20 Surgical Prep & Assisting Practice Questions & Answers

1. 1. An assistant is packing hemostatic forceps into a cloth wrap for steam sterilization. How should these ratcheted instruments be placed in the pack?

   • A.With every box lock and ratchet left open so steam reaches all surfaces✓ Answer
   • B.With every ratchet fully locked and the jaws padded with a gauze sponge
   • C.With every box lock closed and the joints coated in petroleum-based grease
   • D.With every ratchet closed on the first notch so the tips stay aligned

   Steam sterilization only works where steam physically contacts the metal, and a closed box lock hides the ratchet and the mating jaw surfaces from that contact. Instruments with box locks are therefore wrapped in the fully open position, and joints are lubricated with a water-soluble instrument lubricant rather than petroleum grease, which forms a film steam cannot penetrate.

   Source: AAHA Infection Control, Prevention, and Biosecurity Guidelines — cleaning and sterilization of instrumentsReport a problem with this question

2. 2. A clinic must sterilize a flexible fiberoptic endoscope and several plastic instruments that heat would ruin. Which statement about ethylene oxide sterilization of these items is correct?

   • A.It works at low temperature, but the load must be aerated before the items are used✓ Answer
   • B.It works only after the items have been steam-cycled to loosen surface debris
   • C.It works at low temperature, but only on items sealed inside glass or metal cases
   • D.It works at low temperature, and the load may be used as soon as the cycle ends

   Ethylene oxide is a gas that kills organisms without heat or moisture, which is exactly why it suits endoscopes, plastics, cords and optics that an autoclave would destroy. The gas is absorbed into those same materials and is toxic and carcinogenic, so every load must go through a mandatory aeration period to drive off residual gas before the items may touch a patient.

   Source: CDC Guideline for Disinfection and Sterilization in Healthcare Facilities — ethylene oxide sterilization and aerationReport a problem with this question

3. 3. Instruments have soaked for twenty minutes in a glutaraldehyde cold sterilization tray. How should they be described and handled?

   • A.They are disinfected at high level, so rinse them with sterile saline first✓ Answer
   • B.They are sterile, so rinsing them under running tap water is enough
   • C.They are sterile, so they may be dropped straight onto the instrument tray
   • D.They are sanitized only, so they must be autoclaved before touching tissue

   Glutaraldehyde reaches true sterilization only after many hours of complete immersion, so the short soaks used on a practice cold tray achieve high-level disinfection: vegetative bacteria and most viruses are killed, but resistant bacterial spores are not. Cold-tray instruments are therefore not sterile-field instruments, and the chemical residue irritates tissue, so they are rinsed with sterile saline before contacting a patient.

   Source: CDC Guideline for Disinfection and Sterilization in Healthcare Facilities — high-level disinfection with glutaraldehydeReport a problem with this question

4. 4. A wrapped pack leaves the autoclave with the stripes on its external indicator tape fully darkened. What does the darkened tape prove?

   • A.That the pack reached sterilizing conditions and its contents are sterile
   • B.That the pack was exposed to steam, not that its contents are sterile✓ Answer
   • C.That the pack contents were free of spores when the cycle ended
   • D.That the pack held the required temperature for the whole cycle time

   Autoclave tape is a chemical process indicator: its dye changes once it meets steam at a threshold temperature, but it does not measure how long that temperature was held, and it sits on the outside of the wrapper rather than among the contents. It therefore separates processed packs from unprocessed ones and proves nothing about whether organisms inside were killed.

   Source: CDC Guideline for Disinfection and Sterilization in Healthcare Facilities — chemical indicatorsReport a problem with this question

5. 5. The spore strip run through the autoclave as a biological indicator is incubated and shows bacterial growth. What must the practice do with that load?

   • A.Release the load for use, since the indicator tape on the packs changed
   • B.Regard the load as unsterile, recall the packs, and reprocess them✓ Answer
   • C.Release the load for clean elective cases only and log the failed strip
   • D.Regard the failed strip as a handling error and repeat it next week

   A biological indicator carries highly heat-resistant bacterial spores, so growth after incubation means the cycle failed to kill the most resistant organisms it was meant to destroy. It is the only monitor that demonstrates actual killing, which is why a positive result outranks a colour change on the tape: the load is treated as unsterile, recalled and reprocessed, and the sterilizer is investigated before further use.

   Source: CDC Guideline for Disinfection and Sterilization in Healthcare Facilities — biological indicators and sterilizer failureReport a problem with this question

6. 6. The surgeon wants a needle holder that carries no cutting blades, so suture cannot be shortened by accident while the needle is driven. Which instrument meets that description?

