AORN PERIOP 101
1. Several workflow pressures are present, but patient safety remains the priority. During a patient safety
activity, the circulating nurse reviews sharps safety. Which team action is most appropriate?
A. Use a neutral zone or other hands-free technique when feasible and communicate sharps transfers clearly.
B. Pass all sharps hand to hand to save time.
C. Recap contaminated needles using two hands.
D. Place used sharps on the instrument table until the end of the case.
Correct Answer: A. Use a neutral zone or other hands-free technique when feasible and communicate sharps
transfers clearly.
Rationale: Hands-free transfer strategies and immediate sharps control reduce percutaneous injuries.
2. Several workflow pressures are present, but patient safety remains the priority. During a health care
information management activity, the circulating nurse reviews timely documentation. Which team action
is most appropriate?
A. Document perioperative care accurately, objectively, and as close to the time of care as practical.
B. Reconstruct the entire record from memory at the end of the shift.
C. Document an action before it is performed.
D. Delete an error without following the electronic correction process.
Correct Answer: A. Document perioperative care accurately, objectively, and as close to the time of care as
practical.
Rationale: Timely, objective documentation supports continuity, legal integrity, and quality review.
3. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for specimen identification. Which proposed practice should be retained?
A. Place multiple unlabeled specimens together until pathology pickup.
B. Use room number as the primary specimen identifier.
C. Label the specimen with required patient and specimen identifiers immediately and verify the information with
a read-back process before transfer.
D. Label specimens at the end of the case from memory.
Correct Answer: C. Label the specimen with required patient and specimen identifiers immediately and verify
the information with a read-back process before transfer.
Rationale: Immediate standardized identification reduces wrong-patient and wrong-specimen errors.
4. The team is revising its workflow for preanesthesia verification. Which proposed practice should be
retained?
A. Wait until induction to ask about allergies.
B. Omit medication review when the procedure is brief.
C. Assume the preoperative note is complete without patient verification.
D. Confirm allergies, fasting status, medications, comorbidities, airway risk, and required testing before
anesthesia begins.
Correct Answer: D. Confirm allergies, fasting status, medications, comorbidities, airway risk, and required
testing before anesthesia begins.
Rationale: Preanesthesia assessment identifies modifiable risks and information essential to safe anesthetic
planning.
5. Several workflow pressures are present, but patient safety remains the priority. During a endoscopic
surgery activity, the circulating nurse reviews specimen retrieval. Which team action is most appropriate?
A. Fragment every specimen to simplify removal regardless of pathology needs.
B. Place the specimen directly on unsterile equipment after removal.
C. Extract a potentially malignant specimen unprotected through the wound.
D. Use an appropriate retrieval method to remove specimens while minimizing tissue spillage and contamination.
Correct Answer: D. Use an appropriate retrieval method to remove specimens while minimizing tissue spillage
and contamination.
Rationale: Controlled retrieval protects the wound, preserves pathology integrity, and limits contamination.
6. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for cleaning workflow. Which proposed practice should be retained?
A. Return a visibly soiled mop head to the clean solution.
,B. Use a systematic workflow that prevents moving contamination from dirtier areas to cleaner areas and change
cleaning materials when soiled.
C. Clean equipment only when it appears visibly dirty.
D. Clean from the dirtiest area toward cleaner surfaces with the same cloth.
Correct Answer: B. Use a systematic workflow that prevents moving contamination from dirtier areas to cleaner
areas and change cleaning materials when soiled.
Rationale: A planned cleaning sequence and fresh supplies reduce cross-contamination.
7. Several workflow pressures are present, but patient safety remains the priority. Which action should the
nurse prioritize when a case raises a concern involving immediate-use steam sterilization?
A. Store items processed for immediate use for later elective cases.
B. Use immediate-use steam sterilization only when clinically necessary and when all required cleaning, cycle,
transport, and documentation steps can be completed.
C. Shorten the cleaning step because the item will be sterilized immediately.
D. Use immediate-use sterilization routinely to compensate for insufficient inventory.
Correct Answer: B. Use immediate-use steam sterilization only when clinically necessary and when all required
cleaning, cycle, transport, and documentation steps can be completed.
Rationale: Immediate-use processing is not a substitute for adequate inventory or full cleaning and must follow
validated processes.
8. A novice perioperative nurse asks about topical hemostatic agents. Which response by the preceptor is
most accurate?
A. Verify indications, contraindications, application method, amount, and removal requirements for topical
hemostatic products.
