CNOR (Certified Nurse Operating Room) Practice Exam
200 Original Questions with Detailed Rationales
Section 1: Preoperative Patient Assessment and Diagnosis
1. During preoperative verification, the nurse notes the patient has an
implantable cardioverter-defibrillator (ICD). Which action is most important for
the perioperative nurse to take?
A. Place a magnet over the device before induction
B. Ensure the device is deactivated per institutional protocol before surgery
C. Document the device presence and continue with standard prep
D. Instruct the patient to hold all cardiac medications
Correct Answer: B
Rationale: Electromagnetic interference from electrocautery can cause
inappropriate ICD discharges or inhibit pacing. The device must be deactivated or
reprogrammed per protocol before surgery, with external pacing and
defibrillation pads placed. A magnet may be used for some devices but is not the
primary nursing action; verifying deactivation with the electrophysiology team or
device representative is essential.
2. A patient scheduled for a total knee arthroplasty reports taking ginkgo biloba
daily. The perioperative nurse should recognize that this herbal supplement
increases the risk for which complication?
A. Hypertensive crisis
B. Bleeding
C. Malignant hyperthermia
D. Serotonin syndrome
Correct Answer: B
Rationale: Ginkgo biloba has antiplatelet effects and can increase bleeding
risk during and after surgery. Patients should be instructed to discontinue it at
,least 1–2 weeks before surgery. Other herbal supplements with bleeding risk
include garlic, ginseng, ginger, and feverfew.
3. Which of the following are components of the Universal Protocol? (Select all
that apply.)
A. Preprocedure verification
B. Marking the procedure site
C. Time-out
D. Medication reconciliation
E. Postoperative debriefing
Correct Answers: A, B, C
Rationale: The Universal Protocol consists of three components:
preprocedure verification, marking the procedure site, and a time-out
immediately before the procedure. Medication reconciliation and debriefing are
important but are not part of the Universal Protocol.
4. A 78-year-old patient is scheduled for a hip fracture repair. Which
preoperative assessment finding places the patient at highest risk for
postoperative delirium?
A. Mild hypertension
B. Baseline cognitive impairment
C. History of osteoarthritis
D. Controlled type 2 diabetes
Correct Answer: B
Rationale: Baseline cognitive impairment is the strongest independent risk
factor for postoperative delirium in older adults. Other risk factors include
advanced age, polypharmacy, sensory impairment, and alcohol use. Early
mobilization, orientation, and pain control are key prevention strategies.
,5. The perioperative nurse is reviewing laboratory values for a patient
scheduled for a colon resection. Which value should be reported to the surgeon
immediately?
A. Hemoglobin 11.2 g/dL
B. Platelet count 85,000/mm³
C. Serum potassium 4.1 mEq/L
D. Creatinine 1.0 mg/dL
Correct Answer: B
Rationale: A platelet count of 85,000/mm³ indicates significant
thrombocytopenia and increases the risk of intraoperative and postoperative
bleeding. Normal platelet count is 150,000–450,000/mm³. The surgeon must be
notified, and the case may need to be delayed or blood products made available.
6. A patient with a documented latex allergy is scheduled for surgery. Which
action is the priority for the perioperative nurse?
A. Place the patient in a room farthest from the supply room
B. Schedule the patient as the first case of the day
C. Ensure a latex-safe environment and have an anaphylaxis kit available
D. Administer diphenhydramine preoperatively
Correct Answer: C
Rationale: For patients with latex allergy, the priority is creating a latex-
safe environment—removing all latex-containing products from the OR and
ensuring emergency medications (epinephrine, diphenhydramine, corticosteroids)
are immediately available. Scheduling first case and room location are secondary
considerations.
7. Which of the following questions is most important for the perioperative
nurse to ask during the preoperative assessment?
A. "Do you have a living will?"
B. "Have you ever had a problem with anesthesia?"
, C. "What is your preferred name?"
D. "Do you have dental insurance?"
Correct Answer: B
Rationale: A history of anesthesia complications—including malignant
hyperthermia, difficult intubation, prolonged emergence, or adverse drug
reactions—is critical to identify to prevent recurrence. This information directly
impacts anesthetic planning and patient safety.
8. A patient scheduled for a laparoscopic cholecystectomy tells the nurse she is
8 weeks pregnant. What is the priority nursing action?
A. Document the finding and proceed with surgery
B. Notify the surgeon and anesthesia professional immediately
C. Ask the patient if she wants to continue with surgery
D. Place a wedge under the patient's right hip
Correct Answer: B
Rationale: Pregnancy significantly alters surgical and anesthetic risk, and
many elective procedures are postponed until after delivery. The surgeon and
anesthesia professional must be notified immediately to discuss risks and
benefits. If surgery proceeds, left lateral tilt positioning and fetal monitoring may
be required.
9. Which of the following are risk factors for surgical site infection (SSI)? (Select
all that apply.)
