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Quizzes > Health & Medicine

Perioperative Nursing Quiz: Check Your OR Workflow Skills

Quick perioperative quiz to check your OR knowledge. Instant results.

Editorial: Review CompletedCreated By: Campionato Di FotografiaUpdated Aug 24, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art surgical instruments nurse icons on dark blue background promoting perioperative nursing quiz

This perioperative nursing quiz helps you check core OR workflows, from admission and anesthesia checks to PACU handoff. To widen your practice, try the general surgery quiz, strengthen instrument know-how with the sterile processing quiz, and refresh bedside basics with a patient care skills quiz.

What is the primary purpose of a surgical time-out?
To sterilize all instruments
To decide on postoperative pain management
To measure patient's vital signs
To confirm patient identity and planned procedure
A surgical time-out is a final verification step before incision to confirm the patient, procedure, and site. This process reduces wrong-site, wrong-procedure, and wrong-patient surgery. It is a recommended safety practice by the World Health Organization.
According to fasting guidelines, how long should an adult fast from clear liquids before elective surgery?
8 hours
4 hours
6 hours
2 hours
Current guidelines recommend at least a 2-hour fast from clear liquids to reduce aspiration risk while minimizing dehydration. Longer fasts do not further reduce gastric volume significantly. These guidelines are endorsed by anesthesia societies worldwide.
Which vital sign is most critical to monitor continuously during surgery?
Body mass index
Heart rate
Blood glucose
Hemoglobin level
Continuous heart rate monitoring provides real-time feedback on hemodynamic status and can prompt interventions for arrhythmias or instability. It's standard in all operative settings. Intraoperative monitors ensure patient safety.
During ward admission, which document must the patient sign before surgery?
Nursing shift report
Informed consent form
Dietary preference sheet
Family visitation log
Informed consent ensures that patients understand the risks, benefits, and alternatives of the procedure. It is a legal and ethical requirement before any invasive intervention. The nurse confirms the signature and clarifies questions.
What is the ASA physical status classification IV?
Patient with severe systemic disease that is a constant threat to life
Patient with mild systemic disease
Moribund patient not expected to survive without the operation
Healthy patient with no systemic disease
ASA IV denotes a patient whose systemic disease poses a constant threat to life, such as advanced heart failure. This classification guides anesthetic planning and risk stratification. It is widely used in perioperative assessment.
Which checklist is recommended by WHO to improve surgical safety?
Surgical Safety Checklist
Medication Reconciliation Checklist
Preoperative Nutrition Checklist
Critical Incident Checklist
The WHO Surgical Safety Checklist spans three phases: sign-in, time-out, and sign-out. Its use has been shown to reduce complications and mortality. It fosters team communication and accountability.
Which position helps prevent vena caval compression in pregnant patients on the OR table?
Supine with legs elevated
Left lateral tilt
Trendelenburg
Prone
Left lateral tilt shifts the uterus off the inferior vena cava to maintain venous return and cardiac output. It is essential after 20 weeks' gestation. This reduces maternal hypotension and fetal compromise.
What color indicates a sterile field in most operating rooms?
Yellow
Red
Orange
Blue
Blue is the most common drape color used in surgery because it provides high contrast with blood and reduces glare. It helps staff identify contaminants. Sterile fields use matched drapes and gowns.
What does 'NPO after midnight' stand for in perioperative orders?
Nurse performs only oral care
Nothing by mouth after midnight
Nutrition provided past midnight
No procedures only after midnight
NPO means nil per os, nothing by mouth, to reduce aspiration risk under anesthesia. Standard practice is to withhold food and liquids after midnight. Exceptions can be made for clear liquids.
Which medication is commonly given preoperatively to reduce anxiety?
Metformin
Lisinopril
Ibuprofen
Midazolam
Midazolam is a short-acting benzodiazepine used for anxiolysis before induction. It provides amnesia and sedation. Its rapid onset and brief duration are ideal for the perioperative period.
What is the minimum temperature recommended to prevent perioperative hypothermia?
34°C (93.2°F)
36°C (96.8°F)
38°C (100.4°F)
40°C (104°F)
