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ABSA SA-C Exam Practice Bank 2026: 350 Questions & Rationales Exam Overview
FeatureDetails CertificationSurgical Assistant – Certified (SA-C) Issuing BodyAmerican Board of Surgical Assistants (ABSA) Exam FormatComputer-based, live remote proctoring Number of Questions150 total (140 scored, 10 unscored pretest) Time Limit3 hours Passing Score70% Exam Fee$455 ($400 for active military/veterans) RenewalEvery 2 years Retake PolicyUp to 4 times within 1 year; 30 days between attempts
Exam Content Domains
DomainPercentage Perioperative Care50% General Surgical & Medical Knowledge39% Professional Practice Knowledge11%
Detailed Breakdown
TopicPercentage Preoperative4% Operative – General11% Operative – Orthopedic8% Operative – Plastic/Reconstructive8% Operative – Gynecological8% Operative – Other Specialties8% Postoperative3% Surgical Anatomy13% Terminology6% Surgical Instrumentation & Equipment4% General Medical Knowledge10% Asepsis3% Patient Safety/Risk Management/Emergency Protocols4% Code of Ethics/Scope of Practice4% OSHA/HIPAA3%
SECTION 1: PERIOPERATIVE CARE – PREOPERATIVE (Questions 1–30) Question 1 A patient scheduled for an elective inguinal hernia repair reports taking 81 mg aspirin this morning. The surgical assistant should anticipate which action?
Question 3 A patient has a documented latex allergy. Which action should the surgical assistant take when setting up the operating room? A) Wear standard gloves but avoid latex drapes B) Remove all latex-containing products from the room and use latex-safe alternatives C) Administer diphenhydramine preoperatively D) Use latex gloves but double-glove Answer: B Rationale: For patients with latex allergy, all latex-containing products must be removed from the operating room. This includes gloves, drapes, tubing, and other supplies. Latex-safe alternatives must be used throughout the procedure.
Question 4 A patient with an elevated INR is scheduled for elective surgery. The surgical assistant should recognize that an INR above what threshold indicates increased bleeding risk? A) 1. B) 1. C) 2.
D) 3.
Answer: B Rationale: An INR above 1.5–2.0 for most procedures (or above 1.2 for neurosurgery) indicates increased bleeding risk. Elective surgery is often delayed or warfarin is reversed with vitamin K or bridging therapy.
Question 5 Before induction of anesthesia, who should perform the surgical site marking? A) The circulating nurse B) The anesthesia provider C) The operating surgeon, ideally with the patient involved and awake D) The surgical assistant Answer: C Rationale: The Joint Commission requires the surgeon to mark the operative site using a permanent marker, and the patient should participate when possible. The mark should be unambiguous and placed at or near the incision site.
Question 6
Rationale: Prophylactic antibiotics should be administered within 60 minutes before surgical incision to achieve adequate tissue concentrations. Vancomycin and fluoroquinolones may require infusion over 1–2 hours and should be started earlier.
Question 8 Which of the following patients is at highest risk for venous thromboembolism (VTE) postoperatively? A) A 25-year-old undergoing knee arthroscopy B) A 65-year-old undergoing total hip arthroplasty with a history of DVT C) A 40-year-old undergoing laparoscopic cholecystectomy D) A 30-year-old undergoing breast biopsy Answer: B Rationale: Major orthopedic surgery (hip/knee arthroplasty) combined with advanced age and history of VTE places the patient at highest risk. Risk stratification guides VTE prophylaxis.
Question 9 The surgical assistant is reviewing a patient's preoperative laboratory results. Which finding would most likely delay an elective surgical procedure? A) Hemoglobin 12.5 g/dL
B) White blood cell count 11,000/mm³ C) Platelet count 150,000/mm³ D) Serum potassium 2.8 mEq/L Answer: D Rationale: Severe hypokalemia (K < 3.0 mEq/L) increases the risk of cardiac arrhythmias during anesthesia and surgery. This finding should be corrected before proceeding with elective surgery.
Question 10 A patient reports they have not eaten or drank anything since midnight for a scheduled 8:00 AM surgery. The surgical assistant confirms: A) The patient has followed NPO guidelines B) The patient should have a clear liquid breakfast C) The patient should receive IV dextrose immediately D) The surgery should be canceled Answer: A Rationale: Standard NPO guidelines require no food for 6–8 hours and no clear liquids for 2 hours before surgery. This patient has appropriately followed NPO instructions.
Answer: C Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic agents (succinylcholine, volatile gases). A family history requires avoidance of triggering agents and preparation of dantrolene for emergency use.
Question 13 The surgical assistant is performing a preoperative "timeout." Which of the following is NOT a required element? A) Correct patient identity B) Correct procedure C) Correct surgical site D) Confirmation of the patient's insurance coverage Answer: D Rationale: The Universal Protocol timeout requires confirmation of correct patient, correct procedure, and correct site. Insurance verification is not part of the timeout process.
