Fall Semester 2026–2027 SURG240 – Operating
Room Safety Updated 2026 | 190+ Questions and
Answers | SURG240 Operating Room Safety
Comprehensive Study Guide, Practice Exam, Exam
Prep Test Bank, Perioperative Nursing, Sterile
Technique, Surgical Asepsis, Infection Prevention &
Control, Surgical Instrumentation, Patient
Positioning, Anesthesia Safety, Fire Safety,
Specimen Handling, Clinical Judgment, Detailed
Rationales and Complete Revision Material
Question 1: What is the single most critical component of the time-out
procedure prior to surgical incision?
A. Verification of the patient's insurance information
B. Confirmation of the correct surgical site, procedure, and patient identity
C. Review of the anesthesia machine's calibration
D. Ensuring the surgical lights are properly focused
CORRECT ANSWER: B. Confirmation of the correct surgical site, procedure,
and patient identity
Rationale: The time-out is a critical safety check performed immediately before incision.
Its primary purpose is the final verification of the correct patient, correct site, and
correct procedure to prevent wrong-site, wrong-patient, and wrong-procedure surgery.
The other options are important but are not the central focus of the time-out.
Question 2: Which principle of aseptic technique is violated when a sterile
team member reaches over an unsterile field?
A. Sterile persons avoid leaning on unsterile areas.
B. Sterile persons avoid contact with unsterile persons or objects.
C. Sterile persons avoid unsterile areas when passing.
D. Sterile persons should only face the sterile field.
CORRECT ANSWER: B. Sterile persons avoid contact with unsterile persons or
objects.
Rationale: The core principle is that a sterile object or person must not touch an
unsterile object or person. Reaching over an unsterile field (e.g., a back table)
compromises the sterility of the team member's gown or gloves, as unsterile air currents
or accidental contact can occur. The other options are related but less directly about the
act of reaching over a field.
Question 3: In the context of the surgical environment, what does the term
"flash sterilization" refer to?
,A. Sterilization of implants using a rapid UV light process.
B. Steam sterilization of an unwrapped item for immediate use.
C. A chemical sterilization process for heat-sensitive instruments.
D. The process of sterilizing the operating room air between cases.
CORRECT ANSWER: B. Steam sterilization of an unwrapped item for
immediate use.
Rationale: Flash sterilization, now more commonly known as "immediate-use steam
sterilization," is a process for sterilizing an unwrapped item in a steam sterilizer for a
short cycle, typically for immediate use when an item is dropped or a special instrument
is needed urgently. It is not the standard for implants.
Question 4: Which type of surgical fire is most common in the operating room?
A. Electrical fires from faulty equipment
B. Airway fires
C. Fire on the patient's skin from prepping agents
D. Fire in the sterile field drapes
CORRECT ANSWER: B. Airway fires
Rationale: Airway fires, which occur on or around the patient's airway, are the most
commonly reported type of surgical fire. They involve the oxidizer (oxygen or nitrous
oxide), fuel (ETT or other airway device), and an ignition source (electrocautery or
laser).
Question 5: A patient is to receive a blood transfusion. What is the mandatory
safety check that must be performed at the patient's bedside by two qualified
professionals?
A. Verify the patient's age and weight.
B. Confirm the patient's allergy status.
C. Verify the patient's identity and blood product against the order and compatibility tag.
D. Check the expiration date on the blood bag only.
CORRECT ANSWER: C. Verify the patient's identity and blood product against
the order and compatibility tag.
Rationale: Before any blood product is transfused, a two-person verification process is
mandatory. This requires two professionals to check the patient's identity (using two
identifiers) and compare it against the blood product's compatibility tag and the
physician's order to prevent hemolytic transfusion reactions. Other checks are part of
the process but this is the core safety check.
Question 6: What is the primary purpose of using a surgical safety checklist,
such as the one developed by the WHO?
A. To document the surgical team's credentials.
B. To improve team communication and reduce preventable complications.
,C. To ensure the operating room is clean.
D. To create a legal record of the procedure.
CORRECT ANSWER: B. To improve team communication and reduce
preventable complications.
