1
Q
According to accrediting bodies such as CAAHEP (Commission of Accreditation of Allied Health Education Programs) and NBSTSA (National Board of Surgical Technology and Surgical Assisting) are increasingly standardized SFA programs. Which outcomes below best illustrate the impact of these standardized requirements on students and programs?
A
Programs must meet consistent national criteria and graduates demonstrate uniform competencies
2
Q
You have just assisted in a complex orthopedic surgery involving unfamiliar anatomical structures. Referring to “Take Notes” and “Practice to Improve,” what is the best next step to solidify and build upon your new knowledge?
A
Immediately document the unfamilar structures and techniques, then research and review these points before the next day
3
Q
Suzie has taken the CSFA Exam and passed. For Suzie to keep her certification without retaking the exam, she must do which of the following:
A
Maintain continuing education (CE) credits
4
Q
Effective January 1, 2020, once certified, _____ CEUs must be maintained every _____ years.
A
38; 2
5
Q
Which type of business model would the SFA’s personal assets be protected?
A
Limited Liability Company
6
Q
The CSFA Examination consist of 175 questions, how many are scored?
A
150
7
Q
What is the current passing score on the CSFA examination?
A
99
8
Q
According to the ASA Code of Ethics, SFAs must respect patient autonomy and self-determination. Which scenario BEST illustrates a violation of this ethical principle?
A
Overriding the patient’s expressed wishes because the surgeon feels the patient “doesn’t really know what’s best”
9
Q
You are designing a new training curriculum for SFAs that reflects the principle stated by the Association of Surgical Assistants (ASA): A SFA operates at the same skill level as other nonphysician healthcare professional in similar roles. Which component best demonstrates this advanced practice concept?
A
Providing in-depth instructions on tissue handling, suturing techniques, and hemostasis management
10
Q
Which organization retains the sole authority to establish eligibility requirements and make final decisions regarding a surgical first assistant’s certification exam?
A
National Board of Surgical Technology and Surgical Assisting (NBSTSA)
11
Q
To verify that you graduated from a CAAHEP-accredited surgical first assisting program, which of the following is NOT an acceptable form of documentation?
A
A current resume listing surgical experience
12
Q
Billing requires the SFA to have a:
A
NPI
13
Q
Most Surgical Assistant programs are accredited through _____________.
A
CAAHEP
14
Q
A SFA maybe negligent if he/she exceeds his/her scope of practice that is defined by:
1. Education
2. Experience
3. Policies and procedures
4. Knowledge
A
All of the above
15
Q
The American College of Surgeons (ACS) issued a statement regarding who is best suited to perfrom in the role of the assistant at surgery. Based on this emphasis, how would you critically evaluate the suitability of a candidate for the first assistant postion?
A
Whether the candidate has both the formal training (e.g., accredited program) and demonstrates mastery of essential intraoperative skills
16
Q
Types of credentialing include:
1. Registration
2. Certificate from accredited school
3. Certification
4. Licensure
A
1, 3, and 4
17
Q
_______________ demonstrates that a SFA from an accredited program has achieved a minimum level of knowledge and skills.
A
Certification
18
Q
A new SFA struggles to master “Two Hands and Ten Fingers.” Which scenario best illustrates a misunderstanding of this principle?
A
Switching scissors from the left hand repeatedly during cutting
19
Q
What year were the ASA Code of Ethics approved by the ASA Board of Directors?
A
2018
20
Q
Healthcare professionals, such as SFAs are guided in their practice by:
1. Standards
2. Laws
3. Regulations
4. Policies
A
All of the above
21
Q
The __________ is responsible for all decisions related to certification such as eligibility, renewal, and revocation, as well as developing the certification examination.
A
National Board of Surgical Technology and Surgical Assisting (NBSTSA)
22
Q
The Latin phrase “aeger primo” refers to:
A
Patient First
23
Q
Ethics is defined as:
A
Moral obligation that one person owes another person
24
Q
Which of the following ethical principles refers to “do no harm”
A
Nonmaleficene
25
Which of the following is not a tort?
