CNOR Certification Exam
CNOR Certification Exam Test Bank – 2024/2025
Practice Questions with Correct Answers & Rationales
1. A patient scheduled for a total knee arthroplasty reports a history of MRSA
infection 6 months ago. Which preoperative intervention is most important to
reduce surgical site infection risk?
• A. Administer prophylactic antibiotics 2 hours before incision
• B. Shave the surgical site with a razor the night before surgery
• C. Perform preoperative nasal screening and decolonization as prescribed
• D. Schedule the patient as the last case of the day
2. During a laparoscopic cholecystectomy, the surgeon requests the table be
placed in reverse Trendelenburg. What is the primary purpose of this position
change?
• A. To increase venous return to the heart
• B. To displace the bowel away from the surgical site
• C. To decrease the risk of nerve injury
• D. To improve visualization of the pelvic structures
3. A patient undergoing a craniotomy receives mannitol intraoperatively. Which
therapeutic effect is expected?
• A. Increased cerebral perfusion pressure
• B. Decreased intracranial pressure
• C. Increased blood pressure
• D. Decreased urine output
4. The perioperative nurse observes that the surgeon’s gown becomes wet with
blood at the chest level during a procedure. What is the appropriate action?
• A. Ignore the wet area as it is above the sterile field
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,CNOR Certification Exam
• B. Have the surgeon immediately change the gown and gloves
• C. Cover the wet area with a sterile drape
• D. Notify the surgeon after the procedure is complete
5. Which of the following is the most reliable method to confirm sterilization of an
implant before use?
• A. Visual inspection of the implant surface
• B. Manufacturer labeling on the outer packaging
• C. Verification of intact packaging and internal chemical indicator
• D. Relying on the expiration date only
6. A patient in the lithotomy position for a vaginal hysterectomy develops sudden
hypotension and oxygen desaturation. What is the most likely cause?
• A. Malignant hyperthermia
• B. Venous air embolism
• C. Anaphylaxis
• D. Myocardial infarction
7. Which statement regarding surgical hand antisepsis is correct according to
current guidelines?
• A. Artificial nails are permitted if covered with gloves
• B. Rings may be worn under gloves without restriction
• C. Surgical hand antisepsis should be performed with a water-based or
alcohol-based product according to manufacturer instructions
• D. Hand antisepsis is required only before the first case of the day
8. A patient with a known allergy to latex is scheduled for a laparotomy. Which
action is most appropriate?
• A. Schedule the patient as the last case of the day
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,CNOR Certification Exam
• B. Ensure all supplies in the operating room are latex-free and have a
latex-free cart available
• C. Administer diphenhydramine preoperatively without other precautions
• D. Use only non-sterile gloves for the procedure
9. During a procedure using monopolar electrosurgery, where should the return
electrode pad be placed?
• A. Over a bony prominence
• B. On a clean, dry, well-vascularized area close to the surgical site
• C. Over scar tissue or a tattoo
• D. On the opposite side of the body from the surgical site
10. A patient undergoing a thyroidectomy is positioned with the neck extended.
What is the primary risk associated with this position?
• A. Brachial plexus injury
• B. Cervical spine injury and excessive stretching of the trachea
• C. Femoral nerve compression
• D. Increased intracranial pressure
11. The perioperative nurse is setting up a sterile field. A sterile item falls off the
field and lands on the floor. What is the appropriate action?
• A. Pick up the item and use it if it appears clean
• B. Discard the item and obtain a new sterile item
• C. Wipe the item with an alcohol wipe and return to the field
• D. Use the item for a non-critical portion of the procedure
12. Which of the following is an early sign of malignant hyperthermia?
• A. Decreased heart rate
• B. Decreased body temperature
• C. Unexplained increase in end-tidal CO₂
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, CNOR Certification Exam
• D. Decreased oxygen saturation
13. A patient scheduled for a vitrectomy reports taking tamsulosin (Flomax) for
benign prostatic hyperplasia. What is the significance of this finding?
• A. Increased risk of urinary retention postoperatively
• B. Increased risk of intraoperative floppy iris syndrome
• C. Increased risk of bleeding during surgery
• D. Contraindication to general anesthesia
14. Which of the following is an appropriate method for hair removal at the
surgical site?
• A. Dry shaving with a straight razor the night before surgery
• B. Wet shaving with a disposable razor in the preoperative holding area
• C. Clipping with electric clippers immediately before the procedure
• D. Chemical depilatory applied 2 hours prior to incision
15. A patient undergoing a mastectomy develops sudden wheezing, hypotension,
and urticaria after administration of intravenous antibiotics. What is the priority
action?
• A. Complete the surgical procedure quickly
• B. Notify the anesthesia provider and prepare to treat anaphylaxis
• C. Administer additional antibiotics
• D. Place the patient in Trendelenburg position
16. Which of the following patients is at highest risk for postoperative venous
thromboembolism?
• A. 25-year-old undergoing ACL repair
• B. 45-year-old undergoing laparoscopic cholecystectomy
• C. 70-year-old undergoing total hip arthroplasty with history of prior DVT
• D. 30-year-old undergoing thyroidectomy
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CNOR Certification Exam Test Bank – 2024/2025
Practice Questions with Correct Answers & Rationales
1. A patient scheduled for a total knee arthroplasty reports a history of MRSA
infection 6 months ago. Which preoperative intervention is most important to
reduce surgical site infection risk?
