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CST Certified Surgical Technologist Exam
2026/2027 Actual Exam - 500 Questions with
Detailed Rationales | 100% Verified Graded
A+ Pass Guaranteed - A+ Graded
Section 1: Perioperative Fundamentals
Q1: A surgical technologist is preparing the operating room for a laparoscopic cholecystectomy.
The patient has a known allergy to latex. Which of the following actions should the technologist
take FIRST?
A. Use powder-free latex gloves to reduce airborne particles
B. Replace all latex-containing items in the room with non-latex alternatives [CORRECT]
C. Ask the patient if the allergy is a contact allergy or anaphylactic
D. Double-glove with latex gloves to provide an extra barrier
Correct Answer: B
Rationale: The primary safe action when a latex allergy is known is the complete removal and
substitution of all latex-containing products from the sterile field and environment. Using any
latex, even powder-free or double-gloved, poses an unacceptable risk of anaphylaxis. Asking the
patient about the severity is a nursing assessment action, not the first step for room preparation.
Q2: During the surgical time-out, which team member is responsible for verbally confirming the
patient's identity, procedure, and surgical site?
A. The circulating registered nurse
B. The attending surgeon
C. The entire surgical team simultaneously
D. The anesthesiologist [CORRECT]
Correct Answer: D
Rationale: While the entire team participates, the anesthesiologist or the circulating nurse
typically initiates the time-out by pausing, and the surgeon usually confirms the site, but standard
protocol dictates the anesthesiologist initiates the "hard stop" to confirm patient identity,
,2
procedure, and site before incision. The circulator confirms the consent board, but the
anesthesiologist's pause is the required catalyst. (Note: Institutional protocols may vary, but the
active pause/initiation is heavily associated with anesthesia in NBSTSA standards for patient
safety pauses).
Q3: The surgical technologist is transferring a sterile item to the scrubbed team member. The
item drops below waist level but is caught before hitting the floor. What is the correct action?
A. Hand the item to the scrubbed person since it never touched the floor
B. Discard the item or re-sterilize it [CORRECT]
C. Wipe the item with a sterile damp sponge and use it
D. Inspect the item closely for visible debris before passing it
Correct Answer: B
Rationale: Sterile items must never fall below waist level, as the area below the waist is
considered unsterile. Even if caught, the item has breached the sterile field boundaries and must
be discarded or reprocessed. Visual inspection or wiping does not restore sterility.
Q4: A patient is undergoing a right hernia repair. The circulating nurse places the patient in the
supine position. Where should the surgical technologist stand during the initial incision?
A. On the patient's left side, directly across from the surgeon
B. On the patient's right side, opposite the surgeon [CORRECT]
C. At the head of the bed behind the anesthesiologist
D. At the foot of the bed to pass instruments toward the surgeon
Correct Answer: B
Rationale: The surgical technologist should stand on the side opposite the surgeon to facilitate
direct, unobstructed passing of instruments. For a right-sided procedure, the surgeon typically
stands on the right, placing the technologist on the left side of the patient (which is the surgeon's
right as they face the patient).
Q5: Which of the following is the primary purpose of the surgical conscience?
A. To report colleagues who violate hospital policy to administration
,3
B. To strictly adhere to written policies regardless of patient outcome
C. To monitor one's own adherence to sterile technique even when unobserved [CORRECT]
D. To ensure the surgical technologist works faster than the surgeon's expectations
Correct Answer: C
Rationale: Surgical conscience is the inner voice that dictates strict adherence to principles of
asepsis and sterile technique at all times, especially when no one is watching. It is about self-
regulation and integrity, not policing others or prioritizing speed.
Q6: During an exploratory laparotomy, the surgeon asks for a sponge count. When should this
count occur?
A. Immediately before the patient is extubated
B. When the peritoneum is being closed [CORRECT]
C. After the skin incision is made
D. At the beginning of the case only
Correct Answer: B
Rationale: Initial counts are performed before the procedure begins, but subsequent counts must
occur before closure of a cavity (like the peritoneum), before fascial closure, and at skin closure.
