CRCST Ready
All CRCST practice questions

CRCST Preparation and Packaging practice questions

Inspecting instruments for cleanliness and function, assembling sets with count sheets and indicators, choosing and closing packaging, and labeling packages correctly. This domain is about 21% of the exam. Try each question, then open the answer.

Read the Preparation and Packaging study guide

Question 1

A technician sealing paper-plastic pouches notices wrinkles and small channels running across the width of several seals. What is the best action?
  1. Repackage them and have the sealer's settings checked
  2. Cover the wrinkled part of each seal with a strip of indicator tape
  3. Run each pouch through the sealer again over the same seal
  4. Sterilize the pouches and recheck the seals after the cycle
Show answer

Answer: A. Repackage them and have the sealer's settings checked

A good heat seal is continuous and uniform, with no wrinkles, channels, or gaps, because any channel can let microorganisms in after sterilization. Defective pouches are repackaged. Repeated defects suggest a sealer problem, so the settings should be checked against the manufacturer's IFU.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging; ANSI/AAMI ST79:2017/(R)2022, section on packaging (pouch sealing)

Question 2

During assembly of a laparoscopic set, a technician runs each insulated grasper through an insulation tester. What is the main purpose of this test?
  1. To confirm the grasper's jaws close with even tension
  2. To find insulation breaks that could burn the patient
  3. To verify that the instrument's lumen is free of soil
  4. To check that the instrument is dry enough to package
Show answer

Answer: B. To find insulation breaks that could burn the patient

Insulated electrosurgical instruments can have tiny cracks or pinholes in their coating that are hard to see. Current can escape through these breaks and burn tissue away from the surgical site. An insulation tester finds breaks that visual inspection can miss.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 11, Complex Surgical Instruments (topic: insulated instruments); ANSI/AAMI ST79:2017/(R)2022, section on inspection

Question 3

During inspection under lighted magnification, a technician sees dried debris in the box lock of a needle holder that came through the washer-disinfector. What is the correct action?
  1. Spray it with instrument lubricant to loosen the debris
  2. Package it, since steam will penetrate the dried debris
  3. Wipe the box lock with a damp cloth at the prep station
  4. Return it to decontamination for recleaning
Show answer

Answer: D. Return it to decontamination for recleaning

Inspection in the prep area is a check on cleaning. Any instrument with visible soil goes back to decontamination to be recleaned, because you cannot sterilize what is not clean. Box locks, serrations, and hinges are common places for soil to hide, which is why they are inspected under magnification.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 10, Surgical Instrumentation (topic: inspection); ANSI/AAMI ST79:2017/(R)2022, section on inspection

Question 4

What is the main reason mineral oil and silicone are not used to lubricate surgical instruments?
  1. They are too thick to reach inside box locks
  2. Oils and silicone leave a film that blocks sterilant
  3. Mineral oil turns dark when heated and stains the tray
  4. Silicone dissolves stainless steel's passivation layer
Show answer

Answer: B. Oils and silicone leave a film that blocks sterilant

Mineral oil and silicone leave a coating that steam and other sterilants cannot pass through, so microorganisms under the film may survive. Lubricants are chosen and used per the instrument and lubricant IFUs.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 10, Surgical Instrumentation (topic: lubrication); ANSI/AAMI ST79:2017/(R)2022, section on inspection and lubrication

Question 5

Which type of stainless steel is usually used for scissors and clamps because it can be hardened to hold an edge?
  1. 300-series (austenitic) stainless steel
  2. 400-series (martensitic) stainless steel
  3. Anodized aluminum alloy
  4. Chrome-plated brass
Show answer

Answer: B. 400-series (martensitic) stainless steel

400-series (martensitic) stainless steel can be heat-hardened, so it keeps a cutting edge and holds up to clamping stress. 300-series (austenitic) stainless steel is more corrosion resistant but softer, so it is used for retractors, basins, and other non-cutting items. Knowing this helps explain why some instruments need more care.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 10, Surgical Instrumentation (topic: instrument metals)

