22 Professional Practice Practice Questions & Answers

1. 1. During a laparotomy the scrubbed surgical technologist realizes that an additional suture will be needed within the next few minutes. What is the MOST appropriate action?

   • A.Break scrub, retrieve the suture from the sterile core, then re-gown and re-glove
   • B.Ask the circulator to obtain the suture and deliver it to the sterile field✓ Answer
   • C.Say nothing until the surgeon actually asks for the suture
   • D.Leave the field briefly to check the supply cart, since the second scrub is present

   The first scrub role is confined to the sterile field; the scrubbed person cannot leave it without contaminating himself and abandoning accountability for the instruments and counted items. Retrieving supplies from outside the field is the non-sterile circulator's function, and anticipating the need before it is voiced is part of the scrub role.

   Source: AST Standards of Practice — division of sterile team (first scrub) and non-sterile circulator dutiesReport a problem with this question

2. 2. A scrubbed surgical technologist must be relieved in the middle of an open abdominal procedure. Which action is ESSENTIAL before the original technologist breaks scrub and leaves the room?

   • A.The original technologist leaves a written list on the back table for the relieving technologist
   • B.The surgeon repeats the entire time out for the incoming team member
   • C.The circulator documents the personnel change after the procedure has ended
   • D.A full count is completed and the relieving technologist confirms it as correct with the surgeon, the original technologist and the circulator✓ Answer

   Accountability for everything on and in the field transfers only when the incoming scrub has personally verified a correct count with the surgeon, the outgoing scrub and the circulator; if the original technologist leaves first, no one can establish the baseline that later proves whether an item was retained. The verbal handover must also cover the procedure in progress, items or sponges inside the cavity, sharps location, specimens, and every medication and solution on the field.

   Source: AST Standards of Practice for Transfer of Care During Intraoperative Case ManagementReport a problem with this question

3. 3. The circulator presents a labeled syringe of local anesthetic to the sterile field and states the drug name and strength aloud. Which response by the surgical technologist BEST demonstrates closed-loop communication?

   • A.Accept it and write an abbreviation of the drug name on a piece of tape
   • B.Nod, accept the syringe and place it on the back table for later use
   • C.Repeat the drug name and strength aloud while visually confirming the label, and have the circulator confirm the read-back✓ Answer
   • D.Accept the syringe and ask the surgeon later what was delivered

   Closed-loop communication has three parts: the sender states the message, the receiver repeats it back, and the sender confirms that the read-back was correct. Applied to medications it forces a verbal and visual verification of name and strength by two people at the moment of transfer, which is where wrong-drug errors on the sterile field originate; abbreviations are avoided because they are a documented source of medication error.

   Source: AST Guidelines for Safe Medication Practices; Joint Commission National Patient Safety Goal on labeling medications on the sterile fieldReport a problem with this question

4. 4. Late in a long case the surgical technologist is the only person who sees her own glove brush the unsterile edge of the drape. What should she do?

   • A.Announce the break in technique immediately and correct it by changing the glove✓ Answer
   • B.Wipe the glove with sterile saline and continue
   • C.Continue working, since no one observed it and the case is nearly over
   • D.Note it privately and report it to the supervisor after the patient leaves the room

   Surgical conscience is the obligation to be honest about one's own actions, errors and limitations and to correct a break in technique regardless of who is watching or what it costs in time; contamination that is concealed still delivers organisms to the wound, so silence converts a recoverable event into an avoidable infection risk for which the technologist is personally accountable.

   Source: AST Code of Ethics — always follow the principles of asepsis; surgical conscienceReport a problem with this question

5. 5. During a procedure, who is responsible for recording the initial count and any items subsequently added to the sterile field on the count record?

   • A.The circulator, while the counts themselves are performed audibly and concurrently with the scrubbed technologist✓ Answer
   • B.The scrubbed technologist, who documents on the sterile field and hands the sheet off at the end
   • C.The anesthesia provider, as part of the anesthesia record
   • D.The surgeon, who confirms the totals verbally

   Counts are performed together, audibly, with both people seeing and separating each item, but only the circulator is unsterile and therefore able to write; the record must show the types of counts, the number of each item, the names and titles of the people who counted, the result, any measures taken for an incorrect count, and an explanation for any count not done. Whether and where the technologist also signs is set by facility policy.

