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Cheat sheet

CST Cheat Sheet

Practice QuestionsStudy Guide

Perioperative Care

65%of exam

Preoperative SetupSterile FieldPositioningIntraoperative FlowPostoperative Turnover

Ancillary Duties

15%of exam

Admin SafetySterilizationIndicatorsEquipment CareProfessional Practice

Basic Science

20%of exam

Surgical AnatomyMicrobiologyPharmacologyWound ClassesAnesthesia

Quick Facts

Exam
CST
Provider
NBSTSA
Questions
175
Scored
150 scored
Pretest
25 unscored
Time
4 hours
Pass
98 scored
Format
Multiple choice

Sterile vs Clean

Sterile

  • No viable microbes
  • Operative field
  • Critical items

Clean

  • Reduced bioburden
  • Nonsterile areas
  • Routine handling

Absence vs reduction

Safety Picker

  1. Wrong-site conflict→Stop time out(Team verify)
  2. Package compromised→Do not use
  3. Count incorrect→Notify surgeon
  4. Medication unlabeled→Remove/label now
  5. Specimen unclear→Verify source
  6. Implant mismatch→Do not open

Preoperative Setup

Preference card
Surgeon setup map
Consent
Procedure authorization
Allergies
Latex/drug risk
PPE
Barrier before opening
Package check
Integrity/indicator/date
Skin prep
Clean to dirty
SCD
VTE prevention
Time out
Final team pause

Preop vs Intraop

Preop

  • Verify/setup
  • Open field
  • Position/drape

Intraop

  • Maintain field
  • Pass instruments
  • Count/label

Prepare vs perform

Field Picker

  1. Need setup map→Preference card
  2. Opening wrapped set→Far flap first
  3. Prepping incision→Center outward
  4. Stoma in field→Stoma last
  5. Legs in lithotomy→Move together
  6. Draping patient→Incision outward

Sterile Field

Sterile waist
Table level up
Edges
One inch unsterile
Moisture
Strike-through risk
Break
Declare and correct
Scrub
Hands above elbows
Gown front
Chest to table
Closed gloving
Best first glove
Draping
Incision outward

Monopolar vs Bipolar

Monopolar

  • Dispersive pad
  • Current exits patient
  • Broader use

Bipolar

  • No pad
  • Between tips
  • Wet field safer

Pad vs tips

Positioning

Supine
Back lying
Prone
Eye pressure risk
Lithotomy
Legs move together
Trendelenburg
Head down
Reverse Trendelenburg
Head up
Fowler
Sitting
Lateral
Axillary roll
Safety strap
Above knees

Absorbable vs Nonabsorbable

Absorbable

  • Temporary strength
  • Body degrades
  • Internal layers

Nonabsorbable

  • Long-term support
  • Body retains
  • Skin/tendon/vessel

Temporary vs lasting

Intraoperative Flow

Counts
Baseline plus closure
Sharps
Neutral zone
Specimen
Verify and label
Implant
Size/type verified
Meds
Label on field
Irrigation
Fluid in/out
Drains
Prepare and connect
Emergency
Act by protocol

Mechanical vs Chemical

Mechanical

  • Pressure/clamps
  • Ligatures
  • Bone wax

Chemical

  • Topical agents
  • Thrombin
  • Oxidized cellulose

Physical vs agent

Instruments Sutures

Hemostat
Clamp vessels
Forceps
Grasp tissue
Retractor
Expose field
Needle holder
Drive needle
Metz
Delicate tissue scissors
Mayo scissors
Dense tissue/suture
#10 blade
Large skin incision
#11 blade
Stab incision
Absorbable
Temporary support
Nonabsorbable
Permanent support

Hemostasis

Mechanical
Pressure/clamps/ligature
Thermal
ESU/laser/ultrasonic
Chemical
Topical agents
Surgicel
Oxidized cellulose
Gelfoam
Gelatin sponge
Thrombin
Clot enzyme
Bone wax
Mechanical bone plug
Epinephrine
Vasoconstrictor

Postoperative Turnover

Dressing
Protect wound
Transfer
Team body mechanics
QBL
Measured blood loss
Debrief
Case closing review
Sharps disposal
Puncture container
Room turnover
Clean reset
Unused supplies
Return appropriately
Abnormal finding
Report immediately

