PERIOPERATIVE NURSING ED UCATION
AORN Periop 101
Final Exam
Test Bank
A comprehensive test bank of 255 multiple-choice
questions with revised correct answers and detailed
rationales, aligned with the AORN Guidelines for
Perioperative Practice (2026/2027) and the complete
Periop 101 curriculum.
Competency Validation Series | Revised Edition
100% GU A RA NTE E PA SS | V E RIFIE D A NSWE RS | D E TA ILE D
RATIONA LE S
ED I TI ON | 25 5 QUESTI ONS
,AORN Periop 101 Final Exam Test Bank (2026/2027)
AORN Periop 101 Final Exam Test Bank
Edition | Expected 250+ Questions (255 Included) | Revised Correct Answers with Detailed
Rationales
Aligned with the AORN Guidelines for Perioperative Practice (2026/2027) and the Complete Periop 101
Curriculum | 100% Guarantee Pass Format | Verified Answers and Comprehensive Rationales
SECTION 1 - PERIOPERATIVE PATIENT ASSESSMENT AND PLANNING
Questions 1-20
Q1: A 58-year-old patient arrives at the preoperative holding area for an elective open cholecystectomy. During
the preoperative patient interview, the perioperative nurse's FIRST priority is to:
A. Verify the patient's identity using two identifiers and confirm the planned procedure and surgical site
[CORRECT]
B. Explain the circulating nurse's role during the intraoperative phase
C. Document the patient's lifetime occupational history in detail
D. Review the patient's insurance coverage and financial responsibility
Correct Answer: A
Rationale: Correct patient identification with at least two identifiers, verification of the planned procedure, and
confirmation of the correct surgical site are the foundational patient safety interventions and are required before any
other assessment activity. The AORN Guideline for Patient Information Management and The Joint Commission
Universal Protocol both mandate this verification. Insurance review is a business function, explaining staff roles can
occur after safety verification, and a detailed occupational history is not an immediate preoperative priority.
Q2: The perioperative nurse is reviewing the chart of a patient scheduled for total knee arthroplasty. Which
assessment finding is MOST important to report to the anesthesia provider and surgeon before the patient enters
the OR?
A. The patient has a documented allergy to penicillin with a history of mild rash
B. The patient wears reading glasses for near vision
C. The patient states a preference for a window in the operating room
D. The patient reports taking 325 mg aspirin daily, with the last dose taken this morning [CORRECT]
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that impairs hemostasis and significantly increases intraoperative and
postoperative bleeding risk, especially in orthopedic surgery with large bone surfaces. This finding must be
communicated before incision so the surgical team can decide whether to proceed. A remote mild rash to penicillin
requires documentation but does not delay surgery, and eyewear preference and reading glasses are routine, non-urgent
data. Medication reconciliation including anticoagulants and antiplatelets is a core element of preoperative assessment.
Perioperative Nursing Education - Competency Validation Series 1
,AORN Periop 101 Final Exam Test Bank (2026/2027)
Q3: Which statement by a patient scheduled for a laparoscopic appendectomy BEST indicates that informed
consent has been achieved from the patient's perspective?
A. I know the hospital requires the form before the anesthesia provider can put me to sleep
B. I signed the form at my doctor's office last week, so I am ready to go
C. My daughter read the form to me and she said the surgery is necessary
D. I understand the surgeon will remove my appendix through small incisions using a camera, and that a
larger incision may be needed if complications occur [CORRECT]
Correct Answer: D
Rationale: Informed consent requires that the patient demonstrates understanding of the nature of the procedure, its
risks and benefits, and reasonable alternatives, including possible conversion to an open procedure. The surgeon is
legally responsible for obtaining consent, but the perioperative nurse verifies the patient's understanding before
sedation. Signing without comprehension, delegating understanding to a family member, or viewing the form as an
administrative barrier all indicate that consent is not truly informed and must be escalated to the surgeon.
Q4: A patient scheduled for elective surgery at 0800 reports drinking a clear protein nutritional shake at 0530.
The patient's NPO status should be interpreted as:
A. Acceptable, because clear liquids are permitted up to 1 hour before surgery
B. Unacceptable, because the patient consumed a liquid with protein and fat that is not a clear liquid and
does not meet fasting guidelines [CORRECT]
C. Acceptable, because the intake was more than 2 hours before the scheduled incision time
D. Unacceptable, because any oral intake within 8 hours requires surgery cancellation without exception
Correct Answer: B
Rationale: Enhanced Recovery and ASA fasting guidance permits clear liquids up to approximately 2 hours before
anesthesia, but a protein nutritional shake contains protein and fat and is not a clear liquid; it follows the heavier-meal
fasting rule of 6 or more hours. The perioperative nurse must notify the anesthesia provider and surgeon for a
case-by-case decision rather than proceeding or canceling unilaterally. Blanket cancellation is not automatic, and 'clear
liquids up to 1 hour' does not reflect accepted practice.
