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200+ Free CST Practice Questions

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Before a surgical procedure begins, the scrub technologist counts sponges, sharps, and instruments. When is the FIRST count performed?

A
B
C
D
to track
2026 Statistics

Key Facts: CST Exam

175

Total Exam Questions

NBSTSA 2025 Candidate Handbook

150 scored

Scored Items (25 unscored pretest)

NBSTSA 2025 Candidate Handbook

98/150

Passing Score (65.3%)

NBSTSA 2025 Candidate Handbook

4 hours

Exam Duration

NBSTSA 2025 Candidate Handbook

$230–$340

Exam Fee (member / non-member)

NBSTSA 2025 Candidate Handbook

45.3%

Largest Domain (Intra-Operative)

NBSTSA content outline

NBSTSA's CST exam consists of 175 total questions (150 scored + 25 unscored pretest items) delivered in 4 hours at Pearson VUE test centers. The 2025 candidate handbook shows passing requires 98 correct of 150 scored items (65.3%). Intra-Operative Procedures is the dominant domain at 45.3% of scored content, followed by Pre-Operative Preparation (12.7%) and Anatomy/Physiology (12%). Exam fees are $230 for AST members and $340 for non-members.

Sample CST Practice Questions

Try these sample questions to test your CST exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Before a surgical procedure begins, the scrub technologist counts sponges, sharps, and instruments. When is the FIRST count performed?
A.Immediately before the surgical incision is made
B.Before the procedure begins, when instruments are set up on the sterile field
C.After the surgeon opens the body cavity
D.During wound closure at the fascia layer
Explanation: The initial sponge, sharp, and instrument count is performed before the procedure begins, as items are placed on the sterile field. This baseline count is compared with counts at cavity closure, skin closure, and whenever requested to detect any retained surgical items.
2A surgical technologist is performing the surgical hand scrub. Which of the following surfaces should receive the MOST scrubbing attention?
A.The back of the hand and wrist
B.The fingertips, fingernails, and interdigital spaces
C.The lower forearm near the elbow
D.The dorsal surface of the fingers only
Explanation: The fingertips, subungual areas (under the nails), and interdigital spaces harbor the highest bacterial concentrations and are the most common sites for transient organisms. These areas require the most thorough scrubbing and are counted as separate surfaces in a counted-stroke or timed scrub protocol.
3Which of the following best describes the purpose of a surgical skin prep?
A.To sterilize the patient's skin before the incision
B.To reduce the number of microorganisms on the skin to the lowest possible count
C.To apply a bacterial-proof barrier to the operative site
D.To kill all microorganisms including spores on the skin surface
Explanation: The skin cannot be sterilized because it contains microorganisms in hair follicles and sebaceous glands. The goal of surgical skin prep is to reduce transient and resident microorganisms to the lowest possible count to minimize the risk of surgical site infection (SSI). Spore-forming organisms on intact skin cannot be eliminated by prep agents alone.
4When setting up the sterile back table, the surgical technologist should:
A.Open sterile items and drop them onto the table from 12 inches away
B.Reach over a sterile surface only when wearing sterile gloves
C.Keep all sterile items at waist level or above while maintaining sterility
D.Set up the back table before performing the surgical hand scrub
Explanation: Sterile items must be kept at or above waist level at all times. Items that fall below the waist are considered contaminated because they are out of the scrubbed technologist's visual field. The back table is set up after the surgical hand scrub and gowning/gloving.
5A surgical technologist is checking a peel-pack prior to opening it onto the sterile field. The chemical indicator inside has NOT changed color. What should the technologist do?
A.Open the package and use the contents since the indicator may have malfunctioned
B.Check the expiration date and use the item if it has not expired
C.Do not use the item; remove it from the sterile field and report it
D.Re-sterilize the package using flash sterilization before use