Waiting until extubation is too late, as a retained sponge could be missed.
Q7: The circulating nurse opens a peel pouch onto the sterile field. The flaps are folded back.
Which flap should be opened FIRST?
A. The flap closest to the circulator
B. The flap farthest away from the circulator [CORRECT]
C. The left lateral flap
D. The right lateral flap
Correct Answer: B
Rationale: When opening a peel pouch, the flap farthest away from the circulator is opened first
to prevent the circulator's unsterile arm from reaching over the sterile field. The side flaps are
opened next, and the closest flap is opened last.
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Q8: A surgical technologist is setting up the back table and notices a puncture in the sterile drape.
What is the appropriate action?
A. Cover the hole with a sterile, self-adhesive patch [CORRECT]
B. Place a sterile towel over the hole temporarily
C. Ignore it if the puncture is on the extreme edge of the table
D. Tear the drape further to make it look uniform and cover it with a basin
Correct Answer: A
Rationale: A sterile barrier that has been compromised must be immediately repaired or replaced.
A sterile, self-adhesive patch is the standard and approved method to repair a small puncture on a
drape. A towel can shift, and ignoring it violates sterile technique.
Q9: The patient arrives in the OR suite. The surgical technologist notices the patient's ID band
says "John Doe" but the operative consent says "Jane Doe." What should the technologist do?
A. Proceed with the setup but alert the surgeon before incision
B. Stop the setup and immediately inform the circulating nurse [CORRECT]
C. Assume the circulator has already verified the patient and continue
D. Ask the patient directly if they are John or Jane
Correct Answer: B
Rationale: The surgical technologist must stop the preparation process immediately and alert the
circulating nurse of the discrepancy. Patient identification mismatches are critical safety failures
that must be resolved before the patient is prepped or draped.
Q10: Which of the following types of anesthesia is commonly used for a carpal tunnel release?
A. General endotracheal anesthesia
B. Local anesthesia with monitored anesthesia care (MAC) [CORRECT]
C. Spinal anesthesia
D. Epidural anesthesia
Correct Answer: B
CST Certified Surgical Technologist Exam
2026/2027 Actual Exam - 500 Questions with
Detailed Rationales | 100% Verified Graded
A+ Pass Guaranteed - A+ Graded
Section 1: Perioperative Fundamentals
Q1: A surgical technologist is preparing the operating room for a laparoscopic cholecystectomy.
The patient has a known allergy to latex. Which of the following actions should the technologist
take FIRST?
A. Use powder-free latex gloves to reduce airborne particles
B. Replace all latex-containing items in the room with non-latex alternatives [CORRECT]
C. Ask the patient if the allergy is a contact allergy or anaphylactic
D. Double-glove with latex gloves to provide an extra barrier
Correct Answer: B
Rationale: The primary safe action when a latex allergy is known is the complete removal and
substitution of all latex-containing products from the sterile field and environment. Using any
latex, even powder-free or double-gloved, poses an unacceptable risk of anaphylaxis. Asking the
patient about the severity is a nursing assessment action, not the first step for room preparation.
Q2: During the surgical time-out, which team member is responsible for verbally confirming the
patient's identity, procedure, and surgical site?
A. The circulating registered nurse
B. The attending surgeon
C. The entire surgical team simultaneously
D. The anesthesiologist [CORRECT]
Correct Answer: D
Rationale: While the entire team participates, the anesthesiologist or the circulating nurse
typically initiates the time-out by pausing, and the surgeon usually confirms the site, but standard
protocol dictates the anesthesiologist initiates the "hard stop" to confirm patient identity,
,2
procedure, and site before incision. The circulator confirms the consent board, but the
anesthesiologist's pause is the required catalyst. (Note: Institutional protocols may vary, but the
active pause/initiation is heavily associated with anesthesia in NBSTSA standards for patient
safety pauses).
Q3: The surgical technologist is transferring a sterile item to the scrubbed team member. The
item drops below waist level but is caught before hitting the floor. What is the correct action?
