ABSA SURGICAL ASSISTANT CERTIFICATION (SA-C) EXAM
2 (PDF) | 2026 QUESTIONS & ANSWERS + RATIONALES |
STUDY GUIDE | 100% CORRECT
1. During a preoperative "time-out" for a scheduled bilateral inguinal hernia repair, the
surgical team discovers that the surgeon intends to repair the left side, but the surgical
consent form and the preoperative site marking indicate the right side. What is the most
appropriate immediate action for the surgical assistant?
A) Proceed with the left-side repair as the surgeon has identified it as the correct
pathology
B) Verify the side with the patient's family in the waiting area before making an incision
C) Stop the procedure immediately and request that the surgeon and circulating nurse
resolve the discrepancy with the patient and medical records
D) Proceed with the right-side repair as it matches the legal consent form, regardless of
the surgeon's current plan
Correct Answer: C) Stop the procedure immediately and request that the surgeon and circulating
nurse resolve the discrepancy with the patient and medical records
Rationale: The Universal Protocol for preventing wrong-site surgery mandates a "timeout"
immediately before starting a procedure. Any discrepancy identified during the timeout must be
resolved before the incision is made. Proceeding without clarification violates patient safety
protocols .
2. A patient scheduled for an elective bilateral inguinal hernia repair states during the
preoperative interview that they took their daily 81 mg aspirin with a sip of water this
morning. Which action should the surgical assistant anticipate?
A) Proceed with the surgical case as planned without any additional precautions
B) Alert the surgeon immediately; aspirin irreversibly inhibits platelet aggregation and is
typically withheld 5 to 7 days preoperatively
C) Administer 10 mg of intravenous Vitamin K to instantly reverse the antiplatelet effect
D) Order a 6-unit platelet transfusion to be infused in the holding area prior to surgical
incision
Correct Answer: B) Alert the surgeon immediately; aspirin irreversibly inhibits platelet
aggregation and is typically withheld 5 to 7 days preoperatively
Rationale: Aspirin irreversibly inhibits platelet aggregation for the lifespan of the platelet (7-10
days). For procedures with intermediate to high bleeding risk, antiplatelet therapies are generally
held for 5 to 7 days before surgery. Vitamin K reverses warfarin, not aspirin .
3. During a preoperative timeout executed under the Universal Protocol guidelines, which
three elements must the surgical assistant, primary surgeon, and circulating nurse
verbally confirm?
, A) Patient age, admitting diagnosis, and health insurance authorization status
B) Correct patient identity, correct planned surgical procedure, and correct surgical site
C) Primary surgeon's name, planned anesthesia modality, and expected operative
duration
D) Blood type compatibility, patient drug allergies, and exact duration of NPO fasting
status
Correct Answer: B) Correct patient identity, correct planned surgical procedure, and correct
surgical site
Rationale: The Joint Commission's Universal Protocol mandates a "timeout" immediately before
making the surgical incision. The entire perioperative team must actively and verbally confirm
the correct patient identity, the correct planned procedure, and the correct anatomically marked
surgical site .
4. The surgical assistant is helping place a patient in the prone position for a lumbar
laminectomy. Which positioning consideration is most critical to prevent intraoperative
respiratory compromise and vena cava compression?
A) Positioning the patient's arms at a 120-degree angle on padded arm boards to open the
chest wall
B) Utilizing axillary rolls and ensuring the abdomen hangs freely between chest rolls and
pelvic bolsters
C) Placing a rigid donut headrest underneath the patient's chin to hyperextend the neck
D) Keeping the patient's legs completely straight and unpadded to maximize systemic
venous return
Correct Answer: B) Utilizing axillary rolls and ensuring the abdomen hangs freely between chest
rolls and pelvic bolsters
Rationale: In the prone position, the weight of the torso must be supported by firm chest rolls and
pelvic bolsters so that the abdominal wall can hang completely free. If the abdomen is
compressed against the operating table, intra-abdominal pressure rises, compressing the inferior
vena cava and decreasing venous return .
5. A patient is undergoing a total thyroidectomy. While positioning the patient in a modified
reverse Trendelenburg position with a shoulder roll, which anatomical structure must be
carefully protected against hyperextension and compression injuries?
A) The brachial plexus and the cervical spine
B) The sciatic nerve and the popliteal artery
C) The peroneal nerve at the fibular head
D) The femoral nerve within the inguinal canal
Correct Answer: A) The brachial plexus and the cervical spine
Rationale: Extension of the neck for thyroid or anterior cervical surgery requires careful
positioning. Excessive extension or inappropriate placement of shoulder rolls can stretch or
compress the cervical spine nerves and the brachial plexus .
