TL;DR
The CST Certified Surgical Technologist Exam exam is administered by National Board of Surgical Technology and Surgical Assisting (NBSTSA) with a Approximately 72% nationally; 77% from CAAHEP-accredited programs pass rate. This guide covers all 3 content domains, common failure modes, and sample questions. The exam format is 175 multiple-choice questions (150 scored, 25 pretest) with a 4 hours time limit.
CST Certified Surgical Technologist Exam: Complete Guide
Everything you need to know before you start studying.
Exam Facts
What the Exam Tests
Perioperative Care
64.7%The largest domain, covering all phases of surgery. Preoperative (12.7%): patient identification, consent verification, skin prep, positioning. Intraoperative (45.3% — nearly half the exam): surgical instruments by specialty, passing techniques, sponge/sharp/instrument counts, hemostasis, wound closure, sterile field maintenance. Postoperative (6.7%): dressing application, drain management, room turnover.
Ancillary Duties
15.3%Administrative tasks (4.7%): surgical scheduling, supply management, documentation, preference cards. Equipment sterilization (10.7%): steam autoclaving parameters (270°F/132°C prevacuum, 250°F/121°C gravity), chemical sterilization (Sterrad, glutaraldehyde), biological indicators, Spaulding classification.
Basic Science
20%Anatomy & physiology (12%): surgical anatomy by body system, blood supply, nerve paths at risk. Microbiology (4%): surgical site infection classification (clean/clean-contaminated/contaminated/dirty), pathogen types, aseptic technique. Surgical pharmacology (4%): local anesthetics (lidocaine limits), hemostatic agents (gelfoam, surgicel, bone wax), prophylactic antibiotics (within 60 min of incision).
Common Reasons Candidates Fail
1. Instrument identification across surgical specialties
The intraoperative section is 45.3% of the exam and heavily tests instrument recognition across general, orthopedic, cardiovascular, and OB/GYN surgery. Candidates who only know instruments from their clinical rotation specialty miss questions about specialties they haven't worked in.
2. Sterilization parameters
Exact temperatures, times, and pressures for steam sterilization (gravity vs prevacuum), which biological indicator to use (B. stearothermophilus for steam, B. atrophaeus for EtO), and chemical indicator classes are frequently tested and frequently confused.
3. Surgical pharmacology
Despite being only 4% of the exam, pharmacology is disproportionately difficult. Maximum doses of local anesthetics (lidocaine 4.5mg/kg without epi, 7mg/kg with epi), which hemostatic agent for which situation, and prophylactic antibiotic timing trip up many candidates.
4. Count discrepancy procedures
What to do when a sponge/sharp/instrument count is incorrect (notify surgeon, do NOT close, X-ray, document) is tested repeatedly. Candidates who don't know the exact protocol lose multiple points.
Practice Questions
Click "Reveal answer" to see the correct answer and explanation.
Q1.During a cholecystectomy, the surgeon asks for the instrument used to grasp the gallbladder fundus. Which instrument should the surgical technologist pass?
Q2.What is the minimum temperature and time for prevacuum (flash) steam sterilization?
Q3.The biological indicator used to test steam sterilization effectiveness contains:
Q4.During the closing count, one raytec sponge is missing. What is the surgical technologist's FIRST action?
Practice adaptively for the CST exam: Valenke covers surgical instruments, perioperative care, sterilization, anatomy, and pharmacology — drilling your weakest areas.
Start free practice →Frequently Asked Questions
▶How many questions is the CST exam?
The CST exam has 175 multiple-choice questions, of which 150 are scored and 25 are unscored pretest items. You have 4 hours to complete it. You need 98 out of 150 correct to pass.
▶What is the CST exam pass rate?
The national pass rate for the CST exam is approximately 72%. Graduates of CAAHEP-accredited programs have a higher pass rate of about 77%.
▶What topics are on the CST exam?
The CST exam covers Perioperative Care (64.7% — preoperative, intraoperative, and postoperative procedures), Ancillary Duties (15.3% — administrative and sterilization), and Basic Science (20% — anatomy, microbiology, and surgical pharmacology). The intraoperative section alone is 45.3% of the exam.
▶What is the hardest part of the CST exam?
Community consensus is that instrument identification across multiple surgical specialties is the hardest area, followed by sterilization parameters and surgical pharmacology. The intraoperative section (45.3% of the exam) requires broad knowledge across general, orthopedic, cardiovascular, and OB/GYN surgery.