Explanation: An internal chemical indicator that has not changed color indicates the sterilization process may not have been completed correctly. The package should not be opened and the item should be removed from use. Internal indicators confirm that sterilizing conditions reached the interior of the package.
6What is the correct technique for a non-scrubbed circulator to open a sterile wrapped instrument set onto the sterile field?
A.Reach across the sterile field to place items in the center
B.Open the wrapper flaps in order: far flap first, then sides, then near flap toward self
C.Open near flap first, then sides, then the far flap away from the body
D.Unfold all wrapper edges simultaneously to prevent contamination
Explanation: When opening a sterile wrap, the correct sequence is: far flap first (away from body), then left and right side flaps, then the near flap (toward self last). This prevents the circulator's unsterile forearms from reaching over the sterile contents. The near flap protects the front of the sterile item during opening.
7A patient is scheduled for a right inguinal hernia repair. During the time-out procedure, the surgeon states the site is "left." The correct action of the surgical technologist is to:
A.Proceed with the procedure since the surgeon has final authority
B.Pause the procedure and voice the discrepancy immediately
C.Document the discrepancy on the count sheet and continue
D.Check the consent form privately and tell the circulator after the case
Explanation: The Universal Protocol requires every team member to stop and voice concerns identified during a time-out. The surgical technologist has a professional and ethical obligation to pause the procedure and speak up when a discrepancy is noted. Wrong-site surgery is a never event, and all team members share responsibility for preventing it.
8When prepping a patient's abdomen for a laparotomy, in which direction should the prep solution be applied?
A.From the periphery toward the incision site
B.From the incision site outward to the periphery in a circular motion
C.In a back-and-forth linear motion across the entire abdomen
D.Applied directly to the umbilicus first, then moving downward
Explanation: Surgical skin prep is applied using a circular motion starting at the intended incision site and moving outward to the periphery. This technique moves microorganisms away from the cleanest area (the incision site) toward the less-clean peripheral skin. The applicator must never return to the incision site once it has moved to the periphery.
9A patient undergoing a total hip replacement requires supine positioning. Which positioning device is MOST important to prevent peroneal nerve injury?
A.Heel padding beneath the Achilles tendon
B.Padding at the lateral knee to protect the common peroneal nerve
C.Ankle positioning strap to prevent foot drop
D.Foam wedge under the lumbar spine for support
Explanation: The common peroneal nerve wraps around the fibular head at the lateral knee and is extremely vulnerable to compression injury. Adequate padding at the lateral knee is essential to prevent foot drop from peroneal nerve injury. In supine positioning, the lateral knee can compress against bed rails or stirrups.
10A patient is positioned in the lithotomy position for a vaginal hysterectomy. Both legs are elevated simultaneously. What is the PRIMARY reason for this requirement?
A.To prevent the patient from sliding down the OR table
B.To reduce the risk of venous thromboembolism
C.To prevent hypotension and cardiovascular instability from unequal blood distribution
D.To allow the surgical technologist to position the Mayo stand correctly
Explanation: Legs must be raised and lowered simultaneously in lithotomy position because sequential leg movement causes unequal venous return and can cause significant cardiovascular instability (hypotension). Sudden blood redistribution when only one leg is raised or lowered can lead to hemodynamic compromise, especially in elderly patients.

About the CST Exam

The CST credential validates entry-level surgical technology competency across the full perioperative continuum. NBSTSA's current exam blueprint covers pre-operative preparation, intra-operative procedures, post-operative care, equipment and sterilization, anatomy and physiology, microbiology, surgical pharmacology, and ancillary/administrative duties.

