1|Page
CST Certified Surgical Technologist
Exam Prep 2026 | 300 NBSTSA Practice
Questions with Answers & Rationales |
Surgical Technology Study Guide for
Sterile Processing, Instrumentation,
Anatomy & Patient Care | Pass Your CST
Board Exam with Confidence
Get ready for the NBSTSA Certified Surgical
Technologist (CST) exam with this focused study guide
featuring 300 high-yield practice questions covering
sterile technique, surgical instrumentation, anatomy,
pharmacology, patient positioning, and perioperative
care. Each question includes a verified correct answer
and a concise rationale to reinforce key concepts.
Updated for 2026 standards, this resource is ideal for
surgical technology students seeking to build confidence
and master exam content. Download instantly and take
the next step toward passing your CST board exam on
the first attempt.
,2|Page
1. A patient is scheduled for a laparoscopic cholecystectomy. After the surgeon
makes the initial incision, which of the following is the FIRST instrument passed
to establish pneumoperitoneum?
a) Veress needle
b) Hasson trocar
c) Umbilical clamp
d) Scalpel #10
a) Veress needle
Rationale: The Veress needle is used to insufflate the abdomen with CO2 to create
pneumoperitoneum before inserting the primary trocar. The Hasson trocar is used in an
open technique, not for initial insufflation.
2. Which of the following medical conditions is characterized by a decrease in
bone density, leading to an increased risk of fractures?
a) Osteomyelitis
b) Osteoporosis
c) Osteoarthritis
d) Osteogenesis imperfecta
b) Osteoporosis
Rationale: Osteoporosis literally means "porous bone." It is a metabolic bone disease
where bone resorption outpaces bone formation, decreasing bone mineral density.
3. The surgical technologist is preparing a back table. Which of the following
actions is MOST appropriate for maintaining the sterile field?
a) Placing items within 1 inch of the edge of the table
b) Placing items within 2 inches of the edge of the table
c) Placing items directly on the edge of the table for easy access
d) Placing items more than 2 inches away from the edge of the table
d) Placing items more than 2 inches away from the edge of the table
Rationale: The sterile field extends to 1 inch below the edge of the drape. Keeping items
at least 2 inches away from the edge ensures they are not accidentally contaminated
by contact with unsterile areas.
4. The "Z-track" injection technique is primarily used to:
a) Prevent subcutaneous injection of irritating medications
b) Ensure rapid absorption of the medication
c) Administer medication into the bone marrow
d) Reduce the risk of anaphylaxis
a) Prevent subcutaneous injection of irritating medications
Rationale: The Z-track technique displaces the skin and subcutaneous tissue before
injection. When the needle is withdrawn, the tissue layers seal the needle track,
preventing medication from leaking back into the subcutaneous tissue.
,3|Page
5. Which of the following positions places the patient supine with the legs
separated and the knees flexed?
a) Trendelenburg
b) Reverse Trendelenburg
c) Lithotomy
d) Kraske
c) Lithotomy
Rationale: The lithotomy position involves the patient lying supine with hips and knees
flexed and legs in stirrups. This position provides access to the perineal area for
gynecological and urological procedures.
6. The primary purpose of using a pneumatic tourniquet during extremity
surgery is to:
a) Prevent nerve damage
b) Reduce blood loss and provide a bloodless field
c) Increase venous return to the heart
d) Administer local anesthetic
b) Reduce blood loss and provide a bloodless field
Rationale: A pneumatic tourniquet is inflated to a pressure exceeding the patient's
systolic blood pressure, occluding arterial blood flow to the extremity. This creates a
bloodless surgical field.
7. Which of the following sutures is a natural, absorbable multifilament suture?
a) Polydioxanone (PDS)
b) Polyglactin 910 (Vicryl)
c) Surgical gut
d) Polypropylene (Prolene)
c) Surgical gut
Rationale: Surgical gut is a natural absorbable suture made from the submucosa of
sheep intestine or the serosa of beef intestine. It is digested by body enzymes.
