AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
AORN Periop 101 Final Exam Review
Questions and Revised Correct Answers
Edition • 100% Guarantee Pass
Total Questions 185 Multiple Choice (A-D)
Cognitive Mix 30% Recall | 50% Application | 20% Analysis
Question Style 75% Scenario-based | 25% Direct AORN Standard Recall
Content Standard AORN Guidelines for Perioperative Practice (2026/2027)
Sections 10 Competency Domains
Answer Format Verified Correct Answer + Detailed Rationale
This comprehensive exam review has been developed to align with the AORN Guidelines for Perioperative Practice
(2026/2027 edition) and the AORN Periop 101 Final Examination competency framework. Each question is designed to
test both recall of perioperative standards and application of clinical judgment in authentic intraoperative scenarios.
Correct answers are verified against current AORN recommendations and include detailed rationales that explain not
only why the correct option is right but also why each distractor is wrong, providing high-yield review value for final
examination preparation. Distractors reflect the most commonly confused perioperative concepts and the most frequent
clinical errors identified in AORN competency assessments.
Section Overview: The exam is organized into 10 sections that mirror the Periop 101 curriculum domains: (1)
Perioperative Patient Assessment and Planning; (2) Surgical Asepsis and Sterile Technique; (3) Infection Prevention and
Control; (4) Surgical Instrumentation and Equipment; (5) Anesthesia and Medication Management; (6) Positioning,
Draping, and Patient Safety; (7) Intraoperative Nursing Roles; (8) Surgical Specialties and Procedures; (9) Emergency
Situations and Complications; and (10) Postoperative Care, Ethics, and Professional Practice. Work through each
section systematically, reviewing the rationale after each answer to consolidate the underlying AORN guideline citation
and clinical reasoning.
Page 1 | AORN Periop 101 Final Exam Review
,AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
SECTION 1: Perioperative Patient Assessment and Planning
Questions: Q1 - Q17 | Focus: Preoperative Assessment, Patient Interview, Chart Review, Informed Consent, & Care Planning
Q1: During the preoperative interview, a 67-year-old male scheduled for an elective inguinal hernia repair
reports he took 81 mg aspirin daily for the past 10 years and "stopped it yesterday" on his own. The
patient also has type 2 diabetes managed with metformin. Which action by the perioperative nurse best
reflects AORN recommendations for preoperative medication management?
A. Document the report only; aspirin does not need to be held for herniorrhaphy.
B. Notify the surgeon and anesthesia provider immediately, because aspirin should generally be held
7 days before surgery unless cardiac risk outweighs bleeding risk. [CORRECT]
C. Tell the patient to take a double dose the morning of surgery to "make up" for the missed day.
D. Hold the metformin but disregard the aspirin because it is over-the-counter.
Correct Answer: B
Rationale: AORN recommends a complete preoperative medication reconciliation with attention to medications that
increase bleeding risk. Aspirin and other antiplatelet agents should generally be held 7 days before elective surgery unless
the cardiac thrombotic risk outweighs bleeding risk (a decision made by the surgeon and anesthesia provider, not the nurse).
The perioperative nurse must communicate this finding immediately rather than independently deciding to disregard it.
Metformin is held the morning of surgery for procedures requiring NPO status, but the aspirin issue is the more urgent
finding here. Telling the patient to "double dose" is unsafe and could increase bleeding further.
Q2: A circulating nurse is reviewing the chart of a patient scheduled for a laparoscopic cholecystectomy.
Which finding requires clarification with the surgeon before proceeding to the operating room?
A. The patient signed the surgical consent 4 hours ago after the surgeon explained risks, benefits, and
alternatives.
B. The consent form indicates "laparoscopic cholecystectomy, possible conversion to open
procedure" but the patient verbalized understanding only of the laparoscopic approach.
