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NBSTSA-CST Certified Surgical Technologist plan |

NBSTSA-CST plan - Certified Surgical Technologist Updated: 2024

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Exam Code: NBSTSA-CST Certified Surgical Technologist plan January 2024 by team

NBSTSA-CST Certified Surgical Technologist

The CST examination consists of 175 questions, 150 of which are scored. The 25 pretest items (unscored) are randomly distributed throughout the examination for the purpose of analysis and statistical evaluation. The passing score is the
minimum number of questions that must be answered correctly. Candidates should refer to for the number of questions which must be answered correctly in order to obtain a passing score. Score reports are provided to all candidates who take the examination


A. Preoperative Preparation (18 items)

- Review surgeons preference card.

- Verify availability of surgery equipment (e.g., reserve equipment for surgery).

- Don personal protective equipment.

- Utilize preoperative documentation (e.g., informed consent, advanced directives, allergies, laboratory results).

- Consider patient needs (e.g., bariatrics, geriatrics, pediatrics, immunocompromised, patient allergies).

- Prepare the operating room environment (e.g., temperature, lights, suction, wiping down the room and furniture).

- Coordinate additional equipment (e.g., bovie pad, pneumatic tourniquet, sequential compression devices, thermoregulatory devices, positioning devices).

- Obtain instruments and supplies needed for surgery.

- Perform medical hand wash.

- Check package integrity of sterile supplies.

- Open sterile supplies/instruments while maintaining aseptic technique.

- Perform surgical scrub (e.g., initial, waterless).

- Don gown and gloves.

- Assemble and set up sterile instruments and supplies for surgical procedures.

- Transport the patient to and from operating room.

- Transfer patient to operating room table.

- Apply patient safety devices (e.g., bovie pad, safety strap, protective padding, x-ray safety).

- Apply patient monitoring devices as directed.

- Participate in positioning the patient.

- Prepare surgical site (e.g., hair removal, surgical preparation).

- Gown and glove sterile team members.

- Participate in draping the patient.

- Secure cords/tubing to drapes and apply light handles.

- Drape specialty equipment (e.g., c-arm, Da Vinci, microscope).

- Participate in Universal Protocol (Time Out).

B. Intraoperative Procedures (61 items)

- Maintain aseptic technique throughout the procedure.

- Follow Standard and Universal Precautions.

- Anticipate the steps of surgical procedures.

- Perform counts with circulator at appropriate intervals.

- Verify, receive, mix, and label all medications and solutions.

- Provide intraoperative assistance under the direction of the surgeon.

- Identify different types of operative incisions.

- Identify instruments by:

- function.

- application.

- classification.

- Assemble, test, operate, and disassemble specialty equipment:

- microscopes.

- computer navigation systems.

- thermal technology.

- laser technology (e.g., helium, argon, CO2 beam coagulators).

- ultrasound technology (e.g., harmonic scalpel, phacoemulsification).

- endoscopic technology.

- power equipment.

- Assemble and maintain retractors.

- Pass instruments and supplies.

- Identify appropriate usage of sutures/needles and stapling devices.

- Prepare, pass, and cut suture material as directed.

- Provide assistance with stapling devices.

- Differentiate among the various methods and applications of hemostasis (e.g., mechanical, thermal, chemical).

- Irrigate, suction, and sponge operative site.

- Monitor medication and solution use.

- Verify with surgeon the correct type and/or size of specialty specific implantable items.

- Prepare bone and tissue grafts (e.g., allograft, autograft, synthetic).

- Verify, prepare, and label specimen(s).

- Prepare drains, catheters, and tubing for insertion.

- Observe patients intraoperative status (e.g., monitor color of blood, blood loss, patient position).

- Perform appropriate actions during an emergency.

- Initiate preventative actions in potentially harmful situations.

- Connect and activate drains to suction apparatus.

- Prepare dressings and wound site.

- Assist in the application of casts, splints, braces, and similar devices.