8. The surgical technologist is counting sponges, sharps, and instruments.
When should the INITIAL count be performed?
a) Before the patient is brought into the room
b) Before the incision is made
c) Before closure of the fascia
d) Before closure of the skin
b) Before the incision is made
Rationale: The initial count is performed before the surgical incision to establish a
baseline for all items (sponges, sharps, and instruments) on the sterile field. This
ensures accuracy for subsequent counts.
9. What is the normal range for a patient's oxygen saturation (SpO2)?
a) 70-80%
, 4|Page
b) 85-90%
c) 95-100%
d) 80-85%
c) 95-100%
Rationale: Normal SpO2 in a healthy individual is between 95% and 100%. Values
below 90% indicate hypoxemia and require immediate intervention.
10. A patient is having a total knee arthroplasty. Which of the following
retractors is commonly used to retract the patella?
a) Richardson retractor
b) Army-Navy retractor
c) Senn retractor
d) Hohmann retractor
d) Hohmann retractor
Rationale: The Hohmann retractor is a sharp, curved retractor often used in orthopedic
surgery to retract bone and soft tissue, such as the patella, during a knee arthroplasty.
11. Which of the following is a sign of malignant hyperthermia?
a) Decreased body temperature
b) Decreased heart rate
c) Muscle rigidity and increased body temperature
d) Hypotension
c) Muscle rigidity and increased body temperature
Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic
agents. Classic signs include a rapid rise in body temperature and severe muscle
rigidity (masseter spasm).
12. The instrument used to grasp and hold tissue, often with teeth, is called
a(n):
a) Hemostat
b) Forceps
c) Needle holder
d) Scissor
b) Forceps
Rationale: Forceps are grasping instruments. They can be toothed (e.g., Adson) for
holding tissue securely or non-toothed (e.g., DeBakey) for grasping delicate tissue
without trauma.
13. What is the primary function of the surgical technologist during the "time
out" (surgical pause)?
a) To pass the scalpel to the surgeon
b) To actively participate and confirm patient, site, and procedure
c) To document the time of the incision
d) To adjust the OR lights
CST Certified Surgical Technologist
Exam Prep 2026 | 300 NBSTSA Practice
Questions with Answers & Rationales |
Surgical Technology Study Guide for
Sterile Processing, Instrumentation,
Anatomy & Patient Care | Pass Your CST
Board Exam with Confidence
Get ready for the NBSTSA Certified Surgical
Technologist (CST) exam with this focused study guide
featuring 300 high-yield practice questions covering
sterile technique, surgical instrumentation, anatomy,
pharmacology, patient positioning, and perioperative
care. Each question includes a verified correct answer
and a concise rationale to reinforce key concepts.
Updated for 2026 standards, this resource is ideal for
surgical technology students seeking to build confidence
and master exam content. Download instantly and take
the next step toward passing your CST board exam on
the first attempt.
,2|Page
1. A patient is scheduled for a laparoscopic cholecystectomy. After the surgeon
makes the initial incision, which of the following is the FIRST instrument passed
to establish pneumoperitoneum?
a) Veress needle
b) Hasson trocar
c) Umbilical clamp
d) Scalpel #10
a) Veress needle
Rationale: The Veress needle is used to insufflate the abdomen with CO2 to create
pneumoperitoneum before inserting the primary trocar. The Hasson trocar is used in an
open technique, not for initial insufflation.
2. Which of the following medical conditions is characterized by a decrease in
bone density, leading to an increased risk of fractures?
a) Osteomyelitis
b) Osteoporosis
c) Osteoarthritis
d) Osteogenesis imperfecta
b) Osteoporosis
Rationale: Osteoporosis literally means "porous bone." It is a metabolic bone disease
where bone resorption outpaces bone formation, decreasing bone mineral density.
3. The surgical technologist is preparing a back table. Which of the following
actions is MOST appropriate for maintaining the sterile field?
a) Placing items within 1 inch of the edge of the table
b) Placing items within 2 inches of the edge of the table
c) Placing items directly on the edge of the table for easy access
d) Placing items more than 2 inches away from the edge of the table
d) Placing items more than 2 inches away from the edge of the table
Rationale: The sterile field extends to 1 inch below the edge of the drape. Keeping items
at least 2 inches away from the edge ensures they are not accidentally contaminated
by contact with unsterile areas.
