Free NBSTSA CST Practice Test: 50 Questions With Answers

This free NBSTSA CST practice test has 50 original, unofficial questions across selected topics in the current content outline—not a full-length exam. Pick an answer, then open the explanation—each one names a source you can check, and there's no signup.

Practice questions

Question 1 of 50

Preoperative preparation · CST-001

The patient is prepped and draped for a right inguinal hernia repair. The surgeon reaches for the scalpel. When should the time-out happen, and who takes part?

A. Immediately before the incision, with the immediate procedure team pausing to agree on patient, site, and procedure
B. In preoperative holding, between the patient and the circulator only
C. Right after the incision, once the surgeon has confirmed the anatomy
D. Only for procedures that involve a left or right side

Show answer and explanation

Correct answer: A. The time-out is done immediately before the invasive procedure or incision. It involves the immediate members of the procedure team, including the surgeon, anesthesia, the circulator and the surgical technologist.

Why the other choices don't fit

B: Verification in holding is a separate, earlier step. It doesn't replace the time-out in the room.
C: A time-out after incision can't prevent a wrong-site or wrong-procedure error.
D: The time-out is required for every procedure covered by the protocol, not just ones with laterality.

Takeaway: Last pause before the knife, whole immediate team, agreement on patient, site, procedure.

Source: Joint Commission, National Performance Goals, Hospital Program (effective January 2026), NPG.01.06.03, EPs 1–2 and 4 (p. 6).

Question 2 of 50

Intraoperative procedures · CST-002

You receive bupivacaine into a medicine cup on the back table. It's the only medication on the field, and the surgeon won't use it for another 30 minutes. What should you do?

A. Leave it unlabeled, because nothing else on the field could be confused with it
B. Label the cup now, before anything else happens
C. Label it only if a second medication is added to the field
D. Keep the cup in one corner of the back table so everyone knows what it is

Show answer and explanation

Correct answer: B. Medications and solutions on the sterile field that aren't given immediately must be labeled—even when only one medication is being used.

Why the other choices don't fit

A: The "only one medication" situation is specifically covered by the labeling rule.
C: Waiting for a second drug leaves the first one unidentified.
D: Location isn't a label. Back tables get rearranged and staff change at breaks.

Takeaway: Not given right now? It gets a label—one drug or ten.

Source: Joint Commission, National Performance Goals, Hospital Program (effective January 2026), NPG.14.03.01, EPs 1–2 and 5 (pp. 43–44).

Question 3 of 50

Equipment sterilization and maintenance · CST-003

A reusable bone curette will be used inside the medullary canal during an orthopedic case. Under the Spaulding approach CDC uses, what processing does it need before each use?

A. High-level disinfection
B. Intermediate-level disinfection
C. Sterilization
D. Low-level disinfection

Show answer and explanation

Correct answer: C. An instrument that enters sterile tissue or the vascular system is a critical item. CDC says to sterilize critical instruments before use on each patient.

Why the other choices don't fit

A: High-level disinfection is the minimum for semicritical items that touch mucous membranes or nonintact skin.
B: Intermediate-level disinfection isn't enough for anything entering sterile tissue.
D: Low-level disinfection is for noncritical items that touch only intact skin.

Takeaway: Enters sterile tissue → critical → sterilize.

Source: CDC, Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), Summary Recommendations, Rec. 3.a.

Question 4 of 50

Anatomy and physiology · CST-004

During an open cholecystectomy, the surgeon identifies the structures of the biliary tree. Which two ducts join to form the common bile duct?

A. The right and left hepatic ducts
B. The cystic duct and the main pancreatic duct
C. The common hepatic duct and the main pancreatic duct
D. The common hepatic duct and the cystic duct

Show answer and explanation

Correct answer: D. The right and left hepatic ducts merge into the common hepatic duct, which then joins the cystic duct from the gallbladder to form the common bile duct.

Why the other choices don't fit

A: The right and left hepatic ducts form the common hepatic duct, one step upstream.
B: The cystic duct joins the common hepatic duct, not the pancreatic duct.
C: The pancreatic duct meets the common bile duct near the duodenum, after the common bile duct has already formed.

Takeaway: Common hepatic + cystic = common bile duct.

Source: OpenStax, Anatomy and Physiology 2e, §23.6, "The Liver" (Histology).

Question 5 of 50

Preoperative preparation · CST-005

A patient is having a left total knee arthroplasty with monopolar electrosurgery. She has a metal hip prosthesis on the right side. No tourniquet will restrict circulation at the proposed pad site. Where is the best place for the dispersive (return) electrode?

A. Over the right hip, because it's a large area
B. Over the left kneecap, as close to the incision as possible
C. Over clean, dry skin on a large, well-perfused muscle of the left thigh, close to the site
D. On the lower back, over the sacrum

Show answer and explanation

Correct answer: C. AST's electrosurgery standard calls for placing the return electrode on clean, dry skin over a large muscle with good blood supply, as close to the surgical site as practical, and away from bony prominences and metal prostheses. The site must also remain well perfused; do not place the pad distal to an inflated tourniquet. Follow the electrode manufacturer's instructions.

Why the other choices don't fit

A: The pad should not go over or near a metal prosthesis.
B: The patella is a bony prominence, and pad contact there is poor.
D: The sacrum is a bony prominence and is far from the site.

Takeaway: Big, well-perfused muscle; clean, dry skin; near the site; away from bone and metal.

Source: AST Standards of Practice for Use of Electrosurgery, Standards III.2.B, III.7.A–C (pp. 3–5).

Question 6 of 50

Postoperative procedures · CST-006

At the end of the case, the sharps container in the room is at its fill line. You still have used suture needles on the needle counter. What should you do?

A. Push the contents down to make room for the needles
B. Drop the needle counter into the regular trash with the drapes
C. Leave the needles on the back table for environmental services
D. Close the full container and use a new closable, puncture-resistant, leakproof, labeled container

Show answer and explanation

Correct answer: D. OSHA requires contaminated sharps to go into containers that are closable, puncture resistant, leakproof on the sides and bottom, and labeled or color-coded. Containers must not be allowed to overfill.

Why the other choices don't fit

A: Compressing sharps invites a needlestick, and the container would be overfilled.
B: Sharps never go in regular trash.
C: Sharps are discarded immediately or as soon as feasible—not left for someone else to find.

Takeaway: Full means closed and replaced. Never push sharps down.

Source: OSHA, 29 CFR 1910.1030, paragraphs (d)(4)(iii)(A)(1) and (A)(2)(iii).

Question 7 of 50

Preoperative preparation · CST-007

A patient is brought from holding to the OR. Which pair of identifiers meets the requirement for confirming identity before care begins?

A. Full name and medical record number
B. Full name and holding-bay number
C. Scheduled procedure and surgeon's name
D. Wristband color and OR room number

Show answer and explanation

Correct answer: A. At least two patient identifiers are required. An assigned ID number such as a medical record number is person-specific, and so is the full name.

Why the other choices don't fit

B: A room or physical location may not be used as an identifier.
C: The procedure and surgeon are what you're verifying, not who the patient is.
D: Neither identifies a person.

Takeaway: Two person-specific identifiers; never a location.

