Perioperative Nursing Final Exam: AORN
Standards & Surgical Safety (2026 Edition) by
Association of periOperative Registered
Nurses – Just Released for 2025/2026
Academic Year | Pass on Your First Attempt!
nurse's negligence or any intentional act that causes
physical, financial, emotional, psychosocial, and/or
cognitive damage to the person in the nurse's care
Respondeat Superior - ANSWER//An employer is legally
responsible for the nurse employee only when: o The
nurse acts within the scope of practice o Any allegations
brought against the nurse occurred during the nurse's
employment o The nurse's actions were within the
employer's best interests. Tort - ANSWER//A breach of
duty to another person as outlined by law What are the
four elements of malpractice? - ANSWER//• Duty • Breach
of duty • The breach of duty caused an injury • The injury
was harmful to the patient Elements of Informed Consent -
ANSWER//• Must be obtained by the licensed professional
who is performing the procedure • The patient must give
consent voluntarily with the full understanding of all
implications • Must include o Diagnosis o Proposed
treatment o Treatment alternatives o Consequences of
accepting or declining the proposed treatment Five Rights
of Delegation - ANSWER//Right task Right circumstance
Right person Right communication and direction Right
supervision and evaluation Four types of patient privacy
health care providers and personnel have an ethical and
legal responsibility to always maintain - ANSWER//•
Medical information • Physical exposure • Personal
privacy • Electronic privacy Eight factors to consider
before determining what anesthetic to use for a particular
patient - ANSWER//• Patient's age • Length & type of
surgery • Patient & surgeon preferences • Patient's co-
existing diseases • Patient's mental & psychological status
• Patient's previous experiences with anesthesia • Plans &
,protocols for postoperative pain management • Position of
the patient during surgery The American Society of
Anesthesiologist's NPO Guidelines - ANSWER//• Clear
liquids - stop 2 hours before surgery • Breast milk - stop 4
hours before surgery • Infant formula - stop 6 hours before
surgery • Light meal (toast & a clear liquid) - stop 6 hours
before surgery • Fried foods, fatty foods, meat - stop 8
hours before surgery Circulator RN duties during Induction
of anesthesia and assisting anesthesia professional with
Cricoid Pressure - ANSWER//• Cricoid pressure
application is not released until the endotracheal (ET) tube
cuff is inflated, tube placement is confirmed, and
anesthesia provider has given a verbal confirmation to the
nurse that the cricoid pressure can be released. • If
intubation or ventilation of the patient becomes difficult,
the perioperative nurse should retrieve additional airway
equipment and supplies. General anesthesia -
ANSWER//• A drug-induced reversible state of
unconsciousness • Results in amnesia, analgesia, and
loss of responsiveness, decreased stress response, and
loss of skeletal muscle reflexes to a varying degree
Regional anesthesia - ANSWER//• An injection of local
anesthetics near nerve fibers that causes reversible loss
of sensation over an area of the body • Examples include
spinal, epidural, and peripheral nerve blocks. Monitored
anesthesia care (MAC) - ANSWER//An anesthesia
provider monitors the patient, administers sedatives and
other agents as needed, and provides medical services as
required. Moderate sedation - ANSWER//• The
administration of sedative, analgesic, and/or anxiolytic
agents by a physician or by a nurse under physician
supervision • Depending on state laws and hospital
policies, an RN may administer moderate sedation. Local
anesthesia - ANSWER//• The infiltration or topical
administration of agents to anesthetize a part of the body •
The perioperative nurse provides patient monitoring and
supportive care. Phases of general anesthesia -
,ANSWER//• Phase I: Induction o IV medications and
inhalational agents are administered by the anesthesia
provider. • Phase II: Maintenance o Medications and
inhalational agents are administered to keep the patient
anesthetized. • Phase III: Emergence o At the end of the
procedure, the anesthetic agents are discontinued or
reversed to allow the patient to wake up. Anesthesia
Reversal agents: Muscle relaxants: - ANSWER//1.
neostigmine 2. edrophonium. Note: There is no reversal
agent for succinylcholine Anesthesia Reversal agents:
Sugammadex: - ANSWER//reversal agent for rocuronium,
vecuronium, and pancuronium Anesthesia Reversal
agents: Benzodiazepines: Midazolam -
ANSWER//Flumazenil Anesthesia Reversal agents:
Narcotics: Fentanyl: - ANSWER//Naloxone Patients at
Increased Risk for Hypothermia - ANSWER//• Older adults
• Infants and children • Women • Patients with lower-than-
normal body weight Medical Conditions Associated with
Increased Risk for Hypothermia - ANSWER//•
Hypothyroidism • Hypoglycemia • Burns • Trauma •
Hypotension • Congestive heart failure • Cardiac vessel
disease Signs of Malignant Hyperthermia (MH) -
ANSWER//• ΜΗ is triggered by inhalation anesthetic
gases and succinylcholine • Increased end-tidal carbon
dioxide is the most specific sign of MH. • Other signs
include skeletal muscle rigidity, ventricular dysrhythmia,
skin mottling, and hyperthermia. Medical professionals
who can provide anesthesia services are: - ANSWER//•
Anesthesiologists • Certified registered nurse anesthetists
(CRNAs) • Anesthesiologist assistants (AAs) Surgical
Safety Checklist Includes: - ANSWER//• Μοbility •
Preexisting health conditions • Planned duration of the
procedure. • Type of anesthesia The Preoperative Nurse
Visit Should Include: - ANSWER//• Introduce yourself and
ask your patient how they would like to be addressed. •
Confirm your patient's identity with two patient identifier • If
your patient discusses suicidal thoughts during the
, preoperative visit, report this immediately by following your
facility's policy and procedure. • Use the same scale for
pain assessment throughout all patient care areas. •
Consider all elements of patient care needs prior to
surgery. • Consider how the required surgical position may
impact a current condition that the patient contends with.