4. The "Z-track" injection technique is primarily used to:
a) Prevent subcutaneous injection of irritating medications
b) Ensure rapid absorption of the medication
c) Administer medication into the bone marrow
d) Reduce the risk of anaphylaxis
a) Prevent subcutaneous injection of irritating medications
Rationale: The Z-track technique displaces the skin and subcutaneous tissue before
injection. When the needle is withdrawn, the tissue layers seal the needle track,
preventing medication from leaking back into the subcutaneous tissue.
,3|Page
5. Which of the following positions places the patient supine with the legs
separated and the knees flexed?
a) Trendelenburg
b) Reverse Trendelenburg
c) Lithotomy
d) Kraske
c) Lithotomy
Rationale: The lithotomy position involves the patient lying supine with hips and knees
flexed and legs in stirrups. This position provides access to the perineal area for
gynecological and urological procedures.
6. The primary purpose of using a pneumatic tourniquet during extremity
surgery is to:
a) Prevent nerve damage
b) Reduce blood loss and provide a bloodless field
c) Increase venous return to the heart
d) Administer local anesthetic
b) Reduce blood loss and provide a bloodless field
Rationale: A pneumatic tourniquet is inflated to a pressure exceeding the patient's
systolic blood pressure, occluding arterial blood flow to the extremity. This creates a
bloodless surgical field.
7. Which of the following sutures is a natural, absorbable multifilament suture?
a) Polydioxanone (PDS)
b) Polyglactin 910 (Vicryl)
c) Surgical gut
d) Polypropylene (Prolene)
c) Surgical gut
Rationale: Surgical gut is a natural absorbable suture made from the submucosa of
sheep intestine or the serosa of beef intestine. It is digested by body enzymes.
8. The surgical technologist is counting sponges, sharps, and instruments.
When should the INITIAL count be performed?
a) Before the patient is brought into the room
b) Before the incision is made
c) Before closure of the fascia
d) Before closure of the skin
b) Before the incision is made
Rationale: The initial count is performed before the surgical incision to establish a
baseline for all items (sponges, sharps, and instruments) on the sterile field. This
ensures accuracy for subsequent counts.
9. What is the normal range for a patient's oxygen saturation (SpO2)?
a) 70-80%
, 4|Page
b) 85-90%
c) 95-100%
d) 80-85%
c) 95-100%
Rationale: Normal SpO2 in a healthy individual is between 95% and 100%. Values
below 90% indicate hypoxemia and require immediate intervention.
10. A patient is having a total knee arthroplasty. Which of the following
retractors is commonly used to retract the patella?
a) Richardson retractor
b) Army-Navy retractor
c) Senn retractor
d) Hohmann retractor
d) Hohmann retractor
Rationale: The Hohmann retractor is a sharp, curved retractor often used in orthopedic
surgery to retract bone and soft tissue, such as the patella, during a knee arthroplasty.
11. Which of the following is a sign of malignant hyperthermia?
a) Decreased body temperature
b) Decreased heart rate
c) Muscle rigidity and increased body temperature
d) Hypotension
c) Muscle rigidity and increased body temperature
Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic
agents. Classic signs include a rapid rise in body temperature and severe muscle
rigidity (masseter spasm).
12. The instrument used to grasp and hold tissue, often with teeth, is called
a(n):
a) Hemostat
b) Forceps
c) Needle holder
d) Scissor
b) Forceps
Rationale: Forceps are grasping instruments. They can be toothed (e.g., Adson) for
holding tissue securely or non-toothed (e.g., DeBakey) for grasping delicate tissue
without trauma.
13. What is the primary function of the surgical technologist during the "time
out" (surgical pause)?
a) To pass the scalpel to the surgeon
b) To actively participate and confirm patient, site, and procedure
c) To document the time of the incision
d) To adjust the OR lights
