CNOR Perioperative Nursing Certification Exam
ACTUAL EXAM 2026/2027 | Surgical Safety
Sterile Technique Anesthesia | Verified Q&A |
Pass Guaranteed - A+ Graded
TABLE OF CONTENTS
Total Questions: 100
Passing Score: 90%
Time Limit: 3 hours 45 minutes (standard CNOR format)
Section 1: Surgical Safety & Universal Protocol (Q1–18)
Section 2: Sterile Technique & Aseptic Principles (Q19–40)
Section 3: Anesthesia Principles & Perioperative Care (Q41–65)
Section 4: Intraoperative Patient Care & Complications (Q66–85)
Section 5: Regulatory Standards & Documentation (Q86–93)
Section 6: Emergency Preparedness in OR (Q94–100)
SECTION 1: SURGICAL SAFETY & UNIVERSAL PROTOCOL (Q1–18)
Q1: During the preoperative verification process, the circulating nurse discovers that the surgical
consent form lists the left knee, but the surgeon's office notes and the patient's verbal confirmation
indicate the right knee. Which action should the nurse take first?
A. Proceed with the scheduled surgery on the left knee as documented on the consent form
B. Mark the right knee and proceed with the time-out
C. Stop the process and notify the surgeon immediately to reconcile the discrepancy
D. Ask the patient to sign a new consent form for the right knee
,Correct Answer: C
Rationale: The Universal Protocol requires immediate cessation of the process when discrepancies are
identified in the surgical site, procedure, or patient identity; the surgeon must reconcile all
documentation before proceeding. [CORRECT]
Q2: The surgical team is performing the time-out before skin incision for a total hip arthroplasty.
According to The Joint Commission National Patient Safety Goals, which three elements must be actively
verified by all team members during the time-out?
A. Patient identity, anesthesia plan, and expected blood loss
B. Correct patient, correct site, and correct procedure
C. Surgical instruments, sponge count, and patient allergies
D. Surgeon preference card, positioning plan, and DVT prophylaxis
Correct Answer: B
Rationale: The Joint Commission NPSG for surgery mandates that the time-out verify the correct
patient, correct site, and correct procedure with active participation from the entire surgical team
before incision. [CORRECT]
Q3: A patient is scheduled for breast surgery. Where should the surgical site marking be placed?
A. On the patient's shoulder on the operative side
B. On the patient's breast in the area of the incision
C. On the patient's wristband
D. On the surgical drape after the patient is prepped
Correct Answer: B
Rationale: Site marking must be placed at or near the incision site using a permanent marker that
remains visible after skin preparation; the mark should be initialed by the surgeon performing the
procedure. [CORRECT]
Q4: During a laparoscopic procedure, the circulating nurse notices the electrosurgical unit (ESU) active
electrode is resting on the surgical drape near the patient's oxygen tubing. Which fire triad component is
most at risk in this scenario?
A. Ignition source only
B. Fuel only
C. Oxidizer only
D. Both ignition source and fuel
,Correct Answer: D
Rationale: The ESU active electrode serves as the ignition source while the surgical drape is fuel and
oxygen is the oxidizer; this scenario creates a high-risk fire triad requiring immediate separation of
components. [CORRECT]
Q5: A fire occurs in the surgical field during a head and neck procedure using an alcohol-based skin prep
and electrocautery. What is the first action the surgical team should take?
A. Extinguish the fire with a CO2 fire extinguisher
B. Remove the burning drapes and stop the flow of oxygen
C. Pour saline on the fire and continue the procedure
D. Evacuate the patient from the OR
Correct Answer: B
Rationale: The immediate response to an OR fire is to stop the flow of oxidizer (oxygen), remove the
fuel source (drapes), and extinguish the ignition source; this follows the R.A.C.E. protocol adapted for
surgical fires. [CORRECT]
Q6: The surgical team is preparing for a spinal fusion. The patient is positioned prone. Which nerve is
most at risk for injury due to improper arm positioning in this position?
