NIFA PERIOPERATIVE QUIZ 1 & QUIZ 2 | 2025/2026
Actual Exam with Complete Questions & Verified Answers | National Institute for First Assistants
Overview
This 2025/2026 updated resource contains the actual NIFA Perioperative Quizzes 1 & 2 with complete
questions and verified answers, following the National Institute for First Assistants' current
certification standards for RNFA/CSFA candidates.
Key Features
✓ Actual NIFA quiz format and content structure
✓ Verified answers aligned with AORN/AST standards
✓ Comprehensive coverage of both Quiz 1 & Quiz 2 domains
✓ Surgical first assist techniques and role-specific knowledge
✓ Updated 2025/2026 guidelines for perioperative practice
Core Content Areas - Quiz 1
• Surgical Anatomy & Physiology (15 Qs)
• Aseptic Technique & Sterile Field (12 Qs)
• Surgical Instruments & Equipment (10 Qs)
• Wound Healing & Tissue Handling (8 Qs)
• Legal & Ethical Responsibilities (5 Qs)
Core Content Areas - Quiz 2
• Advanced Hemostasis & Suturing (12 Qs)
• Surgical Complications & Emergency Response (10 Qs)
• Specialty Procedure Assistance (e.g., Laparoscopic, Ortho) (10 Qs)
• Patient Positioning & Safety (8 Qs)
• Postoperative Care & Documentation (10 Qs)
Answer Format
Correct answers are marked in bold green and include:
• References to AORN/AST guidelines
• Rationale based on current perioperative evidence
• First assist best practices and clinical pearls
Updates for 2025/2026
Reflects 2025 AORN updated guidelines
Enhanced focus on minimally invasive surgery assistance
Updated surgical safety protocols (e.g., WHO Surgical Safety Checklist revisions)
Latest evidence on infection prevention and antimicrobial stewardship
NIFA QUIZ 1 – ACTUAL QUESTIONS & ANSWERS (50 Questions)
SURGICAL ANATOMY & PHYSIOLOGY (Questions 1–15)
1. During a laparoscopic cholecystectomy, the cystic artery is most commonly found within
which structure?
, a) Hepatoduodenal ligament
b) Gastrohepatic ligament
c) Phrenoesophageal ligament
d) Falciform ligament
a) Hepatoduodenal ligament
Rationale: Calot’s triangle is bounded by the cystic artery, common hepatic duct, and liver
edge; all lie within the hepatoduodenal ligament (AORN 2025).
2. The blood supply to the parathyroid glands is primarily derived from:
a) Superior thyroid artery
b) Inferior thyroid artery
c) Thyroidea ima
d) External carotid artery
b) Inferior thyroid artery
Rationale: Preservation of the inferior thyroid artery during thyroidectomy helps avoid
hypoparathyroidism.
3. Which anatomical landmark indicates the approximate location of the ureter as it crosses the
iliac vessels?
a) Umbilicus
b) Anterior superior iliac spine
c) Sacral promontory
d) Ischial spine
c) Sacral promontory
Rationale: Ureter crosses the bifurcation of the common iliac artery at the sacral
promontory—critical to avoid injury during pelvic surgery.
4. The fascial layer enclosing the femoral vessels in the groin is:
a) Scarpa’s fascia
b) Fascia lata
c) Femoral sheath
d) Poupart’s ligament
c) Femoral sheath
Rationale: Femoral sheath contains femoral artery, vein, and lymphatics but not the nerve.
5. During inguinal herniorrhaphy, the ilioinguinal nerve is typically found between:
a) External and internal oblique muscles
b) Transversus abdominis and peritoneum
c) Rectus sheath and transversalis fascia
d) Inguinal ligament and lacunar ligament
a) External and internal oblique muscles
Rationale: Identification and preservation reduce postoperative neuralgia.
6. The principal blood supply to the liver segments IV–VIII is:
a) Left hepatic artery
b) Right hepatic artery
c) Common hepatic artery
d) Cystic artery
b) Right hepatic artery
Rationale: Segments V–VIII are supplied by the right hepatic artery; knowledge vital for
hepatectomy.
7. Which structure forms the “floor” of the femoral canal?
a) Inguinal ligament
b) Cooper’s ligament
c) Pectineal ligament
d) Lacunar ligament
b) Cooper’s ligament
Rationale: Strong ligament used in hernia repairs; also called pectineal ligament.