   Source: AST Standards of Practice for Counts — performance and documentation of countsReport a problem with this question

6. 6. A surgical technologist notices that an entry she made in the intraoperative record is wrong. What is the correct way to fix it?

   • A.Erase the entry completely so the record contains only accurate information
   • B.Draw a single line through the entry so it remains readable, write the correct information, and initial and date the correction✓ Answer
   • C.Rewrite the page cleanly, destroy the original, and keep the corrected copy
   • D.Cover the entry with correction fluid and write the correct information over it

   The operative record is legal evidence, so a correction must preserve the original entry and show who changed what and when; obliterating, erasing, destroying or back-dating an entry destroys the audit trail and creates an appearance of concealment that is far more damaging in litigation than the original error. Documentation is also made contemporaneously, because an entry written from memory hours later carries little evidentiary weight.

   Source: Health-record integrity rules for correcting an entry in the legal medical recordReport a problem with this question

7. 7. Two weeks after an abdominal operation a radiograph shows a retained laparotomy sponge. In the resulting lawsuit the patient argues that this injury does not happen unless someone was negligent. Which doctrine is being invoked?

   • A.Res ipsa loquitur✓ Answer
   • B.Respondeat superior
   • C.Primum non nocere
   • D.Doctrine of corporate negligence

   Res ipsa loquitur means 'the thing speaks for itself' and shifts the burden to the defendants when the injury would not ordinarily occur without negligence, the instrumentality was under the defendants' exclusive control, and the patient did nothing to contribute; a retained sponge in an anesthetized patient satisfies all three, which is why it is the textbook example. Respondeat superior addresses who pays for an employee's act, not whether negligence can be inferred.

   Source: Doctrine of res ipsa loquitur as applied to retained surgical itemsReport a problem with this question

8. 8. A surgical technologist employed by the hospital injures a patient while carrying out an assigned duty within the scope of that employment. Which doctrine allows the hospital to be held answerable for the technologist's act?

   • A.Respondeat superior✓ Answer
   • B.Doctrine of personal liability
   • C.Doctrine of implied consent
   • D.Res ipsa loquitur

   Respondeat superior means 'let the master answer' and makes an employer liable for the acts of employees performed within the scope of employment; in current practice the facility, not the surgeon, employs the surgical technologist. Importantly, it adds the employer's liability rather than removing the technologist's, because the doctrine of personal liability still holds every individual answerable for his or her own acts.

   Source: Doctrine of respondeat superior — employer liability for employee acts within the scope of employmentReport a problem with this question

9. 9. A sponge is retained after the scrubbed technologist reports a count as correct when it was not. Under the modern narrowing of the borrowed servant doctrine, which statement BEST describes liability?

   • A.Only the hospital can be liable, because the technologist is its employee
   • B.The surgeon is automatically liable for every act performed in his operating room
   • C.No liability attaches to anyone, because the count is a shared team responsibility
   • D.The technologist remains accountable, because the count is an independent routine duty he was trained to perform, and the surgeon is not automatically liable simply for directing the case✓ Answer

   The borrowed servant doctrine places greater responsibility on the person directing and controlling the work than on the one paying the wages, but courts have narrowed it: a surgeon is not held liable when a technologist or nurse fails at an independent routine duty within their own training, such as the count. Blanket surgeon liability is the abandoned 'captain of the ship' idea, and shared team responsibility for counts means any member may be held liable, not that none is.

   Source: Doctrine of the borrowed servant as narrowed in modern perioperative practice; doctrine of personal liabilityReport a problem with this question

10. 10. A surgeon directs the scrubbed surgical technologist to perform a task that is clearly outside the technologist's training and role, saying he will take responsibility. What should the technologist do FIRST?

