AORN PERIOP 101 EXAM 2 2026/2027 | Perioperative
Study Guide | 100% Verified Answers | Pass Guaranteed -
A+ Graded
Section 1: Surgical Asepsis & Sterile Technique Application
(Questions 1-15)
Question 1
A circulating nurse observes a scrubbed surgical technologist reach across the sterile
field to retrieve a dropped instrument from the Mayo stand. The instrument was
below the level of the sterile field when retrieved. Which action is required?
A. Continue the procedure with heightened observation
B. Replace only the instrument that was dropped
C. Consider the entire sterile field contaminated and establish a new field [CORRECT]
D. Have the technologist reglove and continue
Rationale: Reaching across the sterile field violates the principle that the back and
sides of the sterile gown, as well as anything below waist level, are considered
unsterile. When a scrubbed person reaches below the sterile field, the front of the
gown may contact unsterile areas, contaminating the entire field. Only replacing the
instrument or regloving is insufficient because the gown itself may be contaminated.
Correct Answer: C
Question 2
During a total knee arthroplasty, the scrub nurse turns away from the sterile field to
speak with the anesthesia provider. The back of the sterile gown faces the sterile
instruments. Which principle of surgical asepsis has been violated?
,A. The sterile field must remain within the line of sight at all times
B. The back of the gown is considered unsterile [CORRECT]
C. Only the front of the gown below the waist is unsterile
D. Speaking during surgery contaminates the field
Rationale: The back of a sterile gown is considered unsterile because it cannot be
observed by the wearer and may contact non-sterile surfaces. Turning the back to
the sterile field risks contamination of instruments. The sides and back of the gown,
as well as areas below the waist and above the neckline, are all considered unsterile
zones.
Correct Answer: B
Question 3
A perioperative nurse is opening a sterile package of sutures using the sterile-to-
sterile transfer technique. The wrapper is opened with the non-sterile hand while the
sterile item is presented to the scrubbed person. Which action by the circulating
nurse would contaminate the suture package?
A. Holding the wrapper by the outer 1-inch border
B. Touching the inner surface of the wrapper that will contact the sterile field
[CORRECT]
C. Allowing the wrapper to fall below waist level after opening
D. Peeling the wrapper back slowly and deliberately
Rationale: The inner surface of the sterile wrapper is considered sterile and must not
be touched by ungloved hands. The outer 1-inch border is considered non-sterile
and is the only area the circulating nurse should handle. Allowing the wrapper to fall
below waist level is also a break, but touching the inner surface directly contaminates
the item itself.
Correct Answer: B
,Question 4
A scrubbed surgical technologist needs to pour sterile saline into a sterile basin on
the back table. Which technique is correct?
A. Hold the bottle with the label facing the palm and pour from a height of 6-12
inches above the basin [CORRECT]
B. Hold the bottle with the label facing outward and pour directly onto the sterile
field
C. Touch the lip of the bottle to the edge of the basin to guide the pour
D. Pour the solution from a height greater than 12 inches to ensure clearance
Rationale: When pouring sterile solutions, the label should face the palm to prevent
solution from running over and obscuring the label. The bottle should be held 6-12
inches above the receptacle to prevent splashing while avoiding contact between the
bottle lip and the sterile field. Touching the lip to any surface contaminates it, and
pouring from excessive height causes splashing that may breach asepsis.
Correct Answer: A
Question 5
During a laparoscopic cholecystectomy, the surgeon's glove is punctured by a trocar
needle. The surgeon does not notice the puncture. The scrub nurse observes a visible
tear in the glove. What is the first action the scrub nurse must take?
A. Wait until the end of the procedure to mention it
B. Immediately inform the surgeon and assist with regloving [CORRECT]
C. Apply a sterile glove patch over the tear
D. Document the incident in the operative record only
Rationale: A punctured or torn glove represents a break in sterile technique and
must be addressed immediately to prevent microbial transmission from the
surgeon's skin to the sterile field or patient wound. Glove patches are not standard
practice and do not ensure sterility. Delayed notification risks patient infection;
documentation is important but secondary to immediate corrective action.
Correct Answer: B
, Question 6
A sterile instrument set is opened on the back table. The circulating nurse opens the
outer wrapper and presents the inner sterile package to the scrubbed technologist.
Which area of the wrapper is considered contaminated and must not contact the
sterile field?
A. The inner surface that was folded to the inside
B. The outer 1-inch border of the wrapper [CORRECT]
C. The center panel that was protected by the folds
D. The flaps that were opened by the circulating nurse
Rationale: The outer 1-inch border of any sterile wrapper is considered non-sterile
because it is handled by ungloved hands during opening and may have contacted
the external environment. The inner surfaces, center panel, and opened flaps (if
opened without touching the inner surface) remain sterile. This principle applies to all
wrapped sterile items.
Correct Answer: B
Question 7
A perioperative nurse is preparing to open a sterile peel-pack containing a scalpel.
Which technique ensures aseptic presentation to the scrubbed person?
A. Pull the tabs apart quickly to minimize air exposure
B. Peel the package open slowly, presenting the item without touching the inner
surface [CORRECT]
C. Open the package and drop the item onto the sterile field from 12 inches above
D. Tear the package open at the corner and remove the item with bare hands
Rationale: Peel-pack items are opened by slowly separating the sealed edges
(peeling), which presents the sterile item while maintaining the integrity of the inner
sterile surface. The item should not be dropped (risk of contamination on landing),
Study Guide | 100% Verified Answers | Pass Guaranteed -
A+ Graded
Section 1: Surgical Asepsis & Sterile Technique Application
(Questions 1-15)
Question 1
A circulating nurse observes a scrubbed surgical technologist reach across the sterile
field to retrieve a dropped instrument from the Mayo stand. The instrument was
below the level of the sterile field when retrieved. Which action is required?