C. Postoperative Procedures (12 items)

- Report medication and solution amount used.

- Participate in case debrief.

- Remove drapes and other equipment (e.g., suction, cautery, instrumentation,nondisposable items) from patient.

- Report abnormal postoperative findings (e.g., bleeding at surgical site,hematoma, rash).

- Dispose of contaminated waste and drapes after surgery incompliance with Standard Precautions.

- Transfer patient from operating table to stretcher.

- Dispose of contaminated sharps after surgery in compliance with Standard Precautions.

- Perform room clean up and restock supplies.


A. Administrative and Personnel (9 items)

- Revise surgeons preference card as necessary.

- Follow proper cost containment processes.

- Utilize computer technology for:

- surgeons preference cards

- interdepartmental communication

- continuing education.

- research.

- Follow hospital and national disaster plan protocol.

- Recognize safety and environmental hazards (e.g., fire, chemical spill, laser, smoke).

- Understand basic principles of electricity and electrical safety.

- Apply ethical and legal practices related to surgical patient care.

- Use interpersonal skills (e.g., listening, diplomacy, responsiveness) and group dynamics.

- Understand the importance of cultural diversity.

- Understand concepts of death and dying.

- Participate in organ and tissue procurement.

- Serve as preceptor to perioperative personnel.

B. Equipment Sterilization and Maintenance (17 items)

- Troubleshoot equipment malfunctions.

- Decontaminate and clean instruments and equipment.

- Inspect, test, and assemble instruments and equipment.

- Sterilize instruments for immediate use (e.g., short cycle).

- Package and sterilize instruments and equipment.


A. Anatomy and Physiology (20 items)

- Use appropriate medical terminology and abbreviations.

- Demonstrate knowledge of anatomical systems as they relate to the surgical procedure:

- cardiovascular.

- endocrine.

- gastrointestinal.

- genitourinary.

- integumentary.

- lymphatic.

- muscular.

- neurological.

- ophthalmic.

- otorhinolaryngology.

- peripheral vascular.

- pulmonary.

- reproductive.

- skeletal.

- Demonstrate knowledge of human physiology as they relate to the surgical procedure:

- cardiovascular.

- endocrine.

- gastrointestinal.

- genitourinary.

- integumentary.

- lymphatic.

- muscular.

- neurological.

- ophthalmic.

- otorhinolaryngology.

- peripheral vascular.

- pulmonary.

- reproductive.

- skeletal.

- Identify the following surgical pathologies:

- abnormal anatomy.

- disease processes.

- malignancies.

- traumatic injuries.

B. Microbiology (6 items)

- Apply principles of surgical microbiology to operative practice:

- classification and pathogenesis of microorganisms (e.g., cultures).

- infection control procedures (e.g., aseptic technique).

- principles of tissue handling (e.g., Halsted principles, tissue manipulation methods, traction/counter traction).

- stages of, and factors influencing wound healing (e.g., condition of patient, wound type).

- surgical wound classification.

- Identify and address factors that can influence an infectious process.

C. Surgical Pharmacology (7 items)

- Apply principles of surgical pharmacology to operative practice:

- anesthesia related agents and medications.

- blood and fluid replacement.

- complications from drug interactions (e.g., malignant hyperthermia).

- methods of anesthesia administration (e.g., general, local, block).

- types, uses, action, and interactions of drugs and solution (e.g., hemostaticagents, antibiotics, IV solutions).

- weights, measures, and conversions.

