CSFA - Certified Surgical First Assistant Practice Test

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CSFA Practice Test PDF โ€“ Free Download for 2026

The Certified Surgical First Assistant (CSFA) credential is awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). It recognizes surgical technologists who have advanced into first-assisting roles, actively participating in surgical procedures by performing tissue handling, hemostasis, and wound closure tasks alongside the operating surgeon. This free CSFA practice test PDF lets you study the full exam content domain offline โ€” print it, mark it up, and work through it on your own schedule.

The NBSTSA CSFA examination covers perioperative patient care, surgical anatomy, first-assisting techniques, aseptic and sterile technique, surgical instrumentation, specimen handling, wound management, specialty procedures, patient safety, and pharmacology relevant to surgical settings. The printable questions in this PDF mirror the format and difficulty level you will encounter on exam day.

What the CSFA Exam Covers

Perioperative Patient Care

Questions test your knowledge of preoperative preparation, patient positioning for various surgical approaches, safety checks, and OR setup. You must know positioning risks โ€” nerve compression, pressure injuries, and compartment syndrome โ€” and the corrective actions for each.

Surgical Anatomy

Regional anatomy is tested across major surgical specialties including abdominal, thoracic, orthopedic, neurosurgical, and vascular procedures. You need to identify structures at risk during dissection and understand the anatomical landmarks surgeons use for incisions and port placement.

First-Assisting Techniques

This domain covers tissue retraction, hemostasis (cauterization, suture ligation, clip application), and wound closure including suture types and materials, stapling devices, and tissue adhesives. You must demonstrate knowledge of when each technique is appropriate and how to execute it correctly.

Aseptic and Sterile Technique

Maintaining the sterile field, gowning and gloving, draping procedures, and recognizing breaks in sterile technique are fundamental competencies tested on the CSFA. A single lapse in sterile technique can result in surgical site infection, making this a high-priority domain.

Patient Safety and Pharmacology

Surgical counts (sponge, sharps, instrument), time-out procedures, and OR fire safety are covered alongside pharmacology relevant to surgery: prophylactic antibiotics, anticoagulants, local anesthetics, and topical hemostatic agents.

Review NBSTSA CSFA candidate handbook and content outline
Study regional surgical anatomy for abdomen, thorax, orthopedics, neuro, and vascular specialties
Practice identifying suture types, materials, and appropriate clinical applications
Review hemostasis methods: electrocautery, suture ligation, surgical clips, topical agents
Memorize wound closure layering sequences and common stapling device types
Study aseptic technique: gowning, gloving, draping, sterile field maintenance rules
Review surgical count procedures and policies for discrepancy management
Study laparoscopic and robotic assisting: trocar placement, scope handling, energy devices
Review OR pharmacology: antibiotics, anticoagulants, local anesthetics, hemostatic agents
Complete the free printable CSFA PDF and score your answers against the answer key
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Free CSFA Practice Tests Online

In addition to this printable PDF, you can sharpen your CSFA exam readiness with our full online question bank. The online CSFA practice test delivers immediate feedback on every answer โ€” explaining why each correct option is right and why the distractors are wrong. This targeted feedback accelerates learning far more efficiently than reviewing a textbook chapter, and you can work through timed sets to build the pacing skills you need for the real exam.

What is the CSFA certification and who awards it?

The Certified Surgical First Assistant (CSFA) credential is awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). It certifies that a surgical technologist has the advanced skills required to perform first-assisting duties in the operating room, including tissue handling, hemostasis, and wound closure under surgeon supervision.

How many questions are on the CSFA exam and what is the passing score?

The NBSTSA CSFA examination is a computer-based multiple-choice test. Candidates should consult the current NBSTSA candidate handbook for the exact number of scored items and the passing scaled score, as these details may be updated. The exam is administered at Pearson VUE testing centers.

What topics should I focus on most when studying for the CSFA?

High-priority topics include surgical anatomy across major specialties, first-assisting techniques (retraction, hemostasis, wound closure), aseptic and sterile technique, patient safety (surgical counts, time-out), and OR pharmacology. Perioperative patient care and specialty procedures such as laparoscopic and robotic assisting are also heavily represented.

Can I use this free PDF to prepare for the actual CSFA exam?

Yes. This free printable CSFA practice test PDF covers the core content domains tested on the NBSTSA examination. Use it alongside our online practice tests for the most effective preparation. The online tests provide instant answer explanations, while the PDF is ideal for offline, paper-based review sessions.
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