Source: Joint Commission, National Performance Goals, Hospital Program (effective January 2026), NPG.01.01.01, EP 1 (p. 1).

Question 8 of 50

Intraoperative procedures · CST-008

During the closing count for an open colectomy, you and the circulator come up one lap sponge short. The patient is stable. What should happen first?

A. Recount quietly with the circulator and close if you both think the first count was a mistake
B. Tell the surgeon and team right away so the search begins before closure
C. Let closure continue and plan an X-ray in recovery
D. Record the count as correct and fill out a report after the case

Show answer and explanation

Correct answer: B. The whole team shares responsibility for preventing a retained item. ACS recommends standardized counting, a methodical wound exploration before closure, and X-ray or other technology as indicated. None of that can happen if the surgeon doesn't know.

Why the other choices don't fit

A: A private recount skips the surgeon and the search, and a real retained sponge could be missed.
C: Finding the sponge after closure may mean another operation.
D: Recording a false count is a documentation and safety failure.

Takeaway: A count discrepancy is a team event—announce it before closure.

Source: American College of Surgeons, Revised Statement on the Prevention of Unintentionally Retained Surgical Items After Surgery, October 1, 2016, recommendations list.

Question 9 of 50

Surgical pharmacology · CST-009

A healthy 70 kg adult is having a lesion excised under local. The surgeon is using 1% lidocaine without epinephrine (10 mg/mL) and asks you to keep track of the total. Using the FDA-approved Xylocaine label's adult maximum for plain lidocaine, what's the most that should be used?

A. 3 mL
B. 31.5 mL
C. 30 mL
D. 60 mL

Show answer and explanation

Correct answer: C. The label's maximum individual dose without epinephrine is 4.5 mg/kg, and the total generally shouldn't exceed 300 mg. For 70 kg: 70 × 4.5 = 315 mg, so the 300 mg ceiling applies. At 10 mg/mL, 300 mg ÷ 10 = 30 mL.

Why the other choices don't fit

A: This treats 1% as 100 mg/mL—a decimal error.
B: This uses 315 mg and ignores the 300 mg total ceiling.
D: This treats 1% as 5 mg/mL. A 1% solution is 10 mg per mL.

Takeaway: 1% = 10 mg/mL. Do the mg/kg math, then check the total ceiling. Dosing decisions are the surgeon's and anesthesia's; your job is accurate tracking and reporting.

Source: Xylocaine (lidocaine HCl) injection, FDA label on DailyMed, Dosage and Administration ("Maximum Recommended Dosages," adults) and How Supplied.

Question 10 of 50

Equipment sterilization and maintenance · CST-010

Which biological indicator organism is used to monitor steam sterilization?

A. Bacillus atrophaeus spores
B. Geobacillus stearothermophilus spores
C. Staphylococcus aureus
D. Mycobacterium tuberculosis

Show answer and explanation

Correct answer: B. CDC states that G. stearothermophilus spores are used to monitor steam sterilization.

Why the other choices don't fit

A: B. atrophaeus spores monitor ethylene oxide and dry heat.
C: A vegetative bacterium does not provide the resistant spore challenge used for steam monitoring.
D: Mycobacteria are tough, but not the steam BI organism.

Takeaway: Steam → G. stearothermophilus. EtO and dry heat → B. atrophaeus.

Source: CDC, Sterilizing Practices, "Monitoring."

Question 11 of 50

Intraoperative procedures · CST-011

The surgeon asks for the finest suture of the four on your back table. Which one do you hand up?

A. 2-0
B. 0
C. 6-0
D. 1

Show answer and explanation

Correct answer: C. In the USP sizing system used for sutures, the more zeros, the thinner the suture. 6-0 is finer than 2-0, which is finer than 0. Sizes without a zero (1, 2) are heavier still.

Why the other choices don't fit

A: 2-0 has fewer zeros, so it's thicker than 6-0.
B: 0 is thicker than any "-0" size above it.
D: Size 1 is heavier than size 0.

Takeaway: More zeros, finer suture.

Source: University of Saskatchewan, Suture Size, USP diameter conventions.

Question 12 of 50

Administrative and personnel · CST-012

A long laparotomy uses heavy electrosurgery, and the room is filling with plume. What's the best control?

A. Prop the OR door open to clear the air
B. Rely on general room ventilation
C. Have staff wear surgical masks and continue
D. Capture the plume at the source with a smoke evacuator (local exhaust ventilation)

Show answer and explanation

Correct answer: D. NIOSH recommends local exhaust ventilation at the site, used with general room ventilation, and says room ventilation by itself isn't sufficient to capture surgical smoke.

Why the other choices don't fit

A: An open door doesn't capture smoke at the source.
B: NIOSH says general room ventilation alone isn't enough.
C: Masks don't remove the plume from the room. Source capture comes first.

Takeaway: Catch plume where it's made.

Source: NIOSH, Control of Smoke From Laser/Electric Surgical Procedures, Engineering Controls, general ventilation and local exhaust ventilation.

Question 13 of 50

Preoperative preparation · CST-013

You're doing a surgical hand scrub with an antimicrobial soap. How long should you scrub hands and forearms?

A. For the time the product manufacturer recommends, usually 2 to 6 minutes
B. At least 10 minutes, to be safe
C. About 30 seconds, as for a routine hand wash
D. Until your skin looks clean

Show answer and explanation

Correct answer: A. CDC's clinical hand-hygiene guidance says to scrub hands and forearms for the time the manufacturer recommends, usually 2–6 minutes. Long scrubs such as 10 minutes aren't necessary.

Why the other choices don't fit

B: CDC states that long scrub times, such as 10 minutes, aren't necessary.
C: A routine hand wash isn't surgical hand antisepsis.
D: Looking clean says nothing about microbial counts.

Takeaway: Follow the product's labeled time—typically 2–6 minutes.

Source: CDC, Clinical Safety: Hand Hygiene for Healthcare Workers, Surgical hand antisepsis; May 15, 2024.

Question 14 of 50

Intraoperative procedures · CST-014

During a facial procedure, the drapes near the field catch fire. It is not an airway fire. What should the team do immediately?

A. Stop the flow of airway gases, remove the drapes and burning material, and put out the fire with saline or other means
B. Wait for anesthesia to finish ventilating before touching anything
C. Cover the flames with a dry towel and keep operating
D. Evacuate the room first, then return to deal with the fire

Show answer and explanation

Correct answer: A. For a non-airway fire, the ASA algorithm says to act immediately without waiting: stop all airway gases, remove drapes and burning or flammable materials, and extinguish with saline or other means. These are coordinated team actions, not steps that wait for one another; anesthesia manages the gas supply while other team members remove burning materials and extinguish the fire.

Why the other choices don't fit

B: The algorithm says to act immediately, without waiting.
C: A dry towel is more fuel, and oxygen may still be flowing.
D: The algorithm's first steps happen right at the patient: gases off, burning material removed, fire put out.

Takeaway: Gases off, burning stuff off, saline on.

Source: ASA, Practice Advisory for the Prevention and Management of Operating Room Fires (2013), Fig. 1 algorithm (p. 6).

Question 15 of 50

Anatomy and physiology · CST-015

Which term means surgical removal of the gallbladder?

