AORN Periop 101 - Final Test Review Version 3 (Qns & Ans) - 2025, Exams of Nursing

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AORN Periop 1 01

Final Test Review (Version 3 )

(Questions & Solutions)

1. (Multiple Choice) In the perioperative continuum, which phase focuses on tasks such as 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 is dedicated to preparing the patient for surgery. This includes confirming the patient’s identity, ensuring consent is documented, and marking the correct surgical site— all critical to preventing errors such as wrong-site surgery.
2. (Fill-in-the-Blank) A key element of perioperative nursing is ensuring __________ of care, which connects preoperative, intraoperative, and postoperative processes seamlessly. ANS: continuity Rationale: Continuity of care is fundamental, as it guarantees that all phases of nursing care are integrated to provide a safe and effective patient experience throughout the surgical process.
3. (True/False) True or False: During the intraoperative phase, the nurse’s role is solely technical, focusing exclusively on instrument handling without the need for team communication. ANS: False

members to ensure that patient safety is maintained throughout the surgical process._ ANS: collaboration Rationale: Interdisciplinary collaboration is vital in the perioperative setting; it ensures that all team members share information and support one another for optimal patient outcomes.

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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 quickly document the procedure B. To confirm the correct patient, procedure, and site before incision C. To evaluate the performance of the surgical team D. To expedite turnover between surgical cases ANS: B Rationale: The checklist is used to verify the patient’s identity, the intended procedure, and the correct surgical site. This practice helps prevent errors such as wrong-site surgery and enhances patient safety.
8. (Fill-in-the-Blank) Standard __________ precautions require that all blood and body fluids be considered potentially infectious, necessitating the use of appropriate personal protective equipment (PPE). ANS: universal Rationale: Universal precautions ensure that healthcare workers protect themselves by using PPE such as gloves, masks, and gowns regardless of the patient’s apparent infection status.

9. (True/False) True or False: Only the scrub nurse is responsible for maintaining a sterile field in the OR, while the circulating nurse focuses solely on non- sterile tasks. ANS: False Rationale: Both scrub and circulating nurses share the responsibility of maintaining the sterile field. The circulating nurse ensures that non- sterile items do not contaminate the field and helps facilitate overall infection control.
10. (Multiple Response) Select all that are considered core components of effective infection control in the OR: A. Rigorous hand hygiene protocols B. Use of barrier protections such as gloves and masks C. Routine disinfection of surfaces and equipment D. Reuse of disposable items to conserve resources ANSs: A, B, C Rationale: Proper hand hygiene, use of barrier precautions, and routine disinfection are essential to prevent infection. Reusing disposable items is not advised as it increases contamination risks.
11. (Multiple Choice) During steam sterilization of surgical instruments, which factors are essential to ensure microbial destruction? A. Temperature, steam pressure, and exposure time B. Instrument arrangement, humidity, and air circulation C. Steam volume, chemical additives, and instrument weight D. Water temperature, ambient room temperature, and time ANS: A Rationale: Effective steam sterilization depends on a combination of high temperature, adequate steam pressure, and proper exposure time

Rationale: Self‑retaining retractors (e.g., the Bookwalter retractor) offer continuous, stable retraction of tissues, which is essential during complex surgical exposures.

15. (True/False) True or False: Disposable surgical instruments eliminate the need for subsequent sterilization processes before use. ANS: False Rationale: Although disposable instruments are intended for single use, they must be handled with care to maintain their sterility. Moreover, reprocessing protocols do not apply to disposables, but careful storage and handling are still important.
16. (Multiple Response) Select all measures that help prevent retention of surgical items during procedures: A. Performing initial, intermediate, and final counts of sponges, instruments, and sharps B. Using sponges with radiopaque markers C. Relying solely on the surgeon’s recollection D. Reconciling counts before wound closure ANSs: A, B, D Rationale: A systematic counting process using radiopaque markers and final verification immediately before closure minimizes the risk of retaining surgical items. Relying on memory is not acceptable.
17. (Multiple Choice) Which retractor is preferred for providing broad exposure in deep tissue areas during an open abdominal procedure? A. Senn retractor B. Deaver retractor C. Army‑Navy retractor D. Richardson retractor

ANS: B

Rationale: The Deaver retractor is designed to retract large areas of tissue and provide excellent exposure in deep abdominal cavities, facilitating safe and effective surgical procedures.