    • A.Leave the room and report the surgeon directly to the medical director
    • B.Say nothing and quietly let the circulator deal with the surgeon
    • C.Respectfully decline at the field, state the reason, and alert the circulator so the charge nurse or supervisor can resolve it✓ Answer
    • D.Perform the task, since the surgeon has accepted responsibility for the outcome

    Under the doctrine of personal liability every practitioner answers for his or her own acts, so 'the surgeon told me to' is never a defense and no one can transfer that liability by accepting it verbally. The expected response is to address the problem directly and professionally at the field, then escalate through the facility chain of command, and to document; silence and unquestioning compliance are both departures from the standard of care, and the technologist's specific scope of practice is defined by state law and facility policy.

    Source: Doctrine of personal liability; facility chain of command and scope-of-practice limitsReport a problem with this question

11. 11. The team preps and begins operating on the patient's left knee although the signed consent and the site mark designate the right knee. This act is BEST classified as which of the following?

    • A.Battery, an intentional tort, because the touching was not authorized by the consent✓ Answer
    • B.Invasion of privacy, because the patient's body was exposed without permission
    • C.Simple negligence, because the team merely failed to be careful
    • D.Abandonment, because the correct site was left untreated

    Consent authorizes a specific procedure on a specific site; touching beyond that authorization is battery, an intentional tort, and no proof of carelessness is required because the wrong was the unauthorized contact itself. Candidates commonly default to negligence, but negligence requires a breach of a duty of care, whereas an intentional tort turns on the intent to make the contact, not on the intent to cause harm. Wrong-site surgery is also a classic sentinel event requiring root cause analysis.

    Source: Intentional tort of battery — unauthorized touching outside the scope of the consentReport a problem with this question

12. 12. A scrubbed surgical technologist walks off the sterile field and out of the room during an ongoing procedure without arranging relief. This exposes the technologist to a claim of which of the following?

    • A.False imprisonment
    • B.Defamation
    • C.Assault
    • D.Abandonment✓ Answer

    Abandonment is withdrawing care from a patient who still needs it without ensuring qualified relief, and the surgical patient is completely dependent on the team; the standard of care is what a reasonable, prudent technologist with similar training would do, and leaving the field unrelieved falls below it and can also cause direct harm through loss of accountability for counts and sharps. Assault is the threat of unwanted contact, false imprisonment is unwarranted restraint, and defamation is a damaging false statement.

    Source: Tort of abandonment; AST Standards of Practice for Transfer of Care during a procedureReport a problem with this question

13. 13. The team is preparing to move an anesthetized adult from the operating table to the stretcher. Which practice BEST protects both the patient and the staff?

    • A.Have two staff members grasp the corners of the draw sheet and pull with arms fully extended
    • B.Use a lateral transfer device with enough personnel, stand close to the load with a wide base and bent knees, and move on a single command given by the anesthesia provider✓ Answer
    • C.Keep the feet planted and twist at the waist to swing the patient across
    • D.Let the strongest team member lift the patient's torso alone while another takes the legs

    Safe patient handling relies on equipment and enough people rather than muscle: a transfer device removes shear and friction injury to the patient's skin, keeping the load close with a wide base and bent knees uses the large leg muscles instead of the lumbar spine, and moving on one command prevents the uncoordinated pull that causes both patient falls and staff back injury. Reaching with extended arms and twisting at the waist are the two classic mechanisms of occupational back injury.

    Source: Occupational safe patient handling and body-mechanics principles for lateral patient transferReport a problem with this question

14. 14. Who carries the responsibility for obtaining the patient's informed consent for a surgical procedure, including disclosure of the diagnosis, the nature and purpose of the procedure, its risks and benefits, the alternatives, and the consequences of refusal?

    • A.The surgeon who will perform the procedure✓ Answer
    • B.The surgical technologist who witnesses the signature
    • C.Any licensed member of the surgical team who is familiar with the procedure
    • D.The circulator, as the patient's advocate in the room

    The duty of disclosure belongs to the practitioner performing the procedure and is not delegable, because only that person can describe what he intends to do, his own experience and the specific risks involved; the anesthesia provider obtains a separate consent for anesthesia. Other team members verify that a valid consent exists and is consistent with the scheduled procedure and site, but they never supply the disclosure themselves.