Rationale: The WHO Surgical Safety Checklist is designed to be a tool to improve
communication and teamwork among the surgical team. Its use has been proven to
reduce surgical morbidity and mortality by ensuring key safety steps are taken during
the three critical phases: sign-in, time-out, and sign-out.
Question 7: According to the Association of periOperative Registered Nurses
(AORN), what is the recommended method for transporting a patient to the
operating room?
A. Alone, to minimize distractions.
B. On a bed, with side rails up and a safety belt applied.
C. On a stretcher, with side rails up and a safety belt applied.
D. In a wheelchair, to allow for easier transfer.
CORRECT ANSWER: C. On a stretcher, with side rails up and a safety belt
applied.
Rationale: AORN guidelines recommend transporting anesthetized or preoperative
patients on a stretcher with side rails raised and a safety belt fastened across the
patient's hips for safety and fall prevention. This provides a secure and safe mode of
transport.
Question 8: Which of the following is a key element of a fire safety risk
assessment in the OR for a procedure on the head or neck?
A. Checking the battery life of surgical lights.
B. Evaluating the potential for an oxygen-enriched atmosphere.
C. Ensuring all staff members have completed fire extinguisher training.
D. Confirming the patient's fasting status.
CORRECT ANSWER: B. Evaluating the potential for an oxygen-enriched
atmosphere.
Rationale: The OR fire triad consists of an oxidizer, fuel, and ignition source. For head
and neck surgeries, where oxygen or nitrous oxide may be administered in proximity to
the surgical site and an ignition source like an ESU, assessing for an oxygen-enriched
environment is a critical part of the fire risk assessment.
Question 9: A surgical technologist is opening a sterile pack. They notice a
small, dark spot on the inner wrapper. What is the appropriate action?
A. Proceed with opening the pack; it is likely harmless.
B. Ignore the spot and use the contents.
, C. Discard the entire pack and open a new one.
D. Cut around the spot and use the rest of the contents.
CORRECT ANSWER: C. Discard the entire pack and open a new one.
Rationale: Any visible evidence of contamination, such as a stain, dark spot (which
could be moisture), or a tear in the sterile packaging, renders the contents non-sterile.
The integrity of the barrier is compromised, and the entire pack must be considered
unsterile and discarded.
Question 10: What is the primary function of the scrub nurse during the
surgical procedure?
A. To monitor the patient's vital signs.
B. To manage the sterile field, pass instruments, and anticipate the surgeon's needs.
C. To document the surgical procedure.
D. To coordinate the schedule for the day.
CORRECT ANSWER: B. To manage the sterile field, pass instruments, and
anticipate the surgeon's needs.
Rationale: The scrub nurse (or surgical technologist) is the sterile member of the team
whose primary role is to set up, maintain, and manage the sterile field. They pass
instruments, supplies, and equipment to the surgeon and assistants, ensuring a smooth
and efficient workflow. Monitoring vital signs is the anesthetist's role.
Question 11: An electrosurgical unit (ESU) is in use. What is the recommended
placement for the dispersive (grounding) pad?
A. Over a bony prominence, close to the surgical site.
B. Over a muscle mass, as close to the surgical site as possible.
C. Over a large bony area, like the scapula.
D. Over an area with excessive hair or adipose tissue.
CORRECT ANSWER: B. Over a muscle mass, as close to the surgical site as
possible.
Rationale: The dispersive pad should be placed on a well-vascularized muscle mass
(e.g., upper thigh, buttocks) close to the surgical site to provide the shortest, most direct
pathway for the electrical current. This minimizes impedance and reduces the risk of
pad-site burns. Bony prominences and adipose tissue have poor conductivity.
Question 12: Which of the following is a critical component of the "sign-in"
phase of the WHO surgical checklist?
A. The surgical team introduces themselves and their roles.
B. The surgeon confirms the patient's identity and the procedure.
C. The patient confirms their identity, site, and consent.
D. The entire team reviews the key concerns for recovery and management.
CORRECT ANSWER: C. The patient confirms their identity, site, and consent.