B. Use a product without checking compatibility near neural or vascular structures.
C. Apply excess product because more always improves hemostasis.
D. Assume all topical hemostats may remain in the wound permanently.
Correct Answer: A. Verify indications, contraindications, application method, amount, and removal
requirements for topical hemostatic products.
Rationale: Topical hemostats differ in composition and use; product-specific instructions are essential.
9. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for discharge instructions. Which proposed practice should be retained?
A. Limit discharge teaching to medication names.
B. Provide clear written and verbal instructions on medications, wound care, activity, warning signs, follow-up,
and whom to contact.
C. Avoid discussing warning signs because they may increase anxiety.
D. Assume the accompanying adult will read the instructions later.
Correct Answer: B. Provide clear written and verbal instructions on medications, wound care, activity, warning
signs, follow-up, and whom to contact.
Rationale: Complete discharge teaching supports safe recovery and timely recognition of complications.
10. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for local anesthetic systemic toxicity. Which proposed practice should be retained?
A. Recognize neurologic or cardiovascular deterioration after local anesthetic administration as possible LAST
and activate the emergency response immediately.
B. Delay reporting symptoms until hypotension develops.
C. Assume tinnitus and perioral numbness are normal sedation effects.
D. Give additional local anesthetic to test whether symptoms worsen.
Correct Answer: A. Recognize neurologic or cardiovascular deterioration after local anesthetic administration as
possible LAST and activate the emergency response immediately.
Rationale: LAST can progress rapidly from early neurologic symptoms to seizures and cardiovascular collapse.
11. A novice perioperative nurse asks about arm positioning. Which response by the preceptor is most
accurate?
A. Position the arms to avoid excessive abduction, stretch, pressure, and contact with hard surfaces.
B. Allow the arm to hang off the edge of the arm board.
C. Abduct both arms beyond 90 degrees routinely.
D. Secure restraints tightly across superficial nerves.
,Correct Answer: A. Position the arms to avoid excessive abduction, stretch, pressure, and contact with hard
surfaces.
Rationale: Careful arm positioning helps prevent brachial plexus and peripheral nerve injury.
12. Several workflow pressures are present, but patient safety remains the priority. During a perioperative
assessment activity, the circulating nurse reviews allergy assessment. Which team action is most
appropriate?
A. Assume a reported latex allergy is unimportant when gloves are latex free.
B. Verify medication, food, latex, adhesive, antiseptic, and other relevant allergies and communicate them to the
team.
C. Wait until skin prep to ask about antiseptic reactions.
D. Document only drug allergies because other allergies do not affect surgery.
Correct Answer: B. Verify medication, food, latex, adhesive, antiseptic, and other relevant allergies and
communicate them to the team.
Rationale: Perioperative exposure includes many nonmedication allergens that can affect equipment and product
selection.
13. Which action best reflects safe perioperative practice related to chain of custody?
A. Maintain documented chain of custody for forensic or legally sensitive specimens according to policy.
B. Allow multiple undocumented handoffs to speed transport.
C. Relabel evidence after leaving the OR without witnessing.
D. Leave the specimen unattended until security arrives.
Correct Answer: A. Maintain documented chain of custody for forensic or legally sensitive specimens according
to policy.
Rationale: Chain-of-custody documentation protects specimen integrity and legal admissibility.
14. The patient has multiple perioperative risk factors and the team is balancing efficiency, sterility, and
physiologic safety. A novice perioperative nurse asks about fire risk assessment. Which response by the
preceptor is most accurate?
A. Assess fire risk before the procedure and coordinate controls for oxidizers, ignition sources, and fuels.
B. Increase open oxygen under drapes when electrosurgery is planned near the head.
C. Perform a fire risk review only after an ignition event occurs.
D. Focus only on the electrosurgical unit because it is the usual ignition source.
Correct Answer: A. Assess fire risk before the procedure and coordinate controls for oxidizers, ignition sources,
and fuels.
Rationale: Surgical fire prevention requires managing all three elements of the fire triangle before ignition can
occur.
15. Which action best reflects safe perioperative practice related to delicate instrument protection?
A. Place microsurgical instruments beneath heavy retractors to prevent movement.
B. Close ratcheted instruments tightly during transport to save space.
C. Protect delicate and sharp instruments from crushing, bending, and contact with heavier items during handling
and transport.
