AORN Periop 101 - Final Test Review Version 1 (Qns & Ans) - 2025, Exams of Nursing

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AORN Periop 1 01

Final Test Review (Version 1)

(Questions & Solutions)

Question 1 (Multiple Choice): In the perioperative environment, which of the following best describes the three primary phases of care? A. Preoperative, intraoperative, and postoperative B. Admission, surgical intervention, and recovery C. Assessment, intervention, and evaluation D. Preoperative, operative, and discharge ANS: A Rationale: The fundamental care phases in perioperative nursing consist of preoperative (patient preparation), intraoperative (surgical procedure), and postoperative (recovery and follow‐up). This framework is central to safe and effective patient care.

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Question 2 (Fill-in-the-Blank): The _________ phase of perioperative care involves patient education, verification of informed consent, and final surgical site marking. ANS: Preoperative Rationale: The preoperative phase includes all necessary preparations such as patient education, obtaining consent, and ensuring correct surgical site marking to prevent errors and enhance patient safety.

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Question 3 (True/False): True or False: In perioperative nursing, the intraoperative phase exclusively involves technical instrument handling and does not include communication with the surgical team. ANS: False

complications, and ensuring the patient’s comfort and safety.

Question 6 (Fill-in-the-Blank): The concept of “time-out” in the operating room is implemented during the _________ phase to verify the correct patient, procedure, and site before surgery begins. ANS: Preoperative Rationale: The “time‑out” is a safety protocol observed before making any incision, ensuring that all identifiers—patient, procedure, and site— are confirmed to prevent wrong-site surgery.

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Patient Safety & Infection Control Question 7 (Multiple Choice): Which practice is critical for preventing surgical site infections (SSI) in the OR? A. Using high-intensity lighting B. Maintaining strict adherence to aseptic technique and hand hygiene C. Increasing the number of surgical personnel D. Minimizing communication between team members ANS: B Rationale: Proper hand hygiene and aseptic technique are cornerstones of infection control that directly decrease the risk of SSIs.

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Question 8 (Fill-in-the-Blank): Universal precautions require that all blood and body fluids are treated as potentially ________, thereby mandating the use of personal

protective equipment (PPE). ANS: Infectious Rationale: Treating all body fluids as potentially infectious ensures that healthcare workers use appropriate PPE to protect against bloodborne pathogens.

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Question 9 (True/False): True or False: The use of a surgical count is solely for ensuring that no instruments are left inside the patient at the end of surgery. ANS: False Rationale: Although a surgical count helps prevent retained items, its purposes include ensuring that all sponges, sharps, and instruments are accounted for, thereby serving as a critical safety check against multiple errors.

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Question 10 (Multiple Response): Which of the following infection prevention measures should be implemented in the OR? (Select all that apply) A. Strict hand washing between cases B. Use of sterile drapes and barriers C. Routine disinfection of all surfaces D. Minimizing turnover time without cleaning ANSs: A, B, C Rationale: Hand hygiene, use of sterile barriers, and thorough disinfection of surfaces are vital to reduce infection risk. Minimizing turnover time without cleaning is counterproductive to infection control protocols.

B. The OR floor C. The patient’s incision site D. The trash receptacle ANS: C Rationale: When a discrepancy occurs, the incision site is typically the first point of investigation since instruments or sponges are most likely to remain near the surgical field.

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Question 14 (Fill-in-the-Blank): When placing dispersive electrodes for electrosurgery, it is critical to avoid areas of ________ tissue to reduce the risk of burns. ANS: Scar Rationale: Placing a dispersive pad over scar tissue can lead to inadequate conduction and an increased risk of skin burns due to impaired electrical flow.

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Question 15 (True/False): True or False: A surgical instrument set should be reassembled without verifying the integrity of each instrument’s condition because the sterile processing department has already inspected them. ANS: False Rationale: Even though instruments are processed by sterile services, the surgical team is responsible for a final visual inspection to ensure instrument integrity, proper function, and absence of damage before use.