   • A.Halsted mosquito forceps
   • B.Brown-Adson thumb forceps
   • C.Olsen-Hegar needle holder
   • D.Mayo-Hegar needle holder✓ Answer

   Both Mayo-Hegar and Olsen-Hegar are ratcheted needle holders with short, cross-serrated jaws, but the Olsen-Hegar has small scissor blades built in just behind the jaws so the operator can cut suture without a second instrument. That same built-in blade is what cuts a suture unintentionally, so the Mayo-Hegar, which has jaws only, is the instrument described.

   Source: McCurnin's Clinical Textbook for Veterinary Technicians and Nurses — surgical instrumentation, needle holdersReport a problem with this question

7. 7. The veterinarian is dissecting delicate fascia and asks for scissors with long shanks and short, blunt blades made for fine tissue. Which scissors are handed over?

   • A.Mayo dissecting scissors
   • B.Metzenbaum tissue scissors✓ Answer
   • C.Lister bandage scissors
   • D.Spencer suture scissors

   Metzenbaum scissors have a long shank with a short, fine, blunt-tipped blade, a design that concentrates control at the tip for delicate dissection of fascia and other soft tissue. Mayo scissors are heavier with a long blade for dense tissue and suture, Lister scissors carry a blunt probe tip for cutting bandages off skin, and suture scissors have one hooked blade for slipping under a stitch.

   Source: McCurnin's Clinical Textbook for Veterinary Technicians and Nurses — surgical instrumentation, scissorsReport a problem with this question

8. 8. While checking a spay pack, the veterinarian asks for the large crushing forceps used on the ovarian pedicle. Which jaw pattern identifies that instrument?

   • A.Lengthwise grooves along the jaws with cross-hatching at the tip✓ Answer
   • B.Slender jaws with fine transverse ridges tapering to a point
   • C.Transverse serrations over only the distal half of the jaws
   • D.Transverse serrations running the full length of the jaws

   Rochester-Carmalt forceps are recognised by longitudinal grooves along the jaws with a cross-hatched pattern at the tip, a pattern that lets the jaws crush and hold a bulky vascular pedicle without cutting through it. Full-length transverse serrations belong to Crile forceps, serrations over the distal half to Kelly forceps, and fine ridges on slender tapering jaws to mosquito forceps, all far smaller hemostats.

   Source: McCurnin's Clinical Textbook for Veterinary Technicians and Nurses — surgical instrumentation, hemostatic forcepsReport a problem with this question

9. 9. The surgeon needs ratcheted forceps to hold a loop of small intestine with as little trauma as possible. Which jaw description fits the instrument to hand over?

   • A.Heavy jaws with lengthwise grooves and a cross-hatched tip
   • B.Flat blades, one of them hooked, for lifting a strand clear
   • C.Short jaws that meet in a row of interlocking sharp teeth
   • D.Broad, smooth, rounded jaws with an open oval between them✓ Answer

   Babcock tissue forceps have broad, smooth, curved jaws enclosing an open oval, so they surround and cradle a hollow structure such as bowel or bladder instead of pinching it, which is what makes them atraumatic. Allis forceps close on interlocking teeth and are deliberately traumatic, so they are reserved for tissue that will be excised, never for viable bowel.

   Source: McCurnin's Clinical Textbook for Veterinary Technicians and Nurses — surgical instrumentation, tissue forcepsReport a problem with this question

10. 10. One suture packet is labeled 3-0 nylon and another is labeled 0 nylon. How do the two strands compare?

    • A.The 3-0 strand is thinner than the 0 strand, with a smaller diameter✓ Answer
    • B.The 3-0 strand matches the 0 strand in thickness but has three fibers
    • C.The 3-0 strand is thicker than the 0 strand, with a larger diameter
    • D.The 3-0 strand matches the 0 strand in thickness but runs longer

    In the United States Pharmacopeia scale used for suture, each added zero denotes a thinner strand, so the sequence from thickest to thinnest runs 2, 1, 0, 2-0, 3-0 and onward, and 3-0 is finer than 0. The designation describes diameter alone and says nothing about the length on the reel or whether the strand is braided.

    Source: United States Pharmacopeia suture size designation; NAVTA Essential Skills List, Surgical Preparation and Assisting — suture materials, types, and sizesReport a problem with this question

11. 11. A non-scrubbed assistant is opening a cloth-wrapped instrument pack on a table for the scrubbed surgeon. In what order are the wrapper flaps opened?

