AORN Periop 101 Final Exam Study Guide | 100
Comprehensive Practice Questions & Rationales
(Latest Edition 2026)
The AORN Periop 101 Course Final Exam! This high-yield digital study guide
contains 100 comprehensive, NCLEX/AORN-style practice multiple-choice questions
split across two distinct batches. Each question includes the correct answer in bold
italic and an in-depth clinical rationale explaining the underlying AORN guidelines
(Sterile Technique, Patient Positioning, Counting Protocols, Electrosurgical Safety,
and Malignant Hyperthermia). Perfect for perioperative residency nurses seeking a
definitive review tool to pass on the first attempt!
BATCH 1 (Questions 1 - 50)
1. Which areas of the surgical attire are considered sterile once the team member is
fully gowned and gloved?
A. The entire gown from head to toe, front and back
B. The front of the gown from the chest to the level of the sterile field, and the
sleeves from two inches above the elbow to the cuff
C. The entire front of the gown including the neckline and shoulders
D. From the waist down to the hemline of the gown, including the back
According to AORN sterile technique guidelines, only the front of the gown from the
chest to the sterile field level and the sleeves from 2 inches above the elbow to the
cuffs are considered sterile. The back is always considered unsterile.
2. What is the minimum recommended distance that unscrubbed personnel must
maintain from the sterile field?
A. 6 inches
B. 12 inches (1 foot)
C. 24 inches (2 feet)
D. 3 feet
Unscrubbed team members must maintain a distance of at least 12 inches from any
sterile field to prevent accidental contamination via touch or air currents.
3. During a surgical procedure, a piece of sterile equipment is suspected to have been
contaminated. What is the immediate action of the perioperative nurse?
, A. Wait until the end of the step to see if it was actually touched
B. Wipe the area with an alcohol swab and continue using it
C. Remove the item from the sterile field immediately and replace it
D. Ask the surgeon if they mind using the contaminated item
If there is any doubt about the sterility of an item, it must be considered
contaminated. The item must be removed from the sterile field immediately to
prevent surgical site infections (SSIs).
4. When transferring a patient from the holding area to the operating room table, what
is the minimum number of personnel required to ensure safety?
A. One person if the patient is fully alert
B. Two people (one stabilizing the gurney, one assisting at the OR table)
C. Four people regardless of the patient's weight
D. Three people only if the patient is under general anesthesia
A minimum of two personnel is required for a safe lateral transfer of an alert,
cooperative patient to prevent falls and mechanical injuries. More may be needed for
dependent or obese patients.
5. Which chemical agent is commonly used for surgical skin prep because it provides
both rapid initial microbial reduction and persistent residual activity?
A. 70% Isopropyl Alcohol alone
B. Chlorhexidine Gluconate (CHG) with Alcohol
C. Povidone-Iodine without alcohol
D. Hydrogen Peroxide solution
CHG combined with alcohol is highly preferred for surgical skin prep because
alcohol kills microbes rapidly, while CHG binds to the skin stratum corneum to
provide persistent antimicrobial action for hours.
6. What is the primary purpose of the "Time Out" conducted immediately before making
the surgical incision?
A. To verify the anesthesia billing codes are correct
B. To confirm the correct patient, correct site, correct procedure, and that all
necessary equipment is available
C. To allow the surgeon to review their operative notes one last time
D. To give the circulator time to finish documenting the skin prep
The Universal Protocol Time Out is a critical safety step performed right before
incision to prevent wrong-site, wrong-procedure, and wrong-person surgery.
, 7. When opening a sterile wrapped item, which flap should the perioperative nurse
open first?
A. The flap closest to their body
B. The right side flap
C. The left side flap
D. The topmost flap, opening it away from the body
Opening the furthest/topmost flap first prevents the unscrubbed nurse from reaching
across the exposed sterile contents of the package, minimizing contamination risks.
8. Which type of indicator must be present on the inside of every sterile instrument tray
to verify that the sterilant penetrated the package?
A. Mechanical indicator on the sterilizer door
B. External biological indicator strip
C. Internal chemical indicator (Class 5 or 6)
D. Biological spore test capsule
Internal chemical indicators change color when exposed to specific sterilization
parameters (such as steam, time, temperature), confirming the sterilant reached the
inside of the tray.
9. A patient is undergoing a laparoscopic cholecystectomy. The nurse notes sudden,
unexplained subcutaneous emphysema around the neck and chest. What gas is
likely causing this?
A. Nitrous Oxide
B. Oxygen
C. Carbon Dioxide
D. Helium
Carbon dioxide is used to create a pneumoperitoneum during laparoscopy. If the
gas escapes into the subcutaneous tissues, it causes subcutaneous emphysema,
characterized by a crackling sensation under the skin.
10. What is the correct protocol for counting surgical sponges during an open abdominal
procedure?
