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AORN Periop 101 Final Exam Study Guide: Key Concepts and Best Practices, Study Guides, Projects, Research of Nursing

Johns Hopkins University (JHU)Nursing

This study guide covers essential topics for the aorn periop 101 final exam, focusing on clinical signs, surgical procedures, medication safety, patient positioning, and infection control. It includes key concepts such as gas embolism symptoms, fluid selection criteria, surgical positions, and medication error prevention. The guide also addresses important aspects of surgical instrument handling, sterilization, and patient safety protocols, providing a comprehensive review for perioperative nurses preparing for their certification.

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2025/2026

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AORN Periop 101 Final Exam Study Guide

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Clinical signs of a gas embolism include: - correct answer • Dyspnea

• Systemic hypotension

• Cardiac anomalies

• Hypoxemia

• End-tidal CO2 changes

Intra-abdominal gas embolism is a rare but potentially serious complication of

insufflation because it: - correct answer • Gas increases abdominal pressures.

• Open blood vessels allow the gas to enter the circulatory system.

• The gas embolism enters the vascular system.

• The embolism travels to the right ventricle or pulmonary artery.

Gas cylinder safety include: - correct answer • Verify that the correct gas is being used

by checking the cylinder's label, connector, and color coding.

• Make sure there is enough gas in the cylinder.

• Check that the key can open the cylinder.

• Ensure that the cylinder is opened before use.

• Have a second, full cylinder of the same gas being used immediately available.

Fluids can be used to create a surgical working space either by gravity or pump

infusion. The fluid selected is based on the: - correct answer • Surgical procedure

• Patient assessment

• Instruments used during the surgical procedure

Low viscosity non-electrolyte fluid is used for: - correct answer • Gynecological and

urological procedures

• Used with monopolar instruments

• Hypotonic

• Can cause transurethral resection syndrome if large quantities are absorbed

Examples of Low viscosity non-electrolyte fluids include: - correct answer o

1.5%glycine

o 5% mannitol

o 3% sorbitol

Normal saline is used: - correct answer • bipolar instruments

• Isotonic

Discover Study Guides, Projects, Research of Nursing Johns Hopkins University (JHU)

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Download AORN Periop 101 Final Exam Study Guide: Key Concepts and Best Practices and more Study Guides, Projects, Research Nursing in PDF only on Docsity!

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Clinical signs of a gas embolism include: - correct answer • Dyspnea

Systemic hypotension
Cardiac anomalies
Hypoxemia
End-tidal CO2 changes Intra-abdominal gas embolism is a rare but potentially serious complication of insufflation because it: - correct answer • Gas increases abdominal pressures.
Open blood vessels allow the gas to enter the circulatory system.
The gas embolism enters the vascular system.
The embolism travels to the right ventricle or pulmonary artery. Gas cylinder safety include: - correct answer • Verify that the correct gas is being used by checking the cylinder's label, connector, and color coding.
Make sure there is enough gas in the cylinder.
Check that the key can open the cylinder.
Ensure that the cylinder is opened before use.
Have a second, full cylinder of the same gas being used immediately available. Fluids can be used to create a surgical working space either by gravity or pump infusion. The fluid selected is based on the: - correct answer • Surgical procedure
Patient assessment
Instruments used during the surgical procedure Low viscosity non-electrolyte fluid is used for: - correct answer • Gynecological and urological procedures
Used with monopolar instruments
Hypotonic
Can cause transurethral resection syndrome if large quantities are absorbed Examples of Low viscosity non-electrolyte fluids include: - correct answer o 1.5%glycine o 5% mannitol o 3% sorbitol Normal saline is used: - correct answer • bipolar instruments
Isotonic

