Free CST Exam Flashcards

The exam includes 175 total questions, with 150 scored and 25 unscored pretest items. Because pretest items are mixed in, treat every question as if it affects your result.

Candidates have 4 hours for the full exam. Timed practice matters because surgical scenarios often require reading the setup, identifying the safety priority, and choosing the next action.

A CST anticipates needs, maintains the sterile field, handles instruments and supplies, and communicates concerns. Diagnosis, prescribing, and independent surgical decisions remain outside the CST role.

A CST has a duty to voice concerns about wrong site, count discrepancy, contamination, missing implants, or unsafe equipment. Patient safety takes priority over hierarchy or case speed.

A sterile field is considered sterile only where it can be seen and controlled. Items below waist level, outside the field of vision, or beyond the established field are treated as contaminated.

Moisture can carry microorganisms from a nonsterile surface to a sterile surface. A wet wrapper, drape, or table cover is no longer reliable as a sterile barrier.

Sterile items remain sterile only when they touch other sterile items. Contact with an unsterile hand, sleeve, table edge, floor, or questionable surface means the item should be replaced.

If sterility is uncertain, consider the item contaminated. The safe CST action is to speak up, remove the item from use, and replace it without trying to rationalize the risk.

Scrubbed personnel pass front-to-front or back-to-back to maintain sterile surfaces. A scrubbed front should not brush against an unsterile back or a nonsterile person.

The surgical scrub or surgical hand rub reduces resident and transient microorganisms on the hands and forearms. It does not make skin sterile, so sterile gowning and gloving still matter.

The nonsterile opener protects the contents by opening the far flap first, then the side flaps, and the near flap last. This avoids reaching over the sterile contents.

Before opening a peel pack, check the package integrity, seal, labeling, and chemical indicator. A tear, puncture, wet area, or failed indicator means the item should not be used.

The circulator pours without touching the sterile basin or splashing the field. Splashing or overfilling can create contamination risk and may make labels or medication identity unclear.

Every medication or solution on the sterile field must be identified and labeled. Unlabeled medication should not be used because look-alike clear fluids are a serious patient safety risk.

The Mayo stand holds the instruments and supplies needed immediately for the current part of the case. It should stay organized so the scrub can anticipate the surgeon's next need.

The team verifies the patient, procedure, site, position, laterality, needed implants, and key safety items before incision. A CST should speak up immediately if any detail conflicts.

The consent should match the scheduled procedure, site, and laterality before the case starts. The surgeon explains risks and alternatives; the CST helps verify that the correct document is present.

Prep begins at the planned incision site and moves outward toward the periphery. Once the applicator has moved to a dirtier area, it should not return to the incision site.

A stoma is treated as a contaminated area. Prep the clean incision area first and manage the stoma last with separate supplies so contamination is not carried back to the surgical site.

Draping protects the incision area first, then extends outward. A drape that has been placed should not be shifted because movement can carry contamination into the sterile field.

In supine position, protect the heels, sacrum, elbows, occiput, and common peroneal nerve near the fibular head. Padding prevents pressure injury and nerve compression.

Both legs should be raised and lowered together. Uneven movement can strain joints and alter venous return, creating unnecessary injury and hemodynamic risk.

Prone positioning requires careful protection of the eyes, face, airway, chest, genitalia, and pressure points. Direct eye pressure can cause serious postoperative vision injury.

Trendelenburg shifts abdominal contents toward the head, which may improve pelvic exposure but can affect ventilation, venous pressure, and eye pressure during long cases.

The safety strap secures the patient without restricting circulation or compressing nerves. It should be visible, accessible, and placed according to facility policy for the chosen position.

Metzenbaum scissors are delicate dissection scissors used for soft tissue. They are not the preferred choice for cutting heavy fascia, suture, or dressings.

Mayo scissors are heavier scissors used for dense tissue, fascia, or suture depending on the pattern. Straight Mayo scissors are commonly used for cutting suture.

A Kelly is a hemostatic clamp with transverse serrations on part of the jaw. It is used to clamp vessels or tissue, but instrument choice depends on tissue size and surgeon preference.

An Allis clamp grasps tissue with interlocking teeth and can crush delicate structures. It is useful for firm tissue that will be removed or can tolerate traction.

A Babcock clamp has smooth, rounded jaws for atraumatic grasping of delicate tubular structures such as bowel, appendix, fallopian tube, or ureter when appropriate.

Load the needle securely in the needle holder so the surgeon can drive it with control. Passing the loaded holder in the direction of intended use reduces unnecessary repositioning.

Absorbable suture loses tensile strength as tissue heals, so it is used where long-term foreign material is not needed. Nonabsorbable suture provides longer support or permanent fixation.

Monopolar electrosurgery sends current from the active electrode through the patient to a dispersive pad. Safe pad placement and avoiding alternate pathways help prevent burns.

Bipolar forceps confine current between the two tips of the instrument. This is useful near delicate structures or when limiting current spread is important.

Energy devices can create surgical smoke containing irritating and potentially infectious particles. Use smoke evacuation and appropriate protection according to facility policy.

An OR fire needs an oxidizer, ignition source, and fuel. Risk reduction means controlling oxygen concentration when possible, allowing prep agents to dry, and managing active energy devices safely.

A neutral zone creates a hands-free transfer area for sharps. It lowers the risk of passing injuries, especially during fast-paced or minimally invasive cases.

If a count is incorrect, the team is notified immediately and a systematic search begins. The patient should not leave the OR with an unresolved count discrepancy.

Calot's triangle is a key landmark during cholecystectomy. The surgeon identifies structures in this region to avoid injury to the bile ducts and associated vessels.

Hesselbach's triangle is associated with direct inguinal hernias. Understanding the landmark helps the CST anticipate anatomy, mesh use, and dissection needs during hernia repair.

The recurrent laryngeal nerve is a critical structure during thyroid surgery. Injury can affect vocal cord function, so exposure and careful handling around the thyroid are essential.

Carbon dioxide insufflation creates working space for laparoscopy. The team watches for physiologic effects, subcutaneous emphysema, gas embolism risk, and equipment or tubing problems.

Steam sterilization uses saturated steam under pressure. Items must be clean, correctly packaged, and exposed according to the sterilizer cycle and manufacturer instructions for use.

A biological indicator uses resistant spores to verify that a sterilization process can kill microorganisms. It gives stronger process evidence than a chemical color change alone.

A Bowie-Dick test checks air removal and steam penetration in a prevacuum steam sterilizer. A failed test suggests the sterilizer should not be used until the problem is addressed.

Critical items enter sterile tissue and require sterilization. Semicritical items contact mucous membranes and need at least high-level disinfection. Noncritical items contact intact skin.

An antiseptic is used on living tissue, while a disinfectant is used on inanimate surfaces or equipment. Confusing the two can harm patients or fail to control microbes.

Epinephrine may be used for vasoconstriction and hemostasis, often with local anesthetic or topical application. Because concentration matters, it must be clearly labeled and verified.

Dantrolene is the emergency drug associated with malignant hyperthermia management. The CST may help gather supplies and support rapid preparation while the team cools and stabilizes the patient.

Specimens must be protected, correctly identified, and passed off with clear communication about type, source, laterality, and any special handling needs such as fresh, frozen, culture, or formalin.