AORN AORN Surgical Counts 2 — Questions and Answers
Question 1: At which points during a procedure must counts be performed per AORN standards?
- Before the procedure, at closure of each cavity, at skin closure, and when the team changes (Correct answer)
- Only before the procedure and at skin closure
- Only at skin closure
- Only when a discrepancy is suspected
Correct answer: Before the procedure, at closure of each cavity, at skin closure, and when the team changes
AORN mandates counts at specific intervals — initial, before closure of each body cavity, at skin closure, and upon significant team member changes.
Question 2: What should the circulating nurse do when a sponge leaves the sterile field?
- Place it in the designated sponge bag and count it off the field (Correct answer)
- Discard it immediately in the trash
- Hand it back to the scrub tech
- Set it aside without documenting
Correct answer: Place it in the designated sponge bag and count it off the field
Sponges removed from the sterile field should go immediately into a designated counting bag so they remain accounted for in the running tally.
Question 3: Which of the following best describes a 'retained surgical item' (RSI)?
- Any item unintentionally left inside a patient after surgery (Correct answer)
- An item that was counted but not used
- A sharps item returned to the back table
- An instrument handed back to the circulating nurse
Correct answer: Any item unintentionally left inside a patient after surgery
An RSI is any item — sponge, instrument, or sharp — inadvertently left inside the patient's body after wound closure.
Question 4: When a relief circulating nurse takes over a case mid-procedure, what must happen?
- A count must be performed during the handoff to establish a baseline for the incoming nurse (Correct answer)
- The incoming nurse accepts responsibility without a count
- Only the surgeon needs to be notified
- The count resumes at the next scheduled count point
Correct answer: A count must be performed during the handoff to establish a baseline for the incoming nurse
AORN standards require a count when a relief circulator assumes responsibility so the new nurse has a verified baseline.
Question 5: Why are radiopaque markers incorporated into surgical sponges?
- To allow detection via X-ray if a sponge is inadvertently retained (Correct answer)
- To color-code sponge types
- To indicate sterility
- To absorb fluids more efficiently
Correct answer: To allow detection via X-ray if a sponge is inadvertently retained
Radiopaque markers make sponges visible on intraoperative or postoperative X-rays, serving as a safety backup when count discrepancies occur.
Question 6: Which documentation is required following a surgical count?
- The circulating nurse documents count results, any discrepancies, and actions taken in the intraoperative record (Correct answer)
- Only verbal communication to the surgeon is needed
- Documentation occurs only if there is a discrepancy
- The scrub tech documents the count in a personal log
Correct answer: The circulating nurse documents count results, any discrepancies, and actions taken in the intraoperative record
AORN requires the circulating nurse to document each count result, discrepancies, corrective actions, and final reconciliation in the official intraoperative nursing record.
AORN AORN Surgical Counts 2
At which points during a procedure must counts be performed per AORN standards?