- Maintain awareness of maximum dosage.
Certified Surgical Technologist
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NBSTSA-CST Certified Surgical Technologist

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Certified Surgical Technologist?
Question: 44
What is the purpose of covering reconstituted disinfectant solutions when not in
A. The solutions may otherwise become contaminated.
B. The solutions may emit noxious fumes or odors.
C. The solutions may otherwise lose levels of concentration.
D. The solutions may expire more quickly.
Answer: B
The purpose of covering reconstituted disinfectant solutions is that the solutions
may emit noxious fumes or odors. Disinfectant solutions can contain very
powerful odors because they are created from chemical compounds designed to
kill microorganisms. However, noxious odors and fumes from these chemicals
can become overwhelming to staff when left unattended and may be very
uncomfortable for the patient who is recovering.
Question: 45
Which of the following steps is part of the terminal process of cleaning
instruments used in surgery?
A. Disinfection
B. Neutralization
C. Sterilization
D. Both A and C
Answer: D
Disinfection and sterilization are both parts of the terminal process of cleaning
instruments used in surgery. Both disinfection and sterilization involve
eliminating microorganisms that have the potential to cause disease so
instruments may be used again for future procedures. The process follows the
decontamination stage and is done before supplies are stored for use.
Question: 46
What items must the perioperative nurse check to ensure safety during a surgery
that uses electrocautery?
A. The electrosurgical unit is set at the highest setting necessary for the
B. The footpad should be located just next to the suction canister for ease of use.
C. The ground pad is in an appropriate location, such as on the back of the elbow.
D. The alarm is turned on and can be heard by those in the room.
Answer: D
The perioperative nurse should ensure that the alarm for the electrocautery unit
has been turned on and can be heard by those in the room. This alarm typically
activates if the ground pad is not working or if the patient is at risk of becoming
burned. The nurse can also check for this by ensuring the ground pad stays dry
during the procedure and that it maintains consistent contact with the patient.
Question: 47
Which of the following factors may have an effect on a patient’s risk of
developing an infection after a surgical procedure?
A. The patient’s condition before surgery
B. The state of the surgical wound at closure
C. The route the antibiotics were administered preoperatively
D. Both A and B
Answer: D
Both the patient’s condition before surgery and the state of the surgical wound at
closure have an effect on the patient’s risk of developing an infection after a
surgical procedure. Some patients with certain medical conditions are more likely
to develop infections than others; for example, a patient with diabetes may be at
higher risk. A wound that is kept clean during the surgical procedure is less likely
to become infected.
Question: 48
A nurse in the operating room helps the surgeon by using surgical instruments,
providing suturing and handling tissue specimens. The most likely title of this
nurse would be:
A. Scrub nurse
B. RN first assistant
C. Circulating nurse
D. Nurse anesthetist
Answer: B
The most likely title of this nurse would be an RN first assistant. This type of
nurse works in the perioperative setting but may have duties that exceed those of
the circulating or scrub nurse. The RN first assistant usually assists the physician
directly, but their real scope of practice may vary between states.
Question: 49
While administering blood products during a surgical procedure, the nurse notes
that the patient has spiked a fever to 101 degrees, their skin is flushing and their
heart rate has increased. What is the nurse’s first reaction?
A. Administer oxygen by non-rebreather mask at 10L/min.
B. Call the Blood Bank to verify labeling of the blood products.
C. Check the patient’s chart to ensure the orders are correct.
D. Stop the transfusion and notify the physician.
Answer: D
The nurse’s first action is to stop the transfusion and notify the physician. When
giving a blood transfusion, if the patient develops a fever, flushing and becomes
tachycardic, they are most likely having a transfusion reaction. The nurse needs to
notify the physician who placed the order, as well as the Blood Bank; treat the
signs of transfusion reaction; and begin another transfusion, if ordered.
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Michael Cohen arrives at New York Supreme Court for former President Donald Trump's civil business fraud trial on Oct. 25, 2023 in New York. Cohen says he unwittingly passed along to his attorney bogus artificial intelligence-generated legal case citations he got online before they were submitted to a New York judge. Yuki Iwamura/AP hide caption

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Google has a plan for incorporating artificial intelligence into its healthcare offerings and now its lobbyists are working to influence future regulations, according to Politico.

Lawmakers are questioning whether Google's plans for rolling out advanced AI before regulations are released could put patient data at risk and reinforce biases. Google already has AI partnerships with health systems including Rochester, Minn.-based Mayo Clinic to deploy tools examining medical records, research papers and more to help clinicians diagnose and treat patients.

