CNOR EXAM PREPARATION 400 PRACTICE QUESTIONS WITH VERIFIED ANSWERS & RATIONALES CERTIFIED PERIOPERATIVE NURSE TEST BANK LATEST UPDATE 2026/2027

CNOR EXAM PREPARATION 400 PRACTICE
QUESTIONS WITH VERIFIED ANSWERS & RATIONALES
CERTIFIED PERIOPERATIVE NURSE TEST BANK LATEST
UPDATE 2026/2027
SECTION 1: PATIENT MONITORING & EMERGENCY RESPONSE (Questions 1-67)
Question 1
During a procedure under local anesthesia, the patient complains of circumoral
numbness, blurred vision, and dizziness. What should be the immediate action of
the preoperative nurse monitoring this patient?
A) Administer oxygen
B) Ensure an airway
C) Check vital signs
D) Notify anesthesia
Correct Answer: B
Rationale: Circumoral numbness, blurred vision, and dizziness are early signs of
local anesthetic systemic toxicity (LAST). Ensuring a patent airway is the priority
intervention. These symptoms indicate the patient is experiencing central nervous
system effects of local anesthetic toxicity, which can progress to seizures and
respiratory depression.

Question 2
The circulating nurse reports that the needle count is incorrect. The surgeon
continues to close the wound stating "I know it is not in the wound and I am not
going to stop to look for it." The best plan of action is to:
A) Ignore the surgeon and document the incident
B) Inform the surgeon of the hospital policy and document subsequent actions
C) Call the operating room supervisor immediately
D) Continue with the case and document the count discrepancy
Correct Answer: B
Rationale: The circulating nurse has a responsibility to advocate for patient safety.
The nurse must inform the surgeon of hospital policy regarding incorrect counts

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,and document all actions taken. If the surgeon refuses to follow policy, the nurse
should escalate to the supervisor while documenting the situation thoroughly.

Question 3
A new employee unknowingly dispensed an unsterile solution to the sterile field.
The following day the supervisor learns of the incident. The supervisor's first
action would be to:
A) Terminate the new employee
B) Notify the surgeon of the break in technique
C) Write up the employee for the incident
D) Retrain the employee on sterile technique
Correct Answer: B
Rationale: Patient safety is the priority. The surgeon must be notified of any break
in sterile technique that could affect the patient. After notification, the supervisor
should investigate the incident and provide appropriate education and corrective
actions.

Question 4
What are the signs and symptoms of LAST (Local Anesthetic Systemic Toxicity)?
A) Hypertension only
B) Metallic taste, circumoral numbness, tinnitus, seizures
C) Hypotension and bradycardia only
D) Respiratory depression only
Correct Answer: B
Rationale: LAST presents with a characteristic progression: early signs include
metallic taste, circumoral numbness, tinnitus, and headache. The excitation phase
includes shivering, slurred speech, and seizures. The depression phase includes
coma, bradycardia, hypotension, and cardiac arrest.

Question 5
How is LAST treated?
A) Administer epinephrine immediately
B) Call for help and administer 20% lipid emulsion

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,C) Administer naloxone
D) Increase IV fluids
Correct Answer: B
Rationale: Treatment of LAST includes calling for help, administering 20% lipid
emulsion, and using benzodiazepines to control seizures. Lipid emulsion therapy is
the specific antidote for LAST. Avoid any pressure points and maintain airway
support.

Question 6
The earliest sign of air embolism during a procedure is:
A) Increased blood pressure
B) Decreased CO2
C) Tachycardia
D) Cyanosis
Correct Answer: B
Rationale: A sudden decrease in end-tidal CO2 is the earliest sign of air embolism.
This occurs because air in the pulmonary vasculature creates a ventilation-
perfusion mismatch. Other signs include hypotension, tachycardia, and cardiac
arrhythmias.

Question 7
What maneuver is performed for venous air embolism?
A) Trendelenburg position
B) Durant's maneuver (left lateral position)
C) Reverse Trendelenburg
D) Prone position
Correct Answer: B
Rationale: Durant's maneuver places the patient in the left lateral position, which
traps air in the right ventricle and prevents it from entering the pulmonary
circulation. This is the standard position for managing venous air embolism.

Question 8
Which procedure has a common complication of venous-sided air embolism?

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, A) Cholecystectomy
B) TURP (Transurethral Resection of the Prostate)
C) Appendectomy
D) Hernia repair
Correct Answer: B
Rationale: TURP has a significant risk of venous air embolism because the
procedure is performed with the patient in lithotomy position with the
resectoscope allowing air to enter the venous system through open prostatic
sinuses.

Question 9
What is the treatment for arterial-sided air embolism?
A) Anticoagulants and bypass to remove it
B) Durant's maneuver
C) Trendelenburg position
D) Oxygen therapy only
Correct Answer: A
Rationale: Arterial air embolism requires urgent intervention including
anticoagulation and hyperbaric oxygen therapy or surgical removal of the air. This
is a life-threatening emergency that requires immediate intervention.

Question 10
A patient with an Andrew score of 7 in the PACU will generally be:
A) Transferred out of the PACU to the surgical unit
B) Transferred out of PACU to ICU
C) Returned to the OR
D) Retained in PACU until condition improves
Correct Answer: D
Rationale: The Aldrete (Andrew) score is a post-anesthesia recovery scoring
system. A score of 7 indicates the patient is not ready for discharge from PACU.
Patients are typically discharged when they achieve a score of 9 or 10.




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