- Invasion of privacy
- Defamation
- Assault
26
Unlawful physical harm is called:
Battery
27
Which of the following is an affirmative defense that alleges that the plaintiff is mutually responsible for an injury through a lack of care in combination with negligence of the healthcare provider?
Contributory Negligence
28
The legal doctrine that mandates every professional to carry out his or her duties according to national standards of care practiced throughout the country is the:
Doctrine of Reasonable Man
29
The principles of personal liability is a legal rule which:
Assault and Battery
30
The Patient's Bill of Rights entitles the patient to all of the following EXCEPT:
Experimental Treatment Without Consent
31
Granting of implied or informed permission by a patient for someone else to perform an action is called:
Consent
32
A durable power of attorney made for healthcare decisions is called a:
Health-Care Proxy
33
When you pass the CSFA exam, the certification is described as:
Recognition by an appropriate body that an individual has met a predetermined standard
34
Libel refers to:
Written Information
35
A system of principles and beliefs intended to govern the behavior of those entrusted with providing care to the sick is commonly referred to as:
Code of Ethics
36
____________ is defined as the threat of touching in an injurious way.
Assault
37
If a SFA places the operative patient's well-being above all other factors, then the SFA is said to have a strong:
Surgical Conscience
38
_______________ techniques are used to resolve disputes in a rational way without anger or resentment.
Peaceful Dispute Resolution
39
Name the legal doctrine which applies to a SFA when he/she is acting under the direction and control of a physician or hospital who may be responsible for his/her negligence.
Respondeat Superior
40
A failure to exercise that degree of skill ordinarily employed under similar circumstances by members of their profession in good standing in the same community or locality is the legal definition of:
Negligence
41
The Health Insurance Portability and Accountability Act (HIPPA):
Privacy standards to protect the patient's medical records
42
SFA Programs are accredited by:
CAAHEP
43
Which of the following refers to a civil wrong committed against a person or property, not including a breach of contract?
Tort
44
If a Kelly clamp is left in a patient who underwent a cholecystectomy, which of the following legal charges can be filed?
Res Ipsa Loquitur
45
Which of the following is not a form of intentional misconduct?
Negligence
46
_____________ means understanding your own world views and those of the patient, while avoiding stereotyping and sssumptions.
Culture Competence
47
Which of the following describes the legal doctrine of respondeat superior?
Let the master answer
48
The ways in which the skin promotes loss of excess body heat is/are:
- Dilation of dermal blood vessels
- Activation of eccrine sweat glands to release more sweat to skin surface
- Loss of heat by radiation, conduction, and convection
49
The prefix pertaining to fingernail is:
Onych-
50
The lines of cleavage of Langer's lines are:
The direction of the rows of collagen fibers in the dermis
51
When closing skin in surgery, this type of needle is preferred:
Cutting
52
The most common skin cancer:
Basal Cell carcinoma
53
Before firing any stapler when performing an anastomosis, it is most important to:
Verify that the tissue edges are correctly aligned and that no other tissue is inadvertently caught in the jaws
54
The function of skin includes:
Regulating Body Temperature
55
Place the following layers of the abdominal wall in order from laparotomy closure:
1. Subcutaneous tissue
2. Muscle
3. Peritoneum
4. Extraperitoneal fat
5. Transversalis fascia
6. Skin
7. Deep fasica
3, 4, 5, 2, 7, 1, and 6
o Peritoneum,
o Extraperitoneal fat
o Transversalis fascia
o Muscle
o Deep Fasica
o Subcutaneous Tissue
o Skin
56
The subcutaneous layer can be described as:
- Being Composed of loose connective tissue and adipose tissue
- Containing blood vessels that supply the skin
- Functioning as a heat insulator or helping to conserve body heat
57
When closing the skin wiht a subcuticular (subdermal) stitch, which of the following is MOST important to minimize complications?
