Patient safety in the Operating Theatre (OT) and correct positioning are core competencies for every nurse. Whether you are preparing for AIIMS NORCET Skill Test or NCLEX-RN, these topics are unavoidable.
This daily mock test covers high-yield questions on the WHO Surgical Safety Checklist (Sign In, Time Out, Sign Out) and its components. We also focus on various Patient Positions (Lithotomy, Trendelenburg, Fowler's) used for surgeries and therapeutic procedures. Master these fundamental skills with our solved MCQs.
OT Safety & Positioning Techniques
💡 Golden Points to Remember:
- Time Out (Surgical Pause): Done before skin incision to confirm correct patient, site, and procedure.
- Trendelenburg Position: Used for Shock (Hypotension) and Cord Prolapse.
- Lithotomy Position: Used for Gynecological surgeries and Normal Delivery.
- Left Lateral Position: Best for Enema administration and Rectal temperature.
- Sign In: Done before induction of anesthesia.
Fundamentals: Surgical Safety & Positioning Quiz
Q1.Which phase of the WHO Surgical Safety Checklist is performed before the induction of anesthesia?
A. Time Out
B. Sign In
C. Sign Out
D. Debriefing
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Sign In happens before anesthesia induction (confirming patient identity, site, consent). Time Out (Option A) is before skin incision. Sign Out (Option C) is before the patient leaves the OR.
Source: www.logyanlo.in
Q2.The "Trendelenburg Position" involves:
A. Head of bed elevated 45 degrees
B. Patient flat on back
C. Head lower than feet
D. Feet lower than head
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. In Trendelenburg, the patient lies supine with the head tilted down (15-30 degrees) and feet up. It is used for pelvic surgery or shock (historically). Option D is Reverse Trendelenburg.
Source: www.logyanlo.in
Q3."Sims' Position" is primarily used for:
A. Vaginal Examination
B. Rectal Examination and Enema administration
C. Abdominal Surgery
D. Thyroid Surgery
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Sims' (Left Lateral) position allows easy access to the anus and sigmoid colon, making it ideal for Rectal exams and Enemas.
Source: www.logyanlo.in
Q4.Who is responsible for initiating the "Time Out" phase in the OT?
A. Surgeon
B. Anesthesiologist
C. Circulating Nurse / Any team member
D. Scrub Nurse
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. While typically led by a designated person (often the circulating nurse), any team member can and should initiate the Time Out before the incision to ensure the team is ready.
Source: www.logyanlo.in
Q5.Which position is indicated for a patient with increased Intracranial Pressure (ICP)?
A. Trendelenburg
B. Prone
C. Semi-Fowler's (Head elevated 30 degrees)
D. Supine
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Elevating the head 30 degrees promotes venous drainage from the brain via the jugular veins, thereby reducing ICP. Flat or head-down positions increase ICP.
Source: www.logyanlo.in
Q6.The "Lithotomy Position" is standard for:
A. Renal Surgery
B. Gynecological, Rectal, and Urological procedures
C. Neuro Surgery
D. Spinal Surgery
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The patient is supine with legs raised and supported in stirrups, exposing the perineum for Vaginal/Rectal/Urologic surgeries.
Source: www.logyanlo.in
Q7.During the "Sign Out" phase of the WHO Checklist, the nurse confirms:
A. Patient identity
B. Site marking
C. Needle, sponge, and instrument counts
D. Antibiotic prophylaxis
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Sign Out occurs before the patient leaves the room. The team confirms the counts are correct, specimens are labeled, and any equipment issues are noted.
Source: www.logyanlo.in
Q8.A patient post-Lumbar Puncture should be placed in which position?
A. High Fowler's
B. Supine (Flat)
C. Prone
D. Side-lying with knees flexed
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The patient should lie Supine (flat) for 4-6 hours to prevent CSF leakage and spinal headache. Option D is the position during the procedure.
Source: www.logyanlo.in
Q9."Fowler's Position" refers to the head of the bed elevated at:
A. 15-30 degrees
B. 45-60 degrees
C. 90 degrees
D. 10 degrees
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Standard Fowler's is 45-60 degrees. Low Fowler's is 15-30 degrees. High Fowler's is 90 degrees (Option C).
