HSPA Cheat Sheet 2026

The 30 highest-yield HSPA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. When transporting contaminated instruments from the point of use to the decontamination area, the cart or container must be: → Covered, leak-proof, and labeled with a biohazard symbol
2. Which organism is used as the biological indicator for ethylene oxide (EtO) sterilization? → Bacillus atrophaeus (formerly B. subtilis var. niger)
3. The chain of infection requires a causative agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and what final component? → A susceptible host
4. When placing a heavy instrument inside a peel pouch, it should be positioned so that: → The handle is toward the sealed (chevron) end
5. How should a blood pressure cuff be reprocessed per Spaulding classification? → Low-level disinfection as a non-critical item
6. What is the significance of bacterial endospores in sterilization? → The most resistant form of microbial life and the benchmark for sterilization efficacy
7. What is the minimum recommended contact time for high-level disinfection of a flexible endoscope using 2% glutaraldehyde at 25 degrees Celsius? → 20 minutes
8. What is the recommended procedure for cleaning instruments before sterilization? → Use enzymatic detergent and follow manufacturer instructions
9. Which organization publishes the ST79 guide for steam sterilization? → AAMI
10. What type of water should be used for the final rinse in instrument reprocessing? → Critical water meeting AAMI quality standards
11. What is the difference between perpetual and periodic inventory systems? → Perpetual continuously tracks in real-time; periodic counts at scheduled intervals
12. How should a reprocessed endoscope be stored to minimize contamination risk? → Hung vertically in a well-ventilated drying cabinet with valves removed
13. What is immediate-use steam sterilization (IUSS) and when is it appropriate? → Emergency shortened cycle when no sterile alternative is available
14. What three parameters must be achieved simultaneously for effective steam sterilization? → Temperature, time, and steam quality (moisture)
15. What standard addresses safe ethylene oxide sterilization in healthcare? → AAMI ST41
16. What is the most commonly used method for sterilizing surgical instruments in healthcare facilities? → Steam sterilization
17. When using the sequential wrapping method for an instrument tray, how many wrappers are used? → Two separate, single-layer wrappers
18. How should needle holders be tested for proper jaw function? → By clamping a suture needle and testing it holds at first ratchet position
19. What is the primary purpose of aeration following an Ethylene Oxide (EtO) sterilization cycle? → To remove residual toxic gas from the sterilized items.
20. What is the recommended position of instrument box locks during packaging for sterilization? → In the open (unlocked) position
21. What is the recommended method for storing sterilized instruments? → In a clean, closed cabinet or storage area
22. What determines the minimum exposure time for manual cleaning with enzymatic detergent? → The time specified by the detergent manufacturer's IFU
23. What indicates tissue forceps require replacement? → Teeth are bent, missing, or do not interdigitate properly
24. What reprocessing level is required for flexible GI endoscopes? → High-level disinfection minimum, sterilization preferred
25. What certification does HSPA offer for sterile processing technicians? → CRCST certification requiring education, passing exam, and continuing education
26. Prions are a significant concern in sterile processing because they are: → Highly resistant to standard sterilization processes
27. Why is it important to test cleaning solution concentration during manual cleaning? → To verify detergent is at manufacturer-specified concentration for optimal cleaning
28. During manual cleaning, instruments should be brushed: → Under the surface of the water
29. What is the primary purpose of using a cleaning verification test, such as an ATP or protein test, after the cleaning process? → To verify the removal of microscopic soil and bioburden
30. What is the correct sequence of steps in endoscope reprocessing? → Pre-clean, leak test, manual clean, rinse, HLD, rinse, dry