A. Diabetes mellitus
B. Obesity
C. Smoking
D. Young age
E. Prolonged operative time
Correct Answers: A, B, C, E
200 Original Questions with Detailed Rationales
Section 1: Preoperative Patient Assessment and Diagnosis
1. During preoperative verification, the nurse notes the patient has an
implantable cardioverter-defibrillator (ICD). Which action is most important for
the perioperative nurse to take?
A. Place a magnet over the device before induction
B. Ensure the device is deactivated per institutional protocol before surgery
C. Document the device presence and continue with standard prep
D. Instruct the patient to hold all cardiac medications
Correct Answer: B
Rationale: Electromagnetic interference from electrocautery can cause
inappropriate ICD discharges or inhibit pacing. The device must be deactivated or
reprogrammed per protocol before surgery, with external pacing and
defibrillation pads placed. A magnet may be used for some devices but is not the
primary nursing action; verifying deactivation with the electrophysiology team or
device representative is essential.
2. A patient scheduled for a total knee arthroplasty reports taking ginkgo biloba
daily. The perioperative nurse should recognize that this herbal supplement
increases the risk for which complication?
A. Hypertensive crisis
B. Bleeding
C. Malignant hyperthermia
D. Serotonin syndrome
Correct Answer: B
Rationale: Ginkgo biloba has antiplatelet effects and can increase bleeding
risk during and after surgery. Patients should be instructed to discontinue it at
,least 1–2 weeks before surgery. Other herbal supplements with bleeding risk
include garlic, ginseng, ginger, and feverfew.
3. Which of the following are components of the Universal Protocol? (Select all
that apply.)
A. Preprocedure verification
B. Marking the procedure site
C. Time-out
D. Medication reconciliation
E. Postoperative debriefing
Correct Answers: A, B, C
Rationale: The Universal Protocol consists of three components:
preprocedure verification, marking the procedure site, and a time-out
immediately before the procedure. Medication reconciliation and debriefing are
important but are not part of the Universal Protocol.
4. A 78-year-old patient is scheduled for a hip fracture repair. Which
preoperative assessment finding places the patient at highest risk for
postoperative delirium?
A. Mild hypertension
B. Baseline cognitive impairment
C. History of osteoarthritis
D. Controlled type 2 diabetes
Correct Answer: B
Rationale: Baseline cognitive impairment is the strongest independent risk
factor for postoperative delirium in older adults. Other risk factors include
advanced age, polypharmacy, sensory impairment, and alcohol use. Early
mobilization, orientation, and pain control are key prevention strategies.
,5. The perioperative nurse is reviewing laboratory values for a patient
scheduled for a colon resection. Which value should be reported to the surgeon
immediately?
A. Hemoglobin 11.2 g/dL
B. Platelet count 85,000/mm³
C. Serum potassium 4.1 mEq/L
D. Creatinine 1.0 mg/dL
Correct Answer: B
Rationale: A platelet count of 85,000/mm³ indicates significant
thrombocytopenia and increases the risk of intraoperative and postoperative
bleeding. Normal platelet count is 150,000–450,000/mm³. The surgeon must be
notified, and the case may need to be delayed or blood products made available.
6. A patient with a documented latex allergy is scheduled for surgery. Which
action is the priority for the perioperative nurse?
A. Place the patient in a room farthest from the supply room
B. Schedule the patient as the first case of the day
C. Ensure a latex-safe environment and have an anaphylaxis kit available
D. Administer diphenhydramine preoperatively
Correct Answer: C
Rationale: For patients with latex allergy, the priority is creating a latex-
safe environment—removing all latex-containing products from the OR and
ensuring emergency medications (epinephrine, diphenhydramine, corticosteroids)
are immediately available. Scheduling first case and room location are secondary
considerations.
7. Which of the following questions is most important for the perioperative
nurse to ask during the preoperative assessment?
A. "Do you have a living will?"
B. "Have you ever had a problem with anesthesia?"
, C. "What is your preferred name?"
D. "Do you have dental insurance?"
Correct Answer: B
Rationale: A history of anesthesia complications—including malignant
hyperthermia, difficult intubation, prolonged emergence, or adverse drug
reactions—is critical to identify to prevent recurrence. This information directly
impacts anesthetic planning and patient safety.
8. A patient scheduled for a laparoscopic cholecystectomy tells the nurse she is
8 weeks pregnant. What is the priority nursing action?
A. Document the finding and proceed with surgery
B. Notify the surgeon and anesthesia professional immediately
C. Ask the patient if she wants to continue with surgery
D. Place a wedge under the patient's right hip
Correct Answer: B
Rationale: Pregnancy significantly alters surgical and anesthetic risk, and
many elective procedures are postponed until after delivery. The surgeon and
anesthesia professional must be notified immediately to discuss risks and
benefits. If surgery proceeds, left lateral tilt positioning and fetal monitoring may
be required.
9. Which of the following are risk factors for surgical site infection (SSI)? (Select
all that apply.)
A. Diabetes mellitus
B. Obesity
C. Smoking
D. Young age
E. Prolonged operative time
Correct Answers: A, B, C, E
