SURG110 Aseptic Technique Exam Prep – Real Practice Questions,
Answers & Detailed Rationales (Updated 2026) | Sterile Field
Setup & Maintenance, Surgical Hand Scrubbing Procedures, Infection
Control & Prevention, Sterilization & Disinfection Methods, Surgical
Instrument Handling, Personal Protective Equipment (PPE), Operating
Room Safety, Cross-Contamination Prevention & Surgical Environment
Protocols
Question 1: Which of the following is the PRIMARY purpose of performing a surgical
hand scrub before donning sterile gown and gloves?
A. To remove all transient microorganisms and reduce resident flora to a minimum
B. To completely sterilize the hands and forearms
C. To moisturize the skin and prevent irritation during long procedures
D. To satisfy regulatory documentation requirements
CORRECT ANSWER: A. To remove all transient microorganisms and reduce resident
flora to a minimum
Rationale: The surgical hand scrub is designed to eliminate transient microorganisms
acquired through contact and significantly reduce the population of resident flora on
the hands and forearms. Complete sterilization of skin is not achievable due to
microorganisms residing in hair follicles and sebaceous glands. The goal is microbial
reduction to minimize the risk of surgical site contamination if glove perforation occurs.
Question 2: When establishing a sterile field on a Mayo stand, which action
constitutes a break in sterile technique?
A. Opening sterile wrapper away from the body first
B. Allowing sterile items to be placed within the 1-inch border of the drape
C. Reaching over the sterile field to retrieve an instrument
D. Using sterile transfer forceps to add items to the field
CORRECT ANSWER: C. Reaching over the sterile field to retrieve an instrument
Rationale: Reaching over a sterile field risks contamination through shedding of
microorganisms from non-sterile attire or accidental contact. Sterile fields must be
maintained within the line of sight and at or above waist level. Items placed within the 1-
inch border are considered non-sterile, but placing items there is not the same as
reaching over the field, which directly compromises sterility of the central working area.
Question 3: Which sterilization method is MOST appropriate for heat-sensitive,
moisture-sensitive instruments such as fiber-optic endoscopes?
A. Steam autoclaving at 121°C for 15 minutes
B. Ethylene oxide gas sterilization
C. Flash sterilization at 132°C
D. Boiling in distilled water for 30 minutes
,CORRECT ANSWER: B. Ethylene oxide gas sterilization
Rationale: Ethylene oxide (EtO) gas sterilization is effective for heat- and moisture-
sensitive items because it operates at low temperatures (37-63°C) and penetrates
complex lumens. Steam autoclaving and flash sterilization use high heat and moisture
that can damage delicate optics. Boiling is a disinfection method, not sterilization, and
does not eliminate all microbial life including spores.
Question 4: During gowning using the closed-gloving technique, when should the
hands first contact the exterior of the sterile gloves?
A. Before the gown cuffs are pulled over the hands
B. After the gown cuffs are fully pulled over the hands and the hands remain inside the
cuffs
C. Immediately upon opening the glove packet
D. Only after a circulating nurse assists with glove application
CORRECT ANSWER: B. After the gown cuffs are fully pulled over the hands and the
hands remain inside the cuffs
Rationale: In closed-gloving, the hands never exit the gown cuffs until fully gloved. The
gown cuffs are considered non-sterile on the interior; by keeping hands within the cuffs
while manipulating the gloves, only sterile glove surfaces contact sterile gown surfaces.
This technique maintains sterility without requiring assistance and is standard for self-
gowning.
Question 5: Which of the following solutions is MOST appropriate for preoperative
skin preparation of a patient with a known iodine allergy?
A. Povidone-iodine 10% solution
B. Chlorhexidine gluconate 2% in 70% isopropyl alcohol
C. Tincture of iodine 2%
D. Iodophor scrub with 7.5% povidone-iodine
CORRECT ANSWER: B. Chlorhexidine gluconate 2% in 70% isopropyl alcohol
Rationale: Chlorhexidine-alcohol combinations provide broad-spectrum antimicrobial
activity without iodine, making them safe for patients with iodine hypersensitivity.
Povidone-iodine, tincture of iodine, and iodophors all contain iodine and pose risk of
allergic reaction. Chlorhexidine-alcohol is also preferred by many guidelines for its rapid
action and persistent effect.
