AORN · Perioperative Nursing
MAXE LANIF
✦AORN ✦
PERIOP Periop 101 · Final Examination
SAFE SURGERY TOGETHER
SAFETY
AORN Periop 101 Final Exam
N U R S I N G P R O C E SS · A N E ST H E S I A · ST E R I L E T E C H N I Q U E · P O S I T I O N I N G · H E M O STA S I S · S A F E TY
ORGANIZATION AORN (Association of periOperative CERTIFICATION Periop 101 · Core Curriculum
Registered Nurses)
EXAM TYPE Final Examination ACADEMIC YEAR
TOTAL QUESTIONS 40 Questions SUBJECT AREAS Nursing Process · Anesthesia · Sterile
Technique · Positioning · Hemostasis ·
Safety
FORMAT Multiple Choice — Select the Single Best
Answer
FINAL EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Content covers: nursing process, anesthesia, sterile technique, surgical positioning, hemostasis, safety protocols, and
perioperative nursing roles.
▸ Each question includes the correct answer with a detailed rationale based on AORN Guidelines.
SECTION I — COMPREHENSIVE PERIOP 101 FINAL EXAMINATION Questions 1 – 40
1. What are the six elements of the nursing process that the professional perioperative nurse utilizes?
A. Assessment, Diagnosis, Planning, Implementation, Evaluation, Documentation
B. Assessment, Nursing Diagnosis, Outcome Identification, Planning, Implementation, Evaluation
C. Screening, Diagnosis, Treatment, Monitoring, Follow-up, Discharge
D. History, Physical, Labs, Imaging, Treatment, Referral
CORRECT ANSWER B — Assessment, Nursing Diagnosis, Outcome Identification, Planning, Implementation, Evaluation
RATIONALE The six elements of the nursing process are: ASSESSMENT (collecting data), NURSING DIAGNOSIS (identifying
problems), OUTCOME IDENTIFICATION (setting goals), PLANNING (developing interventions),
IMPLEMENTATION (carrying out the plan), and EVALUATION (determining effectiveness). The perioperative RN
uses this framework throughout the surgical experience. The preoperative nurse visit should include
introducing yourself, confirming identity with TWO patient identifiers, assessing pain using the same scale
throughout, and considering all elements of patient care needs. If a patient discusses suicidal thoughts,
report immediately per facility policy.
, 2. What are the four elements required to prove nursing malpractice?
A. Injury, complaint, investigation, penalty
B. Duty, Breach of duty, Causation (the breach caused injury), Harm (the injury was harmful to the patient)
C. Witness, documentation, confession, settlement
D. Assessment, error, reporting, discipline
CORRECT ANSWER B — Duty, Breach of duty, Causation (breach caused injury), Harm (injury was harmful)
RATIONALE The four elements of malpractice are: (1) DUTY — the nurse had a professional obligation to the patient; (2)
BREACH OF DUTY — the nurse deviated from the standard of care; (3) CAUSATION — the breach directly
caused the injury; (4) HARM — the patient suffered physical, financial, emotional, psychosocial, or cognitive
damage. Respondeat Superior: an employer is legally responsible only when the nurse acts within scope of
practice, the allegations occurred during employment, and actions were in the employer's best interests. The
standard of care is what a reasonable and prudent professional would do in similar circumstances. To reduce
lawsuit risk: maintain open communication, confidentiality, competence, and know your scope of practice.
3. According to the American Society of Anesthesiologists NPO guidelines, how long before surgery must clear liquids
be stopped?
A. 1 hour
B. 2 hours
C. 4 hours
D. 6 hours
CORRECT ANSWER B — 2 hours
RATIONALE ASA NPO Guidelines: Clear liquids — stop 2 HOURS before surgery; Breast milk — stop 4 HOURS; Infant
formula — stop 6 HOURS; Light meal (toast and clear liquid) — stop 6 HOURS; Fried/fatty foods and meat —
stop 8 HOURS. During induction, the RN circulator assists with cricoid pressure — pressure is NOT released
until the ET tube cuff is inflated, tube placement is confirmed, AND the anesthesia provider gives verbal
confirmation. If intubation/ventilation becomes difficult, the nurse should retrieve ADDITIONAL airway
equipment and supplies.
4. What is the MOST specific sign of Malignant Hyperthermia (MH)?
A. Fever exceeding 110°F
B. Skeletal muscle rigidity
C. Increased end-tidal carbon dioxide (ETCO2)
D. Skin mottling
CORRECT ANSWER C — Increased end-tidal carbon dioxide (ETCO2)
RATIONALE Increased ETCO2 is the MOST SPECIFIC and earliest sign of MH. MH is triggered by inhalation anesthetic gases
and SUCCINYLCHOLINE. Other signs: skeletal muscle rigidity, ventricular dysrhythmia, skin mottling, and
hyperthermia (fever may exceed 110°F). Treatment: DANTROLENE SODIUM (2.5 mg/kg IV — mix 20 mg per vial
with 60 mL sterile water) or RYANODEX (250 mg per vial mixed with 5 mL sterile water). Call the MHAUS
Hotline immediately. MH crisis can lead to cardiac arrest, brain damage, and death due to secondary
cardiovascular collapse. There is NO reversal agent for succinylcholine.
