The Surgical Technologist Exam with correct
answers and rationale graded A+
Section 1: Preoperative Preparation
1. Which of the following is the primary purpose of a preoperative skin prep?
A. Remove all hair from the surgical site
B. Reduce microbial count on the skin surface
C. Sterilize the skin completely
D. Improve adhesion of surgical drapes
Answer: B
Rationale: The goal of surgical skin preparation is to reduce the microbial count on the skin to as low
a level as possible, not to sterilize the skin completely (which is impossible without damaging tissue).
Hair removal, when necessary, should be done with clippers rather than razors to avoid micro-
abrasions. The prep solution must remain in contact with the skin for the manufacturer's specified
time to achieve maximum antimicrobial effect -15.
2. A surgical technologist is preparing the OR for a pediatric tonsillectomy. Which size knife blade
should be assembled on the handle?
A. #10
B. #11
C. #12
D. #15
Answer: C
Rationale: The #12 blade is specifically designed for tonsillectomy procedures. It has a curved cutting
edge that facilitates the dissection of tonsillar tissue. The #10 blade is used for general skin incisions,
the #11 blade is for sharp puncture incisions (such as abscess drainage), and the #15 blade is used
for fine dissection on small structures -9.
3. Which of the following positions is optimal for a hysterectomy?
A. Supine
B. Trendelenburg
C. Reverse Trendelenburg
D. Lateral
Answer: B
Rationale: The Trendelenburg position (head down, feet elevated) uses gravity to displace the
abdominal contents cephalad, providing optimal visualization of the pelvic organs during
hysterectomy. This position also reduces the need for extensive retraction. Supine is used for most
,general abdominal procedures, reverse Trendelenburg for upper abdominal and biliary procedures,
and lateral for renal and hip procedures -16.
4. Which of the following is the correct order for donning sterile attire?
A. Gown, then gloves
B. Gloves, then gown
C. Mask, then gown
D. Gloves, then mask
Answer: A
Rationale: When donning sterile attire, the surgical technologist first dons the sterile gown (with
assistance from a circulating nurse at the back ties), then performs the closed-gloving technique.
This sequence maintains sterility throughout the process. The mask is applied before entering the
OR, prior to the sterile gowning procedure.
5. A patient is scheduled for a laparoscopic cholecystectomy. Which of the following equipment is
essential to have available?
A. CUSA
B. CO2 insufflator
C. Cryotherapy unit
D. Nd:YAG laser
Answer: B
Rationale: Laparoscopic procedures require carbon dioxide (CO2) insufflation to create
pneumoperitoneum, lifting the abdominal wall away from the organs to create working space. The
CO2 insufflator controls gas flow and maintains intra-abdominal pressure. The CUSA (Cavitron
Ultrasonic Surgical Aspirator) is used for hepatic resections, cryotherapy for tumor ablation, and
Nd:YAG laser for specific urologic and gynecologic procedures -15.
6. Which of the following describes a clean-contaminated wound?
A. A surgical wound made under aseptic conditions without entry into the respiratory, alimentary, or
genitourinary tracts
B. A surgical wound that enters the respiratory, alimentary, or genitourinary tract under controlled
conditions without unusual contamination
C. A wound with acute nonpurulent inflammation
D. A wound with existing clinical infection or perforated viscera
Answer: B
Rationale: The wound classification system has four categories: Class I (Clean)—no entry into the
tracts; Class II (Clean-Contaminated)—controlled entry into the respiratory, alimentary, or
genitourinary tracts; Class III (Contaminated)—acute nonpurulent inflammation or major break in
,sterile technique; Class IV (Dirty/Infected)—existing clinical infection or perforated viscera. A
bronchoscopy is classified as clean-contaminated -16.
7. Which of the following must be verified during the surgical timeout?
A. Patient's favorite food
B. Patient identity, procedure, and site
C. Surgeon's golf handicap
D. Anesthesia provider's preference
Answer: B
Rationale: The surgical timeout is a universal protocol requirement to prevent wrong-site, wrong-
procedure, and wrong-patient surgery. The team must verify patient identity, the exact procedure to
be performed, the correct surgical site (with marking when applicable), patient allergies, and other
critical information. This occurs immediately before the incision is made.
8. Which of the following is the appropriate method for transporting a sterile instrument tray?
A. Hold the tray close to the body
B. Hold the tray below waist level
C. Hold the tray above waist level, close to the body
D. Hold the tray at arm's length
Answer: C
Rationale: Sterile trays should be held above waist level and close to the body to maintain the sterile
field. Items below waist level are considered contaminated. Holding the tray close to the body
minimizes exposure to potential contaminants in the air and prevents accidental contact with non-
sterile objects.
