AORN Periop 101 - Final Test Review Version 2 (Qns & Ans) - 2025, Exams of Nursing

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AORN Periop 1 01

Final Test Review (Version 2 )

(Questions & Solutions)

1. (Multiple Choice) In perioperative nursing, which phase is responsible for verifying patient identity, obtaining informed consent, and marking the surgical site? A. Intraoperative B. Preoperative C. Postoperative D. Recovery ANS: B Rationale: The preoperative phase prepares the patient for surgery— including verifying identity, ensuring consent is in place, and marking the site—to prevent errors such as wrong-site surgery.
2. (Fill-in-the-Blank) A hallmark of effective perioperative care is ________, which ensures continuity from preoperative planning to full postoperative recovery. ANS: continuity Rationale: Continuity of care is essential in perioperative nursing as it guarantees seamless transitions, effective teamwork, and consistent monitoring of patient outcomes across all phases.
3. (True/False) True or False: The intraoperative phase is limited solely to the technical handling of instruments and does not require active communication among the surgical team. ANS: False Rationale: Although technical skills are paramount during the intraoperative phase, active communication is critical for coordinating tasks, managing unexpected issues, and maintaining a safe environment.
4. (Multiple Response)

information, support one another, and collectively contribute to patient safety.

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Patient Safety & Infection Control

7. (Multiple Choice) What is the primary purpose of a surgical safety checklist in the operating room? A. To accelerate the turnover between cases B. To confirm the correct patient, procedure, and site before incision C. To document the surgeon’s preferences D. To track inventory of surgical supplies ANS: B Rationale: The surgical safety checklist is designed to verify the correct patient, procedure, and surgical site, thereby reducing errors and preventing adverse events such as wrong-site surgery.
8. (Fill-in-the-Blank) Standard ________ precautions require that all blood and body fluids be treated as potentially infectious, mandating the use of appropriate personal protective equipment (PPE). ANS: universal Rationale: Universal precautions are a cornerstone of infection control, ensuring that healthcare workers consistently use PPE to protect themselves and patients against bloodborne pathogens.
9. (True/False) True or False: Maintaining a sterile field is the exclusive responsibility of the scrub nurse, while the circulating nurse does not participate in infection control.

ANS: False Rationale: Although the scrub nurse is primarily charged with maintaining sterility at the field, the circulating nurse also plays a vital role by ensuring that non-sterile items do not contaminate the sterile field and by facilitating overall infection control.

10. (Multiple Response) Which of the following are critical components of effective infection control in the operating room? (Select all that apply.) A. Rigorous hand hygiene before and after procedures B. Use of barrier precautions such as gloves and masks C. Routine disinfection of surfaces and equipment D. Reusing disposable items when possible ANSs: A, B, C Rationale: Hand hygiene, barrier protection, and routine disinfection are fundamental measures to reduce the transmission of pathogens. Reusing disposable items is not recommended as it increases the risk of contamination.
11. (Multiple Choice) During steam sterilization, which three parameters are essential to eradicate microbial life on surgical instruments? A. Steam pressure, time, and temperature B. Humidity, instrument arrangement, and time C. Temperature, airflow, and chemical concentration D. Pressure, water volume, and ambient room temperature ANS: A Rationale: Effective steam sterilization relies on maintaining adequate steam pressure, time, and temperature to denature microbial proteins and ensure the complete eradication of all pathogens.
12. (Fill-in-the-Blank) A robust ________ in the healthcare environment fosters continuous

15. (True/False) True or False: The use of disposable surgical instruments completely eliminates the need for proper decontamination and sterilization protocols. ANS: False Rationale: Even disposable items require proper handling and must be maintained in a sterile state until use; they are not a substitute for decontamination and must be discarded after use according to established protocols.
16. (Multiple Response) Which steps are crucial to prevent the retention of surgical items at the end of a procedure? (Select all that apply.) A. Counting sponges, instruments, and sharps at key times B. Using radiopaque markers on sponges C. Relying on memory without a physical count D. Performing a final count before wound closure ANSs: A, B, D Rationale: Systematic counting, use of radiopaque sponges, and a final count at wound closure are essential strategies to prevent retained surgical items. Relying solely on memory is not acceptable practice.
17. (Multiple Choice) Which retractor is most appropriate for retracting large and deep tissue areas during open abdominal surgery? A. Senn retractor B. Deaver retractor C. Army‑Navy retractor D. Richardson retractor ANS: B Rationale: The Deaver retractor is specifically designed for deep tissue retraction in abdominal procedures, offering robust exposure for large

cavities.