Bury the knot to avoid leaving foreign material at the wound edge
58
Inflammation of a sweat gland is known as:
Hidradenitis
59
Regardless of the specific closure method chosen (e.g., vertical or horizonatal mattress sutures, staples, or skin glue), the main principle in skin closure is to:
Minimize excessive pressure on wound edges to promote healing and reduce scarring
60
The force of integumentary injuries that results from the skin remaining stationary while the underlying tissues shift is known as:
Shearing
61
Epidermis is distinguished by being ___________, whereas dermis is distinguished by being ____________.
- Composed of stratified squamous epithelial tissue
- Composed of fibrous connective tissue
62
An autograft involves covering an injured area of skin with:
Skin from an uninjured region of the patient's body
63
The nerve fibers in the dermis function to stimulate:
Muscles and glands in the dermis
64
Body heat is lost by radiation by:
Heat rays escaping to cooler surroundings
65
Which statement BEST descirbes the primary objective when closing the fascial layer in a midline incision?
Achieve a watertight seal that prevents infection and provides primary strength to the closure
66
When performing suturing or stapling to close a wound or create an anastomosis, the primary goal is to:
Achieve a tension-free approximation that does not compromise blood supply
67
Which is NOT a characteristic of the epidermis?
Highly Vascular
68
A patient recently operated on for a ruptured appendix had a temperature of 103° F and returned to the OR for a debridement and washout of purulent drainage from his wound on postoperative day 3. What was the wound classification at the time of his debridement and washout surgery?
Infected wound, Classification IV
69
After tissue injury, the initial vascular and cellular response is the:
Inflammatory Phase
70
Which of the following heals the quickest after injury?
Epithelium
71
Wounds in which there is significant bacterial contamination, foreign bodies, or extensive tissue trauma are generally closed by which intention?
Granulation
72
A 62-year-old man had surgery 6 days ago for a ruptured diverticulum. He is back in the OR for a debridement and washout. The patient's fever has subsided, and the drainage is clear. The surgeon will schedule the patient to return to the OR in 3 days for:
Delayed primary sutured closure
73
Between which of the following postoperative days can dehiscence typically occur?
Fifth and Tenth
74
During a sleeve gastrectomy, suction efficiency suddenly drops despite stable wall suction pressure. The SFA inspects the field and observes thick fluid stagnating near trocar sites. What is the MOST likely equipment-related cause?
Partial obstruction within the suction tubing or tip
75
When assisting with chest tube removal, what immediate postoperative action provides the most effective protection against pneumothorax?
Have patient inspire deeply as tube is removed, then seal site
76
Delayed wound healing may be related to:
Age
77
The most common cause of delayed wound healing in the operative patient is:
Wound Infection
78
Which of the following would affect normal wound healing?
Peripheral Vascular Disease (PVD)
79
The three pases of would healing include all the the following except:
Chronic Phase
80
What cells are responsible for the synthesis and secretion of collagen and elastin?
Fibroblasts
81
When a tissue defect decreases in size by wound contraction, it is designated as healing by:
Secondary Intention
82
Which of the following are the MOST important considerations when preventing wound infection in the surgical patient?
1. Pathogen transmittal
2. Portal of entry into the susceptible host
3. Anesthetic options for the patient's operative process
4. Invasion of the susceptible hos
1, 2, and 4
83
Delayed primary closure would be the most appropriate would closure technique for which of the following procedures?
Removal of Perforated Appendix
84
Why is it often recommended to make surgical incisions parallel to relaxed skin tension lines?
It leads to minimal tension and usually produces a less noticeable scar
85
An adult male is injured in an automobile accident at 2a.m. An exploratory laparotomy for possible perforated bowel is initiated at 5a.m. Which of the following is the BEST wound classification in this scenario?
