Advanced CNOR (Certified Perioperative
Nurse) Multiple Choice Questions (MCQs)
with Answers and Explanations for
Perioperative Nursing Certification Exams
1. A circulating nurse notes that the sterile field has been contaminated during a
laparoscopic cholecystectomy. Which action is most appropriate?
A. Continue the procedure because contamination is minimal.
B. Cover the contaminated area with a sterile drape.
C. Ask the surgeon whether the contamination is acceptable.
D. Remove the contaminated items and re-establish a sterile field immediately.
Explanation: Maintenance of aseptic technique is critical in preventing surgical site infections.
Any contaminated item must be removed promptly and the sterile field restored.
2. During a surgical timeout, which information must be verified according to national
patient safety standards?
A. Insurance information and discharge plans
B. Medical history and medication allergies only
C. Availability of blood products and transportation arrangements
D. Correct patient, procedure, site, and required implants or equipment
Explanation: Surgical timeouts are designed to prevent wrong-patient, wrong-site, and wrong-
procedure events by verifying essential information immediately before incision.
3. A patient undergoing total hip arthroplasty develops malignant hyperthermia. Which
medication should the perioperative nurse anticipate administering?
A. Protamine sulfate
B. Naloxone
C. Atropine
, D. Dantrolene
Explanation: Dantrolene is the specific treatment for malignant hyperthermia because it
decreases calcium release from skeletal muscle cells and reduces hypermetabolism.
4. Which patient is at greatest risk for developing perioperative hypothermia?
A. A healthy adolescent undergoing arthroscopy
B. A middle-aged patient receiving local anesthesia
C. A patient undergoing cataract surgery
D. An older adult undergoing prolonged abdominal surgery under general anesthesia
Explanation: Older adults and patients undergoing lengthy procedures under general anesthesia
are particularly susceptible to hypothermia due to impaired thermoregulation and heat loss.
5. A scrub nurse notices that the chemical indicator on an instrument tray has not changed
color. Which action is most appropriate?
A. Use the instruments if the package is intact.
B. Ask the surgeon whether the tray can be used.
C. Continue using the instruments until replacements arrive.
D. Remove the tray from the sterile field and obtain another set.
Explanation: Failure of the chemical indicator to change color suggests improper sterilization,
making the instruments unsafe for use.
6. Which action by the circulating nurse best reduces the risk of retained surgical items?
A. Limiting the number of surgical personnel
B. Counting instruments after wound closure
C. Avoiding intraoperative radiographs
D. Performing standardized counts before, during, and after the procedure
Explanation: Standardized counts of sponges, sharps, and instruments are essential to prevent
retained foreign objects.
Nurse) Multiple Choice Questions (MCQs)
with Answers and Explanations for
Perioperative Nursing Certification Exams
1. A circulating nurse notes that the sterile field has been contaminated during a
laparoscopic cholecystectomy. Which action is most appropriate?
A. Continue the procedure because contamination is minimal.
B. Cover the contaminated area with a sterile drape.
C. Ask the surgeon whether the contamination is acceptable.
D. Remove the contaminated items and re-establish a sterile field immediately.
Explanation: Maintenance of aseptic technique is critical in preventing surgical site infections.
Any contaminated item must be removed promptly and the sterile field restored.
2. During a surgical timeout, which information must be verified according to national
patient safety standards?
A. Insurance information and discharge plans
B. Medical history and medication allergies only
C. Availability of blood products and transportation arrangements
D. Correct patient, procedure, site, and required implants or equipment
Explanation: Surgical timeouts are designed to prevent wrong-patient, wrong-site, and wrong-
procedure events by verifying essential information immediately before incision.
3. A patient undergoing total hip arthroplasty develops malignant hyperthermia. Which
medication should the perioperative nurse anticipate administering?
A. Protamine sulfate
B. Naloxone
C. Atropine
, D. Dantrolene
Explanation: Dantrolene is the specific treatment for malignant hyperthermia because it
decreases calcium release from skeletal muscle cells and reduces hypermetabolism.
4. Which patient is at greatest risk for developing perioperative hypothermia?
A. A healthy adolescent undergoing arthroscopy
B. A middle-aged patient receiving local anesthesia
C. A patient undergoing cataract surgery
D. An older adult undergoing prolonged abdominal surgery under general anesthesia
Explanation: Older adults and patients undergoing lengthy procedures under general anesthesia
are particularly susceptible to hypothermia due to impaired thermoregulation and heat loss.
5. A scrub nurse notices that the chemical indicator on an instrument tray has not changed
color. Which action is most appropriate?
A. Use the instruments if the package is intact.
B. Ask the surgeon whether the tray can be used.
C. Continue using the instruments until replacements arrive.
D. Remove the tray from the sterile field and obtain another set.
Explanation: Failure of the chemical indicator to change color suggests improper sterilization,
making the instruments unsafe for use.
6. Which action by the circulating nurse best reduces the risk of retained surgical items?
A. Limiting the number of surgical personnel
B. Counting instruments after wound closure
C. Avoiding intraoperative radiographs
D. Performing standardized counts before, during, and after the procedure
Explanation: Standardized counts of sponges, sharps, and instruments are essential to prevent
retained foreign objects.