Source: www.logyanlo.in
Q10.Which position is used to prevent aspiration during mouth care in an unconscious patient?
A. Supine
B. Side-lying (Lateral)
C. High Fowler's
D. Prone
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Side-lying position allows fluids/secretions to drain out of the mouth by gravity, preventing them from trickling into the trachea (aspiration).
Source: www.logyanlo.in
Q11.The "Jackknife Position" (Kraske) is typically used for surgeries involving the:
A. Abdomen
B. Rectum/Anus (e.g., Hemorrhoidectomy)
C. Kidney
D. Thyroid
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The patient is prone with hips flexed at 90 degrees (like a jackknife), exposing the Rectal/Anal area.
Source: www.logyanlo.in
Q12."Site Marking" for surgery should be done:
A. After anesthesia induction
B. In the sterile field
C. Before the patient enters the OT (usually in ward/holding area)
D. During Time Out
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Site marking should be done before induction while the patient is awake and can participate/confirm, typically in the pre-op holding area.
Source: www.logyanlo.in
Q13.Which position is contraindicated in a patient with a spinal cord injury until stabilized?
A. Prone
B. Supine (Log-roll)
C. Sitting
D. Trendelenburg
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Sitting or flexing the spine can worsen the injury. The patient must be kept flat and Log-rolled as needed. Sitting position is dangerous and contraindicated until the spine is stabilized.
Source: www.logyanlo.in
Q14.For a Liver Biopsy, the patient is positioned:
A. On the Right side with a pillow under the site
B. On the Left side
C. Supine with right arm raised
D. Prone
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. During the procedure, the patient is Supine with the Right arm raised to expose the intercostal spaces. After the procedure, they are placed on the Right side (Option A) to apply pressure.
Source: www.logyanlo.in
Q15."Orthopneic Position" is used for patients with:
A. Hypotension
B. Severe Dyspnea (COPD/Asthma)
C. Back pain
D. Abdominal surgery
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The patient sits upright and leans forward over a bedside table (Tripod), allowing maximum chest expansion for severe Dyspnea.
Source: www.logyanlo.in
Q16.Which item is NOT part of the WHO Surgical Safety Checklist "Sign In"?
A. Patient identity confirmed
B. Surgical site marked
C. Anesthesia safety check completed
D. Specimen labeling confirmed
View Answer & Rationale
Answer: D
Rationale: Answer D is correct. Specimen labeling is confirmed during Sign Out (end of surgery). Sign In focuses on identity, site, consent, and anesthesia equipment check.
Source: www.logyanlo.in
Q17.The "Rose Position" (head extension) is used for:
A. Tonsillectomy / Adenoidectomy
B. Appendectomy
C. Herniorrhaphy
D. Cholecystectomy
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. The Rose position involves the head hanging over the edge of the table (extended) to prevent aspiration of blood into the trachea during oral/throat surgeries.
Source: www.logyanlo.in
Q18.To insert a Nasogastric (NG) tube, the patient should be placed in:
A. Supine
B. High Fowler's
C. Left Lateral
D. Trendelenburg
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. High Fowler's allows gravity to help the tube pass and reduces the risk of aspiration if the patient vomits.
Source: www.logyanlo.in
Q19."Lateral Decubitus" position is essential for:
A. Kidney Surgery (Nephrectomy)
B. Thyroid Surgery
C. Cataract Surgery
D. Hernia Surgery
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. The Lateral Decubitus (Kidney position) exposes the flank for Renal surgery. The patient lies on the unaffected side.
Source: www.logyanlo.in
Q20.What is the primary purpose of the "Time Out" phase?
A. To check anesthesia machine
B. To confirm correct patient, site, and procedure immediately before incision
C. To count instruments
D. To introduce the team
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Time Out is the final pause before skin incision where the entire team verbally confirms the Right Patient, Right Site, and Right Procedure.
Source: www.logyanlo.in
Q21.Which of the following team members is responsible for audibly reading out the checklist items during the "Time Out"?
