1
Santa Clara County
Operating Room Nurse
Examination Comprehensive
Practice Question Bank 150
Multiple-Choice Questions with Answers and
Rationales a well detailed one 2025 /
2026 written and graded A+ upgraded
, 2
Exam Title: Santa Clara County Operating Room Nurse Examination: Comprehensive
Perioperative Competency Assessment for Advanced Clinical Practice in Acute Care
Surgical Settings
Domain 1: Preoperative Patient Assessment and Preparation
(Questions 1–20)
1. A 72-year-old patient with a history of hypertension, type 2 diabetes, and
chronic kidney disease stage 3 is scheduled for an open cholecystectomy. Which
preoperative laboratory value should the perioperative nurse prioritize for
immediate notification to the anesthesia provider?
A. Hemoglobin of 11.2 g/dL
B. Serum potassium of 5.8 mEq/L
C. Fasting blood glucose of 148 mg/dL
D. Serum creatinine of 1.8 mg/dL
-detailed answer 100% correct :- B
Rationale: A serum potassium of 5.8 mEq/L is significantly elevated (hyperkalemia) and
poses an immediate risk for cardiac arrhythmias during anesthesia induction. This
finding requires urgent intervention and anesthesia provider notification prior to
proceeding with surgery. While the other values are abnormal (anemia, hyperglycemia,
and renal insufficiency), they do not represent the same level of immediate perioperative
risk.
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2. During the preoperative verification process, the circulating nurse notes that the
informed consent form for a right total knee arthroplasty indicates "left total knee
arthroplasty." What is the nurse's MOST appropriate action?
A. Cross out "left" and write "right" with the nurse's initials
B. Proceed with surgery as the surgeon will correct it intraoperatively
C. Notify the surgeon and do not proceed until the consent is corrected
D. Document the discrepancy in the nursing notes and proceed
-detailed answer 100% correct :- C
Rationale: The informed consent must be accurate and match the planned surgical
procedure and site. The Universal Protocol requires that all discrepancies be resolved
before the procedure begins. The circulating nurse must stop the process, notify the
surgeon, and ensure a corrected consent is obtained from the patient or legally
authorized representative before proceeding.
3. Which of the following findings in a preoperative patient assessment would be
considered the HIGHEST priority for intervention prior to elective surgery?
A. Patient reports drinking a glass of water 2 hours ago
B. Patient reports a history of malignant hyperthermia in a sibling
C. Patient's hemoglobin A1c is 7.2%
D. Patient has a body mass index of 31 kg/m²
-detailed answer 100% correct :- B
Rationale: A family history of malignant hyperthermia is a critical finding that requires
immediate preoperative planning, including preparation of dantrolene and avoidance of
triggering anesthetic agents. This represents a potentially life-threatening emergency if
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not properly addressed. The other findings, while requiring attention, can be managed
with appropriate preoperative interventions.
4. The perioperative nurse is performing a preoperative assessment on a patient
scheduled for a laparoscopic appendectomy. Which patient statement would
MOST significantly impact the surgical plan?
A. "I had a hysterectomy 10 years ago."
B. "I took my blood pressure medication this morning."
C. "I took aspirin yesterday for a headache."
D. "I am allergic to penicillin."
-detailed answer 100% correct :- C
Rationale: Aspirin inhibits platelet aggregation for 7–10 days and significantly increases
the risk of perioperative bleeding. This information must be communicated to the
surgical team and may impact the decision to proceed with surgery. The other findings
are important but do not carry the same immediate surgical risk.
