BARKLEY CNOR PERIOPERATIVE NURSING PRACTICE EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027.
Core Domains
1. Perioperative Nursing Process (Assessment, Planning, Implementation, Evaluation)
2. Surgical Asepsis and Sterile Technique
3. Environmental Safety and Hazard Management
4. Patient Safety and Risk Management
5. Surgical Instrumentation and Equipment
6. Anesthesia and Pharmacology
7. Wound Healing and Hemostasis
8. Emergency and Crisis Management
9. Professional Ethics and Legal Standards
10. Leadership and Communication
Introduction
This comprehensive examination is designed to rigorously assess the cognitive and clinical preparedness of
perioperative nursing professionals. It evaluates a candidate's mastery of core principles, from foundational aseptic
technique to complex critical thinking required for high-stakes surgical environments. The exam is structured with
multiple-choice and scenario-based questions to challenge both theoretical knowledge and its practical
application. Each question emphasizes real-world decision-making, including risk assessment, ethical dilemmas,
,and adherence to regulatory standards. This assessment is a vital tool for validating the advanced expertise
necessary to deliver safe, competent, and high-quality patient care throughout the entire perioperative continuum.
SECTION ONE: Questions 1–100
1. A patient is positioned in the lithotomy position for a prolonged gynecological procedure. Which of the
following is the primary nursing intervention to prevent a lower extremity neuropraxia?
A. Placing a pillow under the patient's head
B. Securing the patient's arms on padded arm boards
C. Ensuring the knees are positioned wider than the hips
D. Avoiding hyperextension of the legs and limiting external rotation
🟢 D. Avoiding hyperextension of the legs and limiting external rotation
🔴 RATIONALE: Neuropraxia in the lithotomy position is primarily a result of injury to the common peroneal
nerve and femoral nerve. This is caused by excessive external rotation of the hips, hyperextension of the legs,
and pressure from the leg holders against the popliteal space. The standard preventative intervention is to
avoid these extreme positions and ensure the knees are at the same level as or slightly lower than the hips, with
no pressure on the back of the knees.
2. A nurse enters the OR and notices the relative humidity is reading 52%. What is the most appropriate
initial action?
,A. Report the reading to the maintenance department immediately
B. Proceed with the surgery as this is within the acceptable range
C. Turn on additional humidifiers to increase the level
D. Ensure all electronic equipment is unplugged
🟢 B. Proceed with the surgery as this is within the acceptable range
🔴 RATIONALE: The recommended relative humidity for operating rooms is between 20% and 60%, with many
guidelines specifying a tighter range of 30-60% or 20-50%. A reading of 52% is well within the accepted
standard range. No corrective action is required.
3. During a preoperative assessment, a patient reports a history of malignant hyperthermia in a family
member. Which of the following is the most critical pharmacological intervention to have immediately
available prior to anesthesia induction?
A. Naloxone
B. Protamine sulfate
C. Dantrolene sodium
D. Atropine
🟢 C. Dantrolene sodium
🔴 RATIONALE: Malignant hyperthermia (MH) is a life-threatening genetic condition triggered by certain
anesthetics. The primary treatment is the rapid administration of dantrolene sodium, a muscle relaxant that acts
on the ryanodine receptors. While other medications manage symptoms, dantrolene is the specific antidote and
must be immediately available when a patient is at risk for MH.
4. To maintain the sterility of a back table, which of the following practices is correct?
, A. Sterile items may be placed within 3 inches of the edge
B. The table may be used as a writing surface as long as the back is sterile
C. The entire surface area of the back table is considered sterile
D. Only the area covered by the sterile towel is considered sterile
🟢 C. The entire surface area of the back table is considered sterile
🔴 RATIONALE: For the principles of sterile technique, the entire top surface of a properly draped back table is
considered sterile. All items must be placed on the sterile surface, and nothing should hang over the edge. The
standard rule is that only the portion of the table at or above the tabletop level is sterile.
5. A circulating nurse is planning the care for a patient undergoing a total hip arthroplasty. What is the most
important reason for administering prophylactic antibiotics prior to the surgical incision?
A. To reduce the risk of a urinary tract infection postoperatively
B. To reduce the risk of surgical site infection (SSI)
C. To prevent pneumonia in the postoperative period
D. To treat an existing infection the patient has prior to surgery
🟢 B. To reduce the risk of surgical site infection (SSI)
🔴 RATIONALE: Prophylactic antibiotics are administered to reduce the incidence of surgical site infections
(SSIs), which is a primary quality indicator in surgery. These antibiotics are given to achieve bactericidal
concentrations in the blood and tissues during the time the incision is open and at risk of bacterial
contamination. They are not for treating existing infections or preventing UTIs/pneumonia, though they may
have a secondary effect.
ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027.
Core Domains
1. Perioperative Nursing Process (Assessment, Planning, Implementation, Evaluation)
2. Surgical Asepsis and Sterile Technique
3. Environmental Safety and Hazard Management
4. Patient Safety and Risk Management
5. Surgical Instrumentation and Equipment
6. Anesthesia and Pharmacology
7. Wound Healing and Hemostasis
8. Emergency and Crisis Management
9. Professional Ethics and Legal Standards
10. Leadership and Communication
Introduction
This comprehensive examination is designed to rigorously assess the cognitive and clinical preparedness of
perioperative nursing professionals. It evaluates a candidate's mastery of core principles, from foundational aseptic
technique to complex critical thinking required for high-stakes surgical environments. The exam is structured with
multiple-choice and scenario-based questions to challenge both theoretical knowledge and its practical
application. Each question emphasizes real-world decision-making, including risk assessment, ethical dilemmas,
,and adherence to regulatory standards. This assessment is a vital tool for validating the advanced expertise
necessary to deliver safe, competent, and high-quality patient care throughout the entire perioperative continuum.
SECTION ONE: Questions 1–100
1. A patient is positioned in the lithotomy position for a prolonged gynecological procedure. Which of the
following is the primary nursing intervention to prevent a lower extremity neuropraxia?
A. Placing a pillow under the patient's head
B. Securing the patient's arms on padded arm boards
C. Ensuring the knees are positioned wider than the hips
D. Avoiding hyperextension of the legs and limiting external rotation
🟢 D. Avoiding hyperextension of the legs and limiting external rotation
🔴 RATIONALE: Neuropraxia in the lithotomy position is primarily a result of injury to the common peroneal
nerve and femoral nerve. This is caused by excessive external rotation of the hips, hyperextension of the legs,
and pressure from the leg holders against the popliteal space. The standard preventative intervention is to
avoid these extreme positions and ensure the knees are at the same level as or slightly lower than the hips, with
no pressure on the back of the knees.
2. A nurse enters the OR and notices the relative humidity is reading 52%. What is the most appropriate
initial action?
,A. Report the reading to the maintenance department immediately
B. Proceed with the surgery as this is within the acceptable range
C. Turn on additional humidifiers to increase the level
D. Ensure all electronic equipment is unplugged
🟢 B. Proceed with the surgery as this is within the acceptable range
🔴 RATIONALE: The recommended relative humidity for operating rooms is between 20% and 60%, with many
guidelines specifying a tighter range of 30-60% or 20-50%. A reading of 52% is well within the accepted
standard range. No corrective action is required.
3. During a preoperative assessment, a patient reports a history of malignant hyperthermia in a family
member. Which of the following is the most critical pharmacological intervention to have immediately
available prior to anesthesia induction?
A. Naloxone
B. Protamine sulfate
C. Dantrolene sodium
D. Atropine
🟢 C. Dantrolene sodium
🔴 RATIONALE: Malignant hyperthermia (MH) is a life-threatening genetic condition triggered by certain
anesthetics. The primary treatment is the rapid administration of dantrolene sodium, a muscle relaxant that acts
on the ryanodine receptors. While other medications manage symptoms, dantrolene is the specific antidote and
must be immediately available when a patient is at risk for MH.
4. To maintain the sterility of a back table, which of the following practices is correct?
, A. Sterile items may be placed within 3 inches of the edge
B. The table may be used as a writing surface as long as the back is sterile
C. The entire surface area of the back table is considered sterile
D. Only the area covered by the sterile towel is considered sterile
🟢 C. The entire surface area of the back table is considered sterile
🔴 RATIONALE: For the principles of sterile technique, the entire top surface of a properly draped back table is
considered sterile. All items must be placed on the sterile surface, and nothing should hang over the edge. The
standard rule is that only the portion of the table at or above the tabletop level is sterile.
5. A circulating nurse is planning the care for a patient undergoing a total hip arthroplasty. What is the most
important reason for administering prophylactic antibiotics prior to the surgical incision?
A. To reduce the risk of a urinary tract infection postoperatively
B. To reduce the risk of surgical site infection (SSI)
C. To prevent pneumonia in the postoperative period
D. To treat an existing infection the patient has prior to surgery
🟢 B. To reduce the risk of surgical site infection (SSI)
🔴 RATIONALE: Prophylactic antibiotics are administered to reduce the incidence of surgical site infections
(SSIs), which is a primary quality indicator in surgery. These antibiotics are given to achieve bactericidal
concentrations in the blood and tissues during the time the incision is open and at risk of bacterial
contamination. They are not for treating existing infections or preventing UTIs/pneumonia, though they may
have a secondary effect.
