CSPDT Exam Flashcards

Q: How many questions are on the CSPDT exam?

The CBSPD CSPDT exam has 150 multiple-choice questions: 125 scored items and 25 unscored pretest items. Candidates have 3 hours to complete it. Questions are weighted across eight domains, with Decontamination & Disinfection (19%) and Sterilization (18%) carrying the most weight.

Q: What is the passing score for the CSPDT exam?

The passing standard is a scaled score of 70, which is not the same as answering 70% of questions correctly. CBSPD scales each exam form to account for differences in difficulty, so the raw number of correct answers needed can vary from form to form.

Q: What is the CSPDT exam pass rate?

According to CBSPD's published statistics, the 2025 CSPDT pass rate was about 48.1%—1,928 of 4,004 candidates passed. Thorough preparation on decontamination, sterilization cycles, and indicator monitoring is important because roughly half of candidates do not pass on a given attempt.

Q: How long is CSPDT certification valid and how do I recertify?

CSPDT certification is valid for five years. To recertify, a technician must earn 100 approved continuing-education points within the five-year cycle and submit the recertification packet and fee before the certification expires.

Q: What is the CSPDT retake policy if I fail?

CBSPD offers the CSPDT exam in scheduled windows (commonly February, May, August, and November) and allows only one attempt per window for exam security. If you do not pass, you must reapply, pay the fee again, and test in the next available window. CBSPD does not publish a fixed number of days you must wait—the practical wait is until the next quarterly window (roughly 90 days, depending on when you tested)—and there is no separate escalating penalty after multiple failures.

Q: Is the CSPDT the same as the CRCST?

No. The CSPDT is issued by CBSPD (the Certification Board for Sterile Processing and Distribution). The CRCST is a separate, independent credential issued by HSPA (formerly IAHCSMM). Both certify sterile processing technicians, but they are different organizations with different exams, eligibility rules, and content outlines.

Question 1

One-way workflow in the Sterile Processing Department (SPD)

Accepted Answer

Items move in one direction only: decontamination (soiled) → preparation and packaging → sterilization → sterile storage and distribution. Clean and sterile items never travel back toward the dirty side, which prevents cross-contamination.

Question 2

Load control and lot traceability

Accepted Answer

Every sterilizer load is documented with a load/lot number, sterilizer ID, cycle, date, operator, contents, and monitoring results. This record lets the department trace and recall specific items if a sterilization failure is later discovered.

Question 3

When to recall a sterilizer load

Accepted Answer

If a biological indicator turns positive (spore growth), recall every load processed since the last negative BI, quarantine those items, re-sterilize them, and notify the supervisor and infection prevention per policy.

Question 4

Count sheet (tray list / set recipe)

Accepted Answer

A count sheet lists every instrument and quantity for a specific tray. Technicians use it during assembly to build the set correctly and confirm all instruments are present and functional before packaging.

Question 5

Key AAMI/ANSI standards for sterile processing

Accepted Answer

ST79 covers steam sterilization; ST91 covers flexible and semi-rigid endoscope reprocessing; ST58 covers chemical/low-temperature sterilization and high-level disinfection; ST108 covers water quality for processing medical devices.

Question 6

CSPDT certification maintenance

Accepted Answer

CBSPD certification is valid for five years. To recertify, a technician must earn 100 approved continuing-education points within that period and submit the recertification packet and fee before the credential expires.

Question 7

Handling a damaged or malfunctioning instrument

Accepted Answer

The technician must inspect each instrument and remove any that is damaged, dull, misaligned, or malfunctioning from service, tag it, and route it for repair or replacement rather than assembling it into a set.

Question 8

Bioburden

Accepted Answer

The number and type of viable microorganisms on an item before decontamination or sterilization. Higher bioburden and dried organic soil make sterilization harder to achieve, which is why thorough cleaning must always come first.

Question 9

Bacterial endospore

Accepted Answer

The most resistant form of microbial life. Spores of Geobacillus stearothermophilus and Bacillus atrophaeus resist heat and chemicals, so they are used in biological indicators—if a process kills these spores, it kills everything less resistant.

Question 10

Sterility Assurance Level (SAL)

Accepted Answer

The probability that a single viable microorganism survives on an item after sterilization. The accepted standard for medical devices is a SAL of 10⁻⁶—no more than one chance in one million of a surviving organism.

Question 11

Cleaning vs. disinfection vs. sterilization

Accepted Answer

Cleaning removes visible soil and organic material; disinfection destroys most pathogens but not all spores; sterilization destroys ALL microbial life, including spores. An item cannot be reliably disinfected or sterilized unless it is cleaned first.

Question 12

Spaulding classification: critical items

Accepted Answer

Items that enter sterile tissue or the vascular system—surgical instruments, implants, needles. They pose the highest infection risk and must be STERILIZED.

Question 13

Spaulding classification: semi-critical items

Accepted Answer

Items that contact mucous membranes or non-intact skin—flexible endoscopes, respiratory therapy equipment, laryngoscope blades. They require at minimum HIGH-LEVEL DISINFECTION (HLD).

