AORN AORN Surgical Counts 1 — Questions and Answers
Question 1: When must the initial surgical count be performed?
- Before the procedure begins, before the incision is made (Correct answer)
- After the incision is made
- At the time of wound closure
- At the end of the procedure
Correct answer: Before the procedure begins, before the incision is made
The initial count must occur before the procedure begins so a baseline is established prior to any items entering the surgical field.
Question 2: Which items are included in the standard surgical count according to AORN guidelines?
- Sponges, sharps, and instruments (Correct answer)
- Only sponges and sharps
- Only instruments and needles
- Only soft goods like sponges and towels
Correct answer: Sponges, sharps, and instruments
AORN guidelines require counting sponges, sharps (needles, blades), and instruments to prevent retained surgical items.
Question 3: Who is responsible for performing and reconciling surgical counts in the OR?
- The scrub person and the circulating nurse together (Correct answer)
- The surgeon alone
- The anesthesia provider
- The surgical technologist alone
Correct answer: The scrub person and the circulating nurse together
AORN standards require that counts be performed jointly by the scrub person and the circulating nurse, with both verbally confirming each item.
Question 4: What action should be taken if a closing count does not reconcile?
- Inform the surgeon immediately and search the field, patient, and environment before closure (Correct answer)
- Proceed with closure and document the discrepancy
- Recount only the sponges
- Notify the charge nurse and continue the case
Correct answer: Inform the surgeon immediately and search the field, patient, and environment before closure
An unresolved count discrepancy requires immediate notification of the surgeon and a systematic search before closure to prevent a retained foreign body.
Question 5: How should items used in the sterile field be tracked to facilitate accurate counting?
- Items should be kept together in the sterile field and not removed unless accounted for (Correct answer)
- Items can be discarded off the field at any time
- Only the scrub tech needs to track field items
- Items are tracked only at the closing count
Correct answer: Items should be kept together in the sterile field and not removed unless accounted for
Maintaining items within the sterile field and accounting for every item that leaves prevents discrepancies and retained foreign bodies.
Question 6: What is the correct method for counting sponges according to AORN?
- Count each sponge individually in groups of five, audibly and visibly confirming each (Correct answer)
- Count the entire bundle at once to save time
- Count only the sponges used, not the unused ones
- Count only once at closure
Correct answer: Count each sponge individually in groups of five, audibly and visibly confirming each
AORN recommends counting sponges individually in standardized groups of five with both visual and verbal confirmation to minimize errors.
AORN AORN Surgical Counts 1
When must the initial surgical count be performed?