The case cart for a total knee arthroplasty was assembled from the surgeon's preference card. While opening, the ST recalls that the surgeon recently switched to a different suture for capsular closure. What is the BEST action?

Obtain the new suture and have the preference card updated to reflect the change

Open the suture listed on the card, since the card is the official record of the surgeon's needs

Open both sutures to the field so the surgeon can choose between them at closure

Wait until closure and ask the surgeon which suture to open at that time

Stop here for Section 1 complete (40 questions). The surgeon plans an intraoperative cholangiogram during a laparoscopic cholecystectomy. While preparing the contrast, which step by the surgical technologist is MOST important for an accurate image?

Purge all air bubbles from the syringes, tubing, and catheter

Warm the contrast agent to body temperature in the solution warmer

Use full-strength contrast rather than diluting it

Draw up contrast into the same syringe used for saline

At the end of a total abdominal hysterectomy, which sharps practice is correct?

Remove blades with an instrument and replace the container at its fill line

Remove blades with gloved fingers, then press them down into the container

Recap needles with two hands before placing them in the sharps container

Keep the container in use until it is full to the top, then seal it shut

A patient with an unresectable pancreatic head tumor is scheduled for a cholecystojejunostomy to relieve biliary obstruction. Based on its word parts, what does this procedure create?

A surgical opening (anastomosis) between the gallbladder and the jejunum

Removal of the gallbladder with resection of the proximal jejunum

An incision into the gallbladder to remove stones lodged in the jejunum

Surgical fixation of the gallbladder to the wall of the jejunum

An awake patient is moving from the transport stretcher to the OR bed for a thyroidectomy. What should be done FIRST?

Lock the wheels of both the stretcher and the OR bed

Apply the safety strap across the patient's thighs

Lower the stretcher so it sits slightly below the OR bed

Remove the stretcher side rail and ask the patient to slide over

During a craniotomy for tumor resection, the surgeon removes the bone flap and hands it to the surgical technologist. How should the bone flap be handled?

Wrapped in a moist sponge and kept protected on the back table

Placed in formalin and sent to pathology with the tumor

Placed on the drapes next to the incision so it is easy to reach

Handed off the field to the circulator for storage

Which item from a laparoscopic cholecystectomy belongs in regulated medical waste (the red bag)?

A sponge that would release blood if compressed

A drape with a few small spots of dried blood

Paper wrappers from the opened sterile packages

An empty, uncontaminated irrigation solution bottle

CST Certified Surgical Technologist Exam

Free CST Certified Surgical Practice Questions

10 sample questions for the CST Certified Surgical Technologist Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Perioperative Care, Ancillary Duties, Basic Science.