Question 6: What is the MINIMUM recommended distance a non-sterile person
should maintain from a sterile field to prevent airborne contamination?
A. 6 inches
B. 12 inches
C. 18 inches
D. 3 feet
,CORRECT ANSWER: D. 3 feet
Rationale: AORN guidelines recommend maintaining at least 3 feet (approximately 1
meter) between non-sterile personnel and sterile fields to minimize contamination from
airborne particles shed from clothing, skin, or respiratory droplets. Closer proximity
increases risk of microbial settlement on sterile surfaces, especially during movement
or talking.
Question 7: Which statement BEST describes the concept of "sterile conscience" in
the operating room?
A. The legal obligation to report all breaks in technique to hospital administration
B. The personal responsibility of each team member to recognize and correct breaches
in aseptic technique immediately
C. The requirement to document every sterile item used during a procedure
D. The psychological stress experienced by new surgical technologists
CORRECT ANSWER: B. The personal responsibility of each team member to
recognize and correct breaches in aseptic technique immediately
Rationale: "Sterile conscience" refers to the ethical and professional commitment of
every OR team member to vigilantly monitor for and address any compromise in
sterility, regardless of role or seniority. This principle empowers all personnel to speak
up and intervene, fostering a culture of safety and reducing surgical site infection risk.
Question 8: When opening a sterile pack wrapped in a peel pouch, which action is
CORRECT?
A. Tear the pouch open quickly to minimize exposure time
B. Allow the contents to fall freely onto the sterile field without touching the pouch
interior
C. Hold the pouch above waist level and gently slide the item onto the sterile field
without allowing the item to contact the pouch exterior
D. Use bare hands to remove the item after wiping the pouch exterior with alcohol
CORRECT ANSWER: C. Hold the pouch above waist level and gently slide the item
onto the sterile field without allowing the item to contact the pouch exterior
Rationale: Peel pouches have a sterile interior and non-sterile exterior. The item must
be transferred aseptically by allowing it to slide out without touching the outside of the
pouch, which is considered contaminated. The pouch should be held at or above waist
level to maintain sterility, and the item should not contact non-sterile surfaces during
transfer.
Question 9: Which of the following is a CRITICAL indicator that a steam sterilization
cycle has failed?
A. The external chemical indicator changes color
B. The biological indicator shows growth after incubation
, C. The load feels dry at the end of the cycle
D. The pressure gauge reached 15 psi
CORRECT ANSWER: B. The biological indicator shows growth after incubation
Rationale: Biological indicators containing Geobacillus stearothermophilus spores
provide the highest level of assurance for steam sterilization efficacy. Growth after
incubation indicates sterilization failure, regardless of mechanical parameters or
chemical indicator results. External chemical indicators only confirm exposure to
steam, not sterility; dryness and pressure are process parameters but not definitive
proof of microbial kill.
Question 10: During draping of a surgical site, which principle ensures maximum
protection of the sterile field?
A. Drapes should be adjusted frequently to maintain patient comfort
B. The drape opening should be placed first over the incision site, then expanded
outward
C. Non-sterile team members may hold drapes in place if wearing clean gloves
D. Drapes may be reused between cases if visibly soiled areas are covered
CORRECT ANSWER: B. The drape opening should be placed first over the incision
site, then expanded outward
Rationale: Drapes should be positioned by first placing the aperture over the prepared
incision site, then unfolding outward toward the periphery. This technique minimizes
the risk of dragging non-sterile drape surfaces over the sterile surgical site. Drapes are
single-use only; adjustment after placement should be minimal and only by sterile
personnel; non-sterile personnel must never contact sterile drapes.
Question 11: Which microorganism is MOST commonly associated with surgical
site infections following clean procedures involving implants?
A. Escherichia coli
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Clostridium perfringens
CORRECT ANSWER: B. Staphylococcus aureus
Rationale: Staphylococcus aureus, particularly methicillin-resistant strains (MRSA), is
the leading pathogen in surgical site infections after clean procedures with implants
due to its ability to form biofilms on foreign material and its prevalence on human skin.
E. coli and Pseudomonas are more common in contaminated or dirty cases; C.
perfringens is associated with traumatic wounds and gas gangrene.
Question 12: What is the PRIMARY reason for limiting traffic and movement in the
operating room during a procedure?