Questions

175 scored questions

Time Limit

4 hours

Passing Score

98/150 scaled (65.3% of scored items)

Exam Fee

$230 AST members / $340 non-members (NBSTSA / Pearson VUE)

CST Exam Content Outline

12.7%

Pre-Operative Preparation

Patient assessment, surgical positioning, skin prep, sterile field setup, surgical counts, PPE donning, and draping procedures

45.3%

Intra-Operative Procedures

Aseptic technique, instrument handling and passing, wound closure, hemostasis, specimen handling, medication management, and procedural assistance across surgical specialties

6.7%

Post-Operative Procedures

Wound dressing application, patient transfer, room turnover, instrument decontamination, and post-op documentation

4.7%

Ancillary Duties / Administrative

Professional practice, documentation, ethical standards, informed consent, scope of practice, and workplace compliance

10.7%

Equipment Sterilization & Maintenance

Steam sterilization, EO gas, hydrogen peroxide plasma, biological indicators, Bowie-Dick test, Spaulding classification, HLD, and instrument care

12%

Anatomy & Physiology

Surgical anatomy landmarks (Calot's triangle, Hesselbach's triangle, femoral triangle, Circle of Willis), body systems, and their implications in surgical procedures

4%

Microbiology

Pathogenic organisms, SSI prevention, sterility principles, chain of infection, sterilization resistance hierarchy, and antiseptics vs. disinfectants

4%

Surgical Pharmacology

Common surgical drugs (epinephrine, heparin, thrombin, succinylcholine, ketamine, neostigmine, dantrolene), medication labeling on the sterile field, and anesthesia support

How to Pass the CST Exam

What You Need to Know

  • Passing score: 98/150 scaled (65.3% of scored items)
  • Exam length: 175 questions
  • Time limit: 4 hours
  • Exam fee: $230 AST members / $340 non-members

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CST Study Tips from Top Performers

1Weight study heavily to Intra-Op Procedures (45%): master the 10 principles of aseptic technique, instrument passing sequence, and wound closure layers
2Drill surgical counts at all 4 time points: setup, before cavity closure, at skin closure, and with any relief scrub
3Memorize Spaulding's classification: Critical (sterile) → Semi-critical (HLD minimum) → Non-critical (low-level disinfection)
4Know sterilization parameters: steam (121°C gravity / 132°C pre-vac), EO gas (54-60°C, 100% humidity, aeration required), and H2O2 plasma (50-55°C, no cellulose or liquids)
5For pharmacology: know epinephrine (vasoconstriction/hemostasis), heparin/protamine sulfate (anticoagulation reversal), dantrolene (malignant hyperthermia), and succinylcholine (rapid sequence intubation, MH trigger)
6Learn key anatomical triangles: Calot's (cholecystectomy), Hesselbach's (inguinal hernia), femoral triangle (vascular access), and anatomical snuffbox (scaphoid fracture)

Frequently Asked Questions

How many questions are on the CST exam?

The NBSTSA CST exam contains 175 total multiple-choice questions: 150 scored items and 25 unscored pretest items. You won't know which questions are pretest during the exam, so treat every question as scored.

What score do I need to pass the CST exam?

You must answer 98 of the 150 scored items correctly, which is approximately 65.3%. Results are typically available within 6 weeks of testing.

How long is the CST exam and where is it taken?

The CST exam is 4 hours long and is delivered at Pearson VUE testing centers nationwide. Candidates must complete a CST-accredited program or an alternative eligibility pathway before applying.

What is the largest domain on the CST exam?

Intra-Operative Procedures is by far the largest domain, accounting for approximately 45.3% of scored questions. Focus the majority of your study time on aseptic technique, instrument handling, wound closure, hemostasis, and specialty procedures.

How should I prepare for the CST exam in 2026?

Use weighted preparation: (1) master aseptic technique and the 10 principles, (2) drill surgical counts at all 4 time points, (3) memorize Spaulding's classification and sterilization cycles, (4) learn key anatomical landmarks for major surgical specialties, and (5) run timed 150-question mixed sets to build exam-day pacing.

What is the career outlook for surgical technologists?

BLS projects 5% employment growth for surgical technologists from 2023-2033, with median pay of $58,740 (May 2024). Surgical technologists work in hospital ORs, ambulatory surgical centers, and specialty clinics nationwide.