent vocal cord paralysis. The carotid artery is a lateral landmark;
the thyroid ima artery is an anomalous vessel; the sternocleidomastoid is a superficial
landmark .
Q5. In which position is the sacrum at greatest risk for pressure injury?
A) Supine
B) Prone
C) Lateral decubitus
D) Lithotomy
Answer: A
Rationale: The sacrum bears the greatest weight in the supine position and is the most
common site for pressure ulcer development. Heels and occiput are also at risk but less so. The
sciatic nerve is at risk in the lithotomy position .
, Q6. Which nerve is most vulnerable to injury when a patient is placed in the lateral decubitus
position without adequate axillary roll placement?
A) Sciatic nerve
B) Radial nerve
C) Brachial plexus
D) Femoral nerve
Answer: C
Rationale: In the lateral decubitus position, if an axillary roll is omitted or placed improperly,
the body weight compresses the chest wall against the support, stretching and injuring the
brachial plexus running through the axilla .
Q7. During lithotomy positioning, what complication requires vigilance?
A) Corneal transplant rejection
B) Lower-extremity nerve and pressure injury
C) Wrist fracture
D) Dental implant failure
Answer: B
Rationale: Lithotomy positioning places the lower extremities in a position that can cause nerve
compression and pressure injuries. The sciatic and common peroneal nerves are particularly at
risk .
Sterile Technique & Asepsis
Q8. Which statement regarding surgical mask use is NOT correct?
A) Masks should be changed between cases
B) Masks are worn to protect both patient and surgical team
C) Ties may be tied crisscross on top of the head
D) Masks should cover both nose and mouth completely
Answer: C
Rationale: Mask ties must be properly secured—the upper ties should be tied at the crown of
the head and lower ties at the neck. Tying them crisscross on top of the head does not provide
a secure fit and compromises the seal .