• A. Administer prophylactic antibiotics 2 hours before incision
• B. Shave the surgical site with a razor the night before surgery
• C. Perform preoperative nasal screening and decolonization as prescribed
• D. Schedule the patient as the last case of the day
2. During a laparoscopic cholecystectomy, the surgeon requests the table be
placed in reverse Trendelenburg. What is the primary purpose of this position
change?
• A. To increase venous return to the heart
• B. To displace the bowel away from the surgical site
• C. To decrease the risk of nerve injury
• D. To improve visualization of the pelvic structures
3. A patient undergoing a craniotomy receives mannitol intraoperatively. Which
therapeutic effect is expected?
• A. Increased cerebral perfusion pressure
• B. Decreased intracranial pressure
• C. Increased blood pressure
• D. Decreased urine output
4. The perioperative nurse observes that the surgeon’s gown becomes wet with
blood at the chest level during a procedure. What is the appropriate action?
• A. Ignore the wet area as it is above the sterile field
Page 1 of 51
,CNOR Certification Exam
• B. Have the surgeon immediately change the gown and gloves
• C. Cover the wet area with a sterile drape
• D. Notify the surgeon after the procedure is complete
5. Which of the following is the most reliable method to confirm sterilization of an
implant before use?
• A. Visual inspection of the implant surface
• B. Manufacturer labeling on the outer packaging
• C. Verification of intact packaging and internal chemical indicator
• D. Relying on the expiration date only
6. A patient in the lithotomy position for a vaginal hysterectomy develops sudden
hypotension and oxygen desaturation. What is the most likely cause?
• A. Malignant hyperthermia
• B. Venous air embolism
• C. Anaphylaxis
• D. Myocardial infarction
7. Which statement regarding surgical hand antisepsis is correct according to
current guidelines?
• A. Artificial nails are permitted if covered with gloves
• B. Rings may be worn under gloves without restriction
• C. Surgical hand antisepsis should be performed with a water-based or
alcohol-based product according to manufacturer instructions
• D. Hand antisepsis is required only before the first case of the day
8. A patient with a known allergy to latex is scheduled for a laparotomy. Which
action is most appropriate?
• A. Schedule the patient as the last case of the day
Page 2 of 51
,CNOR Certification Exam
• B. Ensure all supplies in the operating room are latex-free and have a
latex-free cart available
• C. Administer diphenhydramine preoperatively without other precautions
• D. Use only non-sterile gloves for the procedure
9. During a procedure using monopolar electrosurgery, where should the return
electrode pad be placed?
• A. Over a bony prominence
• B. On a clean, dry, well-vascularized area close to the surgical site
• C. Over scar tissue or a tattoo
• D. On the opposite side of the body from the surgical site
10. A patient undergoing a thyroidectomy is positioned with the neck extended.
What is the primary risk associated with this position?
• A. Brachial plexus injury
• B. Cervical spine injury and excessive stretching of the trachea
• C. Femoral nerve compression
• D. Increased intracranial pressure
11. The perioperative nurse is setting up a sterile field. A sterile item falls off the
field and lands on the floor. What is the appropriate action?
• A. Pick up the item and use it if it appears clean
• B. Discard the item and obtain a new sterile item
• C. Wipe the item with an alcohol wipe and return to the field
• D. Use the item for a non-critical portion of the procedure
12. Which of the following is an early sign of malignant hyperthermia?
• A. Decreased heart rate
• B. Decreased body temperature
• C. Unexplained increase in end-tidal CO₂
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, CNOR Certification Exam
• D. Decreased oxygen saturation
13. A patient scheduled for a vitrectomy reports taking tamsulosin (Flomax) for
benign prostatic hyperplasia. What is the significance of this finding?
• A. Increased risk of urinary retention postoperatively
• B. Increased risk of intraoperative floppy iris syndrome
• C. Increased risk of bleeding during surgery
• D. Contraindication to general anesthesia
14. Which of the following is an appropriate method for hair removal at the
surgical site?
• A. Dry shaving with a straight razor the night before surgery
• B. Wet shaving with a disposable razor in the preoperative holding area
• C. Clipping with electric clippers immediately before the procedure
• D. Chemical depilatory applied 2 hours prior to incision
15. A patient undergoing a mastectomy develops sudden wheezing, hypotension,
and urticaria after administration of intravenous antibiotics. What is the priority
action?
• A. Complete the surgical procedure quickly
• B. Notify the anesthesia provider and prepare to treat anaphylaxis
• C. Administer additional antibiotics
• D. Place the patient in Trendelenburg position
16. Which of the following patients is at highest risk for postoperative venous
thromboembolism?
• A. 25-year-old undergoing ACL repair
• B. 45-year-old undergoing laparoscopic cholecystectomy
• C. 70-year-old undergoing total hip arthroplasty with history of prior DVT
• D. 30-year-old undergoing thyroidectomy
Page 4 of 51