Question 6

A count sheet lists six Kelly hemostats, but the set returned from the OR has seven. What should the technician do?
  1. Leave all seven, since an extra instrument does no harm
  2. Change the count sheet to show seven hemostats
  3. Discard the extra hemostat to keep the count correct
  4. Remove the extra one and route it per policy
Show answer

Answer: D. Remove the extra one and route it per policy

Sets are assembled to match the count sheet exactly, because the surgical team relies on accurate counts. An extra instrument usually belongs to another set, so it is routed per policy to where it belongs. Count sheets are changed only through the approved process.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: count sheets)

Question 7

A technician puts tight, non-vented plastic tip guards on fine scissors in a steam set. What is the problem?
  1. There is no problem, because tight guards cannot fall off
  2. Tip protectors are allowed only in low-temperature sterilization
  3. They may block steam; use validated, permeable protectors
  4. Tip guards should be added after sterilization, not before
Show answer

Answer: C. They may block steam; use validated, permeable protectors

Tip protectors guard sharp or delicate tips. They must be made of material the sterilant can pass through, be validated for the sterilization method, and fit without sealing off the tips. Tight, non-vented guards can keep steam from contacting the surfaces under them.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: protective devices); ANSI/AAMI ST79:2017/(R)2022, section on preparation of instrument sets

Question 8

A technician is packaging three nested basins for steam sterilization. Which practice is correct?
  1. Nest same-size basins tightly together so that no air gaps remain between them
  2. Alternate the direction each basin faces so the weight is balanced in the set
  3. Place the heaviest instruments inside the top basin to make good use of space
  4. Separate with absorbent material; 1-inch size difference; all facing one way
Show answer

Answer: D. Separate with absorbent material; 1-inch size difference; all facing one way

Nested basins need space between them so steam can reach every surface and condensate can drain. A difference of at least 1 inch in diameter, absorbent material between basins, and all basins facing the same way make this possible.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: basin sets); ANSI/AAMI ST79:2017/(R)2022, section on preparation of instrument sets

Question 9

What does the external indicator tape on a wrapped pack show after a cycle?
  1. That the pack was exposed to the process
  2. That the contents of the pack are sterile
  3. That all critical variables were met inside the pack
  4. That the sterilizer passed its air-removal test
Show answer

Answer: A. That the pack was exposed to the process

External indicator tape is a Type 1 process indicator. Its color change shows that the package was exposed to the sterilization process, which separates processed packs from unprocessed ones. It does not show that the contents are sterile.

Source: ANSI/AAMI/ISO 11140-1:2014/(R)2025, chemical indicator classes; HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: chemical indicators)

Question 10

A two-level rigid container set is being assembled. Where should internal chemical indicators be placed?
  1. On top of the upper basket only, where the user sees it first
  2. Taped to the outside of the container lid
  3. In the bottom level only, since it heats last
  4. In each level, at the hardest-to-reach spot per IFU
Show answer

Answer: D. In each level, at the hardest-to-reach spot per IFU

An internal chemical indicator goes where the sterilant is least likely to reach, as stated in the IFU. That is often the geometric center, or opposite corners in containers. In multi-level sets, each level gets its own indicator, because conditions can differ between levels. The user then checks each indicator when the set is opened.

Source: ANSI/AAMI ST79:2017/(R)2022, section on chemical indicators (placement); HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging

Question 11

What is the maximum recommended weight for an instrument set, including its container or wrap?
  1. 15 lb (6.8 kg)
  2. 30 lb (13.6 kg)
  3. 25 lb (11.3 kg)
  4. 40 lb (18.1 kg)
Show answer

Answer: C. 25 lb (11.3 kg)

AAMI ST79 and ST77 limit instrument sets to 25 lb (about 11.3 kg), counting the container or wrap. Heavier sets are harder to sterilize and dry and are a lifting hazard for staff. Sets over the limit are split or reconfigured.

