Free practice test · FirstCase Academy by SurgSoul

Free CST practice test: 50 questions with explanations

50 original questions written to the NBSTSA CST content outline and spread across all 8 of its domains. Answer them, then score your test by domain, or open any explanation as you go. No account needed.

Your answers stay on this page. Nothing is saved or sent anywhere.

Original practice questions written against the NBSTSA CST content outline and the NCCT TS-C test plan. They are not official, recalled, or validated exam questions, and practice scores do not predict an exam result. FirstCase Academy is independent of the NBSTSA, NCCT, AST and ARC/STSA; none of them has written, reviewed or endorsed these questions.

  1. Which part of a sterile gown is generally considered outside the maintained sterile area?
    Show the answer and explanation

    A. The back of the gown

    The gown's back cannot be continuously observed and is not treated as a maintained sterile working surface.

    Outline domain I.A: Preoperative preparation

  2. Pressure near the fibular head during lithotomy positioning most directly threatens which nerve?
    Show the answer and explanation

    B. Common fibular nerve

    The common fibular, or peroneal, nerve passes superficially near the fibular neck and is vulnerable to compression.

    Outline domain I.A: Preoperative preparation

  3. For a case using fluoroscopy, which combination best supports radiation protection?
    Show the answer and explanation

    C. Minimize time, maximize distance, and use shielding

    Radiation protection uses time, distance, and shielding. Standard sterile attire does not provide meaningful x-ray shielding.

    Outline domain I.A: Preoperative preparation

  4. Which practice best supports the closed-gloving method during initial gowning?
    Show the answer and explanation

    D. Keep bare hands covered by the gown cuffs

    Closed gloving uses the gown sleeve as a barrier during application, keeping bare skin from contacting the glove exterior.

    Outline domain I.A: Preoperative preparation

  5. Compared with adults, infants are particularly vulnerable to heat loss during surgery primarily because they have which feature?
    Show the answer and explanation

    A. A larger surface-area-to-body-mass ratio

    Greater relative surface area increases heat exchange, making temperature-preserving preparation especially important.

    Outline domain I.A: Preoperative preparation

  6. Which patient characteristic most directly requires checking the operating table's weight capacity and transfer equipment?
    Show the answer and explanation

    B. Weight above standard equipment capacity

    Safe support and transfer require equipment rated for the patient's size and the intended configuration.

    Outline domain I.A: Preoperative preparation

  7. A sequential compression device is used primarily to reduce which risk?
    Show the answer and explanation

    C. Lower-extremity venous stasis

    Intermittent compression promotes venous return. It does not address nerve stretch, electrical burns, or airway patency.

    Outline domain I.A: Preoperative preparation

  8. A trial component fits during joint arthroplasty. What should occur before opening the permanent implant?
    Show the answer and explanation

    D. Verify final implant identity, size, and compatibility

    Trial findings guide selection, but final identity and compatibility still require explicit verification.

    Outline domain I.B: Intraoperative procedures

  9. In conventional bipolar electrosurgery, current primarily passes through which path?
    Show the answer and explanation

    A. Between the two tips through the grasped tissue

    The bipolar instrument incorporates both poles at its working tips, localizing the intended current path.

    Outline domain I.B: Intraoperative procedures

  10. Bone wax controls bleeding primarily by which mechanism?
    Show the answer and explanation

    B. Mechanical plugging of bleeding bone channels

    Bone wax acts as a mechanical barrier in bleeding bone; it is not a systemic anticoagulant or an enzymatic clotting agent.

    Outline domain I.B: Intraoperative procedures

  11. The closing count is short by one needle. What is the best immediate action?
    Show the answer and explanation

    C. Announce the discrepancy and initiate reconciliation

    An unresolved needle is a count discrepancy, not a presumed disposal. Prompt communication supports systematic reconciliation.

    Outline domain I.B: Intraoperative procedures

  12. A ureteral stent is placed after treatment of an obstructing stone. What is its intended function?
    Show the answer and explanation

    D. Maintain ureteral drainage to the bladder

    A stent supports urinary drainage through the ureter; it does not perform the kidney's filtration function.