Question 14

Spaulding classification: non-critical items

Accepted Answer

Items that contact only intact skin—blood pressure cuffs, stethoscopes, bedpans. They require LOW- or INTERMEDIATE-LEVEL disinfection, because intact skin is an effective barrier to most organisms.

Question 15

Point-of-use treatment

Accepted Answer

At the end of a procedure, the OR team removes gross soil and keeps instruments moist (with water or an approved pretreatment product—not saline) so blood and debris do not dry on, which would make later cleaning far harder.

Question 16

PPE required in the decontamination area

Accepted Answer

Because all items are treated as contaminated, staff wear a fluid-resistant gown, gloves, a mask, and eye protection or a face shield; hair and shoe covers are added per policy. PPE guards against splashes and aerosols.

Question 17

Enzymatic detergent/cleaner

Accepted Answer

A cleaning agent containing enzymes (such as protease) that break down and dissolve organic soil—blood, protein, and tissue. It loosens debris from surfaces and lumens so it can be rinsed away before disinfection or sterilization.

Question 18

Ultrasonic cleaner and cavitation

Accepted Answer

An ultrasonic cleaner uses high-frequency sound waves to form microscopic bubbles that implode (cavitation), dislodging fine soil from hinges, box locks, and hard-to-reach areas. It is used after gross soil is removed, and items are rinsed afterward.

Question 19

Washer-disinfector

Accepted Answer

Automated equipment that cleans and then thermally disinfects instruments through wash, rinse, and a heated (thermal) rinse phase. It provides consistent, validated cleaning and reduces staff handling of contaminated items.

Question 20

Utility water vs. critical water (AAMI ST108)

Accepted Answer

Utility (tap) water is acceptable for flushing, washing, and initial rinsing. Critical water—highly treated with low mineral and endotoxin content (e.g., deionized/RO)—is required for final rinsing so residues and contaminants are not left on devices.

Question 21

Liquid chemical high-level disinfectants

Accepted Answer

Common high-level disinfectants include glutaraldehyde, ortho-phthalaldehyde (OPA), and peracetic acid. They destroy vegetative bacteria, fungi, and viruses and—with sufficient contact time—spores. Contact time and temperature per the IFU are critical.

Question 22

Instrument inspection before assembly

Accepted Answer

Each instrument is checked for cleanliness, function, sharpness, alignment, and damage—often with a lighted magnifier. Instruments must be visibly clean and dry; any that are soiled or defective are removed from the set.

Question 23

Instrument lubrication ('instrument milk')

Accepted Answer

Hinged instruments are lubricated with a water-soluble, steam-permeable lubricant ('instrument milk'). Oil-based or mineral-oil lubricants are NEVER used because they block steam and sterilant contact and prevent sterilization.

Question 24

Positioning hinged instruments for sterilization

Accepted Answer

Instruments with hinges, box locks, or ratchets are packaged OPEN and unlocked so the sterilant reaches every surface. Closed jaws trap air and block steam contact, causing sterilization failure.

Question 25

Peel pouch loading and orientation

Accepted Answer

Load peel pouches so instruments fit without stressing the seal, and place a chemical indicator inside. When double-pouching, orient paper-to-paper and plastic-to-plastic, and stand pouches on edge in the sterilizer for drainage and steam contact.

Question 26

Purpose of packaging (sterile barrier)

Accepted Answer

Packaging must allow the sterilant to penetrate during processing and then maintain a sterile barrier during storage and handling. A package is presumed sterile until its integrity is compromised (event-related sterility).

Question 27

Sequential (double) wrapping

Accepted Answer

Wrapping an item in two barrier layers—two sheets wrapped sequentially or a bonded double-ply wrap—creates a package that can be opened aseptically and protects the contents. The wrap must still permit sterilant penetration and air removal.

Question 28

Instrument set weight limit

Accepted Answer

AAMI ST79 recommends that a wrapped instrument set not exceed 25 pounds (about 11.3 kg). Overweight sets are hard to dry, promote wet packs and condensate, and strain staff—risking sterilization failure and injury.

Question 29

Internal chemical indicator placement

Accepted Answer

An internal chemical indicator (commonly a Type 5 integrating indicator) is placed inside every package or tray in the location considered hardest for the sterilant to reach, verifying that conditions were met inside the pack.

Question 30

Gravity-displacement steam cycle parameters

Accepted Answer

Typical gravity cycles for wrapped instruments: 121°C (250°F) for 30 minutes, or 132°C (270°F) for 15 minutes, plus a drying time. Gravity cycles rely on incoming steam pushing air down and out of the chamber.

Question 31

Prevacuum (dynamic-air-removal) steam cycle parameters

Accepted Answer

Prevacuum sterilizers actively pump air out first, so exposure is shorter: 132°C (270°F) for 4 minutes, or 135°C (275°F) for 3 minutes, plus drying. Better air removal allows faster, more reliable steam penetration.

Question 32

Ethylene oxide (EO/EtO) sterilization

Accepted Answer

A low-temperature GAS process for heat- and moisture-sensitive devices. EO is toxic, flammable, and carcinogenic and requires a lengthy AERATION phase to remove residual gas before items are safe to handle. Biological indicator: Bacillus atrophaeus.

