A battery-powered surgical drill cannot be immersed. How does the WHO manual say it is cleaned?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Manual cleaning, Non-immersion method. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
A technician finishes work at the decontamination sink. When must personal protective equipment come off, under the OSHA bloodborne pathogens standard?OSHA, 29 CFR 1910.1030, Bloodborne pathogens, 1910.1030(d)(3)(vii). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
A test product that mimics dried blood comes out clean from the washer-disinfector. What does the WHO manual say about that passing result?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Cleaning verification and quality control. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
Show all 72 questions (69 more)
Decontamination processes, continued
An ultrasonic cleaner has just been filled with fresh solution. What does the WHO manual say to do before instruments go in?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Ultrasonic cleaners. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
In the CDC report on an outbreak of toxic anterior segment syndrome (TASS), which change to the cleaning of eye instruments was made before surgeries resumed?CDC, MMWR 56(25), Toxic Anterior Segment Syndrome After Cataract Surgery, Maine, 2006. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
Which brush does the WHO manual call for to clean the lumen of an instrument?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Manual cleaning, Immersion method. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
Which tissues does the CDC list as high-infectivity for Creutzfeldt-Jakob disease, a prion disease?CDC, Infection Control for CJD, High- and low-infectivity tissue examples. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
Which water does the WHO manual name for the final rinse of the lumens of intravascular devices?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Rinsing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
Why does the WHO manual say saline is not used to soak soiled instruments or keep them moist?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Point-of-use preparation. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section I: Decontamination Processes.
Instrumentation identification 23
A device is identified as "single-patient use". How does the WHO manual describe its use?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Reuse of single-use medical devices, Single-patient use. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
A hospital provides a tracked implant to a patient. Which of these must it promptly give the manufacturer?21 CFR 821.30, Tracking obligations of persons other than device manufacturers: distributor requirements (FDA), paragraph (b). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
A set is pulled for a tracheotomy. What does the ending "-otomy" mean?MedlinePlus (National Library of Medicine), Appendix A: Word Parts and What They Mean, Procedures, Diagnosis and Surgery. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
A tonsil snare, an adenoid curette and a nasal rasp belong to which federal group of manual instruments?21 CFR 874.4420, Ear, nose, and throat manual surgical instrument (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
A tray list is headed "rhinoplasty". What does the ending "-plasty" mean?MedlinePlus (National Library of Medicine), Appendix A: Word Parts and What They Mean, Procedures, Diagnosis and Surgery. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
An instrument set is named for a hysteroscopy. Which organ does "hyster-" refer to?MedlinePlus (National Library of Medicine), Appendix A: Word Parts and What They Mean, Body Parts and Disorders. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
For how long must a device be intended to stay in the body to count as an implant under the federal classification rules?21 CFR 860.3, Definitions (FDA), Implant. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
From which materials is a dental bur made, in its federal device identification?21 CFR 872.3240, Dental bur (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
How is the country of origin marked on surgical instruments imported from outside the USMCA countries?19 CFR 134.43, Methods of marking specific articles (U.S. Customs and Border Protection), paragraph (a). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
What is a uterine tenaculum?21 CFR 884.4530, Obstetric-gynecologic specialized manual instrument (FDA), paragraph (a)(15). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
What is a vascular clamp used for?21 CFR 870.4450, Vascular clamp (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
What is an arthroscope?21 CFR 888.1100, Arthroscope (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
What is PMMA bone cement used for in joint surgery?21 CFR 888.3027, Polymethylmethacrylate (PMMA) bone cement (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
What makes a neurosurgical retractor "self-retaining"?21 CFR 882.4800, Self-retaining retractor for neurosurgery (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
What must the country of origin marking on an imported instrument show the buyer?19 CFR 134.11, Country of origin marking required (U.S. Customs and Border Protection). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which alloys do federal device rules name for metallic bone fixation plates?21 CFR 888.3030, Single/multiple component metallic bone fixation appliances and accessories (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which device uses a fragmenting needle and ultrasound to break up and extract a cataract?21 CFR 886.4670, Phacofragmentation system (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which devices must carry a permanent UDI marking on the device itself?21 CFR 801.45, Devices that must be directly marked with a unique device identifier (FDA), paragraph (a). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which instrument is inserted into the uterine cavity to determine the depth of the uterus?21 CFR 884.4530, Obstetric-gynecologic specialized manual instrument (FDA), paragraph (a)(12). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which neurosurgical instrument is identified in federal device rules as used for cutting or biting bone in surgery on the skull or spinal column?21 CFR 882.4840, Manual rongeur (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which of these is on the federal list of manual ophthalmic surgical instruments?21 CFR 886.4350, Manual ophthalmic surgical instrument (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which of these is on the federal list of orthopedic manual surgical instruments?21 CFR 888.4540, Orthopedic manual surgical instrument (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Which of these may lead the FDA to order a manufacturer to track a class II or class III device?21 CFR 821.1, Scope (FDA), paragraph (a). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section II: Instrumentation Identification.
