1
NBSTSA PSI CST EXAM REVIEW
ACTUAL 2026/2027 QUESTIONS AND
100% CORRECT ANSWERS.
Q1: The surgical technologist is preparing to transfer a patient from the ward bed to the OR
stretcher. Which action is the highest priority before initiating movement?
A. Raising the side rails on the stretcher
B. Verifying the patient's identity with two identifiers
C. Checking that the stretcher wheels are locked
D. Ensuring the patient has voided
Correct Answer: B
Rationale: Patient safety begins with correct identification using two unique identifiers per
Universal Protocol; this prevents wrong-patient surgery and must precede all other preoperative
actions.
Q2: During the surgical time-out, the circulating nurse states the patient's name, procedure, and
site. The surgical technologist notices the consent form lists a different procedure than what the
team is verbally confirming. What is the appropriate immediate action?
A. Proceed with the time-out and clarify the discrepancy after incision
B. Stop the time-out and notify the surgeon immediately
C. Ask the patient to confirm which procedure is correct
D. Document the discrepancy in the medical record and continue
Correct Answer: B
Rationale: Any discrepancy between the consent and the planned procedure is a "stop" event; the
time-out must be halted until the inconsistency is resolved to prevent wrong-site or wrong-
procedure surgery.
Q3: A patient with a known latex allergy is scheduled for a laparoscopic cholecystectomy. Which
supply consideration is most critical for the surgical technologist during room preparation?
A. Substituting powder-free gloves for powdered gloves
B. Removing all latex-containing products from the room and using latex-free alternatives
C. Applying a topical corticosteroid to the patient's skin preoperatively
D. Using only synthetic suture materials
Correct Answer: B
, 2
Rationale: True latex allergy requires a completely latex-free environment; simply switching glove
powder is insufficient, as latex is present in many OR items including gloves, drains, and
tourniquets.
Q4: The surgical technologist is performing a surgical hand scrub using an antimicrobial agent.
What is the minimum recommended duration for the scrub procedure?
A. 2 minutes
B. 3 minutes
C. 5 minutes
D. 10 minutes
Correct Answer: C
Rationale: A surgical hand scrub should last at least 5 minutes with an approved antimicrobial
agent to effectively reduce resident and transient skin flora to safe levels before gowning and
gloving.
Q5: A patient is scheduled for a total knee arthroplasty in the lateral position. Which
neurovascular structure is at greatest risk if padding is inadequate at the fibular head?
A. Tibial nerve
B. Common peroneal nerve
C. Saphenous nerve
D. Femoral nerve
Correct Answer: B
Rationale: The common peroneal (fibular) nerve wraps superficially around the fibular head;
compression in lateral positioning can cause foot drop and sensory deficits in the lower leg.
Q6: When preparing the patient's skin for a midline laparotomy, the surgical technologist notes
the patient has a healing abrasion near the intended incision site. How should this be managed?
A. Prep the abrasion vigorously to ensure it is clean
B. Apply an occlusive dressing over the abrasion and prep around it
C. Cancel the case until the abrasion is fully healed
D. Prep the area normally, as abrasions do not increase infection risk
Correct Answer: B
Rationale: An abrasion represents a break in skin integrity; it should be protected with an
occlusive dressing during prep to prevent further trauma and reduce the risk of introducing
pathogens into the wound.
Q7: The surgeon requests a Foley catheter insertion for a 4-hour urologic procedure. What is the
primary purpose of intraoperative urinary catheterization in this context?
A. To measure cardiac output indirectly
, 3
B. To decompress the bladder and monitor urine output
C. To administer intravesical chemotherapy
D. To prevent postoperative urinary retention only
Correct Answer: B
Rationale: Intraoperative Foley catheterization decompresses the bladder to improve surgical
exposure and provides continuous urine output monitoring, which is critical for assessing fluid
balance and perfusion during lengthy procedures.
Q8: During draping of a patient for a right inguinal hernia repair, the surgical technologist
observes that the bottom drape was placed below the intended fenestration level. What is the
correct response?
A. Adjust the drape upward to the correct position
B. Remove the contaminated drape and apply a new sterile drape
C. Cover the exposed area with an additional towel
D. Ask the circulator to pull the drape into position
Correct Answer: B
Rationale: Once a sterile drape is placed below the intended level and then moved upward, it is
considered contaminated; the correct action is to remove it and replace it with a new sterile drape
to maintain asepsis.
Q9: A morbidly obese patient is positioned supine for an open abdominal procedure. To reduce
the risk of postoperative respiratory complications, what positioning adjustment is most
appropriate?