Room Safety Updated 2026 | 190+ Questions and
Answers | SURG240 Operating Room Safety
Comprehensive Study Guide, Practice Exam, Exam
Prep Test Bank, Perioperative Nursing, Sterile
Technique, Surgical Asepsis, Infection Prevention &
Control, Surgical Instrumentation, Patient
Positioning, Anesthesia Safety, Fire Safety,
Specimen Handling, Clinical Judgment, Detailed
Rationales and Complete Revision Material
Question 1: What is the single most critical component of the time-out
procedure prior to surgical incision?
A. Verification of the patient's insurance information
B. Confirmation of the correct surgical site, procedure, and patient identity
C. Review of the anesthesia machine's calibration
D. Ensuring the surgical lights are properly focused
CORRECT ANSWER: B. Confirmation of the correct surgical site, procedure,
and patient identity
Rationale: The time-out is a critical safety check performed immediately before incision.
Its primary purpose is the final verification of the correct patient, correct site, and
correct procedure to prevent wrong-site, wrong-patient, and wrong-procedure surgery.
The other options are important but are not the central focus of the time-out.
Question 2: Which principle of aseptic technique is violated when a sterile
team member reaches over an unsterile field?
A. Sterile persons avoid leaning on unsterile areas.
B. Sterile persons avoid contact with unsterile persons or objects.
C. Sterile persons avoid unsterile areas when passing.
D. Sterile persons should only face the sterile field.
CORRECT ANSWER: B. Sterile persons avoid contact with unsterile persons or
objects.
Rationale: The core principle is that a sterile object or person must not touch an
unsterile object or person. Reaching over an unsterile field (e.g., a back table)
compromises the sterility of the team member's gown or gloves, as unsterile air currents
or accidental contact can occur. The other options are related but less directly about the
act of reaching over a field.
Question 3: In the context of the surgical environment, what does the term
"flash sterilization" refer to?
,A. Sterilization of implants using a rapid UV light process.
B. Steam sterilization of an unwrapped item for immediate use.
C. A chemical sterilization process for heat-sensitive instruments.
D. The process of sterilizing the operating room air between cases.
CORRECT ANSWER: B. Steam sterilization of an unwrapped item for
immediate use.
Rationale: Flash sterilization, now more commonly known as "immediate-use steam
sterilization," is a process for sterilizing an unwrapped item in a steam sterilizer for a
short cycle, typically for immediate use when an item is dropped or a special instrument
is needed urgently. It is not the standard for implants.
Question 4: Which type of surgical fire is most common in the operating room?
A. Electrical fires from faulty equipment
B. Airway fires
C. Fire on the patient's skin from prepping agents
D. Fire in the sterile field drapes
CORRECT ANSWER: B. Airway fires
Rationale: Airway fires, which occur on or around the patient's airway, are the most
commonly reported type of surgical fire. They involve the oxidizer (oxygen or nitrous
oxide), fuel (ETT or other airway device), and an ignition source (electrocautery or
laser).
Question 5: A patient is to receive a blood transfusion. What is the mandatory
safety check that must be performed at the patient's bedside by two qualified
professionals?
A. Verify the patient's age and weight.
B. Confirm the patient's allergy status.
C. Verify the patient's identity and blood product against the order and compatibility tag.
D. Check the expiration date on the blood bag only.
CORRECT ANSWER: C. Verify the patient's identity and blood product against
the order and compatibility tag.
Rationale: Before any blood product is transfused, a two-person verification process is
mandatory. This requires two professionals to check the patient's identity (using two
identifiers) and compare it against the blood product's compatibility tag and the
physician's order to prevent hemolytic transfusion reactions. Other checks are part of
the process but this is the core safety check.
Question 6: What is the primary purpose of using a surgical safety checklist,
such as the one developed by the WHO?
A. To document the surgical team's credentials.
B. To improve team communication and reduce preventable complications.
,C. To ensure the operating room is clean.
D. To create a legal record of the procedure.
CORRECT ANSWER: B. To improve team communication and reduce
preventable complications.