5. A patient scheduled for an elective inguinal hernia repair reports using herbal
supplements including ginkgo biloba and garlic. The nurse's MOST appropriate
response is:
A. "These supplements are safe and you may continue them."
B. "You should stop these supplements immediately as they increase bleeding risk."
C. "Please stop these supplements 7 days before surgery and notify your surgeon."
D. "These supplements are only a concern if you are having cardiac surgery."
Santa Clara County
Operating Room Nurse
Examination Comprehensive
Practice Question Bank 150
Multiple-Choice Questions with Answers and
Rationales a well detailed one 2025 /
2026 written and graded A+ upgraded
, 2
Exam Title: Santa Clara County Operating Room Nurse Examination: Comprehensive
Perioperative Competency Assessment for Advanced Clinical Practice in Acute Care
Surgical Settings
Domain 1: Preoperative Patient Assessment and Preparation
(Questions 1–20)
1. A 72-year-old patient with a history of hypertension, type 2 diabetes, and
chronic kidney disease stage 3 is scheduled for an open cholecystectomy. Which
preoperative laboratory value should the perioperative nurse prioritize for
immediate notification to the anesthesia provider?
A. Hemoglobin of 11.2 g/dL
B. Serum potassium of 5.8 mEq/L
C. Fasting blood glucose of 148 mg/dL
D. Serum creatinine of 1.8 mg/dL
-detailed answer 100% correct :- B
Rationale: A serum potassium of 5.8 mEq/L is significantly elevated (hyperkalemia) and
poses an immediate risk for cardiac arrhythmias during anesthesia induction. This
finding requires urgent intervention and anesthesia provider notification prior to
proceeding with surgery. While the other values are abnormal (anemia, hyperglycemia,
and renal insufficiency), they do not represent the same level of immediate perioperative
risk.
, 3
2. During the preoperative verification process, the circulating nurse notes that the
informed consent form for a right total knee arthroplasty indicates "left total knee
arthroplasty." What is the nurse's MOST appropriate action?
A. Cross out "left" and write "right" with the nurse's initials
B. Proceed with surgery as the surgeon will correct it intraoperatively
C. Notify the surgeon and do not proceed until the consent is corrected
D. Document the discrepancy in the nursing notes and proceed
-detailed answer 100% correct :- C
Rationale: The informed consent must be accurate and match the planned surgical
procedure and site. The Universal Protocol requires that all discrepancies be resolved
before the procedure begins. The circulating nurse must stop the process, notify the
surgeon, and ensure a corrected consent is obtained from the patient or legally
authorized representative before proceeding.
3. Which of the following findings in a preoperative patient assessment would be
considered the HIGHEST priority for intervention prior to elective surgery?
A. Patient reports drinking a glass of water 2 hours ago
B. Patient reports a history of malignant hyperthermia in a sibling
C. Patient's hemoglobin A1c is 7.2%
D. Patient has a body mass index of 31 kg/m²
-detailed answer 100% correct :- B
Rationale: A family history of malignant hyperthermia is a critical finding that requires
immediate preoperative planning, including preparation of dantrolene and avoidance of
triggering anesthetic agents. This represents a potentially life-threatening emergency if
, 4
not properly addressed. The other findings, while requiring attention, can be managed
with appropriate preoperative interventions.
4. The perioperative nurse is performing a preoperative assessment on a patient
scheduled for a laparoscopic appendectomy. Which patient statement would
MOST significantly impact the surgical plan?
A. "I had a hysterectomy 10 years ago."
B. "I took my blood pressure medication this morning."
C. "I took aspirin yesterday for a headache."
D. "I am allergic to penicillin."
-detailed answer 100% correct :- C
Rationale: Aspirin inhibits platelet aggregation for 7–10 days and significantly increases
the risk of perioperative bleeding. This information must be communicated to the
surgical team and may impact the decision to proceed with surgery. The other findings
are important but do not carry the same immediate surgical risk.
5. A patient scheduled for an elective inguinal hernia repair reports using herbal
supplements including ginkgo biloba and garlic. The nurse's MOST appropriate
response is:
A. "These supplements are safe and you may continue them."
B. "You should stop these supplements immediately as they increase bleeding risk."
C. "Please stop these supplements 7 days before surgery and notify your surgeon."
D. "These supplements are only a concern if you are having cardiac surgery."
