RELIAS OPERATING ROOM RN A V2 Actual
Exam | Official Practice Exam – Complete
Q&A with Rationales – Pass Guaranteed -
A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Perioperative Nursing Principles & Aseptic Technique | Q1 – Q10
Section 2 | Surgical Instrumentation & Equipment | Q11 – Q20
Section 3 | Patient Safety & Positioning | Q21 – Q30
Section 4 | Sterilization, High-Level Disinfection & Environmental Controls | Q31 – Q40
Section 5 | Emergency Situations & Surgical Team Collaboration | Q41 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: PERIOPERATIVE NURSING PRINCIPLES & ASEPTIC TECHNIQUE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
During a laparoscopic cholecystectomy, the surgeon asks the scrub tech to pass a
laparoscopic grasper. The scrub tech holds the instrument above the sterile field while
the surgeon reaches across to grasp it, causing the scrub tech's gown sleeve to brush
against the surgeon's ungloved arm.
A. The scrub tech should have placed the instrument directly into the surgeon's hand. ✓
CORRECT
B. The scrub tech should have dropped the instrument onto the back table for pickup.
C. The surgeon should have put on a sterile glove before reaching for the instrument.
D. The circulator should have passed the instrument to avoid any contact.
,Correct Answer: A
Rationale: Instruments must always be passed directly hand-to-hand within the sterile
field to prevent contact between sterile and unsterile surfaces. Allowing the surgeon to
reach across the field from an unsterile area contaminated the scrub tech's gown
sleeve. The circulator is unsterile and should never pass instruments directly to the
sterile field.
Question 2 of 50
A 62-year-old patient is scheduled for an open right hemicolectomy. In the preoperative
holding area, the circulator reviews the chart and notes the patient received
chlorhexidine gluconate skin prep in the holding area. The patient reports a severe
shellfish allergy.
A. Apply povidone-iodine as an alternative prep in the operating room.
B. Continue with the planned procedure using chlorhexidine gluconate. ✓ CORRECT
C. Cancel the case until the allergy service clears the patient.
D. Rinse the prep site with sterile saline to remove the chlorhexidine.
Correct Answer: B
Rationale: Chlorhexidine gluconate is the preferred prep solution for patients with
shellfish allergies because it does not contain iodine, which cross-reacts with shellfish
proteins. Povidone-iodine is iodine-based and should be avoided in these patients.
There is no need to cancel the case or rinse the site when the correct prep has already
been applied.
Question 3 of 50
The circulator opens a sterile major abdominal instrument tray and notices that the
internal chemical indicator is missing from the wrapped set. The tray was processed
through the steam sterilizer earlier that morning.
, A. Proceed with the case and document the missing indicator in the sterilization log.
B. Use the tray only for non-sterile portions of the procedure.
C. Remove and replace the tray immediately. ✓ CORRECT
D. Ask the scrub tech to add an indicator before the case begins.
Correct Answer: C
Rationale: A missing chemical indicator means the sterilization process cannot be
verified for that specific pack, so the tray must be removed from use and replaced with
a properly monitored set. Proceeding without verification violates basic sterility
assurance principles. Indicators cannot be added after the fact because they must be
exposed to the sterilization cycle inside the pack.
Question 4 of 50
In the preoperative holding area, a 58-year-old patient scheduled for a total knee
arthroplasty has vital signs recorded as heart rate 45 bpm, blood pressure 171/95
mmHg, respiratory rate 14, and SpO2 96% on room air. The patient denies chest pain
and reports feeling well.
A. Proceed with transport to the operating room since the patient is asymptomatic.
B. Administer a beta-blocker to control the blood pressure before transport.
C. Place the patient in Trendelenburg position to increase the heart rate.
D. Contact the anesthesia provider immediately. ✓ CORRECT
Correct Answer: D
Rationale: Significant bradycardia combined with hypertension in the preoperative
setting warrants immediate notification of the anesthesia provider to evaluate for
possible autonomic dysfunction, medication effects, or cardiac conduction issues.
Proceeding without evaluation could lead to hemodynamic instability under anesthesia.
Trendelenburg is inappropriate for bradycardia and beta-blockers should not be given
without provider orders.
