100+ Free CER Practice Questions

Pass your HSPA Certified Endoscope Reprocessor exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately

Not publicly reported Pass Rate

100+ Questions

100% Free

1 / 10

Question 1

Score: 0/0

What is the FIRST step in endoscope reprocessing after a procedure is completed?

Immerse the endoscope in enzymatic detergent

Perform a leak test

Wipe the insertion tube and flush channels at the point of use

Place the endoscope in an automated endoscope reprocessor

to track

2026 Statistics

Key Facts: CER Exam

150

Total Questions

125 scored + 25 pretest

3 hrs

Exam Time

HSPA CER exam page

$140

Exam Fee

HSPA fee schedule

32%

Reprocessing Domain

Content outline (heaviest)

3 mo

Required Experience

HSPA eligibility

6 CEs

Annual Renewal

Technical endoscope CEs

The HSPA CER exam uses 150 questions (125 scored + 25 pretest) with a 3-hour time limit and $140 fee. Content: Reprocessing Steps (32%), Handling/Storage (16%), Microbiology (12%), Work Area (12%), Endoscope Design (10%), Tracking/Repair (10%), Human Factors (8%). Administered year-round at Prometric. Requires 3+ months endoscope reprocessing experience. Annual renewal with 6 CEs.

Sample CER Practice Questions

Try these sample questions to test your CER exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1What is the FIRST step in endoscope reprocessing after a procedure is completed?

A.Immerse the endoscope in enzymatic detergent

B.Perform a leak test

C.Wipe the insertion tube and flush channels at the point of use

D.Place the endoscope in an automated endoscope reprocessor

Explanation: Point-of-use precleaning is the first step in endoscope reprocessing. Immediately after the procedure, the insertion tube should be wiped with a lint-free cloth and channels flushed with enzymatic solution or water per manufacturer's IFU. This prevents soil from drying on or inside the endoscope, which would make subsequent cleaning more difficult and less effective.

2Why is leak testing performed before manual cleaning of a flexible endoscope?

A.To verify the endoscope is free of biofilm

B.To detect damage that could allow fluid ingress into the internal components during immersion

C.To confirm the endoscope has been properly precleaned at the point of use

D.To ensure the enzymatic detergent is at the correct concentration

Explanation: Leak testing detects holes, cracks, or breaches in the endoscope's outer sheath or internal channels that could allow moisture to penetrate into the internal components during immersion steps. If a leak is detected, the endoscope must not be immersed and should be sent for repair. Immersing a damaged endoscope can cause costly internal damage and compromise patient safety.

3During manual cleaning, what is the primary purpose of using an enzymatic detergent?

A.To achieve high-level disinfection of the endoscope surfaces

B.To break down organic material such as blood, tissue, and mucus within channels

C.To sterilize the biopsy channel

D.To neutralize chemical disinfectant residue from previous cycles

Explanation: Enzymatic detergents contain protease, lipase, and amylase enzymes that break down organic soil (blood, tissue, mucus, and other proteinaceous material) on endoscope surfaces and within channels. This step is critical because organic debris left on the endoscope can shield microorganisms from subsequent high-level disinfection, rendering it ineffective.

4According to the Spaulding classification system, flexible endoscopes that contact mucous membranes are classified as:

A.Critical devices

B.Semi-critical devices

C.Non-critical devices

D.Intermediate devices

Explanation: Under the Spaulding classification system, semi-critical devices are those that contact mucous membranes or non-intact skin. Flexible endoscopes (gastroscopes, colonoscopes, bronchoscopes) fall into this category and require a minimum of high-level disinfection between patient uses. Critical devices contact sterile tissue and require sterilization, while non-critical devices contact only intact skin.

5What is the minimum level of reprocessing required for a flexible endoscope used in a colonoscopy?

A.Intermediate-level disinfection

B.Low-level disinfection

C.High-level disinfection

D.Sterilization

Explanation: Flexible endoscopes used in colonoscopy are semi-critical devices under the Spaulding classification because they contact mucous membranes. The minimum reprocessing requirement for semi-critical devices is high-level disinfection (HLD), which kills all microorganisms except high numbers of bacterial spores. HLD is achieved using FDA-cleared liquid chemical germicides or automated endoscope reprocessors.

6Which component of a flexible endoscope allows the physician to obtain tissue samples during a procedure?

A.Air/water channel

B.Suction channel

C.Biopsy/instrument channel

D.Light guide bundle

Explanation: The biopsy/instrument channel (also called the working channel) allows passage of accessories such as biopsy forceps, snares, and cytology brushes for tissue sampling and therapeutic interventions. This channel is typically the largest internal channel of the endoscope and requires thorough brushing during reprocessing due to the tissue and blood exposure it receives.