    Source: Informed consent doctrine — the operating practitioner's non-delegable duty of disclosureReport a problem with this question

15. 15. A surgical technologist is asked to serve as an authorized witness to a patient's signature on the surgical consent form. Her signature as witness attests to which of the following?

    • A.That the patient understood the risks, benefits and alternatives that were explained
    • B.That the signer's identity was verified and the signature was given voluntarily✓ Answer
    • C.That she personally explained the procedure to the patient beforehand
    • D.That the surgeon disclosed every material risk in her presence

    A witness attests only to the identity of the person signing and to the voluntary nature of that signature; the witness cannot vouch for the patient's comprehension, which is the disclosing surgeon's responsibility, and the surgeon performing the procedure does not serve as one of the witnesses. AST's position is that a graduate of an accredited surgical technology program is qualified to act as an authorized witness, while the number of witnesses and the process itself follow facility policy under applicable law.

    Source: AST Position Statement on Witness of Informed ConsentReport a problem with this question

16. 16. In the preoperative holding area a patient tells the surgical technologist, 'I've changed my mind, and anyway I'm not sure which side they're operating on.' What is the technologist's FIRST action?

    • A.Ask a family member at the bedside to explain the operation to the patient
    • B.Reassure the patient that the operation is routine and continue preparing the room
    • C.Read the consent form aloud to the patient and explain what the procedure involves
    • D.Stop the process and notify the circulator and the surgeon so the surgeon can speak with the patient✓ Answer

    Consent may be withdrawn at any time, and expressed confusion means the consent may not be informed, so the case does not move forward until the surgeon resolves it directly with the patient. Explaining the procedure is outside the technologist's scope and could itself invalidate the consent; a family member is not an acceptable substitute for the surgeon's disclosure, just as a family member is not an acceptable substitute for a qualified medical interpreter.

    Source: Scope of practice — the surgical technologist neither obtains nor explains informed consent; consent may be withdrawn at any timeReport a problem with this question

17. 17. A rare anatomic finding is exposed during a case and a team member wants to photograph it with a personal phone to post on social media. What is the correct response?

    • A.It is acceptable if the image is shared only in a closed group of health professionals
    • B.Intraoperative images are protected health information; photography requires the patient's separate written authorization and facility approval, and posting the image is a privacy violation✓ Answer
    • C.It is acceptable if the circulator takes the photograph with a hospital-owned camera, because no consent is then needed
    • D.It is acceptable if the patient's face and name do not appear in the frame

    Images are themselves protected health information, and 'de-identified' surgical photographs routinely remain identifiable through dates, implants, scars, tattoos, wristbands or a visible whiteboard, so consent for the operation never implies consent to be photographed. Sharing within a closed professional group is still a disclosure, and the minimum-necessary standard limits access to what the role requires; violations carry facility discipline and civil or criminal penalties.

    Source: HIPAA Privacy Rule — images as protected health information and the minimum-necessary standard; AST Code of Ethics on confidentialityReport a problem with this question

18. 18. An anesthetized patient is being positioned and prepped while several staff members move in and out of the room. Which action BEST demonstrates the surgical technologist's role as patient advocate?

    • A.Allow anyone interested to observe, since the patient is asleep and will never know
    • B.Use the quiet period to discuss the patient's history and social circumstances with the team
    • C.Keep the patient covered until the prep begins, expose only the operative area, keep the door closed and traffic minimal, and keep conversation professional and case related✓ Answer
    • D.Uncover the patient completely so the prep can be done quickly and the case can start on time

    An anesthetized patient cannot protect his own dignity, privacy or safety, so the team speaks and acts for him; unnecessary exposure violates privacy and also causes heat loss, uncontrolled traffic raises airborne contamination, and observers require the patient's prior knowledge and agreement. Conversation matters because hearing may persist during induction and emergence and because case discussion is itself a confidentiality issue.

    Source: AST Code of Ethics — patient advocacy and protection of the patient's dignity and privacyReport a problem with this question

19. 19. A patient with an existing do-not-resuscitate (DNR) order is scheduled for a palliative surgical procedure. Which statement about that order is correct?