Contaminated
86
Which can affect wound healing:
1. Diabetes
2. Nutritional status of patient
3. Anemia
4. Location of incision
5. Age of patient
6. Uremia
All of the above
87
Fibroblasts multiple rapidly, bridging wound edges and restoring of body structures during the __________ phase of first intention wound healing.
Healing
88
During deep abdominal retraction, friction is noted between the retractor blade and surrounding tissue. What action most effectively reduces tissue desiccation and shear injury?
Place a saline-moistened laparotomy pad between blade and tissue.
89
The splitting open or gaping of a wound is call:
Dehiscence
90
An inexperienced SFA retracts tissue based on their own visual perspective rather than anatomical priority. The primary risk of this behavior is:
Exposure of irrelevant anatomy and surgeon frustration
91
During a laparotomy, the surgeon requests deeper exposure around a vascular pedicle in a small incision. What SFA strategy BEST aligns with exposure principles
Focus on identifying key anatomy and protecting important structures
92
A wound that is known to be infected at the time of surgery and is left open to be closed at a later date is categorized as:
Delayed primary closure
93
Which of the following techniques demonstrate a proven benefit in the prevention of postoperative wound infections?
1. Administering appropriate antibiotics within 1 hour of incision time
2. Maintaining suitable antibiotic coverage from 48-72 hours postoperatively
3. Irrigating the wound with normal saline
4. Irrigating the wound with sterile wate
1 and 3
94
Which statement BEST describes healing by primary intention?
The wound edges are approximated (e.g., with sutures) for minimal scarring and faster healing
95
The space caused by the separation of wound edges which have not been closely approximated by sutures is called:
Dead Space
96
During healing by first intention, the first five days are the ___________ phase; up to the fourteenth day is the ______________ phase; and from the fourteenth day until wound is fully healed is the _________ phase.
- Inflammatory (lag)
- fibroplasia (healing)
- maturation
97
For a healthy patient following a routine laparotomy, when should the SFA expect skin staples to be removed under standard healing conditions?
Postoperative day 7-14
98
A common pathogen typically associated with decubitus ulcers in Staphylococcus:
Aureus
99
A 48-year-old tetraplegic with chronic sacral wound is scheduled for wound debridement. What is the purpose of doing a wound debridement on a chronic wound?
The debridement will remove dead tissue that could support infection
100
During an open abdominal procedure, the surgeon requests increased exposure to the renal hilum. The SFA applies additional handheld retraction force. The tissue begins to blanch. What is the BEST action?
Decrease traction and notify the surgeon
101
Which of the following organisms normally found on the skin can cause wound infections?
Staphylococcus aureus
102
Which statement concerning healing by second intention is FALSE?
Collagen fibers hold wound edges together initially
103
Wound classification is assigned when:
Procedure is complete
104
The protrusion of bowel through the separated edges of an abdominal wound closure is called:
Evisceration
105
A 62-year-old man had surgery 6 days ago for a ruptured diverticulum. what was the wound classification at the time of his emergency surgery?
- Contaminated wound
- Classification III
106
An inexperienced assistant is holding a Richardson and appears frozen, not adjusting angle or depth. What is the MOST important principle to reinforce?
Retraction must adjust continuously to surgeon movement and tissue response
107
During MIS, the surgeon requests the laparoscope be angled more anteriorly. The SFA interprets this as a need to:
Reposition to change the field of view relative to surgical planes
108
While assisting with exposure, the SFA notices the surgeon’s view narrowing as the assistant retracts too aggressively. What is the most appropriate action?
Reduce tension and reposition per the surgeon's visual field
109
A key hallmark of the proliferative (Stage 2) phase is the formation of granulation tissue. This granulation tissue is described as:
New, vascular tissue containing collagen fibers and blood vessels
110
During a robotic cholecystectomy, visualization becomes poor due to smoke and accumulating bile pooling in the right upper quadrant. The SFA increases suction but visibility remains inadequate. What is the MOST appropriate next action?