    Outline domain I.B: Intraoperative procedures

  13. Which clamp is designed to hold delicate tubular tissue with less crushing than an Allis clamp?
    Show the answer and explanation

    A. Babcock clamp

    The Babcock's rounded, fenestrated jaws distribute pressure; toothed or heavy hemostatic clamps can injure delicate tissue.

    Outline domain I.B: Intraoperative procedures

  14. A stapler reload fits the device but is not labeled for the tissue thickness being treated. What is the best response?
    Show the answer and explanation

    B. Obtain a reload validated for the tissue and device

    Mechanical fit alone does not establish an appropriate staple height or tissue range; selection must follow device labeling.

    Outline domain I.B: Intraoperative procedures

  15. A substance not previously discussed is about to enter the operative field during cell salvage. What should be checked?
    Show the answer and explanation

    C. Compatibility with the salvage system and clinical plan

    Not all contaminants or fluids are suitable for salvage. Compatibility must be established through the system instructions and team plan.

    Outline domain I.B: Intraoperative procedures

  16. During operative hysteroscopy, why is accurate distention-fluid accounting important?
    Show the answer and explanation

    D. Absorbed fluid can disturb volume and electrolyte balance

    Fluid absorption can harm the patient. Risk depends on the fluid and system, so inflow and outflow require reliable tracking.

    Outline domain I.B: Intraoperative procedures

  17. A small incision needs sustained exposure without continuous handheld retraction. Which instrument fits this request?
    Show the answer and explanation

    A. Weitlaner retractor

    A Weitlaner is a self-retaining retractor; the other instruments grasp, suction, or hold a needle.

    Outline domain I.B: Intraoperative procedures

  18. A package contains a swaged needle-suture combination. What does swaged mean?
    Show the answer and explanation

    B. The suture is factory-attached to the needle

    A swaged attachment joins needle and suture without the bulk of a manually threaded eye.

    Outline domain I.B: Intraoperative procedures

  19. Two specimens from different sites are removed from the same patient. How should their identities be maintained?
    Show the answer and explanation

    C. Separate them and verify each specimen source

    Patient identity alone does not identify specimen source. Distinct site labeling preserves diagnostic meaning.

    Outline domain I.B: Intraoperative procedures

  20. Percutaneous nephrolithotomy provides access to the kidney by which route?
    Show the answer and explanation

    D. A tract through the skin into the renal collecting system

    Percutaneous nephrolithotomy uses a skin-to-kidney access tract for removal of selected renal stones.

    Outline domain I.B: Intraoperative procedures

  21. The surgeon requests scissors for delicate soft-tissue dissection. Which instrument is the best choice?
    Show the answer and explanation

    A. Metzenbaum scissors

    Metzenbaum scissors are designed for delicate dissection; cutting wire or dressings requires different blade geometry and strength.

    Outline domain I.B: Intraoperative procedures

  22. A nonadherent primary dressing is selected for a delicate wound surface. What is its main purpose?
    Show the answer and explanation

    B. Reduce adherence to the wound surface

    A nonadherent contact layer helps protect fragile tissue when a dressing is removed; it does not replace bleeding control.

    Outline domain I.B: Intraoperative procedures

  23. A specimen is requested for frozen-section examination. Before adding a preservative, what should the scrub person do?
    Show the answer and explanation

    C. Verify the required fresh-specimen handling

    A preservative can interfere with the requested examination. Confirm handling before making an irreversible change.

    Outline domain I.B: Intraoperative procedures

  24. During a vascular repair, why are atraumatic vascular clamps preferred over heavy toothed clamps?
    Show the answer and explanation

    D. They limit vessel trauma while controlling blood flow

    Vessel-wall injury can compromise a repair. Atraumatic designs reduce, but do not eliminate, trauma from clamping.

    Outline domain I.B: Intraoperative procedures

  25. A fine spring-action needle holder is requested for microsurgical suturing. Which instrument best fits?
    Show the answer and explanation

    A. Castroviejo needle holder

    Castroviejo holders provide fine control for delicate needles; large holders may damage or poorly control them.

