The NBSTSA certifies surgical technologists through the CST exam and surgical first assistants through the CSFA exam. This page gives candidates free practice sets on instrumentation, safety, standards and documentation, worked explanations, a study plan, and the exam facts the board publishes on format, fees and retakes.
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
| Item | Detail | Source · Verified |
|---|---|---|
| Number of questions (CST) | 175 questions (150 scored, 25 unscored pretest)[1] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
| Time limit (CST) | 4 hours (breaks count against time)[1] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
| Exam fee (CST) | $340 ($230 AST members)[1] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
| Retake policy (CST) | No waiting period; up to 3 exams per calendar year[1] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
| Renewal (CST) | $40 renewal fee with CE credits, or re-exam ($440 AST member / $540 non-member)[1] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
| Eligibility (CSFA) | Graduate of a CAAHEP-accredited surgical first assistant program[2] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
| Eligibility (CST) | Graduate of a CAAHEP- or ABHES-accredited surgical technology program[3] | National Board of Surgical Technology and Surgical Assisting · Oct 25, 2026 |
According to National Board of Surgical Technology and Surgical Assisting, “The CST examination consists of 175 multiple choice questions, 150 of which are scored.”[1]
The National Board of Surgical Technology and Surgical Assisting (NBSTSA) is the body behind the CST credential for surgical technologists and the CSFA credential for surgical first assistants. Passing the exam is how a candidate shows they meet a national standard. Employers and states may set their own requirements on top of that, and these vary, so check with your state and employer as well as the board.
Eligibility. For the CST exam, you must graduate from a CAAHEP- or ABHES-accredited surgical technology program. For the CSFA exam, you must graduate from a CAAHEP-accredited surgical first assistant program.
Format. The CST exam has 175 multiple choice questions, and 150 of them are scored. The other 25 are unscored pretest questions, and you will not be told which they are. You get 4 hours, and breaks count against that time.
Fees. The CST exam fee is $340, or $230 for AST members. Renewal costs $40 with continuing education credits, or you can renew by re-examination at $440 for AST members and $540 for non-members.
Retakes. There is no waiting period. You can reapply immediately, but you are limited to 3 exams in a calendar year.
The passing score and the detailed content outline are not listed here. Read the current candidate handbook on nbstsa.org before you apply, because fees and rules can change.
Prepare for the NBSTSA - National Board of Surgical Technology and Surgical Assisting Certified exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.
Question: What is the primary purpose of the Weitlaner retractor?
Answer: B. Self-retaining retraction of wound edges in smaller incisions
Explanation:
The correct answer is self-retaining retraction of wound edges in smaller incisions. The Weitlaner has sharp prongs and a ratchet that lock it open, so it holds the wound edges apart without an assistant's hands.
Retracting the chest wall is wrong because that work needs a rib spreader built for rigid bone. Retracting the liver is wrong because it calls for a broad, smooth blade that spreads pressure over organ tissue, not a prong-style retractor. Deep pelvic exposure is wrong because it needs a long-bladed, deep retractor, and the Weitlaner is a shallow-field instrument.
Rule to remember: match the retractor to the depth, the tissue and whether it must hold itself open. Self-retaining retractors with prongs suit superficial or small incisions. Deep cavities and solid organs need different tools.
Question: What quality assurance measure supports safety and compliance?
Answer: B. Regular self-assessment, peer review, and adherence to established standards
Explanation:
The correct answer is regular self-assessment, peer review, and adherence to established standards. Quality assurance is a continuing process that covers everyone on the team, so it checks practice against a standard and corrects gaps as they appear.
The claim that checks are unnecessary for experienced professionals is wrong because experience does not remove drift, habit or outdated technique. The claim that quality only matters for new practitioners is wrong for the same reason: errors and unsafe shortcuts can happen at any career stage. The claim that an annual review is sufficient is wrong because a single yearly look cannot catch problems as they develop in daily work.
Rule to remember: safety and compliance depend on ongoing, shared checking against written standards, not on seniority or one scheduled review.
Question: A Kocher (Ochsner) clamp is characterized by which of the following features?
Answer: C. Teeth at the tip of the jaws
Explanation:
The correct answer is teeth at the tip of the jaws. A Kocher (Ochsner) clamp has interlocking teeth at the tip, which give a firm grip on tough tissue such as fascia. That grip crushes tissue, so it is a traumatic instrument.
Smooth jaws for atraumatic handling is wrong because that describes a different class of clamp, designed to protect delicate structures. Horizontal serrations only is wrong because the defining feature here is the tip teeth, not serrations alone. A ratchet-free locking mechanism is wrong because clamps of this type lock with a ratchet so they stay closed without hand pressure.
Rule to remember: toothed tips mean a strong hold and more tissue damage, so use them on tough tissue and keep them away from delicate structures.
Start with the official material. Download the current candidate handbook from nbstsa.org and read the sections on eligibility, exam format and the content outline, so you know what the board expects before you practise.
Next, take a short practice test as a baseline. Do not worry about the score. Note which topics feel weakest and write them down.
Then work through the topic sets in an order that follows your gaps. Spend time on surgical instrumentation and equipment, safety and compliance, and professional standards and ethics. Add communication and documentation and applied methods and techniques as you go.
After every set, read the explanation for each question you missed and also for the ones you guessed right. Write the general rule in your own words, such as why a clamp is traumatic or why a retractor suits a given depth. Check any doubtful point against your program notes and the handbook.
In the last stretch, sit a full practice test in one sitting with a timer, since breaks count against exam time. Our questions are written by us to practise concepts, and they are not real exam questions.
You must graduate from a CAAHEP- or ABHES-accredited surgical technology program. The board sets this rule, so confirm the current wording on nbstsa.org or in the candidate handbook before you apply.
To be eligible for the CSFA exam, you must graduate from a CAAHEP-accredited surgical first assistant program. Check the board's CSFA eligibility page for current details, as it is the official source.
The CST exam has 175 multiple choice questions, and 150 are scored. The other 25 are unscored pretest questions. You have 4 hours, and any breaks you take count against that time, so plan your pacing.
The CST exam fee is $340, or $230 if you are an AST member. Fees can change, so confirm the amount in the current candidate handbook on nbstsa.org before you submit your application.
Yes. There is no waiting period, and you can resubmit an application immediately. You are limited to 3 exams in one calendar year, so use the time between attempts to review the topics you missed.
You can renew for $40 with continuing education credits, or by re-examination for $440 if you are an AST member or $540 if you are not. See the handbook for credit requirements and deadlines.
How we verify: editorial & fact-checking policy. Report an error: contact us.