, 6. A patient is scheduled for a mastectomy and is found to have a permanent cardiac
pacemaker. The surgical assistant is preparing the operative field. Which of the following
is the primary safety concern regarding the use of electrosurgical units (ESU) in this
patient?
A) The ESU may cause the pacemaker to switch to an asynchronous mode or inhibit
pacing due to electromagnetic interference
B) The ESU will inevitably drain the battery of the pacemaker, leading to immediate
postoperative failure
C) The ESU current will be diverted through the pacemaker leads, potentially causing a
myocardial infarction
D) The ESU ground pad placement is irrelevant as long as the pacemaker is shielded by a
lead apron
Correct Answer: A) The ESU may cause the pacemaker to switch to an asynchronous mode or
inhibit pacing due to electromagnetic interference
Rationale: Electrosurgical units create electromagnetic interference that can be interpreted by the
pacemaker as cardiac activity, potentially inhibiting the device's output. It can also cause the
device to revert to an asynchronous (fixed-rate) mode. The primary concern is interference with
the device's sensing/pacing logic .
7. A 45-year-old male is scheduled for an elective indirect inguinal hernia repair. During the
preoperative assessment, the patient reveals he has been taking aspirin 81 mg daily.
When should the patient be instructed to discontinue this medication prior to surgery?
A) 24 hours before surgery
B) 48 hours before surgery
C) 72 hours before surgery
D) 7 days before surgery
Correct Answer: D) 7 days before surgery
Rationale: Aspirin irreversibly inhibits platelet function for the lifespan of the platelet (7-10
days). Discontinuing aspirin 7 days before surgery allows adequate platelet regeneration and
reduces bleeding risk during surgery .
8. A patient requires emergency surgery following a motor vehicle accident. The patient is
unconscious, and no family member is immediately available. What is the appropriate
legal action regarding informed consent?
A) Delay surgery until a family member can be contacted
B) Obtain verbal consent from the patient's primary care physician
C) Proceed with surgery under the doctrine of implied consent
D) Obtain consent from the hospital administrator
Correct Answer: C) Proceed with surgery under the doctrine of implied consent
2 (PDF) | 2026 QUESTIONS & ANSWERS + RATIONALES |
STUDY GUIDE | 100% CORRECT
1. During a preoperative "time-out" for a scheduled bilateral inguinal hernia repair, the
surgical team discovers that the surgeon intends to repair the left side, but the surgical
consent form and the preoperative site marking indicate the right side. What is the most
appropriate immediate action for the surgical assistant?
A) Proceed with the left-side repair as the surgeon has identified it as the correct
pathology
B) Verify the side with the patient's family in the waiting area before making an incision
C) Stop the procedure immediately and request that the surgeon and circulating nurse
resolve the discrepancy with the patient and medical records
D) Proceed with the right-side repair as it matches the legal consent form, regardless of
the surgeon's current plan
Correct Answer: C) Stop the procedure immediately and request that the surgeon and circulating
nurse resolve the discrepancy with the patient and medical records
Rationale: The Universal Protocol for preventing wrong-site surgery mandates a "timeout"
immediately before starting a procedure. Any discrepancy identified during the timeout must be
resolved before the incision is made. Proceeding without clarification violates patient safety
protocols .
2. A patient scheduled for an elective bilateral inguinal hernia repair states during the
preoperative interview that they took their daily 81 mg aspirin with a sip of water this
morning. Which action should the surgical assistant anticipate?
A) Proceed with the surgical case as planned without any additional precautions
B) Alert the surgeon immediately; aspirin irreversibly inhibits platelet aggregation and is
typically withheld 5 to 7 days preoperatively
C) Administer 10 mg of intravenous Vitamin K to instantly reverse the antiplatelet effect
D) Order a 6-unit platelet transfusion to be infused in the holding area prior to surgical
incision
Correct Answer: B) Alert the surgeon immediately; aspirin irreversibly inhibits platelet
aggregation and is typically withheld 5 to 7 days preoperatively
Rationale: Aspirin irreversibly inhibits platelet aggregation for the lifespan of the platelet (7-10
days). For procedures with intermediate to high bleeding risk, antiplatelet therapies are generally
held for 5 to 7 days before surgery. Vitamin K reverses warfarin, not aspirin .
