PERIOPERATIVE NURSING EDUCATION AND COMPETENCY VALIDATION SERIES
AORN Periop 101 Final Examination
2026/2027 Expected Questions and Revised Correct Answers
100% Guarantee Pass Edition
Aligned with the AORN Guidelines for Perioperative Practice (2026/2027 Edition) | Verified Answers with Comprehensive
Rationales
150 10 / 20 A-D
Recall / Application / Analysis
Total Questions Competency Sections One Best Answer Format
(%)
HOW TO USE THIS EXAMINATION REVIEW: Each item is presented in the standardized Periop 101 assessment format with
one best answer among four options (A through D). The verified correct answer is marked [CORRECT] immediately after the
corresponding option and is restated beneath each item for quick self-assessment. A comprehensive rationale follows every
answer, explaining why the correct response is right and why the remaining options represent common perioperative nursing
errors, with references to the relevant AORN Guidelines for Perioperative Practice and evidence-based patient safety principles.
For supervised testing, cover the answer and rationale blocks and score responses against the marked keys. Content reflects
high-frequency, expected questions across the ten Periop 101 curriculum and competency domains.
Section 1: Perioperative Patient Assessment and Planning Questions 1-15
Preoperative Assessment, Patient Interview, Chart Review, and Care Planning
Q1: A circulating nurse is reviewing the preoperative record of a 68-year-old patient scheduled for an elective
open inguinal hernia repair. The history and physical is complete, the consent is signed, and the patient has been
NPO since midnight except for sips of water taken with an antihypertensive at 06:00. Yesterday's laboratory
report shows a potassium level of 5.9 mEq/L. What should the circulating nurse do first?
A. Proceed with transport to the preoperative holding area so the schedule stays on time.
B. Notify the surgeon and the anesthesia professional of the critical potassium value before the patient is
transported. [CORRECT]
C. Document the potassium value in the nursing notes and plan to reassess it after the operative procedure is
completed.
D. Ask the laboratory to repeat the specimen the following morning because one elevated value is rarely
significant.
Correct Answer: B
Rationale: A critical laboratory abnormality must be communicated to the surgeon and anesthesia professional before an
elective procedure proceeds, because hyperkalemia can precipitate perioperative cardiac dysrhythmias and is likely to
change the operative plan. Documenting for later or proceeding on schedule ignores an unresolved safety risk, and
requesting a next-day repeat delays indicated care without addressing the current danger. Verification and communication
of preoperative assessment findings are core expectations of perioperative assessment and of the AORN Guideline for
Perioperative Nursing Education Series 1
,AORN Periop 101 Final Examination (2026/2027) 100% Guarantee Pass Edition
Patient Information Management.
Q2: Which member of the surgical team has the primary legal responsibility for explaining the risks, benefits,
and alternatives of the planned operation to the patient?
A. The anesthesia professional who will administer the anesthetic.
B. The circulating nurse who witnesses the signature on the consent form.
C. The hospital risk management department representative.
D. The surgeon or licensed independent practitioner who will perform the procedure. [CORRECT]
Correct Answer: D
Rationale: Informed consent for the surgical procedure is obtained by the practitioner who will perform it, because only
that provider can fully explain the planned intervention, its risks, benefits, and reasonable alternatives. The circulating nurse
witnesses the signature, verifies that the patient's questions were answered, and documents the consent, but the nurse does
not obtain the surgical consent. The anesthesia professional separately discusses anesthesia-specific risks, and risk
management supports but does not own the informed consent process.
Q3: During the preoperative interview, a patient scheduled for an elective laparoscopic cholecystectomy states
that he ate a full solid meal, including eggs and toast, approximately three hours ago. What is the nurse's most
appropriate action?
A. Notify the anesthesia professional and the surgeon so the team can decide whether the procedure should be
delayed or rescheduled. [CORRECT]
B. Proceed as scheduled, because solid stomach contents empty within two hours of ingestion.
C. Encourage the patient to vomit to empty the stomach before transport to the operating room.
D. Document the intake and proceed, since only clear liquids increase the risk of pulmonary aspiration.
Correct Answer: A
Rationale: Current fasting standards require abstinence from solid food for at least six to eight hours before elective
anesthesia, so a solid meal three hours before surgery creates a serious pulmonary aspiration risk. The nurse's role is to
verify and communicate NPO status and allow the anesthesia professional and surgeon to make the decision to delay,
reschedule, or proceed with protective measures. Inducing vomiting is dangerous and outside nursing scope, and proceeding
without notifying the team violates the advocacy and verification expectations of perioperative assessment standards.
