CNOR CERTIFICATION EXAM PREP 2026–2027 – 100 PRACTICE
QUESTIONS WITH DETAILED RATIONALES
1. A patient scheduled for a total hip arthroplasty reports a history of severe latex
sensitivity during the preoperative interview. Which action is most important
before the patient enters the operating room?
A. Place a latex-allergy identification band on the patient after anesthesia induction
B. Notify the surgical team and prepare an appropriately latex-safe environment
C. Administer prophylactic antihistamine therapy before transporting the patient
D. Ask the surgeon whether latex-free gloves are necessary for the procedure
Rationale: B. Notify the surgical team and prepare an appropriately latex-safe environment is
correct because a documented latex sensitivity requires proactive environmental and equipment
planning before exposure occurs. The perioperative team should identify potential latex-
containing products and substitute appropriate alternatives. Waiting until induction or relying
only on an identification band does not adequately prevent exposure.
2. During positioning for a prolonged lithotomy procedure, which intervention best
reduces the risk of lower-extremity nerve injury?
A. Elevating both legs simultaneously into the stirrups
B. Keeping the hips maximally flexed throughout the procedure
C. Maintaining neutral alignment and avoiding excessive hip flexion or abduction
D. Placing the patient's legs below heart level whenever possible
Rationale: C. Maintaining neutral alignment and avoiding excessive hip flexion or abduction
is correct because prolonged or excessive positioning can compress or stretch peripheral nerves.
Controlled positioning with attention to alignment, pressure points, and physiologic limits
reduces positioning-related injury.
3. The surgical team is preparing for an abdominal procedure. The initial count is
correct, but a soft item is missing during the closing count. What should the RN
circulator do first?
A. Document the discrepancy and continue closure
B. Ask the surgeon to visually inspect the operative field
C. Initiate the established count-discrepancy procedure and immediately communicate the
missing item
D. Obtain an additional item from central sterile processing to replace the missing item
Rationale: C. Initiate the established count-discrepancy procedure and immediately
communicate the missing item is correct because an unresolved count discrepancy creates a
significant patient-safety risk. The team should systematically search according to policy,
including the field, room, receptacles, and other designated locations, while communicating the
discrepancy.
, 4. A patient undergoing surgery has an implanted cardiac device. Monopolar
electrosurgery is anticipated. Which consideration is most important during
perioperative planning?
A. Avoid documenting the device because it is unrelated to the surgical procedure
B. Determine the device type and coordinate appropriate perioperative management
C. Place the grounding pad directly over the implanted device
D. Automatically cancel the procedure because electrosurgery is contraindicated
Rationale: B. Determine the device type and coordinate appropriate perioperative management
is correct because implanted cardiac devices may be affected by electromagnetic interference.
Management depends on the specific device, procedure, and anticipated energy use. Automatic
cancellation is not appropriate.
5. A patient is positioned prone for a lengthy spinal procedure. Which assessment is
particularly important before final positioning is completed?
A. Whether the patient's arms are completely immobilized
B. Whether abdominal pressure is minimized and pressure points are protected
C. Whether both feet extend beyond the operating table
D. Whether the patient's head is rotated as far as possible
Rationale: B. Whether abdominal pressure is minimized and pressure points are protected is
correct because prone positioning can impair ventilation and venous return when abdominal
compression occurs and can contribute to pressure-related injuries. Proper alignment and
protection of vulnerable areas are essential.
6. During a procedure, the surgeon requests that the electrosurgical unit be
activated while a flammable alcohol-based skin preparation is still visibly wet.
What is the most appropriate response by the perioperative nurse?
A. Activate the unit because the skin preparation has already been applied
B. Place additional sterile towels over the wet area and activate the unit
C. Stop the activation and ensure the preparation is completely dry before ignition sources are
used
D. Ask anesthesia to increase oxygen flow before activation
Rationale: C. Stop the activation and ensure the preparation is completely dry before ignition
sources are used is correct because residual alcohol-based antiseptic can create a surgical fire
hazard when exposed to an ignition source. Allowing adequate drying time is an essential fire-
prevention measure.