Source: ANSI/AAMI ST79:2017/(R)2022, section on instrument set weight; ANSI/AAMI ST77:2013/(R)2018, containment devices for reusable medical device sterilization; HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging

Question 12

A disposable nonwoven wrap is removed from a tray that was opened but never used. The wrap looks clean and intact. What should be done with it?
  1. Reuse it once, since it never contacted a patient
  2. Reuse it if it passes a careful visual check
  3. Launder it with the woven textiles, then reuse it
  4. Discard it; disposable wrap is made for one use
Show answer

Answer: D. Discard it; disposable wrap is made for one use

Disposable nonwoven wraps are made and cleared for a single use. Handling, folding and the sterilization cycle can weaken the material and leave damage too small to see. Nothing validates the wrap for a second cycle. Only reusable woven textiles are laundered and inspected between uses.

Source: ANSI/AAMI ST79:2017/(R)2022, section on packaging systems; wrap manufacturer's IFU; HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging

Question 13

What is sequential wrapping?
  1. Wrapping with one double-layer wrap folded as a single sheet
  2. Wrapping several sets one after another in the same wrap
  3. Wrapping with two separate wraps, one after the other
  4. Placing a peel pouch inside a single wrap
Show answer

Answer: C. Wrapping with two separate wraps, one after the other

Sequential wrapping uses two separate wraps. The item is wrapped completely in the first wrap, then wrapped again in the second, making a package within a package.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: sequential and simultaneous wrapping)

Question 14

An item is being double-pouched. Which setup is correct?
  1. Two pouches of the same size, with the inner pouch folded to fit
  2. A smaller inner pouch, not folded, placed paper side to paper side
  3. A smaller inner pouch placed plastic side facing the outer paper side
  4. A larger inner pouch with its seal folded under the item
Show answer

Answer: B. A smaller inner pouch, not folded, placed paper side to paper side

In double pouching, the inner pouch is smaller so it fits without folding. The paper sides face the same way (paper to paper) so the sterilant can pass through both layers and air can be removed. The contents can then be seen through both plastic sides.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: peel pouches); ANSI/AAMI ST79:2017/(R)2022, section on peel pouches

Question 15

While preparing a rigid container, a technician finds that the lid gasket is cracked. What should be done?
  1. Use it, since the filter is the only barrier that matters
  2. Wrap the container in one layer of wrap and use it
  3. Seal the crack with indicator tape and use it
  4. Take it out of use until the gasket is replaced
Show answer

Answer: D. Take it out of use until the gasket is replaced

Rigid containers are inspected before each use: gaskets, filters or valves, latches, and locks. A damaged gasket means the lid will not seal, so the container cannot keep its contents sterile. It is removed from service and repaired per the container IFU.

Source: ANSI/AAMI ST77:2013/(R)2018, containment devices for reusable medical device sterilization; ANSI/AAMI ST79:2017/(R)2022, section on rigid sterilization containers; HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging

Question 16

Where should a technician write the label information on a wrapped pack?
  1. Directly on the wrap with a ballpoint pen
  2. On the wrap with a pencil so it can be erased
  3. On a sticky note tucked under the final fold of the wrap
  4. On indicator tape or a label, with a felt-tip marker
Show answer

Answer: D. On indicator tape or a label, with a felt-tip marker

Label information goes on the indicator tape or on a label made for sterilization, never directly on the wrap. A felt-tip, non-toxic, indelible marker is used so the writing lasts and does not damage the package. Sharp pens can puncture packaging.

Source: HSPA Sterile Processing Technical Manual, 9th ed. (2023), Ch. 12, Preparation and Packaging (topic: labeling); ANSI/AAMI ST79:2017/(R)2022, section on labeling

Test yourself under exam conditions

The free diagnostic mixes every domain at the real exam's weights and scores you by domain. No account needed.