18. (Fill-in-the-Blank) Prior to using surgical instruments, the nursing team must perform a thorough ________ to ensure that all instruments are intact and free of defects. ANS: inspection Rationale: Instrument inspection is crucial to verify that each instrument is in proper working condition, which prevents intraoperative delays or complications arising from damaged or malfunctioning equipment.

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Patient Assessment & Perioperative Care 

19. (Multiple Choice) Immediately following surgery, which vital sign is most critical to monitor for ensuring adequate patient oxygenation? A. Blood pressure B. Temperature C. Oxygen saturation D. Heart rate ANS: C Rationale: Oxygen saturation directly reflects respiratory efficiency and is critical for detecting early signs of hypoxia or respiratory compromise in the postoperative period.
20. (Fill-in-the-Blank) The __________ Coma Scale is frequently used in the perioperative setting to assess a patient’s level of consciousness after anesthesia. ANS: Glasgow

C. Hyperglycemia D. Bradycardia ANS: B Rationale: Long surgical procedures can lead to prolonged immobility and venous stasis, which significantly increases the risk of deep vein thrombosis; early recognition and prophylactic measures are crucial.

24. (Fill-in-the-Blank) In the post-anesthesia care unit (PACU), continuous monitoring of ________ is vital to detect early signs of postoperative deterioration. ANS: vital signs Rationale: Ongoing monitoring of vital signs (heart rate, blood pressure, respiratory rate, and oxygen saturation) is essential in the PACU to promptly identify and manage any complications that may arise after surgery.

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Evidence‑Based Practice & Clinical Decision Making 

25. (Multiple Choice) When developing a research question using the PICOT format, which element is key to ensuring focused inquiry? A. Inclusion of a detailed cost analysis B. Clear definition of the patient population C. Emphasis on the institution’s past protocols D. Consideration of the surgeon’s preferences ANS: B Rationale: The PICOT format (Population, Intervention, Comparison, Outcome, Time) relies on clearly defining the patient population as a foundation for formulating a focused, evidence-based research question.

26. (Fill-in-the-Blank) The practice of integrating the best current research evidence with clinical expertise and patient preferences is known as __________. ANS: evidence-based practice Rationale: Evidence‑based practice (EBP) represents the standard approach to clinical decision making that ensures care is based on the most reliable and current scientific evidence available.
27. (True/False) True or False: Relying solely on traditional practices without reviewing current literature is sufficient for sound clinical decision making in perioperative care. ANS: False Rationale: Contemporary clinical decision making requires the incorporation of up-to-date research evidence along with clinical expertise to provide the highest quality care.
28. (Multiple Response) Which steps are integral to the process of evidence-based practice in perioperative nursing? (Select all that apply.) A. Formulating a focused clinical question B. Critically appraising the relevant literature C. Implementing changes solely based on anecdotal experience D. Evaluating patient outcomes following practice changes E. Disseminating findings to the healthcare team ANSs: A, B, D, E Rationale: The EBP process involves clearly articulating a clinical question, appraising the literature, implementing evidence-based changes, evaluating outcomes, and sharing the results. Relying on anecdotal experience does not align with EBP principles.
29. (Multiple Choice)

ANS: c) Notifying the surgeon immediately. Rationale: A sudden increase in intra-abdominal pressure can indicate complications like pneumoperitoneum or bleeding, requiring immediate surgical intervention.

2. Fill-in-the-Blank: The sterile field is established and maintained by a process known as __. ANS: Aseptic technique. Rationale: Aseptic technique is the cornerstone of preventing surgical site infections.
3. True/False: The circulating nurse is responsible for directly handling sterile instruments. ANS: False. Rationale: The scrub nurse or surgical technician handles sterile instruments. The circulating nurse's role is to manage the environment and assist the surgical team.
4. Multiple Choice: Which of the following are essential components of a surgical timeout? (Select all that apply.) a) Patient identification. b) Confirmation of the surgical site. c) Review of the patient's allergies. d) Counting of surgical instruments.

e) Assessment of the patient's pain level. ANS: a, b, c, d Rationale: The surgical timeout ensures the correct patient, site, procedure, and that all necessary items are available and accounted for.