A. Ulnar nerve
B. Radial nerve
C. Brachial plexus
D. Median nerve
Correct Answer: C
Rationale: In the prone position, arms abducted >90 degrees or externally rotated place the brachial
plexus at risk for stretch injury; arms should be positioned at the sides or on arm boards with abduction
<90 degrees. [CORRECT]
Q7: During a lengthy procedure, the circulating nurse notices a red area developing on the patient's
heel. Which pressure injury prevention intervention should be implemented immediately?
A. Apply a heating pad to improve circulation
B. Reposition the patient and place a pressure-redistributing pad under the heel
C. Massage the red area to increase blood flow
D. Document the finding and continue monitoring
, Correct Answer: B
Rationale: AORN guidelines recommend offloading pressure from bony prominences using pressure-
redistributing devices; massage of non-blanchable erythema is contraindicated as it may cause deep
tissue damage. [CORRECT]
Q8: The scrub nurse is performing the initial sponge count before incision. Which action represents a
correct count procedure according to AORN guidelines?
A. Counting sponges while they remain in the packaging
B. Counting each sponge individually with the circulating nurse simultaneously viewing and vocalizing
C. Counting sponges in groups of five to save time
D. Relying on the manufacturer's count as accurate
Correct Answer: B
Rationale: AORN requires that all counted items be counted simultaneously by two individuals (scrub
and circulating nurse) with each item viewed and vocalized to ensure accuracy and prevent cognitive
errors. [CORRECT]
Q9: At the conclusion of a laparotomy, the final sponge count is incorrect—one lap sponge is missing.
Which action should the surgical team take first?
A. Close the incision and obtain an intraoperative X-ray
B. Extend the search to include the room trash, linen hamper, and off-field areas
C. Ask the surgeon to leave the room while the search continues
D. Document the discrepancy and proceed with closure
Correct Answer: B
Rationale: AORN guidelines mandate a systematic search of the sterile field, room trash, linen hamper,
and off-field areas before requesting radiographic imaging; the incision should not be closed until the
discrepancy is resolved. [CORRECT]
Q10: A patient is scheduled for a right total knee replacement. The surgeon marks the right knee with
the word "YES" and the left knee with "NO." Which element of the Universal Protocol does this
represent?
A. Preoperative verification only
B. Site marking only
C. Both preoperative verification and site marking
D. The time-out process
ACTUAL EXAM 2026/2027 | Surgical Safety
Sterile Technique Anesthesia | Verified Q&A |
Pass Guaranteed - A+ Graded
TABLE OF CONTENTS
Total Questions: 100
Passing Score: 90%
Time Limit: 3 hours 45 minutes (standard CNOR format)
Section 1: Surgical Safety & Universal Protocol (Q1–18)
Section 2: Sterile Technique & Aseptic Principles (Q19–40)
Section 3: Anesthesia Principles & Perioperative Care (Q41–65)
Section 4: Intraoperative Patient Care & Complications (Q66–85)
Section 5: Regulatory Standards & Documentation (Q86–93)
Section 6: Emergency Preparedness in OR (Q94–100)
SECTION 1: SURGICAL SAFETY & UNIVERSAL PROTOCOL (Q1–18)
Q1: During the preoperative verification process, the circulating nurse discovers that the surgical
consent form lists the left knee, but the surgeon's office notes and the patient's verbal confirmation
indicate the right knee. Which action should the nurse take first?
A. Proceed with the scheduled surgery on the left knee as documented on the consent form
B. Mark the right knee and proceed with the time-out
C. Stop the process and notify the surgeon immediately to reconcile the discrepancy
D. Ask the patient to sign a new consent form for the right knee
,Correct Answer: C
Rationale: The Universal Protocol requires immediate cessation of the process when discrepancies are
identified in the surgical site, procedure, or patient identity; the surgeon must reconcile all
documentation before proceeding. [CORRECT]
Q2: The surgical team is performing the time-out before skin incision for a total hip arthroplasty.
According to The Joint Commission National Patient Safety Goals, which three elements must be actively
verified by all team members during the time-out?
A. Patient identity, anesthesia plan, and expected blood loss
B. Correct patient, correct site, and correct procedure
C. Surgical instruments, sponge count, and patient allergies
D. Surgeon preference card, positioning plan, and DVT prophylaxis
Correct Answer: B
Rationale: The Joint Commission NPSG for surgery mandates that the time-out verify the correct
patient, correct site, and correct procedure with active participation from the entire surgical team
before incision. [CORRECT]
Q3: A patient is scheduled for breast surgery. Where should the surgical site marking be placed?
