2026 CST–CERTIFIED SURGICAL TECHNOLOGIST
NBSTSA CERTIFICATION EXAM COMPREHENSIVE
QUESTIONS AND ANSWERS|2 VERSIONS||ACTUAL
&As|GRADED A+ — 370 Questions and Answers Already
Graded A+ Premium Exam Tested And Verified
Subject Area Surgical Technology
Description This comprehensive exam covers core surgical technology concepts including
aseptic technique, surgical procedures, instrumentation, pharmacology, and
perioperative patient care, aligned with NBSTSA CST certification standards for
2026.
Expected Grade A+
Total Questions 370
Duration 3 hours
Learning Outcomes 1. Apply principles of sterile technique and infection prevention in the operating
room.
2. Identify and troubleshoot surgical instrumentation and equipment malfunctions.
3. Integrate knowledge of surgical anatomy and physiology to anticipate surgeon
needs.
4. Demonstrate proficiency in perioperative patient care and safety protocols.
Accreditation Accredited by the National Board of Surgical Technology and Surgical Assisting
(NBSTSA) and compliant with Association of Surgical Technologists (AST)
standards.
Page 1
,1. During a laparoscopic cholecystectomy, the surgeon requests a cholangiogram.
The surgical technologist should prepare all of the following EXCEPT:
A. A 22-gauge spinal needle for contrast injection
B. A 0.035-inch J-tip guidewire for biliary access
C. A 5-Fr ureteral catheter for cystic duct cannulation
D. A 10-mL syringe filled with saline for flushing
Answer: A. A 22-gauge spinal needle for contrast injection
A cholangiogram typically uses a small catheter (e.g., 5-Fr ureteral catheter) to
cannulate the cystic duct, not a spinal needle. A J-tip guidewire may be used if the
catheter needs to be advanced, and saline flushing is standard. The spinal needle is not
appropriate for contrast injection into the biliary tree.
2. Which of the following best explains the rationale for using a closed-wound
suction drain (e.g., Jackson-Pratt) after a radical mastectomy?
A. To prevent seroma formation by evacuating fluid and promoting flap adherence
B. To provide a portal for postoperative irrigation of the wound bed
C. To monitor for anastomotic leak by analyzing drain output color
D. To reduce dead space and prevent hematoma by applying negative pressure
Answer: A. To prevent seroma formation by evacuating fluid and promoting flap
adherence
The primary purpose of a closed-wound suction drain after mastectomy is to prevent
seroma by evacuating lymph fluid and promoting skin flap adherence to the chest wall.
Option D is partially correct but seroma prevention is the key goal. Irrigation (B) is not
standard. Anastomotic leak monitoring (C) applies to gastrointestinal surgeries, not
mastectomy.
Page 2
,3. A patient undergoing a right hemicolectomy has a history of anaphylaxis to
cefazolin. The surgeon orders a preoperative dose of clindamycin 900 mg IV. The
surgical technologist knows that clindamycin is effective against which of the
following pathogens commonly encountered in colorectal surgery?
A. Escherichia coli and Bacteroides fragilis
B. Bacteroides fragilis and Clostridium difficile
C. Staphylococcus aureus and Streptococcus pyogenes
D. Pseudomonas aeruginosa and Enterococcus faecalis
Answer: B. Bacteroides fragilis and Clostridium difficile
Clindamycin has excellent activity against anaerobic bacteria such as Bacteroides
fragilis and also covers many gram-positive cocci including Staphylococcus and
Streptococcus, but it does not cover aerobic gram-negative rods like E. coli. In
colorectal surgery, the main concern is anaerobes (B. fragilis) and gram-negative
aerobes (E. coli); however, clindamycin is often combined with an aminoglycoside or
aztreonam for gram-negative coverage. Option B correctly identifies its anaerobic and
Clostridium coverage.
4. During a total knee arthroplasty, the surgical technologist notices that the bone
cement (polymethylmethacrylate, PMMA) has a doughy consistency. Which stage of
polymerization does this indicate, and what is the appropriate action?
