PROPHECY RN OPERATING ROOM (OR) EXAM ACTUAL
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PROPHECY RN OPERATING ROOM (OR) EXAM
Most Commonly Used Title:
Prophecy RN Operating Room (OR) Exam
Prophecy RN Operating Room Assessment
Prophecy OR RN Competency Exam
Prophecy Perioperative Registered Nurse (OR RN) Assessment
EXAM COVERAGE
Perioperative Patient Care & Clinical Judgment (Core Exam Area)
This is the highest-weighted section of the Prophecy RN Operating Room (OR) Exam. Candidates are
expected to demonstrate safe perioperative nursing practice throughout the preoperative,
intraoperative, and immediate postoperative phases of care. The assessment focuses heavily on clinical
judgment, prioritization, patient safety, and evidence-based perioperative nursing interventions using
realistic operating room scenarios.
Topics include preoperative assessment, patient identification, informed consent verification, surgical
site verification, allergy assessment, medical history review, medication reconciliation, laboratory
review, patient positioning, risk assessment, perioperative nursing process, clinical judgment, nursing
priorities, documentation, and postoperative patient transfer.
Sterile Technique & Surgical Asepsis
A major exam domain emphasizing infection prevention and maintenance of the sterile field.
Topics include sterile technique, surgical asepsis, sterile field maintenance, surgical attire, surgical hand
antisepsis, sterile gowning, gloving procedures, contamination recognition, sterile supplies, opening
sterile packages, movement around the sterile field, sterile field monitoring, and maintaining surgical
sterility.
Operating Room Safety & Patient Positioning
One of the most heavily tested sections.
Topics include patient positioning, pressure injury prevention, nerve injury prevention, positioning
devices, supine position, prone position, lateral position, lithotomy position, Trendelenburg position,
reverse Trendelenburg position, padding techniques, safety straps, transfer techniques, fire prevention,
electrical safety, laser safety, and operating room environmental safety.
Surgical Instruments & Equipment
A major operating room competency area.
Topics include basic surgical instruments, tissue forceps, hemostats, needle holders, retractors, scissors,
clamps, suction devices, electrosurgical units (ESU), smoke evacuation, surgical tables, lighting systems,
tourniquets, sequential compression devices (SCDs), Cell Saver systems, warming devices, and specialty
surgical equipment.
Specimen Handling & Surgical Counts
A critical patient safety domain.
Topics include specimen identification, specimen labeling, chain of custody, pathology specimens,
culture specimens, frozen sections, surgical count procedures, sponge counts, needle counts, instrument
counts, count discrepancies, retained surgical item prevention, and documentation of counts.
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Anesthesia & Perioperative Pharmacology
A major exam section emphasizing patient monitoring during anesthesia.
Topics include general anesthesia, regional anesthesia, local anesthesia, moderate sedation, airway
management, anesthesia complications, malignant hyperthermia, reversal agents, anesthetic
medications, perioperative medications, blood product administration, medication labeling, medication
safety, and adverse drug reactions.
Infection Prevention & Surgical Site Safety
One of the most frequently tested areas.
Topics include surgical skin preparation, antiseptic solutions, chlorhexidine, povidone-iodine, alcohol-
based preparations, surgical wound classification, surgical site infection prevention, prophylactic
antibiotics, isolation precautions, transmission-based precautions, environmental cleaning, and
instrument sterilization principles.
Intraoperative Nursing Responsibilities
A major practical nursing domain.
Topics include circulating nurse responsibilities, scrub nurse collaboration, patient advocacy, time-out
procedures, communication with the surgical team, documentation, equipment checks, intraoperative
assessment, emergency response, and coordination of surgical care.
Postoperative Care & PACU Transfer
Candidates must safely transition patients following surgery.
Topics include postoperative assessment, airway assessment, pain assessment, vital sign monitoring,
surgical dressing assessment, bleeding recognition, postoperative complications, laryngospasm, nausea
and vomiting, handoff communication, PACU transfer procedures, and discharge criteria.
Emergency Situations & Critical Events
A critical clinical judgment section.
Topics include malignant hyperthermia, hemorrhage, anaphylaxis, airway obstruction, cardiac arrest,
hypothermia, hyperthermia, transfusion reactions, aspiration, equipment failure, fire emergencies, rapid
response, and emergency medication administration.
Professional Practice, Communication & Ethics
A major nursing practice section.
Topics include informed consent, patient advocacy, ethical decision-making, legal responsibilities,
confidentiality, interdisciplinary communication, SBAR communication, closed-loop communication,
vendor interactions, conflict resolution, documentation standards, and professional accountability.
QUESTIONS
QUESTION 1
A patient is scheduled for surgery and the circulating nurse is performing the preoperative verification.
What is the FIRST step in the patient identification process?
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A) Ask the patient to state their name and date of birth
B) Verify the patient's wristband against the surgical schedule
C) Check the patient's medical record number
D) Ask the family member to confirm the patient's identity
Correct Answer: A
Rationale: The patient must be actively involved in identification by stating their name and date of birth.
Wristband verification (B) follows active identification, checking medical record number (C) is not the
first step, and family confirmation (D) is not the primary method of patient identification.
QUESTION 2
Informed consent for surgery is the responsibility of which healthcare provider?
A) The circulating nurse
B) The surgeon performing the procedure
C) The anesthesiologist
D) The charge nurse
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Correct Answer: B
Rationale: The surgeon performing the procedure is responsible for obtaining informed consent. The
circulating nurse (A) verifies consent but does not obtain it, the anesthesiologist (C) obtains consent for
anesthesia separately, and the charge nurse (D) is not responsible for obtaining surgical consent.
QUESTION 3
A patient is allergic to latex. Which of the following actions is MOST important during the preoperative
preparation?
A) Document the allergy in the chart only
B) Ensure all latex-containing products are removed from the room
C) Notify the surgeon of the allergy
D) Administer an antihistamine preoperatively
Correct Answer: B