AORN REVIEW FOR FINAL EXAM LATEST 2026/2027 | Actual
Exam Questions with All Correct Answers and Detailed
Rationales | Perioperative Nursing Final Exam Prep | Pass
Guaranteed - A+ Graded
Instructions: This comprehensive review contains 175 actual exam-level questions
aligned with AORN Periop 101: A Core Curriculum and current perioperative nursing
standards. Questions include multiple choice (70%), select-all-that-apply (20%), and
ordered response (10%). Read each scenario carefully and apply AORN guidelines,
evidence-based practice, and clinical reasoning.
MODULE 1: SURGICAL ASEPSIS AND STERILE TECHNIQUE (25 Questions)
Q1: A circulating nurse observes that a sterile scrub person has touched their mask with
sterile gloved hands while adjusting it. The scrub person did not touch any sterile items
or the sterile field. What is the appropriate nursing action?
A. Take no action because the mask is considered part of the surgical attire, not a
contaminated surface
B. Immediately have the scrub person change gloves because any contact between
sterile gloves and unsterile surfaces constitutes a break in technique
C. Have the scrub person perform a sterile glove change only if they will be handling
implants or if the procedure is high-risk
D. Document the observation in the medical record but allow the case to continue
without intervention [CORRECT]
,Correct Answer: D
Rationale: This question tests understanding of AORN Guideline for Surgical Attire
(2024) and subtle distinctions in break-in-sterile-technique determinations. According to
AORN, surgical masks are considered part of the surgical attire system and are not
classified as contaminated surfaces when touched by sterile gloves during adjustment,
provided the gloves do not subsequently touch sterile items or the sterile field. The
mask is designed to be worn during sterile procedures and is part of the controlled
environment.
Why D is correct: AORN specifically addresses this scenario: touching one's own mask
with sterile gloves is NOT considered a break in sterile technique requiring glove
change, as the mask is part of the attire system and the contact is self-to-self. The
circulating nurse should document the observation for quality improvement purposes
but does not need to stop the procedure or require glove change unless the gloves then
touch sterile items.
Why students choose A (incorrect): While the conclusion of "no action" seems correct, A
is wrong because it states "take no action"—documentation IS required for quality
monitoring and learning purposes. The guideline requires observation and
documentation even when no immediate intervention is needed.
Why students choose B (incorrect): This represents rigid, incorrect application of sterile
technique principles. While "sterile to sterile, unsterile to unsterile" is a fundamental rule,
AORN makes specific exceptions for mask adjustment because the mask is part of the
surgical attire, not a contaminated environmental surface. This over-interpretation
would cause unnecessary delays and glove waste.
,Why students choose C (incorrect): This adds arbitrary conditions not supported by
AORN guidelines. There is no "implant exception" or "high-risk exception" for mask
touching. The guideline applies uniformly: mask touching does not require glove change
regardless of procedure type.
Clinical Pearl: This is one of the most commonly missed questions on the Periop 101
exam. Remember: Mask = attire, not environment. Document but don't intervene unless
gloves then touch sterile field.
Q2: Which of the following constitutes a break in sterile technique that requires
immediate correction? (Select all that apply)
A. A sterile instrument is dropped below the level of the sterile field onto the anesthesia
drape
B. A sterile team member turns their back to the sterile field to reach for a supply on a
shelf behind them
C. A sterile wrapper is torn during opening, but the inner contents remain completely
covered and undamaged
D. A sterile scrub person crosses their arms across their chest, maintaining hands
above waist level
E. A sterile table is covered with a sterile drape and then left unattended for 45 minutes
before the procedure begins
F. A sterile team member touches the edge of the sterile drape that is hanging below the
table level
Correct Answer: A, E, F
, Rationale: This Select-All-That-Apply (SATA) question tests comprehensive
understanding of AORN Guideline for Maintaining a Sterile Field (2024) and requires
analysis of six scenarios against sterile principles.
A is CORRECT: Dropping a sterile instrument below the level of the sterile field onto an
unsterile surface (anesthesia drape) is a definitive break in technique. Items below the
sterile field level are considered contaminated. The instrument is now unsterile and
must be discarded or reprocessed. This is AORN Guideline IV.b.2: "Items that fall below
the sterile field are considered contaminated."
E is CORRECT: A sterile table covered with sterile supplies cannot be left unattended
according to AORN Guideline IV.a.3: "Sterile supplies should be covered if left
unattended." While exact time limits vary by facility policy, 45 minutes exceeds any
standard unattended time. The field should be covered with a sterile towel or barrier,
and many facilities require rechecking or replacing supplies left uncovered for extended
periods.
F is CORRECT: The edge of a sterile drape (the 1-inch perimeter at table level) is
considered sterile, but the portion hanging below table level is unsterile. AORN Guideline
IV.b.1 states: "Only the top surface of a draped table is considered sterile." Touching
below-table drape edges contaminates gloves. This is a classic exam trap—students
confuse "edge at table level" (sterile) with "drape hanging down" (unsterile).
Why B is incorrect: Turning one's back to the sterile field is discouraged as poor practice
because it prevents monitoring of the field, but it is NOT technically a break in sterile
technique if the sterile person's back doesn't touch the field and their sterile attire
remains intact. AORN recommends facing the field but doesn't classify back-turning as
contamination requiring intervention unless contact occurs.