A. Dough stage; the cement should be applied immediately to the bone surface
B. Curing stage; the cement should be discarded as it has passed the working time
C. Dough stage; the cement should be kneaded further to reduce porosity
D. Curing stage; the cement should be applied rapidly before it hardens
Answer: A. Dough stage; the cement should be applied immediately to the bone
surface
The dough stage is the optimal working phase for PMMA application. At this stage, the
cement is no longer sticky and can be molded without adhering to gloves. It should be
applied to the bone surface promptly. The curing stage is later when the cement
hardens and is no longer workable. Kneading further (C) is unnecessary and may
introduce air bubbles.
Page 3
, 5. The surgical technologist is setting up for a robotic-assisted prostatectomy. Which
of the following best describes the primary role of the surgical technologist during
the docking phase?
A. Directing the surgical team to position the patient in steep Trendelenburg
B. Ensuring that the robotic arms are sterilely draped and positioned over the patient
C. Calibrating the robotic console and foot pedals for the surgeon
D. Inserting the Veress needle for pneumoperitoneum establishment
Answer: B. Ensuring that the robotic arms are sterilely draped and positioned over
the patient
During docking, the surgical technologist's primary responsibility is to assist in sterilely
draping the robotic arms and positioning them over the patient's sterile field. Option A
is the responsibility of the circulating nurse and surgeon. Option C is done by the
surgeon or assistant. Option D occurs earlier during access.
6. A patient with a history of malignant hyperthermia (MH) is scheduled for an open
reduction and internal fixation of a femur fracture. Which of the following
anesthesia-related precautions is most critical for the surgical technologist to verify?
A. The anesthesia machine has been flushed with 10 L/min of oxygen for 20 minutes
B. Dantrolene sodium is available in the operating room at a dose of 2.5 mg/kg
C. The vaporizers for sevoflurane and desflurane have been removed from the machine
D. A cooling blanket and ice packs are ready for immediate use
Answer: C. The vaporizers for sevoflurane and desflurane have been removed
from the machine
For an MH-susceptible patient, the most critical precaution is to remove all volatile
anesthetic agents (e.g., sevoflurane, desflurane) from the anesthesia machine, as they
can trigger MH. Flushing the machine (A) is also important but removal of vaporizers
is definitive. Dantrolene (B) should be available but is a treatment, not prevention.
Cooling measures (D) are supportive but not primary.
Page 4
NBSTSA CERTIFICATION EXAM COMPREHENSIVE
QUESTIONS AND ANSWERS|2 VERSIONS||ACTUAL
&As|GRADED A+ — 370 Questions and Answers Already
Graded A+ Premium Exam Tested And Verified
Subject Area Surgical Technology
Description This comprehensive exam covers core surgical technology concepts including
aseptic technique, surgical procedures, instrumentation, pharmacology, and
perioperative patient care, aligned with NBSTSA CST certification standards for
2026.
Expected Grade A+
Total Questions 370
Duration 3 hours
Learning Outcomes 1. Apply principles of sterile technique and infection prevention in the operating
room.
2. Identify and troubleshoot surgical instrumentation and equipment malfunctions.
3. Integrate knowledge of surgical anatomy and physiology to anticipate surgeon
needs.
4. Demonstrate proficiency in perioperative patient care and safety protocols.
Accreditation Accredited by the National Board of Surgical Technology and Surgical Assisting
(NBSTSA) and compliant with Association of Surgical Technologists (AST)
standards.
Page 1
,1. During a laparoscopic cholecystectomy, the surgeon requests a cholangiogram.
The surgical technologist should prepare all of the following EXCEPT:
A. A 22-gauge spinal needle for contrast injection
B. A 0.035-inch J-tip guidewire for biliary access
C. A 5-Fr ureteral catheter for cystic duct cannulation
D. A 10-mL syringe filled with saline for flushing
Answer: A. A 22-gauge spinal needle for contrast injection
A cholangiogram typically uses a small catheter (e.g., 5-Fr ureteral catheter) to
cannulate the cystic duct, not a spinal needle. A J-tip guidewire may be used if the
catheter needs to be advanced, and saline flushing is standard. The spinal needle is not
appropriate for contrast injection into the biliary tree.
2. Which of the following best explains the rationale for using a closed-wound
suction drain (e.g., Jackson-Pratt) after a radical mastectomy?
