CNOR Exam Original Practice Questions 1–150: High-Yield Perioperative Nursing Test Bank with
Verified Answers and Detailed Rationales for Surgical Safety, Asepsis, Positioning, Hemostasis,
Sterilization, and Emergency Management
Questions 1–20
1. A patient undergoing a total knee arthroplasty has a history of MRSA colonization. Which
preoperative intervention is most critical?
A. Preoperative shower with chlorhexidine
B. Nasal mupirocin twice daily for 5 days
C. IV vancomycin on call to OR
D. Contact precautions in preoperative holding
Answer: B – Nasal mupirocin twice daily for 5 days
Rationale: Nasal decolonization with mupirocin reduces S. aureus surgical site infection risk.
Chlorhexidine bathing helps but is adjunctive. Preoperative vancomycin is not routine prophylaxis.
Contact precautions alone do not decolonize.
2. Which position places the patient at highest risk for brachial plexus injury?
A. Lithotomy
B. Trendelenburg
C. Lateral decubitus
D. Prone
Answer: C – Lateral decubitus
Rationale: The dependent arm in lateral decubitus can stretch the brachial plexus if axillary roll is
misplaced or arm positioning is poor.
3. A surgical fire is most likely to occur when which three elements are present?
A. Oxygen, fuel, ignition source
B. Alcohol, drapes, laser
C. Bowel gas, electrosurgery, towel
D. Hair, oxygen, scalpel
Answer: A – Oxygen, fuel, ignition source
Rationale: The fire triangle (oxidizer, fuel, ignition) must be managed. Oxygen-enriched atmosphere
dramatically increases risk.
,4. When opening a sterile peel-pack item, the scrub person should:
A. Tear open and drop contents onto the sterile field from 6 inches above
B. Peel open and present the inner contents to the field without touching the inner wrapper
C. Open the outer wrapper and flip contents onto back table
D. Remove inner package with unsterile hands and hand to surgeon
Answer: B – Peel open and present the inner contents to the field without touching the inner wrapper
Rationale: The inner contents must be presented or dropped without contamination. Flipping or
tearing incorrectly can cause edge contamination.
5. Which stage of anesthesia is characterized by irregular breathing, delirium, and risk of
laryngospasm?
A. Stage I – Analgesia
B. Stage II – Excitement
C. Stage III – Surgical anesthesia
D. Stage IV – Medullary depression
Answer: B – Stage II (Excitement/delirium)
Rationale: Stage II is dangerous; patient may vomit, breath-hold, or laryngospasm.
6. The primary purpose of the time-out before skin incision is to:
A. Verify correct patient, procedure, site, and implants
B. Count all sponges and instruments
C. Administer prophylactic antibiotics
D. Check anesthesia machine
Answer: A – Verify correct patient, procedure, site, and implants
Rationale: Time-out is the final verification for patient safety per Universal Protocol.
7. Which of the following is NOT an acceptable method of sterilization for laparoscopic lenses?
A. Ethylene oxide
B. Hydrogen peroxide gas plasma (Sterrad)
C. Steam autoclave at 270°F
D. Peracetic acid (Steris)
Answer: C – Steam autoclave at 270°F
Rationale: High heat damages delicate optics. Low-temp sterilization methods are required.
, 8. A patient has a pacemaker. During electrosurgery use, the most important precaution is:
A. Place return electrode over pacemaker generator
B. Use bipolar electrosurgery exclusively
C. Position return electrode as far from pacemaker as possible and use short bursts
D. Deactivate pacemaker before surgery
Answer: C – Position return electrode as far from pacemaker as possible and use short bursts
Rationale: Avoid current pathway through pacemaker. Bipolar is safer but not always feasible. Never
deactivate without cardiology.
9. Which hemostatic agent should be avoided in patients with a known shellfish allergy?
A. Surgicel (oxidized cellulose)
B. Gelfoam (gelatin)
C. Floseal (bovine gelatin/thrombin)
D. Chitosan-based patches
Answer: D – Chitosan-based patches
Rationale: Chitosan is derived from chitin in shellfish shells.
10. A nurse notices the prep solution pooling under a patient in lithotomy position. The most
appropriate action is:
A. Wipe it up with a sterile towel
B. Reposition patient immediately
C. Notify surgeon after procedure
D. Ignore if skin appears intact
Answer: A – Wipe it up with a sterile towel
Rationale: Pooling prep solution increases chemical burn risk, especially in dependent areas.
11. During a laparoscopic cholecystectomy, the gallbladder is perforated, spilling stones. The best
action is:
A. Irrigate and aspirate immediately
B. Convert to open procedure
C. Remove stones with a stone catcher or suction
D. Leave stones; they will dissolve
Answer: C – Remove stones with a stone catcher or suction
Rationale: Retained stones can cause abscess or peritonitis.