7. A patient is undergoing a procedure requiring a pneumatic tourniquet. Which
assessment finding requires particular attention before inflation?
, A. History of seasonal allergies
B. History of sickle cell disease
C. Mild myopia
D. Previous appendectomy
Rationale: B. History of sickle cell disease is correct because tourniquet application can create
conditions that may increase the risk of complications in susceptible patients. The perioperative
nurse should identify relevant patient-specific risks and communicate them to the surgical team.
8. A specimen is removed during surgery and requires pathologic examination.
Which action is most important before the specimen leaves the operating room?
A. Place the specimen in any available container
B. Allow the scrub person to determine the specimen identification
C. Confirm correct specimen identification and labeling with the appropriate team members
D. Send the specimen without documentation when the procedure is urgent
Rationale: C. Confirm correct specimen identification and labeling with the appropriate team
members is correct because specimen errors can lead to incorrect diagnosis or treatment.
Identification, labeling, and communication must follow established policy and specimen
requirements.
9. A patient begins moving unexpectedly during a procedure while under monitored
anesthesia care. What is the perioperative nurse's priority?
A. Restrain the patient immediately without notifying the team
B. Ignore the movement because it is expected
C. Communicate the change promptly and assist the anesthesia provider and surgical team in
maintaining patient safety
D. Leave the room to obtain additional equipment
Rationale: C. Communicate the change promptly and assist the anesthesia provider and
surgical team in maintaining patient safety is correct because unexpected movement can create
immediate risks for the patient and surgical team. Coordinated communication allows the
anesthesia provider to assess the cause and intervene appropriately.
10. During a procedure, a member of the surgical team notices that the patient's
identification does not match the information on the operative schedule. What
should occur?
A. Continue because the procedure has already started
B. Verify the patient's identity and resolve the discrepancy before proceeding
C. Ask the patient after anesthesia induction whether the procedure is correct
D. Change the schedule without notifying the team
QUESTIONS WITH DETAILED RATIONALES
1. A patient scheduled for a total hip arthroplasty reports a history of severe latex
sensitivity during the preoperative interview. Which action is most important
before the patient enters the operating room?
A. Place a latex-allergy identification band on the patient after anesthesia induction
B. Notify the surgical team and prepare an appropriately latex-safe environment
C. Administer prophylactic antihistamine therapy before transporting the patient
D. Ask the surgeon whether latex-free gloves are necessary for the procedure
Rationale: B. Notify the surgical team and prepare an appropriately latex-safe environment is
correct because a documented latex sensitivity requires proactive environmental and equipment
planning before exposure occurs. The perioperative team should identify potential latex-
containing products and substitute appropriate alternatives. Waiting until induction or relying
only on an identification band does not adequately prevent exposure.
2. During positioning for a prolonged lithotomy procedure, which intervention best
reduces the risk of lower-extremity nerve injury?
A. Elevating both legs simultaneously into the stirrups
B. Keeping the hips maximally flexed throughout the procedure
C. Maintaining neutral alignment and avoiding excessive hip flexion or abduction
D. Placing the patient's legs below heart level whenever possible
Rationale: C. Maintaining neutral alignment and avoiding excessive hip flexion or abduction
is correct because prolonged or excessive positioning can compress or stretch peripheral nerves.
Controlled positioning with attention to alignment, pressure points, and physiologic limits
reduces positioning-related injury.
3. The surgical team is preparing for an abdominal procedure. The initial count is
correct, but a soft item is missing during the closing count. What should the RN
circulator do first?
A. Document the discrepancy and continue closure
B. Ask the surgeon to visually inspect the operative field
C. Initiate the established count-discrepancy procedure and immediately communicate the
missing item
D. Obtain an additional item from central sterile processing to replace the missing item
Rationale: C. Initiate the established count-discrepancy procedure and immediately
communicate the missing item is correct because an unresolved count discrepancy creates a
significant patient-safety risk. The team should systematically search according to policy,
including the field, room, receptacles, and other designated locations, while communicating the
discrepancy.