[CORRECT]
C. The patient's Hgb is 13.2 g/dL and INR is 1.0.
D. The patient reports mild nausea from the preoperative antibiotic.
Correct Answer: B
Rationale: AORN and ACS guidelines require that informed consent reflect the patient's understanding of the planned
procedure AND reasonably foreseeable risks, including the possibility of conversion to an open procedure. The nurse
serves as patient advocate by ensuring the patient understands both possibilities. The other options describe acceptable
findings: consent signed within a reasonable time frame, normal lab values, and a common side effect of preoperative
antibiotics. The nurse's role is to verify and advocate, not to withhold or modify consent independently.
Page 2 | AORN Periop 101 Final Exam Review
,AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
Q3: A patient is scheduled for an elective procedure under general anesthesia at 7:30 a.m. The patient tells
the preop nurse, "I had a small cup of water around 5:00 a.m. because my mouth was dry." According to
AORN and ASA fasting guidelines, which action is most appropriate?
A. Proceed with surgery because clear liquids in small amounts are allowed up to 2 hours before anesthesia.
B. Cancel and reschedule the surgery because the patient violated NPO status.
C. Notify anesthesia and delay the case by at least 2 hours from the time of liquid ingestion.
[CORRECT]
D. Give the patient an antiemetic and proceed as scheduled.
Correct Answer: C
Rationale: ASA and AORN fasting guidelines allow clear liquids up to 2 hours before induction for healthy adults. The
patient consumed water at 5:00 a.m. with surgery scheduled at 7:30 a.m. - technically within the 2-hour window. However,
the perioperative nurse must verify the exact timing and notify the anesthesia provider, who may recommend a brief delay
to ensure the 2-hour minimum is met safely. Automatic cancellation is unnecessary for clear liquids within guidelines.
Giving an antiemetic does not address the timing concern. The anesthesia provider, not the nurse, makes the final decision
to proceed or delay.
Q4: Which of the following is the most reliable indicator that a patient has provided true informed consent
for surgery?
A. The patient has signed the consent form in the presence of a witness.
B. The patient can verbalize the procedure, its major risks, and the alternatives in their own words.
[CORRECT]
C. The consent form is on the chart with the surgeon's signature.
D. The patient's family member has signed as a witness.
Correct Answer: B
Rationale: True informed consent is a process, not merely a signed document. AORN recognizes that the patient must
demonstrate understanding of the procedure, risks, benefits, and alternatives in their own words. A signed form alone is
documentation of consent but does not confirm comprehension. The surgeon is responsible for the consent discussion; the
perioperative nurse verifies and witnesses but does not obtain consent. Family member signature is only appropriate for
patients without decision-making capacity.
Q5: A patient with a known allergy to latex is scheduled for elective surgery. Which nursing action best
reflects AORN recommendations for the latex-sensitive patient?
A. Place the patient first on the OR schedule if possible, use latex-free supplies throughout, and post
a latex-free sign on the door. [CORRECT]
B. Schedule the patient last on the OR schedule to allow time for cleaning, then use standard supplies.
C. Use latex gloves only for the surgical team and latex-free supplies for the patient.
D. Administer diphenhydramine prophylactically and proceed with standard latex precautions.
Correct Answer: A
Rationale: AORN recommends that latex-sensitive patients be scheduled as the first case of the day to minimize airborne
latex allergen exposure from prior cases. A latex-safe environment includes latex-free supplies, equipment, and
instrumentation, with signage to alert all team members. Scheduling last is incorrect because latex allergen levels increase
through the day. Prophylactic diphenhydramine does not prevent anaphylaxis and may mask early symptoms. The entire
perioperative environment must be latex-safe, not just patient-contact items.
Page 3 | AORN Periop 101 Final Exam Review
, AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
Q6: When performing a preoperative chart review, the circulating nurse identifies that the patient's most
recent Hgb is 9.8 g/dL (reference 12-16 g/dL). The surgeon has not addressed this finding. Which action
best reflects AORN's advocacy role?