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Question 16 (Multiple Response): Which of the following are considered best practices when handling surgical instruments? (Select all that apply) A. Inspecting instruments for damage or malfunction B. Using designated trays to maintain instrument organization C. Mixing instruments from different sets to save time D. Ensuring instruments remain sterile until use ANSs: A, B, D Rationale: Best practices include performing a pre-use inspection, organizing instruments via dedicated trays, and maintaining sterility— mixing instruments from different sets can lead to miscounts and compromise technique.

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Question 17 (Multiple Choice): In troubleshooting electro‑surgical unit (ESU) malfunctions, which step is most essential for the perioperative nurse? A. Adjusting the OR lighting to reduce glare B. Confirming that the dispersive electrode is properly placed C. Calling the primary surgeon immediately D. Ignoring minor alerts on the device ANS: B Rationale: A common cause of ESU malfunction is improper dispersive electrode placement. Verifying proper contact and placement is the first step before escalating the issue further.

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Question 18 (Fill-in-the-Blank): In the event of an instrument malfunction during surgery, the nurse should immediately notify the _______ to ensure patient safety.

Question 21 (True/False): True or False: Pain assessment in the postoperative period should only be performed based on the patient’s verbal reports. ANS: False Rationale: While patient self-report is vital, pain assessment should also include observational measures—such as facial expressions and physiological indicators—to provide a more comprehensive evaluation, especially when patients are unable to communicate effectively.

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Question 22 (Multiple Response): Which factors should be included in a comprehensive postoperative assessment? (Select all that apply) A. Airway and breathing B. Circulation and vital signs C. Cognitive and emotional status D. Inventory of unused surgical supplies ANSs: A, B, C Rationale: A thorough postoperative assessment covers airway, circulation, and neurological status alongside cognitive and emotional responses; surgical supply inventory is not directly related to patient assessment.

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Question 23 (Multiple Choice): A patient who has undergone a long surgical procedure is at high risk for developing which postoperative complication? A. Hypothermia B. Deep vein thrombosis (DVT) C. Acute renal failure

D. Hyperglycemia ANS: B Rationale: Prolonged surgical procedures increase the risk of venous stasis, making deep vein thrombosis a significant postoperative complication that requires early assessment and intervention.

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Question 24 (Fill-in-the-Blank): In the assessment of postoperative pain, the use of a standardized tool such as the __________ rating scale helps guide effective pain management interventions. ANS: Numeric Rationale: The Numeric Rating Scale is a commonly used, standardized tool that allows patients to rate their pain intensity, providing objective data that informs clinical decision making for pain management.

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Evidence‑Based Practice & Clinical Decision Making Question 25 (Multiple Choice): Which component is essential in formulating a PICOT question for evidence‑based practice? A. Population and Intervention B. Process and Integration C. Predictors and Outcomes D. Prevention and Implementation ANS: A Rationale: The PICOT framework—Population, Intervention, Comparison, Outcome, and Time—is foundational for structuring evidence‑based inquiries, where identifying the appropriate population

ANSs: A, B, D Rationale: Evidence-based practice involves developing a focused question, critically appraising the literature, and then evaluating outcomes. Decisions guided solely by tradition do not incorporate current evidence.

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Question 29 (Multiple Choice): When integrating research findings into perioperative protocols, which factor is most important? A. The seniority of the researcher B. The methodological quality and relevance of the study C. The cost of implementing new protocols D. The length of the article ANS: B Rationale: Methodological rigor and the study’s relevance to the clinical question are key when integrating research findings. This ensures that any applied changes improve patient care based on reliable evidence.

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Question 30 (Fill-in-the-Blank): The use of outcome measures to assess the effectiveness of a new perioperative protocol is an example of __________ in action. ANS: clinical decision making Rationale: Incorporating outcome measures allows nurses to evaluate the impact of changes on patient care, thereby closing the loop in clinical decision making and fostering continuous quality improvement.