Q5: During the preoperative chart review, which laboratory result requires the MOST urgent follow-up for a
patient scheduled for an elective colectomy this morning?
A. White blood cell count of 8,500/mm3
B. Hemoglobin of 13.5 g/dL
C. Platelet count of 250,000/mm3
D. Serum potassium of 2.8 mEq/L [CORRECT]
Correct Answer: D
Rationale: Hypokalemia of 2.8 mEq/L places the patient at serious risk for perioperative dysrhythmias, especially
during anesthesia and with the use of neuromuscular blockers, and must be reported before induction so surgery can be
delayed if indicated. The other values are within normal limits and require no urgent action. Preoperative assessment
includes systematic review of laboratory studies against the planned procedure and anesthesia type, with abnormal
results escalated to the surgeon and anesthesia provider.
Perioperative Nursing Education - Competency Validation Series 2
, AORN Periop 101 Final Exam Test Bank (2026/2027)
Q6: A perioperative nurse is completing the preoperative assessment for a patient with diabetes mellitus who
takes long-acting insulin. Which action reflects BEST practice for the morning of surgery?
A. Withhold all diabetes medications for 24 hours before surgery regardless of type
B. Give the patient a regular breakfast to prevent hypoglycemia, then administer insulin
C. Administer the full long-acting insulin dose as scheduled without discussion
D. Confirm the anesthesia-directed modification of the morning insulin dose and evaluate the blood glucose
result before transferring the patient [CORRECT]
Correct Answer: D
Rationale: Insulin requirements are typically modified on the morning of surgery, often reduced, and the plan is
individualized by the anesthesia provider or prescribing clinician; the perioperative nurse verifies the modification and
checks the point-of-care glucose before transfer. Giving the full dose risks intraoperative hypoglycemia, blanket
withholding risks hyperglycemia and ketoacidosis, and feeding a patient scheduled for anesthesia violates NPO
requirements. Hyperglycemia above 200 mg/dL increases surgical site infection risk, making glucose evaluation a
documented safety measure.
Q7: While performing the preoperative interview, the nurse notes that the patient is visibly anxious, asking
repeated questions about whether he will wake up during surgery. The nurse's MOST appropriate response is to:
A. Administer PRN antianxiety medication without further assessment
B. Tell the patient that anxiety is unreasonable because the surgeon is highly experienced
C. Provide honest information about anesthesia safety, remain with the patient, and notify the anesthesia
provider of the patient's expressed fears [CORRECT]
D. Reassure the patient that everything will be fine and change the subject to reduce distress
Correct Answer: C
Rationale: Preoperative anxiety is common and unmanaged anxiety increases physiologic stress and postoperative pain
perception. The nurse should acknowledge concerns, provide truthful, developmentally appropriate information, and
communicate the patient's fears to the anesthesia provider who will address them directly. Dismissing anxiety as
unreasonable is non-therapeutic, empty reassurance without information does not build trust, and medication
administration without assessment and an order process bypasses individualized care planning central to the AORN
assessment guideline.
Q8: The preoperative nurse discovers that the signed surgical consent for a patient scheduled for right total hip
arthroplasty lists the wrong laterality, stating left. The surgeon is in the OR and the patient is already sedated. The
nurse should:
A. Correct the word left to right on the form, initial the change, and proceed
B. Ask the surgeon to come to the preoperative area and complete an entirely new consent with the awake
patient before proceeding, if the patient can legally do so given sedation status [CORRECT]
C. Proceed because the surgeon verbally confirmed the correct hip and the form is a formality
D. Have the anesthesia provider sign as a witness to the verbal correction
Correct Answer: B
Rationale: A consent document that misidentifies the side of surgery is invalid, and altering a legal document after the
fact is falsification. The surgeon must obtain a new valid consent from a patient with decision-making capacity;
sedation may invalidate the patient's ability to legally consent, so the status must be assessed before proceeding. Verbal
confirmation does not substitute for the signed legal document, and witnessing an alteration does not make an invalid
consent valid. This scenario also triggers site-verification elements of the Universal Protocol.