Question 5 of 50
Exam | Official Practice Exam – Complete
Q&A with Rationales – Pass Guaranteed -
A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Perioperative Nursing Principles & Aseptic Technique | Q1 – Q10
Section 2 | Surgical Instrumentation & Equipment | Q11 – Q20
Section 3 | Patient Safety & Positioning | Q21 – Q30
Section 4 | Sterilization, High-Level Disinfection & Environmental Controls | Q31 – Q40
Section 5 | Emergency Situations & Surgical Team Collaboration | Q41 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: PERIOPERATIVE NURSING PRINCIPLES & ASEPTIC TECHNIQUE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
During a laparoscopic cholecystectomy, the surgeon asks the scrub tech to pass a
laparoscopic grasper. The scrub tech holds the instrument above the sterile field while
the surgeon reaches across to grasp it, causing the scrub tech's gown sleeve to brush
against the surgeon's ungloved arm.
A. The scrub tech should have placed the instrument directly into the surgeon's hand. ✓
CORRECT
B. The scrub tech should have dropped the instrument onto the back table for pickup.
C. The surgeon should have put on a sterile glove before reaching for the instrument.
D. The circulator should have passed the instrument to avoid any contact.
,Correct Answer: A
Rationale: Instruments must always be passed directly hand-to-hand within the sterile
field to prevent contact between sterile and unsterile surfaces. Allowing the surgeon to
reach across the field from an unsterile area contaminated the scrub tech's gown
sleeve. The circulator is unsterile and should never pass instruments directly to the
sterile field.
Question 2 of 50
A 62-year-old patient is scheduled for an open right hemicolectomy. In the preoperative
holding area, the circulator reviews the chart and notes the patient received
chlorhexidine gluconate skin prep in the holding area. The patient reports a severe
shellfish allergy.
A. Apply povidone-iodine as an alternative prep in the operating room.
B. Continue with the planned procedure using chlorhexidine gluconate. ✓ CORRECT
C. Cancel the case until the allergy service clears the patient.
D. Rinse the prep site with sterile saline to remove the chlorhexidine.
Correct Answer: B
Rationale: Chlorhexidine gluconate is the preferred prep solution for patients with
shellfish allergies because it does not contain iodine, which cross-reacts with shellfish
proteins. Povidone-iodine is iodine-based and should be avoided in these patients.
There is no need to cancel the case or rinse the site when the correct prep has already
been applied.
Question 3 of 50
The circulator opens a sterile major abdominal instrument tray and notices that the
internal chemical indicator is missing from the wrapped set. The tray was processed
through the steam sterilizer earlier that morning.
, A. Proceed with the case and document the missing indicator in the sterilization log.
B. Use the tray only for non-sterile portions of the procedure.
C. Remove and replace the tray immediately. ✓ CORRECT
D. Ask the scrub tech to add an indicator before the case begins.
Correct Answer: C
Rationale: A missing chemical indicator means the sterilization process cannot be
verified for that specific pack, so the tray must be removed from use and replaced with
a properly monitored set. Proceeding without verification violates basic sterility
assurance principles. Indicators cannot be added after the fact because they must be
exposed to the sterilization cycle inside the pack.
Question 4 of 50
In the preoperative holding area, a 58-year-old patient scheduled for a total knee
arthroplasty has vital signs recorded as heart rate 45 bpm, blood pressure 171/95
mmHg, respiratory rate 14, and SpO2 96% on room air. The patient denies chest pain
and reports feeling well.
A. Proceed with transport to the operating room since the patient is asymptomatic.
B. Administer a beta-blocker to control the blood pressure before transport.
C. Place the patient in Trendelenburg position to increase the heart rate.
D. Contact the anesthesia provider immediately. ✓ CORRECT
Correct Answer: D
Rationale: Significant bradycardia combined with hypertension in the preoperative
setting warrants immediate notification of the anesthesia provider to evaluate for
possible autonomic dysfunction, medication effects, or cardiac conduction issues.
Proceeding without evaluation could lead to hemodynamic instability under anesthesia.
Trendelenburg is inappropriate for bradycardia and beta-blockers should not be given
without provider orders.
Question 5 of 50