A. Continue the procedure with heightened observation
B. Replace only the instrument that was dropped
C. Consider the entire sterile field contaminated and establish a new field [CORRECT]
D. Have the technologist reglove and continue
Rationale: Reaching across the sterile field violates the principle that the back and
sides of the sterile gown, as well as anything below waist level, are considered
unsterile. When a scrubbed person reaches below the sterile field, the front of the
gown may contact unsterile areas, contaminating the entire field. Only replacing the
instrument or regloving is insufficient because the gown itself may be contaminated.
Correct Answer: C
Question 2
During a total knee arthroplasty, the scrub nurse turns away from the sterile field to
speak with the anesthesia provider. The back of the sterile gown faces the sterile
instruments. Which principle of surgical asepsis has been violated?
,A. The sterile field must remain within the line of sight at all times
B. The back of the gown is considered unsterile [CORRECT]
C. Only the front of the gown below the waist is unsterile
D. Speaking during surgery contaminates the field
Rationale: The back of a sterile gown is considered unsterile because it cannot be
observed by the wearer and may contact non-sterile surfaces. Turning the back to
the sterile field risks contamination of instruments. The sides and back of the gown,
as well as areas below the waist and above the neckline, are all considered unsterile
zones.
Correct Answer: B
Question 3
A perioperative nurse is opening a sterile package of sutures using the sterile-to-
sterile transfer technique. The wrapper is opened with the non-sterile hand while the
sterile item is presented to the scrubbed person. Which action by the circulating
nurse would contaminate the suture package?
A. Holding the wrapper by the outer 1-inch border
B. Touching the inner surface of the wrapper that will contact the sterile field
[CORRECT]
C. Allowing the wrapper to fall below waist level after opening
D. Peeling the wrapper back slowly and deliberately
Rationale: The inner surface of the sterile wrapper is considered sterile and must not
be touched by ungloved hands. The outer 1-inch border is considered non-sterile
and is the only area the circulating nurse should handle. Allowing the wrapper to fall
below waist level is also a break, but touching the inner surface directly contaminates
the item itself.
Correct Answer: B
,Question 4
A scrubbed surgical technologist needs to pour sterile saline into a sterile basin on
the back table. Which technique is correct?
A. Hold the bottle with the label facing the palm and pour from a height of 6-12
inches above the basin [CORRECT]
B. Hold the bottle with the label facing outward and pour directly onto the sterile
field
C. Touch the lip of the bottle to the edge of the basin to guide the pour
D. Pour the solution from a height greater than 12 inches to ensure clearance
Rationale: When pouring sterile solutions, the label should face the palm to prevent
solution from running over and obscuring the label. The bottle should be held 6-12
inches above the receptacle to prevent splashing while avoiding contact between the
bottle lip and the sterile field. Touching the lip to any surface contaminates it, and
pouring from excessive height causes splashing that may breach asepsis.
Correct Answer: A
Question 5
During a laparoscopic cholecystectomy, the surgeon's glove is punctured by a trocar
needle. The surgeon does not notice the puncture. The scrub nurse observes a visible
tear in the glove. What is the first action the scrub nurse must take?
A. Wait until the end of the procedure to mention it
B. Immediately inform the surgeon and assist with regloving [CORRECT]
C. Apply a sterile glove patch over the tear
D. Document the incident in the operative record only
Rationale: A punctured or torn glove represents a break in sterile technique and
must be addressed immediately to prevent microbial transmission from the
surgeon's skin to the sterile field or patient wound. Glove patches are not standard
practice and do not ensure sterility. Delayed notification risks patient infection;
documentation is important but secondary to immediate corrective action.
Correct Answer: B
, Question 6
A sterile instrument set is opened on the back table. The circulating nurse opens the
outer wrapper and presents the inner sterile package to the scrubbed technologist.
Which area of the wrapper is considered contaminated and must not contact the
sterile field?
A. The inner surface that was folded to the inside
B. The outer 1-inch border of the wrapper [CORRECT]
C. The center panel that was protected by the folds
D. The flaps that were opened by the circulating nurse
Rationale: The outer 1-inch border of any sterile wrapper is considered non-sterile
because it is handled by ungloved hands during opening and may have contacted
the external environment. The inner surfaces, center panel, and opened flaps (if
opened without touching the inner surface) remain sterile. This principle applies to all
wrapped sterile items.
Correct Answer: B
Question 7
A perioperative nurse is preparing to open a sterile peel-pack containing a scalpel.
Which technique ensures aseptic presentation to the scrubbed person?
A. Pull the tabs apart quickly to minimize air exposure
B. Peel the package open slowly, presenting the item without touching the inner
surface [CORRECT]
C. Open the package and drop the item onto the sterile field from 12 inches above
D. Tear the package open at the corner and remove the item with bare hands
Rationale: Peel-pack items are opened by slowly separating the sealed edges
(peeling), which presents the sterile item while maintaining the integrity of the inner
sterile surface. The item should not be dropped (risk of contamination on landing),