18. (Fill-in-the-Blank) Before a procedure, the nursing team must perform a thorough __________ of all surgical instruments to ensure they are intact and functioning properly. ANS: inspection Rationale: Instrument inspection is crucial to identify any damage or malfunction that could compromise the surgical procedure. This step is an important component of quality control in the OR.

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Patient Assessment & Perioperative Care 

19. (Multiple Choice) After surgery, which vital sign is most immediately indicative of adequate oxygenation and respiratory function in the PACU? A. Blood pressure B. Temperature C. Oxygen saturation D. Pulse rate ANS: C Rationale: Oxygen saturation is a direct measure of respiratory efficiency. Monitoring oxygen levels in the immediate postoperative period is essential for early detection of hypoxia.
20. (Fill-in-the-Blank) _The __________ Coma Scale is a standardized tool used postoperatively

B. Deep vein thrombosis (DVT) C. Hyperglycemia D. Bradycardia ANS: B Rationale: Extended surgical duration predisposes patients to venous stasis, increasing the risk for deep vein thrombosis. Early intervention (e.g., prophylactic anticoagulation, mobilization) is therefore critical.

24. (Fill-in-the-Blank) In the post-anesthesia care unit (PACU), continuous monitoring of __________ is essential to detect early signs of patient deterioration. ANS: vital signs Rationale: Tracking vital signs—including heart rate, blood pressure, respiratory rate, and oxygen saturation—is vital for identifying any deviations from normal that may indicate complications.

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Evidence‑Based Practice & Clinical Decision Making 

25. (Multiple Choice) The PICOT framework is essential for developing focused clinical questions. Which component of PICOT stands for “Intervention”? A. I B. C C. O D. T ANS: A Rationale: PICOT stands for Population, Intervention, Comparison, Outcome, and Time. The “I” represents the intervention being evaluated, and it is critical for formulating a research question that can guide evidence-based practice.

26. (Fill-in-the-Blank) The process 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) ensures that clinical decisions are grounded in the most reliable and current research, combined with professional expertise and patient values for optimal care outcomes.
27. (True/False) True or False: Relying exclusively on long-standing clinical practices, without reviewing current literature, is sufficient for ensuring best practice in perioperative care. ANS: False Rationale: Best practice requires continuous integration of current research findings with clinical expertise. Relying solely on tradition may lead to outdated practices that do not reflect the latest advancements in care.
28. (Multiple Response) Select the integral steps in the process of evidence-based practice as applied to perioperative nursing: A. Formulating a clear clinical question using a structured format (e.g., PICOT) B. Critically appraising the relevant scientific literature C. Implementing practice changes solely based on anecdotal reports D. Evaluating patient outcomes after the implementation of new protocols E. Disseminating research findings to inform and educate the healthcare team ANSs: A, B, D, E Rationale: The evidence-based practice process encompasses clearly

b) Checking the patient's blood glucose level. c) Ensuring the patient has removed all jewelry. d) Verifying the correct surgical site with the patient. Correct ANS: d) Verifying the correct surgical site with the patient. Rationale: Surgical site verification is a crucial step in preventing wrong-site surgery, a significant patient safety concern. While the other options are important, surgical site verification directly addresses this risk. Fill-in-the-Blank: The sterile field is established and maintained by a set of principles. One of these principles is that only _ items are used within the sterile field. Correct ANS: sterile Rationale: This is a fundamental principle of sterile technique. True/False: The circulating nurse is responsible for directly handling sterile instruments and maintaining the sterile field. Correct ANS: False Rationale: The scrub nurse or surgical technician is responsible for handling sterile instruments and maintaining the sterile field. The circulating nurse's role is to manage the environment and provide support. Multiple Response:

Which of the following are essential components of a surgical time- out? (Select all that apply) a) Verification of the patient's identity. b) Confirmation of the surgical site and procedure. c) Review of the patient's allergies. d) Counting of surgical instruments and supplies. Correct ANS: a, b, c, d Rationale: The surgical time-out is a critical safety measure involving all team members to prevent errors. All the listed components are crucial for a complete time-out. Multiple Choice: A patient undergoing a laparoscopic cholecystectomy develops a sudden increase in abdominal distension and decreased oxygen saturation. What is the most likely cause? a) Hemorrhage. b) Pneumoperitoneum. c) Atelectasis. d) Pulmonary embolism. Correct ANS: b) Pneumoperitoneum. Rationale: Pneumoperitoneum, the insufflation of the abdomen with gas during laparoscopy, can cause increased abdominal pressure, potentially affecting ventilation and oxygenation. Fill-in-the-Blank: The surgical instrument used to grasp and hold tissues during surgery is called a __.

a) To administer medications. b) To remove fluid and air from the surgical site. c) To provide irrigation to the surgical site. d) To monitor the patient's vital signs. Correct ANS: b) To remove fluid and air from the surgical site. Rationale: Surgical drains are primarily used to prevent fluid accumulation and promote wound healing. Fill-in-the-Blank: The process of rendering an object free from all living microorganisms, including spores, is called __. Correct ANS: sterilization Rationale: Sterilization is the highest level of microbial control. True/False: The circulating nurse is responsible for the initial assessment of the patient in the operating room. Correct ANS: True Rationale: The circulating nurse is the first point of contact for the patient in the OR and performs the initial assessment. Multiple Response: Which factors increase the risk of a surgical site infection (SSI)? (Select all that apply) a) Prolonged surgical time.

b) Preoperative antibiotic prophylaxis. c) Poor glycemic control. d) Use of clean surgical technique. Correct ANS: a, c Rationale: Prolonged surgical time and poor glycemic control increase the risk of SSI. Preoperative antibiotics and clean technique decrease the risk. Multiple Choice: A patient is scheduled for a total knee arthroplasty. Which of the following is most important for the perioperative nurse to assess related to the patient's mobility? a) The patient's ability to perform activities of daily living. b) The patient's range of motion in the unaffected leg. c) The patient's baseline gait and mobility. d) The patient's level of pain. Correct ANS: c) The patient's baseline gait and mobility. Rationale: Understanding the patient's pre-operative mobility is crucial for post-operative care and rehabilitation planning. Fill-in-the-Blank: The term for the destruction of pathogens on an inanimate object is __. Correct ANS: disinfection Rationale: Disinfection is a lower level of microbial control than sterilization.

b) Hemorrhage. c) Malignant hyperthermia. d) Pneumothorax. Correct ANS: b) Hemorrhage. Rationale: These vital sign changes are consistent with blood loss. Fill-in-the-Blank: The surgical instrument used to cut tissue is called a __. Correct ANS: scalpel Rationale: The scalpel is a fundamental surgical instrument. True/False: Evidence-based practice relies on intuition and personal experience. Correct ANS: False Rationale: Evidence-based practice relies on the integration of research evidence, clinical expertise, and patient values. Multiple Response: Which of the following are key components of a safe medication administration process in the perioperative setting? (Select all that apply) a) Verifying the medication with the medication administration record (MAR). b) Confirming the patient's allergies. c) Administering the medication as quickly as possible. d) Documenting the medication administration.

Correct ANS: a, b, d Rationale: Safe medication administration involves verification, allergy checks, and documentation. Speed is not a primary consideration; accuracy is paramount. Multiple Choice (MCQ)

1. Which phase of perioperative care focuses on verifying patient identity, surgical site, and procedure prior to anesthesia induction? A. Preoperative phase B. Intraoperative phase C. Pre-induction phase D. Postoperative phase ANS: C Rationale: The pre-induction phase involves critical verification to prevent wrong-site, wrong-procedure, wrong-person surgery.
2. What is the most effective method to prevent transmission of microorganisms in the perioperative setting? A. Wearing sterile gloves B. Hand hygiene C. Use of surgical mask D. Environmental cleaning ANS: B Rationale: Hand hygiene is the single most effective means to prevent health care–associated infections.
3. During a surgical count, which items must be accounted for? A. Sponges and instruments only B. Sponges, needles, instruments, and small items C. Instruments and personal items