Maintaining core temperature at or above 36°C reduces surgical site infections and coagulopathy. Active warming measures are used if temperatures drop below target. Guidelines from anesthesia authorities support this threshold.
Which IV fluid is isotonic and commonly used for initial volume resuscitation?
5% dextrose
0.45% saline
10% dextrose
0.9% normal saline
0.9% normal saline is isotonic with plasma and remains in the extracellular space, making it suitable for resuscitation. It restores circulating volume without shifting fluids intracellularly. It is standard in perioperative fluid management.
Which assessment tool evaluates a patient's risk for postoperative nausea and vomiting?
Braden scale
CHA2DS2-VASc score
Glasgow Coma Scale
Apfel score
The Apfel score uses four factors: female sex, nonsmoker, history of PONV or motion sickness, and postoperative opioids. It predicts risk and guides prophylaxis. It's simple and evidence-based.
What is the typical gauge of an IV catheter used for blood transfusion?
24-gauge
18-gauge
20-gauge
22-gauge
An 18-gauge IV catheter allows adequate flow rates for safe transfusion and rapid fluid administration. Smaller gauges increase transfusion time and hemolysis risk. Guidelines recommend 16 - 18 gauge for most adult transfusions.
Which electrolyte abnormality can predispose to cardiac arrhythmias intraoperatively?
Hypokalemia
Hypermagnesemia
Hypercalcemia
Hyperphosphatemia
Hypokalemia can cause QT prolongation and ventricular arrhythmias during anesthesia. It is routinely checked and corrected preoperatively. Maintaining potassium within normal limits is critical for stability.
What is the recommended head position to maintain a patent airway under anesthesia?
Flexed chin to chest
Extended hyperflexion
Head turned to side
Sniffing position
The sniffing position aligns the oral, pharyngeal, and laryngeal axes to facilitate mask ventilation and intubation. It reduces airway resistance and obstruction. It's a standard between induction and securing airway.
Which postoperative scoring system assesses recovery in the PACU?
Braden scale
Aldrete score
APGAR score
SOFA score
The Aldrete score evaluates activity, respiration, circulation, consciousness, and oxygen saturation. It is used to determine readiness for discharge from PACU. A score of 9 - 10 indicates safe transfer.
What is the most sensitive monitoring method for detecting endotracheal tube placement?
Chest rise observation
Waveform capnography
Auscultation only
Pulse oximetry
Waveform capnography provides continuous measurement of exhaled CO? and confirms ventilation. It is the gold standard for tube placement verification. Auscultation and chest rise are less reliable alone.
Which anesthetic agent is inhaled and has a blood-gas partition coefficient of approximately 0.47?
Sevoflurane
Nitrous oxide
Desflurane
Isoflurane
Desflurane's low blood-gas partition coefficient of 0.47 leads to rapid induction and emergence. It's favored where quick turnover is desired. Isoflurane and sevoflurane have higher values.
Which analgesic technique provides localized postoperative pain control via intermittent bolus through a catheter?
Patient-controlled regional analgesia (PCRA)
Oral scheduled opioids
Epidural infusion only
Intravenous PCA
PCRA allows patients to self-administer local anesthetic doses through a peripheral or epidural catheter for targeted pain relief. It maintains sensory blockade with minimal systemic opioid use. It improves mobility and outcomes.
Which dressing allows visualization of a surgical incision while maintaining a sterile barrier?
Adhesive alginate
Transparent semi-permeable film
Hydrocolloid opaque dressing
Gauze with tape
Transparent film dressings permit wound inspection without removal, lowering infection risk. They are breathable and waterproof. They are suitable for clean, closed incisions.
During laparoscopic surgery, what is the primary risk of CO? insufflation?
Hypocalcemia
Hypercarbia and acidosis
Hypothermia
Hypoglycemia
CO? insufflation increases absorption leading to elevated PaCO? and respiratory acidosis if ventilation is not adjusted. Anesthesia providers monitor and adjust minute ventilation. Awareness of cardiovascular effects is essential.
Which lab value is most important to check in a patient on chronic warfarin therapy before surgery?
Platelet count
Creatinine
Hemoglobin
INR
INR indicates the degree of anticoagulation with warfarin and guides reversal decisions. An elevated INR increases bleeding risk. Target values depend on procedure risk.
What is the role of a preoperative albumin level?
Evaluate pulmonary status
Indicate acute blood loss
Measure renal function
Assess nutritional status and healing potential
Albumin reflects protein stores and nutritional status, predicting wound healing and complication risk. Low levels correlate with higher morbidity. It informs perioperative planning.
