CERTIFIED SURGICAL
FIRST ASSISTANT CSFA
PRACTICE TEST
Question 1: Before incision for a total knee arthroplasty, which action by the surgical �rst assistant most directly con�rms that the planned implant can be used safely?
Choices:
1) Con�rm the implant system and required sizes are present and compatible with the surgeon’s plan 2) Open all implant sizes onto the sterile �eld before the patient enters the room 3) Ask anesthesia to document the implant lot number 4) Select the implant only after skin closure begins Correct Answer: Con�rm the implant system and required sizes are present and compatible with the surgeon’s plan Explanation: Implant availability and compatibility should be veri�ed before the procedure begins so the team can proceed without an avoidable delay or substitution. Opening every size unnecessarily increases cost and contamination risk.Page 1
Question 2: A patient scheduled for laparoscopic cholecystectomy reports a severe latex allergy during the preoperative interview. What is the best �rst-assistant response?
Choices:
1) Communicate the allergy to the team and ensure latex-safe supplies and equipment are used 2) Proceed because laparoscopic instruments do not contain latex 3) Wait until the time-out to mention the allergy 4) Cover latex-containing items with sterile towels Correct Answer: Communicate the allergy to the team and ensure latex-safe supplies and equipment are used Explanation: A severe latex allergy requires early team communication and a latex-safe environment. Covering latex does not reliably prevent exposure, and delaying communication increases risk.Question 3: Which �nding should cause the surgical �rst assistant to stop preparation and seek clari�cation before surgery begins?
Choices:
1) The surgeon requests a self-retaining retractor 2) The patient received prophylactic antibiotics 3) The consent states left inguinal hernia repair while the schedule lists right inguinal hernia repair 4) The patient has an 18-gauge peripheral IV Correct Answer: The consent states left inguinal hernia repair while the schedule lists right inguinal hernia repair Page 2
Explanation: A discrepancy involving the operative site must be resolved before proceeding.Site, procedure, and consent must agree as part of the Universal Protocol and time-out process.Question 4: For a patient placed in lithotomy position, which preventive measure best reduces the risk of common peroneal nerve injury?
Choices:
1) Allow one leg to be raised before the other 2) Secure the ankles tightly to the stirrups 3) Pad the lateral aspect of the leg near the �bular head 4) Place the knees in maximal �exion Correct Answer: Pad the lateral aspect of the leg near the �bular head Explanation: The common peroneal nerve is vulnerable where it passes around the �bular head. Proper padding and avoidance of excessive pressure at this site reduce injury risk.Question 5: When selecting suture for a contaminated abdominal wall closure, which property is generally preferred when clinically appropriate?
Choices:
1) Braided material with high capillarity 2) Mono�lament material with lower tissue drag and bacterial harboring potential 3) Rapidly absorbing suture for fascia 4) Suture with the largest possible diameter Correct Answer: Mono�lament material with lower tissue drag and bacterial harboring potential Page 3