Q4: During the preoperative patient interview, a patient reports that eating bananas and avocados causes lip
swelling and intense itching. How should the perioperative nurse interpret and act on this information?
A. Document it as an isolated food intolerance with no relevance to intraoperative care.
B. Reassure the patient that foods and surgical materials are unrelated and proceed without changes.
C. Identify a potential latex allergy, notify the surgical team, and ensure a latex-safe environment is prepared for
the procedure. [CORRECT]
D. Refer the patient for formal allergy testing after discharge and proceed with routine supplies.
Correct Answer: C
Rationale: Banana, avocado, kiwi, and chestnut are foods cross-reactive with natural rubber latex, so this history signals a
probable latex allergy that must be flagged before any supplies are opened. The nurse should notify the team, clearly
identify the patient as latex risk, and ensure a latex-safe environment with latex-free gloves and equipment, consistent with
AORN's recommendations for care of the patient with a latex allergy. Ignoring the history or deferring action places the
patient at risk for intraoperative anaphylaxis, one of the most dangerous perioperative hypersensitivity events.
Perioperative Nursing Education Series 2
,AORN Periop 101 Final Examination (2026/2027) 100% Guarantee Pass Edition
Q5: A complete medication reconciliation reveals that a patient takes ginkgo biloba, garlic capsules, and fish oil
daily. Why must the perioperative nurse report these findings to the surgeon and anesthesia professional?
A. They are safe because they are natural products with no physiologic effects.
B. These supplements are associated with increased bleeding risk and potential interactions with anesthetic
agents. [CORRECT]
C. They require discontinuation only after the operative procedure has been completed.
D. Supplements do not need to be reviewed because they are not prescription medications.
Correct Answer: B
Rationale: Herbal products and dietary supplements are pharmacologically active: ginkgo, garlic, and fish oil inhibit
platelet function and can increase intraoperative and postoperative bleeding. Complete medication reconciliation, including
over-the-counter drugs and supplements, is required so the surgeon and anesthesia professional can decide whether to
cancel, postpone, or proceed, consistent with AORN's medication safety expectations. Dismissing supplements as harmless
or planning discontinuation only after surgery ignores a modifiable hemorrhage risk identified during preoperative
assessment.
Q6: Which preoperative laboratory finding should the perioperative nurse recognize as requiring notification of
the surgical team before an elective procedure?
A. A blood glucose level of 316 mg/dL. [CORRECT]
B. A serum potassium level of 3.9 mEq/L.
C. A hemoglobin level of 14 g/dL.
D. A white blood cell count of 6,800 cells/mcL.
Correct Answer: A
Rationale: Marked perioperative hyperglycemia is associated with increased surgical site infection risk and impaired
wound healing, and glycemic control with a target of less than 180 mg/dL is a core recommendation of the AORN
Guideline for Prevention of Surgical Site Infection. A glucose of 316 mg/dL therefore warrants communication with the
surgical and anesthesia team before proceeding. The potassium, hemoglobin, and white blood cell values listed are all within
normal limits and do not require escalation.
Q7: Which age-related physiologic change best explains why older adults require individualized medication
dosing and heightened monitoring during the perioperative period?
A. Age-related increase in pain perception that mandates lower analgesic doses.
B. Enhanced renal clearance that accelerates elimination of anesthetic agents.
C. Increased hepatic blood flow that speeds drug metabolism.
D. Decline in renal and hepatic function that prolongs drug half-life and increases the risk of accumulation and
adverse effects. [CORRECT]
Correct Answer: D
Rationale: Aging reduces glomerular filtration and hepatic blood flow and metabolism, prolonging the half-life of many
anesthetic, opioid, and muscle relaxant agents and increasing the risk of accumulation, delirium, and respiratory depression.
This decline, along with reduced physiologic reserve and skin fragility, makes the older adult more susceptible to
hypothermia, pressure injury, and medication errors. The AORN Guideline for Care of the Older Adult Undergoing
Surgery emphasizes individualized assessment rather than age-based assumptions such as increased clearance or faster
metabolism.
