CNOR Certification Exam Test Bank
2024/2025 | 120 Practice Questions
with Answers & Rationales
EXAM
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
Answer: C
Rationale: Patients with a history of MRSA are at high risk for
colonization. Preoperative screening and decolonization (e.g., with
mupirocin) are evidence-based practices to reduce the risk of
surgical site infections .
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
Answer: B
,Rationale: Reverse Trendelenburg position uses gravity to move
the abdominal contents (specifically the bowel and stomach)
downward, away from the upper abdomen and liver, improving
visualization of the gallbladder .
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
Answer: B
Rationale: Mannitol is an osmotic diuretic. It works by creating an
osmotic gradient that pulls fluid from the brain tissue into the
bloodstream, thereby decreasing intracranial pressure (ICP) .
4. 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
Answer: C
Rationale: Sterility assurance relies on checking multiple factors.
The external packaging ensures the barrier was intact, while the
internal chemical indicator (like a Class 5 integrator) confirms that
the sterilizing agent (steam, etc.) penetrated the packaging and
reached the implant .
5. 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
Answer: B
Rationale: The surgical site (vagina) is above the level of the
heart. When combined with the lithotomy position, it creates a
pressure gradient that can allow air to enter open venous sinuses,
leading to a venous air embolism .
6. 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
Answer: C
Rationale: Current AORN guidelines recommend performing
surgical hand antisepsis using either an alcohol-based hand rub
(ABHR) following manufacturer instructions or a traditional water-
based scrub. Artificial nails are generally prohibited due to the
high bioburden they carry .
7. 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
B. Use only non-labor gloves for the surgical team
C. Ensure the operating room is latex-safe by removing all latex-
, containing products and having a latex-free cart available
D. Administer diphenhydramine (Benadryl) prophylactically
Answer: C
Rationale: The primary intervention for a patient with a latex
allergy is to create a latex-safe environment. This involves
removing latex products (gloves, tourniquets, equipment) from
the room and having a latex-free cart available to prevent
exposure .
8. 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
Answer: C
Rationale: If hair removal is necessary, clipping with electric
clippers immediately before the procedure is the preferred
method. Shaving with a razor creates micro-abrasions that
increase infection risk, and removing hair the night before allows
bacteria to colonize the area .
9. The recommended timing for administration of
prophylactic antibiotics prior to surgical incision is:
A. Within 30 minutes before incision for all antibiotics
B. Within 60 minutes before incision (120 minutes for vancomycin)
C. At the time of skin closure
D. Immediately after the incision is made
Answer: B
2024/2025 | 120 Practice Questions
with Answers & Rationales
EXAM
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
Answer: C
Rationale: Patients with a history of MRSA are at high risk for
colonization. Preoperative screening and decolonization (e.g., with
mupirocin) are evidence-based practices to reduce the risk of
surgical site infections .
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
Answer: B
,Rationale: Reverse Trendelenburg position uses gravity to move
the abdominal contents (specifically the bowel and stomach)
downward, away from the upper abdomen and liver, improving
visualization of the gallbladder .
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
Answer: B
Rationale: Mannitol is an osmotic diuretic. It works by creating an
osmotic gradient that pulls fluid from the brain tissue into the
bloodstream, thereby decreasing intracranial pressure (ICP) .
4. 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
Answer: C
Rationale: Sterility assurance relies on checking multiple factors.
The external packaging ensures the barrier was intact, while the
internal chemical indicator (like a Class 5 integrator) confirms that
the sterilizing agent (steam, etc.) penetrated the packaging and
reached the implant .
5. 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
Answer: B
Rationale: The surgical site (vagina) is above the level of the
heart. When combined with the lithotomy position, it creates a
pressure gradient that can allow air to enter open venous sinuses,
leading to a venous air embolism .
6. 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
Answer: C
Rationale: Current AORN guidelines recommend performing
surgical hand antisepsis using either an alcohol-based hand rub
(ABHR) following manufacturer instructions or a traditional water-
based scrub. Artificial nails are generally prohibited due to the
high bioburden they carry .
7. 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
B. Use only non-labor gloves for the surgical team
C. Ensure the operating room is latex-safe by removing all latex-
, containing products and having a latex-free cart available
D. Administer diphenhydramine (Benadryl) prophylactically
Answer: C
Rationale: The primary intervention for a patient with a latex
allergy is to create a latex-safe environment. This involves
removing latex products (gloves, tourniquets, equipment) from
the room and having a latex-free cart available to prevent
exposure .
8. 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
Answer: C
Rationale: If hair removal is necessary, clipping with electric
clippers immediately before the procedure is the preferred
method. Shaving with a razor creates micro-abrasions that
increase infection risk, and removing hair the night before allows
bacteria to colonize the area .
9. The recommended timing for administration of
prophylactic antibiotics prior to surgical incision is:
A. Within 30 minutes before incision for all antibiotics
B. Within 60 minutes before incision (120 minutes for vancomycin)
C. At the time of skin closure
D. Immediately after the incision is made
Answer: B