D. Stack powered devices on top of delicate instruments.
Correct Answer: C. Protect delicate and sharp instruments from crushing, bending, and contact with heavier
items during handling and transport.
Rationale: Appropriate handling preserves instrument function and reduces damage.
16. Which action best reflects safe perioperative practice related to retained item response?
A. Assume the item was discarded if the room search is negative.
B. Close the incision and repeat the count in PACU.
C. If a count remains incorrect, notify the surgeon, search systematically, and obtain imaging or other action
according to policy before the patient leaves the procedural setting.
D. Document the discrepancy but avoid delaying the procedure.
Correct Answer: C. If a count remains incorrect, notify the surgeon, search systematically, and obtain imaging or
other action according to policy before the patient leaves the procedural setting.
Rationale: An unresolved count discrepancy requires immediate escalation and a systematic search before the
patient leaves the area.
, 17. Several workflow pressures are present, but patient safety remains the priority. Which action should
the nurse prioritize when a case raises a concern involving instrument accountability?
A. Remove detachable components from the field without telling the circulator.
B. Keep instruments organized and accounted for throughout the procedure, especially small detachable parts.
C. Dispose of broken instrument pieces before confirming all fragments are present.
D. Delay accounting for small components until final closure.
Correct Answer: B. Keep instruments organized and accounted for throughout the procedure, especially small
detachable parts.
Rationale: Continuous instrument accountability helps prevent retained fragments and supports accurate counts.
18. A procedure is underway and the team must make a safe real-time decision. Which action should the
nurse prioritize when a case raises a concern involving body alignment?
A. Allow unsupported joints to hang beyond the table edge.
B. Maintain the head, neck, spine, and extremities in physiologic alignment unless the procedure requires a
planned modification.
C. Use asymmetrical positioning without documenting or reassessing it.
D. Rotate the neck maximally after induction to improve access.
Correct Answer: B. Maintain the head, neck, spine, and extremities in physiologic alignment unless the
procedure requires a planned modification.
Rationale: Neutral alignment helps prevent musculoskeletal, neurologic, and circulatory injury.
19. A procedure is underway and the team must make a safe real-time decision. A novice perioperative
nurse asks about handoff communication. Which response by the preceptor is most accurate?
A. Delay the handoff until the receiving nurse has independently assessed the patient.
B. Omit intraoperative problems that have already been corrected.
C. Give only the surgical diagnosis because the PACU nurse can review the chart later.
D. Use a standardized handoff that includes patient status, procedure, anesthesia, medications, devices,
specimens, blood loss, and current concerns.
Correct Answer: D. Use a standardized handoff that includes patient status, procedure, anesthesia, medications,
devices, specimens, blood loss, and current concerns.
Rationale: Structured handoff supports continuity, prioritization, and recognition of postoperative risk.
20. Which action should the nurse prioritize when a case raises a concern involving discharge readiness?
A. Discharge once a predetermined number of minutes has passed.
B. Use established physiologic and functional discharge criteria rather than elapsed time alone.
C. Use pain score as the only discharge criterion.
D. Discharge a patient with unstable vital signs if a family member is present.
Correct Answer: B. Use established physiologic and functional discharge criteria rather than elapsed time alone.
Rationale: Recovery and discharge decisions require objective criteria addressing physiologic stability and
function.
21. Several workflow pressures are present, but patient safety remains the priority. A novice perioperative
nurse asks about insufflation safety. Which response by the preceptor is most accurate?
A. Monitor physiologic effects of pneumoperitoneum and use insufflation settings appropriate to the patient and
procedure.
B. Increase pressure whenever visualization becomes difficult without reassessing the patient.
C. Assume carbon dioxide insufflation has no cardiopulmonary effects.
D. Ignore rising airway pressures during insufflation.
Correct Answer: A. Monitor physiologic effects of pneumoperitoneum and use insufflation settings appropriate
to the patient and procedure.
Rationale: Pneumoperitoneum can alter ventilation and hemodynamics and requires team awareness.
22. A procedure is underway and the team must make a safe real-time decision. Which action should the
nurse prioritize when a case raises a concern involving massive bleeding response?
A. Infuse large volumes of unwarmed fluid without monitoring temperature.
B. Wait for laboratory confirmation before activating the hemorrhage response.
C. When major hemorrhage occurs, communicate immediately, quantify loss, support rapid access to blood
products and warming, and anticipate coagulopathy.