Verified Answers and Detailed Rationales for Surgical Safety, Asepsis, Positioning, Hemostasis,
Sterilization, and Emergency Management
Questions 1–20
1. A patient undergoing a total knee arthroplasty has a history of MRSA colonization. Which
preoperative intervention is most critical?
A. Preoperative shower with chlorhexidine
B. Nasal mupirocin twice daily for 5 days
C. IV vancomycin on call to OR
D. Contact precautions in preoperative holding
Answer: B – Nasal mupirocin twice daily for 5 days
Rationale: Nasal decolonization with mupirocin reduces S. aureus surgical site infection risk.
Chlorhexidine bathing helps but is adjunctive. Preoperative vancomycin is not routine prophylaxis.
Contact precautions alone do not decolonize.
2. Which position places the patient at highest risk for brachial plexus injury?
A. Lithotomy
B. Trendelenburg
C. Lateral decubitus
D. Prone
Answer: C – Lateral decubitus
Rationale: The dependent arm in lateral decubitus can stretch the brachial plexus if axillary roll is
misplaced or arm positioning is poor.
3. A surgical fire is most likely to occur when which three elements are present?
A. Oxygen, fuel, ignition source
B. Alcohol, drapes, laser
C. Bowel gas, electrosurgery, towel
D. Hair, oxygen, scalpel
Answer: A – Oxygen, fuel, ignition source
Rationale: The fire triangle (oxidizer, fuel, ignition) must be managed. Oxygen-enriched atmosphere
dramatically increases risk.
,4. When opening a sterile peel-pack item, the scrub person should:
A. Tear open and drop contents onto the sterile field from 6 inches above
B. Peel open and present the inner contents to the field without touching the inner wrapper
C. Open the outer wrapper and flip contents onto back table
D. Remove inner package with unsterile hands and hand to surgeon
Answer: B – Peel open and present the inner contents to the field without touching the inner wrapper
Rationale: The inner contents must be presented or dropped without contamination. Flipping or
tearing incorrectly can cause edge contamination.
5. Which stage of anesthesia is characterized by irregular breathing, delirium, and risk of
laryngospasm?
A. Stage I – Analgesia
B. Stage II – Excitement
C. Stage III – Surgical anesthesia
D. Stage IV – Medullary depression
Answer: B – Stage II (Excitement/delirium)
Rationale: Stage II is dangerous; patient may vomit, breath-hold, or laryngospasm.
6. The primary purpose of the time-out before skin incision is to:
A. Verify correct patient, procedure, site, and implants
B. Count all sponges and instruments
C. Administer prophylactic antibiotics
D. Check anesthesia machine
Answer: A – Verify correct patient, procedure, site, and implants
Rationale: Time-out is the final verification for patient safety per Universal Protocol.
7. Which of the following is NOT an acceptable method of sterilization for laparoscopic lenses?
A. Ethylene oxide
B. Hydrogen peroxide gas plasma (Sterrad)
C. Steam autoclave at 270°F
D. Peracetic acid (Steris)
Answer: C – Steam autoclave at 270°F
Rationale: High heat damages delicate optics. Low-temp sterilization methods are required.
, 8. A patient has a pacemaker. During electrosurgery use, the most important precaution is:
A. Place return electrode over pacemaker generator
B. Use bipolar electrosurgery exclusively
C. Position return electrode as far from pacemaker as possible and use short bursts
D. Deactivate pacemaker before surgery
Answer: C – Position return electrode as far from pacemaker as possible and use short bursts
Rationale: Avoid current pathway through pacemaker. Bipolar is safer but not always feasible. Never
deactivate without cardiology.
9. Which hemostatic agent should be avoided in patients with a known shellfish allergy?
A. Surgicel (oxidized cellulose)
B. Gelfoam (gelatin)
C. Floseal (bovine gelatin/thrombin)
D. Chitosan-based patches
Answer: D – Chitosan-based patches
Rationale: Chitosan is derived from chitin in shellfish shells.
10. A nurse notices the prep solution pooling under a patient in lithotomy position. The most
appropriate action is:
A. Wipe it up with a sterile towel
B. Reposition patient immediately
C. Notify surgeon after procedure
D. Ignore if skin appears intact
Answer: A – Wipe it up with a sterile towel
Rationale: Pooling prep solution increases chemical burn risk, especially in dependent areas.
11. During a laparoscopic cholecystectomy, the gallbladder is perforated, spilling stones. The best
action is:
A. Irrigate and aspirate immediately
B. Convert to open procedure
C. Remove stones with a stone catcher or suction
D. Leave stones; they will dissolve
Answer: C – Remove stones with a stone catcher or suction
Rationale: Retained stones can cause abscess or peritonitis.
