TEST BANK RATIONALE: CNOR PRACTICE
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= EXAM (UPDATED 2026/2027) = = =
A+ GRADE =
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Domain 1: Patient Care and Safety (25% of Exam)
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1. A patient is transferred to the PACU following an
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abdominal aortic aneurysm repair under general anesthesia.
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Which assessment finding is most concerning and warrants
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immediate intervention? = =
• A. Blood pressure 148/88 mm Hg
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• B. Heart rate 98 beats/min
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• C. Urine output 15 mL over the past hour
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• D. Temperature 36.8°C (98.2°F)
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Answer: C = =
Rationale: Urine output of 15 mL over one hour indicates
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decreased renal perfusion, potentially resulting from hypovolemia,
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hypotension, or renal artery compromise . This finding is concerning
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,following abdominal aortic aneurysm repair due to risk of renal
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ischemia. Normal urine output should be at least 30 mL/hour. Vital
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signs (A, B) are within acceptable ranges for a postoperative
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patient. Temperature (D) is normal.
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Cognitive Level: Analysis | Exam Domain: Patient Care &
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Safety | Reference: Postoperative Assessment
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2. Which of the following is the most appropriate nursing
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= action when a patient in the operating room experiences an
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anaphylactic reaction to a medication? = = = = =
• A. Administer diphenhydramine
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• B. Stop the offending agent and administer epinephrine
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• C. Apply a warm compress
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• D. Document the reaction
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Answer: B = =
Rationale: The priority action is to stop the offending agent and
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administer epinephrine . Anaphylaxis is a life-
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threatening emergency requiring immediate intervention.
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Epinephrine is the first- = = =
,line treatment. Diphenhydramine may be given as an adjunct but is
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not the priority. Documentation is important but should follow
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immediate stabilization.
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Cognitive Level: Application | Exam Domain: Emergency
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Situations | Reference: Anaphylaxis Management
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3. A 68-year-
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old patient is scheduled for a total knee arthroplasty. The patient
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's history includes type 2 diabetes, hypertension, and a prior
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deep vein thrombosis. Which preoperative intervention is most
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= important to reduce the risk of postoperative complications?
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• A. Administer prophylactic antibiotics
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• B. Assess blood glucose levels and manage hyperglycemia
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• C. Apply sequential compression devices
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• D. All of the above
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Answer: D = =
Rationale: All of these interventions are important for this patient w
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ith multiple risk factors . Antibiotic prophylaxis prevents surgical site
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infections, blood glucose management reduces infection risk and pr
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, omotes wound healing, and mechanical prophylaxis (SCDs) reduces
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the risk of venous thromboembolism given the patient's history of D
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VT and the nature of the surgery.
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Cognitive Level: Application | Exam Domain: Preoperative
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Assessment & Care | Reference: Perioperative Risk Management
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4. The circulating nurse is preparing the OR for a procedure.
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What is the most important action to prevent surgical site infecti
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on (SSI)?
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• A. Ensure the room temperature is set to 65°F
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• B. Minimize traffic in and out of the OR
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• C. Position the patient correctly
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• D. Perform a time-out before incision
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Answer: B = =
Rationale: Minimizing traffic reduces the number of airborne partic
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les and potential contaminants in the operating room . This is a key i
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ntervention in preventing SSI. Room temperature settings, positionin
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g, and performing a time-
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out are important but are not directly related to SSI prevention.
= = = = = = = = = = =
= = = =
= EXAM (UPDATED 2026/2027) = = =
A+ GRADE =
=
Domain 1: Patient Care and Safety (25% of Exam)
= = = = = = = = =
1. A patient is transferred to the PACU following an
= = = = = = = = =
abdominal aortic aneurysm repair under general anesthesia.