Inspection, testing, integrity and assembly 14
A hinged instrument is stiff at inspection. Which lubricant does the WHO manual allow?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
A technician finds an instrument that malfunctions during function testing. What does the WHO manual say to do?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
An extra instrument turns up while a tray is being assembled. What does the WHO manual say to do?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Assembly. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
How does the WHO manual say insulated devices, such as diathermy forceps, are checked?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
How often does the WHO manual say the screws on jointed devices are checked for tightness?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
In the WHO manual's function checks, what are the jaws and teeth of an instrument checked for?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
In what state must a device be before it is lubricated, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Lubricants. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
Tip protectors are placed on sharp instruments in a set. What does the WHO manual require of the protectors?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Assembly. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
What does the WHO manual say to use when cleaned devices are inspected?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Introduction. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
What is a cannulated device checked for at inspection?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
Which instruments does the WHO manual name for a check of the sharpness of cutting edges?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
Which parts of an instrument does the WHO manual say are critically inspected for cleanliness?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
Why are multi-part instruments put together during inspection, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
Why does damaged insulation on an instrument matter, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Inspection and function testing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section III: Instrumentation Inspection, Testing, Integrity and Assembly.
Preparation and packaging 7
What are the two jobs of a sterilization wrap, in its federal device identification?21 CFR 880.6850, Sterilization wrap (FDA). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
What does the WHO manual say is done with a rigid reusable container after each use?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Rigid reusable containers. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
What does the WHO manual say may be packed in a transparent pouch?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Recommendations for packaging material. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
Which defects does the WHO manual say make a reusable woven fabric wrap ineffective?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Reusable fabrics. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
Which packaging does the WHO manual say must not be used, because it does not allow air removal or steam penetration?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Recommendations for packaging material. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
Why are the trays used to package instrument sets perforated, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, General principles for wrapping. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
Why does the WHO manual call a paper tray list placed inside the instrument tray an error?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Preparation and packaging, Assembly, Figure 15. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section IV: Preparation and Packaging.
Disinfection and sterilization processes 5
A glutaraldehyde solution is used 30 times a day. How often does the example in the CDC guideline say to test its concentration?CDC, Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), Chemical Disinfectants, Glutaraldehyde. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section V: Disinfection and Sterilization Processes.
At unloading, what does the operator verify against the lot control label of the load, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Sterilization of reusable medical devices, Unloading. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section V: Disinfection and Sterilization Processes.
What is the ideal steam for sterilization, by the CDC guideline?CDC, Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), Steam Sterilization. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section V: Disinfection and Sterilization Processes.
When may rigid containers be stacked in a steam sterilizer, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Sterilization of reusable medical devices, Loading. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section V: Disinfection and Sterilization Processes.
Which minimum effective concentration do data in the CDC guideline suggest for a glutaraldehyde solution of more than 2% used as a high-level disinfectant?CDC, Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), Chemical Disinfectants, Glutaraldehyde. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section V: Disinfection and Sterilization Processes.
