Fall Semester 2026–2027 SURG240 – Operating Room
Safety Updated 2026 | 190+ Questions and Answers |
Operating Room Safety Comprehensive Study Guide,
Practice Exam, Exam Prep Test Bank, Perioperative
Nursing, Surgical Asepsis, Sterile Technique, Infection
Prevention and Control, Surgical Instrumentation, Patient
Positioning, Anesthesia Safety, Fire Safety, Specimen
Handling, Clinical Judgment, Detailed Rationales and
Complete Revision Material
Question 1: According to the Association of periOperative Registered Nurses
(AORN) "Time Out" protocol, which of the following elements is the
MINIMUM required to be verified by the entire surgical team immediately
before the incision is made?
A. Patient's name and the procedure to be performed
B. Patient's name, procedure, and the site of surgery
C. Patient's name, procedure, site, and presence of required implants
D. Patient's name, procedure, site, and side of the procedure
CORRECT ANSWER: B. Patient's name, procedure, and the site of surgery
Rationale: The universal protocol mandates a final "Time Out" to verify the correct
patient, procedure, and site. While side and laterality are critical, the core minimum
requirement according to the Joint Commission and AORN is the active verification of
the patient identity, the planned procedure, and the surgical site.
Question 2: A surgical technologist notices that the ethylene oxide (EtO)
sterilization indicator has not changed color after a cycle. What is the
PRIMARY concern regarding the use of the instruments in the pack?
A. The instruments may have a toxic residue.
B. The instruments are not sterile due to a failure in the sterilization process.
C. The instruments may have been damaged by the high temperatures.
D. The plastic components of the instruments may have melted.
CORRECT ANSWER: B. The instruments are not sterile due to a failure in the
sterilization process.
Rationale: Chemical indicators (internal or external) provide visual confirmation that the
pack has been exposed to the sterilizing agent (EtO). If the indicator fails to change, it is
a direct indication that the parameters for sterilization were not met, and the
instruments must be considered non-sterile.
Question 3: In the context of laser safety in the OR, what is the PRIMARY
function of the "laser safety officer" (LSO)?
,A. To operate the laser equipment during the procedure
B. To ensure the safe use of lasers and compliance with safety regulations
C. To calibrate the laser energy output before each use
D. To clean the laser lenses post-operatively
CORRECT ANSWER: B. To ensure the safe use of lasers and compliance with
safety regulations
Rationale: The LSO is responsible for the overall laser safety program, including policy
development, hazard evaluation, and ensuring that all personnel adhere to safety
protocols (e.g., eyewear, signage, controlled access). They do not operate the laser; that
is the surgeon's role.
Question 4: A patient with a known latex allergy is scheduled for surgery.
Which of the following actions is MOST critical for the perioperative nurse to
implement?
A. Schedule the patient as the first case of the day.
B. Ensure that all latex-containing products are removed from the OR suite.
C. Administer prophylactic diphenhydramine pre-operatively.
D. Use only povidone-iodine for skin preparation.
CORRECT ANSWER: B. Ensure that all latex-containing products are removed
from the OR suite.
Rationale: The primary intervention for latex allergy is strict avoidance of all latex
products. This involves creating a latex-safe environment by removing latex gloves,
tourniquets, catheters, and other supplies from the room, as even aerosolized latex
proteins from powder can cause a severe reaction.
Question 5: What is the PRIMARY purpose of the "surgical safety checklist" as
advocated by the World Health Organization (WHO)?
A. To improve team communication and reduce preventable complications.
B. To provide a legal document for the surgical record.
C. To increase the speed of the surgical procedure.
D. To assign specific tasks to each member of the surgical team.
CORRECT ANSWER: A. To improve team communication and reduce
preventable complications.
Rationale: The WHO Surgical Safety Checklist is designed to promote communication
and teamwork among the surgical team, which has been shown to significantly reduce
mortality and morbidity by ensuring critical safety steps are not missed.
