ULTIMATE PREP GUIDE RELIAS
PERIOPERATIVE NURSING A EXAM QUESTIONS
& ANSWERS (2025-2026)
This comprehensive practice bank provides accurate
multiple-choice questions with italicized answers and
detailed bold-italic clinical rationales aligned with the
latest AORN guidelines. Designed explicitly for
perioperative nursing success, it covers advanced patient
positioning, sterilization technologies, anesthesia crises,
and emergency pharmacology.
Section 1: Patient Safety, Consent, and Policy
1. A patient scheduled for an exploratory laparotomy
and possible colostomy states, "I will die before I
ever let anyone give me a stoma bag." The surgeon
is currently at the scrub sink. Which action should
the perioperative nurse take first?
A. Document the patient's statement in the
electronic health record.
B. Reassure the patient that the colostomy is only a
temporary possibility.
C. Inform the surgeon immediately and delay
transferring the patient to the OR suite.
D. Proceed with transfer to the OR and allow the
anesthesia provider to sedate the patient.
,Answer: C. Inform the surgeon immediately and
delay transferring the patient to the OR suite.
Rationale: A patient has the right to refuse any part
of a surgical procedure. If a patient expresses clear
opposition to a planned intervention, the nurse must
advocate for the patient by halting the process and
notifying the surgeon so a detailed discussion or
modification of consent can occur before anesthesia
induction.
2. During the definitive "Time Out" phase of the
surgical checklist, which of the following
requirements must be strictly met?
A. The surgeon may continue prepping the patient's
skin while the nurse reads the checklist.
B. It must occur immediately prior to the surgical
incision and involve active agreement from all team
members.
C. The anesthesia provider can omit participation if
they are actively stabilizing the patient's blood
pressure.
D. The checklist must be completed in the holding
area before the patient enters the operating room
room.
Answer: B. It must occur immediately prior to the
,surgical incision and involve active agreement from
all team members.
Rationale: Per AORN and Joint Commission
standards, the Time Out must be a designated
"stoppage of fluid activity" occurring immediately
before the incision. It requires the active, un-
distracted participation of all sterile and non-sterile
team members to verify the correct patient, correct
site, and correct procedure.
3. Who is officially responsible for documenting the
initiation, execution, and specific components
verified during the intraoperative Time Out?
A. The Surgical Technologist
B. The Circulating Registered Nurse
C. The Primary Surgeon
D. The Certified Registered Nurse Anesthetist
(CRNA)
Answer: B. The Circulating Registered Nurse.
Rationale: The circulating nurse serves as the
primary documenter of the intraoperative record.
This includes capturing the exact time, the names of
participating team members, and verification that
all criteria of the Universal Protocol were met.
, 4. While setting up a sterile field for a total knee
arthroplasty, the surgical technologist notices that a
required orthopedic implant contains natural rubber
latex components. The patient's chart lists a severe
"Class I" latex allergy. What is the immediate
priority?
A. Cover the implant with a sterile clear plastic
drape to prevent direct contact.
B. Wash the implant in sterile normal saline to
remove surface latex proteins.
C. Stop the setup, inform the entire surgical team,
and replace the setup with entirely latex-free
alternatives.
D. Request the anesthesia team administer a
prophylactic dose of intravenous diphenhydramine.
Answer: C. Stop the setup, inform the entire
surgical team, and replace the setup with entirely
latex-free alternatives.
Rationale: For a patient with a documented severe
latex allergy, a completely latex-free environment
must be established. Surface barriers or washing
are completely ineffective at preventing systemic
anaphylaxis. The entire field must be cleared of any
contaminated items and reset with safe materials.
PERIOPERATIVE NURSING A EXAM QUESTIONS
& ANSWERS (2025-2026)
This comprehensive practice bank provides accurate
multiple-choice questions with italicized answers and
detailed bold-italic clinical rationales aligned with the
latest AORN guidelines. Designed explicitly for
perioperative nursing success, it covers advanced patient
positioning, sterilization technologies, anesthesia crises,
and emergency pharmacology.
Section 1: Patient Safety, Consent, and Policy
1. A patient scheduled for an exploratory laparotomy
and possible colostomy states, "I will die before I
ever let anyone give me a stoma bag." The surgeon
is currently at the scrub sink. Which action should
the perioperative nurse take first?
A. Document the patient's statement in the
electronic health record.
B. Reassure the patient that the colostomy is only a
temporary possibility.
C. Inform the surgeon immediately and delay
transferring the patient to the OR suite.
D. Proceed with transfer to the OR and allow the
anesthesia provider to sedate the patient.
,Answer: C. Inform the surgeon immediately and
delay transferring the patient to the OR suite.
Rationale: A patient has the right to refuse any part
of a surgical procedure. If a patient expresses clear
opposition to a planned intervention, the nurse must
advocate for the patient by halting the process and
notifying the surgeon so a detailed discussion or
modification of consent can occur before anesthesia
induction.
2. During the definitive "Time Out" phase of the
surgical checklist, which of the following
requirements must be strictly met?
A. The surgeon may continue prepping the patient's
skin while the nurse reads the checklist.
B. It must occur immediately prior to the surgical
incision and involve active agreement from all team
members.
C. The anesthesia provider can omit participation if
they are actively stabilizing the patient's blood
pressure.
D. The checklist must be completed in the holding
area before the patient enters the operating room
room.
Answer: B. It must occur immediately prior to the
,surgical incision and involve active agreement from
all team members.
Rationale: Per AORN and Joint Commission
standards, the Time Out must be a designated
"stoppage of fluid activity" occurring immediately
before the incision. It requires the active, un-
distracted participation of all sterile and non-sterile
team members to verify the correct patient, correct
site, and correct procedure.
3. Who is officially responsible for documenting the
initiation, execution, and specific components
verified during the intraoperative Time Out?
A. The Surgical Technologist
B. The Circulating Registered Nurse
C. The Primary Surgeon
D. The Certified Registered Nurse Anesthetist
(CRNA)
Answer: B. The Circulating Registered Nurse.
Rationale: The circulating nurse serves as the
primary documenter of the intraoperative record.
This includes capturing the exact time, the names of
participating team members, and verification that
all criteria of the Universal Protocol were met.
, 4. While setting up a sterile field for a total knee
arthroplasty, the surgical technologist notices that a
required orthopedic implant contains natural rubber
latex components. The patient's chart lists a severe
"Class I" latex allergy. What is the immediate
priority?
A. Cover the implant with a sterile clear plastic
drape to prevent direct contact.
B. Wash the implant in sterile normal saline to
remove surface latex proteins.
C. Stop the setup, inform the entire surgical team,
and replace the setup with entirely latex-free
alternatives.
D. Request the anesthesia team administer a
prophylactic dose of intravenous diphenhydramine.
Answer: C. Stop the setup, inform the entire
surgical team, and replace the setup with entirely
latex-free alternatives.
Rationale: For a patient with a documented severe
latex allergy, a completely latex-free environment
must be established. Surface barriers or washing
are completely ineffective at preventing systemic
anaphylaxis. The entire field must be cleared of any
contaminated items and reset with safe materials.