Question 33

Hydrogen peroxide gas plasma sterilization

Accepted Answer

A low-temperature process (e.g., Sterrad) for heat- and moisture-sensitive items with NO aeration needed. It CANNOT process cellulose materials (paper, linens, cotton), liquids, or long/narrow lumens beyond stated limits. Biological indicator: Geobacillus stearothermophilus.

Question 34

Ozone sterilization

Accepted Answer

A low-temperature method that uses ozone gas (oxygen converted to O₃) to oxidize and destroy microorganisms, then breaks back down to oxygen and water. Biological indicator: Geobacillus stearothermophilus.

Question 35

Biological indicator (BI) organisms by method

Accepted Answer

Geobacillus stearothermophilus spores monitor STEAM, hydrogen peroxide, and ozone. Bacillus atrophaeus spores monitor ETHYLENE OXIDE and DRY HEAT. A BI is the only monitor that directly proves the process killed resistant spores.

Question 36

Bowie-Dick test

Accepted Answer

A daily AIR-REMOVAL test run in an empty prevacuum steam sterilizer, usually as the first cycle of the day. It is a Type 2 chemical indicator test that detects air leaks and inadequate air removal that would block steam penetration.

Question 37

Chemical indicator (CI) types 1–6

Accepted Answer

Type 1 = process indicator (external, shows exposure, e.g., autoclave tape); Type 2 = specific-use test (e.g., Bowie-Dick); Types 3–4 = single/multi-variable; Type 5 = integrating indicator (responds to all critical variables); Type 6 = emulating (cycle-specific).

Question 38

Immediate-use steam sterilization (IUSS)

Accepted Answer

Formerly called 'flash' sterilization—used only for an urgently needed, already-cleaned item, not for routine processing and (except in emergencies) not for implants. A typical cycle is 132°C (270°F) for 3–4 minutes, and the item is used right away because it is not packaged for storage.

Question 39

Sterile storage environmental conditions

Accepted Answer

Sterile storage is kept cool, dry, and controlled: commonly temperature not exceeding 75°F (24°C), relative humidity not exceeding 70%, positive air pressure relative to adjacent areas, and a minimum of 4 air changes per hour.

Question 40

Sterile storage shelving clearances

Accepted Answer

Store sterile items 8–10 inches (about 20–25 cm) above the floor, 18 inches (about 45 cm) below the ceiling or sprinkler heads, and at least 2 inches (5 cm) from outside walls to protect packages and allow air circulation.

Question 41

Event-related sterility

Accepted Answer

A sterilized package stays sterile until an EVENT compromises its barrier—getting wet, torn, crushed, dropped, or having a broken seal—rather than expiring on a set date. Judge sterility by package integrity, not just a printed date.

Question 42

FIFO stock rotation

Accepted Answer

Sterile supplies are rotated 'first in, first out': older stock is placed in front and used first. This minimizes prolonged storage and reduces the chance that packaging integrity degrades before an item is used.

Question 43

Inspecting packages before dispensing

Accepted Answer

Before an item leaves storage or is opened at the point of use, staff verify the package is intact, dry, and sealed and that the external chemical indicator changed. A wet, torn, or dropped package is considered contaminated and must be reprocessed.

Question 44

Endoscope leak test

Accepted Answer

Before manual cleaning and immersion, a flexible endoscope undergoes a leak test to detect holes or damage in its channels and outer sheath. Skipping it lets fluid invade and damage the scope and can leave a device impossible to clean, endangering patients (AAMI ST91).

Question 45

Flexible endoscope reprocessing sequence

Accepted Answer

Order: point-of-use precleaning → leak test → thorough manual cleaning with brushing and flushing of ALL channels → high-level disinfection or sterilization → rinsing, drying, and proper storage—each step performed per the manufacturer's IFU.

Question 46

Processing powered surgical instruments

Accepted Answer

Powered (pneumatic or electric) surgical instruments generally must NOT be immersed or run through automated washers unless the IFU permits it, because water can ruin the motor. They are cleaned, lubricated, and sterilized strictly per the manufacturer's instructions.

Question 47

Following the manufacturer's IFU

Accepted Answer

Technicians must reprocess every device according to its written Instructions for Use (IFU). Skipping steps or shortening cycle or contact times to save time is an ethical and patient-safety violation, even when the department is busy.

Question 48

Never release a load with a failed indicator

Accepted Answer

If a biological indicator is positive or a chemical indicator did not change correctly, the load must be quarantined and reprocessed—never dispensed. Patient safety always outweighs turnaround time or pressure from the OR.

Question 49

Documentation integrity

Accepted Answer

Sterilization and monitoring records must be accurate and complete. Falsifying cycle records, indicator results, or load contents is a serious ethical breach that can directly cause patient harm and legal liability.

Question 50

Duty to report unsafe practice

Accepted Answer

A technician is obligated to speak up and report unsafe conditions or shortcuts—such as sending incompletely processed or contaminated instruments to the OR—rather than stay silent. Professional accountability protects patients above workplace convenience.

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