,Question 6: During a surgical procedure, the electrosurgical unit (ESU)
grounding pad becomes partially detached. What is the MOST immediate risk
to the patient?
A. Decreased surgical site visualization.
B. Inability to cut tissue effectively.
C. Thermal burn at the grounding pad site.
D. Electrical shock to the surgical team.
CORRECT ANSWER: C. Thermal burn at the grounding pad site.
Rationale: The grounding pad (dispersive electrode) provides a low-resistance return
path for the electrical current. If it becomes partially detached, the surface area for
current return is reduced, increasing the current density at the remaining contact point
and generating heat, which can cause a severe burn.
Question 7: What is the PRIMARY function of personal protective equipment
(PPE) like fluid-resistant gowns and face shields in the OR?
A. To protect the patient from the surgical team's pathogens.
B. To protect the surgical team from splashes and sprays of blood and body fluids.
C. To maintain the sterile field boundaries.
D. To keep the surgical team's clothing free from stains.
CORRECT ANSWER: B. To protect the surgical team from splashes and sprays
of blood and body fluids.
Rationale: According to Standard Precautions, PPE such as gowns, masks, and eye
protection are primarily used as a barrier to protect healthcare workers from exposure to
infectious materials that can be transmitted via splashes, sprays, or aerosols during
procedures.
Question 8: Which of the following is the CORRECT order for donning sterile
gloves using the closed-glove technique?
A. Don the gown, then the gloves, touching only the inside of the glove.
B. Don the gloves, then the gown.
C. Don the gown, then the gloves, touching the folded cuff of the gown.
D. Don the gloves and gown simultaneously.
CORRECT ANSWER: C. Don the gown, then the gloves, touching the folded cuff
of the gown.
Rationale: In the closed-glove technique, the surgeon first dons the sterile gown. The
hands remain inside the gown cuffs, and the gloves are picked up and pulled over the
cuffs without the hands ever directly touching the outside of the glove, thus maintaining
sterility.
, Question 9: While preparing the sterile field, the scrub nurse notices a small
tear in the sterile drape. What is the MOST appropriate action?
A. Cover the tear with a small sterile towel.
B. Notify the surgeon and ignore the tear.
C. Cover the tear with an impervious sterile drape.
D. Replace the entire sterile field and all contents.
CORRECT ANSWER: C. Cover the tear with an impervious sterile drape.
Rationale: If a sterile drape becomes torn or punctured, it is considered contaminated.
The standard of care is to immediately cover the compromised area with a sterile,
impermeable drape to re-establish the barrier. If this is not possible, the area must be
considered contaminated and managed accordingly.
Question 10: What is the PRIMARY mechanical function of a surgical
tourniquet?
A. To prevent the spread of malignant cells.
B. To occlude arterial blood flow to a limb.
C. To provide a clear field by exsanguinating the limb.
D. To keep the limb immobile during surgery.
CORRECT ANSWER: C. To provide a clear field by exsanguinating the limb.
Rationale: A surgical tourniquet has two primary functions: to occlude arterial blood
flow and to exsanguinate the limb. However, the primary purpose for using it is to create
a bloodless surgical field, improving visualization and precision. Exsanguination
(removing blood from the limb) is the key mechanical step to achieve this.
Question 11: A patient undergoing general anesthesia experiences Malignant
Hyperthermia (MH). Which of the following is an EARLY clinical sign?
A. Decreased end-tidal CO2.
B. Generalized muscle flaccidity.
C. Unexplained tachycardia and increased end-tidal CO2.
D. Hypothermia.
CORRECT ANSWER: C. Unexplained tachycardia and increased end-tidal CO2.
Rationale: MH is a hypermetabolic state triggered by succinylcholine or volatile
anesthetics. Early signs include a rapid increase in heart rate (tachycardia) and a rise in
expired carbon dioxide (EtCO2) despite increased minute ventilation, as the body
produces excessive CO2.