Nashville, Tenn.-based HCA Healthcare is also using Google's AI tools for clinical notes to support physicians and nurses. Meditech, an EHR company, has partnered with Google as well to auto-generate clinical documentation and summarize patient histories.

Google maintains its technology is only deployed in "limited capacity" and not trained on personal health information, according to the report. The tech giant did release an AI policy agenda in November and aims to partner with the government to explain the technologies as lawmakers develop standards.

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L3Harris Technologies can say it is the product of almost 200 acquisitions over the past two decades including the big merger in 2019 to create the blue chip defense company that it is today.

For the current iteration of L3Harris' strategy, its estimated $4.7 billion purchase of Aerojet Rocketdyne over the summer will be the one that investors watch post-close to see how that business integrates into its new owner and performs over the long-term.

The company's other big-ticket acquisition and integration exercise was a major point of emphasis for its investor day presentation on Tuesday, where L3Harris' executive team including CEO Chris Kubasik detailed the company's newest three-year blueprint and financial goals.

Six months before the Aerojet closure, L3Harris acquired a secure communication product business from satellite network operator Viasat for close to $2 billion.

The so-called Tactical Data Links business centers a bulk of its work around Link 16, a network used by the U.S. military and NATO partners to move data between soldiers and systems.

As L3Harris' Communication Systems Segment President Sam Mehta told investors, critical and sensitive information is often conveyed across that global waveform and via the nearly 20,000 platforms on it.

"Despite being in operation for several decades, Link 16 is still under continuous development, adding new capabilities," Mehta told analysts. "Recently the DOD (Defense Department) announced that they sent and received their first Link 16 transmission for space, opening up this incredibly important and growing domain to that Link 16 franchise. It was our equipment that helped enable those transmissions."

During that Nov. 21-Nov. 27 exercise, the Space Development Agency sent data from ground radios to satellites flying in low-Earth orbit and within the territory of an unnamed U.S. intelligence sharing ally. SDA's long-term goal is to connect Link 16 to the future military "space backbone" constellation the agency calls the Proliferated Warfighter Space Architecture.

Link 16's wide scope is a big reason why L3Harris wanted more of a footing in that program, which Mehta told analysts is in constant iteration.

"This acquisition of Tactical Data Links allows us access to those platforms, to be able to provide additional capability for waveforms and software that we've developed in the company, and to work alongside that Link 16 capability," Mehta said.

TDL is poised to end the year on a total backlog of $600 million, but that is merely the starting point for L3Harris with respect to how it sees that franchise fitting into the portfolio.

L3Harris is mostly a hardware-defined company, as Kubasik highlighted to analysts.

"The way we're going to really move the needle is through the software upgrades, whether it's in the waveforms as we upgrade Link 16 or in some of our other products," Kubasik said.

Organic growth will be how L3Harris looks to move its overall needle over the next three years with acquisitions being halted "for the foreseeable future," Kubasik said.

L3Harris expects to end 2023 with revenue of $19.2 billion-to-$19.4 billion on a segment operating margin of 14.8%. The company's initial outlook for 2024 has sales of around $21 billion and a margin of 15%, while the 2026 framework has a top-line goal of $23 billion and a bottom line of 16%.

Further divestitures will continue to be on the agenda for L3Harris in the wake of its board of directors' move to stand up a business review committee charged with evaluating the overall company, including the portfolio and operational performance.

"We already have some ideas in process here that we'll review with them, probably in January, and then we'll exit product lines that don't move the needle and aren't strategic to us," Kubasik said.

L3Harris has already lined up a private equity buyer for its commercial aviation solutions business in TJC, which will pay an initial $700 million in cash and potentially $100 million more under an earnout clause. It sure sounded like L3Harris said to stay tuned for more announcements like that.

Below is the full investor day presentation.

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