D. Focus only on replacing red blood cells and ignore coagulation status.
1. Several workflow pressures are present, but patient safety remains the priority. During a patient safety
activity, the circulating nurse reviews sharps safety. Which team action is most appropriate?
A. Use a neutral zone or other hands-free technique when feasible and communicate sharps transfers clearly.
B. Pass all sharps hand to hand to save time.
C. Recap contaminated needles using two hands.
D. Place used sharps on the instrument table until the end of the case.
Correct Answer: A. Use a neutral zone or other hands-free technique when feasible and communicate sharps
transfers clearly.
Rationale: Hands-free transfer strategies and immediate sharps control reduce percutaneous injuries.
2. Several workflow pressures are present, but patient safety remains the priority. During a health care
information management activity, the circulating nurse reviews timely documentation. Which team action
is most appropriate?
A. Document perioperative care accurately, objectively, and as close to the time of care as practical.
B. Reconstruct the entire record from memory at the end of the shift.
C. Document an action before it is performed.
D. Delete an error without following the electronic correction process.
Correct Answer: A. Document perioperative care accurately, objectively, and as close to the time of care as
practical.
Rationale: Timely, objective documentation supports continuity, legal integrity, and quality review.
3. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for specimen identification. Which proposed practice should be retained?
A. Place multiple unlabeled specimens together until pathology pickup.
B. Use room number as the primary specimen identifier.
C. Label the specimen with required patient and specimen identifiers immediately and verify the information with
a read-back process before transfer.
D. Label specimens at the end of the case from memory.
Correct Answer: C. Label the specimen with required patient and specimen identifiers immediately and verify
the information with a read-back process before transfer.
Rationale: Immediate standardized identification reduces wrong-patient and wrong-specimen errors.
4. The team is revising its workflow for preanesthesia verification. Which proposed practice should be
retained?
A. Wait until induction to ask about allergies.
B. Omit medication review when the procedure is brief.
C. Assume the preoperative note is complete without patient verification.
D. Confirm allergies, fasting status, medications, comorbidities, airway risk, and required testing before
anesthesia begins.
Correct Answer: D. Confirm allergies, fasting status, medications, comorbidities, airway risk, and required
testing before anesthesia begins.
Rationale: Preanesthesia assessment identifies modifiable risks and information essential to safe anesthetic
planning.
5. Several workflow pressures are present, but patient safety remains the priority. During a endoscopic
surgery activity, the circulating nurse reviews specimen retrieval. Which team action is most appropriate?
A. Fragment every specimen to simplify removal regardless of pathology needs.
B. Place the specimen directly on unsterile equipment after removal.
C. Extract a potentially malignant specimen unprotected through the wound.
D. Use an appropriate retrieval method to remove specimens while minimizing tissue spillage and contamination.
Correct Answer: D. Use an appropriate retrieval method to remove specimens while minimizing tissue spillage
and contamination.
Rationale: Controlled retrieval protects the wound, preserves pathology integrity, and limits contamination.
6. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for cleaning workflow. Which proposed practice should be retained?
A. Return a visibly soiled mop head to the clean solution.
,B. Use a systematic workflow that prevents moving contamination from dirtier areas to cleaner areas and change
cleaning materials when soiled.
C. Clean equipment only when it appears visibly dirty.
D. Clean from the dirtiest area toward cleaner surfaces with the same cloth.
Correct Answer: B. Use a systematic workflow that prevents moving contamination from dirtier areas to cleaner
areas and change cleaning materials when soiled.
Rationale: A planned cleaning sequence and fresh supplies reduce cross-contamination.
7. Several workflow pressures are present, but patient safety remains the priority. Which action should the
nurse prioritize when a case raises a concern involving immediate-use steam sterilization?
A. Store items processed for immediate use for later elective cases.
B. Use immediate-use steam sterilization only when clinically necessary and when all required cleaning, cycle,
transport, and documentation steps can be completed.
C. Shorten the cleaning step because the item will be sterilized immediately.
D. Use immediate-use sterilization routinely to compensate for insufficient inventory.
Correct Answer: B. Use immediate-use steam sterilization only when clinically necessary and when all required
cleaning, cycle, transport, and documentation steps can be completed.
Rationale: Immediate-use processing is not a substitute for adequate inventory or full cleaning and must follow
validated processes.
8. A novice perioperative nurse asks about topical hemostatic agents. Which response by the preceptor is
most accurate?
A. Verify indications, contraindications, application method, amount, and removal requirements for topical
hemostatic products.
