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 — 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.
Questions test your knowledge of preoperative preparation, patient positioning for various surgical approaches, safety checks, and OR setup. You must know positioning risks — nerve compression, pressure injuries, and compartment syndrome — and the corrective actions for each.
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.
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.
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.
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.
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 — 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.
Try these questions from our free CSFA - Certified Surgical First Assistant practice tests. The correct answer and an explanation follow each question.
Which intervention is the FIRST priority when a patient develops malignant hyperthermia intraoperatively?
Answer: B. Discontinue triggering agents and administer dantrolene
Discontinuing triggering agents (volatile anesthetics, succinylcholine) and giving IV dantrolene are the immediate priorities in malignant hyperthermia management.
The anesthesia provider asks the CSFA to irrigate the wound with epinephrine-containing solution. The PRIMARY reason for epinephrine in local anesthetic solutions is to:
Answer: B. Produce vasoconstriction and prolong analgesia
Epinephrine causes local vasoconstriction, which slows absorption of the local anesthetic, prolongs its effect, and reduces systemic toxicity.
Topical thrombin works by converting which clotting factor to its active form?
Answer: C. Fibrinogen
Topical thrombin directly converts fibrinogen to fibrin, forming a clot at the site of application.
During a spinal fusion procedure, the surgical first assistant is asked to apply bone wax. Its primary purpose is:
Answer: B. Mechanical hemostasis of bleeding cancellous bone surfaces
Bone wax physically occludes the haversian canals of cancellous bone to mechanically control bleeding from cut bony surfaces.
Take the full CSFA - Certified Surgical First Assistant practice test