    Outline domain I.B: Intraoperative procedures

  26. After a difficult case, which debrief statement is most useful for improvement?
    Show the answer and explanation

    B. The suction connection failed twice; assign follow-up and verify a fix before reuse

    Specific observations, ownership, and verification support a practical correction; blame or outcome alone does not identify a reliable fix.

    Outline domain I.C: Postoperative procedures

  27. What information should accompany a patient who leaves with a drain?
    Show the answer and explanation

    C. Drain type, site, function, and output

    The receiving team needs to know what device is present and how it is functioning to continue care safely.

    Outline domain I.C: Postoperative procedures

  28. Which finding after application of a circumferential dressing requires prompt clinical assessment?
    Show the answer and explanation

    D. New pallor and reduced distal perfusion

    A tight dressing can compromise circulation. Distal changes require prompt reporting and assessment by the responsible clinician.

    Outline domain I.C: Postoperative procedures

  29. An unopened sterile item remained protected during the case. What should determine whether it returns to storage?
    Show the answer and explanation

    A. Package condition, exposure, and the return policy

    Unopened does not automatically mean suitable for return; integrity and exposure must be assessed under the approved process.

    Outline domain I.C: Postoperative procedures

  30. A patient needs an explanation but does not share a language with the team. What is the best approach for important clinical communication?
    Show the answer and explanation

    B. Use the facility's qualified interpreter process

    Qualified interpretation supports accurate communication. Volume, family availability, or nodding does not establish informed understanding.

    Outline domain II.A: Administrative and personnel

  31. Which statement is most appropriate for a factual event report?
    Show the answer and explanation

    C. The suction stopped at 10:14; backup suction was connected and the team was notified

    A useful report records observed facts, timing, and actions while separating evidence from blame or speculation.

    Outline domain II.A: Administrative and personnel

  32. A contaminated needle punctures a technologist's skin. What should follow immediate first aid?
    Show the answer and explanation

    D. Prompt reporting and exposure evaluation

    Bloodborne exposure assessment is time-sensitive. An absence of symptoms does not rule out a relevant exposure.

    Outline domain II.A: Administrative and personnel

  33. A blood-pressure cuff contacts only intact skin. Which Spaulding category best describes that contact?
    Show the answer and explanation

    A. Noncritical

    Noncritical items contact intact skin. They still require appropriate cleaning and disinfection between uses.

    Outline domain II.B: Equipment sterilization and maintenance

  34. A nonemergency implant load has a biological indicator result pending. What is the preferred release approach?
    Show the answer and explanation

    B. Hold implants for the required acceptable result

    Implant release requires the applicable monitoring process; routine quarantine until acceptable biological results reduces avoidable risk.

    Outline domain II.B: Equipment sterilization and maintenance

  35. What does a changed external chemical process indicator demonstrate by itself?
    Show the answer and explanation

    C. Exposure to the indicator’s specified conditions

    A chemical indicator responds to specified conditions. Its change alone does not establish cleaning, sterility of every surface, or later integrity.

    Outline domain II.B: Equipment sterilization and maintenance

  36. A reusable instrument contains a narrow lumen. Which cleaning consideration is most important?
    Show the answer and explanation

    D. Brush and flush the lumen as specified

    Internal channels can retain soil. Correctly sized tools and the specified flushing process support effective cleaning without damage.

    Outline domain II.B: Equipment sterilization and maintenance

  37. Which information is particularly useful if an implant or processed load must later be traced?
    Show the answer and explanation

    A. Device and lot identifiers linked to patient or load records

    Traceability links products and processing events to affected patients or loads, supporting targeted investigation and response.

    Outline domain II.B: Equipment sterilization and maintenance

  38. Which cell type is primarily responsible for forming new bone matrix?
    Show the answer and explanation

    B. Osteoblast

    Osteoblasts build bone matrix, whereas osteoclasts resorb bone.

    Outline domain III.A: Anatomy and physiology

  39. Which layer directly covers the surface of the lung?
    Show the answer and explanation

    C. Visceral pleura

    Visceral pleura adheres to the lung surface; parietal pleura lines the thoracic wall.

