CNOR CERTIFICATION EXAM PREP 2026/2027 – PRACTICE
QUESTIONS, CORRECT ANSWERS & DETAILED RATIONALES
1. During a preoperative interview, a patient scheduled for right knee surgery states,
“I thought the surgery was going to be on my left knee.” The consent and
schedule both identify the right knee. What should the perioperative nurse do
first?
A. Continue preparation because the signed consent identifies the operative site
B. Ask the patient to choose which knee should be prepared
C. Pause preparation and initiate resolution of the discrepancy before proceeding
D. Wait until the surgical time-out to address the discrepancy
The discrepancy must be resolved before the procedure proceeds. Patient statements, consent,
scheduling information, and the planned procedure must be reconciled rather than allowing the
issue to persist until the time-out.
2. A patient arrives in the operating room without a completed surgical consent
form. The procedure is elective. Which action is most appropriate?
A. Ask the circulating nurse to sign the consent
B. Stop the preparation process and ensure the appropriate informed-consent process is
completed
C. Proceed because the surgeon verbally confirmed the procedure
D. Have a family member provide consent regardless of the patient's capacity
An elective procedure should not proceed without appropriate informed consent. The nurse
supports verification of the consent process but does not substitute for the provider responsible
for obtaining informed consent.
3. A patient requests that a family member participate in perioperative teaching
because the patient has limited English proficiency. Which nursing action best
demonstrates culturally responsive care?
A. Provide teaching only through written English materials
B. Ask another family member to translate all medical information
C. Delay all teaching until after surgery
D. Use an appropriate qualified interpreter while incorporating the patient's requested
support person when appropriate
Culturally responsive care includes addressing communication needs while protecting accurate
communication and patient autonomy. Qualified interpretation is preferable to relying solely on
an untrained family member for clinical communication.
4. A patient has a documented do-not-resuscitate (DNR) order before an elective
procedure. What is the perioperative nurse's priority?
, A. Automatically suspend the DNR for the duration of surgery
B. Ignore the DNR because anesthesia is responsible for resuscitation
C. Ensure the patient's wishes and the applicable perioperative resuscitation plan are
clarified and communicated
D. Ask the family to decide whether the DNR should remain active
Perioperative care requires clarification of how existing directives apply during the procedure.
The patient's documented wishes should be respected and communicated rather than
automatically suspended or ignored.
5. A patient reports severe pain during the preoperative assessment but is unable to
use a standard numeric pain scale because of a cognitive limitation. Which
approach is most appropriate?
A. Document that pain cannot be assessed
B. Ask the family to assign a pain score
C. Use the numeric scale anyway and record the patient's response
D. Select an age- and ability-appropriate validated pain assessment approach
Pain assessment should be individualized to the patient's communication and cognitive abilities.
An appropriate validated tool can provide a more meaningful assessment than forcing use of an
unsuitable scale.
6. During medication reconciliation, the nurse discovers that the patient's home
medication list differs substantially from the electronic health record. What should
the nurse do?
A. Delete the home medication list
B. Assume the electronic record is correct
C. Clarify the discrepancy and communicate relevant medication information to the
appropriate team members
D. Ask the patient to restart all medications immediately
Medication reconciliation is intended to identify discrepancies and improve medication safety.
Unresolved differences should be clarified and communicated rather than assumed to be
accurate.
7. During preoperative verification, the procedure listed on the schedule differs from
the procedure described in the patient's consent. What is the priority?
A. Use the schedule because it was generated by the operating room
B. Use the consent because it is always the most recent document
C. Ask the scrub person to determine which procedure is correct
D. Stop the process and resolve the discrepancy with the responsible surgical team
QUESTIONS, CORRECT ANSWERS & DETAILED RATIONALES
1. During a preoperative interview, a patient scheduled for right knee surgery states,
“I thought the surgery was going to be on my left knee.” The consent and
schedule both identify the right knee. What should the perioperative nurse do
first?
A. Continue preparation because the signed consent identifies the operative site
B. Ask the patient to choose which knee should be prepared
C. Pause preparation and initiate resolution of the discrepancy before proceeding
D. Wait until the surgical time-out to address the discrepancy
The discrepancy must be resolved before the procedure proceeds. Patient statements, consent,
scheduling information, and the planned procedure must be reconciled rather than allowing the
issue to persist until the time-out.
2. A patient arrives in the operating room without a completed surgical consent
form. The procedure is elective. Which action is most appropriate?
A. Ask the circulating nurse to sign the consent
B. Stop the preparation process and ensure the appropriate informed-consent process is
completed
C. Proceed because the surgeon verbally confirmed the procedure
D. Have a family member provide consent regardless of the patient's capacity
An elective procedure should not proceed without appropriate informed consent. The nurse
supports verification of the consent process but does not substitute for the provider responsible
for obtaining informed consent.
3. A patient requests that a family member participate in perioperative teaching
because the patient has limited English proficiency. Which nursing action best
demonstrates culturally responsive care?
A. Provide teaching only through written English materials
B. Ask another family member to translate all medical information
C. Delay all teaching until after surgery
D. Use an appropriate qualified interpreter while incorporating the patient's requested
support person when appropriate
Culturally responsive care includes addressing communication needs while protecting accurate
communication and patient autonomy. Qualified interpretation is preferable to relying solely on
an untrained family member for clinical communication.
4. A patient has a documented do-not-resuscitate (DNR) order before an elective
procedure. What is the perioperative nurse's priority?
, A. Automatically suspend the DNR for the duration of surgery
B. Ignore the DNR because anesthesia is responsible for resuscitation
C. Ensure the patient's wishes and the applicable perioperative resuscitation plan are
clarified and communicated
D. Ask the family to decide whether the DNR should remain active
Perioperative care requires clarification of how existing directives apply during the procedure.
The patient's documented wishes should be respected and communicated rather than
automatically suspended or ignored.
5. A patient reports severe pain during the preoperative assessment but is unable to
use a standard numeric pain scale because of a cognitive limitation. Which
approach is most appropriate?
A. Document that pain cannot be assessed
B. Ask the family to assign a pain score
C. Use the numeric scale anyway and record the patient's response
D. Select an age- and ability-appropriate validated pain assessment approach
Pain assessment should be individualized to the patient's communication and cognitive abilities.
An appropriate validated tool can provide a more meaningful assessment than forcing use of an
unsuitable scale.
6. During medication reconciliation, the nurse discovers that the patient's home
medication list differs substantially from the electronic health record. What should
the nurse do?
A. Delete the home medication list
B. Assume the electronic record is correct
C. Clarify the discrepancy and communicate relevant medication information to the
appropriate team members
D. Ask the patient to restart all medications immediately
Medication reconciliation is intended to identify discrepancies and improve medication safety.
Unresolved differences should be clarified and communicated rather than assumed to be
accurate.
7. During preoperative verification, the procedure listed on the schedule differs from
the procedure described in the patient's consent. What is the priority?
A. Use the schedule because it was generated by the operating room
B. Use the consent because it is always the most recent document
C. Ask the scrub person to determine which procedure is correct
D. Stop the process and resolve the discrepancy with the responsible surgical team