A. On the patient's shoulder on the operative side
B. On the patient's breast in the area of the incision
C. On the patient's wristband
D. On the surgical drape after the patient is prepped
Correct Answer: B
Rationale: Site marking must be placed at or near the incision site using a permanent marker that
remains visible after skin preparation; the mark should be initialed by the surgeon performing the
procedure. [CORRECT]
Q4: During a laparoscopic procedure, the circulating nurse notices the electrosurgical unit (ESU) active
electrode is resting on the surgical drape near the patient's oxygen tubing. Which fire triad component is
most at risk in this scenario?
A. Ignition source only
B. Fuel only
C. Oxidizer only
D. Both ignition source and fuel
,Correct Answer: D
Rationale: The ESU active electrode serves as the ignition source while the surgical drape is fuel and
oxygen is the oxidizer; this scenario creates a high-risk fire triad requiring immediate separation of
components. [CORRECT]
Q5: A fire occurs in the surgical field during a head and neck procedure using an alcohol-based skin prep
and electrocautery. What is the first action the surgical team should take?
A. Extinguish the fire with a CO2 fire extinguisher
B. Remove the burning drapes and stop the flow of oxygen
C. Pour saline on the fire and continue the procedure
D. Evacuate the patient from the OR
Correct Answer: B
Rationale: The immediate response to an OR fire is to stop the flow of oxidizer (oxygen), remove the
fuel source (drapes), and extinguish the ignition source; this follows the R.A.C.E. protocol adapted for
surgical fires. [CORRECT]
Q6: The surgical team is preparing for a spinal fusion. The patient is positioned prone. Which nerve is
most at risk for injury due to improper arm positioning in this position?
A. Ulnar nerve
B. Radial nerve
C. Brachial plexus
D. Median nerve
Correct Answer: C
Rationale: In the prone position, arms abducted >90 degrees or externally rotated place the brachial
plexus at risk for stretch injury; arms should be positioned at the sides or on arm boards with abduction
<90 degrees. [CORRECT]
Q7: During a lengthy procedure, the circulating nurse notices a red area developing on the patient's
heel. Which pressure injury prevention intervention should be implemented immediately?
A. Apply a heating pad to improve circulation
B. Reposition the patient and place a pressure-redistributing pad under the heel
C. Massage the red area to increase blood flow
D. Document the finding and continue monitoring
, Correct Answer: B
Rationale: AORN guidelines recommend offloading pressure from bony prominences using pressure-
redistributing devices; massage of non-blanchable erythema is contraindicated as it may cause deep
tissue damage. [CORRECT]
Q8: The scrub nurse is performing the initial sponge count before incision. Which action represents a
correct count procedure according to AORN guidelines?
A. Counting sponges while they remain in the packaging
B. Counting each sponge individually with the circulating nurse simultaneously viewing and vocalizing
C. Counting sponges in groups of five to save time
D. Relying on the manufacturer's count as accurate
Correct Answer: B
Rationale: AORN requires that all counted items be counted simultaneously by two individuals (scrub
and circulating nurse) with each item viewed and vocalized to ensure accuracy and prevent cognitive
errors. [CORRECT]
Q9: At the conclusion of a laparotomy, the final sponge count is incorrect—one lap sponge is missing.
Which action should the surgical team take first?
A. Close the incision and obtain an intraoperative X-ray
B. Extend the search to include the room trash, linen hamper, and off-field areas
C. Ask the surgeon to leave the room while the search continues
D. Document the discrepancy and proceed with closure
Correct Answer: B
Rationale: AORN guidelines mandate a systematic search of the sterile field, room trash, linen hamper,
and off-field areas before requesting radiographic imaging; the incision should not be closed until the
discrepancy is resolved. [CORRECT]
Q10: A patient is scheduled for a right total knee replacement. The surgeon marks the right knee with
the word "YES" and the left knee with "NO." Which element of the Universal Protocol does this
represent?
A. Preoperative verification only
B. Site marking only
C. Both preoperative verification and site marking
D. The time-out process