= = = = = = =
Which assessment finding is most concerning and warrants
= = = = = = = =
immediate intervention? = =
• A. Blood pressure 148/88 mm Hg
= = = = = =
• B. Heart rate 98 beats/min
= = = = =
• C. Urine output 15 mL over the past hour
= = = = = = = = =
• D. Temperature 36.8°C (98.2°F)
= = = =
Answer: C = =
Rationale: Urine output of 15 mL over one hour indicates
= = = = = = = = = =
decreased renal perfusion, potentially resulting from hypovolemia,
= = = = = =
hypotension, or renal artery compromise . This finding is concerning
= = = = = = = = = =
,following abdominal aortic aneurysm repair due to risk of renal
= = = = = = = = = =
ischemia. Normal urine output should be at least 30 mL/hour. Vital
= = = = = = = = = = = =
signs (A, B) are within acceptable ranges for a postoperative
= = = = = = = = = =
patient. Temperature (D) is normal.
= = = = =
Cognitive Level: Analysis | Exam Domain: Patient Care &
= = = = = = = = =
Safety | Reference: Postoperative Assessment
= = = = =
=
2. Which of the following is the most appropriate nursing
= = = = = = = =
= action when a patient in the operating room experiences an
= = = = = = = = = =
anaphylactic reaction to a medication? = = = = =
• A. Administer diphenhydramine
= = =
• B. Stop the offending agent and administer epinephrine
= = = = = = = =
• C. Apply a warm compress
= = = = =
• D. Document the reaction
= = = =
Answer: B = =
Rationale: The priority action is to stop the offending agent and
= = = = = = = = = = =
administer epinephrine . Anaphylaxis is a life-
= = = = = =
threatening emergency requiring immediate intervention.
= = = = =
Epinephrine is the first- = = =
,line treatment. Diphenhydramine may be given as an adjunct but is
= = = = = = = = = = =
not the priority. Documentation is important but should follow
= = = = = = = =
immediate stabilization.
= = =
Cognitive Level: Application | Exam Domain: Emergency
= = = = = = =
Situations | Reference: Anaphylaxis Management
= = = = =
=
3. A 68-year-
=
old patient is scheduled for a total knee arthroplasty. The patient
= = = = = = = = = =
's history includes type 2 diabetes, hypertension, and a prior
= = = = = = = = = =
deep vein thrombosis. Which preoperative intervention is most
= = = = = = =
= important to reduce the risk of postoperative complications?
= = = = = = = =
• A. Administer prophylactic antibiotics
= = = =
• B. Assess blood glucose levels and manage hyperglycemia
= = = = = = = =
• C. Apply sequential compression devices
= = = = =
• D. All of the above
= = = = =
Answer: D = =
Rationale: All of these interventions are important for this patient w
= = = = = = = = = =
ith multiple risk factors . Antibiotic prophylaxis prevents surgical site
= = = = = = = = =
infections, blood glucose management reduces infection risk and pr
= = = = = = = = =
, omotes wound healing, and mechanical prophylaxis (SCDs) reduces
= = = = = = =
the risk of venous thromboembolism given the patient's history of D
= = = = = = = = = = =
VT and the nature of the surgery.
= = = = = = =
Cognitive Level: Application | Exam Domain: Preoperative
= = = = = = =
Assessment & Care | Reference: Perioperative Risk Management
= = = = = = = =
=
4. The circulating nurse is preparing the OR for a procedure.
= = = = = = = = = =
What is the most important action to prevent surgical site infecti
= = = = = = = = = =
on (SSI)?
= =
• A. Ensure the room temperature is set to 65°F
= = = = = = = = =
• B. Minimize traffic in and out of the OR
= = = = = = = = =
• C. Position the patient correctly
= = = = =
• D. Perform a time-out before incision
= = = = = =
Answer: B = =
Rationale: Minimizing traffic reduces the number of airborne partic
= = = = = = = =
les and potential contaminants in the operating room . This is a key i
= = = = = = = = = = = = =
ntervention in preventing SSI. Room temperature settings, positionin
= = = = = = =
g, and performing a time-
= = = =
out are important but are not directly related to SSI prevention.
= = = = = = = = = = =