RACE

Rescue Alarm Contain Extinguish

Rescue firstAlarm earlyContain fireExtinguish/evacuate

CI vs BI

CI

  • Chemical change
  • Exposure evidence
  • No sterility proof

BI

  • Live spores
  • Lethality challenge
  • Strongest monitor

Exposure vs kill

Sterility Picker

  1. Sterile tissue contact→Sterilization(Critical)
  2. Mucous contact→HLD minimum(Semicritical)
  3. Intact skin contact→Low disinfection(Noncritical)
  4. Need spore proof→BI
  5. Need exposure proof→CI
  6. Need air removal→Bowie-Dick

Admin Safety

Preference card
Update changes
Cost control
Open when needed
Fire triangle
Fuel/oxygen/ignition
RACE
Rescue alarm contain extinguish
PASS
Pull aim squeeze sweep
Laser
Eye/smoke hazard
ESU
Burn risk
Ethics
Patient-first conduct

PASS

Pull Aim Squeeze Sweep

Pull pinAim baseSqueeze handleSweep side

Critical vs Semicritical

Critical

  • Sterile tissue
  • Vascular system
  • Sterilize

Semicritical

  • Mucous membrane
  • Nonintact skin
  • HLD minimum

Sterilize vs HLD

Sterilization

Decon
Dirty first step
Enzymatic
Breaks organic soil
Inspection
Clean/function check
CI
Process exposure
BI
Spore challenge
Bowie-Dick
Air removal
Steam
Moist heat
EtO
Aeration required
H2O2
Low-temp option

Spaulding

Critical Semi Noncritical

Critical: sterileSemi: HLDNoncritical: low-level

Fire Triangle

Fuel Oxygen Ignition

Drapes fuelO2 oxidizerESU ignition

Amide Locals

Two i's usually amide

LidocaineBupivacaineMepivacaineRopivacaine

General vs MAC

General

  • Unconscious
  • Airway controlled
  • Full anesthesia

MAC

  • Sedated
  • Monitored anesthesia
  • May respond

Unconscious vs sedated

Surgical Anatomy

Calot
Cystic duct/artery
Hesselbach
Direct hernia triangle
Femoral triangle
Vascular access
McBurney
Appendix point
RLN
Thyroid danger nerve
Circle Willis
Cerebral collateral
Treitz
Duodenojejunal landmark
Retroperitoneal
Posterior abdominal organs

Microbiology

Bioburden
Microbial load
Biofilm
Protected microbial layer
Spores
Most resistant form
SSI
Surgical site infection
Clean wound
Class I
Dirty wound
Class IV
Halsted
Gentle tissue handling
Sepsis
Systemic infection response

Pharmacology

General
Unconscious anesthesia
Local
Site numbness
Block
Regional nerve anesthesia
MAC
Monitored sedation
Lidocaine
Amide local
Bupivacaine
Long-acting local
Heparin
Anticoagulant
Protamine
Heparin reversal
Dantrolene
MH antidote
Succinylcholine
MH trigger

Common Traps

Indicator vs sterility

CI shows exposure ≠ BI challenges lethality

Prep direction

Incision to periphery ≠ Stoma last

Lithotomy legs

Raise together ≠ Lower together

Count discrepancy

Notify surgeon ≠ Do not ignore

Sterile edge

Table top sterile ≠ Edges unsterile

Medication safety

Verify aloud ≠ Label immediately

Monopolar pad

Needs dispersive pad ≠ Avoid bony prominences

Skin prep

Reduce microbes ≠ Cannot sterilize skin

Last Minute

  1. 1.Weights: 65 / 15 / 20
  2. 2.Items: 97 / 23 / 30
  3. 3.Intraop: 68 scored items
  4. 4.Pass: 98 of 150
  5. 5.Time: 175 in 4 hours
  6. 6.Time out: stop all activity
  7. 7.Counts: setup and closure
  8. 8.CI exposure; BI lethality
  9. 9.Sterile tissue requires sterilization
  10. 10.Meds verified and labeled
  11. 11.Lithotomy legs move together
  12. 12.Skin prep center outward

NBSTSA Certified Surgical Technologist (CST)

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CST Exam Prep 2026-2027: Complete Study Guide for Certified Surgical Technologist with 1200+ Practice Questions Covering OR Procedures, Sterile Techniques, Instrumentation and NBSTSA Standards

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