Which agent is used to reverse non-depolarizing neuromuscular blockade?
Atropine alone
Succinylcholine
Midazolam
Neostigmine with glycopyrrolate
Neostigmine inhibits acetylcholinesterase, increasing acetylcholine to outcompete blockers. Glycopyrrolate mitigates bradycardia. It is standard reversal for non-depolarizers.
What is the target PaCO? when ventilating a patient during anesthesia?
50 - 60 mmHg
20 - 30 mmHg
35 - 45 mmHg
60 - 70 mmHg
Maintaining PaCO? within 35 - 45 mmHg preserves acid-base balance. Hyperventilation or hypoventilation outside this range can cause complications. Adjust ventilator settings accordingly.
Which nerve block provides postoperative analgesia for shoulder surgery?
Interscalene block
Femoral block
Popliteal block
Sciatic block
The interscalene block targets roots C5 - C7 of the brachial plexus supplying the shoulder. It offers effective analgesia with reduced systemic opioid use. It's commonly used in shoulder arthroscopy.
Which scale assesses pain intensity in nonverbal or sedated patients?
Numeric Rating Scale
Critical-Care Pain Observation Tool (CPOT)
Visual Analog Scale
McGill Pain Questionnaire
CPOT evaluates facial expression, body movements, muscle tension, and compliance with ventilation to quantify pain in nonverbal ICU patients. It is validated and reliable. It guides analgesic adjustments.
What is the recommended maximum concentration of oxygen to prevent absorption atelectasis?
FiO? ? 0.5
FiO? ? 0.3
FiO? ? 0.8
FiO? ? 1.0
High FiO? can lead to nitrogen washout and absorption atelectasis. Keeping FiO? at or below 0.8 reduces this risk while ensuring adequate oxygenation. Lower concentrations are used when possible.
Which device is most accurate for continuous core temperature monitoring?
Esophageal probe
Axillary thermometer
Forehead infrared scanner
Oral thermometer
Esophageal probes placed in the lower third of the esophagus reflect core temperature accurately in anesthetized patients. Peripheral measurements lag behind changes. Continuous monitoring helps prevent hypothermia.
Which medication reduces postoperative shivering by acting on thermoregulatory centers?
Ketorolac
Ondansetron
Meperidine
Morphine
Meperidine has anti-shivering properties by reducing the shivering threshold in the hypothalamus. It is more effective than opioids like morphine for this specific purpose. It is used when shivering is severe.
Which scoring system predicts risk of postoperative pulmonary complications?
APACHE II
CHA2DS2-VASc score
ARISCAT score
Child-Pugh score
The ARISCAT score uses age, SpO?, respiratory infection, surgery type, duration, and emergency status to predict postoperative pulmonary risk. It guides preoperative optimization and interventions. It is validated internationally.
Which factor most increases the risk of malignant hyperthermia?
Hypertension
Family history of MH
Diabetes mellitus
Asthma
Malignant hyperthermia is a genetic disorder triggered by certain anesthetics; family history is the strongest risk factor. It causes uncontrolled calcium release in muscle. Early recognition and dantrolene administration are critical.
What is the mechanism of action of sugammadex?
Acetylcholinesterase inhibition
Competitive binding at nicotinic receptor
Encapsulation of rocuronium molecules
Inhibition of GABA receptors
Sugammadex binds free rocuronium (and vecuronium) in plasma, reducing the amount available at the neuromuscular junction. It provides rapid and complete reversal. It differs from cholinesterase inhibitors.
Which coagulation test best reflects the extrinsic pathway?
Prothrombin time (PT)
Activated partial thromboplastin time (aPTT)
Thromboelastography
Bleeding time
PT measures factors I, II, V, VII, and X, reflecting the extrinsic and common pathways. It's used to monitor warfarin therapy. aPTT evaluates the intrinsic pathway.
Which postoperative intervention reduces the risk of deep vein thrombosis?
Delayed oral intake
Early administration of corticosteroids
High-concentration oxygen
Intermittent pneumatic compression devices
Intermittent pneumatic compression promotes venous return, preventing stasis and clot formation. It's part of multimodal thromboprophylaxis. It's especially important when pharmacologic agents are contraindicated.
Which of the following increases intracranial pressure the most under anesthesia?
Mannitol administration
Hyperventilation
Head elevation
Hypoventilation
Hypoventilation elevates PaCO?, causing cerebral vasodilation and increased intracranial pressure. Hyperventilation lowers PaCO? and reduces pressure. Mannitol and head elevation decrease ICP.
Which antibiotic prophylaxis timing is optimal for surgical site infection prevention?
2 hours post-incision
Within 60 minutes before incision
After skin closure
