1
NBSTSA PSI CST EXAM REVIEW Actual
Exam 2026/2027 Complete Questions and
Verified Answers with Detailed Rationales Pass
Guaranteed - A+ Graded
Section 1: CST Exam Review
Q1: Which of the following is the proper sequence for performing a surgical skin prep on a
patient's abdomen?
A. Center to periphery using circular motions
B. Periphery to center using circular motions
C. Side to side using back-and-forth motions
D. Top to bottom using vertical strokes only
Correct Answer: A
Rationale: The proper technique for surgical skin preparation is to begin at the incision site and
move outward in ever-widening circles, never returning to the center, to reduce the risk of
contamination from peripheral areas to the surgical site. [CORRECT]
Q2: A patient is positioned in the lithotomy position for a vaginal hysterectomy. Which nerve is
most at risk for injury due to improper positioning?
A. Radial nerve
B. Common peroneal nerve
C. Femoral nerve
D. Ulnar nerve
Correct Answer: B
Rationale: The common peroneal nerve is most at risk in lithotomy position because it wraps
around the fibular head and can be compressed against the stirrup, causing foot drop if not
properly padded. [CORRECT]
Q3: During a laparoscopic cholecystectomy, the surgeon requests "laps" to be passed. Which
instrument should the surgical technologist provide?
A. Laparoscopic grasping forceps
1
,2
B. Laparotomy sponges
C. Small Raytec sponges
D. Kittner dissectors
Correct Answer: B
Rationale: In laparoscopic surgery, "laps" refers to laparotomy sponges, which are used to absorb
fluid, provide traction, and protect tissues during port insertion or conversion to open procedures.
[CORRECT]
Q4: Which sterilization method is most appropriate for heat- and moisture-sensitive instruments
such as fiberoptic endoscopes?
A. Steam autoclave
B. Ethylene oxide gas
C. Dry heat oven
D. Boiling water
Correct Answer: B
Rationale: Ethylene oxide gas sterilization is the preferred method for heat- and moisture-
sensitive items because it provides effective sterilization at low temperatures without damaging
delicate instruments. [CORRECT]
Q5: The surgical technologist notices a hole in the surgeon's glove during a procedure. What is
the first appropriate action?
A. Wait until the surgeon notices and requests a glove change
B. Immediately announce the break in sterile technique to the entire room
C. Quietly inform the surgeon and provide a new glove
D. Document the incident in the operative record
Correct Answer: C
Rationale: When a break in sterile technique is observed, the surgical technologist should
discreetly inform the surgeon and provide immediate correction to maintain the sterile field and
professional decorum. [CORRECT]
Q6: Which anatomical structure marks the boundary between the duodenum and the jejunum?
A. Ligament of Treitz
B. Hepatoduodenal ligament
2
,3
C. Gastrocolic ligament
D. Falciform ligament
Correct Answer: A
Rationale: The ligament of Treitz (suspensory muscle of the duodenum) marks the anatomical
division between the duodenum and jejunum and is an important landmark during bowel
resection procedures. [CORRECT]
Q7: During a total knee arthroplasty, which type of retractor would be most appropriate for
exposing the distal femur?
A. Weitlaner self-retaining retractor
B. Hohmann retractor
C. Army-Navy retractor
D. Senn retractor
Correct Answer: B
Rationale: The Hohmann retractor is specifically designed for orthopedic procedures to lever
bone away from soft tissue, providing excellent exposure of the distal femur during knee
replacement surgery. [CORRECT]
Q8: Which medication is commonly used as a topical hemostatic agent on cut bone during
neurosurgical procedures?
A. Bone wax
B. Avitene
C. Gelfoam
D. Surgicel
Correct Answer: A
Rationale: Bone wax is a topical hemostatic agent specifically designed to control bleeding from
bone surfaces by occluding the haversian canals and is commonly used in neurosurgical and
orthopedic procedures. [CORRECT]
Q9: A patient with a history of malignant hyperthermia is scheduled for emergency
appendectomy. Which anesthetic agent is absolutely contraindicated?
A. Propofol
B. Succinylcholine
3
, 4
C. Nitrous oxide
D. Midazolam
Correct Answer: B
Rationale: Succinylcholine is a depolarizing neuromuscular blocker that triggers malignant
hyperthermia in susceptible patients and is absolutely contraindicated; non-depolarizing agents
should be used instead. [CORRECT]
Q10: The surgical technologist is preparing for a cesarean section. Which suture material is most
appropriate for uterine closure?
A. Silk
B. Chromic gut
C. Polydioxanone (PDS)
D. Nylon
Correct Answer: C
Rationale: Polydioxanone (PDS) is a synthetic absorbable suture with extended wound support
that provides adequate strength for uterine closure while minimizing tissue reaction and allowing
absorption over time. [CORRECT]
Q11: Which indicator is used to verify that steam sterilization conditions have been met inside a
surgical pack?
A. Class I indicator (process indicator)
B. Class II indicator ( Bowie-Dick test)
C. Class V indicator (integrating indicator)
D. Class III indicator (single variable indicator)
Correct Answer: C
Rationale: Class V integrating indicators respond to multiple sterilization parameters (time,
temperature, and steam) and provide the most reliable verification that sterilization conditions
have been achieved inside the pack. [CORRECT]
Q12: During a thyroidectomy, the surgeon identifies and preserves the recurrent laryngeal nerve.
Which anatomical structure does this nerve innervate?