Answers & Detailed Rationales (Updated 2026) | Sterile Field
Setup & Maintenance, Surgical Hand Scrubbing Procedures, Infection
Control & Prevention, Sterilization & Disinfection Methods, Surgical
Instrument Handling, Personal Protective Equipment (PPE), Operating
Room Safety, Cross-Contamination Prevention & Surgical Environment
Protocols
Question 1: Which of the following is the PRIMARY purpose of performing a surgical
hand scrub before donning sterile gown and gloves?
A. To remove all transient microorganisms and reduce resident flora to a minimum
B. To completely sterilize the hands and forearms
C. To moisturize the skin and prevent irritation during long procedures
D. To satisfy regulatory documentation requirements
CORRECT ANSWER: A. To remove all transient microorganisms and reduce resident
flora to a minimum
Rationale: The surgical hand scrub is designed to eliminate transient microorganisms
acquired through contact and significantly reduce the population of resident flora on
the hands and forearms. Complete sterilization of skin is not achievable due to
microorganisms residing in hair follicles and sebaceous glands. The goal is microbial
reduction to minimize the risk of surgical site contamination if glove perforation occurs.
Question 2: When establishing a sterile field on a Mayo stand, which action
constitutes a break in sterile technique?
A. Opening sterile wrapper away from the body first
B. Allowing sterile items to be placed within the 1-inch border of the drape
C. Reaching over the sterile field to retrieve an instrument
D. Using sterile transfer forceps to add items to the field
CORRECT ANSWER: C. Reaching over the sterile field to retrieve an instrument
Rationale: Reaching over a sterile field risks contamination through shedding of
microorganisms from non-sterile attire or accidental contact. Sterile fields must be
maintained within the line of sight and at or above waist level. Items placed within the 1-
inch border are considered non-sterile, but placing items there is not the same as
reaching over the field, which directly compromises sterility of the central working area.
Question 3: Which sterilization method is MOST appropriate for heat-sensitive,
moisture-sensitive instruments such as fiber-optic endoscopes?
A. Steam autoclaving at 121°C for 15 minutes
B. Ethylene oxide gas sterilization
C. Flash sterilization at 132°C
D. Boiling in distilled water for 30 minutes
,CORRECT ANSWER: B. Ethylene oxide gas sterilization
Rationale: Ethylene oxide (EtO) gas sterilization is effective for heat- and moisture-
sensitive items because it operates at low temperatures (37-63°C) and penetrates
complex lumens. Steam autoclaving and flash sterilization use high heat and moisture
that can damage delicate optics. Boiling is a disinfection method, not sterilization, and
does not eliminate all microbial life including spores.
Question 4: During gowning using the closed-gloving technique, when should the
hands first contact the exterior of the sterile gloves?
A. Before the gown cuffs are pulled over the hands
B. After the gown cuffs are fully pulled over the hands and the hands remain inside the
cuffs
C. Immediately upon opening the glove packet
D. Only after a circulating nurse assists with glove application
CORRECT ANSWER: B. After the gown cuffs are fully pulled over the hands and the
hands remain inside the cuffs
Rationale: In closed-gloving, the hands never exit the gown cuffs until fully gloved. The
gown cuffs are considered non-sterile on the interior; by keeping hands within the cuffs
while manipulating the gloves, only sterile glove surfaces contact sterile gown surfaces.
This technique maintains sterility without requiring assistance and is standard for self-
gowning.
Question 5: Which of the following solutions is MOST appropriate for preoperative
skin preparation of a patient with a known iodine allergy?
A. Povidone-iodine 10% solution
B. Chlorhexidine gluconate 2% in 70% isopropyl alcohol
C. Tincture of iodine 2%
D. Iodophor scrub with 7.5% povidone-iodine
CORRECT ANSWER: B. Chlorhexidine gluconate 2% in 70% isopropyl alcohol
Rationale: Chlorhexidine-alcohol combinations provide broad-spectrum antimicrobial
activity without iodine, making them safe for patients with iodine hypersensitivity.
Povidone-iodine, tincture of iodine, and iodophors all contain iodine and pose risk of
allergic reaction. Chlorhexidine-alcohol is also preferred by many guidelines for its rapid
action and persistent effect.