A. Surgeon
B. Anesthesiologist
C. A designated coordinator (usually Circulating Nurse)
D. Scrub Nurse
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. While all team members participate, a designated coordinator (often the Circulating Nurse) typically leads the verbal check to ensure compliance.
Source: www.logyanlo.in
Q22.For a patient undergoing a Thyroidectomy, the correct position is:
A. Rose Position (Neck hyperextended)
B. Prone
C. Lateral
D. Knee-chest
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. The Rose Position (supine with a sandbag under the shoulders to hyperextend the neck) provides optimal exposure of the thyroid gland.
Source: www.logyanlo.in
Q23."Reverse Trendelenburg" position is commonly used for:
A. Hypotension treatment
B. Laparoscopic Cholecystectomy
C. Rectal surgery
D. Spinal surgery
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. In Reverse Trendelenburg (head up, feet down), gravity pulls the abdominal viscera down, providing better exposure of the upper abdomen (gallbladder/liver).
Source: www.logyanlo.in
Q24.After a Total Hip Replacement, the patient should be positioned to prevent:
A. Hip Flexion > 90 degrees
B. Hip Adduction (Crossing legs)
C. Hip Internal Rotation
D. All of the above
View Answer & Rationale
Answer: D
Rationale: Answer D is correct. To prevent prosthesis dislocation, the hip must be kept abducted (using a wedge pillow) and never flexed >90 degrees or adducted across the midline.
Source: www.logyanlo.in
Q25.The "Knee-Chest" (Genupectoral) position is indicated for:
A. Sigmoidoscopy / Rectal Exam
B. Abdominal Exam
C. Breast Exam
D. Eye Surgery
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. The Knee-Chest position (weight on knees and chest) exposes the anal and rectal area for examination or proctoscopy.
Source: www.logyanlo.in
Q26.Which phase of the Surgical Safety Checklist confirms that antibiotic prophylaxis has been administered within the last 60 minutes?
A. Sign In
B. Time Out
C. Sign Out
D. Pre-operative check
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. During the Time Out (before incision), the team confirms that prophylactic antibiotics were given within the therapeutic window (usually 60 mins).
Source: www.logyanlo.in
Q27.A patient with a prolapsed umbilical cord should be immediately placed in which position?
A. Supine
B. High Fowler's
C. Trendelenburg or Knee-Chest
D. Prone
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Trendelenburg or Knee-Chest position uses gravity to relieve the pressure of the fetal presenting part on the cord, preventing fetal hypoxia.
Source: www.logyanlo.in
Q28.When positioning a patient in the "Lithotomy" position, both legs should be raised and lowered simultaneously to prevent:
A. Nerve damage
B. Hip dislocation and Hypotension
C. Muscle spasm
D. Back pain
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Rapid or uneven movement can cause hip dislocation and sudden shifts in blood volume, leading to Hypotension.
Source: www.logyanlo.in
Q29.The "Semi-Fowler's" position (30 degrees) is most appropriate for a patient with:
A. Increased ICP
B. Hypovolemic Shock
C. Spinal Anesthesia recovery
D. Lumbar puncture recovery
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. Elevating the head 30 degrees facilitates venous return from the brain and decreases Intracranial Pressure.
Source: www.logyanlo.in
Q30.Which component is checked during the "Sign Out" phase?
A. Known allergies
B. Instrument, sponge, and needle counts
C. Difficulty of intubation
D. Site marking
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Before the patient leaves the room (Sign Out), the nurse confirms that all counts are correct to prevent retained foreign bodies.
Source: www.logyanlo.in
Q31.The "Dorsal Recumbent" position is used for:
A. Vaginal examination and Catheterization
B. Rectal surgery
C. Back surgery
D. Liver biopsy
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. In Dorsal Recumbent (supine with knees flexed), the abdominal muscles relax, making it suitable for Vaginal exams and abdominal palpation.
Source: www.logyanlo.in
Q32.Which position is recommended for administering an enema?