Perioperative Nursing Education Series 3
, AORN Periop 101 Final Examination (2026/2027) 100% Guarantee Pass Edition
Q8: During the preoperative interview, an anxious patient states, "I am afraid I will not wake up after the
surgery." What is the nurse's best response?
A. Change the subject quickly to distract the patient from frightening thoughts.
B. Reassure the patient that nothing bad ever happens in the operating room.
C. Acknowledge the concern, provide honest information about continuous intraoperative monitoring, and
notify the anesthesia professional so the patient's questions can be addressed. [CORRECT]
D. Explain that signing the surgical consent form releases the hospital from any such outcome.
Correct Answer: C
Rationale: Therapeutic communication requires acknowledging the patient's fear, providing truthful information about the
continuous monitoring and safety measures in place, and involving the anesthesia professional, who can address
anesthesia-specific concerns directly. Untreated anxiety elevates heart rate, blood pressure, and analgesic requirements and
impairs recovery, while preoperative teaching has been shown to reduce anxiety and improve outcomes. False reassurance,
deflection, or misrepresenting the consent process destroys trust and does not meet the patient communication expectations
of perioperative nursing standards.
Q9: A patient scheduled for an elective abdominal hysterectomy has a type and crossmatch on file because the
surgeon anticipates possible transfusion. What is the circulating nurse's correct responsibility regarding blood
products?
A. Recognize that consent for transfusion is implied whenever a surgical consent is signed.
B. Verify that the type and crossmatch results are available, confirm that consent for blood administration is
documented, and use two patient identifiers with a two-person check before any transfusion. [CORRECT]
C. Delegate all blood verification to the anesthesia professional because only anesthesia touches blood products.
D. Release the crossmatched units back to the blood bank at the start of the case to keep them available for other
patients.
Correct Answer: B
Rationale: Blood administration requires documented informed consent, availability of appropriately crossmatched units,
and verification by two qualified individuals using two patient identifiers at the bedside, per blood management and patient
identification standards. The circulating nurse shares accountability with the anesthesia professional for this verification and
for documentation; transfusion consent is never implied by the surgical consent. Releasing crossmatched units prematurely
defeats the purpose of the crossmatch and delays care if bleeding occurs.
Perioperative Nursing Education Series 4
AORN Periop 101 Final Examination
2026/2027 Expected Questions and Revised Correct Answers
100% Guarantee Pass Edition
Aligned with the AORN Guidelines for Perioperative Practice (2026/2027 Edition) | Verified Answers with Comprehensive
Rationales
150 10 / 20 A-D
Recall / Application / Analysis
Total Questions Competency Sections One Best Answer Format
(%)
HOW TO USE THIS EXAMINATION REVIEW: Each item is presented in the standardized Periop 101 assessment format with
one best answer among four options (A through D). The verified correct answer is marked [CORRECT] immediately after the
corresponding option and is restated beneath each item for quick self-assessment. A comprehensive rationale follows every
answer, explaining why the correct response is right and why the remaining options represent common perioperative nursing
errors, with references to the relevant AORN Guidelines for Perioperative Practice and evidence-based patient safety principles.
For supervised testing, cover the answer and rationale blocks and score responses against the marked keys. Content reflects
high-frequency, expected questions across the ten Periop 101 curriculum and competency domains.
Section 1: Perioperative Patient Assessment and Planning Questions 1-15
Preoperative Assessment, Patient Interview, Chart Review, and Care Planning
Q1: A circulating nurse is reviewing the preoperative record of a 68-year-old patient scheduled for an elective
open inguinal hernia repair. The history and physical is complete, the consent is signed, and the patient has been
NPO since midnight except for sips of water taken with an antihypertensive at 06:00. Yesterday's laboratory
report shows a potassium level of 5.9 mEq/L. What should the circulating nurse do first?
A. Proceed with transport to the preoperative holding area so the schedule stays on time.
B. Notify the surgeon and the anesthesia professional of the critical potassium value before the patient is
transported. [CORRECT]
C. Document the potassium value in the nursing notes and plan to reassess it after the operative procedure is
completed.
D. Ask the laboratory to repeat the specimen the following morning because one elevated value is rarely
significant.