9. Which of the following medications is typically administered preoperatively to reduce gastric
acidity?
A. Heparin
B. Sodium citrate
C. Mannitol
D. Vitamin K
Answer: B
Rationale: Sodium citrate (Bicitra) is a non-particulate antacid administered preoperatively to
neutralize gastric acid and reduce the risk of aspiration pneumonitis (Mendelson's syndrome) during
induction of anesthesia. Heparin is an anticoagulant, mannitol is an osmotic diuretic, and vitamin K is
used to reverse warfarin anticoagulation -5.
10. Which of the following is a non-adherent dressing?
, A. Adaptic
B. ABD pad
C. Kerlix
D. Coban
Answer: A
Rationale: Adaptic is a non-adherent dressing designed to prevent sticking to the wound surface,
making dressing changes less painful and preventing disruption of healing tissue. ABD pads (ABD =
abdominal) are absorbent dressings, Kerlix is a gauze wrap, and Coban is a self-adherent elastic
wrap -16.
Section 2: Intraoperative Procedures
11. During a cholecystectomy, which structures are ligated and divided?
A. Hepatic artery and hepatic duct
B. Cystic artery and cystic duct
C. Common bile duct and pancreatic duct
D. Portal vein and common hepatic duct
Answer: B
Rationale: The cystic artery and cystic duct are the two structures that must be identified, ligated,
and divided during a cholecystectomy. These are found in the Triangle of Calot, bounded by the
cystic duct, common hepatic duct, and inferior edge of the liver. The hepatic artery and hepatic duct
are preserved, as are the common bile duct and pancreatic duct -14.
12. Which of the following instruments is used for common bile duct exploration?
A. Fogarty clamp
B. Randall forceps
C. Pennington clamp
D. Forester ring forceps
Answer: B
Rationale: Randall forceps are specifically designed for common bile duct exploration to retrieve
stones. They have a curved, fenestrated jaw that allows grasping stones without crushing them. The
Fogarty clamp is used for vascular procedures, Pennington clamps for grasping tissue, and Forester
ring forceps for grasping sponges -14.
13. A #12 knife blade on a #7 handle is MOST commonly used for which type of surgery?
A. Gastrectomy
B. Hysterectomy
C. Adenoidectomy
D. Tonsillectomy
answers and rationale graded A+
Section 1: Preoperative Preparation
1. Which of the following is the primary purpose of a preoperative skin prep?
A. Remove all hair from the surgical site
B. Reduce microbial count on the skin surface
C. Sterilize the skin completely
D. Improve adhesion of surgical drapes
Answer: B
Rationale: The goal of surgical skin preparation is to reduce the microbial count on the skin to as low
a level as possible, not to sterilize the skin completely (which is impossible without damaging tissue).
Hair removal, when necessary, should be done with clippers rather than razors to avoid micro-
abrasions. The prep solution must remain in contact with the skin for the manufacturer's specified
time to achieve maximum antimicrobial effect -15.
2. A surgical technologist is preparing the OR for a pediatric tonsillectomy. Which size knife blade
should be assembled on the handle?
A. #10
B. #11
C. #12
D. #15
Answer: C
Rationale: The #12 blade is specifically designed for tonsillectomy procedures. It has a curved cutting
edge that facilitates the dissection of tonsillar tissue. The #10 blade is used for general skin incisions,
the #11 blade is for sharp puncture incisions (such as abscess drainage), and the #15 blade is used
for fine dissection on small structures -9.
3. Which of the following positions is optimal for a hysterectomy?
A. Supine
B. Trendelenburg
C. Reverse Trendelenburg
D. Lateral
Answer: B
Rationale: The Trendelenburg position (head down, feet elevated) uses gravity to displace the
abdominal contents cephalad, providing optimal visualization of the pelvic organs during
hysterectomy. This position also reduces the need for extensive retraction. Supine is used for most
,general abdominal procedures, reverse Trendelenburg for upper abdominal and biliary procedures,
and lateral for renal and hip procedures -16.
4. Which of the following is the correct order for donning sterile attire?
A. Gown, then gloves
B. Gloves, then gown
C. Mask, then gown
D. Gloves, then mask
Answer: A
Rationale: When donning sterile attire, the surgical technologist first dons the sterile gown (with
assistance from a circulating nurse at the back ties), then performs the closed-gloving technique.
This sequence maintains sterility throughout the process. The mask is applied before entering the
OR, prior to the sterile gowning procedure.
5. A patient is scheduled for a laparoscopic cholecystectomy. Which of the following equipment is
essential to have available?
