CFA Instrument Identification & Passing 2 — Questions and Answers
Question 1: When passing a needle holder to the surgeon, the first assistant should present it:
- With the needle pointing toward the surgeon's thumb
- In the closed, locked position with the needle loaded and tips pointing down (Correct answer)
- Unlocked with the needle removed for safety
- Handle-first with the needle pointing upward
Correct answer: In the closed, locked position with the needle loaded and tips pointing down
The needle holder is passed locked, loaded, and tips-down so the surgeon can immediately grasp it in proper working position.
Question 2: Which instrument is specifically designed to grasp delicate tissue without crushing?
- Kocher clamp
- Allis clamp
- DeBakey forceps (Correct answer)
- Backhaus towel clamp
Correct answer: DeBakey forceps
DeBakey forceps have fine, atraumatic serrations that grip tissue gently without causing crush injury.
Question 3: A Weitlaner retractor differs from a Gelpi retractor primarily in that it:
- Is handheld rather than self-retaining
- Has blunt rather than sharp prongs and a ratchet locking mechanism (Correct answer)
- Is used only in thoracic surgery
- Requires an assistant to hold it at all times
Correct answer: Has blunt rather than sharp prongs and a ratchet locking mechanism
The Weitlaner is a self-retaining retractor with a ratchet lock and typically has blunt prongs, while the Gelpi has sharp single prongs.
Question 4: The correct technique for passing a scalpel to the surgeon is:
- Blade-first, handle toward the surgeon
- Place it in a basin for the surgeon to pick up
- Handle-first in the neutral zone or by passing handle-first directly (Correct answer)
- Blade-up so the surgeon can verify the size
Correct answer: Handle-first in the neutral zone or by passing handle-first directly
AORN safety guidelines require scalpels to be passed handle-first or via a neutral/hands-free zone to prevent sharps injuries.
Question 5: A Metzenbaum scissors is most appropriately used for:
- Cutting suture ends flush with the knot
- Dissecting delicate tissue and cutting fine structures (Correct answer)
- Cutting through fascia and heavy tissue
- Trimming drapes and dressings
Correct answer: Dissecting delicate tissue and cutting fine structures
Metzenbaum scissors have long, slender blades ideal for fine tissue dissection rather than cutting suture or heavy material.
Question 6: Which clamp is BEST suited for occluding a large blood vessel during vascular surgery?
- Mosquito hemostat
- Satinsky (partial-occlusion) clamp (Correct answer)
- Allis tissue clamp
- Ochsner clamp
Correct answer: Satinsky (partial-occlusion) clamp
The Satinsky clamp allows partial occlusion of a large vessel without fully stopping flow, making it ideal for vascular anastomosis.
Question 7: When the surgeon requests a 'right angle' instrument, the first assistant should pass a:
- Heaney clamp
- Mixter (right-angle) clamp (Correct answer)
- Babcock clamp
- Harrington retractor
Correct answer: Mixter (right-angle) clamp
The Mixter clamp, also called a right-angle clamp, has jaws bent at 90° for passing ligatures around vessels or ducts.
CFA Instrument Identification & Passing 2
When passing a needle holder to the surgeon, the first assistant should present it: