Page 1 of 235
NIFA Perioperative Quiz 1 & 2 Actual
Exam 2026/2027
Question 1
Scenario: A 68-year-old patient with a history of hypertension
and diabetes is scheduled for an elective laparoscopic
cholecystectomy. During preoperative assessment, the patient
reports taking 81 mg of aspirin daily for cardiac protection. The
patient's last dose was yesterday. What is the MOST
appropriate action?
A) Proceed with surgery as scheduled since aspirin 81 mg is a
low dose
B) Cancel the surgery and reschedule for 14 days later
C) Consult with the surgeon and anesthesiologist regarding
bleeding risk
D) Administer vitamin K to reverse the aspirin effect
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Answer: C
Rationale: Low-dose aspirin (81 mg) for cardiac protection may
need to be continued perioperatively depending on the patient's
cardiac risk factors and the type of surgery. The perioperative
nurse should facilitate communication between the surgical and
anesthesia teams to determine the risk-benefit ratio of continuing
or holding aspirin. Elective laparoscopic cholecystectomy has
variable bleeding risk, and the decision requires multidisciplinary
input. Vitamin K does not reverse aspirin (which irreversibly
inhibits cyclooxygenase), and proceeding without consultation
risks complications.
Question 2
A surgical first assistant is positioning a patient for a posterior
lumbar fusion. Which positioning device requires verification of
proper pressure distribution BEFORE the patient is anesthetized?
,Page 3 of 235
A) Wilson frame
B) Jackson table with spine attachments
C) Gel rolls for axillary support
D) Prone positioner with chest rolls
Answer: C
Rationale: Gel rolls placed under the axillae for prone
positioning MUST be verified before anesthesia induction to
ensure they are positioned correctly to avoid brachial plexus
injury. After induction, the patient cannot communicate pressure
points or malpositioning. While all positioning devices require
verification, axillary gel rolls pose specific risk for nerve injury if
malpositioned, and pre-induction verification allows the awake
patient to confirm comfort.
Question 3
, Page 4 of 235
Scenario: During a total knee arthroplasty, the surgical
technologist hands the surgeon a loaded scalpel handle. The
surgeon completes the skin incision and hands the scalpel back.
What is the correct protocol for the surgical technologist?
A) Place the scalpel on the Mayo stand for reuse
B) Place the scalpel in the neutral zone (hands-free transfer) for
passing back
C) Discard the scalpel blade immediately into the sharps
container
D) Recap the blade using the one-handed scoop technique
Answer: C
Rationale: Used scalpel blades must be immediately discarded
into an approved sharps container by the person who used them
(or received them) to prevent sharps injuries. The neutral zone
(hands-free transfer) is for PASSING instruments, not for
discarding. Recapping is prohibited under OSHA Bloodborne
NIFA Perioperative Quiz 1 & 2 Actual
Exam 2026/2027
Question 1
Scenario: A 68-year-old patient with a history of hypertension
and diabetes is scheduled for an elective laparoscopic
cholecystectomy. During preoperative assessment, the patient
reports taking 81 mg of aspirin daily for cardiac protection. The
patient's last dose was yesterday. What is the MOST
appropriate action?
A) Proceed with surgery as scheduled since aspirin 81 mg is a
low dose
B) Cancel the surgery and reschedule for 14 days later
C) Consult with the surgeon and anesthesiologist regarding
bleeding risk
D) Administer vitamin K to reverse the aspirin effect
,Page 2 of 235
Answer: C
Rationale: Low-dose aspirin (81 mg) for cardiac protection may
need to be continued perioperatively depending on the patient's
cardiac risk factors and the type of surgery. The perioperative
nurse should facilitate communication between the surgical and
anesthesia teams to determine the risk-benefit ratio of continuing
or holding aspirin. Elective laparoscopic cholecystectomy has
variable bleeding risk, and the decision requires multidisciplinary
input. Vitamin K does not reverse aspirin (which irreversibly
inhibits cyclooxygenase), and proceeding without consultation
risks complications.
Question 2
A surgical first assistant is positioning a patient for a posterior
lumbar fusion. Which positioning device requires verification of
proper pressure distribution BEFORE the patient is anesthetized?
,Page 3 of 235
A) Wilson frame
B) Jackson table with spine attachments
C) Gel rolls for axillary support
D) Prone positioner with chest rolls
Answer: C
Rationale: Gel rolls placed under the axillae for prone
positioning MUST be verified before anesthesia induction to
ensure they are positioned correctly to avoid brachial plexus
injury. After induction, the patient cannot communicate pressure
points or malpositioning. While all positioning devices require
verification, axillary gel rolls pose specific risk for nerve injury if
malpositioned, and pre-induction verification allows the awake
patient to confirm comfort.
Question 3
, Page 4 of 235
Scenario: During a total knee arthroplasty, the surgical
technologist hands the surgeon a loaded scalpel handle. The
surgeon completes the skin incision and hands the scalpel back.
What is the correct protocol for the surgical technologist?
A) Place the scalpel on the Mayo stand for reuse
B) Place the scalpel in the neutral zone (hands-free transfer) for
passing back
C) Discard the scalpel blade immediately into the sharps
container
D) Recap the blade using the one-handed scoop technique
Answer: C
Rationale: Used scalpel blades must be immediately discarded
into an approved sharps container by the person who used them
(or received them) to prevent sharps injuries. The neutral zone
(hands-free transfer) is for PASSING instruments, not for
discarding. Recapping is prohibited under OSHA Bloodborne