A. Trendelenburg position
B. Reverse Trendelenburg position
C. Elevating the head and upper torso 10–15 degrees (ramp position)
D. Lateral decubitus position
Correct Answer: C
Rationale: Elevating the head and upper torso (ramp position) in obese patients reduces pressure
on the diaphragm from abdominal contents, improving ventilation and reducing atelectasis risk
during and after surgery.
Q10: The surgical technologist is verifying instrument sets for a craniotomy. Which instrument is
considered essential for this procedure?
A. Gigli saw
B. Lambotte osteotome
C. Hudson brace
D. Sternal saw
, 4
Correct Answer: C
Rationale: The Hudson brace is a specialized instrument used to create burr holes and remove
bone flaps during craniotomy procedures; the other instruments are designed for orthopedic or
sternal applications.
Q11: A patient with a history of malignant hyperthermia is scheduled for general anesthesia.
Which medication must be removed from the anesthesia cart and OR environment prior to
induction?
A. Propofol
B. Succinylcholine
C. Midazolam
D. Fentanyl
Correct Answer: B
Rationale: Succinylcholine, along with volatile anesthetics like halothane and sevoflurane, is a
known trigger for malignant hyperthermia; it must be eliminated from the environment to prevent
a potentially fatal hypermetabolic crisis.
Q12: The surgical technologist is applying an alcohol-based skin prep solution to the patient's
abdomen. What safety precaution is most important during application?
A. Allowing the solution to pool in the umbilicus for thorough disinfection
B. Applying the solution broadly beyond the intended incision site
C. Ensuring the solution is completely dry before draping to prevent fire risk
D. Warming the solution to 105°F for patient comfort
Correct Answer: C
Rationale: Alcohol-based prep solutions are flammable; ensuring complete drying before draping
and use of electrosurgical equipment is essential to prevent surgical fires, particularly near the
oxygen-rich surgical field.
Q13: During preoperative assessment, the surgical technologist notes the patient has a
pacemaker and the procedure requires use of monopolar electrosurgery. What is the most
appropriate action?
A. Place the electrosurgical dispersive pad directly over the pacemaker generator
B. Position the dispersive pad as close to the surgical site as possible and away from the
pacemaker
C. Use only bipolar electrosurgery and avoid monopolar entirely
D. Turn off the pacemaker during the procedure
Correct Answer: B
NBSTSA PSI CST EXAM REVIEW
ACTUAL 2026/2027 QUESTIONS AND
100% CORRECT ANSWERS.
Q1: The surgical technologist is preparing to transfer a patient from the ward bed to the OR
stretcher. Which action is the highest priority before initiating movement?
A. Raising the side rails on the stretcher
B. Verifying the patient's identity with two identifiers
C. Checking that the stretcher wheels are locked
D. Ensuring the patient has voided
Correct Answer: B
Rationale: Patient safety begins with correct identification using two unique identifiers per
Universal Protocol; this prevents wrong-patient surgery and must precede all other preoperative
actions.
Q2: During the surgical time-out, the circulating nurse states the patient's name, procedure, and
site. The surgical technologist notices the consent form lists a different procedure than what the
team is verbally confirming. What is the appropriate immediate action?
A. Proceed with the time-out and clarify the discrepancy after incision
B. Stop the time-out and notify the surgeon immediately
C. Ask the patient to confirm which procedure is correct
D. Document the discrepancy in the medical record and continue
Correct Answer: B
Rationale: Any discrepancy between the consent and the planned procedure is a "stop" event; the
time-out must be halted until the inconsistency is resolved to prevent wrong-site or wrong-
procedure surgery.
Q3: A patient with a known latex allergy is scheduled for a laparoscopic cholecystectomy. Which
supply consideration is most critical for the surgical technologist during room preparation?
A. Substituting powder-free gloves for powdered gloves
B. Removing all latex-containing products from the room and using latex-free alternatives
C. Applying a topical corticosteroid to the patient's skin preoperatively
D. Using only synthetic suture materials
Correct Answer: B
, 2
Rationale: True latex allergy requires a completely latex-free environment; simply switching glove
powder is insufficient, as latex is present in many OR items including gloves, drains, and
tourniquets.
Q4: The surgical technologist is performing a surgical hand scrub using an antimicrobial agent.
What is the minimum recommended duration for the scrub procedure?
A. 2 minutes
B. 3 minutes
C. 5 minutes
D. 10 minutes
Correct Answer: C
Rationale: A surgical hand scrub should last at least 5 minutes with an approved antimicrobial
agent to effectively reduce resident and transient skin flora to safe levels before gowning and
gloving.