B. Use a product without checking compatibility near neural or vascular structures.
C. Apply excess product because more always improves hemostasis.
D. Assume all topical hemostats may remain in the wound permanently.
Correct Answer: A. Verify indications, contraindications, application method, amount, and removal
requirements for topical hemostatic products.
Rationale: Topical hemostats differ in composition and use; product-specific instructions are essential.
9. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for discharge instructions. Which proposed practice should be retained?
A. Limit discharge teaching to medication names.
B. Provide clear written and verbal instructions on medications, wound care, activity, warning signs, follow-up,
and whom to contact.
C. Avoid discussing warning signs because they may increase anxiety.
D. Assume the accompanying adult will read the instructions later.
Correct Answer: B. Provide clear written and verbal instructions on medications, wound care, activity, warning
signs, follow-up, and whom to contact.
Rationale: Complete discharge teaching supports safe recovery and timely recognition of complications.
10. A procedure is underway and the team must make a safe real-time decision. The team is revising its
workflow for local anesthetic systemic toxicity. Which proposed practice should be retained?
A. Recognize neurologic or cardiovascular deterioration after local anesthetic administration as possible LAST
and activate the emergency response immediately.
B. Delay reporting symptoms until hypotension develops.
C. Assume tinnitus and perioral numbness are normal sedation effects.
D. Give additional local anesthetic to test whether symptoms worsen.
Correct Answer: A. Recognize neurologic or cardiovascular deterioration after local anesthetic administration as
possible LAST and activate the emergency response immediately.
Rationale: LAST can progress rapidly from early neurologic symptoms to seizures and cardiovascular collapse.
11. A novice perioperative nurse asks about arm positioning. Which response by the preceptor is most
accurate?
A. Position the arms to avoid excessive abduction, stretch, pressure, and contact with hard surfaces.
B. Allow the arm to hang off the edge of the arm board.
C. Abduct both arms beyond 90 degrees routinely.
D. Secure restraints tightly across superficial nerves.
,Correct Answer: A. Position the arms to avoid excessive abduction, stretch, pressure, and contact with hard
surfaces.
Rationale: Careful arm positioning helps prevent brachial plexus and peripheral nerve injury.
12. Several workflow pressures are present, but patient safety remains the priority. During a perioperative
assessment activity, the circulating nurse reviews allergy assessment. Which team action is most
appropriate?
A. Assume a reported latex allergy is unimportant when gloves are latex free.
B. Verify medication, food, latex, adhesive, antiseptic, and other relevant allergies and communicate them to the
team.
C. Wait until skin prep to ask about antiseptic reactions.
D. Document only drug allergies because other allergies do not affect surgery.
Correct Answer: B. Verify medication, food, latex, adhesive, antiseptic, and other relevant allergies and
communicate them to the team.
Rationale: Perioperative exposure includes many nonmedication allergens that can affect equipment and product
selection.
13. Which action best reflects safe perioperative practice related to chain of custody?
A. Maintain documented chain of custody for forensic or legally sensitive specimens according to policy.
B. Allow multiple undocumented handoffs to speed transport.
C. Relabel evidence after leaving the OR without witnessing.
D. Leave the specimen unattended until security arrives.
Correct Answer: A. Maintain documented chain of custody for forensic or legally sensitive specimens according
to policy.
Rationale: Chain-of-custody documentation protects specimen integrity and legal admissibility.
14. The patient has multiple perioperative risk factors and the team is balancing efficiency, sterility, and
physiologic safety. A novice perioperative nurse asks about fire risk assessment. Which response by the
preceptor is most accurate?
A. Assess fire risk before the procedure and coordinate controls for oxidizers, ignition sources, and fuels.
B. Increase open oxygen under drapes when electrosurgery is planned near the head.
C. Perform a fire risk review only after an ignition event occurs.
D. Focus only on the electrosurgical unit because it is the usual ignition source.
Correct Answer: A. Assess fire risk before the procedure and coordinate controls for oxidizers, ignition sources,
and fuels.
Rationale: Surgical fire prevention requires managing all three elements of the fire triangle before ignition can
occur.
15. Which action best reflects safe perioperative practice related to delicate instrument protection?
A. Place microsurgical instruments beneath heavy retractors to prevent movement.
B. Close ratcheted instruments tightly during transport to save space.
C. Protect delicate and sharp instruments from crushing, bending, and contact with heavier items during handling
and transport.