Alert the surgeon that low wall suction pressure may be limiting evacuation volume
111
Serosanguineous drainage means:
Blood-tingued
112
During a postoperative wound assessment, the surgeon instructs the SFA to transition the patient from wet-to-dry dressing to a plain wound covering. What factor most likely prompted this change?
Sufficient granulation tissue is present
113
Dense unsightly connective tissue or excessive scar formation that often is removed surgically is known as (a):
Keloid
114
A type of wound in which the alimentary, oropharyngeal, respiratory, or genitourinary regions are entered is classified as:
Clean contaminated
115
The SFA notes a small-caliber drain left in place after abdominal surgery. Based on best practice, how should the exit site be dressed to support healing and reduce infection risk?
Cover with a bandage to protect and absorb drainage
116
There are many factors that influence surgical wound healing. Select the response below that reflects a factor with high influence over wound healing and is within the control of the surgical team.
Antimicrobial prophylaxis
117
While holding the laparoscope, the SFA notices the surgeon repositioning instruments frequently and losing exposure. What adjustment MOST improves visualization and efficiency?
short, controlled scope movements synchronized with surgeon motion
118
When administering local anesthetic via infilation, which of the following steps is recommended in minimize patient discomfort and reduce the risk of complications?
Use the smallest reasonable gauge needle, inject slowly, and consider a test dose
119
Your surgeon ask you to dilute 2% lidocaine so you can use 0.5% lidocaine for a local. How many cc of sterile water should be added to 1 ml of 2% lidocaine to create 0.5% lidocaine.
3 cc
120
The generic name for Marcaine is:
Bupivaciane
121
Which of the following is a parenteral medication route?
- Intramuscular
- Subcutaneous
- Intravenous
122
A vasoconstrictor that, when added to a local anesthetic agent, extends its life is:
Epinephrine
123
One mL is equal to:
1 cc
124
According to "Kern's Rule," which states "Percent of drug x 10=mg of drug per cc," how many milligrams of lidocaine are in 1 cc of a 2% lidocaine solution?
20 mg
125
The most widely used local anesthetic is:
Lidocaine
126
Which of the following is the correct order of the pathway of pain?
Nerve endings in a wound, to the nerves, through the paravertebral space, through the epidural space, through the subarachnoid space, to the spinal cord, to the cerebral cortex of the brain
127
A standard syringe is calibrated in _______________________.
Cubic Centimeters
128
Which group of local anesthetics is most commonly used in surgery due to fewer allergic reactions and lower toxicity?
Amides (Lidocaine, Bupivacaine, Ropivacaine)
129
When drawing anesthetic from a vial using a large needle (18 gauge), what is the main reason for using this size needle?
It allows air and anesthetic to be drawn more efficiently due to decreased resistance
130
When adding 30 mL of injectable saline to 30 mL of 0.5% Marcaine, what strength does the drug become?
0.25%
131
Which local anesthetic has the longest duration of action?
Bupivacaine with Epinephrine
132
Which anesthetic listed has the highest relative potency?
Bupivacaine
133
In which of the following patients would the use of epinephrine with a local anesthetic be contraindicated?
A patient with peripheral arterial disease requiring toe surgery
134
One of the many proprietary names for lidocaine is?
Xylocaine HCL
135
What portion of the nerve do local anesthetics work?
Nerve Membrane
136
Which anesthetic has the fastest onset of action?
- Lidocaine
- Mepivacaine
137
Another name for adrenaline is:
Epinephrine
138
All of the following are reasons to include a vasoconstrictor EXCEPT:
Increase anesthetic blood levels
139
Epidural anesthesia is administered:
Into the space between the spinal canal and the dura mater covering the nerve roots
140
The type of anesthetic technique in which medication is injected under the skin to anesthetize the nerve endings and nerve fibers is call a(n) _______ anesthetic
Local
141
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