A. The scrub person counts them silently before the case begins
B. The scrub person and the circulator count them aloud together at specified
intervals (before incision, before closure of a cavity, skin closure)
C. The circulator counts the dirty sponges on the floor after the case closes
D. Sponges are only counted if the surgeon requests a count
Sponges must be counted audibly and concurrently by the scrub person and the
Comprehensive Practice Questions & Rationales
(Latest Edition 2026)
The AORN Periop 101 Course Final Exam! This high-yield digital study guide
contains 100 comprehensive, NCLEX/AORN-style practice multiple-choice questions
split across two distinct batches. Each question includes the correct answer in bold
italic and an in-depth clinical rationale explaining the underlying AORN guidelines
(Sterile Technique, Patient Positioning, Counting Protocols, Electrosurgical Safety,
and Malignant Hyperthermia). Perfect for perioperative residency nurses seeking a
definitive review tool to pass on the first attempt!
BATCH 1 (Questions 1 - 50)
1. Which areas of the surgical attire are considered sterile once the team member is
fully gowned and gloved?
A. The entire gown from head to toe, front and back
B. The front of the gown from the chest to the level of the sterile field, and the
sleeves from two inches above the elbow to the cuff
C. The entire front of the gown including the neckline and shoulders
D. From the waist down to the hemline of the gown, including the back
According to AORN sterile technique guidelines, only the front of the gown from the
chest to the sterile field level and the sleeves from 2 inches above the elbow to the
cuffs are considered sterile. The back is always considered unsterile.
2. What is the minimum recommended distance that unscrubbed personnel must
maintain from the sterile field?
A. 6 inches
B. 12 inches (1 foot)
C. 24 inches (2 feet)
D. 3 feet
Unscrubbed team members must maintain a distance of at least 12 inches from any
sterile field to prevent accidental contamination via touch or air currents.
3. During a surgical procedure, a piece of sterile equipment is suspected to have been
contaminated. What is the immediate action of the perioperative nurse?
, A. Wait until the end of the step to see if it was actually touched
B. Wipe the area with an alcohol swab and continue using it
C. Remove the item from the sterile field immediately and replace it
D. Ask the surgeon if they mind using the contaminated item
If there is any doubt about the sterility of an item, it must be considered
contaminated. The item must be removed from the sterile field immediately to
prevent surgical site infections (SSIs).
4. When transferring a patient from the holding area to the operating room table, what
is the minimum number of personnel required to ensure safety?
A. One person if the patient is fully alert
B. Two people (one stabilizing the gurney, one assisting at the OR table)
C. Four people regardless of the patient's weight
D. Three people only if the patient is under general anesthesia
A minimum of two personnel is required for a safe lateral transfer of an alert,
cooperative patient to prevent falls and mechanical injuries. More may be needed for
dependent or obese patients.
5. Which chemical agent is commonly used for surgical skin prep because it provides
both rapid initial microbial reduction and persistent residual activity?
A. 70% Isopropyl Alcohol alone
B. Chlorhexidine Gluconate (CHG) with Alcohol
C. Povidone-Iodine without alcohol
D. Hydrogen Peroxide solution
CHG combined with alcohol is highly preferred for surgical skin prep because
alcohol kills microbes rapidly, while CHG binds to the skin stratum corneum to
provide persistent antimicrobial action for hours.
6. What is the primary purpose of the "Time Out" conducted immediately before making
the surgical incision?
A. To verify the anesthesia billing codes are correct
B. To confirm the correct patient, correct site, correct procedure, and that all
necessary equipment is available
C. To allow the surgeon to review their operative notes one last time
D. To give the circulator time to finish documenting the skin prep
The Universal Protocol Time Out is a critical safety step performed right before
incision to prevent wrong-site, wrong-procedure, and wrong-person surgery.
, 7. When opening a sterile wrapped item, which flap should the perioperative nurse
open first?
A. The flap closest to their body
B. The right side flap
C. The left side flap
D. The topmost flap, opening it away from the body
Opening the furthest/topmost flap first prevents the unscrubbed nurse from reaching
across the exposed sterile contents of the package, minimizing contamination risks.
8. Which type of indicator must be present on the inside of every sterile instrument tray
to verify that the sterilant penetrated the package?
A. Mechanical indicator on the sterilizer door
B. External biological indicator strip
C. Internal chemical indicator (Class 5 or 6)
D. Biological spore test capsule
Internal chemical indicators change color when exposed to specific sterilization
parameters (such as steam, time, temperature), confirming the sterilant reached the
inside of the tray.
9. A patient is undergoing a laparoscopic cholecystectomy. The nurse notes sudden,
unexplained subcutaneous emphysema around the neck and chest. What gas is
likely causing this?
A. Nitrous Oxide
B. Oxygen
C. Carbon Dioxide
D. Helium
Carbon dioxide is used to create a pneumoperitoneum during laparoscopy. If the
gas escapes into the subcutaneous tissues, it causes subcutaneous emphysema,
characterized by a crackling sensation under the skin.
10. What is the correct protocol for counting surgical sponges during an open abdominal
procedure?
A. The scrub person counts them silently before the case begins
B. The scrub person and the circulator count them aloud together at specified
intervals (before incision, before closure of a cavity, skin closure)
C. The circulator counts the dirty sponges on the floor after the case closes
D. Sponges are only counted if the surgeon requests a count
Sponges must be counted audibly and concurrently by the scrub person and the