Safety Updated 2026 | 190+ Questions and Answers |
Operating Room Safety Comprehensive Study Guide,
Practice Exam, Exam Prep Test Bank, Perioperative
Nursing, Surgical Asepsis, Sterile Technique, Infection
Prevention and Control, Surgical Instrumentation, Patient
Positioning, Anesthesia Safety, Fire Safety, Specimen
Handling, Clinical Judgment, Detailed Rationales and
Complete Revision Material
Question 1: According to the Association of periOperative Registered Nurses
(AORN) "Time Out" protocol, which of the following elements is the
MINIMUM required to be verified by the entire surgical team immediately
before the incision is made?
A. Patient's name and the procedure to be performed
B. Patient's name, procedure, and the site of surgery
C. Patient's name, procedure, site, and presence of required implants
D. Patient's name, procedure, site, and side of the procedure
CORRECT ANSWER: B. Patient's name, procedure, and the site of surgery
Rationale: The universal protocol mandates a final "Time Out" to verify the correct
patient, procedure, and site. While side and laterality are critical, the core minimum
requirement according to the Joint Commission and AORN is the active verification of
the patient identity, the planned procedure, and the surgical site.
Question 2: A surgical technologist notices that the ethylene oxide (EtO)
sterilization indicator has not changed color after a cycle. What is the
PRIMARY concern regarding the use of the instruments in the pack?
A. The instruments may have a toxic residue.
B. The instruments are not sterile due to a failure in the sterilization process.
C. The instruments may have been damaged by the high temperatures.
D. The plastic components of the instruments may have melted.
CORRECT ANSWER: B. The instruments are not sterile due to a failure in the
sterilization process.
Rationale: Chemical indicators (internal or external) provide visual confirmation that the
pack has been exposed to the sterilizing agent (EtO). If the indicator fails to change, it is
a direct indication that the parameters for sterilization were not met, and the
instruments must be considered non-sterile.
Question 3: In the context of laser safety in the OR, what is the PRIMARY
function of the "laser safety officer" (LSO)?
,A. To operate the laser equipment during the procedure
B. To ensure the safe use of lasers and compliance with safety regulations
C. To calibrate the laser energy output before each use
D. To clean the laser lenses post-operatively
CORRECT ANSWER: B. To ensure the safe use of lasers and compliance with
safety regulations
Rationale: The LSO is responsible for the overall laser safety program, including policy
development, hazard evaluation, and ensuring that all personnel adhere to safety
protocols (e.g., eyewear, signage, controlled access). They do not operate the laser; that
is the surgeon's role.
Question 4: A patient with a known latex allergy is scheduled for surgery.
Which of the following actions is MOST critical for the perioperative nurse to
implement?
A. Schedule the patient as the first case of the day.
B. Ensure that all latex-containing products are removed from the OR suite.
C. Administer prophylactic diphenhydramine pre-operatively.
D. Use only povidone-iodine for skin preparation.
CORRECT ANSWER: B. Ensure that all latex-containing products are removed
from the OR suite.
Rationale: The primary intervention for latex allergy is strict avoidance of all latex
products. This involves creating a latex-safe environment by removing latex gloves,
tourniquets, catheters, and other supplies from the room, as even aerosolized latex
proteins from powder can cause a severe reaction.
Question 5: What is the PRIMARY purpose of the "surgical safety checklist" as
advocated by the World Health Organization (WHO)?
A. To improve team communication and reduce preventable complications.
B. To provide a legal document for the surgical record.
C. To increase the speed of the surgical procedure.
D. To assign specific tasks to each member of the surgical team.
CORRECT ANSWER: A. To improve team communication and reduce
preventable complications.
Rationale: The WHO Surgical Safety Checklist is designed to promote communication
and teamwork among the surgical team, which has been shown to significantly reduce
mortality and morbidity by ensuring critical safety steps are not missed.