Question 1 · Perioperative Care
The case cart for a total knee arthroplasty was assembled from the surgeon's preference card. While opening, the ST recalls that the surgeon recently switched to a different suture for capsular closure. What is the BEST action?
- A.Open the suture listed on the card, since the card is the official record of the surgeon's needs
- B.Obtain the new suture and have the preference card updated to reflect the change
- C.Open both sutures to the field so the surgeon can choose between them at closure
- D.Wait until closure and ask the surgeon which suture to open at that time
Show answer and explanation
Answer: B. Obtain the new suture and have the preference card updated to reflect the change
Preference cards must be kept current; when a surgeon's routine changes, the needed item is obtained and the card is revised so future carts are pulled correctly. Opening both sutures wastes costly supplies and adds an unnecessary item to the count, and waiting until closure causes avoidable delay.
Question 2 · Perioperative Care
During a lumbar laminectomy, the surgeon wants to remove small bites of lamina and ligamentum flavum close to the dura. Which instrument should the surgical technologist pass?
- A.Kerrison rongeur
- B.Leksell rongeur
- C.Straight osteotome
- D.Bone curette
Show answer and explanation
Answer: A. Kerrison rongeur
The Kerrison rongeur has a thin footplate that slides under the lamina and punches out small bites of bone, protecting the dura. A Leksell rongeur takes large bites from exposed bone edges and is too bulky for work against the dura.
Question 3 · Perioperative Care
Stop here for Section 1 complete (40 questions).
The surgeon plans an intraoperative cholangiogram during a laparoscopic cholecystectomy. While preparing the contrast, which step by the surgical technologist is MOST important for an accurate image?
- A.Purge all air bubbles from the syringes, tubing, and catheter
- B.Warm the contrast agent to body temperature in the solution warmer
- C.Use full-strength contrast rather than diluting it
- D.Draw up contrast into the same syringe used for saline
Show answer and explanation
Answer: A. Purge all air bubbles from the syringes, tubing, and catheter
Air bubbles injected into the biliary tree look like filling defects on fluoroscopy and can be mistaken for retained common duct stones, leading to unnecessary exploration. The ST purges air from the catheter and both the contrast and saline syringes, which are kept separate and clearly labeled. Contrast is commonly diluted with saline for cholangiography, so insisting on full strength is not the key step.
Question 4 · Perioperative Care
At the end of a total abdominal hysterectomy, which sharps practice is correct?
- A.Remove blades with gloved fingers, then press them down into the container
- B.Remove blades with an instrument and replace the container at its fill line
- C.Recap needles with two hands before placing them in the sharps container
- D.Keep the container in use until it is full to the top, then seal it shut
Show answer and explanation
Answer: B. Remove blades with an instrument and replace the container at its fill line
Blades are removed with an instrument or a blade-removal device, never with fingers, and needles are not recapped by hand. Sharps containers are replaced when they reach the marked fill line, about three-quarters full, because overfilling forces hands near exposed sharps.
Question 5 · Basic Science
A patient with an unresectable pancreatic head tumor is scheduled for a cholecystojejunostomy to relieve biliary obstruction. Based on its word parts, what does this procedure create?
- A.Removal of the gallbladder with resection of the proximal jejunum
- B.An incision into the gallbladder to remove stones lodged in the jejunum
- C.Surgical fixation of the gallbladder to the wall of the jejunum
- D.A surgical opening (anastomosis) between the gallbladder and the jejunum
Show answer and explanation
Answer: D. A surgical opening (anastomosis) between the gallbladder and the jejunum
Chole- (bile), cyst- (bladder), jejun- (jejunum), and -ostomy (surgical opening) describe an anastomosis that drains bile from the gallbladder directly into the jejunum. Removal would use -ectomy, an incision -otomy, and fixation -pexy, so each distractor misreads a single suffix.
Question 6 · Perioperative Care
An awake patient is moving from the transport stretcher to the OR bed for a thyroidectomy. What should be done FIRST?
- A.Apply the safety strap across the patient's thighs
- B.Lower the stretcher so it sits slightly below the OR bed
- C.Lock the wheels of both the stretcher and the OR bed
- D.Remove the stretcher side rail and ask the patient to slide over
Show answer and explanation
Answer: C. Lock the wheels of both the stretcher and the OR bed
Both surfaces must be locked before any transfer so neither can roll apart while the patient moves. The stretcher and bed should be at the same height, not at different levels, and the safety strap is applied only after the patient is on the OR bed.
Question 7 · Perioperative Care
During a coronary artery bypass graft, the surgeon requests a nonabsorbable monofilament suture with very low tissue reactivity for the distal anastomosis. Which suture is MOST appropriate?
- A.Polypropylene
- B.Silk
- C.Polyglactin 910
- D.Chromic gut
Show answer and explanation
Answer: A. Polypropylene
Polypropylene is a nonabsorbable monofilament that is very inert and passes smoothly through vessel walls, which makes it a standard vascular suture. Silk is nonabsorbable but braided and more reactive, and the other choices absorb, which is unacceptable for a permanent anastomosis.
Question 8 · Perioperative Care
During a craniotomy for tumor resection, the surgeon removes the bone flap and hands it to the surgical technologist. How should the bone flap be handled?
- A.Placed in formalin and sent to pathology with the tumor
- B.Placed on the drapes next to the incision so it is easy to reach
- C.Wrapped in a moist sponge and kept protected on the back table
- D.Handed off the field to the circulator for storage
Show answer and explanation
Answer: C. Wrapped in a moist sponge and kept protected on the back table
The bone flap is usually replaced at the end of the case, so it is kept sterile on the back table, wrapped in a saline-moistened sponge or towel and clearly identified so it is not discarded or dropped. It is later fixed back in place with plates and screws or other cranial fixation. It is not a pathology specimen unless the surgeon states that the bone is involved by tumor.
Question 9 · Perioperative Care
Which item from a laparoscopic cholecystectomy belongs in regulated medical waste (the red bag)?
- A.A sponge that would release blood if compressed
- B.A drape with a few small spots of dried blood
- C.Paper wrappers from the opened sterile packages
- D.An empty, uncontaminated irrigation solution bottle
Show answer and explanation
Answer: A. A sponge that would release blood if compressed
Regulated medical waste includes items saturated or dripping with blood or body fluids, or caked with dried blood that could flake off. Lightly spotted drapes and clean packaging are general waste; putting them in red bags raises disposal costs without improving safety. Tissue not sent to pathology is handled as pathological waste according to facility policy.
Question 10 · Basic Science
A surgeon finishes an open inguinal hernia repair by suturing the tissue edges together without placing mesh. Which term BEST describes this primary tissue repair?
- A.Hernioplasty
- B.Herniorrhaphy
- C.Herniotomy
- D.Herniopexy
Show answer and explanation
Answer: B. Herniorrhaphy
The suffix -rrhaphy means suture repair, so a herniorrhaphy closes the defect by suturing native tissue. Hernioplasty (-plasty, surgical reconstruction) is the term generally used when the defect is reinforced with mesh, and herniotomy means only an incision into the hernia sac.

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