Surgical Technology Board Exam Practice
Questions 2026-2027: 100 NBSTSA-Style
Questions with Rationales for CST & CSFA
Certification
Description:
Ace your CST or CSFA exam in 2026/2027 with 100 high-yield surgical technology
practice questions. Covers OR positioning, sterilization, robotic surgery, vascular
procedures, and wound management. Includes detailed answers and academic rationales.
Download this comprehensive study guide today and pass with confidence!
, Surgical Tech Exam Prep 2026-2027
SECTION I: PATIENT POSITIONING AND SAFETY
1. A complication of steep reverse Trendelenburg position is
A. deep vein thrombosis.
B. arterial compression.
C. cardiac overload.
D. respiratory alkalosis.
Answer: A. deep vein thrombosis.
Explanation: Steep reverse Trendelenburg position increases venous pooling in the lower
extremities due to gravity, which significantly elevates the risk of deep vein thrombosis. This
position also places patients at risk for venous air embolism and hemodynamic instability.
The pooling of blood in the lower extremities reduces venous return to the heart, potentially
causing hypotension and decreased cardiac output.
2. Which of the following positions should be utilized for posterior colpotomy?
A. prone
B. supine
C. lithotomy
D. Fowler's
Answer: C. lithotomy
Explanation: Posterior colpotomy requires access to the vaginal vault and pelvic structures,
necessitating the lithotomy position with the patient's legs elevated and abducted. This
position provides optimal surgical exposure for accessing the posterior vaginal fornix and
cul-de-sac. Proper positioning requires careful attention to hip and knee alignment to prevent
nerve injuries.
3. Which of the following patient positions would be MOST likely to cause an obturator
nerve injury?
A. lateral
B. prone
,C. lithotomy
D. semi-Fowler's
Answer: C. lithotomy
Explanation: The lithotomy position places significant stress on the obturator nerve due to
extreme hip flexion and abduction. The obturator nerve passes through the obturator foramen
and can be compressed against the pelvic rim during prolonged lithotomy positioning.
Excessive hip flexion (>80 degrees) or external rotation increases this risk substantially.
4. Which of the following types of positioning injury occurs when underlying tissue is
stationary while the skeletal structure moves?
A. friction injury
B. pressure injury
C. shear injury
D. negativity injury
Answer: C. shear injury
Explanation: Shear injury results from opposing forces where deeper tissues remain fixed
while superficial tissues move relative to them. This occurs when the patient's body slides on
the OR table while the skeletal structure remains stationary, causing tissue layers to separate
and compromising microcirculation. Shear forces are particularly damaging to adipose tissue
and can precipitate pressure ulcer formation.
5. Which of the following are the preferred positioning devices used during surgical
procedures?
A. foam pads
B. saline bags
C. gel pads
D. sheet rolls
Answer: C. gel pads
Explanation: Gel pads are the preferred positioning devices because they provide superior
pressure distribution and conform to body contours while maintaining stability. They offer
excellent viscoelastic properties that reduce peak pressure points and minimize tissue
, ischemia. Gel pads also resist fluid absorption and are easily cleaned, making them more
hygienic than foam alternatives.
6. When placing a patient prone using chest rolls, which direction should the breasts be
diverted?
A. inward
B. outward
C. upward
D. downward
Answer: A. inward
Explanation: When positioning a patient prone, breast tissue should be diverted medially
(inward) to reduce tension on the pectoral attachments and minimize compression. This
positioning prevents excessive pressure on breast tissue and reduces the risk of postoperative
breast pain or tissue necrosis. Proper placement of chest rolls supports the shoulders and iliac
crests while allowing abdominal movement for ventilation.
7. When placing a patient in the lateral position, right side down with the aid of a Vac-
Pac bean bag, which of the following structures is compressed, impairing blood flow?
A. common iliac
B. vena cava
C. great saphenous vein
D. aorta
Answer: B. vena cava
Explanation: In the lateral decubitus position with the right side down, the inferior vena cava
can be compressed against the vertebral bodies, significantly reducing venous return to the
heart. This compression can lead to decreased cardiac output, hypotension, and impaired
renal perfusion. The Vac-Pac bean bag should be positioned to avoid excessive pressure on
the abdominal contents and major vessels.