A. Right Lateral
B. Left Lateral (Sims')
C. Prone
D. Supine
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Left Lateral position follows the natural anatomical curve of the sigmoid colon, facilitating fluid flow into the rectum.
Source: www.logyanlo.in
Q33.A patient recovering from general anesthesia should be placed in which position to maintain a patent airway?
A. Supine
B. Side-lying (Lateral)
C. Prone
D. Trendelenburg
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Side-lying position prevents the tongue from falling back and obstructing the airway and allows drainage of vomit/secretions.
Source: www.logyanlo.in
Q34."Prone Position" is contraindicated in patients with:
A. ARDS
B. Spinal surgery
C. Increased ICP or Abdominal incisions
D. Pressure sores on back
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Prone positioning increases intra-abdominal and intrathoracic pressure, which can raise ICP and compromise abdominal wounds. It is used for ARDS to improve oxygenation.
Source: www.logyanlo.in
Q35.Which nerve is most at risk of injury if the legs are improperly positioned in stirrups (Lithotomy)?
A. Sciatic Nerve
B. Common Peroneal Nerve
C. Femoral Nerve
D. Obturator Nerve
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Common Peroneal Nerve runs superficially along the lateral aspect of the knee and can be compressed against the stirrup, causing foot drop.
Source: www.logyanlo.in
Q36.The "Sitting Position" is primarily used for neurosurgical procedures involving the:
A. Frontal Lobe
B. Posterior Fossa (Cerebellum/Brainstem)
C. Temporal Lobe
D. Spinal Cord (Lumbar)
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Sitting position provides optimal access to the Posterior Fossa and cervical spine while facilitating venous drainage.
Source: www.logyanlo.in
Q37.After a Pneumonectomy (removal of one lung), the patient should be positioned:
A. On the unoperated side
B. On the operated side or back
C. High Fowler's
D. Prone
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The patient is usually positioned on the Operated Side to allow the remaining lung to expand fully. Laying on the healthy side (Option A) can restrict its expansion.
Source: www.logyanlo.in
Q38.Which of the following is verified during the "Sign In" phase?
A. Sterility of instruments
B. Patient has confirmed identity, site, procedure, and consent
C. Sponge count
D. Specimen labeling
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Sign In is the first check (before anesthesia) to confirm the basics: Who is the patient? What is the procedure? Is there consent?
Source: www.logyanlo.in
Q39.For "Thoracentesis", the patient is positioned sitting on the edge of the bed leaning over a table. This position helps to:
A. Spread the ribs and enlarge intercostal spaces
B. Decrease venous return
C. Increase comfort
D. Prevent hypotension
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. Leaning forward spreads the ribs, making it easier to insert the needle into the pleural space without hitting bone.
Source: www.logyanlo.in
Q40.After a Liver Biopsy, the patient is positioned on the Right Side to:
A. Prevent aspiration
B. Apply pressure to the biopsy site (Hemostasis)
C. Promote drainage
D. Reduce pain
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Since the liver is on the right, lying on the Right Side uses the patient's body weight to tamponade the puncture site and prevent bleeding.
Source: www.logyanlo.in
🔗 Read Also: More Fundamental Nursing Questions (Procedures & CPR)
Frequently Asked Questions (Surgical Nursing)
Q1: What are the three phases of the WHO Surgical Safety Checklist?
Ans: The three phases are: Sign In (Before anesthesia), Time Out (Before skin incision), and Sign Out (Before patient leaves the OT).
Q2: Which position is contraindicated in a patient with Increased Intracranial Pressure (ICP)?
Ans: Trendelenburg Position (Head down) is contraindicated as it increases ICP. The head should be elevated (Semi-Fowler's).
Q3: What is the purpose of the "Sims' Position"?
Ans: Sims' Position (Left lateral with right leg flexed) is primarily used for Rectal Examination, Enema administration, and Suppository insertion.
Question for You:
Which position is used for a patient post-Liver Biopsy to prevent bleeding?
A. Left Lateral
B. Right Lateral
C. Supine
D. Prone
👉 Comment your answer below! (Hint: We need to apply pressure on the liver).
0 Comments