Question 14 A patient with a history of MRSA colonization is scheduled for surgery. The surgical assistant should anticipate:
A) No special precautions B) Contact precautions and appropriate antibiotic prophylaxis C) Cancellation of the surgery D) Use of standard precautions only Answer: B Rationale: Patients with MRSA colonization should be placed on contact precautions. Antibiotic prophylaxis should be adjusted to cover MRSA (e.g., vancomycin) if indicated.
Question 15 Which laboratory value is most important to assess before surgery in a patient taking warfarin? A) aPTT B) INR C) Platelet count D) Hemoglobin Answer: B Rationale: The INR (International Normalized Ratio) monitors warfarin therapy and assesses bleeding risk. An elevated INR may require postponing surgery or reversing anticoagulation.
Answer: B Rationale: Only the inner sterile field is considered sterile; the outer 1 inch of the sterile field is considered contaminated. Edges of tables and dropped instruments are always considered contaminated and cannot be used.
Question 18 A patient scheduled for surgery has a blood pressure of 180/110 mmHg. The surgical assistant should: A) Proceed with surgery as planned B) Notify the surgeon and anesthesia provider; elective surgery may be delayed C) Administer antihypertensive medication immediately D) Document the finding and proceed Answer: B Rationale: Severe hypertension (systolic > 180 or diastolic > 110) increases the risk of cardiovascular complications during anesthesia and surgery. Elective surgery may be delayed until blood pressure is controlled.
Question 19 The surgical assistant is reviewing the patient's history and notes a history of deep vein thrombosis (DVT). Which intervention should be anticipated?
A) No special precautions B) Venous thromboembolism prophylaxis C) Cancellation of surgery D) Use of aspirin only Answer: B Rationale: Patients with a history of DVT are at increased risk for postoperative VTE and should receive appropriate prophylaxis (mechanical and/or pharmacological) per evidence-based guidelines.
Question 20 A patient with a history of smoking is scheduled for surgery. The surgical assistant should educate the patient that smoking cessation should begin: A) The day of surgery B) At least 4–6 weeks before surgery C) 1 week before surgery D) Only after surgery Answer: B
B) Notify the surgeon and anesthesia provider; use alternative antibiotics C) Administer diphenhydramine before penicillin D) Proceed with surgery without antibiotics Answer: B Rationale: A history of anaphylaxis to penicillin is an absolute contraindication to penicillin use. Alternative antibiotics (e.g., cefazolin if no cross-reactivity, or vancomycin) should be used for prophylaxis.
Question 23 The surgical assistant is reviewing a patient's pregnancy test result before surgery. A positive result in a patient of childbearing age requires: A) Proceeding with surgery as planned B) Notifying the surgeon and anesthesia provider; elective surgery may be delayed C) Administering medications to terminate the pregnancy D) Documenting the finding and proceeding Answer: B Rationale: Pregnancy testing is standard for women of childbearing age before surgery. A positive result requires discussion with the surgeon and anesthesia provider; elective surgery may be postponed or modified to minimize fetal risk.
Question 24 A patient is scheduled for surgery and reports taking an herbal supplement, ginkgo biloba. The surgical assistant should recognize this may: A) Increase the risk of bleeding B) Decrease the risk of infection C) Improve wound healing D) Have no effect on surgery Answer: A Rationale: Ginkgo biloba inhibits platelet aggregation and increases bleeding risk. It should be discontinued 2–3 weeks before elective surgery.
Question 25 The surgical assistant is preparing the OR for a case. Which statement about sterile gowning and gloving is correct? A) The back of the sterile gown is considered sterile B) The arms of the sterile gown are considered sterile from the shoulders to the wrists C) The front of the sterile gown from chest to waist is considered sterile D) Gloves can be donned after touching non-sterile surfaces
A) Warfarin B) Clopidogrel C) Levothyroxine D) Metformin Answer: C Rationale: Levothyroxine should be continued in the perioperative period to prevent hypothyroidism. Warfarin and clopidogrel are typically held; metformin may be held for 24– 48 hours due to lactic acidosis risk.
Question 28 A patient is scheduled for surgery and reports a history of opioid dependence. The surgical assistant should anticipate: A) No special precautions B) Need for increased doses of pain medications and monitoring for withdrawal C) Use of non-opioid analgesics only D) Cancellation of surgery Answer: B
Rationale: Patients with opioid dependence may require increased doses of pain medications and monitoring for withdrawal symptoms. A multimodal analgesic approach and communication with the pain management team are important.
Question 29 The surgical assistant is preparing the OR for a case. Which of the following is a correct principle regarding the sterile field? A) Sterile fields should be prepared as early as possible B) Sterile fields should be prepared just before the procedure to minimize contamination risk C) Sterile fields can be left unattended D) Sterile fields do not need to be monitored Answer: B Rationale: Sterile fields should be prepared just before the procedure to minimize the risk of contamination. Unattended sterile fields are considered contaminated.
Question 30 A patient scheduled for surgery has a history of renal insufficiency. The surgical assistant should recognize this may affect: A) Only wound healing