Perioperative Nursing Education - Competency Validation Series 3
AORN Periop 101
Final Exam
Test Bank
A comprehensive test bank of 255 multiple-choice
questions with revised correct answers and detailed
rationales, aligned with the AORN Guidelines for
Perioperative Practice (2026/2027) and the complete
Periop 101 curriculum.
Competency Validation Series | Revised Edition
100% GU A RA NTE E PA SS | V E RIFIE D A NSWE RS | D E TA ILE D
RATIONA LE S
ED I TI ON | 25 5 QUESTI ONS
,AORN Periop 101 Final Exam Test Bank (2026/2027)
AORN Periop 101 Final Exam Test Bank
Edition | Expected 250+ Questions (255 Included) | Revised Correct Answers with Detailed
Rationales
Aligned with the AORN Guidelines for Perioperative Practice (2026/2027) and the Complete Periop 101
Curriculum | 100% Guarantee Pass Format | Verified Answers and Comprehensive Rationales
SECTION 1 - PERIOPERATIVE PATIENT ASSESSMENT AND PLANNING
Questions 1-20
Q1: A 58-year-old patient arrives at the preoperative holding area for an elective open cholecystectomy. During
the preoperative patient interview, the perioperative nurse's FIRST priority is to:
A. Verify the patient's identity using two identifiers and confirm the planned procedure and surgical site
[CORRECT]
B. Explain the circulating nurse's role during the intraoperative phase
C. Document the patient's lifetime occupational history in detail
D. Review the patient's insurance coverage and financial responsibility
Correct Answer: A
Rationale: Correct patient identification with at least two identifiers, verification of the planned procedure, and
confirmation of the correct surgical site are the foundational patient safety interventions and are required before any
other assessment activity. The AORN Guideline for Patient Information Management and The Joint Commission
Universal Protocol both mandate this verification. Insurance review is a business function, explaining staff roles can
occur after safety verification, and a detailed occupational history is not an immediate preoperative priority.
Q2: The perioperative nurse is reviewing the chart of a patient scheduled for total knee arthroplasty. Which
assessment finding is MOST important to report to the anesthesia provider and surgeon before the patient enters
the OR?
A. The patient has a documented allergy to penicillin with a history of mild rash
B. The patient wears reading glasses for near vision
C. The patient states a preference for a window in the operating room
D. The patient reports taking 325 mg aspirin daily, with the last dose taken this morning [CORRECT]
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that impairs hemostasis and significantly increases intraoperative and
postoperative bleeding risk, especially in orthopedic surgery with large bone surfaces. This finding must be
communicated before incision so the surgical team can decide whether to proceed. A remote mild rash to penicillin
requires documentation but does not delay surgery, and eyewear preference and reading glasses are routine, non-urgent
data. Medication reconciliation including anticoagulants and antiplatelets is a core element of preoperative assessment.
Perioperative Nursing Education - Competency Validation Series 1
,AORN Periop 101 Final Exam Test Bank (2026/2027)
Q3: Which statement by a patient scheduled for a laparoscopic appendectomy BEST indicates that informed
consent has been achieved from the patient's perspective?
A. I know the hospital requires the form before the anesthesia provider can put me to sleep
B. I signed the form at my doctor's office last week, so I am ready to go
C. My daughter read the form to me and she said the surgery is necessary
D. I understand the surgeon will remove my appendix through small incisions using a camera, and that a
larger incision may be needed if complications occur [CORRECT]
Correct Answer: D
Rationale: Informed consent requires that the patient demonstrates understanding of the nature of the procedure, its
risks and benefits, and reasonable alternatives, including possible conversion to an open procedure. The surgeon is
legally responsible for obtaining consent, but the perioperative nurse verifies the patient's understanding before
sedation. Signing without comprehension, delegating understanding to a family member, or viewing the form as an
administrative barrier all indicate that consent is not truly informed and must be escalated to the surgeon.
Q4: A patient scheduled for elective surgery at 0800 reports drinking a clear protein nutritional shake at 0530.
The patient's NPO status should be interpreted as:
A. Acceptable, because clear liquids are permitted up to 1 hour before surgery
B. Unacceptable, because the patient consumed a liquid with protein and fat that is not a clear liquid and
does not meet fasting guidelines [CORRECT]
C. Acceptable, because the intake was more than 2 hours before the scheduled incision time
D. Unacceptable, because any oral intake within 8 hours requires surgery cancellation without exception
Correct Answer: B
Rationale: Enhanced Recovery and ASA fasting guidance permits clear liquids up to approximately 2 hours before
anesthesia, but a protein nutritional shake contains protein and fat and is not a clear liquid; it follows the heavier-meal
fasting rule of 6 or more hours. The perioperative nurse must notify the anesthesia provider and surgeon for a
case-by-case decision rather than proceeding or canceling unilaterally. Blanket cancellation is not automatic, and 'clear
liquids up to 1 hour' does not reflect accepted practice.