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Contains electrolytes
Safer than non-electrolyte fluids if large amounts are absorbed High-viscosity fluid used as: - correct answer • Plasma volume expander
Can draw six times its own volume into the bloodstream
Has a high glucose content High-viscosity fluid can cause significant complications such as: - correct answer o Fluid overload o Heart failure o Pulmonary edema Type(s) of High-viscosity fluid include: - correct answer Dextran Benefits of robotic surgery include: - correct answer • Precision o Surgeon hand, wrist, and finger movements control the movements of the scope and the thin, lightweight robotic instruments within the patient's body.
Flexibility o Robotic instrumentation may have more flexibility and range of motion than the human wrist. o Each instrument performs a specific task (eg, coagulation, cutting, retraction).
Efficiency o The instrument's quick release from the robotic arm allows for faster instrument changes during surgery.
Safety o Safety features built into the robotic system prevent inadvertent or independent instrument or arm movements that may harm the patient. Energy-generating device safety practices include: - correct answer • Use the lowest power setting possible.
The person controlling the hand piece is the only person who should operate the foot pedal.
Only use trocar systems that protect the patient from errant electrical current.
Inspect instrument insulation before, during, and after use.
Use a scanning device during the sterilization process to ensure the instrument's insulation is not compromised. Chain of Infection - Reservoir: - correct answer - Dirty surfaces & equipment

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Do not use spray bottles to apply cleaning agents in the perioperative environment.
Clearly label an environmental cleaning agent that is removed from its original container and placed into a secondary container. How do you clean in the perioperative environment? - correct answer • Top to bottom.
Less-soiled areas to the dirtiest.
Move the OR bed and mop under that area.
Before the first surgical procedure of the day, damp dust all horizontal surfaces in the operating room.
Turnover cleaning, or between-case cleaning, occurs after a patient exits an operating room and before the next surgery setup begins. It is a standardized, methodical, cleaning process.
Terminal cleaning occurs at the end of each day the operating or procedure room are used. It is a more extensive, thorough cleaning that is performed by trained personnel.
Scheduled cleaning is cleaning of equipment (eg, appliances, air-handling systems, closets, cupboards) that occurs on a periodic, routine basis (eg, daily, weekly, monthly).
Enhanced cleaning measures are implemented for patients who are suspected or diagnosed with transmissible diseases. How is is the OR cleaned after procedures performed on patients with known or suspected airborne transmissible diseases such as tuberculosis, chickenpox, measles? - correct answer The OR must be empty for a designated amount of time for the airborne particulars to be filtered before environmental cleaning begins. Universal key points about environmental cleaning in a perioperative setting: - correct answer • Always keep trash, equipment, and contaminated linen in OR until patient leaves for PACU.
Always clean and disinfect surgical equipment before bringing it into the OR and before returning it to the storage room/area.
The floor is always considered contaminated in every area (eg, preoperative area, OR, postanesthesia care unit, SPD). Wear personal protective equipment and follow standard precautions when: - correct answer - handling trash
linens
items contaminated with: - blood

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

body fluids
other infectious materials What types of waste get placed in red biohazard bags? - correct answer medical waste such as laparotomy sponges saturated with blood/fluids Note: follow state and local laws when disposing of liquid medical waste (containers of liquid waste placed in red biohazard bags) Cleaning after construction/renovation/repair areas in the perioperative environment are performed: - correct answer • before barriers are removed.
Terminally clean areas before they are returned to service. Three ways that assist in measuring cleanliness of the perioperative environment: - correct answer o Visual inspections o Fluorescent gels/markers with black light illumination o Adenosine triphosphate (ATP) monitoring Brand(s) of natural absorbable, monofilament sutures: - correct answer - Catgut Plain
Chromic Brand(s) of synthetic absorbable, monofilament sutures: - correct answer - PDS
Monocryl Brand(s) of synthetic absorbable, multifilament sutures: - correct answer - Vicryl
Dexon Brand(s) of natural non-absorbable, monofilament sutures: - correct answer - Steel Brand(s) of synthetic non-absorbable, monofilament sutures: - correct answer - Ethilon
Prolene
Dermalon
Surgilene Brand(s) of natural non-absorbable, multifilament sutures: - correct answer - Silk