Question 6: What is the MINIMUM recommended distance a non-sterile person
should maintain from a sterile field to prevent airborne contamination?
A. 6 inches
B. 12 inches
C. 18 inches
D. 3 feet
,CORRECT ANSWER: D. 3 feet
Rationale: AORN guidelines recommend maintaining at least 3 feet (approximately 1
meter) between non-sterile personnel and sterile fields to minimize contamination from
airborne particles shed from clothing, skin, or respiratory droplets. Closer proximity
increases risk of microbial settlement on sterile surfaces, especially during movement
or talking.
Question 7: Which statement BEST describes the concept of "sterile conscience" in
the operating room?
A. The legal obligation to report all breaks in technique to hospital administration
B. The personal responsibility of each team member to recognize and correct breaches
in aseptic technique immediately
C. The requirement to document every sterile item used during a procedure
D. The psychological stress experienced by new surgical technologists
CORRECT ANSWER: B. The personal responsibility of each team member to
recognize and correct breaches in aseptic technique immediately
Rationale: "Sterile conscience" refers to the ethical and professional commitment of
every OR team member to vigilantly monitor for and address any compromise in
sterility, regardless of role or seniority. This principle empowers all personnel to speak
up and intervene, fostering a culture of safety and reducing surgical site infection risk.
Question 8: When opening a sterile pack wrapped in a peel pouch, which action is
CORRECT?
A. Tear the pouch open quickly to minimize exposure time
B. Allow the contents to fall freely onto the sterile field without touching the pouch
interior
C. Hold the pouch above waist level and gently slide the item onto the sterile field
without allowing the item to contact the pouch exterior
D. Use bare hands to remove the item after wiping the pouch exterior with alcohol
CORRECT ANSWER: C. Hold the pouch above waist level and gently slide the item
onto the sterile field without allowing the item to contact the pouch exterior
Rationale: Peel pouches have a sterile interior and non-sterile exterior. The item must
be transferred aseptically by allowing it to slide out without touching the outside of the
pouch, which is considered contaminated. The pouch should be held at or above waist
level to maintain sterility, and the item should not contact non-sterile surfaces during
transfer.
Question 9: Which of the following is a CRITICAL indicator that a steam sterilization
cycle has failed?
A. The external chemical indicator changes color
B. The biological indicator shows growth after incubation
, C. The load feels dry at the end of the cycle
D. The pressure gauge reached 15 psi
CORRECT ANSWER: B. The biological indicator shows growth after incubation
Rationale: Biological indicators containing Geobacillus stearothermophilus spores
provide the highest level of assurance for steam sterilization efficacy. Growth after
incubation indicates sterilization failure, regardless of mechanical parameters or
chemical indicator results. External chemical indicators only confirm exposure to
steam, not sterility; dryness and pressure are process parameters but not definitive
proof of microbial kill.
Question 10: During draping of a surgical site, which principle ensures maximum
protection of the sterile field?
A. Drapes should be adjusted frequently to maintain patient comfort
B. The drape opening should be placed first over the incision site, then expanded
outward
C. Non-sterile team members may hold drapes in place if wearing clean gloves
D. Drapes may be reused between cases if visibly soiled areas are covered
CORRECT ANSWER: B. The drape opening should be placed first over the incision
site, then expanded outward
Rationale: Drapes should be positioned by first placing the aperture over the prepared
incision site, then unfolding outward toward the periphery. This technique minimizes
the risk of dragging non-sterile drape surfaces over the sterile surgical site. Drapes are
single-use only; adjustment after placement should be minimal and only by sterile
personnel; non-sterile personnel must never contact sterile drapes.
Question 11: Which microorganism is MOST commonly associated with surgical
site infections following clean procedures involving implants?
A. Escherichia coli
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Clostridium perfringens
CORRECT ANSWER: B. Staphylococcus aureus
Rationale: Staphylococcus aureus, particularly methicillin-resistant strains (MRSA), is
the leading pathogen in surgical site infections after clean procedures with implants
due to its ability to form biofilms on foreign material and its prevalence on human skin.
E. coli and Pseudomonas are more common in contaminated or dirty cases; C.
perfringens is associated with traumatic wounds and gas gangrene.
Question 12: What is the PRIMARY reason for limiting traffic and movement in the
operating room during a procedure?