Quality and information systems 14
Against what must each level of sterile services staff be competent, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Staffing in the SSD, Education and training. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
How does failure mode and effects analysis (FMEA) differ from root cause analysis (RCA), by the CMS guidance?CMS, Guidance for Performing Failure Mode and Effects Analysis with Performance Improvement Projects, Overview. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
In which two forms must a unique device identifier (UDI) be presented?21 CFR 801.40, Form of a unique device identifier (FDA), paragraph (a). Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
Lime, rust, chlorine and salt can be left on devices by steam made from water that is not demineralized. What can these deposits lead to?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Water quality for steam sterilizers. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
On a fishbone (cause and effect) diagram, where is the problem shown?CMS, How to Use the Fishbone Tool for Root Cause Analysis, Overview. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
What determines the hardness of water, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Water quality for cleaning and sterilization. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
What does a final rinse with de-ionized water in a washer-disinfector help to prevent?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Cleaning of medical devices, Automated washers. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
What does a tracking and traceability system make possible when a medical device is recalled, by the WHO manual?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Quality assurance, Essential elements of quality management systems. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
What does the WHO manual call an important part of an audit of sterile services?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Quality assurance, Auditing. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
Which cycle does the WHO manual name for continuous improvement in risk management?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Risk management in decontamination and sterilization. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
Which part of a device's UDI does the FDA's Global Unique Device Identification Database (GUDID) contain?FDA, UDI Basics, Submitting information to the GUDID. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
Which step does the WHO manual list to cut routine immediate use steam sterilization (IUSS)?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Sterilization of reusable medical devices, Minimizing IUSS sterilization. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
Which water treatment does the WHO manual say is required to remove chlorides?WHO and PAHO, Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016), Water quality for cleaning and sterilization. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
Why does the FDA say reprocessing staff need periodic retraining?FDA, Factors Affecting Quality of Reprocessing, Reprocessing Methodology. Outline: HSPA CIS Exam Content Outline (revised October 2024), Section VI: Quality and Information Systems.
How this list was compiled: Our own questions, written to the six sections of the Certified Instrument Specialist (CIS) Exam Content Outline of the Healthcare Sterile Processing Association (revised October 2024, https://myhspa.org/wp-content/uploads/2025/02/HSPA_CIS_Content_Outline_2024.pdf, linked from https://myhspa.org/certification/certification-overview/certified-instrument-specialist-cis/, read 2026-10-07 and opened again 2026-10-08), in its weights of 12, 32, 20, 10, 6 and 20 percent. The bank holds 9, 23, 14, 7, 5, 14 questions in that order. Every fact was read on 2026-10-07 in the public text the question names: the WHO and PAHO manual Decontamination and Reprocessing of Medical Devices for Health-care Facilities (2016, https://iris.who.int/handle/10665/250232), the device identifications of 21 CFR parts 801 to 888 and the marking rules of 19 CFR part 134 (ecfr.gov), the CDC Guideline for Disinfection and Sterilization in Healthcare Facilities (2008) and other CDC pages, OSHA 29 CFR 1910.1030, FDA pages on reprocessing and device identifiers, CMS quality tools and MedlinePlus. The paid manuals and the private standards the owner lists as references were not used. Licence: Questions, choices and explanations are original work of this site.
How it works
This IAHCSMM CIS practice test has 72 questions of our own for the Certified Instrument Specialist exam of HSPA, the association once called IAHCSMM. It is unofficial and not affiliated with, endorsed by or sponsored by HSPA.
Read the full guide
What the exam covers
HSPA's CIS Exam Content Outline, revised October 2024 and read October 8, 2026, has six sections: decontamination processes 12%, instrumentation identification 32%, inspection, testing, integrity and assembly 20%, preparation and packaging 10%, disinfection and sterilization processes 6%, and quality and information systems 20%.
How the bank is split
The 72 questions follow those weights: 9, 23, 14, 7, 5 and 14. Exam mode asks 50 in 60 minutes, the pace of 150 questions in three hours.
Where the facts come from
Each answer names the public text it was read in: a World Health Organization reprocessing manual, the federal device rules in 21 CFR, the CDC, OSHA and others. HSPA's manuals and private standards were not used, so points found only there are not asked.
Where your course manual or a newer standard differs from the WHO manual or the 2008 CDC guideline, follow the manual for the exam.
Questions and answers
Is a CIS IAHCSMM practice test the same as an HSPA one?
Yes. The association took the name Healthcare Sterile Processing Association (HSPA) in 2022, by its history page, so this IAHCSMM practice test for CIS follows the current HSPA outline.
How many questions are on the CIS exam?
The CIS exam has 150 multiple choice questions and a three-hour limit, by HSPA's certification handbook, revised January 2026. Only 125 count toward the result; the other 25 are pretest questions mixed in at random.
What is the passing score for the CIS exam?
HSPA prints no percent. Its handbook says each correct scored answer earns one point and the passing point was set by the Angoff procedure. A result here is the number right, not a forecast.
What do you need before taking the CIS exam?
A current, full CRCST certification plus 200 hours spent working hands-on in a sterile processing department, by HSPA's CIS page. Those hours are separate from the CRCST hours and gained within the past five years.