5. Multiple Choice: A patient with a history of diabetes is scheduled for a total hip arthroplasty. Which of the following perioperative considerations is most critical? a) Administering prophylactic antibiotics. b) Monitoring blood glucose levels. c) Ensuring adequate hydration. d) Providing emotional support. ANS: b) Monitoring blood glucose levels. Rationale: Tight glycemic control is crucial to reduce the risk of surgical site infections and delayed wound healing in diabetic patients.
6. Fill-in-the-Blank: The term for the process of removing all microorganisms, including spores, from an object is __. ANS: Sterilization. Rationale: Sterilization is the highest level of microbial control.
7. True/False: Surgical smoke is a potential health hazard to surgical staff.

Rationale: Early ambulation helps to improve circulation and reduce the risk of blood clots.

10. Fill-in-the-Blank: The surgical instrument used to grasp and hold tissue is called a __. ANS: Forceps. Rationale: Forceps come in various types and are essential for tissue manipulation during surgery.
11. True/False: The circulating nurse is responsible for the initial count of surgical sponges, sharps, and instruments. ANS: False. Rationale: The scrub person and the circulating nurse jointly perform the initial count.
12. Multiple Choice: Which of the following is a critical component of informed consent? a) The patient's signature on the consent form. b) The surgeon's explanation of the procedure, risks, and benefits. c) The nurse's signature on the consent form. d) The date and time the consent form was signed. ANS: b) The surgeon's explanation of the procedure, risks, and benefits. Rationale: Informed consent requires the patient to understand the procedure, its risks, and benefits before agreeing to it.

13. Multiple Choice: Which of the following actions by the surgical team most effectively reduces the risk of surgical site infection (SSI)? a) Administering prophylactic antibiotics. b) Using sterile technique. c) Performing thorough hand hygiene. d) All of the above. ANS: d) All of the above. Rationale: A combination of measures is needed to minimize the risk of SSI.
14. Fill-in-the-Blank: The technique used to prevent the transfer of microorganisms from the surgical team to the patient is called __. ANS: Aseptic technique. Rationale: Aseptic technique is the cornerstone of preventing surgical site infections.
15. True/False: The surgical drape is considered sterile on both sides. ANS: False. Rationale: Only the side of the drape facing the sterile field is considered sterile.

Rationale: The scalpel is a basic surgical instrument used for making incisions.

19. True/False: The circulating nurse is responsible for documenting the surgical procedure. ANS: True. Rationale: The circulating nurse documents the details of the procedure, including the team members, instruments used, and any complications.
20. Multiple Choice: Which of the following is the primary goal of evidence-based practice in perioperative nursing? a) To reduce healthcare costs. b) To improve patient outcomes. c) To increase nurse satisfaction. d) To standardize nursing care. ANS: b) To improve patient outcomes. Rationale: Evidence-based practice aims to provide the best possible care based on the most current research. I. Fundamentals of Perioperative Nursing

1. Multiple Choice: Which perioperative nurse role is primarily responsible for maintaining a sterile field and accounting for all surgical instruments during a procedure? A. Circulating nurse B. Registered nurse first assistant (RNFA) C. Scrub nurse D. Preoperative nurse ANS: C. Scrub nurse Rationale: The scrub nurse ensures sterility and counts all items to prevent retained surgical items.
2. Fill-in-the-Blank: The ________ phase of perioperative nursing includes verifying consent, patient assessment, and confirming surgical site marking. ANS: preoperative Rationale: These essential activities are completed before the patient enters the operating room.
3. True/False: The circulating nurse documents intraoperative events, mediates environmental controls, and maintains anonymity of the surgical team. ANS: False Rationale: The circulating nurse documents events, manages the environment, but does not maintain anonymity—a misunderstanding of roles.
4. Multiple Response: Select all items included in the Universal Protocol. A. Time-out B. Surgical site marking C. Verification of patient identity