A. To prevent seroma formation by evacuating fluid and promoting flap adherence
B. To provide a portal for postoperative irrigation of the wound bed
C. To monitor for anastomotic leak by analyzing drain output color
D. To reduce dead space and prevent hematoma by applying negative pressure
Answer: A. To prevent seroma formation by evacuating fluid and promoting flap
adherence
The primary purpose of a closed-wound suction drain after mastectomy is to prevent
seroma by evacuating lymph fluid and promoting skin flap adherence to the chest wall.
Option D is partially correct but seroma prevention is the key goal. Irrigation (B) is not
standard. Anastomotic leak monitoring (C) applies to gastrointestinal surgeries, not
mastectomy.
Page 2
,3. A patient undergoing a right hemicolectomy has a history of anaphylaxis to
cefazolin. The surgeon orders a preoperative dose of clindamycin 900 mg IV. The
surgical technologist knows that clindamycin is effective against which of the
following pathogens commonly encountered in colorectal surgery?
A. Escherichia coli and Bacteroides fragilis
B. Bacteroides fragilis and Clostridium difficile
C. Staphylococcus aureus and Streptococcus pyogenes
D. Pseudomonas aeruginosa and Enterococcus faecalis
Answer: B. Bacteroides fragilis and Clostridium difficile
Clindamycin has excellent activity against anaerobic bacteria such as Bacteroides
fragilis and also covers many gram-positive cocci including Staphylococcus and
Streptococcus, but it does not cover aerobic gram-negative rods like E. coli. In
colorectal surgery, the main concern is anaerobes (B. fragilis) and gram-negative
aerobes (E. coli); however, clindamycin is often combined with an aminoglycoside or
aztreonam for gram-negative coverage. Option B correctly identifies its anaerobic and
Clostridium coverage.
4. During a total knee arthroplasty, the surgical technologist notices that the bone
cement (polymethylmethacrylate, PMMA) has a doughy consistency. Which stage of
polymerization does this indicate, and what is the appropriate action?
A. Dough stage; the cement should be applied immediately to the bone surface
B. Curing stage; the cement should be discarded as it has passed the working time
C. Dough stage; the cement should be kneaded further to reduce porosity
D. Curing stage; the cement should be applied rapidly before it hardens
Answer: A. Dough stage; the cement should be applied immediately to the bone
surface
The dough stage is the optimal working phase for PMMA application. At this stage, the
cement is no longer sticky and can be molded without adhering to gloves. It should be
applied to the bone surface promptly. The curing stage is later when the cement
hardens and is no longer workable. Kneading further (C) is unnecessary and may
introduce air bubbles.
Page 3
, 5. The surgical technologist is setting up for a robotic-assisted prostatectomy. Which
of the following best describes the primary role of the surgical technologist during
the docking phase?
A. Directing the surgical team to position the patient in steep Trendelenburg
B. Ensuring that the robotic arms are sterilely draped and positioned over the patient
C. Calibrating the robotic console and foot pedals for the surgeon
D. Inserting the Veress needle for pneumoperitoneum establishment
Answer: B. Ensuring that the robotic arms are sterilely draped and positioned over
the patient
During docking, the surgical technologist's primary responsibility is to assist in sterilely
draping the robotic arms and positioning them over the patient's sterile field. Option A
is the responsibility of the circulating nurse and surgeon. Option C is done by the
surgeon or assistant. Option D occurs earlier during access.
6. A patient with a history of malignant hyperthermia (MH) is scheduled for an open
reduction and internal fixation of a femur fracture. Which of the following
anesthesia-related precautions is most critical for the surgical technologist to verify?
A. The anesthesia machine has been flushed with 10 L/min of oxygen for 20 minutes
B. Dantrolene sodium is available in the operating room at a dose of 2.5 mg/kg
C. The vaporizers for sevoflurane and desflurane have been removed from the machine
D. A cooling blanket and ice packs are ready for immediate use
Answer: C. The vaporizers for sevoflurane and desflurane have been removed
from the machine
For an MH-susceptible patient, the most critical precaution is to remove all volatile
anesthetic agents (e.g., sevoflurane, desflurane) from the anesthesia machine, as they
can trigger MH. Flushing the machine (A) is also important but removal of vaporizers
is definitive. Dantrolene (B) should be available but is a treatment, not prevention.
Cooling measures (D) are supportive but not primary.
Page 4
