CST Exam Flashcards

Q: How many questions are on the CST exam?

The CST exam has 175 total multiple-choice questions: 150 scored questions and 25 unscored pretest questions.

Q: What score do I need to pass the CST exam?

The local CST metadata lists the passing standard as 98 correct answers out of 150 scored questions, or about 65.3%.

Q: What is the largest CST exam content area?

Intra-operative procedures are the largest content area, so prioritize aseptic technique, instrument handling, counts, hemostasis, wound closure, specimens, and procedural assistance.

Q: Can I retake the CST exam if I fail?

Local CST materials list a 30-day waiting period and a maximum of three attempts per calendar year. Candidates should confirm current details with NBSTSA when applying.

Q: What should CST candidates memorize first?

Start with sterile field rules, count safety, common instruments, positioning risks, sterilization principles, surgical anatomy landmarks, specimen handling, and medication labeling on the sterile field.

Question 1

CST Exam Format

Accepted Answer

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.

Question 2

CST Time Limit

Accepted Answer

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.

Question 3

CST Professional Scope

Accepted Answer

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.

Question 4

Speaking Up for Safety

Accepted Answer

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.

Question 5

Sterile Field Boundary Rule

Accepted Answer

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.

Question 6

Moisture and Strike-Through

Accepted Answer

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.

Question 7

Sterile-to-Sterile Contact

Accepted Answer

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.

Question 8

When Sterility Is Doubtful

Accepted Answer

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.

Question 9

Scrubbed Team Member Movement

Accepted Answer

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.

Question 10

Surgical Hand Antisepsis Goal

Accepted Answer

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.

Question 11

Opening a Wrapped Sterile Set

Accepted Answer

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.

Question 12

Peel Pack Inspection

Accepted Answer

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.

Question 13

Pouring Sterile Fluids

Accepted Answer

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.

Question 14

Medication on the Sterile Field

Accepted Answer

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.

Question 15

Mayo Stand Role

Accepted Answer

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.

Question 16

Universal Protocol

Accepted Answer

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.

Question 17

Consent Check

Accepted Answer

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.

Question 18

Surgical Skin Prep Direction

Accepted Answer

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.

Question 19

Prepping Around a Stoma

Accepted Answer

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.

Question 20

Draping Principle

Accepted Answer

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.

Question 21

Supine Position Risks

Accepted Answer

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

Question 22

Lithotomy Leg Handling

Accepted Answer

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

Question 23

Prone Position Eye Safety

Accepted Answer

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

Question 24

Trendelenburg Concerns

Accepted Answer

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

Question 25

Safety Strap Placement

Accepted Answer

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.

Question 26

Metzenbaum Scissors

Accepted Answer

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

Question 27

Mayo Scissors

Accepted Answer

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.

Question 28

Kelly Clamp

Accepted Answer

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.

Question 29

Allis Clamp

Accepted Answer

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.

Question 30

Babcock Clamp

Accepted Answer

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

Question 31

Needle Holder Loading

Accepted Answer

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.

Question 32

Absorbable vs Nonabsorbable Suture

Accepted Answer

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.

Question 33

Monopolar ESU Safety

Accepted Answer

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.

Question 34

Bipolar Electrosurgery

Accepted Answer

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

Question 35

Surgical Smoke

Accepted Answer

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

Question 36

Fire Triangle in the OR

Accepted Answer

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.

Question 37

Sharps Neutral Zone

Accepted Answer

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.

Question 38

Surgical Count Discrepancy

Accepted Answer

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.

Question 39

Calot's Triangle

Accepted Answer

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.

Question 40

Hesselbach's Triangle

Accepted Answer

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.

Question 41

Recurrent Laryngeal Nerve

Accepted Answer

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.

Question 42

Laparoscopy Pneumoperitoneum

Accepted Answer

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

Question 43

Steam Sterilization

Accepted Answer

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.

Question 44

Biological Indicator

Accepted Answer

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.

Question 45

Bowie-Dick Test

Accepted Answer

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.

Question 46

Spaulding Classification

Accepted Answer

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.

Question 47

Antiseptic vs Disinfectant

Accepted Answer

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.

Question 48

Epinephrine on the Field

Accepted Answer

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.

Question 49

Dantrolene

Accepted Answer

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.

Question 50

Specimen Handling

Accepted Answer

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.

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NBSTSA Certified Surgical Technologist (CST)