Correct Answer: B
Rationale: A critical laboratory abnormality must be communicated to the surgeon and anesthesia professional before an
elective procedure proceeds, because hyperkalemia can precipitate perioperative cardiac dysrhythmias and is likely to
change the operative plan. Documenting for later or proceeding on schedule ignores an unresolved safety risk, and
requesting a next-day repeat delays indicated care without addressing the current danger. Verification and communication
of preoperative assessment findings are core expectations of perioperative assessment and of the AORN Guideline for
Perioperative Nursing Education Series 1
,AORN Periop 101 Final Examination (2026/2027) 100% Guarantee Pass Edition
Patient Information Management.
Q2: Which member of the surgical team has the primary legal responsibility for explaining the risks, benefits,
and alternatives of the planned operation to the patient?
A. The anesthesia professional who will administer the anesthetic.
B. The circulating nurse who witnesses the signature on the consent form.
C. The hospital risk management department representative.
D. The surgeon or licensed independent practitioner who will perform the procedure. [CORRECT]
Correct Answer: D
Rationale: Informed consent for the surgical procedure is obtained by the practitioner who will perform it, because only
that provider can fully explain the planned intervention, its risks, benefits, and reasonable alternatives. The circulating nurse
witnesses the signature, verifies that the patient's questions were answered, and documents the consent, but the nurse does
not obtain the surgical consent. The anesthesia professional separately discusses anesthesia-specific risks, and risk
management supports but does not own the informed consent process.
Q3: During the preoperative interview, a patient scheduled for an elective laparoscopic cholecystectomy states
that he ate a full solid meal, including eggs and toast, approximately three hours ago. What is the nurse's most
appropriate action?
A. Notify the anesthesia professional and the surgeon so the team can decide whether the procedure should be
delayed or rescheduled. [CORRECT]
B. Proceed as scheduled, because solid stomach contents empty within two hours of ingestion.
C. Encourage the patient to vomit to empty the stomach before transport to the operating room.
D. Document the intake and proceed, since only clear liquids increase the risk of pulmonary aspiration.
Correct Answer: A
Rationale: Current fasting standards require abstinence from solid food for at least six to eight hours before elective
anesthesia, so a solid meal three hours before surgery creates a serious pulmonary aspiration risk. The nurse's role is to
verify and communicate NPO status and allow the anesthesia professional and surgeon to make the decision to delay,
reschedule, or proceed with protective measures. Inducing vomiting is dangerous and outside nursing scope, and proceeding
without notifying the team violates the advocacy and verification expectations of perioperative assessment standards.
Q4: During the preoperative patient interview, a patient reports that eating bananas and avocados causes lip
swelling and intense itching. How should the perioperative nurse interpret and act on this information?
A. Document it as an isolated food intolerance with no relevance to intraoperative care.
B. Reassure the patient that foods and surgical materials are unrelated and proceed without changes.
C. Identify a potential latex allergy, notify the surgical team, and ensure a latex-safe environment is prepared for
the procedure. [CORRECT]
D. Refer the patient for formal allergy testing after discharge and proceed with routine supplies.
Correct Answer: C
Rationale: Banana, avocado, kiwi, and chestnut are foods cross-reactive with natural rubber latex, so this history signals a
probable latex allergy that must be flagged before any supplies are opened. The nurse should notify the team, clearly
identify the patient as latex risk, and ensure a latex-safe environment with latex-free gloves and equipment, consistent with
AORN's recommendations for care of the patient with a latex allergy. Ignoring the history or deferring action places the
patient at risk for intraoperative anaphylaxis, one of the most dangerous perioperative hypersensitivity events.
Perioperative Nursing Education Series 2
,AORN Periop 101 Final Examination (2026/2027) 100% Guarantee Pass Edition
Q5: A complete medication reconciliation reveals that a patient takes ginkgo biloba, garlic capsules, and fish oil
daily. Why must the perioperative nurse report these findings to the surgeon and anesthesia professional?
A. They are safe because they are natural products with no physiologic effects.
B. These supplements are associated with increased bleeding risk and potential interactions with anesthetic
agents. [CORRECT]
C. They require discontinuation only after the operative procedure has been completed.
D. Supplements do not need to be reviewed because they are not prescription medications.
Correct Answer: B
Rationale: Herbal products and dietary supplements are pharmacologically active: ginkgo, garlic, and fish oil inhibit
platelet function and can increase intraoperative and postoperative bleeding. Complete medication reconciliation, including
over-the-counter drugs and supplements, is required so the surgeon and anesthesia professional can decide whether to
cancel, postpone, or proceed, consistent with AORN's medication safety expectations. Dismissing supplements as harmless
or planning discontinuation only after surgery ignores a modifiable hemorrhage risk identified during preoperative
assessment.