    • A.The near flap first, then the two side flaps, then the far flap
    • B.The two side flaps first, then the near flap, then the far flap
    • C.The far flap first, then the two side flaps, then the near flap✓ Answer
    • D.The near flap first, then the far flap, then the two side flaps

    The far flap is opened first so the assistant's hand and forearm never pass over contents that are already exposed, and the near flap is opened last so the wrapper is drawn back toward the body and away from the sterile field. Each corner is held down as it is opened so the wrapper cannot spring back across the instruments.

    Source: NAVTA Essential Skills List, Surgical Preparation and Assisting — aseptic unwrapping of sterile packagingReport a problem with this question

12. 12. While setting up, an assistant finds a water stain and a damp area on the cloth wrapper of a sterilized pack stored in the cabinet. What should be done with the pack?

    • A.Use it, because the wrapper is dry everywhere except that one small area
    • B.Use it, because the chemical indicator sealed inside the pack changed color
    • C.Set it aside as contaminated and have it rewrapped and resterilized✓ Answer
    • D.Set it aside to air-dry, then return it to the cabinet for a later case

    Moisture wicks organisms from the outside of a wrapper straight through to the contents, an effect called strike-through, so a pack that is wet or has been wet is no longer sterile whatever the indicator showed when the cycle finished. Sterility is event-related rather than purely time-related: dampness, a tear, a dropped pack or a broken seal ends it, and the pack must be reprocessed.

    Source: AAHA Infection Control, Prevention, and Biosecurity Guidelines — sterile pack storage and integrityReport a problem with this question

13. 13. During surgery the scrubbed surgeon asks for an extra sterile gauze sponge sealed in a peel pouch. How should the non-scrubbed assistant deliver it?

    • A.Hand the whole sealed pouch to the surgeon and let it be torn open
    • B.Push the gauze through the pouch seal so it lands on the instrument tray
    • C.Peel the pouch open and hold it out so the surgeon lifts the gauze free✓ Answer
    • D.Reach across the sterile field and lay the gauze down on the drape

    A non-scrubbed circulating person may touch only the outside of packaging and must never reach or lean over the sterile field, because anything above it that is not sterile can shed onto it. Peeling the pouch back on itself exposes the contents so the scrubbed person can lift them straight up, whereas pushing an item through the seal drags it across the unsterile cut edge and contaminates it.

    Source: NAVTA Essential Skills List, Surgical Preparation and Assisting — scrubbed vs. non-scrubbed personnel protocolsReport a problem with this question

14. 14. When and where should the surgical site of a dog scheduled for an elective abdominal procedure be clipped?

    • A.The evening before surgery, in the preparation area, while the dog is awake
    • B.After induction of anesthesia, inside the operating room, just before surgery
    • C.After induction of anesthesia, in the preparation area, just before surgery✓ Answer
    • D.On admission that morning, in the treatment ward, while the dog is awake

    Clipping leaves micro-abrasions in the skin in which bacteria multiply, so the interval between hair removal and incision is kept as short as possible; clipping the night before measurably raises the surgical site infection rate. It is done after induction, when the patient is still enough for a close, even clip, and in the preparation area, because loose hair carried into the operating room contaminates the room and the sterile field.

    Source: AAHA Infection Control, Prevention, and Biosecurity Guidelines — surgical site preparation and hair removalReport a problem with this question

15. 15. How is the antiseptic scrub of a clipped abdominal surgical site carried out?

    • A.From the outer edge inward toward the incision line, discarding each gauze
    • B.From the incision line outward in widening circles, discarding each gauze✓ Answer
    • C.In back-and-forth strokes across the whole site, discarding each used gauze
    • D.From the incision line outward in circles, returning each gauze to the center

    The scrub always moves from the cleanest skin to the least clean, so starting on the proposed incision line and working outward in widening circles keeps peripheral organisms away from the tissue that will be cut. A gauze that has reached the outer edge is discarded rather than brought back to the centre, and the cycle is repeated several times with each solution before the final antiseptic is left to dry.

    Source: AAHA Infection Control, Prevention, and Biosecurity Guidelines — antiseptic skin preparationReport a problem with this question

16. 16. A dog is being positioned for a ventral midline approach for an ovariohysterectomy. How is the patient placed on the table?