A. Cholecystotomy
B. Cholecystostomy
C. Cholecystectomy
D. Cholecystitis

Show answer and explanation

Correct answer: C. -ectomy means cutting out or removal. Cholecyst- refers to the gallbladder.

Why the other choices don't fit

A: -otomy means incision—cutting into, not removing.
B: -ostomy means creating an opening.
D: -itis means inflammation, not a procedure.

Takeaway: -ectomy removes, -otomy opens, -ostomy makes an opening.

Source: MedlinePlus, Appendix A: Word Parts and What They Mean, "Procedures, Diagnosis and Surgery."

Question 16 of 50

Preoperative preparation · CST-016

For a laparoscopic cholecystectomy, the surgeon wants abdominal contents to fall away from the upper abdomen. Which position helps?

A. Trendelenburg
B. Lithotomy
C. Prone
D. Reverse Trendelenburg

Show answer and explanation

Correct answer: D. Reverse Trendelenburg tips the head up. STERIS identifies laparoscopic cholecystectomy as one of its uses.

Why the other choices don't fit

A: Trendelenburg tilts the head down, shifting abdominal contents toward the diaphragm—the opposite of what's wanted here.
B: Lithotomy raises the legs for perineal access, not the upper abdomen.
C: Prone gives access to the back, not the gallbladder.

Takeaway: Reverse Trendelenburg = head up; it helps the upper-abdominal exposure described here.

Source: STERIS, Trendelenburg Position, Reverse Trendelenburg; October 15, 2020.

Question 17 of 50

Microbiology · CST-017

An elective cholecystectomy is completed with no bile spillage, no infection found, and no break in technique. Under the traditional surgical wound classification, which class is it?

A. Class I, clean
B. Class II, clean-contaminated
C. Class III, contaminated
D. Class IV, dirty-infected

Show answer and explanation

Correct answer: B. A clean-contaminated wound enters the respiratory, alimentary, genital or urinary tract under controlled conditions without unusual contamination. The classification lists the biliary tract as an example when there's no infection or major break in technique.

Why the other choices don't fit

A: Clean wounds don't enter those tracts.
C: Contaminated wounds involve a major break in technique, gross spillage, or acute nonpurulent inflammation—none occurred.
D: Dirty-infected wounds involve existing infection or perforated viscera.

Takeaway: Controlled biliary-tract entry, no infection or major break in technique = Class II.

Source: CDC/HICPAC, Guideline for Prevention of Surgical Site Infection, 1999, Table 7 (p. 259). Historical guideline, cited for the class definitions only.

Question 18 of 50

Equipment sterilization and maintenance · CST-018

A steam load contains an orthopedic screw set for an elective case tomorrow. What does CDC recommend?

A. Run a biological indicator with the load and quarantine the implants until the result is negative, whenever possible
B. Release the implants once the external tape has changed color
C. Rely on last week's routine biological indicator
D. Plan to flash sterilize the screws tomorrow instead

Show answer and explanation

Correct answer: A. CDC recommends a biological indicator in every load containing implantable items, with the items quarantined whenever possible until the indicator is negative.

Why the other choices don't fit

B: External tape shows the package went through a process, not that spores were killed.
C: Implant loads need their own indicator.
D: CDC says not to flash sterilize implants unless it's unavoidable, and an elective case scheduled for tomorrow isn't.

Takeaway: Implants: BI every load; hold until negative whenever possible.

Source: CDC, Guideline for Disinfection and Sterilization (2008), Summary Recommendations, Recs. 16.g and 13.a.

Question 19 of 50

Intraoperative procedures · CST-019

Which part of your sterile gown is considered sterile once you're gowned?

A. The whole gown until something touches it
B. The front from mid-chest to the level of the sterile field, and the sleeves from two inches above the elbow to the cuff seam
C. The back, because it's covered by the wrap
D. The neckline and shoulders

Show answer and explanation

Correct answer: B. AST's core curriculum defines the sterile zones as the front from mid-chest to the level of the sterile field (or waist), and the sleeves from two inches above the elbow to the cuff seam.

Why the other choices don't fit

A: Some gown areas are never considered sterile, even untouched.
C: The back can't be monitored and is not considered sterile.
D: The neckline and shoulders are outside the sterile zone.

Takeaway: Mid-chest to table, two inches above the elbow to the cuff.

Source: AST, Core Curriculum for Surgical Technology, 7th edition, Principles of Asepsis, IV.B.3–5, printed p. 140 (PDF p. 147).

Question 20 of 50

Postoperative procedures · CST-020

Five blood-soaked lap sponges weigh 410 g together. Each dry lap sponge weighs 20 g. Using gravimetric quantitative blood loss, what's the blood loss on these sponges? Assume the sponges contain blood only, with no irrigation or other fluid; use approximately 1 g of blood per mL.

A. 410 mL
B. 390 mL
C. 310 mL
D. 82 mL

Show answer and explanation

Correct answer: C. Subtract the dry weight of all the items from the wet weight, then convert: approximately 1 g = 1 mL. Dry total = 5 × 20 g = 100 g. 410 g − 100 g = 310 g → approximately 310 mL.

Why the other choices don't fit

A: This counts the sponge material as blood.
B: This subtracts the dry weight of only one sponge.
D: This divides by the number of sponges instead of subtracting their dry weight.

Takeaway: Wet weight − total dry weight ≈ mL of blood, after excluding other fluids.

Source: AWHONN Practice Brief No. 1, Quantification of Blood Loss (JOGNN 2015), Table 1, items 6–7, and Table 2 (p. 159); cited for the gravimetric calculation, not a complete operative blood-loss protocol.

Question 21 of 50

Preoperative preparation · CST-021

A patient with moderate hair over the planned incision site is scheduled for surgery. The hair would interfere with the incision. What does WHO recommend?

A. Shave the area with a razor the night before
B. Shave with a razor in holding the morning of surgery
C. Use a depilatory cream two days before surgery
D. Remove it shortly before the operation using electric clippers

Show answer and explanation

Correct answer: D. WHO recommends not removing hair unless it will interfere with the operation, and, if hair is removed, doing it shortly before the operation, using electric clippers.

Why the other choices don't fit

A: It is too early, and WHO advises against razor shaving.
B: Still a razor rather than clippers.
C: A cream two days before surgery does not follow the recommended clipper method shortly before surgery.

Takeaway: Only if it's in the way; clip it, right before surgery.

Source: WHO, Preoperative Bathing and Hair Removal, Hair removal, pp. 1–2; only when necessary, use clippers rather than razors.

Question 22 of 50

Intraoperative procedures · CST-022

The surgeon is using Metzenbaum scissors to dissect delicate tissue. A moment later, she asks you to cut the suture she just tied. What's the right move?

A. Keep the Metzenbaums for tissue and hand up a different pair of scissors for the suture
B. Hand back the Metzenbaums, since the same scissors can cut tissue and suture
C. Use the Metzenbaums to cut the suture yourself, then return them to the surgeon
D. Switch to the Metzenbaums for the heavy fascia next, then use them on the suture

Show answer and explanation

Correct answer: A. Metzenbaum scissors are dissecting scissors for cutting and dissecting tissue. The manufacturer description says they're not recommended for cutting sutures, drains, or heavy tissue, which dulls and damages the delicate blades.