7What is the purpose of the air/water channel in a flexible endoscope?

A.To deliver enzymatic detergent during reprocessing

B.To insufflate the body cavity with air and irrigate the lens with water

C.To aspirate fluids from the procedural field

D.To pass electrical cautery instruments

Explanation: The air/water channel serves two functions during endoscopic procedures: it delivers air to insufflate (inflate) the body cavity for better visualization, and it directs water across the distal lens to keep it clear of debris. This channel is smaller in diameter than the biopsy channel and requires specific cleaning adapters during reprocessing to ensure thorough flushing.

8Which personal protective equipment (PPE) is required when manually cleaning endoscopes in the decontamination area?

A.Gloves only

B.Gloves and a surgical mask

C.Fluid-resistant gown, gloves, face shield or goggles with mask, and hair cover

D.Sterile gown and sterile gloves

Explanation: Full PPE is required in the decontamination area due to exposure risks from bioaerosols, chemical splashes, and contaminated instruments. This includes a fluid-resistant gown, chemical-resistant utility gloves, face protection (face shield or goggles combined with a mask), and a hair cover. The goal is to protect the reprocessing technician from both biological and chemical hazards during cleaning and disinfection.

9What does high-level disinfection (HLD) accomplish?

A.Kills all microorganisms including high numbers of bacterial spores

B.Kills all microorganisms except high numbers of bacterial spores

C.Kills only vegetative bacteria and some viruses

D.Removes all visible soil from instrument surfaces

Explanation: High-level disinfection kills all microorganisms — including vegetative bacteria, mycobacteria, fungi, and viruses — except high numbers of bacterial spores. This level of disinfection is the minimum standard for semi-critical devices like flexible endoscopes. Sterilization, by contrast, kills all forms of microbial life including bacterial spores.

10In a properly designed endoscope reprocessing area, how should workflow be organized?

A.All reprocessing steps should occur in the same room to improve efficiency

B.Dirty-to-clean workflow with physical separation between decontamination and clean areas

C.Clean-to-dirty workflow to ensure endoscopes start in the cleanest area

D.Workflow direction does not matter as long as PPE is worn

Explanation: Endoscope reprocessing areas must be designed with a unidirectional dirty-to-clean workflow. The decontamination (dirty) area where manual cleaning occurs must be physically separated from the clean area where high-level disinfection, rinsing, drying, and storage take place. This separation prevents cross-contamination of reprocessed endoscopes by soiled instruments or aerosols.

About the CER Exam

The CER credential certifies endoscope reprocessing professionals. The exam covers endoscope reprocessing steps including HLD and AER processes (32%), handling, transport, and storage (16%), microbiology and infection control (12%), work area design (12%), endoscope purpose and structure (10%), tracking and maintenance (10%), and human factors (8%). Standalone certification — CRCST not required.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Criterion-referenced (Angoff/Beuk, not disclosed)

Exam Fee

$140 (HSPA)

CER Exam Content Outline

32%

Endoscope Reprocessing Steps

Point-of-use care, leak testing, manual cleaning, enzymatic detergent, HLD, AER, drying, sterilization, QA

16%

Handling, Transport and Storage

Transport containers, storage cabinets, drying cabinets, hang time, labeling

12%

Microbiology and Infection Control

Biofilm, Spaulding classification, transmission routes, standard precautions, PPE

12%

Work Area Design

Decontamination/clean/storage areas, workflow, ventilation, water quality

10%

Endoscope Design and Structure

Flexible endoscope components, channels, insertion tube, video chip, types

10%

Tracking, Repair and Maintenance

Tracking systems, repair, preventive maintenance, IFU compliance, recalls

Human Factors

Staffing, competency, training, communication, error prevention, fatigue

How to Pass the CER Exam

What You Need to Know

Passing score: Criterion-referenced (Angoff/Beuk, not disclosed)
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $140

Keys to Passing

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

CER Study Tips from Top Performers

1Reprocessing Steps is 32% — master the full sequence: bedside pre-cleaning → leak test → manual clean → rinse → HLD/AER → rinse → dry → store

2Know leak testing: perform before EVERY reprocessing cycle; a failed leak test means the scope cannot be reprocessed and must go to repair

3Understand biofilm: forms in channels when organic material is not removed promptly; extremely difficult to remove once established

4Study ANSI/AAMI ST91 standard for flexible endoscope reprocessing — it's a primary exam reference

Frequently Asked Questions

Do I need CRCST to take the CER?

No. CER is a standalone certification. You need 3+ months of hands-on endoscope reprocessing experience verified by a supervisor, but no other credentials.

How many questions are scored?

125 of 150 questions are scored. The other 25 are unscored pretest items randomly distributed throughout.