Only if signs of infection appear
Administering antibiotics within 60 minutes before incision achieves effective tissue levels during surgery. Late or post-incision doses are less effective. Guidelines emphasize this window to lower infection rates.
Which local anesthetic has the longest duration of action when used for peripheral nerve block?
Bupivacaine
Chloroprocaine
Lidocaine
Procaine
Bupivacaine provides prolonged sensory and motor block lasting several hours. Lidocaine is shorter acting. Choice depends on desired block duration.
What is the Parkland formula used for?
Calculating fluid resuscitation in burn patients
Assessing nutritional needs
Estimating blood loss in trauma
Determining antibiotic dosage
The Parkland formula prescribes 4 mL/kg/%TBSA burned of lactated Ringer's over 24 hours, half in the first 8 hours. It standardizes early burn resuscitation. Timely fluid delivery reduces morbidity.
Which gas is contraindicated in pneumothorax during laparoscopy?
Helium
Carbon dioxide
Oxygen
Nitrous oxide
Nitrous oxide diffuses into gas spaces and can expand a pneumothorax, worsening respiratory compromise. CO? is absorbed rapidly. Avoid nitrous if pneumothorax is present or suspected.
Which technique reduces postoperative atelectasis?
Strict bed rest
Late ambulation
Incentive spirometry
High-flow oxygen only
Incentive spirometry promotes deep breaths to reopen collapsed alveoli and improve lung volumes. Early mobilization complements it. Bed rest and delayed ambulation worsen atelectasis.
Which condition predisposes to postoperative delirium in elderly patients?
Well-controlled diabetes
High physical fitness
Young age
Preexisting cognitive impairment
Cognitive impairment is the strongest predictor of postoperative delirium. It increases vulnerability to stressors like anesthesia and pain. Preventive strategies include delirium screening and minimization of sedation.
Which IV anesthetic is associated with pain on injection?
Ketamine
Thiopental
Etomidate
Propofol
Propofol causes pain due to phenol and lipid emulsion components irritating veins. Lidocaine is often added to reduce injection pain. Other induction agents are less painful.
Which genetic mutation is most commonly linked to malignant hyperthermia susceptibility?
HBB gene mutation
RYR1 gene mutation
BRCA1 gene mutation
CFTR gene mutation
Mutations in the RYR1 gene alter calcium release channels in skeletal muscle, predisposing patients to malignant hyperthermia. Genetic testing can identify susceptibility. Clinical vigilance is required if history is positive.
Which parameter from thromboelastography indicates clot strength?
R-time
Maximum amplitude (MA)
Alpha angle
K-time
The MA represents maximum clot firmness influenced by platelets and fibrinogen. It guides transfusion of platelets or fibrinogen. Other values reflect clot initiation and speed.
In a patient with severe aortic stenosis, which anesthetic induction approach is preferred?
Rapid-sequence induction with high-dose propofol
Slow, titrated intravenous induction maintaining preload
High-dose ketamine bolus
Inhalational induction with sevoflurane
Patients with aortic stenosis require stable hemodynamics to maintain coronary perfusion; slow IV induction prevents hypotension. Rapid or high-dose induction can precipitate cardiovascular collapse. Preload and afterload must be preserved.
Which intraoperative monitoring is most sensitive for detecting myocardial ischemia?
Pulse oximetry
Noninvasive blood pressure cuff
Transesophageal echocardiography
Continuous ECG ST-segment analysis
TEE provides real-time visualization of ventricular function and wall motion abnormalities, detecting ischemia earlier than ECG alone. It's invaluable in high-risk cardiac surgery. ECG changes may lag behind mechanical dysfunction.
Which strategy best prevents perioperative pulmonary aspiration in high-risk patients?
Spontaneous ventilation only
Extubation in deep anesthesia
Rapid-sequence induction with cricoid pressure
Inhalational induction with sevoflurane
Rapid-sequence induction includes preoxygenation, cricoid pressure, and swift intubation to prevent regurgitation. It minimizes time airway is unprotected. Other methods have higher aspiration risk.
Which postoperative fluid therapy approach optimizes outcomes in high-risk abdominal surgery?
Fixed-rate crystalloid infusion of 125 mL/hr
Goal-directed fluid therapy using stroke volume variation
Only colloids at 10 mL/kg/hr
Unlimited free water by mouth
Goal-directed therapy tailors fluids to hemodynamic parameters like stroke volume variation, reducing complications and length of stay. Fixed or arbitrary fluids can cause overload or hypovolemia. Evidence favors individualized management.
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Study Outcomes

