Free CSFA Practice Test

💡Best sequence: start with CSFA Practice Test 1 for a baseline. In a balanced 30-question mixed set, a practical blueprint-style split is about 17 Perioperative Care, 4 Ancillary Duties, and 9 Advanced Science items.

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Exam at a Glance

Key facts about the NBSTSA Certified Surgical First Assistant exam.

Total Questions

175 multiple-choice questions

Scored / Unscored

150 scored + 25 pretest items

Testing Time

4 hours

Testing Provider

PSI

Delivery

Computer-based, primarily through PSI test centers; special military overseas arrangements may apply

Passing Standard

99 correct on the 150 scored questions

Exam Fee

$240 AST member / $350 non-member

Retake Rule

You may reapply immediately, but no more than 3 CSFA exams in one calendar year

Results

Score reports are provided to all candidates after testing

Validity / Renewal

2-year cycle; renew with 38 CE credits including 8 live, or by re-examination

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Official Blueprint Breakdown

The current CSFA exam is built from three main domains. The percentages below are based on the published number of scored items in each area.

Domain	Weight	What to Master	Quiz
Perioperative Care	83 / 150 (~55%)	Pre-op preparation, chart review, consent checks, OR setup, positioning, skin prep, draping, time out, exposure, hemostasis, tissue handling, suturing, wound closure, post-op tasks	Quiz →
Ancillary Duties	21 / 150 (~14%)	Administrative and personnel duties, room and workflow support, equipment operation, safe use and readiness of devices, troubleshooting, and support tasks around the procedure	Quiz →
Advanced Science	46 / 150 (~31%)	Advanced anatomy and physiology, surgical microbiology, pharmacology, anesthesia concepts, and science-based decision making during procedures	Quiz →

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Passing Score & Scoring Explained

How the pass standard works and what it means for practice-test interpretation.

99Pass Mark

NBSTSA states that answering 99 of the 150 scored questions correctly meets the current passing standard. The exam still contains 25 unscored pretest questions, so the full exam length is 175 items even though only 150 count toward passing.

ℹ️Important: pretest items are mixed throughout the exam and are not identified. Treat every question as scored.

How to Read Your Practice Scores

Because your practice sets are shorter than the real exam, use them as trend indicators rather than a direct pass prediction. A strong readiness target is repeated performance in the mid-to-high 70% range under timed conditions, especially with stable accuracy in perioperative care.

Why the Cut Score Can Change Over Time

NBSTSA explains that passing standards are set through a formal standard-setting process and may be reviewed when new exam forms are launched. That is why staying close to official current information matters.

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Eligibility Requirements

Current CSFA eligibility is narrower than many allied-health exams, so verify your path before applying.

Be a current or previously certified CSFA, or
Be a graduate of a CAAHEP-accredited Surgical First Assistant program
Provide proof of graduation such as a diploma, transcript, or signed notarized letter on official school letterhead
Use a valid government-issued photo ID that matches your testing record
Military applicants stationed overseas may request testing through a base education center if distance rules are met
If you need accommodations, submit the required documentation with your application

Common Eligibility Questions

Not under the current handbook language. The official eligibility table points to being a current or previously certified CSFA or graduating from a CAAHEP-accredited surgical first assistant program.

A diploma, transcript, or notarized and signed letter from the program director or registrar on official school letterhead showing the graduation date and degree details is generally accepted.

Yes. You may submit a new application and payment immediately, but you are limited to three CSFA examinations in one calendar year.

The official materials emphasize computer-based testing through PSI and certain special arrangements such as military base education centers. At-home remote delivery is not presented as the standard route.

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Study Plan by Weeks

Choose an 8-week, 6-week, or 4-week build. Give the biggest share of your time to perioperative care because it dominates the exam.

Week 1 - Baseline + BlueprintStart

Take CSFA Practice Test 1 timed
Log every miss by the three major domains
Read the official outline once before content drilling

Week 2 - Perioperative Care: Pre-opFoundation

Complete the Perioperative Care domain test
Review chart checks, consent, setup, positioning, prepping, draping, and time out responsibilities

Week 3 - Perioperative Care: Intra-opHighest Weight

Study exposure, retraction, tissue handling, hemostasis, sutures, knots, closure, and minimally invasive assisting
Redo missed perioperative items from Week 2

Week 4 - Ancillary DutiesSupport Systems

Complete the Ancillary Duties domain test
Review administrative flow, staffing support, equipment readiness, device operation, and troubleshooting
End the week with CSFA Practice Test 2 timed

Week 5 - Advanced Science: Anatomy & PhysiologyScience Core

Complete the Advanced Science domain test
Focus on surgical anatomy, planes, vessels, nerves, and structure-function relationships

Week 6 - Advanced Science: Micro + PharmPrecision

Review microbiology, asepsis concepts, anesthesia basics, local agents, and pharmacology safety points
Take CSFA Practice Test 3 timed

Week 7 - Full SimulationsRefine

Take CSFA Practice Tests 4 and 5 timed
Redo the weakest domain quiz once

Week 8 - Final ReviewPolish

Review only misses, suture/hemostasis notes, anatomy weak points, and perioperative workflow traps
Protect sleep, timing, and exam-day routine

Week 1 - Baseline + Perioperative Care

Take Practice Test 1 timed
Complete the Perioperative Care quiz and build an error log

