Pearson Edexcel International
A+ Graded Paper
CNOR Final Exam- Questions from CCI
First Edition (Chapters 1–9) 100% Verified
Q&A for Success
Questions and Mark scheme
Version: Final
,Rationale: The patient is exhibiting signs and symptoms of malignant hyperthermia. Treatment includes rapid
infusion of dantrolene sodium.
A sterile field has been prepared for a vaginal hysterectomy. The surgeon has been called away for an
emergency cesarean section, delaying the scheduled case by at least one hour. The appropriate method for
maintaining the sterile field for the delayed case is to:
A. tape the door closed
B. cover the sterile field with a sterile drape and leave the room
C. cover the sterile field with a sterile drape and remain in the room
D. wait for an house and then tear down the back table - ✔✔C. cover the sterile field with a sterile drape and
remain in the room
Rationale: After a sterile field is established, it should not be left unattended. It is also appropriate to cover the
sterile field with a sterile drape. Covering the field does not negate the need to provide continual observance in
the room. The sterility of the back table is not time related.
The wound classification for a cesarean section in which meconium is released into the abdominal cavity
changes the wound classification from:
A. class I to class II
B. class II to class III
C. class III to class IV
D. class IV to class III - ✔✔B. class II to class III
Rationale: Entering the genitourinary tract in controlled situations without unusual contamination is considered
a class II. Contamination of the wound will change the classification to a class III.
The RN circulator completing the final count for a knee arthroscopy discovers that an atraumatic needle is
missing. After an exhaustive search, an x-ray is ordered. The results are negative and the surgeon closes the
wound. How does the RN circulator document the incident?
A. Document that the count was incorrect or unreconciled and describe the steps that were taken to rectify the
count.
B. Document that the count was correct because the x-ray was negative.
C. Notify the supervisor and document what he/she instructs according to facility policy.
D. Inform the patient that a needle may have been left in the wound. - ✔✔A. Document that the count was
incorrect or unreconciled and describe the steps that were taken to rectify the count.
Rationale: If the x-ray is negative, the count is recorded as incorrect or unreconciled and the x-ray results are
noted on the patient's intraoperative record, as well as the description of the search process.
A patient is scheduled for a total knee replacement. During the time out, the scrub nurse discovers that the
incorrect implant is on the back table. The correct implant is available, but unsterile. The surgeon would like to
continue with the case. What is the best course of action?
A. Notify the surgeon that the correct implant may be sterilized via the immediate-use steam sterilization
(IUSS) method if biological and class V indicators are placed in the load.
B. Notify the surgeon that the correct implant may be sterilized via the ethylene oxide method if the aeration
period is aborted.
, C. Notify the surgeon that a root cause analysis will be initiated.
D. Cancel and reschedule the procedure. - ✔✔A. Notify the surgeon that the correct implant may be sterilized
via the immediate-use steam sterilization (IUSS) method if biological and class V indicators are placed in the
load.
Rationale: IUSS is reserved for those instances in which there is insufficient time to process by the preferred
wrapped or container method. Biological and class V indicators must be run in the load with the implant.
An 18-year-old patient is scheduled for surgery to have cochlear implants placed. The patient refuses to have
the implants tracked even after the team has informed her of the possible implications of a recall or adverse
event. What is the next course of action?
A. Cancel the procedure and have the procedure rescheduled at a different facility.
B. Notify the surgeon and let him decide what to do.
C. Proceed with the surgery and document in the perioperative notes that the patient has refused to allow
tracking of the medical device.
D. Report the incident to the US Food and Drug Administration. - ✔✔C. Proceed with the surgery and
document in the perioperative notes that the patient has refused to allow tracking of the medical device.
Rationale: Patients have the right to refuse racking of their medical devices. If a patient refuses to have the
device tracked, the nurse should document the refusal along with the required product information and report
this information to the manufacturer, but should not include the patient-specific information.
When should the scrub person transfer specimens from the sterile field to the RN circulator?
A. At the end of the procedure
B. When it is conventient for the scrub person
C. As soon as possible
D. Never, because specimens should not be passed off the sterile field. - ✔✔C. As soon as possible.
Rationale: Passing the specimen off the sterile field as soon as possible reduces the potential for the integrity of
the specimen to be compromised or for the specimen to be lost or misplaced.
Which of the following is a common root cause of sentinel events?
A. Failure to use written communication tools
B. Breakdown in communication
C. Absence of or failure to follow policies and procedures
D. Fear of reprisal for speaking up - ✔✔B. Breakdown in communication
Rationale: Including briefings and debriefings before and after surgery, respectively, allows for improved
communication among team members. The goal of effective communication is to ensure that all team members
are aware of key safety strategies and prepared for the surgical procedure.
Use of standardized hand-over communication tool has been demonstrated to:
A. reduce the need for verbal communication
B. reduce the number of caregivers involved in the transfer of patient care.
C. reduce the risk for errors.
D. Eliminate errors associated with the transfer of patient care. - ✔✔C. reduce the risk for errors.
Rationale: Transfer of patient care requires effective communication among caregivers. Use of systems that
A+ Graded Paper
CNOR Final Exam- Questions from CCI
First Edition (Chapters 1–9) 100% Verified
Q&A for Success
Questions and Mark scheme
Version: Final
,Rationale: The patient is exhibiting signs and symptoms of malignant hyperthermia. Treatment includes rapid
infusion of dantrolene sodium.