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A patient scheduled for a laparoscopic cholecystectomy reports a latex allergy. Which of the following actions is most important for the perioperative nurse to take first? a) Document the allergy in the patient's medical record. b) Alert the surgical team about the allergy. c) Ensure a latex-free cart and supplies are available. d) Ask the patient about the severity of the allergic reaction. Correct ANS: c) Ensure a latex-free cart and supplies are available. Rationale: The immediate priority is patient safety. Given the reported allergy, ensuring a latex-free environment prevents a potentially life- threatening reaction. Documentation and alerting the team are also important, but the immediate action is to secure a safe environment. Fill-in-the-Blank: The primary purpose of the Surgical Safety Checklist, as advocated by the World Health Organization (WHO), is to improve _ and reduce surgical complications. Correct ANS: patient safety Rationale: The Surgical Safety Checklist is a standardized tool designed to enhance communication and teamwork, thereby minimizing errors and improving patient outcomes. True/False: Sterilization is the process that destroys all microorganisms, including spores, on an item. Correct ANS: True

the team and taking corrective action, which may involve re-establishing the field or replacing contaminated items. Fill-in-the-Blank: The process of cleaning surgical instruments prior to sterilization is known as _. Correct ANS: decontamination Rationale: Decontamination removes gross debris and reduces the bioburden on instruments, making them safe to handle and preparing them for the sterilization process. True/False: The surgical scrub is designed to remove transient microorganisms and reduce the number of resident microorganisms on the hands and forearms. Correct ANS: True Rationale: The surgical scrub aims to achieve both immediate and sustained reduction of microorganisms on the surgical team's hands and forearms, minimizing the risk of surgical site infections. Multiple Response: Which of the following factors can increase a patient's risk of developing a surgical site infection (SSI)? (Select all that apply.) a) Diabetes mellitus. b) Obesity. c) Smoking. d) Advanced age.

e) Use of prophylactic antibiotics. Correct ANSs: a, b, c, d Rationale: Conditions like diabetes, obesity, smoking, and advanced age can compromise the patient's immune system and wound healing, increasing the risk of SSI. Prophylactic antibiotics, when administered appropriately, decrease the risk of SSI. Multiple Choice: The primary responsibility of the scrub person during a surgical procedure is to: a) Manage the patient's airway. b) Provide the surgical team with sterile instruments and supplies. c) Monitor the patient's vital signs. d) Document the procedure in the operative record. Correct ANS: b) Provide the surgical team with sterile instruments and supplies. Rationale: The scrub person's primary role is to maintain the sterile field and ensure that the surgical team has the necessary sterile instruments and supplies throughout the procedure. Fill-in-the-Blank: The principles of aseptic technique are based on the concept of creating and maintaining a _ environment. Correct ANS: sterile Rationale: Aseptic technique aims to create and maintain a sterile environment, free from microorganisms, to prevent surgical site

a) Using radiopaque surgical sponges. b) Implementing standardized counting procedures. c) Performing a final count at the end of the procedure. d) Documenting all items used during the procedure. Correct ANS: b) Implementing standardized counting procedures. Rationale: Standardized counting procedures, involving accurate and consistent counts by the scrub person and circulating nurse, are the most effective means of preventing retained surgical items. Fill-in-the-Blank: The term for the process of destroying all microorganisms and spores is _. Correct ANS: sterilization Rationale: Sterilization is the highest level of microbial control, eliminating all forms of microbial life. True/False: Patient positioning during surgery should always prioritize patient comfort over surgical access. Correct ANS: False Rationale: While patient comfort is important, the primary goal of positioning is to provide optimal surgical access while ensuring patient safety and preventing injury. Multiple Response:

Which of the following are common methods of sterilization in the operating room? (Select all that apply.) a) Steam sterilization (autoclaving). b) Ethylene oxide sterilization. c) Dry heat sterilization. d) Chemical disinfection. e) Ionizing radiation. Correct ANSs: a, b, c, e Rationale: Steam sterilization (autoclaving), ethylene oxide sterilization, dry heat sterilization, and ionizing radiation are all methods used for sterilizing surgical instruments and equipment. Chemical disinfection is used for surfaces and some instruments, but not for sterilization. Multiple Choice: The AORN guidelines for perioperative practice are based on: a) Expert opinion. b) Evidence-based practice. c) Hospital policy. d) Surgeon preference. Correct ANS: b) Evidence-based practice. Rationale: AORN guidelines are developed and updated based on the best available evidence to promote safe and effective perioperative care. Fill-in-the-Blank: The process of removing gross contamination from surgical instruments is known as _.