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Procedure performed
Any surgical issues/complications and corrective actions taken
Skin condition
Pressure injury risk
Hypothermia status
Estimated blood loss
Input and output
Presence and location of drains, wound packing Patient Care Orders (Medication and Verbal) - correct answer • Enter verbal orders into the patient chart as soon as possible.
Use a read-back process to verify verbal orders.
Record the names and roles of all involved in patient care.
Eliminate trailing zeros in medication dosages.
Use standardized names and terms.
Ensure standing or preprinted orders are reviewed according to your facility's policy and procedures. Seven goals of hemostasis: - correct answer - Decrease and control bleeding
Minimize the need for blood replacement
Optimize the surgical field view
Avoid major organ damage
Shorten the length of surgery and length of facility stay
Decrease the risk of infection
Decrease health care costs for patients and facilities Issues and complications associated with surgical bleeding: - correct answer • Surgical site visualization
Increased surgical time
Necessity of a blood transfusion Blood transfusion risks: - correct answer - Surgical site infection (SSI)
Systemic inflammatory response syndrome
Transfusion related acute lung injury (TRALI)
Multiple organ failure
Increased mortality
hypothermia (Increased risk of coagulopathies)

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

- SSI

Thrombocytopenia
Hemodilution
Lactic acidosis Ways to quantify the surgical patient's blood loss: - correct answer • Inspecting
Suction canisters (amount of irrigation solution - fluid in canisters = EBL)
Drapes
Sponges
Weighing surgical sponges
Monitoring lab values Mechanical hemostasis can be achieved with: - correct answer - Direct pressure
Sutures
staples
clips
Dressings Medications used to suppress surgical bleeding (Chemical hemostasis) include: - correct answer - Epinephrine
Vitamin K
Protamine
Vasopressors Heat can also produce hemostasis. Coagulating energy sources include: - correct answer - Monopolar electrosurgery devices
Bipolar electrosurgery devices
Vessel sealing devices
Ultrasonic devices
Lasers Surgical Sponge Count Best Practices: - correct answer - Requires that all team members are responsible for a correct count
Initial count between the scrub person and RN circulator
Scrub person separates & points to items while counting
RN Circulator records count

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Using prefilled syringe use
Limiting the number of medication concentrations
Purchasing medications in a size that is as close to the anticipated dose
Securing stored medications Actions to decrease and prevent medication errors when transferring onto the sterile field include: - correct answer • Label all medications, medication containers, and other solutions
Write down & read back verbal orders
Verify medications - RN circulator reads aloud the medication name, strength, dosage, and expiration date when transferring medications to the back table
Label medications—the scrubbed team member labels each medication container immediately
Avoid use of abbreviations that could cause medication errors
Do Not use trailing zeroes when documenting medication doses
Retrieve one medication at a time for one patient at a time Before administering a medication, the perioperative RN should verify the: (6 {7} rights of med. admin.) - correct answer • Right patient using two approved identification methods
Right medication
Right dose
Right route
Right time
Right strength or concentration {- Right medication rate/Infusion pump settings, if applicable} Fluid-related complications include: - correct answer - intravasation
extravasation Intravasation of fluids can lead to: - correct answer - hyponatremia
hypervolemia
cardiovascular complications
pulmonary edema Extravasation of fluids can lead to: - correct answer - Edema
abdominal distention

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

intraabdominal compartment syndrome When handling hazardous chemicals and an eye exposure occurs despite using proper PPE, eye wash station should be: - correct answer Along an unobstructed pathway within 10 sec. of chemical usage & storage (note: warm water should be between 60F - 100F) A culture of safety is promoted by: - correct answer • The health care organization's commitment to patient safety above all goals
A commitment to safety at all levels of the organization
A focus on systems, process improvement, and individual accountability
Sufficient resources
The ability of providers to discuss near miss events and errors without reprisal The Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery consists of three key steps: - correct answer • Conducting a pre- procedure verification process
Marking the procedure site
Performing a time out The provider has the knowledge for the action and there is little or no attention or attention is diverted is an example of which type of patient safety error: - correct answer Skill-based behavior error Patient safety mistakes made by healthcare provider include errors in perception, judgement, inference, or interpretation is an example of which type of error: - correct answer Knowledge-based performance error The lack of attention and situational factors play a significant role in this type of patient safety error: - correct answer Situational factor error In an Accountable Care Organization (ACO) model is care that includes physicians, health care organization representatives, and other health care providers voluntarily joining together to: - correct answer - give high-quality, coordinated health care to patients whose care is covered by Medicare (most cost effective)
avoid duplication of services (right care, right time)
decrease errors

