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AORN Periop 101 Final Exam Actual Exam
2026/2027 | Complete Exam-Style Questions |
100% Verified – Detailed Rationales – Pass
Guaranteed – A+ Graded
[SECTION 1: Preoperative Nursing Care — Questions 1-20]
Q1: The perioperative nurse is conducting a preoperative assessment for a patient scheduled for a
cholecystectomy. Which finding in the patient's medical history places them at the highest risk
for malignant hyperthermia (MH)?
A. Type 1 Diabetes Mellitus
B. Latex allergy
C. Family history of anesthesia complications
C. Family history of anesthesia complications [CORRECT]
D. Chronic obstructive pulmonary disease (COPD)
Correct Answer: C
Rationale: Malignant hyperthermia (MH) is a life-threatening hypermetabolic reaction triggered
by volatile anesthetics (e.g., sevoflurane) or succinylcholine in genetically susceptible
individuals. A family history of anesthesia complications or MH is the most significant red flag
during the preoperative assessment because the condition is inherited as an autosomal dominant
trait. While latex allergy (B) is important for planning, it does not trigger MH. Diabetes (A) and
COPD (D) are risk factors for respiratory and metabolic complications but are not direct
indicators for MH susceptibility.
Q2: During the preoperative interview, the patient states they took ibuprofen 400 mg two hours
ago for a headache. What is the nurse's priority action?
A. Document the medication and proceed to surgery.
B. Administer a proton pump inhibitor (PPI) intravenously.
C. Notify the anesthesia provider immediately.
C. Notify the anesthesia provider immediately. [CORRECT]
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D. Cancel the surgery due to increased bleeding risk.
Correct Answer: C
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits platelet
aggregation, potentially increasing the risk of intraoperative bleeding. While documentation (A)
is necessary, the priority is communication with the anesthesia provider to assess the risk versus
benefit of proceeding. The anesthesia provider may decide to proceed or wait depending on the
type of surgery and the patient's coagulation status. Administering a PPI (B) is not the immediate
priority, and cancelling the surgery (D) is a decision made by the surgeon and anesthesiologist,
not the nurse independently.
Q3: The nurse is verifying the patient's NPO status. According to AORN guidelines, what is the
appropriate instruction for a healthy adult regarding clear liquids prior to elective surgery
requiring general anesthesia?
A. NPO after midnight regardless of surgery time.
B. NPO for 8 hours for all liquids.
C. NPO for 2 hours for clear liquids.
C. NPO for 2 hours for clear liquids. [CORRECT]
D. NPO for 6 hours for clear liquids.
Correct Answer: C
Rationale: Current AORN and American Society of Anesthesiologists (ASA) guidelines allow
clear liquids (e.g., water, pulpless juice, black coffee) up to 2 hours before elective surgery in
healthy individuals. This reduces patient dehydration and anxiety without significantly increasing
gastric volume or acidity. NPO after midnight (A) is outdated practice. NPO for 8 hours (B) or 6
hours (D) applies to light meals or solids, not clear liquids.
Q4: Which of the following elements must be verified by the registered nurse during the
preoperative assessment to ensure valid informed consent?
A. The patient understands the risks, benefits, and alternatives.
A. The patient understands the risks, benefits, and alternatives. [CORRECT]
,3
B. The patient has signed the form in the presence of the surgeon.
C. The family member agrees with the procedure.
D. The patient has not eaten or drunk anything for 12 hours.
Correct Answer: A
Rationale: Valid informed consent requires that the patient (or legal guardian) receives an
explanation of the diagnosis, the proposed procedure, the risks, benefits, and alternatives, and has
the opportunity to ask questions. The nurse's role is to witness the patient’s understanding of
these elements, not just the signature. While the signature usually occurs with the surgeon (B),
the nurse verifies understanding. Family agreement (D) is not required if the patient is
competent. NPO status (D) is a clinical instruction, not a component of the legal consent
document.
Q5: The preoperative nurse is teaching a patient about postoperative deep vein thrombosis
(DVT) prophylaxis. Which statement by the patient indicates a need for further teaching?
A. "I will wear the sequential compression device (SCD) while in bed."
B. "I will perform ankle pumps every hour while awake."
C. "I will stay in bed for the first 2 days to prevent bleeding."
C. "I will stay in bed for the first 2 days to prevent bleeding." [CORRECT]
D. "I will take my prescribed blood thinner as instructed."
Correct Answer: C
Rationale: Early ambulation is a critical intervention for preventing DVTs. Staying in bed for 48
hours (C) significantly increases the risk of venous stasis and thrombus formation. SCDs (A),
ankle pumps (B), and anticoagulants (D) are all appropriate adjunct therapies, but immobility
contradicts best practices for DVT prevention. The nurse should reinforce the importance of
mobilization as soon as ordered.
Q6: A patient with a history of hypertension lists their home medications. Which medication is
most likely to be held on the morning of surgery according to typical preoperative protocols?
A. Lisinopril (ACE inhibitor)
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A. Lisinopril (ACE inhibitor) [CORRECT]
B. Levothyroxine
C. Prednisone
D. Metformin
Correct Answer: A
Rationale: ACE inhibitors like Lisinopril are often held on the morning of surgery because they
can increase the risk of refractory intraoperative hypotension, particularly under general
anesthesia. Levothyroxine (B) is typically taken to maintain thyroid levels. Prednisone (C) may
require stress-dose steroids due to adrenal suppression. Metformin (D) is usually held due to
renal function and lactic acidosis risks, but ACE inhibitors are frequently cited specifically for
blood pressure instability concerns during induction.
Q7: When assessing the patient's airway prior to surgery, the nurse identifies a Mallampati Class
III score. What is the implication of this finding?
A. The airway is anticipated to be easy to intubate.
B. The patient is at high risk for aspiration.
C. The airway may be difficult to intubate or ventilate.
C. The airway may be difficult to intubate or ventilate. [CORRECT]
D. The patient requires a nasogastric tube preoperatively.
Correct Answer: C
Rationale: The Mallampati classification assesses the visibility of the faucial pillars, uvula, and
tonsils. A Class III score indicates that only the base of the uvula is visible (or soft palate only),
predicting potential difficulty with laryngoscopy and intubation. It does not directly indicate ease
(A) or specifically aspiration risk (B), though difficult airway management increases aspiration
risk. It does not mandate an NG tube (D); it signals the anesthesia provider to prepare advanced
airway equipment.
AORN Periop 101 Final Exam Actual Exam
2026/2027 | Complete Exam-Style Questions |
100% Verified – Detailed Rationales – Pass
Guaranteed – A+ Graded
[SECTION 1: Preoperative Nursing Care — Questions 1-20]
Q1: The perioperative nurse is conducting a preoperative assessment for a patient scheduled for a
cholecystectomy. Which finding in the patient's medical history places them at the highest risk
for malignant hyperthermia (MH)?
A. Type 1 Diabetes Mellitus
B. Latex allergy
C. Family history of anesthesia complications
C. Family history of anesthesia complications [CORRECT]
D. Chronic obstructive pulmonary disease (COPD)
Correct Answer: C
Rationale: Malignant hyperthermia (MH) is a life-threatening hypermetabolic reaction triggered
by volatile anesthetics (e.g., sevoflurane) or succinylcholine in genetically susceptible
individuals. A family history of anesthesia complications or MH is the most significant red flag
during the preoperative assessment because the condition is inherited as an autosomal dominant
trait. While latex allergy (B) is important for planning, it does not trigger MH. Diabetes (A) and
COPD (D) are risk factors for respiratory and metabolic complications but are not direct
indicators for MH susceptibility.
Q2: During the preoperative interview, the patient states they took ibuprofen 400 mg two hours
ago for a headache. What is the nurse's priority action?
A. Document the medication and proceed to surgery.
B. Administer a proton pump inhibitor (PPI) intravenously.
C. Notify the anesthesia provider immediately.
C. Notify the anesthesia provider immediately. [CORRECT]
,2
D. Cancel the surgery due to increased bleeding risk.
Correct Answer: C
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits platelet
aggregation, potentially increasing the risk of intraoperative bleeding. While documentation (A)
is necessary, the priority is communication with the anesthesia provider to assess the risk versus
benefit of proceeding. The anesthesia provider may decide to proceed or wait depending on the
type of surgery and the patient's coagulation status. Administering a PPI (B) is not the immediate
priority, and cancelling the surgery (D) is a decision made by the surgeon and anesthesiologist,
not the nurse independently.
