CNOR Exam Original Practice Questions 151–300: High-Yield Perioperative Nursing Test Bank with
Verified Answers and Detailed Rationales for Surgical Safety, Asepsis, Positioning, Hemostasis,
Sterilization, and Emergency Management
Questions 151–170
151. A patient in prone position for lumbar spine surgery develops hypotension after being flipped.
The most likely cause is:
A. Hemorrhage
B. Venous compression from abdominal bolsters
C. Anaphylaxis
D. Malignant hyperthermia
Answer: B – Venous compression from abdominal bolsters
Rationale: Improper prone positioning compresses inferior vena cava, reducing preload and causing
hypotension.
152. Which of the following is a sign of a gas embolism during laparoscopic surgery?
A. Hypertension and bradycardia
B. Sudden drop in ETCO2 and hypotension
C. Fever and leukocytosis
D. Polyuria and hyperglycemia
Answer: B – Sudden drop in ETCO2 and hypotension
Rationale: Gas embolism reduces cardiac output and pulmonary blood flow, decreasing ETCO2.
153. The maximum allowable time for a sterilized instrument pack to sit unused before it must be
resterilized depends on:
A. Type of wrap and storage conditions
B. Manufacturer expiration date only
C. 24 hours regardless of conditions
D. 7 days for all wrapped items
Answer: A – Type of wrap and storage conditions
Rationale: Event-related sterility: pack remains sterile until compromised by events (tear, moisture,
dust), not time alone.
,154. Which of the following hemostatic agents should not be left in large quantities in a confined
space (e.g., neurosurgery)?
A. Thrombin powder
B. Oxidized cellulose (Surgicel)
C. Gelatin sponge (Gelfoam)
D. Microfibrillar collagen (Avitene)
Answer: B – Oxidized cellulose (Surgicel)
Rationale: Swells and can cause nerve compression. pH low, may impair bone healing.
155. A patient undergoing a mastectomy has a history of ipsilateral breast cancer. The surgeon
requests a frozen section of a lymph node. The nurse should ensure:
A. Specimen sent in formalin
B. Specimen sent dry to pathology
C. Specimen kept on ice
D. Specimen wrapped in saline gauze
Answer: B – Specimen sent dry to pathology
Rationale: Frozen section requires fresh, unfixed, dry tissue. Formalin prevents freezing.
156. Which of the following is the most reliable method to confirm sterilization of an implantable
device?
A. Chemical indicator (autoclave tape)
B. Bowie-Dick test
C. Biological indicator (spore test) read after implantation
D. Biological indicator read before implantation
Answer: D – Biological indicator read before implantation
Rationale: BI results must be known before implant use if possible; if emergent, document and
quarantine.
157. The surgical hand scrub using chlorhexidine gluconate (CHG) should last at least:
A. 15 seconds
B. 1 minute
C. 2–3 minutes for initial scrub of the day
D. 5 minutes
Answer: C – 2–3 minutes for initial scrub of the day
Rationale: First scrub of day: 2–3 minutes. Subsequent surgeries: 2 minutes or per manufacturer.
, 158. A patient with a known sulfa allergy develops a rash after chlorhexidine skin prep. This
represents:
A. Expected side effect
B. Cross-reaction because CHG contains sulfa
C. Possible CHG allergy, unrelated to sulfa
D. Anaphylaxis requiring epinephrine
Answer: C – Possible CHG allergy, unrelated to sulfa
Rationale: Chlorhexidine contains no sulfa; reaction represents independent allergy.
159. The correct sequence for donning personal protective equipment (PPE) before entering an
airborne isolation OR is:
A. Gown, mask, eye shield, gloves
B. Mask, eye shield, gown, gloves
C. Gloves, gown, mask, eye shield
D. Eye shield, mask, gloves, gown
Answer: B – Mask, eye shield, gown, gloves
Rationale: Respiratory protection first, then body protection, then hand protection.
160. Which of the following is a contraindication to same-day surgery for a pediatric patient?
A. Age under 6 months
B. Uncontrolled asthma with wheezing
C. Parental anxiety
D. Obesity
Answer: B – Uncontrolled asthma with wheezing
Rationale: Active respiratory illness increases anesthesia risk in children.
161. A surgical patient receives 30 mg of ketorolac IV intraoperatively. The nurse must assess for:
A. Hypertension
B. Bleeding risk
C. Bradycardia
D. Hyperglycemia
Answer: B – Bleeding risk
Rationale: Ketorolac (NSAID) inhibits platelet aggregation, increases surgical bleeding risk.