Why the other choices don't fit

B: Cutting suture with Metzenbaums is exactly the use they aren't meant for.
C: Same problem, regardless of who does the cutting.
D: Heavy tissue is also on the not-recommended list.

Takeaway: Metzenbaums are for delicate tissue. Suture, drains and heavy tissue get other scissors.

Source: Sklar, Metzenbaum Dissecting Scissors, product description. Cited for the instrument's intended use only.

Question 23 of 50

Anatomy and physiology · CST-023

After a total thyroidectomy, a patient wakes up hoarse. Injury to which nerve, which runs close to the thyroid, is the classic concern?

A. Phrenic nerve
B. Recurrent laryngeal nerve
C. Hypoglossal nerve
D. Facial nerve

Show answer and explanation

Correct answer: B. The recurrent laryngeal nerve supplies most intrinsic muscles of the larynx. Injury can cause vocal cord paralysis and hoarseness.

Why the other choices don't fit

A: The phrenic nerve supplies the diaphragm, not the vocal cords.
C: The hypoglossal nerve moves the tongue.
D: The facial nerve controls facial expression.

Takeaway: Thyroid surgery + hoarseness → think recurrent laryngeal nerve.

Source: American Thyroid Association, Thyroid Surgery, Risks of thyroid surgery: recurrent laryngeal nerve and hoarseness.

Question 24 of 50

Intraoperative procedures · CST-024

The surgeon hands off a breast lesion and says, "Frozen section." How should you prepare the specimen?

A. Place it in formalin right away to preserve it
B. Place it in saline-soaked gauze and send it to the lab tomorrow
C. Pass it off the field to the circulator only after the case
D. Keep it out of any preservative and send it per the surgeon's frozen-section request

Show answer and explanation

Correct answer: D. AST's specimen standard says specimens designated for frozen section should not be placed in a preservative solution. Pass it off promptly for immediate transport according to the pathology laboratory's instructions.

Why the other choices don't fit

A: Formalin fixes tissue and ruins it for frozen section.
B: A frozen section is done during surgery to guide decisions—waiting defeats its purpose.
C: Holding it until the end delays the result the surgeon needs now.

Takeaway: Frozen section = no formalin, no preservative.

Source: AST, Standards of Practice for Handling and Care of Surgical Specimens, Standard VI, item 2.C.

Question 25 of 50

Administrative and personnel · CST-025

While you're positioning a patient, she asks you to explain the risks of her operation because she's nervous about the consent she signed. What's the best response?

A. Explain the risks yourself, since you've seen this case many times
B. Tell her the consent is signed, so it doesn't matter now
C. Let her know the surgeon is the right person to answer that, and tell the circulator so the surgeon can speak with her
D. Ask the anesthesia provider to sedate her so she relaxes

Show answer and explanation

Correct answer: C. The surgeon is responsible for an understandable informed-consent discussion. Tell the circulator so the patient's unanswered questions reach the surgeon before the procedure proceeds; the CST should not substitute an explanation or seek a signature in place of that discussion.

Why the other choices don't fit

A: The consent discussion isn't the surgical technologist's to give.
B: A signature doesn't erase a patient's questions or her right to understand her care.
D: Sedating a patient who has open questions about consent undermines her decision.

Takeaway: Consent questions go to the surgeon, through the team, right away.

Source: American College of Surgeons, Statement of Principles Underlying Surgeon Responsibility Toward the Patient, Principle 5, responsibility for informed consent.

Question 26 of 50

Intraoperative procedures · CST-026

The circulator pours heparinized saline into a sterile container you're holding. You will hand it to the surgeon later. How should the medication and label be verified?

A. You and the circulator verify it together, out loud and by looking at the label
B. The circulator reads it aloud; you don't need to look
C. You check it yourself after the circulator walks away
D. Verify it when documenting at the end of the case

Show answer and explanation

Correct answer: A. When the person preparing a medication isn't the one administering it, two qualified people verify it verbally and visually.

Why the other choices don't fit

B: Verbal-only checks miss look-alike errors.
C: One person checking alone isn't two-person verification.
D: Verification after use can't prevent an error.

Takeaway: Different preparer and user → two people, out loud and eyes on.

Source: Joint Commission, National Performance Goals, Hospital Program (effective January 2026), NPG.14.03.01, EP 4 (p. 44).

Question 27 of 50

Equipment sterilization and maintenance · CST-027

Your department owns one set of a popular laparoscopic instrument tray, and those cases are booked back to back. A surgeon wants the team to flash sterilize the set between cases routinely. What does CDC say?

A. It's fine if the instruments are cleaned first
B. Flash sterilization shouldn't be used for convenience, to avoid buying more sets, or to save time
C. It's fine if a biological indicator runs with every cycle
D. It's fine for implants too when the schedule is tight

Show answer and explanation

Correct answer: B. CDC states that flash sterilization should not be used for convenience, as an alternative to purchasing additional instrument sets, or to save time.

Why the other choices don't fit

A: Cleaning is always required, but it doesn't make routine convenience use acceptable.
C: Monitoring doesn't fix the underlying problem: using flash to cover an inventory gap.
D: CDC says not to flash sterilize implants unless it's unavoidable.

Takeaway: Flash (immediate-use) sterilization isn't an inventory plan.

Source: CDC, Guideline for Disinfection and Sterilization (2008), Summary Recommendations, Recs. 13.a and 13.b.

Question 28 of 50

Preoperative preparation · CST-028

While opening supplies, you notice a peel pack has a water stain and a small puncture. The sterilizer printout for that load looks fine. What should you do?

A. Use it, because the load record proves it was sterile
B. Use it if the internal indicator changed color
C. Wipe the package with alcohol and open it
D. Don't open it onto the field; return it to be repackaged and reprocessed

Show answer and explanation

Correct answer: D. CDC recommends checking packages before use and repacking and reprocessing any pack that has lost integrity—torn, wet, or punctured.

Why the other choices don't fit

A: A good load record doesn't account for damage after sterilization.
B: The indicator reflects processing, not what happened to the package afterward.
C: Wiping the outside can't repair a breached barrier.

Takeaway: Wet, torn or punctured = not sterile.

Source: CDC, Guideline for Disinfection and Sterilization (2008), Summary Recommendations, Recs. 18.e–18.f.

Question 29 of 50

Intraoperative procedures · CST-029

Which suture is a nonabsorbable monofilament?

A. Polypropylene
B. Polyglactin 910
C. Poliglecaprone 25
D. Chromic gut

Show answer and explanation

Correct answer: A. Polypropylene (for example, Prolene) is a nonabsorbable monofilament suture.

Why the other choices don't fit

B: Polyglactin 910 (Vicryl) is absorbable and braided.
C: Poliglecaprone 25 (Monocryl) is a monofilament, but absorbable.
D: Chromic gut is absorbable.

Takeaway: Polypropylene: monofilament and permanent.

Source: Ethicon, Prolene polypropylene suture, Material/Composition, Suture Construction and Absorbability; Ethicon, Vicryl polyglactin 910 suture, Suture Construction and Absorbability; Ethicon, Monocryl poliglecaprone 25 suture, Suture Construction and Absorbability; Ethicon, Surgical Gut Suture Chromic, device description.