Q5: During the preoperative chart review, which laboratory result requires the MOST urgent follow-up for a
patient scheduled for an elective colectomy this morning?
A. White blood cell count of 8,500/mm3
B. Hemoglobin of 13.5 g/dL
C. Platelet count of 250,000/mm3
D. Serum potassium of 2.8 mEq/L [CORRECT]
Correct Answer: D
Rationale: Hypokalemia of 2.8 mEq/L places the patient at serious risk for perioperative dysrhythmias, especially
during anesthesia and with the use of neuromuscular blockers, and must be reported before induction so surgery can be
delayed if indicated. The other values are within normal limits and require no urgent action. Preoperative assessment
includes systematic review of laboratory studies against the planned procedure and anesthesia type, with abnormal
results escalated to the surgeon and anesthesia provider.
Perioperative Nursing Education - Competency Validation Series 2
, AORN Periop 101 Final Exam Test Bank (2026/2027)
Q6: A perioperative nurse is completing the preoperative assessment for a patient with diabetes mellitus who
takes long-acting insulin. Which action reflects BEST practice for the morning of surgery?
A. Withhold all diabetes medications for 24 hours before surgery regardless of type
B. Give the patient a regular breakfast to prevent hypoglycemia, then administer insulin
C. Administer the full long-acting insulin dose as scheduled without discussion
D. Confirm the anesthesia-directed modification of the morning insulin dose and evaluate the blood glucose
result before transferring the patient [CORRECT]
Correct Answer: D
Rationale: Insulin requirements are typically modified on the morning of surgery, often reduced, and the plan is
individualized by the anesthesia provider or prescribing clinician; the perioperative nurse verifies the modification and
checks the point-of-care glucose before transfer. Giving the full dose risks intraoperative hypoglycemia, blanket
withholding risks hyperglycemia and ketoacidosis, and feeding a patient scheduled for anesthesia violates NPO
requirements. Hyperglycemia above 200 mg/dL increases surgical site infection risk, making glucose evaluation a
documented safety measure.
Q7: While performing the preoperative interview, the nurse notes that the patient is visibly anxious, asking
repeated questions about whether he will wake up during surgery. The nurse's MOST appropriate response is to:
A. Administer PRN antianxiety medication without further assessment
B. Tell the patient that anxiety is unreasonable because the surgeon is highly experienced
C. Provide honest information about anesthesia safety, remain with the patient, and notify the anesthesia
provider of the patient's expressed fears [CORRECT]
D. Reassure the patient that everything will be fine and change the subject to reduce distress
Correct Answer: C
Rationale: Preoperative anxiety is common and unmanaged anxiety increases physiologic stress and postoperative pain
perception. The nurse should acknowledge concerns, provide truthful, developmentally appropriate information, and
communicate the patient's fears to the anesthesia provider who will address them directly. Dismissing anxiety as
unreasonable is non-therapeutic, empty reassurance without information does not build trust, and medication
administration without assessment and an order process bypasses individualized care planning central to the AORN
assessment guideline.
Q8: The preoperative nurse discovers that the signed surgical consent for a patient scheduled for right total hip
arthroplasty lists the wrong laterality, stating left. The surgeon is in the OR and the patient is already sedated. The
nurse should:
A. Correct the word left to right on the form, initial the change, and proceed
B. Ask the surgeon to come to the preoperative area and complete an entirely new consent with the awake
patient before proceeding, if the patient can legally do so given sedation status [CORRECT]
C. Proceed because the surgeon verbally confirmed the correct hip and the form is a formality
D. Have the anesthesia provider sign as a witness to the verbal correction
Correct Answer: B
Rationale: A consent document that misidentifies the side of surgery is invalid, and altering a legal document after the
fact is falsification. The surgeon must obtain a new valid consent from a patient with decision-making capacity;
sedation may invalidate the patient's ability to legally consent, so the status must be assessed before proceeding. Verbal
confirmation does not substitute for the signed legal document, and witnessing an alteration does not make an invalid
consent valid. This scenario also triggers site-verification elements of the Universal Protocol.
Perioperative Nursing Education - Competency Validation Series 3