Week 2 - Intra-op Skills

Deep review of exposure, hemostasis, suturing, wound closure, and surgical flow
Take Practice Test 2 at the end of the week

Week 3 - Ancillary Duties

Complete the domain quiz
Review equipment safety, readiness checks, and support tasks

Week 4 - Advanced Science

Complete the domain quiz
Memorize high-yield anatomy, micro, pharm, and anesthesia points

Week 5 - Simulations

Take Practice Tests 3 and 4 timed
Repeat the weakest domain content only

Week 6 - Final Simulation

Take Practice Test 5 timed
Light final review and pacing control

Week 1 - Baseline + Perioperative Care

Practice Test 1 baseline
Immediate heavy review of pre-op and intra-op perioperative care

Week 2 - Remaining Domains

Complete Ancillary Duties and Advanced Science quizzes
Take Practice Test 2 timed

Week 3 - Two Simulations

Take Practice Tests 3 and 4 timed
Redo the weakest domain quiz

Week 4 - Final Review

Take Practice Test 5 timed
Review only misses, instrument use, anatomy, and hemostasis / closure logic

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High-Yield Topics

These are the areas most likely to move your CSFA score when reviewed repeatedly.

🛏️ Pre-op Preparation

Chart and consent review
Positioning devices
OR setup and readiness
Skin prep and draping
Time out participation

✂️ Intraoperative Assisting

Retraction and exposure
Tissue handling
Hemostasis methods
Suturing and knot logic
Wound closure basics

🔬 Advanced Anatomy & Physiology

Layers and planes
Vessels and nerves
Organ relationships
Procedure-relevant landmarks
Complication awareness

🧫 Microbiology & Asepsis

Common organisms
Transmission principles
Sterile field protection
Contamination response
Infection risk thinking

💉 Pharmacology & Anesthesia

Local anesthetics
Anesthesia support basics
Hemostatic agents
Medication safety
Procedure-related drug awareness

⚙️ Equipment & Ancillary Tasks

Device readiness
Safe equipment use
Troubleshooting logic
Workflow support
Administrative duties

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Question Types & How to Answer

The CSFA exam is multiple-choice, but the best questions test procedural judgment, anatomy, and safe first-assist decisions.

🩺 Workflow / Scenario Questions

These ask what the first assistant should do before, during, or after a procedure. Anchor yourself in the exact phase of care before reading the options.

🧠 Anatomy and Science Questions

Expect anatomy-heavy questions tied to exposure, tissue protection, hemostasis, and operative field decisions rather than isolated textbook trivia.

⚙️ Equipment and Support Questions

These often test safe operation, readiness, appropriate use, and support tasks that keep the procedure moving without compromising patient safety.

The 3-Step Answer Framework

Identify the Phase

Decide whether the item is pre-op, intra-op, post-op, ancillary, or advanced science before choosing anything

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Check Safety + Scope

Remove choices that break aseptic practice, poor tissue handling, unsafe equipment use, or weak operative logic

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Pick the Best Surgical Answer

Choose the option that is anatomically sound, operationally correct, and most consistent with first-assist workflow

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Common Mistakes & Traps

Most missed CSFA questions come from rushing the phase of care or forgetting the anatomy behind the action.

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Skipping the phase-of-care check

Many wrong answers are good actions performed at the wrong time. Always identify whether the question is pre-op, intra-op, or post-op first.

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Confusing hemostasis methods

Know when the stem is pointing to temporary control, permanent control, direct pressure, clips, cautery, or local agents.

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Weak anatomy application

Many advanced science misses happen because candidates memorize structures without linking them to exposure, retraction, or risk during the case.

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Ignoring equipment readiness clues

Ancillary duties questions often turn on device readiness, safe operation, or preparation details rather than the main procedure itself.

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Recommended Resources

Use official NBSTSA materials first, then reinforce weak areas with the internal practice sets listed above.

Official Resources

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CSFA Candidate Handbook

Official source for current eligibility, fees, timing, retakes, accommodations, and content information

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CSFA Content Outline

Detailed task list for perioperative care, ancillary duties, and advanced science

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NBSTSA CSFA Certification Page

Official exam overview, application steps, and current pass-standard summary

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Renewals & Recertification

Renewal process, fees, and CE workflow with AST

Practice on This Site

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CSFA Practice Test 1

Start with a timed baseline, then branch into the domain quiz that matches your weakest area

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Perioperative Care Domain Test

Highest-weight area and the fastest place to gain score if your fundamentals are shaky

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Frequently Asked Questions

Quick answers to the most common CSFA exam questions.

The CSFA exam has 175 multiple-choice questions total. Of those, 150 are scored and 25 are unscored pretest items.

You get 4 hours to complete the computer-based exam.

The current NBSTSA overview states that getting 99 of the 150 scored questions correct is passing.

The current application fee is $240 for AST members and $350 for non-members.

Current official eligibility centers on current or previously certified CSFAs and graduates of CAAHEP-accredited Surgical First Assistant programs, with proper documentation required.

Yes. You may resubmit an application immediately, but you are limited to three CSFA examinations within one calendar year.

CSFA renewal follows a two-step process: submit required CE credits to AST, then complete the NBSTSA renewal. The standard renewal fee is $45.

The current two-year cycle requires 38 CE credits, including 8 that are defined as live.