Question 30 of 50

Surgical pharmacology · CST-030

During a sevoflurane anesthetic that included succinylcholine at induction, the anesthesia provider announces a suspected malignant hyperthermia (MH) crisis. Which immediate response supports treatment?

A. Give more succinylcholine to relax the muscles
B. Increase the sevoflurane to deepen anesthesia
C. Stop the triggering agents, call for help, and get dantrolene and the MH cart
D. Finish the procedure first, then treat in recovery

Show answer and explanation

Correct answer: C. MHAUS's emergency steps begin with discontinuing volatile agents and succinylcholine, calling for help, and getting dantrolene and the MH cart. It also says to have the surgeon stop the procedure as soon as possible. Anesthesia also hyperventilates with 100% oxygen and gives IV dantrolene promptly; the CST supports the coordinated response and obtains needed supplies.

Why the other choices don't fit

A: Succinylcholine is a trigger.
B: Volatile anesthetics are triggers.
D: MH is treated immediately; MHAUS says to halt the procedure ASAP.

Takeaway: MH: stop the triggers, call for help, dantrolene.

Source: MHAUS, Managing a Crisis, emergency treatment steps.

Question 31 of 50

Intraoperative procedures · CST-031

A McBurney (gridiron) incision in the right lower quadrant is traditionally used for which open procedure?

A. Cholecystectomy
B. Splenectomy
C. Cesarean section
D. Appendectomy

Show answer and explanation

Correct answer: D. The gridiron/McBurney incision is a traditional approach for open appendectomy for acute appendicitis.

Why the other choices don't fit

A: The gallbladder sits in the right upper quadrant.
B: The spleen is in the left upper quadrant.
C: A cesarean section isn't done through a right-sided gridiron incision.

Takeaway: RLQ gridiron = appendix.

Source: Texas Tech University Health Sciences Center El Paso, Anterior Abdominal Wall: Clinical Cases, Case 2, introduction and questions 3 and 5.

Question 32 of 50

Anatomy and physiology · CST-032

Which nerve provides motor supply to the diaphragm?

A. Vagus nerve
B. Phrenic nerve
C. Intercostal nerves
D. Recurrent laryngeal nerve

Show answer and explanation

Correct answer: B. The phrenic nerves, from the C3 through C5 nerve roots, supply motor fibers to the diaphragm.

Why the other choices don't fit

A: The vagus nerve has many autonomic roles but isn't the diaphragm's motor nerve.
C: Intercostal nerves supply the intercostal muscles and chest wall.
D: The recurrent laryngeal nerve supplies laryngeal muscles.

Takeaway: "C3, 4, 5 keeps the diaphragm alive"—the phrenic nerve.

Source: OpenStax, Clinical Nursing Skills, 26.1 Structure and Function, Table 26.3, phrenic nerve and diaphragm.

Question 33 of 50

Intraoperative procedures · CST-033

You're scrubbed for an orthopedic case with pulsatile irrigation and power reaming. Spray and spatter of blood are likely. Which choice provides the eye, nose and mouth protection addressed by OSHA's bloodborne-pathogens standard?

A. A surgical mask together with goggles, solid-side-shield glasses, or a chin-length face shield
B. A surgical mask alone
C. Eyeglasses you normally wear
D. Nothing extra, because you're already gowned and gloved

Show answer and explanation

Correct answer: A. OSHA's bloodborne-pathogens standard addresses protection of the eyes, nose and mouth when blood or other potentially infectious material may splash, spray or spatter. A mask together with appropriate eye protection or a face shield covers those exposure routes in this scenario.

Why the other choices don't fit

B: A mask alone leaves the eyes unprotected.
C: Ordinary glasses without solid side shields don't meet the requirement.
D: Gowns and gloves don't protect the face.

Takeaway: Splash risk → eyes and mouth covered.

Source: OSHA, 29 CFR 1910.1030, paragraph (d)(3)(x).

Question 34 of 50

Postoperative procedures · CST-034

At the end of a case, blood-soaked linen is likely to leak through a standard bag. How should it be handled?

A. Shake it out to check for instruments, then bag it
B. Rinse it in the scrub sink so it won't leak
C. Bag it where it was used, with minimal handling, in a labeled or color-coded leakproof bag
D. Carry it unbagged to the soiled utility room and sort it there

Show answer and explanation

Correct answer: C. OSHA requires contaminated laundry to be handled as little as possible with minimal agitation, bagged at the location of use and not sorted or rinsed there, placed in labeled or color-coded bags, and placed in leakproof bags when soak-through is likely.

Why the other choices don't fit

A: Shaking linen agitates it—the opposite of what OSHA requires.
B: Contaminated laundry is not rinsed at the location of use.
D: Sorting at another location means extra handling and carrying it unbagged.

Takeaway: Bag it where it lies; don't shake, sort or rinse it there.

Source: OSHA, 29 CFR 1910.1030, paragraph (d)(4)(iv)(A)(1)–(3).

Question 35 of 50

Preoperative preparation · CST-035

The preference card is ready, but the chart now shows the patient has a confirmed latex allergy. What's the priority as you prepare the room?

A. Use the usual supplies but double-glove
B. Use latex products only for items that don't touch the patient directly
C. Wait until the patient reacts, then change products
D. Set up a latex-free environment and latex-free supplies for the case

Show answer and explanation

Correct answer: D. For a patient with latex allergy, the team provides a latex-free environment, which means checking gloves, catheters, tubing, drains and other supplies before the patient arrives.

Why the other choices don't fit

A: Double-gloving with latex still exposes the patient.
B: Latex anywhere in the setup can still reach the patient, through gloved hands or items on the field.
C: Prevention comes before a reaction, not after.

Takeaway: Known latex allergy → latex-free room, checked before the patient arrives.

Source: ASCIA, Operating Suite Guidelines for Latex Allergic Patients, Preparation of operating room and latex-safe equipment.

Question 36 of 50

Intraoperative procedures · CST-036

Midway through the case, you notice a small puncture in your outer glove. What should you do?

A. Keep going and change gloves at the end of the case
B. Stop sterile handling and promptly replace the damaged glove using sterile technique
C. Cover the hole with sterile tape
D. Pour antiseptic over the glove and continue

Show answer and explanation

Correct answer: B. OSHA requires single-use gloves to be replaced as soon as feasible when torn, punctured or otherwise unable to function as a barrier. Arrange sterile glove replacement and assess whether the inner glove or hand was also affected; an outer-glove puncture alone does not establish that the hand is contaminated.

Why the other choices don't fit

A: Continuing with a torn barrier is not acceptable just because the procedure is nearly finished.
C: Tape doesn't restore a sterile barrier.
D: Antiseptic over a punctured glove doesn't make it sterile.

Takeaway: Glove breach → fix it now.

Source: OSHA, 29 CFR 1910.1030, paragraph (d)(3)(ix)(A)–(B), replacement and no reuse of single-use gloves.

Question 37 of 50

Equipment sterilization and maintenance · CST-037

You open an instrument tray. The external tape changed, but the internal chemical indicator did not. What should happen?

