NBSTSA CST Exam Prep: Free Study Guide and Practice Questions

Start this NBSTSA CST exam prep guide with 15 original, unofficial questions for the Certified Surgical Technologist examination, then use the study map and 6-week plan. This starter set is not a full-length exam or a pass predictor.

15 CST practice questions

What your result means

A score out of 15 is feedback on these 15 questions only. It isn't an NBSTSA score or a pass prediction, and these small subdomain samples are too limited to measure readiness in an area. The set is not weighted like the exam. Use your misses to choose where to start in the plan below, not to decide whether you're ready.

Where the 150 scored points come from

The NBSTSA content outline (effective January 1, 2023) sets how many scored questions come from each area. Intraoperative work alone is close to half the exam.

Perioperative Care = 97 questions (65%), Ancillary Duties = 23 (15%), Basic Science = 30 (20%). Shares are rounded independently; the eight subdomain percentages sum to 101% because of rounding. Source: NBSTSA CST certification page and CST content outline (PDF).

Two things shape how you study. First, the committee in NBSTSA's 2023 job analysis recommended a mostly application-level mix for Perioperative Care (71%) and a mostly recall-level mix for Basic Science (77%) (CST Job Analysis Report, Table 6). Those are committee recommendations, not an audit of every delivered exam form. So for intraop, don't just memorize names. Practice deciding what to do next. Second, the small areas still count. Twelve questions of micro and pharm is enough to matter on a 98-point pass line.

Your 6-week CST study plan

This plan assumes you've finished an accredited surgical technology program and can study five sessions a week, about an hour each. That is 30 hours across six weeks, not an NBSTSA requirement or a promise that 30 hours is enough. Treat this as a starting framework and stretch or shrink it to fit your exam date and your misses. The topic lists point back to your course materials and the full official outline; this page's starter set isn't a complete course.

Each one-hour session:

1. 10 minutes — recall. Without notes, explain the principle behind yesterday's misses.
2. 30 minutes — learn. Work one outline topic from your course textbook or an NBSTSA reference text.
3. 15 minutes — apply. Answer practice questions on that topic, or explain how you'd handle a changed scenario.
4. 5 minutes — log. Add every miss and every lucky guess to your error log.

Short on time (3 weeks): Week 1 = Intraoperative. Week 2 = Preoperative, Postoperative, and Ancillary Duties. Week 3 = Basic Science plus timed practice using the same resource rule above. You'll cover less ground, so put your error log ahead of anything new.

More time (10 weeks): Weeks 1–3 = Intraoperative. Week 4 = Preoperative and Postoperative. Week 5 = Ancillary Duties. Weeks 6–7 = Basic Science. Week 8 = mixed review and repair. Week 9 = timed practice using the same resource rule above. Week 10 = final repair and exam logistics.

Retaking: Start with your practice error log and any content-area feedback supplied with your official score report, not automatically with week 1. Map the gaps to the official outline, put your two weakest areas first, then rejoin the plan.

Your error log

Write down why you picked your answer, not just which letter was right. A correct guess goes in the log too.

In a later session, cover the answer and ask yourself two things: which fact makes the right answer fit, and which fact rules out the tempting wrong one.

Review the concepts behind the questions

Sterile barrier vs. indicators vs. cleaning

These three answer different questions.

CDC also notes that loads containing implants should be monitored with a biological indicator and, when feasible, held until the result is negative. Source: CDC, Sterilizing Practices.

Counts

AST's published counting standard (2006) has the CST and circulator count sponges and sharps audibly and visually:

• before the skin incision
• when closure of the peritoneum or the first layer of a cavity begins
• when fascial closure begins
• when skin closure begins

Instruments are counted before the incision and before the body cavity is closed. Additional items are counted when introduced; sponge and sharps counts also accompany permanent changes of the CST or circulator.

For the stable-patient scenario in Question 6, tell the surgeon and search the field and the room. AST's reconciliation procedure calls for an X-ray before closure and before the patient leaves the OR if the item still isn't found. Source: AST Standard of Practice for Counts. Your facility's policy sets the exact procedure.

Medications, solutions, and specimens on the field

Medications and solutions. If it isn't given right away, it gets labeled the moment it leaves its original container. That includes basins, cups, and syringes, even when it's the only drug on the field. In the Joint Commission's hospital standards, two qualified people verify the labels out loud and by sight when the preparer isn't the person administering the solution (2026 NPG.14.03.01, pp. 43–44).

Specimens. Match the handling to the test that was ordered. A frozen section goes out right away with no preservative. Confirm the requested examination and the laboratory's container and transport instructions before adding any fixative. Never pass a specimen off on a counted sponge (AST specimen standard).

Electrosurgery and surgical fire

Monopolar vs. bipolar. In the conventional setup described in Question 8, monopolar current travels through the patient to a separate return electrode. Bipolar current stays between the two forceps tips, so no separate pad is needed (AORN, circuit explanation).

Equipment compatibility. When using multiple electrosurgical units is unavoidable, follow the manufacturers' instructions, verify compatibility before use, and label accessories to match each generator. AORN's 2026 update also uses the term return electrode, reflecting its circuit function (AORN, 2026 update).

Fire triangle.

Let alcohol prep dry completely and remove alcohol-soaked towels before draping. Source: APSF, Surgical Fire Prevention: A Review.

Universal Protocol

There are three parts:

1. Pre-procedure verification
2. Site marking when required, with a documented alternative for specified exceptions
3. A time-out immediately before the incision, where the team agrees on at least the patient, the procedure, and the site

Any unresolved concern stops the start (The Joint Commission).

Surgical wound classification

Source: WHO SSI surveillance form, Box 3. Classify from the conditions described, not the name of the operation.