A sterile field has been prepared for a vaginal hysterectomy. The surgeon has been called away for an
emergency cesarean section, delaying the scheduled case by at least one hour. The appropriate method for
maintaining the sterile field for the delayed case is to:
A. tape the door closed
B. cover the sterile field with a sterile drape and leave the room
C. cover the sterile field with a sterile drape and remain in the room
D. wait for an house and then tear down the back table - ✔✔C. cover the sterile field with a sterile drape and
remain in the room
Rationale: After a sterile field is established, it should not be left unattended. It is also appropriate to cover the
sterile field with a sterile drape. Covering the field does not negate the need to provide continual observance in
the room. The sterility of the back table is not time related.
The wound classification for a cesarean section in which meconium is released into the abdominal cavity
changes the wound classification from:
A. class I to class II
B. class II to class III
C. class III to class IV
D. class IV to class III - ✔✔B. class II to class III
Rationale: Entering the genitourinary tract in controlled situations without unusual contamination is considered
a class II. Contamination of the wound will change the classification to a class III.
The RN circulator completing the final count for a knee arthroscopy discovers that an atraumatic needle is
missing. After an exhaustive search, an x-ray is ordered. The results are negative and the surgeon closes the
wound. How does the RN circulator document the incident?
A. Document that the count was incorrect or unreconciled and describe the steps that were taken to rectify the
count.
B. Document that the count was correct because the x-ray was negative.
C. Notify the supervisor and document what he/she instructs according to facility policy.
D. Inform the patient that a needle may have been left in the wound. - ✔✔A. Document that the count was
incorrect or unreconciled and describe the steps that were taken to rectify the count.
Rationale: If the x-ray is negative, the count is recorded as incorrect or unreconciled and the x-ray results are
noted on the patient's intraoperative record, as well as the description of the search process.
A patient is scheduled for a total knee replacement. During the time out, the scrub nurse discovers that the
incorrect implant is on the back table. The correct implant is available, but unsterile. The surgeon would like to
continue with the case. What is the best course of action?
A. Notify the surgeon that the correct implant may be sterilized via the immediate-use steam sterilization
(IUSS) method if biological and class V indicators are placed in the load.
B. Notify the surgeon that the correct implant may be sterilized via the ethylene oxide method if the aeration
period is aborted.
, C. Notify the surgeon that a root cause analysis will be initiated.
D. Cancel and reschedule the procedure. - ✔✔A. Notify the surgeon that the correct implant may be sterilized
via the immediate-use steam sterilization (IUSS) method if biological and class V indicators are placed in the
load.
Rationale: IUSS is reserved for those instances in which there is insufficient time to process by the preferred
wrapped or container method. Biological and class V indicators must be run in the load with the implant.
An 18-year-old patient is scheduled for surgery to have cochlear implants placed. The patient refuses to have
the implants tracked even after the team has informed her of the possible implications of a recall or adverse
event. What is the next course of action?
A. Cancel the procedure and have the procedure rescheduled at a different facility.
B. Notify the surgeon and let him decide what to do.
C. Proceed with the surgery and document in the perioperative notes that the patient has refused to allow
tracking of the medical device.
D. Report the incident to the US Food and Drug Administration. - ✔✔C. Proceed with the surgery and
document in the perioperative notes that the patient has refused to allow tracking of the medical device.
Rationale: Patients have the right to refuse racking of their medical devices. If a patient refuses to have the
device tracked, the nurse should document the refusal along with the required product information and report
this information to the manufacturer, but should not include the patient-specific information.
When should the scrub person transfer specimens from the sterile field to the RN circulator?
A. At the end of the procedure
B. When it is conventient for the scrub person
C. As soon as possible
D. Never, because specimens should not be passed off the sterile field. - ✔✔C. As soon as possible.
Rationale: Passing the specimen off the sterile field as soon as possible reduces the potential for the integrity of
the specimen to be compromised or for the specimen to be lost or misplaced.
Which of the following is a common root cause of sentinel events?
A. Failure to use written communication tools
B. Breakdown in communication
C. Absence of or failure to follow policies and procedures
D. Fear of reprisal for speaking up - ✔✔B. Breakdown in communication
Rationale: Including briefings and debriefings before and after surgery, respectively, allows for improved
communication among team members. The goal of effective communication is to ensure that all team members
are aware of key safety strategies and prepared for the surgical procedure.
Use of standardized hand-over communication tool has been demonstrated to:
A. reduce the need for verbal communication
B. reduce the number of caregivers involved in the transfer of patient care.
C. reduce the risk for errors.
D. Eliminate errors associated with the transfer of patient care. - ✔✔C. reduce the risk for errors.
Rationale: Transfer of patient care requires effective communication among caregivers. Use of systems that