,Question 6: During a surgical procedure, the electrosurgical unit (ESU)
grounding pad becomes partially detached. What is the MOST immediate risk
to the patient?
A. Decreased surgical site visualization.
B. Inability to cut tissue effectively.
C. Thermal burn at the grounding pad site.
D. Electrical shock to the surgical team.
CORRECT ANSWER: C. Thermal burn at the grounding pad site.
Rationale: The grounding pad (dispersive electrode) provides a low-resistance return
path for the electrical current. If it becomes partially detached, the surface area for
current return is reduced, increasing the current density at the remaining contact point
and generating heat, which can cause a severe burn.
Question 7: What is the PRIMARY function of personal protective equipment
(PPE) like fluid-resistant gowns and face shields in the OR?
A. To protect the patient from the surgical team's pathogens.
B. To protect the surgical team from splashes and sprays of blood and body fluids.
C. To maintain the sterile field boundaries.
D. To keep the surgical team's clothing free from stains.
CORRECT ANSWER: B. To protect the surgical team from splashes and sprays
of blood and body fluids.
Rationale: According to Standard Precautions, PPE such as gowns, masks, and eye
protection are primarily used as a barrier to protect healthcare workers from exposure to
infectious materials that can be transmitted via splashes, sprays, or aerosols during
procedures.
Question 8: Which of the following is the CORRECT order for donning sterile
gloves using the closed-glove technique?
A. Don the gown, then the gloves, touching only the inside of the glove.
B. Don the gloves, then the gown.
C. Don the gown, then the gloves, touching the folded cuff of the gown.
D. Don the gloves and gown simultaneously.
CORRECT ANSWER: C. Don the gown, then the gloves, touching the folded cuff
of the gown.
Rationale: In the closed-glove technique, the surgeon first dons the sterile gown. The
hands remain inside the gown cuffs, and the gloves are picked up and pulled over the
cuffs without the hands ever directly touching the outside of the glove, thus maintaining
sterility.
, Question 9: While preparing the sterile field, the scrub nurse notices a small
tear in the sterile drape. What is the MOST appropriate action?
A. Cover the tear with a small sterile towel.
B. Notify the surgeon and ignore the tear.
C. Cover the tear with an impervious sterile drape.
D. Replace the entire sterile field and all contents.
CORRECT ANSWER: C. Cover the tear with an impervious sterile drape.
Rationale: If a sterile drape becomes torn or punctured, it is considered contaminated.
The standard of care is to immediately cover the compromised area with a sterile,
impermeable drape to re-establish the barrier. If this is not possible, the area must be
considered contaminated and managed accordingly.
Question 10: What is the PRIMARY mechanical function of a surgical
tourniquet?
A. To prevent the spread of malignant cells.
B. To occlude arterial blood flow to a limb.
C. To provide a clear field by exsanguinating the limb.
D. To keep the limb immobile during surgery.
CORRECT ANSWER: C. To provide a clear field by exsanguinating the limb.
Rationale: A surgical tourniquet has two primary functions: to occlude arterial blood
flow and to exsanguinate the limb. However, the primary purpose for using it is to create
a bloodless surgical field, improving visualization and precision. Exsanguination
(removing blood from the limb) is the key mechanical step to achieve this.
Question 11: A patient undergoing general anesthesia experiences Malignant
Hyperthermia (MH). Which of the following is an EARLY clinical sign?
A. Decreased end-tidal CO2.
B. Generalized muscle flaccidity.
C. Unexplained tachycardia and increased end-tidal CO2.
D. Hypothermia.
CORRECT ANSWER: C. Unexplained tachycardia and increased end-tidal CO2.
Rationale: MH is a hypermetabolic state triggered by succinylcholine or volatile
anesthetics. Early signs include a rapid increase in heart rate (tachycardia) and a rise in
expired carbon dioxide (EtCO2) despite increased minute ventilation, as the body
produces excessive CO2.