Questions 2026-2027: 100 NBSTSA-Style
Questions with Rationales for CST & CSFA
Certification
Description:
Ace your CST or CSFA exam in 2026/2027 with 100 high-yield surgical technology
practice questions. Covers OR positioning, sterilization, robotic surgery, vascular
procedures, and wound management. Includes detailed answers and academic rationales.
Download this comprehensive study guide today and pass with confidence!
, Surgical Tech Exam Prep 2026-2027
SECTION I: PATIENT POSITIONING AND SAFETY
1. A complication of steep reverse Trendelenburg position is
A. deep vein thrombosis.
B. arterial compression.
C. cardiac overload.
D. respiratory alkalosis.
Answer: A. deep vein thrombosis.
Explanation: Steep reverse Trendelenburg position increases venous pooling in the lower
extremities due to gravity, which significantly elevates the risk of deep vein thrombosis. This
position also places patients at risk for venous air embolism and hemodynamic instability.
The pooling of blood in the lower extremities reduces venous return to the heart, potentially
causing hypotension and decreased cardiac output.
2. Which of the following positions should be utilized for posterior colpotomy?
A. prone
B. supine
C. lithotomy
D. Fowler's
Answer: C. lithotomy
Explanation: Posterior colpotomy requires access to the vaginal vault and pelvic structures,
necessitating the lithotomy position with the patient's legs elevated and abducted. This
position provides optimal surgical exposure for accessing the posterior vaginal fornix and
cul-de-sac. Proper positioning requires careful attention to hip and knee alignment to prevent
nerve injuries.
3. Which of the following patient positions would be MOST likely to cause an obturator
nerve injury?
A. lateral
B. prone
,C. lithotomy
D. semi-Fowler's
Answer: C. lithotomy
Explanation: The lithotomy position places significant stress on the obturator nerve due to
extreme hip flexion and abduction. The obturator nerve passes through the obturator foramen
and can be compressed against the pelvic rim during prolonged lithotomy positioning.
Excessive hip flexion (>80 degrees) or external rotation increases this risk substantially.
4. Which of the following types of positioning injury occurs when underlying tissue is
stationary while the skeletal structure moves?
A. friction injury
B. pressure injury
C. shear injury
D. negativity injury
Answer: C. shear injury
Explanation: Shear injury results from opposing forces where deeper tissues remain fixed
while superficial tissues move relative to them. This occurs when the patient's body slides on
the OR table while the skeletal structure remains stationary, causing tissue layers to separate
and compromising microcirculation. Shear forces are particularly damaging to adipose tissue
and can precipitate pressure ulcer formation.
5. Which of the following are the preferred positioning devices used during surgical
procedures?
A. foam pads
B. saline bags
C. gel pads
D. sheet rolls
Answer: C. gel pads
Explanation: Gel pads are the preferred positioning devices because they provide superior
pressure distribution and conform to body contours while maintaining stability. They offer
excellent viscoelastic properties that reduce peak pressure points and minimize tissue
, ischemia. Gel pads also resist fluid absorption and are easily cleaned, making them more
hygienic than foam alternatives.
6. When placing a patient prone using chest rolls, which direction should the breasts be
diverted?
A. inward
B. outward
C. upward
D. downward
Answer: A. inward
Explanation: When positioning a patient prone, breast tissue should be diverted medially
(inward) to reduce tension on the pectoral attachments and minimize compression. This
positioning prevents excessive pressure on breast tissue and reduces the risk of postoperative
breast pain or tissue necrosis. Proper placement of chest rolls supports the shoulders and iliac
crests while allowing abdominal movement for ventilation.
7. When placing a patient in the lateral position, right side down with the aid of a Vac-
Pac bean bag, which of the following structures is compressed, impairing blood flow?
A. common iliac
B. vena cava
C. great saphenous vein
D. aorta
Answer: B. vena cava
Explanation: In the lateral decubitus position with the right side down, the inferior vena cava
can be compressed against the vertebral bodies, significantly reducing venous return to the
heart. This compression can lead to decreased cardiac output, hypotension, and impaired
renal perfusion. The Vac-Pac bean bag should be positioned to avoid excessive pressure on
the abdominal contents and major vessels.