Q3: The nurse is verifying the patient's NPO status. According to AORN guidelines, what is the
appropriate instruction for a healthy adult regarding clear liquids prior to elective surgery
requiring general anesthesia?
A. NPO after midnight regardless of surgery time.
B. NPO for 8 hours for all liquids.
C. NPO for 2 hours for clear liquids.
C. NPO for 2 hours for clear liquids. [CORRECT]
D. NPO for 6 hours for clear liquids.
Correct Answer: C
Rationale: Current AORN and American Society of Anesthesiologists (ASA) guidelines allow
clear liquids (e.g., water, pulpless juice, black coffee) up to 2 hours before elective surgery in
healthy individuals. This reduces patient dehydration and anxiety without significantly increasing
gastric volume or acidity. NPO after midnight (A) is outdated practice. NPO for 8 hours (B) or 6
hours (D) applies to light meals or solids, not clear liquids.
Q4: Which of the following elements must be verified by the registered nurse during the
preoperative assessment to ensure valid informed consent?
A. The patient understands the risks, benefits, and alternatives.
A. The patient understands the risks, benefits, and alternatives. [CORRECT]
,3
B. The patient has signed the form in the presence of the surgeon.
C. The family member agrees with the procedure.
D. The patient has not eaten or drunk anything for 12 hours.
Correct Answer: A
Rationale: Valid informed consent requires that the patient (or legal guardian) receives an
explanation of the diagnosis, the proposed procedure, the risks, benefits, and alternatives, and has
the opportunity to ask questions. The nurse's role is to witness the patient’s understanding of
these elements, not just the signature. While the signature usually occurs with the surgeon (B),
the nurse verifies understanding. Family agreement (D) is not required if the patient is
competent. NPO status (D) is a clinical instruction, not a component of the legal consent
document.
Q5: The preoperative nurse is teaching a patient about postoperative deep vein thrombosis
(DVT) prophylaxis. Which statement by the patient indicates a need for further teaching?
A. "I will wear the sequential compression device (SCD) while in bed."
B. "I will perform ankle pumps every hour while awake."
C. "I will stay in bed for the first 2 days to prevent bleeding."
C. "I will stay in bed for the first 2 days to prevent bleeding." [CORRECT]
D. "I will take my prescribed blood thinner as instructed."
Correct Answer: C
Rationale: Early ambulation is a critical intervention for preventing DVTs. Staying in bed for 48
hours (C) significantly increases the risk of venous stasis and thrombus formation. SCDs (A),
ankle pumps (B), and anticoagulants (D) are all appropriate adjunct therapies, but immobility
contradicts best practices for DVT prevention. The nurse should reinforce the importance of
mobilization as soon as ordered.
Q6: A patient with a history of hypertension lists their home medications. Which medication is
most likely to be held on the morning of surgery according to typical preoperative protocols?
A. Lisinopril (ACE inhibitor)
, 4
A. Lisinopril (ACE inhibitor) [CORRECT]
B. Levothyroxine
C. Prednisone
D. Metformin
Correct Answer: A
Rationale: ACE inhibitors like Lisinopril are often held on the morning of surgery because they
can increase the risk of refractory intraoperative hypotension, particularly under general
anesthesia. Levothyroxine (B) is typically taken to maintain thyroid levels. Prednisone (C) may
require stress-dose steroids due to adrenal suppression. Metformin (D) is usually held due to
renal function and lactic acidosis risks, but ACE inhibitors are frequently cited specifically for
blood pressure instability concerns during induction.
Q7: When assessing the patient's airway prior to surgery, the nurse identifies a Mallampati Class
III score. What is the implication of this finding?
A. The airway is anticipated to be easy to intubate.
B. The patient is at high risk for aspiration.
C. The airway may be difficult to intubate or ventilate.
C. The airway may be difficult to intubate or ventilate. [CORRECT]
D. The patient requires a nasogastric tube preoperatively.
Correct Answer: C
Rationale: The Mallampati classification assesses the visibility of the faucial pillars, uvula, and
tonsils. A Class III score indicates that only the base of the uvula is visible (or soft palate only),
predicting potential difficulty with laryngoscopy and intubation. It does not directly indicate ease
(A) or specifically aspiration risk (B), though difficult airway management increases aspiration
risk. It does not mandate an NG tube (D); it signals the anesthesia provider to prepare advanced
airway equipment.
