CFA First-Assist Surgical Roles 2 — Questions and Answers
Question 1: When the surgeon is suturing deep tissue, what is the first assistant's primary role?
- Observe and document the procedure
- Maintain exposure, control bleeding, and facilitate suture passage (Correct answer)
- Manage the scrub technician's instrument count
- Administer local anesthetic to the wound edges
Correct answer: Maintain exposure, control bleeding, and facilitate suture passage
The first assistant actively maintains exposure and assists with suture placement to facilitate efficient closure.
Question 2: A patient begins experiencing unexpected hemorrhage during abdominal surgery. What is the first assistant's immediate priority?
- Call for additional nursing staff
- Apply direct pressure while alerting the surgeon (Correct answer)
- Document the blood loss in the chart
- Increase IV fluid rate independently
Correct answer: Apply direct pressure while alerting the surgeon
Applying direct pressure to control hemorrhage while immediately communicating with the surgeon is the correct initial response.
Question 3: Which action by the first assistant demonstrates proper tissue handling technique?
- Grasping tissue forcefully to ensure a firm grip
- Using smooth, atraumatic forceps with minimal pressure (Correct answer)
- Avoiding contact with tissue whenever possible
- Clamping all visible tissue to prevent movement
Correct answer: Using smooth, atraumatic forceps with minimal pressure
Atraumatic technique using smooth forceps with minimal pressure reduces tissue damage and promotes healing.
Question 4: During a laparoscopic procedure, the first assistant is managing a port. Which of the following is most important?
- Keeping the port stationary and preventing gas leakage (Correct answer)
- Rotating the port frequently to prevent pressure sores
- Removing the port between instrument passes to reduce contamination
- Positioning the port at maximum insertion depth at all times
Correct answer: Keeping the port stationary and preventing gas leakage
Maintaining port stability and preventing gas leakage preserves pneumoperitoneum and ensures safe instrument passage.
Question 5: The first assistant is asked to cut suture. What is the correct technique?
- Cut flush with the knot to eliminate any tail
- Leave a 3–4 mm tail beyond the knot using the scissor tip at a slight angle (Correct answer)
- Cut 1 cm above the knot for maximum security
- Cut the suture before the knot is fully tied
Correct answer: Leave a 3–4 mm tail beyond the knot using the scissor tip at a slight angle
Leaving a 3–4 mm tail at a slight angle ensures the knot is secure without excessive bulk.
Question 6: Which best describes the first assistant's role in maintaining the sterile field?
- Only the scrub technician is responsible for sterile field integrity
- The first assistant shares responsibility and must recognize and report breaks in sterility (Correct answer)
- The first assistant may pass over non-sterile areas if careful
- Sterile field management is delegated to the circulating nurse
Correct answer: The first assistant shares responsibility and must recognize and report breaks in sterility
All sterile team members share responsibility for recognizing and reporting breaks in the sterile field.
Question 7: When retracting an organ during abdominal surgery, the first assistant should:
- Apply continuous maximum traction to ensure full exposure
- Use intermittent, gentle traction and release pressure periodically to prevent ischemia (Correct answer)
- Delegate retraction to the surgical technologist whenever possible
- Avoid retraction entirely if the organ appears fragile
Correct answer: Use intermittent, gentle traction and release pressure periodically to prevent ischemia
Intermittent gentle traction prevents ischemic injury to organs caused by prolonged constant pressure.
CFA First-Assist Surgical Roles 2
When the surgeon is suturing deep tissue, what is the first assistant's primary role?