    • A.In left lateral recumbency, left side down and the right flank uppermost
    • B.In sternal recumbency, chest on the table and the spine facing the surgeon
    • C.In right lateral recumbency, right side down and the left flank uppermost
    • D.In dorsal recumbency, spine on the table and the abdomen facing the surgeon✓ Answer

    A ventral midline celiotomy is made along the linea alba on the underside of the abdomen, so that surface has to face the surgeon, which means the dog lies on its back in dorsal recumbency. A V-trough and limb ties hold the position squarely without compressing the chest or restricting circulation to the limbs.

    Source: NAVTA Essential Skills List, Surgical Preparation and Assisting — positioning of surgical patientsReport a problem with this question

17. 17. After a team member has gowned and gloved, which part of the gown is treated as sterile?

    • A.The back and shoulders, because the circulator tied them closed
    • B.The whole gown, because it was lifted intact from a sterilized pack
    • C.The front from chest to knee level and the sleeves including the shoulders
    • D.The front from chest to waist level and the sleeves to above the elbow✓ Answer

    Only the areas the wearer can keep in view and above table height stay reliably sterile, so the sterile zone is the gown front from chest to waist or table level and the sleeves from cuff to about two inches above the elbow. The back, the axillae and everything below the waist are not sterile even on a scrubbed person, which is why scrubbed staff keep their hands above waist level and never turn their back to the field.

    Source: AAHA Infection Control, Prevention, and Biosecurity Guidelines — surgical attire, gowning, and glovingReport a problem with this question

18. 18. A cat recovering from anesthesia is shivering and its rectal temperature is below the normal range. Which warming method is appropriate?

    • A.A rubber bottle of near-boiling water tucked against the flank
    • B.An electric heating pad set on high directly against the skin
    • C.A heat lamp aimed into the cage with no further temperature checks
    • D.A circulating warm-water blanket placed under a layer of bedding✓ Answer

    Hypothermia is the commonest complication of anesthetic recovery, and a patient that is still sedated cannot move away from a heat source or reliably feel a burn developing. Safe warming therefore uses a device that holds a controlled temperature, such as a circulating warm-water blanket or a forced warm-air unit, with a barrier between the device and the skin, and the temperature is rechecked and recorded until it is back to normal.

    Source: AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats — recovery period and hypothermiaReport a problem with this question

19. 19. Ten minutes after extubation, an assistant monitoring a dog notes pale mucous membranes, a capillary refill time of four seconds and slow shallow breathing. The reference capillary refill time is under two seconds. What should the assistant do?

    • A.Report the findings to the veterinarian or credentialed technician at once✓ Answer
    • B.Raise the intravenous fluid rate and keep watching the dog closely
    • C.Record the findings and recheck the dog in about thirty minutes
    • D.Start oxygen by mask and reassess the dog after a few minutes

    Pale membranes with a refill time well beyond the reference value, together with depressed breathing, point to failing perfusion or oxygenation and are an emergency during recovery, where minutes matter. Deciding the cause and choosing treatment such as oxygen, fluids or drugs is a veterinary judgement; the assistant's role is accurate physical observation, immediate reporting and documentation, working under veterinary supervision and within what the veterinarian has delegated and the state practice act allows.

    Source: AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats — recovery monitoring; AVMA guidance on veterinary supervision and delegationReport a problem with this question

20. 20. A practice is setting rules for the use of its operating room. Which arrangement is correct?

    • A.Dental cleanings are done there as well, and dirty cases are scheduled first
    • B.Only sterile surgery is done there, and clean elective cases are scheduled first✓ Answer
    • C.Patients are clipped there before draping, and cases are scheduled by arrival
    • D.Spare supplies are stored there in open bins, and cases are scheduled by size

    The operating room is a dedicated, low-traffic room reserved for sterile procedures, because dentistry, abscess drainage, clipping and open supply storage all release organisms and particles into the air of a room that must stay as clean as possible. Ordering the list from clean to contaminated means elective clean patients are never exposed to organisms left behind by a dirty procedure, and horizontal surfaces are damp-dusted before the first case of the day.

    Source: AAHA Infection Control, Prevention, and Biosecurity Guidelines — operating room use, sanitation, and case schedulingReport a problem with this question

Practice questions based on the NAVTA veterinary assistant skill categories and standard veterinary assisting practice. This site is not affiliated with or endorsed by NAVTA. Note that the Approved Veterinary Assistant credential requires completing a NAVTA-approved training program before you may sit the exam — this bank is study material, not a substitute for that program, and it cannot cover the hands-on skills your program assesses in a clinic. What an assistant is permitted to do is set by your state's veterinary practice act and by what the supervising veterinarian delegates, so nothing here should be read as authorising a task where you work. About the AVA credential →