MAXE LANIF
✦AORN ✦
PERIOP Periop 101 · Final Examination
SAFE SURGERY TOGETHER
SAFETY
AORN Periop 101 Final Exam
N U R S I N G P R O C E SS · A N E ST H E S I A · ST E R I L E T E C H N I Q U E · P O S I T I O N I N G · H E M O STA S I S · S A F E TY
ORGANIZATION AORN (Association of periOperative CERTIFICATION Periop 101 · Core Curriculum
Registered Nurses)
EXAM TYPE Final Examination ACADEMIC YEAR
TOTAL QUESTIONS 40 Questions SUBJECT AREAS Nursing Process · Anesthesia · Sterile
Technique · Positioning · Hemostasis ·
Safety
FORMAT Multiple Choice — Select the Single Best
Answer
FINAL EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Content covers: nursing process, anesthesia, sterile technique, surgical positioning, hemostasis, safety protocols, and
perioperative nursing roles.
▸ Each question includes the correct answer with a detailed rationale based on AORN Guidelines.
SECTION I — COMPREHENSIVE PERIOP 101 FINAL EXAMINATION Questions 1 – 40
1. What are the six elements of the nursing process that the professional perioperative nurse utilizes?
A. Assessment, Diagnosis, Planning, Implementation, Evaluation, Documentation
B. Assessment, Nursing Diagnosis, Outcome Identification, Planning, Implementation, Evaluation
C. Screening, Diagnosis, Treatment, Monitoring, Follow-up, Discharge
D. History, Physical, Labs, Imaging, Treatment, Referral
CORRECT ANSWER B — Assessment, Nursing Diagnosis, Outcome Identification, Planning, Implementation, Evaluation
RATIONALE The six elements of the nursing process are: ASSESSMENT (collecting data), NURSING DIAGNOSIS (identifying
problems), OUTCOME IDENTIFICATION (setting goals), PLANNING (developing interventions),
IMPLEMENTATION (carrying out the plan), and EVALUATION (determining effectiveness). The perioperative RN
uses this framework throughout the surgical experience. The preoperative nurse visit should include
introducing yourself, confirming identity with TWO patient identifiers, assessing pain using the same scale
throughout, and considering all elements of patient care needs. If a patient discusses suicidal thoughts,
report immediately per facility policy.
, 2. What are the four elements required to prove nursing malpractice?
A. Injury, complaint, investigation, penalty
B. Duty, Breach of duty, Causation (the breach caused injury), Harm (the injury was harmful to the patient)
C. Witness, documentation, confession, settlement
D. Assessment, error, reporting, discipline
CORRECT ANSWER B — Duty, Breach of duty, Causation (breach caused injury), Harm (injury was harmful)
RATIONALE The four elements of malpractice are: (1) DUTY — the nurse had a professional obligation to the patient; (2)
BREACH OF DUTY — the nurse deviated from the standard of care; (3) CAUSATION — the breach directly
caused the injury; (4) HARM — the patient suffered physical, financial, emotional, psychosocial, or cognitive
damage. Respondeat Superior: an employer is legally responsible only when the nurse acts within scope of
practice, the allegations occurred during employment, and actions were in the employer's best interests. The
standard of care is what a reasonable and prudent professional would do in similar circumstances. To reduce
lawsuit risk: maintain open communication, confidentiality, competence, and know your scope of practice.
3. According to the American Society of Anesthesiologists NPO guidelines, how long before surgery must clear liquids
be stopped?
A. 1 hour
B. 2 hours
C. 4 hours
D. 6 hours
CORRECT ANSWER B — 2 hours
RATIONALE ASA NPO Guidelines: Clear liquids — stop 2 HOURS before surgery; Breast milk — stop 4 HOURS; Infant
formula — stop 6 HOURS; Light meal (toast and clear liquid) — stop 6 HOURS; Fried/fatty foods and meat —
stop 8 HOURS. During induction, the RN circulator assists with cricoid pressure — pressure is NOT released
until the ET tube cuff is inflated, tube placement is confirmed, AND the anesthesia provider gives verbal
confirmation. If intubation/ventilation becomes difficult, the nurse should retrieve ADDITIONAL airway
equipment and supplies.
4. What is the MOST specific sign of Malignant Hyperthermia (MH)?
A. Fever exceeding 110°F
B. Skeletal muscle rigidity
C. Increased end-tidal carbon dioxide (ETCO2)
D. Skin mottling
CORRECT ANSWER C — Increased end-tidal carbon dioxide (ETCO2)
RATIONALE Increased ETCO2 is the MOST SPECIFIC and earliest sign of MH. MH is triggered by inhalation anesthetic gases
and SUCCINYLCHOLINE. Other signs: skeletal muscle rigidity, ventricular dysrhythmia, skin mottling, and
hyperthermia (fever may exceed 110°F). Treatment: DANTROLENE SODIUM (2.5 mg/kg IV — mix 20 mg per vial
with 60 mL sterile water) or RYANODEX (250 mg per vial mixed with 5 mL sterile water). Call the MHAUS
Hotline immediately. MH crisis can lead to cardiac arrest, brain damage, and death due to secondary
cardiovascular collapse. There is NO reversal agent for succinylcholine.