3. During a preoperative timeout executed under the Universal Protocol guidelines, which
three elements must the surgical assistant, primary surgeon, and circulating nurse
verbally confirm?
, A) Patient age, admitting diagnosis, and health insurance authorization status
B) Correct patient identity, correct planned surgical procedure, and correct surgical site
C) Primary surgeon's name, planned anesthesia modality, and expected operative
duration
D) Blood type compatibility, patient drug allergies, and exact duration of NPO fasting
status
Correct Answer: B) Correct patient identity, correct planned surgical procedure, and correct
surgical site
Rationale: The Joint Commission's Universal Protocol mandates a "timeout" immediately before
making the surgical incision. The entire perioperative team must actively and verbally confirm
the correct patient identity, the correct planned procedure, and the correct anatomically marked
surgical site .
4. The surgical assistant is helping place a patient in the prone position for a lumbar
laminectomy. Which positioning consideration is most critical to prevent intraoperative
respiratory compromise and vena cava compression?
A) Positioning the patient's arms at a 120-degree angle on padded arm boards to open the
chest wall
B) Utilizing axillary rolls and ensuring the abdomen hangs freely between chest rolls and
pelvic bolsters
C) Placing a rigid donut headrest underneath the patient's chin to hyperextend the neck
D) Keeping the patient's legs completely straight and unpadded to maximize systemic
venous return
Correct Answer: B) Utilizing axillary rolls and ensuring the abdomen hangs freely between chest
rolls and pelvic bolsters
Rationale: In the prone position, the weight of the torso must be supported by firm chest rolls and
pelvic bolsters so that the abdominal wall can hang completely free. If the abdomen is
compressed against the operating table, intra-abdominal pressure rises, compressing the inferior
vena cava and decreasing venous return .
5. A patient is undergoing a total thyroidectomy. While positioning the patient in a modified
reverse Trendelenburg position with a shoulder roll, which anatomical structure must be
carefully protected against hyperextension and compression injuries?
A) The brachial plexus and the cervical spine
B) The sciatic nerve and the popliteal artery
C) The peroneal nerve at the fibular head
D) The femoral nerve within the inguinal canal
Correct Answer: A) The brachial plexus and the cervical spine
Rationale: Extension of the neck for thyroid or anterior cervical surgery requires careful
positioning. Excessive extension or inappropriate placement of shoulder rolls can stretch or
compress the cervical spine nerves and the brachial plexus .
, 6. A patient is scheduled for a mastectomy and is found to have a permanent cardiac
pacemaker. The surgical assistant is preparing the operative field. Which of the following
is the primary safety concern regarding the use of electrosurgical units (ESU) in this
patient?
A) The ESU may cause the pacemaker to switch to an asynchronous mode or inhibit
pacing due to electromagnetic interference
B) The ESU will inevitably drain the battery of the pacemaker, leading to immediate
postoperative failure
C) The ESU current will be diverted through the pacemaker leads, potentially causing a
myocardial infarction
D) The ESU ground pad placement is irrelevant as long as the pacemaker is shielded by a
lead apron
Correct Answer: A) The ESU may cause the pacemaker to switch to an asynchronous mode or
inhibit pacing due to electromagnetic interference
Rationale: Electrosurgical units create electromagnetic interference that can be interpreted by the
pacemaker as cardiac activity, potentially inhibiting the device's output. It can also cause the
device to revert to an asynchronous (fixed-rate) mode. The primary concern is interference with
the device's sensing/pacing logic .
7. A 45-year-old male is scheduled for an elective indirect inguinal hernia repair. During the
preoperative assessment, the patient reveals he has been taking aspirin 81 mg daily.
When should the patient be instructed to discontinue this medication prior to surgery?
A) 24 hours before surgery
B) 48 hours before surgery
C) 72 hours before surgery
D) 7 days before surgery
Correct Answer: D) 7 days before surgery
Rationale: Aspirin irreversibly inhibits platelet function for the lifespan of the platelet (7-10
days). Discontinuing aspirin 7 days before surgery allows adequate platelet regeneration and
reduces bleeding risk during surgery .
8. A patient requires emergency surgery following a motor vehicle accident. The patient is
unconscious, and no family member is immediately available. What is the appropriate
legal action regarding informed consent?
A) Delay surgery until a family member can be contacted
B) Obtain verbal consent from the patient's primary care physician
C) Proceed with surgery under the doctrine of implied consent
D) Obtain consent from the hospital administrator
Correct Answer: C) Proceed with surgery under the doctrine of implied consent