  1. Identify ward admission criteria -

    Drawing on challenges from this perioperative quiz, describe the essential preoperative checks and documentation needed for safe patient admission in the perioperative setting.

  2. Apply anesthesia monitoring principles -

    Recognize and implement critical safety measures and monitoring protocols during the anesthesia phase to ensure patient stability and minimize risks.

  3. Analyze surgical nursing interventions -

    Analyze the surgical nursing interventions showcased in this surgical nursing quiz, distinguishing appropriate instrument handling, sterile technique, and intraoperative support tasks to optimize outcomes.

  4. Evaluate post-anesthesia recovery protocols -

    Assess patient vital signs, pain management strategies, and discharge criteria to facilitate effective recovery and reduce postoperative complications.

  5. Reinforce case study decision-making -

    Integrate insights from perioperative ISB case study quiz scenarios to strengthen clinical reasoning, perioperative nursing questions response skills, and overall confidence.

Cheat Sheet

  1. Structured Preoperative Assessment -

    Apply the "AMP CHECK" mnemonic (Allergies, Medications, Past surgeries, Cardiac history, Hemoglobin, EKG, Kidney function) to cover all bases in your perioperative nursing questions. Documenting these systematically reduces perioperative risk and boosts your score on any perioperative nursing quiz. Johns Hopkins research shows that checklists cut assessment omissions by 40%.

  2. ASA Physical Status Classification -

    Memorize the ASA I - VI system to stratify patient risk quickly: I (healthy) through VI (brain-dead donor). A clear grasp of this scale is essential for any surgical nursing quiz or perioperative quiz scenario. The American Society of Anesthesiologists (ASA) guidelines remain the gold standard in risk assessment.

  3. Anesthesia Machine and Equipment Check -

    Use the "SODA" mnemonic (Suction, Oxygen, Drugs, Alarms) when performing your anesthesia machine check before induction. Mastering this routine ensures safety and will help you excel in a perioperative isb case study quiz. AORN standards recommend documenting checks in the perioperative record.

  4. WHO Surgical Safety Checklist Implementation -

    Practice the three key phases - Sign In, Time Out, Sign Out - to verify patient identity, procedure, site, and equipment readiness. Incorporating this into your workflow reduces errors by up to 36%, according to WHO data. Familiarity with this tool is a must for any surgical nursing quiz or real”world OR.

  5. Postoperative Recovery and Aldrete Score -

    Use the Aldrete scoring system (Activity, Respiration, Circulation, Consciousness, Oxygen saturation) to assess readiness for PACU discharge; aim for ≥ 9/10. This objective tool is often tested in perioperative nursing quiz questions and validates safe handoff. Research in the Journal of PeriAnesthesia Nursing confirms its reliability in diverse patient populations.

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