A. Sternocleidomastoid muscle
B. Vocal cords
4
NBSTSA PSI CST EXAM REVIEW Actual
Exam 2026/2027 Complete Questions and
Verified Answers with Detailed Rationales Pass
Guaranteed - A+ Graded
Section 1: CST Exam Review
Q1: Which of the following is the proper sequence for performing a surgical skin prep on a
patient's abdomen?
A. Center to periphery using circular motions
B. Periphery to center using circular motions
C. Side to side using back-and-forth motions
D. Top to bottom using vertical strokes only
Correct Answer: A
Rationale: The proper technique for surgical skin preparation is to begin at the incision site and
move outward in ever-widening circles, never returning to the center, to reduce the risk of
contamination from peripheral areas to the surgical site. [CORRECT]
Q2: A patient is positioned in the lithotomy position for a vaginal hysterectomy. Which nerve is
most at risk for injury due to improper positioning?
A. Radial nerve
B. Common peroneal nerve
C. Femoral nerve
D. Ulnar nerve
Correct Answer: B
Rationale: The common peroneal nerve is most at risk in lithotomy position because it wraps
around the fibular head and can be compressed against the stirrup, causing foot drop if not
properly padded. [CORRECT]
Q3: During a laparoscopic cholecystectomy, the surgeon requests "laps" to be passed. Which
instrument should the surgical technologist provide?
A. Laparoscopic grasping forceps
1
,2
B. Laparotomy sponges
C. Small Raytec sponges
D. Kittner dissectors
Correct Answer: B
Rationale: In laparoscopic surgery, "laps" refers to laparotomy sponges, which are used to absorb
fluid, provide traction, and protect tissues during port insertion or conversion to open procedures.
[CORRECT]
Q4: Which sterilization method is most appropriate for heat- and moisture-sensitive instruments
such as fiberoptic endoscopes?
A. Steam autoclave
B. Ethylene oxide gas
C. Dry heat oven
D. Boiling water
Correct Answer: B
Rationale: Ethylene oxide gas sterilization is the preferred method for heat- and moisture-
sensitive items because it provides effective sterilization at low temperatures without damaging
delicate instruments. [CORRECT]
Q5: The surgical technologist notices a hole in the surgeon's glove during a procedure. What is
the first appropriate action?
A. Wait until the surgeon notices and requests a glove change
B. Immediately announce the break in sterile technique to the entire room
C. Quietly inform the surgeon and provide a new glove
D. Document the incident in the operative record
Correct Answer: C
Rationale: When a break in sterile technique is observed, the surgical technologist should
discreetly inform the surgeon and provide immediate correction to maintain the sterile field and
professional decorum. [CORRECT]
Q6: Which anatomical structure marks the boundary between the duodenum and the jejunum?
A. Ligament of Treitz
B. Hepatoduodenal ligament
2
,3
C. Gastrocolic ligament
D. Falciform ligament
Correct Answer: A
Rationale: The ligament of Treitz (suspensory muscle of the duodenum) marks the anatomical
division between the duodenum and jejunum and is an important landmark during bowel
resection procedures. [CORRECT]
Q7: During a total knee arthroplasty, which type of retractor would be most appropriate for
exposing the distal femur?
A. Weitlaner self-retaining retractor
B. Hohmann retractor
C. Army-Navy retractor
D. Senn retractor
Correct Answer: B
Rationale: The Hohmann retractor is specifically designed for orthopedic procedures to lever
bone away from soft tissue, providing excellent exposure of the distal femur during knee
replacement surgery. [CORRECT]
Q8: Which medication is commonly used as a topical hemostatic agent on cut bone during
neurosurgical procedures?
A. Bone wax
B. Avitene
C. Gelfoam
D. Surgicel
Correct Answer: A
Rationale: Bone wax is a topical hemostatic agent specifically designed to control bleeding from
bone surfaces by occluding the haversian canals and is commonly used in neurosurgical and
orthopedic procedures. [CORRECT]
Q9: A patient with a history of malignant hyperthermia is scheduled for emergency
appendectomy. Which anesthetic agent is absolutely contraindicated?
A. Propofol
B. Succinylcholine
3
, 4
C. Nitrous oxide
D. Midazolam
Correct Answer: B
Rationale: Succinylcholine is a depolarizing neuromuscular blocker that triggers malignant
hyperthermia in susceptible patients and is absolutely contraindicated; non-depolarizing agents
should be used instead. [CORRECT]
Q10: The surgical technologist is preparing for a cesarean section. Which suture material is most
appropriate for uterine closure?
A. Silk
B. Chromic gut
C. Polydioxanone (PDS)
D. Nylon
Correct Answer: C
Rationale: Polydioxanone (PDS) is a synthetic absorbable suture with extended wound support
that provides adequate strength for uterine closure while minimizing tissue reaction and allowing
absorption over time. [CORRECT]
Q11: Which indicator is used to verify that steam sterilization conditions have been met inside a
surgical pack?
A. Class I indicator (process indicator)
B. Class II indicator ( Bowie-Dick test)
C. Class V indicator (integrating indicator)
D. Class III indicator (single variable indicator)
Correct Answer: C
Rationale: Class V integrating indicators respond to multiple sterilization parameters (time,
temperature, and steam) and provide the most reliable verification that sterilization conditions
have been achieved inside the pack. [CORRECT]
Q12: During a thyroidectomy, the surgeon identifies and preserves the recurrent laryngeal nerve.
Which anatomical structure does this nerve innervate?
A. Sternocleidomastoid muscle
B. Vocal cords
4