A. Don't use the tray; return it for reprocessing and tell the circulator
B. Use it, because the external tape changed
C. Use it if yesterday's biological indicator was negative
D. Use it if the surgeon approves

Show answer and explanation

Correct answer: A. CDC says not to use processed items if mechanical or chemical indicators suggest inadequate processing.

Why the other choices don't fit

B: The external tape only shows exposure on the outside. The internal indicator says conditions inside may not have been met.
C: A past result says nothing about this tray.
D: Approval can't make an underprocessed tray sterile.

Takeaway: Any indicator says no → the tray doesn't go on the field.

Source: CDC, Guideline for Disinfection and Sterilization (2008), Summary Recommendations, Rec. 16.c.

Question 38 of 50

Intraoperative procedures · CST-038

The surgeon is ready to close skin with a nonabsorbable suture. Which needle type is commonly used for skin?

A. Taper (round-body) needle
B. Blunt needle
C. Reverse cutting needle
D. Ophthalmic lancet needle

Show answer and explanation

Correct answer: C. Reverse cutting needles are commonly used for skin, while taper needles suit soft, delicate tissue.

Why the other choices don't fit

A: Taper needles are for soft, delicate tissue, not tough skin.
B: Blunt needles are designed to push through tissue rather than cut, which suits other uses.
D: An ophthalmic lancet needle is designed for eye structures, not routine skin closure.

Takeaway: Tough tissue (skin) → cutting; soft tissue → taper.

Source: B. Braun, Surgical Sutures, Meshes and Biosurgicals: General Catalog, Needle types: taper p. 24, blunt p. 26, reverse cutting p. 27 and ophthalmic lancet p. 28.

Question 39 of 50

Microbiology · CST-039

Which of these is the most resistant to disinfection and sterilization?

A. Vegetative bacteria
B. Fungi
C. Mycobacteria
D. Bacterial spores

Show answer and explanation

Correct answer: D. In CDC's order of resistance, bacterial spores rank just below prions, and above mycobacteria, small nonlipid viruses, fungi and vegetative bacteria.

Why the other choices don't fit

A: Vegetative bacteria are among the easiest to kill.
B: Fungi are less resistant than spores.
C: Mycobacteria are tough, but spores are tougher.

Takeaway: Spores are why sterilization (not just disinfection) exists.

Source: CDC, Guideline for Disinfection and Sterilization (2008), Figure 1.

Question 40 of 50

Intraoperative procedures · CST-040

Which gas is most commonly used to create pneumoperitoneum for laparoscopy?

A. Nitrous oxide
B. Carbon dioxide
C. Oxygen
D. Room air

Show answer and explanation

Correct answer: B. Carbon dioxide is the most frequently used insufflation gas. It meets most criteria for an ideal gas, including being nonflammable and easily removed by the body.

Why the other choices don't fit

A: Nitrous oxide is used occasionally, but it's not the standard.
C: Oxygen supports combustion—dangerous with electrosurgery in the abdomen.
D: Room air contains oxygen and isn't used for routine insufflation.

Takeaway: Laparoscopy gas = CO2.

Source: Society of Laparoscopic & Robotic Surgeons, The Pneumoperitoneum, Laparoscopic gas; Prevention and Management, 3rd edition.

Question 41 of 50

Anatomy and physiology · CST-041

A patient is scheduled for ACL reconstruction. The anterior cruciate ligament connects which bones, and what motion does it mainly restrain?

A. Femur and tibia; forward movement of the tibia relative to the femur
B. Femur and patella; patellar dislocation
C. Tibia and fibula; ankle inversion
D. Femur and tibia; side-to-side opening on the inner knee

Show answer and explanation

Correct answer: A. The ACL connects the femur and tibia and is the primary restraint to anterior translation of the tibia relative to the femur.

Why the other choices don't fit

B: The ACL doesn't attach to the patella.
C: The ACL is in the knee, not the ankle.
D: Right bones, wrong motion. The ACL's main job is stopping the tibia from sliding forward.

Takeaway: ACL keeps the tibia from sliding forward.

Source: American Academy of Orthopaedic Surgeons, Anterior Cruciate Ligament Injuries, Anatomy: cruciate ligaments.

Question 42 of 50

Intraoperative procedures · CST-042

A sedated patient on supplemental oxygen by nasal cannula is having a forehead lesion removed with electrosurgery. Which step addresses the oxidizer part of the fire triangle?

A. Letting the alcohol-based prep dry before draping
B. Holstering the active electrode when it's not in use
C. Working with anesthesia to limit open oxygen delivery to 30% or less and manage the airway differently if more oxygen is needed
D. Moistening sponges near the site

Show answer and explanation

Correct answer: C. Oxygen is the oxidizer. APSF recommends limiting open oxygen delivery to 30% or less during high-fire-risk procedures. If the patient needs a higher concentration, anesthesia should control the airway rather than continue higher-concentration open delivery near the ignition source. This is a coordinated anesthesia decision, not an instruction for the CST to turn down needed oxygen independently.

Why the other choices don't fit

A: That reduces fuel.
B: That controls the ignition source.
D: Wet sponges reduce fuel.

Takeaway: Fuel, oxidizer, ignition—know which one each action controls.

Source: APSF, Assessing Fire Risk in Surgery: Why Limit Open Oxygen Delivery to 30%?, February 1, 2025, oxygen-concentration recommendation and airway-management discussion.

Question 43 of 50

Equipment sterilization and maintenance · CST-043

A long case ends with instruments heavily soiled with blood. The tray won't reach decontamination for more than an hour. What should happen at the point of use?

A. Leave the instruments as they are; decontamination will handle everything
B. Wipe off gross tissue and let the instruments air-dry on the back table
C. Skip cleaning and send them straight to the sterilizer
D. Remove gross soil and keep blood from drying, following the manufacturer's instructions and the facility's point-of-use process, then send them for cleaning as soon as practical

Show answer and explanation

Correct answer: D. CDC recommends cleaning devices as soon as practical after use—at the point of use, for example—and says surgical instruments should be presoaked or rinsed to keep blood from drying on them.

Why the other choices don't fit

A: An hour of drying makes blood and tissue harder to remove later.
B: Air-drying is the very thing to prevent.
C: Sterilization doesn't replace cleaning. Soil left on instruments gets in the way of the sterilizing process.

Takeaway: Don't let blood dry. Point-of-use care now makes real cleaning work later.

Source: CDC, Guideline for Disinfection and Sterilization (2008), Summary Recommendations, Rec. 2.b.ii; CDC, Cleaning.

Question 44 of 50

Intraoperative procedures · CST-044

An adult patient in the holding area becomes unresponsive and pulseless, and you start chest compressions. What rate and depth do the 2025 AHA guidelines call for?

A. 60 to 80 per minute, about 1 inch deep
B. 100 to 120 per minute, at least 2 inches but not more than 2.4 inches
C. 120 to 140 per minute, at least 3 inches
D. As fast as possible, as deep as possible

Show answer and explanation

Correct answer: B. AHA recommends adult compressions at least 2 inches (5 cm) deep while avoiding more than 2.4 inches (6 cm), at a rate of 100 to 120 per minute.

