AORN Periop 101 Final Exam Study Guide
(2026/2027)
1. A scrubbed team member notices a tear in their sterile glove during a surgical
procedure. Which of the following actions should the team member take?
A) Continue the procedure if the tear is small and not bleeding.
B) Cover the torn glove with a new sterile glove.
C) Step away from the sterile field, remove the torn glove, and don a new sterile
glove using the closed-assisted gloving technique.
D) Change the glove only if the surgeon requests it.
Answer: C) Step away from the sterile field, remove the torn glove, and don a new
sterile glove using the closed-assisted glomming technique.
Rationale: According to AORN, any visible tear or puncture in a sterile glove
compromises the sterile field. The team member must step back from the field
and change the glove immediately using a sterile technique (closed-assisted if
gowned and gloved).
2. When opening a sterile package and pouring a sterile solution into a sterile
basin on the field, which of the following actions prevents contamination of the
sterile field?
A) Pour the solution slowly to avoid splashing.
B) Hold the bottle approximately 12 inches above the basin.
C) Pour the solution with the label facing down to prevent water droplets from
blurring the label.
D) Discard any unused solution remaining in the bottle after the pour.
Answer: D) Discard any unused solution remaining in the bottle after the pour.
,Rationale: Once a sterile bottle is opened and poured, the sterility of the contents
cannot be maintained. Any remaining solution must be discarded. The label
should face the palm (up) to prevent fluid running down and obscuring the label,
and splashing should be avoided, but discarding the remainder is the strict AORN
rule.
3. A nurse is positioning a patient in the lithotomy position. Which of the following
actions is essential to prevent postoperative compartment syndrome or nerve
damage?
A) Placing the patient's arms above their head on armboards.
B) Ensuring the hips are flexed no more than 90 degrees.
C) Lowering the patient's legs simultaneously and slowly at the end of the
procedure.
D) Both B and C
Answer: D) Both B and C
Rationale: Flexing the hips more than 90 degrees can obstruct blood flow and
cause nerve compression. Lowering the legs simultaneously and slowly prevents
sudden shifts in hemodynamics and reduces the risk of injury. Arms should
generally be placed on armboards less than 90 degrees, not over the head, to
prevent brachial plexus stretch.
4. According to AORN guidelines, when should the initial surgical count be
performed?
A) Before the incision
B) After the incision
C) Immediately before closing the cavity
D) At the end of the procedure
, Answer: A) Before the incision
Rationale: The initial count of sponges, sharps, and instruments must be
performed and documented before the surgical incision to establish a baseline.
Subsequent counts are performed before closing a cavity, at skin closure, and at
the end of the procedure.
5. A surgical technologist is handing a sharp instrument to the surgeon. Which of
the following is the correct technique to prevent percutaneous injuries?
A) Hand the sharp directly to the surgeon with the blade facing the surgeon.
B) Place the sharp in a neutral zone, such as a sterile basin or magnetic pad.
C) Toss the sharp onto the sterile field if the surgeon is busy.
D) Announce "sharp coming" and hand it point-first.
Answer: B) Place the sharp in a neutral zone, such as a sterile basin or magnetic
pad.
Rationale: AORN advocates for the use of a "neutral zone" (a designated area on
the sterile field, like a basin or mat) for passing sharps to eliminate hand-to-hand
passing, which significantly reduces the risk of sharps injuries.
6. Which of the following patients is at the highest risk for developing a surgical
site infection (SSI)?
A) A 30-year-old undergoing a knee arthroscopy.
B) A 65-year-old diabetic patient with a blood glucose level of 220 mg/dL
undergoing a colon resection.
C) A 45-year-old undergoing a hernia repair who received a preoperative bath
with chlorhexidine.
D) A 50-year-old undergoing a cholecystectomy with normothermia maintained.
(2026/2027)
1. A scrubbed team member notices a tear in their sterile glove during a surgical
procedure. Which of the following actions should the team member take?
A) Continue the procedure if the tear is small and not bleeding.
B) Cover the torn glove with a new sterile glove.
C) Step away from the sterile field, remove the torn glove, and don a new sterile
glove using the closed-assisted gloving technique.
D) Change the glove only if the surgeon requests it.
Answer: C) Step away from the sterile field, remove the torn glove, and don a new
sterile glove using the closed-assisted glomming technique.
Rationale: According to AORN, any visible tear or puncture in a sterile glove
compromises the sterile field. The team member must step back from the field
and change the glove immediately using a sterile technique (closed-assisted if
gowned and gloved).
2. When opening a sterile package and pouring a sterile solution into a sterile
basin on the field, which of the following actions prevents contamination of the
sterile field?
A) Pour the solution slowly to avoid splashing.
B) Hold the bottle approximately 12 inches above the basin.
C) Pour the solution with the label facing down to prevent water droplets from
blurring the label.
D) Discard any unused solution remaining in the bottle after the pour.
Answer: D) Discard any unused solution remaining in the bottle after the pour.
,Rationale: Once a sterile bottle is opened and poured, the sterility of the contents
cannot be maintained. Any remaining solution must be discarded. The label
should face the palm (up) to prevent fluid running down and obscuring the label,
and splashing should be avoided, but discarding the remainder is the strict AORN
rule.
3. A nurse is positioning a patient in the lithotomy position. Which of the following
actions is essential to prevent postoperative compartment syndrome or nerve
damage?
A) Placing the patient's arms above their head on armboards.
B) Ensuring the hips are flexed no more than 90 degrees.
C) Lowering the patient's legs simultaneously and slowly at the end of the
procedure.
D) Both B and C
Answer: D) Both B and C
Rationale: Flexing the hips more than 90 degrees can obstruct blood flow and
cause nerve compression. Lowering the legs simultaneously and slowly prevents
sudden shifts in hemodynamics and reduces the risk of injury. Arms should
generally be placed on armboards less than 90 degrees, not over the head, to
prevent brachial plexus stretch.
4. According to AORN guidelines, when should the initial surgical count be
performed?
A) Before the incision
B) After the incision
C) Immediately before closing the cavity
D) At the end of the procedure
, Answer: A) Before the incision
Rationale: The initial count of sponges, sharps, and instruments must be
performed and documented before the surgical incision to establish a baseline.
Subsequent counts are performed before closing a cavity, at skin closure, and at
the end of the procedure.
5. A surgical technologist is handing a sharp instrument to the surgeon. Which of
the following is the correct technique to prevent percutaneous injuries?
A) Hand the sharp directly to the surgeon with the blade facing the surgeon.
B) Place the sharp in a neutral zone, such as a sterile basin or magnetic pad.
C) Toss the sharp onto the sterile field if the surgeon is busy.
D) Announce "sharp coming" and hand it point-first.
Answer: B) Place the sharp in a neutral zone, such as a sterile basin or magnetic
pad.
Rationale: AORN advocates for the use of a "neutral zone" (a designated area on
the sterile field, like a basin or mat) for passing sharps to eliminate hand-to-hand
passing, which significantly reduces the risk of sharps injuries.
6. Which of the following patients is at the highest risk for developing a surgical
site infection (SSI)?
A) A 30-year-old undergoing a knee arthroscopy.
B) A 65-year-old diabetic patient with a blood glucose level of 220 mg/dL
undergoing a colon resection.
C) A 45-year-old undergoing a hernia repair who received a preoperative bath
with chlorhexidine.
D) A 50-year-old undergoing a cholecystectomy with normothermia maintained.