A Medication Assessment Should Include: - ANSWER//•
Prescription medications • Herbal preparations: o may
accentuate the toxicity of anesthetics. o interfere with drug
metabolism or clearance. o might affect bleeding times. •
Recreational/street drugs *It is also important to ask if the
patient is using any recreational/street drugs. Close
observation must be maintained for symptoms of
withdrawal, especially during and after long procedures. •
Drugs, alcohol, and smoking can alter lab values or
system assessment. A chemically dependent patient who
is recovering may have concerns about medication he or
she is given. • Patient risk factors due to alcoholism
include: - Lowered immunity - Prolonged bleeding times -
Increased stress response - Cardiac complications
Physiological Effects of Cannabis Include: - ANSWER//-
Tachycardia - atherosclerosis - Airway edema - chronic
bronchitis - Increased appetite - hyperemesis - Paranoia -
BIS elevation - unknown tolerance to analgesics -
Potential increase in pain Elements of SDOH (Social
Determinants of Health) include: - ANSWER//• Economic
Stability • Education • Social and Community Context •
Health and Health Care • Neighborhood and Built
Environment A patient's risk factors for hypothermia
include: - ANSWER//• Extremes in the patient's age (eg,
pediatric, elderly) • History of diabetes • Low body weight •
Peripheral vascular disorders • Thyroid disorders - An
example of a procedural risk for hypothermia is open-
cavity surgery (eg, laparotomy, open thoracotomy).
Potential benefits of minimally invasive surgery include: -
ANSWER//• Decreased risk of surgical site infections •
Decreased tissue trauma • Reduced intraoperative blood
Standards & Surgical Safety (2026 Edition) by
Association of periOperative Registered
Nurses – Just Released for 2025/2026
Academic Year | Pass on Your First Attempt!
nurse's negligence or any intentional act that causes
physical, financial, emotional, psychosocial, and/or
cognitive damage to the person in the nurse's care
Respondeat Superior - ANSWER//An employer is legally
responsible for the nurse employee only when: o The
nurse acts within the scope of practice o Any allegations
brought against the nurse occurred during the nurse's
employment o The nurse's actions were within the
employer's best interests. Tort - ANSWER//A breach of
duty to another person as outlined by law What are the
four elements of malpractice? - ANSWER//• Duty • Breach
of duty • The breach of duty caused an injury • The injury
was harmful to the patient Elements of Informed Consent -
ANSWER//• Must be obtained by the licensed professional
who is performing the procedure • The patient must give
consent voluntarily with the full understanding of all
implications • Must include o Diagnosis o Proposed
treatment o Treatment alternatives o Consequences of
accepting or declining the proposed treatment Five Rights
of Delegation - ANSWER//Right task Right circumstance
Right person Right communication and direction Right
supervision and evaluation Four types of patient privacy
health care providers and personnel have an ethical and
legal responsibility to always maintain - ANSWER//•
Medical information • Physical exposure • Personal
privacy • Electronic privacy Eight factors to consider
before determining what anesthetic to use for a particular
patient - ANSWER//• Patient's age • Length & type of
surgery • Patient & surgeon preferences • Patient's co-
existing diseases • Patient's mental & psychological status
• Patient's previous experiences with anesthesia • Plans &
,protocols for postoperative pain management • Position of
the patient during surgery The American Society of
Anesthesiologist's NPO Guidelines - ANSWER//• Clear
liquids - stop 2 hours before surgery • Breast milk - stop 4
hours before surgery • Infant formula - stop 6 hours before
surgery • Light meal (toast & a clear liquid) - stop 6 hours
before surgery • Fried foods, fatty foods, meat - stop 8
hours before surgery Circulator RN duties during Induction
of anesthesia and assisting anesthesia professional with
Cricoid Pressure - ANSWER//• Cricoid pressure
application is not released until the endotracheal (ET) tube
cuff is inflated, tube placement is confirmed, and
anesthesia provider has given a verbal confirmation to the
nurse that the cricoid pressure can be released. • If
intubation or ventilation of the patient becomes difficult,
the perioperative nurse should retrieve additional airway
equipment and supplies. General anesthesia -
ANSWER//• A drug-induced reversible state of
unconsciousness • Results in amnesia, analgesia, and
loss of responsiveness, decreased stress response, and
loss of skeletal muscle reflexes to a varying degree
Regional anesthesia - ANSWER//• An injection of local
anesthetics near nerve fibers that causes reversible loss
of sensation over an area of the body • Examples include
spinal, epidural, and peripheral nerve blocks. Monitored
anesthesia care (MAC) - ANSWER//An anesthesia
provider monitors the patient, administers sedatives and
other agents as needed, and provides medical services as
required. Moderate sedation - ANSWER//• The
administration of sedative, analgesic, and/or anxiolytic
agents by a physician or by a nurse under physician
supervision • Depending on state laws and hospital
policies, an RN may administer moderate sedation. Local
anesthesia - ANSWER//• The infiltration or topical
administration of agents to anesthetize a part of the body •
The perioperative nurse provides patient monitoring and
supportive care. Phases of general anesthesia -
,ANSWER//• Phase I: Induction o IV medications and
inhalational agents are administered by the anesthesia
provider. • Phase II: Maintenance o Medications and
inhalational agents are administered to keep the patient
anesthetized. • Phase III: Emergence o At the end of the
procedure, the anesthetic agents are discontinued or
reversed to allow the patient to wake up. Anesthesia
Reversal agents: Muscle relaxants: - ANSWER//1.