Why the other choices don't fit

A: Too slow and too shallow.
C: Too fast and too deep.
D: AHA sets an upper limit on both rate and depth.

Takeaway: 100–120/min, 2 to 2.4 inches.

Source: American Heart Association, 2025 Guidelines, Part 7: Adult Basic Life Support, Section 7.3, Recs. 1 and 3.

Question 45 of 50

Intraoperative procedures · CST-045

The surgeon asks for something to control oozing from cut cancellous bone at the sternal edge. Which nonabsorbable material works by mechanically sealing the bone's bleeding channels?

A. Bone wax
B. Oxidized regenerated cellulose
C. Bipolar electrosurgery
D. Monopolar fulguration

Show answer and explanation

Correct answer: A. Bone wax works through physical rather than biochemical properties, mechanically sealing bleeding channels in bone.

Why the other choices don't fit

B: Oxidized regenerated cellulose is an absorbable hemostatic matrix, not a nonabsorbable wax that plugs bone channels.
C: Bipolar electrosurgery produces thermal hemostasis; it is not a material placed into bone channels.
D: Fulguration is also thermal.

Takeaway: Bone wax = mechanical barrier; electrosurgery = thermal hemostasis.

Source: Ethicon, Bone Wax Patient Information Leaflet, Revision 01, November 2021, pp. 1–2; Ethicon, Surgicel Original Hemostat, Product Group, Material/Composition and mechanism of action; AST, Standards of Practice for Use of Electrosurgery, Introduction and Standard I, thermal action of electrosurgery.

Question 46 of 50

Anatomy and physiology · CST-046

During an inguinal hernia repair, the surgeon finds a sac coming through the deep (internal) inguinal ring, lateral to the inferior epigastric vessels. What type of hernia is it?

A. Direct inguinal hernia
B. Femoral hernia
C. Indirect inguinal hernia
D. Umbilical hernia

Show answer and explanation

Correct answer: C. An indirect inguinal hernia protrudes through the internal inguinal ring, lateral to the inferior epigastric vessels.

Why the other choices don't fit

A: A direct hernia pushes through the transversalis fascia within Hesselbach's triangle, medial to those vessels.
B: A femoral hernia doesn't come through the internal inguinal ring.
D: An umbilical hernia is at the navel.

Takeaway: Indirect = through the internal ring, lateral to the epigastrics.

Source: ACS/ASE Medical Student Core Curriculum, Abdominal Wall and Groin Masses, p. 1, inguinal anatomy and direct/indirect hernias; Loyola-hosted copy.

Question 47 of 50

Preoperative preparation · CST-047

You're helping position a patient in lithotomy for a vaginal hysterectomy. How should the legs go into the stirrups?

A. One leg at a time, starting with either side
B. Whichever leg is closer to the circulator first
C. By one team member, one leg right after the other, to save time
D. Raised slowly and simultaneously, with adequate help and symmetrical positioning

Show answer and explanation

Correct answer: D. Raise and lower the legs slowly and simultaneously, keeping them aligned and supported. Obtain adequate help rather than moving one leg first.

Why the other choices don't fit

A: Moving one leg at a time does not maintain the simultaneous, symmetrical positioning described in the instructions.
B: Picking an order by convenience still moves the legs separately.
C: Speed doesn't fix the problem—the legs still move separately.

Takeaway: Lithotomy legs move as a pair.

Source: STERIS, Surgical Table Patient Positioning Instructions, Lithotomy, p. 14, setup step 12 and completion step 2; Allen Medical/AMATECH, Mizuho Levitator Stirrup Instructions for Use, Version A, March 18, 2020, p. 13, setup step 3.

Question 48 of 50

Intraoperative procedures · CST-048

During a mastoid procedure through a small, deep incision, the surgeon wants the edges held open without anyone standing there holding a retractor. Which instrument fits?

A. A handheld retractor, held by the second scrub
B. A Weitlaner retractor
C. Metzenbaum scissors
D. A needle holder

Show answer and explanation

Correct answer: B. The Weitlaner is a self-retaining retractor with finger rings and a ratchet lock. Once opened and locked, it holds tissue back on its own. Its listed uses include small, deep incisions and mastoid surgery.

Why the other choices don't fit

A: A handheld retractor needs a person holding it, which is what the surgeon wants to avoid.
C: Metzenbaums cut and dissect tissue. They don't retract.
D: A needle holder grips suture needles, not wound edges.

Takeaway: Self-retaining retractors (like the Weitlaner) lock open and free up hands.

Source: Sklar, Weitlaner Retractor, product description. Cited for the instrument's design and intended use only.

Question 49 of 50

Intraoperative procedures · CST-049

For a spinal fusion, the surgeon harvests bone from the patient's own iliac crest. What kind of graft is this?

A. Autograft
B. Allograft
C. Xenograft
D. Synthetic graft

Show answer and explanation

Correct answer: A. An autograft uses the patient's own healthy bone.

Why the other choices don't fit

B: An allograft is donated bone from another person.
C: A xenograft comes from another species.
D: Synthetic substitutes aren't harvested from the patient.

Takeaway: Auto = self. Allo = another human.

Source: MedlinePlus, Bone graft, description.

Question 50 of 50

Intraoperative procedures · CST-050

Partway through a laparotomy, you're being permanently relieved by another CST. When should sponges and sharps be counted?

A. Only at skin closure
B. Only if the circulator also changes
C. Only if the surgeon asks for a count
D. At the change of CST, in addition to the scheduled counts

Show answer and explanation

Correct answer: D. AST's counts standard includes a count when the CST is permanently relieved, in addition to counts before incision, at closure of the first layer of a cavity, at fascia closure, and at skin closure.

Why the other choices don't fit

A: Skin closure is one of several scheduled counts, not the only one.
B: Permanent relief of either the circulator or the CST triggers a count.
C: Counts follow the standard and policy, not a request.

Takeaway: Permanent change of CST → count, in addition to scheduled counts.

Source: AST, Recommended Standard of Practice for Counts, Standards I.1.A–B and II.1.A–B.

Score your practice set

Count only the answers you picked before you opened their explanations or the answer key. If you answered all 50, your result is simply correct out of 50. If you skipped some, report it as correct out of the number you answered—and leave out any question where you peeked first.

Use the result to decide what to review, not to predict whether you'll pass. It isn't an NBSTSA score, and these 50 items aren't the exam's 150 scored questions. Some areas here have only two or three questions, so one answer can swing an area's result a lot.