Q6: Which preoperative laboratory finding should the perioperative nurse recognize as requiring notification of
the surgical team before an elective procedure?
A. A blood glucose level of 316 mg/dL. [CORRECT]
B. A serum potassium level of 3.9 mEq/L.
C. A hemoglobin level of 14 g/dL.
D. A white blood cell count of 6,800 cells/mcL.
Correct Answer: A
Rationale: Marked perioperative hyperglycemia is associated with increased surgical site infection risk and impaired
wound healing, and glycemic control with a target of less than 180 mg/dL is a core recommendation of the AORN
Guideline for Prevention of Surgical Site Infection. A glucose of 316 mg/dL therefore warrants communication with the
surgical and anesthesia team before proceeding. The potassium, hemoglobin, and white blood cell values listed are all within
normal limits and do not require escalation.
Q7: Which age-related physiologic change best explains why older adults require individualized medication
dosing and heightened monitoring during the perioperative period?
A. Age-related increase in pain perception that mandates lower analgesic doses.
B. Enhanced renal clearance that accelerates elimination of anesthetic agents.
C. Increased hepatic blood flow that speeds drug metabolism.
D. Decline in renal and hepatic function that prolongs drug half-life and increases the risk of accumulation and
adverse effects. [CORRECT]
Correct Answer: D
Rationale: Aging reduces glomerular filtration and hepatic blood flow and metabolism, prolonging the half-life of many
anesthetic, opioid, and muscle relaxant agents and increasing the risk of accumulation, delirium, and respiratory depression.
This decline, along with reduced physiologic reserve and skin fragility, makes the older adult more susceptible to
hypothermia, pressure injury, and medication errors. The AORN Guideline for Care of the Older Adult Undergoing
Surgery emphasizes individualized assessment rather than age-based assumptions such as increased clearance or faster
metabolism.
Perioperative Nursing Education Series 3
, AORN Periop 101 Final Examination (2026/2027) 100% Guarantee Pass Edition
Q8: During the preoperative interview, an anxious patient states, "I am afraid I will not wake up after the
surgery." What is the nurse's best response?
A. Change the subject quickly to distract the patient from frightening thoughts.
B. Reassure the patient that nothing bad ever happens in the operating room.
C. Acknowledge the concern, provide honest information about continuous intraoperative monitoring, and
notify the anesthesia professional so the patient's questions can be addressed. [CORRECT]
D. Explain that signing the surgical consent form releases the hospital from any such outcome.
Correct Answer: C
Rationale: Therapeutic communication requires acknowledging the patient's fear, providing truthful information about the
continuous monitoring and safety measures in place, and involving the anesthesia professional, who can address
anesthesia-specific concerns directly. Untreated anxiety elevates heart rate, blood pressure, and analgesic requirements and
impairs recovery, while preoperative teaching has been shown to reduce anxiety and improve outcomes. False reassurance,
deflection, or misrepresenting the consent process destroys trust and does not meet the patient communication expectations
of perioperative nursing standards.
Q9: A patient scheduled for an elective abdominal hysterectomy has a type and crossmatch on file because the
surgeon anticipates possible transfusion. What is the circulating nurse's correct responsibility regarding blood
products?
A. Recognize that consent for transfusion is implied whenever a surgical consent is signed.
B. Verify that the type and crossmatch results are available, confirm that consent for blood administration is
documented, and use two patient identifiers with a two-person check before any transfusion. [CORRECT]
C. Delegate all blood verification to the anesthesia professional because only anesthesia touches blood products.
D. Release the crossmatched units back to the blood bank at the start of the case to keep them available for other
patients.
Correct Answer: B
Rationale: Blood administration requires documented informed consent, availability of appropriately crossmatched units,
and verification by two qualified individuals using two patient identifiers at the bedside, per blood management and patient
identification standards. The circulating nurse shares accountability with the anesthesia professional for this verification and
for documentation; transfusion consent is never implied by the surgical consent. Releasing crossmatched units prematurely
defeats the purpose of the crossmatch and delays care if bleeding occurs.
Perioperative Nursing Education Series 4