A. CUSA
B. CO2 insufflator
C. Cryotherapy unit
D. Nd:YAG laser
Answer: B
Rationale: Laparoscopic procedures require carbon dioxide (CO2) insufflation to create
pneumoperitoneum, lifting the abdominal wall away from the organs to create working space. The
CO2 insufflator controls gas flow and maintains intra-abdominal pressure. The CUSA (Cavitron
Ultrasonic Surgical Aspirator) is used for hepatic resections, cryotherapy for tumor ablation, and
Nd:YAG laser for specific urologic and gynecologic procedures -15.
6. Which of the following describes a clean-contaminated wound?
A. A surgical wound made under aseptic conditions without entry into the respiratory, alimentary, or
genitourinary tracts
B. A surgical wound that enters the respiratory, alimentary, or genitourinary tract under controlled
conditions without unusual contamination
C. A wound with acute nonpurulent inflammation
D. A wound with existing clinical infection or perforated viscera
Answer: B
Rationale: The wound classification system has four categories: Class I (Clean)—no entry into the
tracts; Class II (Clean-Contaminated)—controlled entry into the respiratory, alimentary, or
genitourinary tracts; Class III (Contaminated)—acute nonpurulent inflammation or major break in
,sterile technique; Class IV (Dirty/Infected)—existing clinical infection or perforated viscera. A
bronchoscopy is classified as clean-contaminated -16.
7. Which of the following must be verified during the surgical timeout?
A. Patient's favorite food
B. Patient identity, procedure, and site
C. Surgeon's golf handicap
D. Anesthesia provider's preference
Answer: B
Rationale: The surgical timeout is a universal protocol requirement to prevent wrong-site, wrong-
procedure, and wrong-patient surgery. The team must verify patient identity, the exact procedure to
be performed, the correct surgical site (with marking when applicable), patient allergies, and other
critical information. This occurs immediately before the incision is made.
8. Which of the following is the appropriate method for transporting a sterile instrument tray?
A. Hold the tray close to the body
B. Hold the tray below waist level
C. Hold the tray above waist level, close to the body
D. Hold the tray at arm's length
Answer: C
Rationale: Sterile trays should be held above waist level and close to the body to maintain the sterile
field. Items below waist level are considered contaminated. Holding the tray close to the body
minimizes exposure to potential contaminants in the air and prevents accidental contact with non-
sterile objects.
9. Which of the following medications is typically administered preoperatively to reduce gastric
acidity?
A. Heparin
B. Sodium citrate
C. Mannitol
D. Vitamin K
Answer: B
Rationale: Sodium citrate (Bicitra) is a non-particulate antacid administered preoperatively to
neutralize gastric acid and reduce the risk of aspiration pneumonitis (Mendelson's syndrome) during
induction of anesthesia. Heparin is an anticoagulant, mannitol is an osmotic diuretic, and vitamin K is
used to reverse warfarin anticoagulation -5.
10. Which of the following is a non-adherent dressing?
, A. Adaptic
B. ABD pad
C. Kerlix
D. Coban
Answer: A
Rationale: Adaptic is a non-adherent dressing designed to prevent sticking to the wound surface,
making dressing changes less painful and preventing disruption of healing tissue. ABD pads (ABD =
abdominal) are absorbent dressings, Kerlix is a gauze wrap, and Coban is a self-adherent elastic
wrap -16.
Section 2: Intraoperative Procedures
11. During a cholecystectomy, which structures are ligated and divided?
A. Hepatic artery and hepatic duct
B. Cystic artery and cystic duct
C. Common bile duct and pancreatic duct
D. Portal vein and common hepatic duct
Answer: B
Rationale: The cystic artery and cystic duct are the two structures that must be identified, ligated,
and divided during a cholecystectomy. These are found in the Triangle of Calot, bounded by the
cystic duct, common hepatic duct, and inferior edge of the liver. The hepatic artery and hepatic duct
are preserved, as are the common bile duct and pancreatic duct -14.
12. Which of the following instruments is used for common bile duct exploration?
A. Fogarty clamp
B. Randall forceps
C. Pennington clamp
D. Forester ring forceps
Answer: B
Rationale: Randall forceps are specifically designed for common bile duct exploration to retrieve
stones. They have a curved, fenestrated jaw that allows grasping stones without crushing them. The
Fogarty clamp is used for vascular procedures, Pennington clamps for grasping tissue, and Forester
ring forceps for grasping sponges -14.
13. A #12 knife blade on a #7 handle is MOST commonly used for which type of surgery?
A. Gastrectomy
B. Hysterectomy
C. Adenoidectomy
D. Tonsillectomy