, 8. The anatomical boundary between the anal canal and rectum is:
a) Dentate line
b) Anorectal ring
c) Levator ani muscle
d) Puborectalis sling
a) Dentate line
Rationale: Important for lymphatic drainage and innervation during colorectal surgery.
9. During parotidectomy, which cranial nerve is most at risk?
a) Facial (CN VII)
b) Trigeminal (CN V)
c) Glossopharyngeal (CN IX)
d) Vagus (CN X)
a) Facial (CN VII)
Rationale: Nerve courses through the gland; intraoperative monitoring common.
10. The thoracodorsal nerve innervates which muscle used in flap reconstruction?
a) Latissimus dorsi
b) Pectoralis major
c) Serratus anterior
d) Trapezius
a) Latissimus dorsi
Rationale: Preservation maintains flap viability.
11. Which vessel is the first branch of the external carotid artery?
a) Superior thyroid artery
b) Lingual artery
c) Facial artery
d) Occipital artery
a) Superior thyroid artery
Rationale: Arises just above the bifurcation; may be ligated safely in neck dissections.
12. The arcuate line is an anatomical landmark located:
a) 5 cm below the umbilicus
b) At the costal margin
c) At the pubic symphysis
d) At the iliac crest
a) 5 cm below the umbilicus
Rationale: Posterior rectus sheath ends here; important for laparoscopic port placement.
13. During laparoscopic inguinal hernia repair, the triangle of pain is bounded by:
a) Gonadal vessels and iliopubic tract
b) Vas deferens and testicular artery
c) Bladder and median umbilical ligament
d) Epigastric vessels and inguinal ligament
a) Gonadal vessels and iliopubic tract
Rationale: Contains genitofemoral nerve; staples avoided here.
14. The principal arterial supply to the stomach fundus is:
a) Left gastric artery
b) Right gastric artery
c) Short gastric arteries
d) Gastroduodenal artery
c) Short gastric arteries
Rationale: Branches from splenic artery; must be preserved during splenectomy to avoid
gastric ischemia.
15. Which ligament contains the common bile duct?
a) Hepatoduodenal ligament
Actual Exam with Complete Questions & Verified Answers | National Institute for First Assistants
Overview
This 2025/2026 updated resource contains the actual NIFA Perioperative Quizzes 1 & 2 with complete
questions and verified answers, following the National Institute for First Assistants' current
certification standards for RNFA/CSFA candidates.
Key Features
✓ Actual NIFA quiz format and content structure
✓ Verified answers aligned with AORN/AST standards
✓ Comprehensive coverage of both Quiz 1 & Quiz 2 domains
✓ Surgical first assist techniques and role-specific knowledge
✓ Updated 2025/2026 guidelines for perioperative practice
Core Content Areas - Quiz 1
• Surgical Anatomy & Physiology (15 Qs)
• Aseptic Technique & Sterile Field (12 Qs)
• Surgical Instruments & Equipment (10 Qs)
• Wound Healing & Tissue Handling (8 Qs)
• Legal & Ethical Responsibilities (5 Qs)
Core Content Areas - Quiz 2
• Advanced Hemostasis & Suturing (12 Qs)
• Surgical Complications & Emergency Response (10 Qs)
• Specialty Procedure Assistance (e.g., Laparoscopic, Ortho) (10 Qs)
• Patient Positioning & Safety (8 Qs)
• Postoperative Care & Documentation (10 Qs)
Answer Format
Correct answers are marked in bold green and include:
• References to AORN/AST guidelines
• Rationale based on current perioperative evidence
• First assist best practices and clinical pearls
Updates for 2025/2026
Reflects 2025 AORN updated guidelines
Enhanced focus on minimally invasive surgery assistance
Updated surgical safety protocols (e.g., WHO Surgical Safety Checklist revisions)
Latest evidence on infection prevention and antimicrobial stewardship
NIFA QUIZ 1 – ACTUAL QUESTIONS & ANSWERS (50 Questions)
SURGICAL ANATOMY & PHYSIOLOGY (Questions 1–15)
1. During a laparoscopic cholecystectomy, the cystic artery is most commonly found within
which structure?