Q5: A patient is scheduled for a total knee arthroplasty in the lateral position. Which
neurovascular structure is at greatest risk if padding is inadequate at the fibular head?
A. Tibial nerve
B. Common peroneal nerve
C. Saphenous nerve
D. Femoral nerve
Correct Answer: B
Rationale: The common peroneal (fibular) nerve wraps superficially around the fibular head;
compression in lateral positioning can cause foot drop and sensory deficits in the lower leg.
Q6: When preparing the patient's skin for a midline laparotomy, the surgical technologist notes
the patient has a healing abrasion near the intended incision site. How should this be managed?
A. Prep the abrasion vigorously to ensure it is clean
B. Apply an occlusive dressing over the abrasion and prep around it
C. Cancel the case until the abrasion is fully healed
D. Prep the area normally, as abrasions do not increase infection risk
Correct Answer: B
Rationale: An abrasion represents a break in skin integrity; it should be protected with an
occlusive dressing during prep to prevent further trauma and reduce the risk of introducing
pathogens into the wound.
Q7: The surgeon requests a Foley catheter insertion for a 4-hour urologic procedure. What is the
primary purpose of intraoperative urinary catheterization in this context?
A. To measure cardiac output indirectly
, 3
B. To decompress the bladder and monitor urine output
C. To administer intravesical chemotherapy
D. To prevent postoperative urinary retention only
Correct Answer: B
Rationale: Intraoperative Foley catheterization decompresses the bladder to improve surgical
exposure and provides continuous urine output monitoring, which is critical for assessing fluid
balance and perfusion during lengthy procedures.
Q8: During draping of a patient for a right inguinal hernia repair, the surgical technologist
observes that the bottom drape was placed below the intended fenestration level. What is the
correct response?
A. Adjust the drape upward to the correct position
B. Remove the contaminated drape and apply a new sterile drape
C. Cover the exposed area with an additional towel
D. Ask the circulator to pull the drape into position
Correct Answer: B
Rationale: Once a sterile drape is placed below the intended level and then moved upward, it is
considered contaminated; the correct action is to remove it and replace it with a new sterile drape
to maintain asepsis.
Q9: A morbidly obese patient is positioned supine for an open abdominal procedure. To reduce
the risk of postoperative respiratory complications, what positioning adjustment is most
appropriate?
A. Trendelenburg position
B. Reverse Trendelenburg position
C. Elevating the head and upper torso 10–15 degrees (ramp position)
D. Lateral decubitus position
Correct Answer: C
Rationale: Elevating the head and upper torso (ramp position) in obese patients reduces pressure
on the diaphragm from abdominal contents, improving ventilation and reducing atelectasis risk
during and after surgery.
Q10: The surgical technologist is verifying instrument sets for a craniotomy. Which instrument is
considered essential for this procedure?
A. Gigli saw
B. Lambotte osteotome
C. Hudson brace
D. Sternal saw
, 4
Correct Answer: C
Rationale: The Hudson brace is a specialized instrument used to create burr holes and remove
bone flaps during craniotomy procedures; the other instruments are designed for orthopedic or
sternal applications.
Q11: A patient with a history of malignant hyperthermia is scheduled for general anesthesia.
Which medication must be removed from the anesthesia cart and OR environment prior to
induction?
A. Propofol
B. Succinylcholine
C. Midazolam
D. Fentanyl
Correct Answer: B
Rationale: Succinylcholine, along with volatile anesthetics like halothane and sevoflurane, is a
known trigger for malignant hyperthermia; it must be eliminated from the environment to prevent
a potentially fatal hypermetabolic crisis.
Q12: The surgical technologist is applying an alcohol-based skin prep solution to the patient's
abdomen. What safety precaution is most important during application?
A. Allowing the solution to pool in the umbilicus for thorough disinfection
B. Applying the solution broadly beyond the intended incision site
C. Ensuring the solution is completely dry before draping to prevent fire risk
D. Warming the solution to 105°F for patient comfort
Correct Answer: C
Rationale: Alcohol-based prep solutions are flammable; ensuring complete drying before draping
and use of electrosurgical equipment is essential to prevent surgical fires, particularly near the
oxygen-rich surgical field.
Q13: During preoperative assessment, the surgical technologist notes the patient has a
pacemaker and the procedure requires use of monopolar electrosurgery. What is the most
appropriate action?
A. Place the electrosurgical dispersive pad directly over the pacemaker generator
B. Position the dispersive pad as close to the surgical site as possible and away from the
pacemaker
C. Use only bipolar electrosurgery and avoid monopolar entirely
D. Turn off the pacemaker during the procedure
Correct Answer: B