A. Proceed with the case; mild anemia is common and not a perioperative concern.
B. Cancel the surgery immediately and inform the patient's family.
C. Communicate the finding to the surgeon and anesthesia provider before the patient enters the OR,
and document the communication. [CORRECT]
D. Administer iron intravenously in the preop area to correct the anemia.
Correct Answer: C
Rationale: AORN recognizes the perioperative nurse as patient advocate. The nurse must communicate significant
abnormal findings (Hgb < 10 g/dL is generally considered a perioperative concern, especially for procedures with
anticipated blood loss) to the surgeon and anesthesia provider before the patient enters the OR. Documentation of the
communication is essential. The nurse does not have independent authority to cancel surgery, and administering IV iron in
the preop area is outside the perioperative nurse's scope. Mild anemia is a clinical decision point, not an automatic
cancellation.
Q7: A patient tells the preoperative nurse, "I am Jehovah's Witness and I will not accept blood
transfusions under any circumstances, even if I die." The patient has signed the surgical consent and a
refusal-of-blood form. Which nursing action aligns with AORN's guidance on patient advocacy and
autonomy?
A. Override the refusal in the OR if life-threatening hemorrhage occurs because the surgeon has a duty to
save the patient's life.
B. Document the refusal, ensure the anesthesia provider and surgeon are aware, support the patient's
autonomous decision, and consider cell salvage and acute normovolemic hemodilution as acceptable
alternatives if the patient agrees. [CORRECT]
C. Cancel the elective surgery until the patient agrees to accept blood products.
D. Tell the patient that the surgical team will decide about transfusion during surgery based on the clinical
situation.
Correct Answer: B
Rationale: AORN supports the patient's right to autonomous decision-making, including the refusal of blood products
based on religious beliefs. The nurse's role is to ensure the team is aware, document the refusal, and support the use of
blood-conservation strategies such as cell salvage (if acceptable to the patient), acute normovolemic hemodilution, and
antifibrinolytic agents. Overriding the refusal would constitute battery. Canceling surgery violates autonomy. Telling the
patient that the team will decide contradicts the concept of informed refusal.
Page 4 | AORN Periop 101 Final Exam Review
AORN Periop 101 Final Exam Review
Questions and Revised Correct Answers
Edition • 100% Guarantee Pass
Total Questions 185 Multiple Choice (A-D)
Cognitive Mix 30% Recall | 50% Application | 20% Analysis
Question Style 75% Scenario-based | 25% Direct AORN Standard Recall
Content Standard AORN Guidelines for Perioperative Practice (2026/2027)
Sections 10 Competency Domains
Answer Format Verified Correct Answer + Detailed Rationale
This comprehensive exam review has been developed to align with the AORN Guidelines for Perioperative Practice
(2026/2027 edition) and the AORN Periop 101 Final Examination competency framework. Each question is designed to
test both recall of perioperative standards and application of clinical judgment in authentic intraoperative scenarios.
Correct answers are verified against current AORN recommendations and include detailed rationales that explain not
only why the correct option is right but also why each distractor is wrong, providing high-yield review value for final
examination preparation. Distractors reflect the most commonly confused perioperative concepts and the most frequent
clinical errors identified in AORN competency assessments.
Section Overview: The exam is organized into 10 sections that mirror the Periop 101 curriculum domains: (1)
Perioperative Patient Assessment and Planning; (2) Surgical Asepsis and Sterile Technique; (3) Infection Prevention and
Control; (4) Surgical Instrumentation and Equipment; (5) Anesthesia and Medication Management; (6) Positioning,
Draping, and Patient Safety; (7) Intraoperative Nursing Roles; (8) Surgical Specialties and Procedures; (9) Emergency
Situations and Complications; and (10) Postoperative Care, Ethics, and Professional Practice. Work through each
section systematically, reviewing the rationale after each answer to consolidate the underlying AORN guideline citation
and clinical reasoning.