Show the answer key

CST practice answer key
Question	Answer	Area	ID
1	A	Preoperative preparation	CST-001
2	B	Intraoperative procedures	CST-002
3	C	Equipment sterilization and maintenance	CST-003
4	D	Anatomy and physiology	CST-004
5	C	Preoperative preparation	CST-005
6	D	Postoperative procedures	CST-006
7	A	Preoperative preparation	CST-007
8	B	Intraoperative procedures	CST-008
9	C	Surgical pharmacology	CST-009
10	B	Equipment sterilization and maintenance	CST-010
11	C	Intraoperative procedures	CST-011
12	D	Administrative and personnel	CST-012
13	A	Preoperative preparation	CST-013
14	A	Intraoperative procedures	CST-014
15	C	Anatomy and physiology	CST-015
16	D	Preoperative preparation	CST-016
17	B	Microbiology	CST-017
18	A	Equipment sterilization and maintenance	CST-018
19	B	Intraoperative procedures	CST-019
20	C	Postoperative procedures	CST-020
21	D	Preoperative preparation	CST-021
22	A	Intraoperative procedures	CST-022
23	B	Anatomy and physiology	CST-023
24	D	Intraoperative procedures	CST-024
25	C	Administrative and personnel	CST-025
26	A	Intraoperative procedures	CST-026
27	B	Equipment sterilization and maintenance	CST-027
28	D	Preoperative preparation	CST-028
29	A	Intraoperative procedures	CST-029
30	C	Surgical pharmacology	CST-030
31	D	Intraoperative procedures	CST-031
32	B	Anatomy and physiology	CST-032
33	A	Intraoperative procedures	CST-033
34	C	Postoperative procedures	CST-034
35	D	Preoperative preparation	CST-035
36	B	Intraoperative procedures	CST-036
37	A	Equipment sterilization and maintenance	CST-037
38	C	Intraoperative procedures	CST-038
39	D	Microbiology	CST-039
40	B	Intraoperative procedures	CST-040
41	A	Anatomy and physiology	CST-041
42	C	Intraoperative procedures	CST-042
43	D	Equipment sterilization and maintenance	CST-043
44	B	Intraoperative procedures	CST-044
45	A	Intraoperative procedures	CST-045
46	C	Anatomy and physiology	CST-046
47	D	Preoperative preparation	CST-047
48	B	Intraoperative procedures	CST-048
49	A	Intraoperative procedures	CST-049
50	D	Intraoperative procedures	CST-050

Tally by area

Tally by area
Area	Questions	Your correct
Preoperative preparation	1, 5, 7, 13, 16, 21, 28, 35, 47 (9)	__ / 9
Intraoperative procedures	2, 8, 11, 14, 19, 22, 24, 26, 29, 31, 33, 36, 38, 40, 42, 44, 45, 48, 49, 50 (20)	__ / 20
Postoperative procedures	6, 20, 34 (3)	__ / 3
Administrative and personnel	12, 25 (2)	__ / 2
Equipment sterilization and maintenance	3, 10, 18, 27, 37, 43 (6)	__ / 6
Anatomy and physiology	4, 15, 23, 32, 41, 46 (6)	__ / 6
Microbiology	17, 39 (2)	__ / 2
Surgical pharmacology	9, 30 (2)	__ / 2

Turn misses into a review list

Go back through every question you missed and every one you got right but weren't sure about. For each, write the rule, structure or calculation you needed—not just the answer letter. Then retry those questions cold in a few days.

Turn misses into a review list
Question	Concept I missed	Why my choice didn't fit	What I'll review
Row label	Blank	Blank	Blank
Row label	Blank	Blank	Blank
Row label	Blank	Blank	Blank

What this CST practice test covers

The 50 questions cover selected topics in all eight outline areas. The three main-domain totals approximate the official distribution; the smaller area counts are not proportional replicas of the exam.

What this CST practice test covers
Area	Scored items on the exam	Questions in this set
I. Perioperative Care	97	32
A. Preoperative Preparation	19	9
B. Intraoperative Procedures	68	20
C. Postoperative Procedures	10	3
II. Ancillary Duties	23	8
A. Administrative and Personnel	7	2
B. Equipment Sterilization and Maintenance	16	6
III. Basic Science	30	10
A. Anatomy and Physiology	18	6
B. Microbiology	6	2
C. Surgical Pharmacology	6	2
Total	150	50

Exam counts come from NBSTSA's CST Examination Content Outline (effective 1/1/2023). Applying 50/150 to the three main-domain counts gives about 32.3, 7.7 and 10 questions; this set uses 32, 8 and 10. That doesn't make this a mini CST, and 50 questions can't touch every task in the outline. Small area tallies are feedback on these items, not precise readiness measurements.

How this compares with the real CST exam

How this compares with the real CST exam
Row label	This practice set	NBSTSA CST exam
Questions	50 practice questions; count only attempted items	175 multiple-choice: 150 scored, plus 25 unscored pretest questions you can't tell apart
Time	Untimed	4 hours. Breaks are allowed, but the clock keeps running
Passing	No pass mark—use it to find weak spots	98 correct out of the 150 scored questions
Content	Original, unofficial items across selected outline topics	NBSTSA's secure item bank, built to the same outline
Where	This page	PSI testing centers, by appointment; programs can also arrange on-campus group testing

Sources: 2025 CST Candidate Handbook, pp. 5–8 and 11; NBSTSA CST certification page (passing score).

The 98-correct standard applies to the official scored exam. It doesn't turn a percentage on these 50 questions into an equivalent result. For context: in 2025, 68.6% of 11,931 first-time CST candidates passed, according to NBSTSA's certification data.

Frequently asked questions

Is this an official NBSTSA practice test? No. These are original, unofficial Castleport Test Prep questions. NBSTSA's own five sample questions are on page 3 of the CST content outline. Its free CST Study Evaluation is a self-rating checklist by topic, not a scored test.

Are these copied from the real exam? No. NBSTSA's exam questions are copyrighted, and copying or sharing them can lead to denial or revocation of certification (Candidate Handbook, pp. 8–9). Everything here was written from scratch.

What practice score means I'm ready? There's no reliable conversion from this practice set to the real exam. Use your misses and shaky guesses to decide what to study.

How much does the CST cost, and can I retake it? The exam fee is $230 for AST members and $340 for everyone else; the $60 processing portion isn't refundable. NBSTSA permits a maximum of three total attempts per calendar year—not three additional retakes. After an unsuccessful attempt, there is no waiting period to submit a new application, but each attempt requires a new application and the full fee; authorization and appointment availability still govern the test date (Candidate Handbook, pp. 9 and 16–17). Once an application has been processed and the Authorization to Test issued, NBSTSA does not issue a refund.

What should I study after this? Start with your review list. Check those topics against the CST content outline and NBSTSA's reference list, which names the textbooks its item writers use.

Checking whether your state requires certification? See surgical technologist certification requirements by state. Comparing programs? See CST pass rates by surgical technology program.

Sources and editorial notes

Written by the Castleport Test Prep Editorial Team.

Last verified: October 15, 2026. We checked the exam format, time, passing score, content outline, fees, retake rule and historical pass-rate figure against NBSTSA's currently linked Candidate Handbook, content outline, website and certification data file. We checked each explanation against the source linked beside it. AI tools assisted with drafting, source checking and editing. No qualified clinical review of this version is documented. These questions teach general principles, not patient-specific instructions; actual care requires trained clinical judgment, applicable policies and product instructions.

Official NBSTSA sources

Sources used in the explanations

How we build and correct pages: methodology · editorial standards · corrections · independence

Castleport Test Prep is an independent exam prep publisher. It is not affiliated with, endorsed by, or approved by the National Board of Surgical Technology and Surgical Assisting (NBSTSA), the Association of Surgical Technologists (AST), or PSI. CST and other exam and credential names identify the exams discussed; trademarks belong to their respective owners. These practice questions are original and unofficial, and no score on them guarantees a passing result, certification, or permission to practice.