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Preexisting conditions
Physical/mobility limits
Body mass index
Presence of jewelry
Lab results Preoperative Assessment Considerations - Procedural Factors: - correct answer - Type of anesthesia
Length of surgery
Position required during surgery Basic Surgical Positions - Supine: - correct answer Lying on the back aka dorsal recumbent position Basic Surgical Positions - Modification(s) in Supine Position include: - correct answer
Lithotomy
Sitting/semi-sitting
Trendelenburg/Reverse Trendelenburg Basic Surgical Positions - Lateral: - correct answer Lying on non-operative side (pt. will be anesthetized in supine position then log rolled into position) Basic Surgical Positions - Prone: - correct answer Lying face down ( pt. anesthetized on transport vehicle then log rolled onto their stomach) [note: jack knife aka Kraske position is a variation of prone] Considerations and How to position - Supine: - correct answer • Arm extension less than 90 degrees (avoid compression of brachial plexus)
Pad pressure points:
occiput
scapulae
thoracic vertebrae
olecranon process
sacrum/coccyx
elbows
Place soft pillow under knees (prevent stress on lower back)

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Place safety strap 2 inches (5 cm) above knees w/ sheet or blanket placed between strap & pt. skin.
If a patient is pregnant, insert a wedge under pt. right side to displace the uterus to the left.
Use a wide pressure-redistributing surface or heel-suspension device to redistribute heel pressure. How to position - Lithotomy: - correct answer - Prevent strain on sacrum, buttocks are positioned even with lower break in OR bed and should not extend over the break.
Place the arms on padded arm boards.
Protect hands and fingers from injury when manipulating OR bed and adding positioning attachments.
Raise legs into position at the same time.
Lower pt. legs slowly when removing them from stirrups after surgery. note: both legs lowered at the same time Considerations with Lithotomy position - - Physiological changes can occur: - correct answer - When legs are raised and placed in stirrups - the abdominal organs shift, which increases pressure on the diaphragm, leading to respiratory compromise.
A shift in circulatory volume can occur when legs are removed from the stirrups after surgery.
Circulatory and respiratory systems may be compromised due to compression of the abdominal contents on the inferior vena cava and abdominal aorta.
Nerve damage to femoral, obturator, and perineal nerves can occur How to position - Prone: - correct answer - Maintain feet in correct anatomical position to prevent foot drop.
Pad the eyes and avoid pressure to prevent conjunctival edema, corneal abrasion, or retinal ischemia.
Rotate arms slowly when placing them on arm boards to prevent brachial plexus injuries. Considerations when in prone position: - correct answer - Improper positioning can result in pressure on the inferior vena cava and femoral veins which: ~ reduces venous return ~ produces hypotension.

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

o Safe patient handling and movement o Sharps safety o Teamwork An Unrestricted Zone in the perioperative environment are areas where street clothes are permitted and is allowed in: - correct answer - Public hallways

waiting areas A Semi-restricted Zone is an area not open to the public and requires proper attire. These areas are secured via: - correct answer - signage
doors with electronic access/badge requirements to enter Semi-restricted zone includes: - correct answer - Hallways adjacent to OR
Sterile supply storage
Sterile Processing department Restricted Zones: - correct answer - OR is a restricted zone.
Only accessed through semi-restricted areas.
Separated from semi-restricted areas by doors.
Clean surgical attire, a head cover, mask, and facility-approved shoes in the restricted zones.
PPE worn includes: ~ protective eyewear ~ shoe covers when there is a potential for exposure to blood and other body fluids. Preoperative Verification Process and Team Communication standards: - correct answer • Include the patient in the verification process.
Use standardized safety checklists.
Patient identification ~ Always use at least two patient identifiers
Surgical site marking: ~ Surgeon or proceduralist marks site of surgery.
Time out: ~ Time out is a pause in patient care immediately before procedure begins to conduct a final assessment of the patient. ~ Conduct a time out before the start of a regional block, surgery, or other invasive procedure.

