During a long orthopedic procedure, the original scrub person is relieved for a break. Which action is required before the relief scrub person assumes the sterile field?

During a total hip arthroplasty, the surgeon decides intraoperatively to use a different femoral head size than originally planned. The originally opened size has been counted and is on the sterile field. Which action reflects best practice for implant tracking and count integrity?

Which physiologic change is MOST directly associated with placing a patient in steep Trendelenburg position for robotic pelvic surgery?

High-level disinfection with glutaraldehyde achieves its effect primarily by which mechanism?

When preparing a tray that contains both lightweight delicate instruments and heavy retractors for steam sterilization, how should the tray be arranged to protect instruments and ensure sterilization efficacy?

Which statement accurately describes ortho-phthalaldehyde (OPA) used to reprocess heat-sensitive semicritical instruments such as flexible endoscopes?

A patient on long-term corticosteroid therapy (prednisone 10 mg daily for 3 years) presents for elective abdominal surgery. Which perioperative consideration related to this medication is most critical?

A perianesthesia nurse is assessing a 74-year-old patient returning from hip arthroplasty. The patient uses a walker at baseline, received a spinal anesthetic, and is on a beta-blocker for hypertension. Which combination of factors places this patient at the HIGHEST fall risk during PACU care?

During the preoperative assessment of a patient scheduled for a three-hour vascular bypass surgery in the supine position, the perianesthesia nurse identifies a Braden Scale score of 14 and notes the patient has peripheral vascular disease with diminished sensation in both lower extremities. Which intervention is the highest priority based on this assessment?

A facility adopts a just culture approach to adverse event reporting. Which nursing behavior is most consistent with just culture principles in the perioperative setting?

A patient receives two units of packed red blood cells intraoperatively. Which elements must be documented for each unit transfused?

Which statement most accurately describes the purpose of an incident report in the perioperative setting?

During a minimally invasive cardiac procedure, the hospital’s primary electrical system fails and the emergency generator activates. The scrub nurse notices that the video monitor displaying the operative field has gone dark. Which is the most likely explanation and immediate response?

During a laparoscopic procedure, the patient’s blood pressure drops acutely and the heart rate rises. The anesthesia provider suspects insufflation-related cardiovascular compromise. Which perioperative nursing action is most appropriate?

A patient who was successfully extubated in the PACU develops stridor and increasing respiratory distress about 20 minutes later. Laryngospasm is suspected. Which intervention should be performed first?

A nonsmoking patient with a documented history of postoperative nausea and vomiting will receive volatile anesthetic agents during a 3-hour gynecologic procedure. Based on evidence-based risk stratification, which multimodal plan is most appropriate?

A perioperative nurse is selecting interventions to reduce surgical site infection risk for a patient scheduled for a colorectal procedure. Which combination is most consistent with current evidence-based practice?

A perioperative nurse set an expected outcome that a thoracic surgery patient would maintain oxygen saturation above 95% intraoperatively. During single-lung ventilation the saturation drops to 89%. What is the nurse’s most appropriate next action?

A perioperative unit’s surgical site infection rate exceeds the national benchmark for the third consecutive quarter. The QI team wants to map out all potential contributing factors across categories such as people, process, equipment, and environment before selecting an intervention. Which tool is MOST appropriate?

A scrub technician (unlicensed assistive personnel) is preparing the sterile field for an abdominal case. The perioperative RN notices the technician reaching across the sterile field to adjust an instrument, breaking sterile technique. Which action by the RN best reflects appropriate delegation accountability?

In the commonly taught Five Rights of Delegation, which element requires the RN to verify that the individual receiving a delegated perioperative task has the knowledge and skill to perform it safely?