Rationale: The WHO Surgical Safety Checklist is designed to be a tool to improve
communication and teamwork among the surgical team. Its use has been proven to
reduce surgical morbidity and mortality by ensuring key safety steps are taken during
the three critical phases: sign-in, time-out, and sign-out.
Question 7: According to the Association of periOperative Registered Nurses
(AORN), what is the recommended method for transporting a patient to the
operating room?
A. Alone, to minimize distractions.
B. On a bed, with side rails up and a safety belt applied.
C. On a stretcher, with side rails up and a safety belt applied.
D. In a wheelchair, to allow for easier transfer.
CORRECT ANSWER: C. On a stretcher, with side rails up and a safety belt
applied.
Rationale: AORN guidelines recommend transporting anesthetized or preoperative
patients on a stretcher with side rails raised and a safety belt fastened across the
patient's hips for safety and fall prevention. This provides a secure and safe mode of
transport.
Question 8: Which of the following is a key element of a fire safety risk
assessment in the OR for a procedure on the head or neck?
A. Checking the battery life of surgical lights.
B. Evaluating the potential for an oxygen-enriched atmosphere.
C. Ensuring all staff members have completed fire extinguisher training.
D. Confirming the patient's fasting status.
CORRECT ANSWER: B. Evaluating the potential for an oxygen-enriched
atmosphere.
Rationale: The OR fire triad consists of an oxidizer, fuel, and ignition source. For head
and neck surgeries, where oxygen or nitrous oxide may be administered in proximity to
the surgical site and an ignition source like an ESU, assessing for an oxygen-enriched
environment is a critical part of the fire risk assessment.
Question 9: A surgical technologist is opening a sterile pack. They notice a
small, dark spot on the inner wrapper. What is the appropriate action?
A. Proceed with opening the pack; it is likely harmless.
B. Ignore the spot and use the contents.
, C. Discard the entire pack and open a new one.
D. Cut around the spot and use the rest of the contents.
CORRECT ANSWER: C. Discard the entire pack and open a new one.
Rationale: Any visible evidence of contamination, such as a stain, dark spot (which
could be moisture), or a tear in the sterile packaging, renders the contents non-sterile.
The integrity of the barrier is compromised, and the entire pack must be considered
unsterile and discarded.
Question 10: What is the primary function of the scrub nurse during the
surgical procedure?
A. To monitor the patient's vital signs.
B. To manage the sterile field, pass instruments, and anticipate the surgeon's needs.
C. To document the surgical procedure.
D. To coordinate the schedule for the day.
CORRECT ANSWER: B. To manage the sterile field, pass instruments, and
anticipate the surgeon's needs.
Rationale: The scrub nurse (or surgical technologist) is the sterile member of the team
whose primary role is to set up, maintain, and manage the sterile field. They pass
instruments, supplies, and equipment to the surgeon and assistants, ensuring a smooth
and efficient workflow. Monitoring vital signs is the anesthetist's role.
Question 11: An electrosurgical unit (ESU) is in use. What is the recommended
placement for the dispersive (grounding) pad?
A. Over a bony prominence, close to the surgical site.
B. Over a muscle mass, as close to the surgical site as possible.
C. Over a large bony area, like the scapula.
D. Over an area with excessive hair or adipose tissue.
CORRECT ANSWER: B. Over a muscle mass, as close to the surgical site as
possible.
Rationale: The dispersive pad should be placed on a well-vascularized muscle mass
(e.g., upper thigh, buttocks) close to the surgical site to provide the shortest, most direct
pathway for the electrical current. This minimizes impedance and reduces the risk of
pad-site burns. Bony prominences and adipose tissue have poor conductivity.
Question 12: Which of the following is a critical component of the "sign-in"
phase of the WHO surgical checklist?
A. The surgical team introduces themselves and their roles.
B. The surgeon confirms the patient's identity and the procedure.
C. The patient confirms their identity, site, and consent.
D. The entire team reviews the key concerns for recovery and management.
CORRECT ANSWER: C. The patient confirms their identity, site, and consent.