A. Hand the item to the scrubbed person since it never touched the floor
B. Discard the item or re-sterilize it [CORRECT]
C. Wipe the item with a sterile damp sponge and use it
D. Inspect the item closely for visible debris before passing it
Correct Answer: B
Rationale: Sterile items must never fall below waist level, as the area below the waist is
considered unsterile. Even if caught, the item has breached the sterile field boundaries and must
be discarded or reprocessed. Visual inspection or wiping does not restore sterility.
Q4: A patient is undergoing a right hernia repair. The circulating nurse places the patient in the
supine position. Where should the surgical technologist stand during the initial incision?
A. On the patient's left side, directly across from the surgeon
B. On the patient's right side, opposite the surgeon [CORRECT]
C. At the head of the bed behind the anesthesiologist
D. At the foot of the bed to pass instruments toward the surgeon
Correct Answer: B
Rationale: The surgical technologist should stand on the side opposite the surgeon to facilitate
direct, unobstructed passing of instruments. For a right-sided procedure, the surgeon typically
stands on the right, placing the technologist on the left side of the patient (which is the surgeon's
right as they face the patient).
Q5: Which of the following is the primary purpose of the surgical conscience?
A. To report colleagues who violate hospital policy to administration
,3
B. To strictly adhere to written policies regardless of patient outcome
C. To monitor one's own adherence to sterile technique even when unobserved [CORRECT]
D. To ensure the surgical technologist works faster than the surgeon's expectations
Correct Answer: C
Rationale: Surgical conscience is the inner voice that dictates strict adherence to principles of
asepsis and sterile technique at all times, especially when no one is watching. It is about self-
regulation and integrity, not policing others or prioritizing speed.
Q6: During an exploratory laparotomy, the surgeon asks for a sponge count. When should this
count occur?
A. Immediately before the patient is extubated
B. When the peritoneum is being closed [CORRECT]
C. After the skin incision is made
D. At the beginning of the case only
Correct Answer: B
Rationale: Initial counts are performed before the procedure begins, but subsequent counts must
occur before closure of a cavity (like the peritoneum), before fascial closure, and at skin closure.
Waiting until extubation is too late, as a retained sponge could be missed.
Q7: The circulating nurse opens a peel pouch onto the sterile field. The flaps are folded back.
Which flap should be opened FIRST?
A. The flap closest to the circulator
B. The flap farthest away from the circulator [CORRECT]
C. The left lateral flap
D. The right lateral flap
Correct Answer: B
Rationale: When opening a peel pouch, the flap farthest away from the circulator is opened first
to prevent the circulator's unsterile arm from reaching over the sterile field. The side flaps are
opened next, and the closest flap is opened last.
, 4
Q8: A surgical technologist is setting up the back table and notices a puncture in the sterile drape.
What is the appropriate action?
A. Cover the hole with a sterile, self-adhesive patch [CORRECT]
B. Place a sterile towel over the hole temporarily
C. Ignore it if the puncture is on the extreme edge of the table
D. Tear the drape further to make it look uniform and cover it with a basin
Correct Answer: A
Rationale: A sterile barrier that has been compromised must be immediately repaired or replaced.
A sterile, self-adhesive patch is the standard and approved method to repair a small puncture on a
drape. A towel can shift, and ignoring it violates sterile technique.
Q9: The patient arrives in the OR suite. The surgical technologist notices the patient's ID band
says "John Doe" but the operative consent says "Jane Doe." What should the technologist do?
A. Proceed with the setup but alert the surgeon before incision
B. Stop the setup and immediately inform the circulating nurse [CORRECT]
C. Assume the circulator has already verified the patient and continue
D. Ask the patient directly if they are John or Jane
Correct Answer: B
Rationale: The surgical technologist must stop the preparation process immediately and alert the
circulating nurse of the discrepancy. Patient identification mismatches are critical safety failures
that must be resolved before the patient is prepped or draped.
Q10: Which of the following types of anesthesia is commonly used for a carpal tunnel release?
A. General endotracheal anesthesia
B. Local anesthesia with monitored anesthesia care (MAC) [CORRECT]
C. Spinal anesthesia
D. Epidural anesthesia
Correct Answer: B