D. Stack powered devices on top of delicate instruments.
Correct Answer: C. Protect delicate and sharp instruments from crushing, bending, and contact with heavier
items during handling and transport.
Rationale: Appropriate handling preserves instrument function and reduces damage.
16. Which action best reflects safe perioperative practice related to retained item response?
A. Assume the item was discarded if the room search is negative.
B. Close the incision and repeat the count in PACU.
C. If a count remains incorrect, notify the surgeon, search systematically, and obtain imaging or other action
according to policy before the patient leaves the procedural setting.
D. Document the discrepancy but avoid delaying the procedure.
Correct Answer: C. If a count remains incorrect, notify the surgeon, search systematically, and obtain imaging or
other action according to policy before the patient leaves the procedural setting.
Rationale: An unresolved count discrepancy requires immediate escalation and a systematic search before the
patient leaves the area.
, 17. Several workflow pressures are present, but patient safety remains the priority. Which action should
the nurse prioritize when a case raises a concern involving instrument accountability?
A. Remove detachable components from the field without telling the circulator.
B. Keep instruments organized and accounted for throughout the procedure, especially small detachable parts.
C. Dispose of broken instrument pieces before confirming all fragments are present.
D. Delay accounting for small components until final closure.
Correct Answer: B. Keep instruments organized and accounted for throughout the procedure, especially small
detachable parts.
Rationale: Continuous instrument accountability helps prevent retained fragments and supports accurate counts.
18. A procedure is underway and the team must make a safe real-time decision. Which action should the
nurse prioritize when a case raises a concern involving body alignment?
A. Allow unsupported joints to hang beyond the table edge.
B. Maintain the head, neck, spine, and extremities in physiologic alignment unless the procedure requires a
planned modification.
C. Use asymmetrical positioning without documenting or reassessing it.
D. Rotate the neck maximally after induction to improve access.
Correct Answer: B. Maintain the head, neck, spine, and extremities in physiologic alignment unless the
procedure requires a planned modification.
Rationale: Neutral alignment helps prevent musculoskeletal, neurologic, and circulatory injury.
19. A procedure is underway and the team must make a safe real-time decision. A novice perioperative
nurse asks about handoff communication. Which response by the preceptor is most accurate?
A. Delay the handoff until the receiving nurse has independently assessed the patient.
B. Omit intraoperative problems that have already been corrected.
C. Give only the surgical diagnosis because the PACU nurse can review the chart later.
D. Use a standardized handoff that includes patient status, procedure, anesthesia, medications, devices,
specimens, blood loss, and current concerns.
Correct Answer: D. Use a standardized handoff that includes patient status, procedure, anesthesia, medications,
devices, specimens, blood loss, and current concerns.
Rationale: Structured handoff supports continuity, prioritization, and recognition of postoperative risk.
20. Which action should the nurse prioritize when a case raises a concern involving discharge readiness?
A. Discharge once a predetermined number of minutes has passed.
B. Use established physiologic and functional discharge criteria rather than elapsed time alone.
C. Use pain score as the only discharge criterion.
D. Discharge a patient with unstable vital signs if a family member is present.
Correct Answer: B. Use established physiologic and functional discharge criteria rather than elapsed time alone.
Rationale: Recovery and discharge decisions require objective criteria addressing physiologic stability and
function.
21. Several workflow pressures are present, but patient safety remains the priority. A novice perioperative
nurse asks about insufflation safety. Which response by the preceptor is most accurate?
A. Monitor physiologic effects of pneumoperitoneum and use insufflation settings appropriate to the patient and
procedure.
B. Increase pressure whenever visualization becomes difficult without reassessing the patient.
C. Assume carbon dioxide insufflation has no cardiopulmonary effects.
D. Ignore rising airway pressures during insufflation.
Correct Answer: A. Monitor physiologic effects of pneumoperitoneum and use insufflation settings appropriate
to the patient and procedure.
Rationale: Pneumoperitoneum can alter ventilation and hemodynamics and requires team awareness.
22. A procedure is underway and the team must make a safe real-time decision. Which action should the
nurse prioritize when a case raises a concern involving massive bleeding response?
A. Infuse large volumes of unwarmed fluid without monitoring temperature.
B. Wait for laboratory confirmation before activating the hemorrhage response.
C. When major hemorrhage occurs, communicate immediately, quantify loss, support rapid access to blood
products and warming, and anticipate coagulopathy.
D. Focus only on replacing red blood cells and ignore coagulation status.