    Outline domain III.A: Anatomy and physiology

  40. The coronary arteries primarily supply oxygenated blood to which tissue?
    Show the answer and explanation

    D. Myocardium

    Coronary circulation supplies the heart muscle itself, distinct from blood passing through the cardiac chambers.

    Outline domain III.A: Anatomy and physiology

  41. Which cells are major producers of collagen during wound repair?
    Show the answer and explanation

    A. Fibroblasts

    Fibroblasts produce extracellular matrix, including collagen, supporting repair and developing wound strength.

    Outline domain III.A: Anatomy and physiology

  42. Which sequence lists the middle-ear ossicles from the tympanic membrane toward the oval window?
    Show the answer and explanation

    B. Malleus, incus, stapes

    The malleus receives tympanic-membrane vibration, the incus transmits it, and the stapes contacts the oval window.

    Outline domain III.A: Anatomy and physiology

  43. The subarachnoid space normally contains which material?
    Show the answer and explanation

    C. Cerebrospinal fluid

    Cerebrospinal fluid circulates between the arachnoid and pia, surrounding the central nervous system.

    Outline domain III.A: Anatomy and physiology

  44. Which structure is the functional unit of the kidney?
    Show the answer and explanation

    D. Nephron

    Nephrons perform filtration and tubular processing; alveoli, hepatic lobules, and osteons belong to other organ systems.

    Outline domain III.A: Anatomy and physiology

  45. An operation includes gross gastrointestinal spillage without preexisting established infection. Which wound class is most appropriate?
    Show the answer and explanation

    A. Contaminated

    Gross spillage exceeds controlled tract entry and supports a contaminated classification.

    Outline domain III.B: Microbiology

  46. The colon is entered under controlled conditions without unusual contamination or infection. Which wound class is most appropriate?
    Show the answer and explanation

    B. Clean-contaminated

    Controlled entry into the alimentary tract without unusual contamination fits clean-contaminated classification.

    Outline domain III.B: Microbiology

  47. A bacterium that retains the crystal-violet complex during the Gram stain is classified as what?
    Show the answer and explanation

    C. Gram-positive

    Gram-positive bacteria retain the primary stain under the procedure, reflecting cell-wall properties; staining alone does not identify the species.

    Outline domain III.B: Microbiology

  48. In a calculation exercise, a solution is labeled 2% weight/volume. What concentration does that represent?
    Show the answer and explanation

    D. 20 mg/mL

    Two percent weight/volume means 2 g per 100 mL: 2000 mg divided by 100 mL equals 20 mg/mL.

    Outline domain III.C: Surgical pharmacology

  49. For a calculation exercise only, an order calls for 80 mg from a verified 20 mg/mL stock. What volume contains 80 mg?
    Show the answer and explanation

    A. 4 mL

    Divide the required amount by concentration: 80 mg divided by 20 mg/mL equals 4 mL. Clinical preparation still requires all applicable checks.

    Outline domain III.C: Surgical pharmacology

  50. Which medication is used by authorized clinicians to neutralize the anticoagulant effect of unfractionated heparin?
    Show the answer and explanation

    B. Protamine sulfate

    Protamine binds and neutralizes heparin. Its administration requires clinical oversight because important adverse reactions can occur.

    Outline domain III.C: Surgical pharmacology

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Frequently asked questions

Are these real NBSTSA exam questions?

No. They are original practice questions written against the NBSTSA CST content outline. They are not official, recalled or validated exam items. FirstCase Academy is independent of the NBSTSA, NCCT, AST and ARC/STSA; none of them has written, reviewed or endorsed these questions.

Does my score predict how I will do on the CST?

No. A practice score does not predict an exam result. Use it to see which domains to practice next.

Do I need an account? Is anything saved?

No account is needed. Your answers stay on this page: nothing is saved or sent anywhere.

How were the questions chosen?

From FirstCase Academy’s original certification questions, spread across all 8 domains of the NBSTSA CST content outline, with at least three in each so every domain gets a score. The mix is not the exam’s.

How long is the real exam, and how is it timed?

Check the current NBSTSA candidate handbook: the exam length, timing and fees are set by the NBSTSA and can change.

Who wrote them?

SurgSoul’s founder wrote them. How our content is made explains how questions are written, sourced and reviewed.

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