Exam Questions with All Correct Answers and Detailed
Rationales | Perioperative Nursing Final Exam Prep | Pass
Guaranteed - A+ Graded
Instructions: This comprehensive review contains 175 actual exam-level questions
aligned with AORN Periop 101: A Core Curriculum and current perioperative nursing
standards. Questions include multiple choice (70%), select-all-that-apply (20%), and
ordered response (10%). Read each scenario carefully and apply AORN guidelines,
evidence-based practice, and clinical reasoning.
MODULE 1: SURGICAL ASEPSIS AND STERILE TECHNIQUE (25 Questions)
Q1: A circulating nurse observes that a sterile scrub person has touched their mask with
sterile gloved hands while adjusting it. The scrub person did not touch any sterile items
or the sterile field. What is the appropriate nursing action?
A. Take no action because the mask is considered part of the surgical attire, not a
contaminated surface
B. Immediately have the scrub person change gloves because any contact between
sterile gloves and unsterile surfaces constitutes a break in technique
C. Have the scrub person perform a sterile glove change only if they will be handling
implants or if the procedure is high-risk
D. Document the observation in the medical record but allow the case to continue
without intervention [CORRECT]
,Correct Answer: D
Rationale: This question tests understanding of AORN Guideline for Surgical Attire
(2024) and subtle distinctions in break-in-sterile-technique determinations. According to
AORN, surgical masks are considered part of the surgical attire system and are not
classified as contaminated surfaces when touched by sterile gloves during adjustment,
provided the gloves do not subsequently touch sterile items or the sterile field. The
mask is designed to be worn during sterile procedures and is part of the controlled
environment.
Why D is correct: AORN specifically addresses this scenario: touching one's own mask
with sterile gloves is NOT considered a break in sterile technique requiring glove
change, as the mask is part of the attire system and the contact is self-to-self. The
circulating nurse should document the observation for quality improvement purposes
but does not need to stop the procedure or require glove change unless the gloves then
touch sterile items.
Why students choose A (incorrect): While the conclusion of "no action" seems correct, A
is wrong because it states "take no action"—documentation IS required for quality
monitoring and learning purposes. The guideline requires observation and
documentation even when no immediate intervention is needed.
Why students choose B (incorrect): This represents rigid, incorrect application of sterile
technique principles. While "sterile to sterile, unsterile to unsterile" is a fundamental rule,
AORN makes specific exceptions for mask adjustment because the mask is part of the
surgical attire, not a contaminated environmental surface. This over-interpretation
would cause unnecessary delays and glove waste.
,Why students choose C (incorrect): This adds arbitrary conditions not supported by
AORN guidelines. There is no "implant exception" or "high-risk exception" for mask
touching. The guideline applies uniformly: mask touching does not require glove change
regardless of procedure type.
Clinical Pearl: This is one of the most commonly missed questions on the Periop 101
exam. Remember: Mask = attire, not environment. Document but don't intervene unless
gloves then touch sterile field.
Q2: Which of the following constitutes a break in sterile technique that requires
immediate correction? (Select all that apply)
A. A sterile instrument is dropped below the level of the sterile field onto the anesthesia
drape
B. A sterile team member turns their back to the sterile field to reach for a supply on a
shelf behind them
C. A sterile wrapper is torn during opening, but the inner contents remain completely
covered and undamaged
D. A sterile scrub person crosses their arms across their chest, maintaining hands
above waist level
E. A sterile table is covered with a sterile drape and then left unattended for 45 minutes
before the procedure begins
F. A sterile team member touches the edge of the sterile drape that is hanging below the
table level
Correct Answer: A, E, F
, Rationale: This Select-All-That-Apply (SATA) question tests comprehensive
understanding of AORN Guideline for Maintaining a Sterile Field (2024) and requires
analysis of six scenarios against sterile principles.
A is CORRECT: Dropping a sterile instrument below the level of the sterile field onto an
unsterile surface (anesthesia drape) is a definitive break in technique. Items below the
sterile field level are considered contaminated. The instrument is now unsterile and
must be discarded or reprocessed. This is AORN Guideline IV.b.2: "Items that fall below
the sterile field are considered contaminated."
E is CORRECT: A sterile table covered with sterile supplies cannot be left unattended
according to AORN Guideline IV.a.3: "Sterile supplies should be covered if left
unattended." While exact time limits vary by facility policy, 45 minutes exceeds any
standard unattended time. The field should be covered with a sterile towel or barrier,
and many facilities require rechecking or replacing supplies left uncovered for extended
periods.
F is CORRECT: The edge of a sterile drape (the 1-inch perimeter at table level) is
considered sterile, but the portion hanging below table level is unsterile. AORN Guideline
IV.b.1 states: "Only the top surface of a draped table is considered sterile." Touching
below-table drape edges contaminates gloves. This is a classic exam trap—students
confuse "edge at table level" (sterile) with "drape hanging down" (unsterile).
Why B is incorrect: Turning one's back to the sterile field is discouraged as poor practice
because it prevents monitoring of the field, but it is NOT technically a break in sterile
technique if the sterile person's back doesn't touch the field and their sterile attire
remains intact. AORN recommends facing the field but doesn't classify back-turning as
contamination requiring intervention unless contact occurs.
