Patient Assessment
15%of exam
PreoperativePostoperativeDiagnosisRisk
Plan and Outcomes
8%of exam
IndividualizedOutcomesPlanningEvaluation
Intraoperative Patient Safety
25%of exam
PositioningDevicesSpecimensProtection
Personnel and Materials
9%of exam
TeamServicesSuppliesResources
Communication and Documentation
11%of exam
HandoffsRecordsCommunicationReporting
Infection Prevention
16%of exam
EnvironmentInstrumentationSuppliesAsepsis
Emergency Situations
10%of exam
RecognitionResponseEscalationSafety
Professional Accountabilities
6%of exam
EthicsStandardsScopeAccountability
Quick Facts
- Owner
- CCI
- Delivery
- PSI
- Items
- 200 multiple choice
- Scored
- 185 items
- Pretest
- 15 unscored
- Time
- 3 hours 45 minutes
- Pass
- 620 scaled
- Eligibility
- 2,400 RN hours
Assessment Versus Plan
Assessment
- Identify risks
- Collect information
- Establish baseline
Plan
- Set outcomes
- Choose protections
- Coordinate actions
Plan follows individualized assessment.
Preoperative Safety Path
- Patient enters care→Verify identity
- Procedure is planned→Confirm procedure details
- History is reviewed→Identify risk factors
- Allergy is reported→Communicate exposure risk
- Mobility is limited→Plan positioning protection
- Skin is assessed→Plan integrity measures
- Care plan is formed→Set expected outcomes
- Team is ready→Communicate key risks
Assessment Cues
- Health history
- Identify perioperative risks
- Allergies
- Verify before exposure
- Skin condition
- Identify protection needs
- Mobility limits
- Plan positioning protection
- Baseline status
- Support later comparison
- Patient concerns
- Inform individualized care
- Postoperative needs
- Plan continuity
Care Plan Cues
- Individualized plan
- Address assessed risks
- Expected outcome
- Define measurable target
- Positioning plan
- Protect pressure areas
- Thermal plan
- Prevent temperature harm
- Skin plan
- Maintain tissue integrity
- Communication plan
- Coordinate team actions
- Evaluation
- Compare outcome evidence
Largest Domains
Safety, infection, assessment lead.
25%16%15%
Scored Versus Pretest
Scored items
- 185 items
- Determine score
- Cannot identify
Pretest items
- 15 items
- Do not affect score
- Cannot identify
Answer every question carefully.
Intraoperative Variance Path
- Change is recognized→Protect patient immediately
- Safety concern remains→Escalate promptly
- Team responds→Clarify roles
- Supply issue occurs→Verify replacement readiness
- Count differs→Resolve discrepancy
- Contamination occurs→Contain and correct
- Specimen is received→Preserve identification
- Care is transferred→Document and hand off
Current Blueprint
- Assessment and diagnosis
- 15% / 28 items
- Plan and outcomes
- 8% / 15 items
- Patient care safety
- 25% / 46 items
- Personnel materials
- 9% / 17 items
- Communication documentation
- 11% / 20 items
- Infection prevention
- 16% / 30 items
- Emergencies
- 10% / 19 items
- Accountabilities
- 6% / 10 items
Intraoperative Safety
- Patient identity
- Verify before procedure
- Procedure details
- Confirm planned care
- Positioning
- Protect nerves and skin
- Safety devices
- Use as intended
- Specimen handling
- Preserve identification
- Surgical counts
- Resolve discrepancies
- Skin preparation
- Follow safe process
Safe Handoff
Facts, risks, actions, ownership.
FactsRisksActionsOwner
Handoff Versus Documentation
Handoff
- Transfer critical facts
- Confirm understanding
- Support continuity
Documentation
- Record actual care
- Preserve evidence
- Support accountability
Do both; neither replaces the other.
Team and Documentation
- Role assignment
- Clarify responsibilities
- Supply readiness
- Confirm before need
- Handoff
- Transfer critical information
- Record accuracy
- Document actual care
- Closed-loop communication
- Confirm message receipt
- Escalation
- Raise safety concerns
- Team coordination
- Align care activities
Sterile Versus Clean
Sterile field
- Protect asepsis
- Prevent contamination
- Maintain integrity
Clean environment
- Support safe care
- Control environment
- Manage supplies
Use the required aseptic level.
Infection Prevention Cues
- Sterile field
- Protect from contamination
- Instrumentation
- Maintain processing controls
- Supplies
- Verify package integrity
- Environmental controls
- Support aseptic practice
- Aseptic technique
- Prevent contamination transfer
- Contamination event
- Recognize and act
- Sterilization evidence
- Review required indicators
Variance Response
Recognize, protect, escalate, document.
RecognizeProtectEscalateDocument
Emergency Versus Routine
Emergency
- Recognize change
- Escalate quickly
- Protect patient
Routine workflow
- Plan ahead
- Coordinate team
- Evaluate outcomes
Escalate when safety changes.
Emergency Cues
- Unexpected change
- Recognize promptly
- Immediate safety
- Protect patient first
- Call for help
- Activate team response
- Available resources
- Bring appropriate support
- Role clarity
- Coordinate response
- Event record
- Document facts
- Follow-up
- Evaluate response outcome
Exam and Eligibility
- Total questions
- 200 multiple choice
- Scored questions
- 185 items
- Pretest questions
- 15 unscored items
- Exam time
- 3 hours 45 minutes
- Passing scaled score
- 620 minimum
- RN license
- Current unrestricted
- Practice requirement
- 2,400 RN hours
- Intraoperative requirement
- 1,200 minimum hours
Accountability Cues
- RN scope
- Practice accountably
- Professional standards
- Guide judgment
- Ethical duty
- Protect patient interests
- Delegation
- Match task competence
- Advocacy
- Voice patient needs
- Confidentiality
- Protect patient information
- Evidence use
- Inform safe practice
Common Traps
Current Blueprint Only
Use May 2026 areas ≠ 2027 changes are future
Unscored Items Remain Hidden
Pretests are dispersed ≠ Answer every item
Scaled Is Not Percent
620 is scaled ≠ Not raw percentage
Count Issues Need Resolution
Do not assume accuracy ≠ Resolve discrepancies
Handoff Needs Documentation
Communicate critical facts ≠ Record actual care
Last Minute
- 1.Recall eight current subject areas
- 2.Prioritize patient safety first
- 3.Review infection prevention cues
- 4.Separate assessment from planning
- 5.Review count discrepancy actions
- 6.Review specimen identification cues
- 7.Review handoff essentials
- 8.Review emergency escalation sequence
- 9.Remember scaled score 620
- 10.Answer all 200 questions
Buy on Amazon
Practice exams on ExamEdge
Flashcards on Mometrix