, a) Hepatoduodenal ligament
b) Gastrohepatic ligament
c) Phrenoesophageal ligament
d) Falciform ligament
a) Hepatoduodenal ligament
Rationale: Calot’s triangle is bounded by the cystic artery, common hepatic duct, and liver
edge; all lie within the hepatoduodenal ligament (AORN 2025).
2. The blood supply to the parathyroid glands is primarily derived from:
a) Superior thyroid artery
b) Inferior thyroid artery
c) Thyroidea ima
d) External carotid artery
b) Inferior thyroid artery
Rationale: Preservation of the inferior thyroid artery during thyroidectomy helps avoid
hypoparathyroidism.
3. Which anatomical landmark indicates the approximate location of the ureter as it crosses the
iliac vessels?
a) Umbilicus
b) Anterior superior iliac spine
c) Sacral promontory
d) Ischial spine
c) Sacral promontory
Rationale: Ureter crosses the bifurcation of the common iliac artery at the sacral
promontory—critical to avoid injury during pelvic surgery.
4. The fascial layer enclosing the femoral vessels in the groin is:
a) Scarpa’s fascia
b) Fascia lata
c) Femoral sheath
d) Poupart’s ligament
c) Femoral sheath
Rationale: Femoral sheath contains femoral artery, vein, and lymphatics but not the nerve.
5. During inguinal herniorrhaphy, the ilioinguinal nerve is typically found between:
a) External and internal oblique muscles
b) Transversus abdominis and peritoneum
c) Rectus sheath and transversalis fascia
d) Inguinal ligament and lacunar ligament
a) External and internal oblique muscles
Rationale: Identification and preservation reduce postoperative neuralgia.
6. The principal blood supply to the liver segments IV–VIII is:
a) Left hepatic artery
b) Right hepatic artery
c) Common hepatic artery
d) Cystic artery
b) Right hepatic artery
Rationale: Segments V–VIII are supplied by the right hepatic artery; knowledge vital for
hepatectomy.
7. Which structure forms the “floor” of the femoral canal?
a) Inguinal ligament
b) Cooper’s ligament
c) Pectineal ligament
d) Lacunar ligament
b) Cooper’s ligament
Rationale: Strong ligament used in hernia repairs; also called pectineal ligament.
, 8. The anatomical boundary between the anal canal and rectum is:
a) Dentate line
b) Anorectal ring
c) Levator ani muscle
d) Puborectalis sling
a) Dentate line
Rationale: Important for lymphatic drainage and innervation during colorectal surgery.
9. During parotidectomy, which cranial nerve is most at risk?
a) Facial (CN VII)
b) Trigeminal (CN V)
c) Glossopharyngeal (CN IX)
d) Vagus (CN X)
a) Facial (CN VII)
Rationale: Nerve courses through the gland; intraoperative monitoring common.
10. The thoracodorsal nerve innervates which muscle used in flap reconstruction?
a) Latissimus dorsi
b) Pectoralis major
c) Serratus anterior
d) Trapezius
a) Latissimus dorsi
Rationale: Preservation maintains flap viability.
11. Which vessel is the first branch of the external carotid artery?
a) Superior thyroid artery
b) Lingual artery
c) Facial artery
d) Occipital artery
a) Superior thyroid artery
Rationale: Arises just above the bifurcation; may be ligated safely in neck dissections.
12. The arcuate line is an anatomical landmark located:
a) 5 cm below the umbilicus
b) At the costal margin
c) At the pubic symphysis
d) At the iliac crest
a) 5 cm below the umbilicus
Rationale: Posterior rectus sheath ends here; important for laparoscopic port placement.
13. During laparoscopic inguinal hernia repair, the triangle of pain is bounded by:
a) Gonadal vessels and iliopubic tract
b) Vas deferens and testicular artery
c) Bladder and median umbilical ligament
d) Epigastric vessels and inguinal ligament
a) Gonadal vessels and iliopubic tract
Rationale: Contains genitofemoral nerve; staples avoided here.
14. The principal arterial supply to the stomach fundus is:
a) Left gastric artery
b) Right gastric artery
c) Short gastric arteries
d) Gastroduodenal artery
c) Short gastric arteries
Rationale: Branches from splenic artery; must be preserved during splenectomy to avoid
gastric ischemia.
15. Which ligament contains the common bile duct?
a) Hepatoduodenal ligament