Page 1 | AORN Periop 101 Final Exam Review
,AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
SECTION 1: Perioperative Patient Assessment and Planning
Questions: Q1 - Q17 | Focus: Preoperative Assessment, Patient Interview, Chart Review, Informed Consent, & Care Planning
Q1: During the preoperative interview, a 67-year-old male scheduled for an elective inguinal hernia repair
reports he took 81 mg aspirin daily for the past 10 years and "stopped it yesterday" on his own. The
patient also has type 2 diabetes managed with metformin. Which action by the perioperative nurse best
reflects AORN recommendations for preoperative medication management?
A. Document the report only; aspirin does not need to be held for herniorrhaphy.
B. Notify the surgeon and anesthesia provider immediately, because aspirin should generally be held
7 days before surgery unless cardiac risk outweighs bleeding risk. [CORRECT]
C. Tell the patient to take a double dose the morning of surgery to "make up" for the missed day.
D. Hold the metformin but disregard the aspirin because it is over-the-counter.
Correct Answer: B
Rationale: AORN recommends a complete preoperative medication reconciliation with attention to medications that
increase bleeding risk. Aspirin and other antiplatelet agents should generally be held 7 days before elective surgery unless
the cardiac thrombotic risk outweighs bleeding risk (a decision made by the surgeon and anesthesia provider, not the nurse).
The perioperative nurse must communicate this finding immediately rather than independently deciding to disregard it.
Metformin is held the morning of surgery for procedures requiring NPO status, but the aspirin issue is the more urgent
finding here. Telling the patient to "double dose" is unsafe and could increase bleeding further.
Q2: A circulating nurse is reviewing the chart of a patient scheduled for a laparoscopic cholecystectomy.
Which finding requires clarification with the surgeon before proceeding to the operating room?
A. The patient signed the surgical consent 4 hours ago after the surgeon explained risks, benefits, and
alternatives.
B. The consent form indicates "laparoscopic cholecystectomy, possible conversion to open
procedure" but the patient verbalized understanding only of the laparoscopic approach.
[CORRECT]
C. The patient's Hgb is 13.2 g/dL and INR is 1.0.
D. The patient reports mild nausea from the preoperative antibiotic.
Correct Answer: B
Rationale: AORN and ACS guidelines require that informed consent reflect the patient's understanding of the planned
procedure AND reasonably foreseeable risks, including the possibility of conversion to an open procedure. The nurse
serves as patient advocate by ensuring the patient understands both possibilities. The other options describe acceptable
findings: consent signed within a reasonable time frame, normal lab values, and a common side effect of preoperative
antibiotics. The nurse's role is to verify and advocate, not to withhold or modify consent independently.
Page 2 | AORN Periop 101 Final Exam Review
,AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
Q3: A patient is scheduled for an elective procedure under general anesthesia at 7:30 a.m. The patient tells
the preop nurse, "I had a small cup of water around 5:00 a.m. because my mouth was dry." According to
AORN and ASA fasting guidelines, which action is most appropriate?
A. Proceed with surgery because clear liquids in small amounts are allowed up to 2 hours before anesthesia.
B. Cancel and reschedule the surgery because the patient violated NPO status.
C. Notify anesthesia and delay the case by at least 2 hours from the time of liquid ingestion.
[CORRECT]
D. Give the patient an antiemetic and proceed as scheduled.
Correct Answer: C
Rationale: ASA and AORN fasting guidelines allow clear liquids up to 2 hours before induction for healthy adults. The
patient consumed water at 5:00 a.m. with surgery scheduled at 7:30 a.m. - technically within the 2-hour window. However,
the perioperative nurse must verify the exact timing and notify the anesthesia provider, who may recommend a brief delay
to ensure the 2-hour minimum is met safely. Automatic cancellation is unnecessary for clear liquids within guidelines.
Giving an antiemetic does not address the timing concern. The anesthesia provider, not the nurse, makes the final decision
to proceed or delay.
Q4: Which of the following is the most reliable indicator that a patient has provided true informed consent
for surgery?
