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The NBSTSA PSI CST Exam is a comprehensive certification test for surgical
technologists. The exam consists of 175 multiple-choice questions, with 150
scored items and 25 unscored pretest questions. Candidates have 4 hours to
complete the exam. The content is distributed across three main domains:
Perioperative Care (65%), Ancillary Duties (15%), and Basic Science (20%).
To pass, candidates must correctly answer at least 98 of the 150 scored
questions. The exam covers aseptic technique, surgical procedures,
instrumentation, sterilization, anatomy, microbiology, and pharmacology.
1. The surgical technologist's primary responsibility during the preoperative phase
(before the patient enters the OR) is:
a) Administering anesthesia
b) Performing the surgical incision
c) Preparing the sterile field, arranging instruments, and ensuring all needed
supplies are available
d) Discharging the patient
Answer: c) Preparing the sterile field, arranging instruments, and ensuring all
needed supplies are available
Rationale: The surgical technologist (ST) prepares the sterile field, arranges
instruments on the back table and Mayo stand, counts sponges, needles, and
instruments, and ensures all supplies needed for the procedure are available.
Anesthesia (a) is administered by the anesthesia provider. The incision (b) is made
by the surgeon .
2. The surgical hand scrub should last for at least how long (using an alcohol-
based surgical hand rub or traditional scrub)?
a) 1-2 minutes for alcohol-based rub; 2-5 minutes for traditional scrub (per
manufacturer guidelines)
b) 2 minutes regardless of method
c) 5 minutes for alcohol-based rub; 1 minute for traditional scrub
, d) 10 minutes for both methods
Answer: a) 1-2 minutes for alcohol-based rub; 2-5 minutes for traditional scrub
(per manufacturer guidelines)
Rationale: The alcohol-based rub is typically applied for 1-2 minutes, while the
traditional scrub with antimicrobial soap takes 2-5 minutes depending on the
product. Hand hygiene is critical for reducing microbial flora. The goal is to render
the hands surgically clean, not sterile .
3. The surgical technologist should don a sterile gown and gloves before:
a) Opening sterile supplies
b) Assisting with patient transfer to the OR table
c) Performing the surgical prep
d) Arranging the sterile field
Answer: d) Arranging the sterile field
Rationale: The ST dons gown and gloves to establish the sterile field and handle
sterile items. Opening supplies (a) is done before gloving. Assisting with patient
transfer (b) is a non-sterile task. The surgical prep (c) is done by the circulator and
surgeon.
4. When gowning and gloving another team member, the ST should:
a) Touch only the inside of the gown
b) Hand the gown to the surgeon to self-don
c) Touch only the outside of the gown
d) Let the surgeon gown themselves without assistance
Answer: a) Touch only the inside of the gown
Rationale: The ST should handle the gown by touching only the inside to
maintain sterility .
5. The purpose of the "count" in surgery is to:
a) Count the number of procedures performed in the OR
b) Count the number of staff in the OR
c) Prevent retained foreign objects (sponges, needles, instruments) in the patient
d) Count surgical supplies for inventory
Answer: c) Prevent retained foreign objects (sponges, needles, instruments) in
the patient
Rationale: The primary purpose of the surgical count is patient safety. It ensures
that all sponges, sharps, and instruments used during the procedure are accounted
for before the patient is closed .
6. Counts should be performed at which times?
, a) Only at the end of the procedure
b) Before the procedure begins, before closure of a cavity, before skin closure,
and after skin closure
c) Before the procedure begins and after skin closure
d) Only before closing a cavity
Answer: b) Before the procedure begins, before closure of a cavity, before skin
closure, and after skin closure
Rationale: Standard of care requires counts at four critical times: initial count,
before closure of a cavity, before skin closure, and after skin closure .
7. If there is a discrepancy in the count, the surgical team should:
a) Ignore the discrepancy
b) Close the incision and document the discrepancy after closing
c) Immediately inform the surgeon and delay closure until the missing item is
located
d) Continue the surgery as planned
Answer: c) Immediately inform the surgeon and delay closure until the missing
item is located
Rationale: A count discrepancy is a serious patient safety event. The surgeon
must be notified and closure delayed until the missing item is found .
8. The "back table" is used for:
a) Positioning the patient
b) Storing non-sterile supplies
c) Holding sterile instruments and supplies for the surgical procedure
d) Placing used instruments during surgery
Answer: c) Holding sterile instruments and supplies for the surgical procedure
Rationale: The back table is the central sterile work area for the ST. It is used to
organize and hold all sterile instruments and supplies needed for the case.
9. The "Mayo stand" is primarily used for:
a) Positioning the patient's arm
b) Holding the instruments the surgeon is currently using
c) Storing large equipment
d) Placing the patient's chart
Answer: b) Holding the instruments the surgeon is currently using
Rationale: The Mayo stand is placed over the patient's lower abdomen/legs to
hold the immediate-use instruments for the surgeon.
10. What is the correct method for opening a sterile package?
, a) Open away from your body starting with the top flap
b) Open towards your body starting with the top flap
c) Open the bottom flap first
d) Open all flaps at once
Answer: a) Open away from your body starting with the top flap
Rationale: Open the top flap away from you, then the side flaps, then the bottom
flap towards you to maintain sterility.
11. The sterile field is considered contaminated if:
a) It is above waist level
b) A non-sterile person reaches over it
c) A sterile person turns their back to the field
d) All of the above
Answer: d) All of the above
Rationale: The sterile field is maintained by specific rules. Items below the waist
or above the shoulders are non-sterile. Non-sterile personnel reaching over it and
sterile personnel turning their back to the field can also contaminate it.
12. The surgical technologist should prepare the sterile field:
a) After the patient is anesthetized and positioned
b) At the end of the procedure
c) During the surgical prep
d) Before the patient enters the OR
Answer: a) After the patient is anesthetized and positioned
Rationale: The field is set up after the patient is brought into the OR,
anesthetized, and positioned, to prevent contamination from patient movement.
13. A "basin set" typically includes:
a) A variety of scissors and forceps
b) Retractors and clamps
c) A basin, sponge sticks, and a medicine cup
d) Orthopedic instruments
Answer: c) A basin, sponge sticks, and a medicine cup
Rationale: The basin set is a basic sterile setup for procedures like prep and
minor surgeries. It provides the necessary bowls and handling instruments.
14. "Laparotomy sponges" are also known as:
a) Ray-Tec sponges
b) Kittner sponges
c) Lap pads