, 4. A patient undergoing surgery has an implanted cardiac device. Monopolar
electrosurgery is anticipated. Which consideration is most important during
perioperative planning?
A. Avoid documenting the device because it is unrelated to the surgical procedure
B. Determine the device type and coordinate appropriate perioperative management
C. Place the grounding pad directly over the implanted device
D. Automatically cancel the procedure because electrosurgery is contraindicated
Rationale: B. Determine the device type and coordinate appropriate perioperative management
is correct because implanted cardiac devices may be affected by electromagnetic interference.
Management depends on the specific device, procedure, and anticipated energy use. Automatic
cancellation is not appropriate.
5. A patient is positioned prone for a lengthy spinal procedure. Which assessment is
particularly important before final positioning is completed?
A. Whether the patient's arms are completely immobilized
B. Whether abdominal pressure is minimized and pressure points are protected
C. Whether both feet extend beyond the operating table
D. Whether the patient's head is rotated as far as possible
Rationale: B. Whether abdominal pressure is minimized and pressure points are protected is
correct because prone positioning can impair ventilation and venous return when abdominal
compression occurs and can contribute to pressure-related injuries. Proper alignment and
protection of vulnerable areas are essential.
6. During a procedure, the surgeon requests that the electrosurgical unit be
activated while a flammable alcohol-based skin preparation is still visibly wet.
What is the most appropriate response by the perioperative nurse?
A. Activate the unit because the skin preparation has already been applied
B. Place additional sterile towels over the wet area and activate the unit
C. Stop the activation and ensure the preparation is completely dry before ignition sources are
used
D. Ask anesthesia to increase oxygen flow before activation
Rationale: C. Stop the activation and ensure the preparation is completely dry before ignition
sources are used is correct because residual alcohol-based antiseptic can create a surgical fire
hazard when exposed to an ignition source. Allowing adequate drying time is an essential fire-
prevention measure.
7. A patient is undergoing a procedure requiring a pneumatic tourniquet. Which
assessment finding requires particular attention before inflation?
, A. History of seasonal allergies
B. History of sickle cell disease
C. Mild myopia
D. Previous appendectomy
Rationale: B. History of sickle cell disease is correct because tourniquet application can create
conditions that may increase the risk of complications in susceptible patients. The perioperative
nurse should identify relevant patient-specific risks and communicate them to the surgical team.
8. A specimen is removed during surgery and requires pathologic examination.
Which action is most important before the specimen leaves the operating room?
A. Place the specimen in any available container
B. Allow the scrub person to determine the specimen identification
C. Confirm correct specimen identification and labeling with the appropriate team members
D. Send the specimen without documentation when the procedure is urgent
Rationale: C. Confirm correct specimen identification and labeling with the appropriate team
members is correct because specimen errors can lead to incorrect diagnosis or treatment.
Identification, labeling, and communication must follow established policy and specimen
requirements.
9. A patient begins moving unexpectedly during a procedure while under monitored
anesthesia care. What is the perioperative nurse's priority?
A. Restrain the patient immediately without notifying the team
B. Ignore the movement because it is expected
C. Communicate the change promptly and assist the anesthesia provider and surgical team in
maintaining patient safety
D. Leave the room to obtain additional equipment
Rationale: C. Communicate the change promptly and assist the anesthesia provider and
surgical team in maintaining patient safety is correct because unexpected movement can create
immediate risks for the patient and surgical team. Coordinated communication allows the
anesthesia provider to assess the cause and intervene appropriately.
10. During a procedure, a member of the surgical team notices that the patient's
identification does not match the information on the operative schedule. What
should occur?
A. Continue because the procedure has already started
B. Verify the patient's identity and resolve the discrepancy before proceeding
C. Ask the patient after anesthesia induction whether the procedure is correct
D. Change the schedule without notifying the team