A. The patient has signed the consent form in the presence of a witness.
B. The patient can verbalize the procedure, its major risks, and the alternatives in their own words.
[CORRECT]
C. The consent form is on the chart with the surgeon's signature.
D. The patient's family member has signed as a witness.
Correct Answer: B
Rationale: True informed consent is a process, not merely a signed document. AORN recognizes that the patient must
demonstrate understanding of the procedure, risks, benefits, and alternatives in their own words. A signed form alone is
documentation of consent but does not confirm comprehension. The surgeon is responsible for the consent discussion; the
perioperative nurse verifies and witnesses but does not obtain consent. Family member signature is only appropriate for
patients without decision-making capacity.
Q5: A patient with a known allergy to latex is scheduled for elective surgery. Which nursing action best
reflects AORN recommendations for the latex-sensitive patient?
A. Place the patient first on the OR schedule if possible, use latex-free supplies throughout, and post
a latex-free sign on the door. [CORRECT]
B. Schedule the patient last on the OR schedule to allow time for cleaning, then use standard supplies.
C. Use latex gloves only for the surgical team and latex-free supplies for the patient.
D. Administer diphenhydramine prophylactically and proceed with standard latex precautions.
Correct Answer: A
Rationale: AORN recommends that latex-sensitive patients be scheduled as the first case of the day to minimize airborne
latex allergen exposure from prior cases. A latex-safe environment includes latex-free supplies, equipment, and
instrumentation, with signage to alert all team members. Scheduling last is incorrect because latex allergen levels increase
through the day. Prophylactic diphenhydramine does not prevent anaphylaxis and may mask early symptoms. The entire
perioperative environment must be latex-safe, not just patient-contact items.
Page 3 | AORN Periop 101 Final Exam Review
, AORN Periop 101 Final Exam Review - 2026/2027 Edition 100% Guarantee Pass
Q6: When performing a preoperative chart review, the circulating nurse identifies that the patient's most
recent Hgb is 9.8 g/dL (reference 12-16 g/dL). The surgeon has not addressed this finding. Which action
best reflects AORN's advocacy role?
A. Proceed with the case; mild anemia is common and not a perioperative concern.
B. Cancel the surgery immediately and inform the patient's family.
C. Communicate the finding to the surgeon and anesthesia provider before the patient enters the OR,
and document the communication. [CORRECT]
D. Administer iron intravenously in the preop area to correct the anemia.
Correct Answer: C
Rationale: AORN recognizes the perioperative nurse as patient advocate. The nurse must communicate significant
abnormal findings (Hgb < 10 g/dL is generally considered a perioperative concern, especially for procedures with
anticipated blood loss) to the surgeon and anesthesia provider before the patient enters the OR. Documentation of the
communication is essential. The nurse does not have independent authority to cancel surgery, and administering IV iron in
the preop area is outside the perioperative nurse's scope. Mild anemia is a clinical decision point, not an automatic
cancellation.
Q7: A patient tells the preoperative nurse, "I am Jehovah's Witness and I will not accept blood
transfusions under any circumstances, even if I die." The patient has signed the surgical consent and a
refusal-of-blood form. Which nursing action aligns with AORN's guidance on patient advocacy and
autonomy?
A. Override the refusal in the OR if life-threatening hemorrhage occurs because the surgeon has a duty to
save the patient's life.
B. Document the refusal, ensure the anesthesia provider and surgeon are aware, support the patient's
autonomous decision, and consider cell salvage and acute normovolemic hemodilution as acceptable
alternatives if the patient agrees. [CORRECT]
C. Cancel the elective surgery until the patient agrees to accept blood products.
D. Tell the patient that the surgical team will decide about transfusion during surgery based on the clinical
situation.
Correct Answer: B
Rationale: AORN supports the patient's right to autonomous decision-making, including the refusal of blood products
based on religious beliefs. The nurse's role is to ensure the team is aware, document the refusal, and support the use of
blood-conservation strategies such as cell salvage (if acceptable to the patient), acute normovolemic hemodilution, and
antifibrinolytic agents. Overriding the refusal would constitute battery. Canceling surgery violates autonomy. Telling the
patient that the team will decide contradicts the concept of informed refusal.
Page 4 | AORN Periop 101 Final Exam Review