Verified Answers and Detailed Rationales for Surgical Safety, Asepsis, Positioning, Hemostasis,
Sterilization, and Emergency Management
Questions 151–170
151. A patient in prone position for lumbar spine surgery develops hypotension after being flipped.
The most likely cause is:
A. Hemorrhage
B. Venous compression from abdominal bolsters
C. Anaphylaxis
D. Malignant hyperthermia
Answer: B – Venous compression from abdominal bolsters
Rationale: Improper prone positioning compresses inferior vena cava, reducing preload and causing
hypotension.
152. Which of the following is a sign of a gas embolism during laparoscopic surgery?
A. Hypertension and bradycardia
B. Sudden drop in ETCO2 and hypotension
C. Fever and leukocytosis
D. Polyuria and hyperglycemia
Answer: B – Sudden drop in ETCO2 and hypotension
Rationale: Gas embolism reduces cardiac output and pulmonary blood flow, decreasing ETCO2.
153. The maximum allowable time for a sterilized instrument pack to sit unused before it must be
resterilized depends on:
A. Type of wrap and storage conditions
B. Manufacturer expiration date only
C. 24 hours regardless of conditions
D. 7 days for all wrapped items
Answer: A – Type of wrap and storage conditions
Rationale: Event-related sterility: pack remains sterile until compromised by events (tear, moisture,
dust), not time alone.
,154. Which of the following hemostatic agents should not be left in large quantities in a confined
space (e.g., neurosurgery)?
A. Thrombin powder
B. Oxidized cellulose (Surgicel)
C. Gelatin sponge (Gelfoam)
D. Microfibrillar collagen (Avitene)
Answer: B – Oxidized cellulose (Surgicel)
Rationale: Swells and can cause nerve compression. pH low, may impair bone healing.
155. A patient undergoing a mastectomy has a history of ipsilateral breast cancer. The surgeon
requests a frozen section of a lymph node. The nurse should ensure:
A. Specimen sent in formalin
B. Specimen sent dry to pathology
C. Specimen kept on ice
D. Specimen wrapped in saline gauze
Answer: B – Specimen sent dry to pathology
Rationale: Frozen section requires fresh, unfixed, dry tissue. Formalin prevents freezing.
156. Which of the following is the most reliable method to confirm sterilization of an implantable
device?
A. Chemical indicator (autoclave tape)
B. Bowie-Dick test
C. Biological indicator (spore test) read after implantation
D. Biological indicator read before implantation
Answer: D – Biological indicator read before implantation
Rationale: BI results must be known before implant use if possible; if emergent, document and
quarantine.
157. The surgical hand scrub using chlorhexidine gluconate (CHG) should last at least:
A. 15 seconds
B. 1 minute
C. 2–3 minutes for initial scrub of the day
D. 5 minutes
Answer: C – 2–3 minutes for initial scrub of the day
Rationale: First scrub of day: 2–3 minutes. Subsequent surgeries: 2 minutes or per manufacturer.
, 158. A patient with a known sulfa allergy develops a rash after chlorhexidine skin prep. This
represents:
A. Expected side effect
B. Cross-reaction because CHG contains sulfa
C. Possible CHG allergy, unrelated to sulfa
D. Anaphylaxis requiring epinephrine
Answer: C – Possible CHG allergy, unrelated to sulfa
Rationale: Chlorhexidine contains no sulfa; reaction represents independent allergy.
159. The correct sequence for donning personal protective equipment (PPE) before entering an
airborne isolation OR is:
A. Gown, mask, eye shield, gloves
B. Mask, eye shield, gown, gloves
C. Gloves, gown, mask, eye shield
D. Eye shield, mask, gloves, gown
Answer: B – Mask, eye shield, gown, gloves
Rationale: Respiratory protection first, then body protection, then hand protection.
160. Which of the following is a contraindication to same-day surgery for a pediatric patient?
A. Age under 6 months
B. Uncontrolled asthma with wheezing
C. Parental anxiety
D. Obesity
Answer: B – Uncontrolled asthma with wheezing
Rationale: Active respiratory illness increases anesthesia risk in children.
161. A surgical patient receives 30 mg of ketorolac IV intraoperatively. The nurse must assess for:
A. Hypertension
B. Bleeding risk
C. Bradycardia
D. Hyperglycemia
Answer: B – Bleeding risk
Rationale: Ketorolac (NSAID) inhibits platelet aggregation, increases surgical bleeding risk.