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

An OR fire can occur when all elements of the fire triangle are present: - correct answer - An ignition source (electrosurgical pencil)

Fuel (flammable preoperative skin antiseptic products, surgical drapes)
An oxidizer (oxygen) [perform a fire risk assessment before starting surgery] Life Safety Events include: - correct answer • Fire in the OR
Malignant hyperthermia (MH) crisis
Local anesthesia systemic toxicity (LAST)
Cardiac arrest
Latex allergy How is LAST treated? Max recommended dose? - correct answer - 20% lipid emulsion at a dose of 1.5ml/kg (lean body mass) over 1 min, followed by infusion of 0.25 ml/kg/min.
Repeat bolus up to 2 more times
Continue infusion for 10 minutes after achieving hemodynamic stability
Max dose 10ml/kg in the first 30 minutes What are the signs and symptoms of an MH crisis: - correct answer - increased heart rate ~ cardiac arrest
muscle rigidity ~ increased metabolism and muscle breakdown and increased acid content in blood
fever exceeding 110F ~ brain damage
Death due to secondary cardio collapse What is the medication used to treat MH: How is it prepared: - correct answer Dantrolene Sodium
Usual loading dosage 2.5 mg/kg IV
20 mg per vial mix with 60 ml sterile water Ryanodex
250 mg per vial mixed with 5 ml sterile water What are signs and symptoms of LAST: - correct answer - Metallic taste

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Do not allow skin antiseptic solutions to pool or soak into linens or the patient's hair.
Use sterile towels to absorb drips and excess solution during application.
Remove saturated materials before pt. is draped.
Allow time for the skin antiseptic to dry before the patient is draped. o Refer to the manufacturer's IFU.
Ensure that team members know that a flammable skin antiseptic was used. The nurse's preoperative assessment is an important step in uncovering any obstacles to surgery. Obstacles may include: - correct answer • Allergy to antiseptic solutions
Skin condition at the surgical site
Jewelry that still needs to be removed
Surgical stie marking that is not visible after the skin prep Protective Measures, Dilution, Application Site, Important Notes about skin antisepsis: - correct answer • Protect equipment from skin prep solutions. o Replace equipment that has come in contact with the prep solution.
Protect buttocks with a fluid-resistant pad to prevent a potential chemical burn.
Remove the skin antiseptic before the application of dressings.
Do not dilute skin antiseptic products - concentration becomes unknown, cause contamination
Apply skin prep to area larger than surgical site
Know dry times and flammability Skin preparation and antisepsis elements are documented in the patient's health record. Some but not all of the elements for documentation include: - correct answer • After the prep o Jewelry removal and disposition o Skin condition at the surgical site o Person(s) performing the skin prep o Skin antiseptic product(s) used o Area(s) prepped
After the surgery o Skin condition An eye prep antiseptic must be: - correct answer • Safe to use around the eye

(Latest Update 2025 / 2026) Study Guide

Questions & Answers [score A] 100%

Correct

Labeled for ophthalmic use ~ Do not use alcohol based solutions ~ allergy to iodine a combo of baby shampoo and balanced salt solution can be used Abdominoperineal surgical site prep area(s) include: - correct answer - Abdomen
Pubis
Vagina
Perineum
Anus
Thighs Abdominoperineal prep, positioning and equipment for Vaginal surgery include: - correct answer - Prep kits
Foley ~ straight cath to ensure empty bladder after vaginal prep
Lithotomy with possible Trendelenburg
Stirrups/holders ERAS (Enhanced Recovery After Surgery) protocols are a prescribed program that patients are to follow after participating in education that is specific to the surgery. These protocols have been shown to be beneficial to the patient, improve surgical outcomes, and decrease costs. - correct answer Patients and their providers follow these specific protocols:
Prior to surgery
The day of surgery
During surgery
After surgery ASA Physical Status Classification ASA 1: - correct answer A normal healthy patient ASA Physical Status Classification ASA 2: - correct answer Patient with mild systemic disease ASA Physical Status Classification ASA 3: - correct answer Patient with severe systemic disease

AORN Periop 101 Final Exam Study Guide: Key Concepts and Best Practices, Study Guides, Projects, Research of Nursing

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