Pharmacology: MH and unit math

Malignant hyperthermia triggers: volatile inhaled anesthetics (desflurane, isoflurane, sevoflurane, and others) and succinylcholine. MHAUS lists local anesthetics, propofol, nitrous oxide, opioids, and nondepolarizing muscle relaxants as safe for MH-susceptible patients (MHAUS).

Percent to milligrams (worked example). This fictional example explicitly uses weight-in-volume percent, % w/v: grams of solute per 100 mL of final solution. So 1% w/v = 1 g/100 mL = 1,000 mg/100 mL = 10 mg/mL. Weight-in-weight and volume-in-volume percentages are different expressions (FDA, Strength Conversion in Drug Listing).

For 18 mL of that 1% w/v solution: 18 mL × 10 mg/mL = 180 mg of solute.

Write the units out, and they'll cancel and leave you with mg. This is a conversion drill only. It isn't a medication order, an injection instruction, or a safe-dose determination.

CST exam facts that affect how you study

Sources: NBSTSA CST page, content outline, 2025 Candidate Handbook.

What that means in practice:

• 98 of 150 is about 65.3% of the scored questions. You can miss up to 52 scored questions and still pass.
• You can't tell which questions are unscored, so treat every question as if it counts.
• Four hours for 175 questions is about 82 seconds each. Breaks are allowed whenever you want, but no time is added for them (Handbook, "Examination Restrictions").

NBSTSA's free preparation resources

Use these official resources to check the complete exam scope and organize the review you do here (NBSTSA, Preparing for the CST Exam).

• CST Study Evaluation (free PDF). Rate yourself 1–5 on each subdomain, then focus on anything you rated 3–5. Here 1 means very knowledgeable and 5 means not knowledgeable; this is self-rating, not a pass predictor.
• Content outline (PDF). The full task list for every subdomain, plus five official sample questions.
• Reference list (PDF). The references NBSTSA identifies for exam development. Use the list to cross-reference your existing course materials or library resources; it is not a requirement to own every listed text.

Test day, retakes, and pass rates

Confirm your applicable route with NBSTSA eligibility and use the official application process, which also links the examination-accommodation request. NBSTSA decides eligibility; this study guide does not.

• Scheduling. After NBSTSA approves your application, you get an Authorization to Test (ATT) email and schedule with PSI. Take the exam before the expiration date on your ATT; the handbook describes a 6-month eligibility period. You can reschedule once at no charge if you call PSI at least 48 hours ahead and keep the new date within that eligibility period.
• ID and arrival. Bring two current IDs, both bearing your current name and signature; one must have a current photo. The names must match your ATT. Check the handbook's acceptable-ID list. Arriving 15 minutes or more late means you aren't admitted and you lose your fees.
• Scores. If you test at a center as a post-graduate, you may get your score report on test day. Students who test on campus receive scores after completing graduation requirements and their school releases the results.
• Fees. $230 for AST members and $340 for everyone else. A $60 processing fee isn't refundable, and no refund is given once your ATT is issued.
• Retakes. You can test up to three times per calendar year. There's no waiting period before you reapply, but each attempt needs a new application and the full fee.

Sources: 2025 Candidate Handbook; NBSTSA eligibility; application process; On Test Day.

How many people pass? NBSTSA reported a national first-time pass rate of 68.6% among 11,931 first-time CST candidates in 2025, down from 71.8% among 9,823 in 2024 (NBSTSA certification data). These rounded historical rates are not your personal chance of passing; our CST pass rates by program research explains how to read them.

Need the credential for a job? National certification and state practice requirements are different questions. See surgical technologist certification requirements by state.

Sources and verification

Last verified October 15, 2026. We checked the exam format, passing score, content outline, fees, retake rules, test-day rules, and the reported 2025 and 2024 first-time pass-rate data against the official sources linked here, including the currently linked 2025 Candidate Handbook. The blueprint file is effective January 1, 2023; it is not a newly issued 2026 blueprint. We checked each practice-question principle against the source listed under that question.

Official NBSTSA sources

• CST certification overview
• CST content outline, effective January 1, 2023 (PDF)
• 2025 CST Candidate Handbook (PDF)
• Preparing for the CST Exam
• CST Study Evaluation (PDF)
• CST Reference List (PDF)
• CST Job Analysis Report, February 2023 (PDF)
• NBSTSA certification data (PDF)
• CST eligibility · Application process · On Test Day

Teaching sources

• CDC, Sterilizing Practices
• CDC, Summary Recommendations: cleaning and package integrity
• The Joint Commission, 2026 Hospital National Performance Goals: Universal Protocol, NPG.01.06.01–03, pp. 5–6
• The Joint Commission, 2026 Hospital National Performance Goals: medication/solution labeling, NPG.14.03.01, pp. 43–44
• AST Standard of Practice for Counts
• AST Standards for Handling and Care of Surgical Specimens
• AORN, Preparation for Electrosurgery: circuit explanation (2024)
• AORN, 2026 Guideline for the Safe Use of Surgical Energy Devices: author update
• OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030
• APSF, Surgical Fire Prevention: A Review
• NIDDK, The Urinary Tract & How It Works
• WHO SSI surveillance form (wound classes)
• MHAUS, Safe and Unsafe Anesthetics

• FDA, Strength Conversion in Drug Listing: w/v, w/w, and v/v definitions

By the Castleport Test Prep Editorial Team.

AI tools assisted with drafting, source checking, and consistency checks. This source-based editorial work is not a credentialed clinical review. See our Editorial Standards and Methodology.

Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). Exam and credential names are used to identify the exam; trademarks belong to their respective owners. Our practice questions are original, unofficial, and are not actual, recalled, or leaked exam questions. This guide doesn't replace your program's training or your facility's policies, and it doesn't guarantee a passing score, certification, or employment.