    • A.It is automatically suspended the moment the patient enters the operating room
    • B.The circulator and the surgical technologist may suspend it once anesthesia begins
    • C.It is not automatically suspended; it must be reconsidered with the patient or surrogate and the responsible physicians, and the outcome documented before the incision✓ Answer
    • D.It legally invalidates the surgical consent, so the procedure cannot proceed

    The accepted perioperative standard is required reconsideration: because anesthesia routinely produces effects that resemble resuscitation, the directive is revisited so the patient may maintain, suspend or modify it, for example permitting intubation and vasopressors but not chest compressions, and that decision is recorded before incision. Blanket automatic suspension overrides the patient's autonomy and is considered improper, and no member of the team may make or reverse a resuscitation decision.

    Source: Perioperative DNR position of the anesthesiology, surgical and perioperative nursing professional organizations — required reconsiderationReport a problem with this question

20. 20. Following an intraoperative equipment failure the surgical technologist completes an occurrence (incident) report. Which statement about that report is correct?

    • A.It should include the technologist's assessment of who was at fault so the problem can be corrected
    • B.It records objective facts without opinion or blame and is neither attached to nor referenced in the patient's medical record✓ Answer
    • C.A copy is filed in the patient's chart so the record of the case is complete
    • D.It replaces charting of the patient's care for the portion of the case affected

    The occurrence report is an internal risk-management and quality document whose purpose is system improvement, not proof of fault; referencing it in the chart pulls it into the legal record and can defeat the protection it is meant to have. Clinical facts about what happened to the patient are still charted objectively in the medical record, and speculation about blame turns a quality tool into evidence against the writer.

    Source: Risk-management practice for incident/occurrence reports as internal quality documents separate from the medical recordReport a problem with this question

21. 21. During a case a surgeon states that from now on she wants a different self-retaining retractor and no longer wants a routinely opened instrument set that is never used. What should the surgical technologist do?

    • A.Revise the surgeon's preference card promptly after the case, spelling items out in full, and notify whoever maintains the cards✓ Answer
    • B.Write the change on the card using abbreviations to save space
    • C.Rely on memory and tell the next technologist assigned to that surgeon
    • D.Continue opening the unused set until a supervisor formally changes the card

    Creating, maintaining and revising preference cards is a stated duty of the surgical technologist, and the revision is made promptly while the detail is accurate, because an out-of-date card drives delays, incorrect case carts and waste. Every item opened is charged whether or not it is used, so cost containment here is an extension of surgical conscience rather than mere economics; error-prone abbreviations are avoided on cards because they cause supply and medication errors.

    Source: NBSTSA CST content outline task — create, maintain and revise surgeon preference cards; cost containment processesReport a problem with this question

22. 22. A traveling surgical technologist is assigned to scrub a robotic case using a system on which she has never been trained or oriented. What is the BEST action?

    • A.Refuse the assignment and leave the department for the day
    • B.Take the assignment and learn the system during the procedure
    • C.Ask the surgeon to teach her the system while the patient is anesthetized
    • D.Inform the charge nurse or supervisor before the case that she has not been trained on that system and request an oriented technologist or supervised orientation✓ Answer

    Accepting a task beyond one's demonstrated competence is itself a breach of the standard of care, and personal liability cannot be shifted to the person who made the assignment; the professional obligation is to disclose the limitation before the case, when it can still be solved safely, and to request orientation rather than to abandon the assignment or improvise on a patient. Maintaining competence through continuing education is likewise a stated ethical duty of the surgical technologist.

    Source: AST Code of Ethics — maintain efficiency through continuing education and practice within one's competence; doctrine of personal liabilityReport a problem with this question

Practice questions based on the NBSTSA Certified Surgical Technologist exam content outline, AST standards of practice, and durable operating-room principles. CST is a mark of the National Board of Surgical Technology and Surgical Assisting; this site is not affiliated with or endorsed by NBSTSA or AST. Surgical counts, documentation, and what a technologist may perform are governed by your facility's policy and by state law, and sterilization parameters follow the manufacturer's written instructions — confirm all of these locally rather than from a practice test, and confirm current eligibility and exam requirements with the certifying board. About the CST exam →