neostigmine 2. edrophonium. Note: There is no reversal
agent for succinylcholine Anesthesia Reversal agents:
Sugammadex: - ANSWER//reversal agent for rocuronium,
vecuronium, and pancuronium Anesthesia Reversal
agents: Benzodiazepines: Midazolam -
ANSWER//Flumazenil Anesthesia Reversal agents:
Narcotics: Fentanyl: - ANSWER//Naloxone Patients at
Increased Risk for Hypothermia - ANSWER//• Older adults
• Infants and children • Women • Patients with lower-than-
normal body weight Medical Conditions Associated with
Increased Risk for Hypothermia - ANSWER//•
Hypothyroidism • Hypoglycemia • Burns • Trauma •
Hypotension • Congestive heart failure • Cardiac vessel
disease Signs of Malignant Hyperthermia (MH) -
ANSWER//• ΜΗ is triggered by inhalation anesthetic
gases and succinylcholine • Increased end-tidal carbon
dioxide is the most specific sign of MH. • Other signs
include skeletal muscle rigidity, ventricular dysrhythmia,
skin mottling, and hyperthermia. Medical professionals
who can provide anesthesia services are: - ANSWER//•
Anesthesiologists • Certified registered nurse anesthetists
(CRNAs) • Anesthesiologist assistants (AAs) Surgical
Safety Checklist Includes: - ANSWER//• Μοbility •
Preexisting health conditions • Planned duration of the
procedure. • Type of anesthesia The Preoperative Nurse
Visit Should Include: - ANSWER//• Introduce yourself and
ask your patient how they would like to be addressed. •
Confirm your patient's identity with two patient identifier • If
your patient discusses suicidal thoughts during the
, preoperative visit, report this immediately by following your
facility's policy and procedure. • Use the same scale for
pain assessment throughout all patient care areas. •
Consider all elements of patient care needs prior to
surgery. • Consider how the required surgical position may
impact a current condition that the patient contends with.
A Medication Assessment Should Include: - ANSWER//•
Prescription medications • Herbal preparations: o may
accentuate the toxicity of anesthetics. o interfere with drug
metabolism or clearance. o might affect bleeding times. •
Recreational/street drugs *It is also important to ask if the
patient is using any recreational/street drugs. Close
observation must be maintained for symptoms of
withdrawal, especially during and after long procedures. •
Drugs, alcohol, and smoking can alter lab values or
system assessment. A chemically dependent patient who
is recovering may have concerns about medication he or
she is given. • Patient risk factors due to alcoholism
include: - Lowered immunity - Prolonged bleeding times -
Increased stress response - Cardiac complications
Physiological Effects of Cannabis Include: - ANSWER//-
Tachycardia - atherosclerosis - Airway edema - chronic
bronchitis - Increased appetite - hyperemesis - Paranoia -
BIS elevation - unknown tolerance to analgesics -
Potential increase in pain Elements of SDOH (Social
Determinants of Health) include: - ANSWER//• Economic
Stability • Education • Social and Community Context •
Health and Health Care • Neighborhood and Built
Environment A patient's risk factors for hypothermia
include: - ANSWER//• Extremes in the patient's age (eg,
pediatric, elderly) • History of diabetes • Low body weight •
Peripheral vascular disorders • Thyroid disorders - An
example of a procedural risk for hypothermia is open-
cavity surgery (eg, laparotomy, open thoracotomy).
Potential benefits of minimally invasive surgery include: -
ANSWER//• Decreased risk of surgical site infections •
Decreased tissue trauma • Reduced intraoperative blood
