CNOR Certification MCQ 2 — Questions and Answers
Question 1: Which principle guides the CNOR's role in maintaining the sterile field during a surgical procedure?
- Any item of doubtful sterility is considered contaminated (Correct answer)
- A sterile field can be re-established after brief contamination
- Sterile items may touch non-sterile items if contact is brief
- The surgeon determines sterility status of items in the field
Correct answer: Any item of doubtful sterility is considered contaminated
A fundamental principle of aseptic technique is that any item whose sterility is uncertain must be treated as contaminated.
Question 2: The scrub person drops a sterile instrument onto the floor. The correct action is to:
- Wipe it with a sterile towel and return it to the field
- Pass it off the sterile field and obtain a replacement (Correct answer)
- Pour sterile saline over it to decontaminate it
- Use it only for non-critical steps of the procedure
Correct answer: Pass it off the sterile field and obtain a replacement
Any item that contacts a non-sterile surface must be removed from the sterile field and replaced; it cannot be reclaimed by cleaning in the OR.
Question 3: When positioning a patient in the lateral decubitus position, the MOST important nursing consideration to prevent injury is:
- Padding all bony prominences and ensuring the axillary roll is placed correctly (Correct answer)
- Applying a warming blanket before positioning begins
- Elevating the head of the bed 30 degrees to improve venous drainage
- Securing the patient with only one safety strap across the hips
Correct answer: Padding all bony prominences and ensuring the axillary roll is placed correctly
Lateral positioning risks brachial plexus injury and pressure injuries; correct axillary roll placement and padding all bony prominences are critical safeguards.
Question 4: A patient undergoing an abdominal procedure under general anesthesia is at GREATEST risk for which thermoregulatory complication?
- Hyperthermia due to metabolic stimulation
- Hypothermia due to heat loss from the open body cavity and anesthesia effects (Correct answer)
- Fever from inflammatory cytokine release
- Diaphoresis causing evaporative cooling only
Correct answer: Hypothermia due to heat loss from the open body cavity and anesthesia effects
General anesthesia impairs thermoregulation and open body cavities cause significant radiant and evaporative heat loss, making hypothermia the primary risk.
Question 5: Which hand-washing technique is recommended before the first surgical case of the day?
- A 90-second alcohol-based hand rub only
- A traditional surgical hand scrub of at least 3–5 minutes using an antimicrobial agent (Correct answer)
- A standard 20-second soap-and-water wash
- A 60-second povidone-iodine scrub of the hands only
Correct answer: A traditional surgical hand scrub of at least 3–5 minutes using an antimicrobial agent
Before the first case of the day, a traditional timed antimicrobial surgical scrub is required to remove resident and transient flora from hands and forearms.
Question 6: Malignant hyperthermia (MH) is triggered by which class of agents?
- Opioid analgesics and benzodiazepines
- Non-depolarizing neuromuscular blocking agents
- Volatile halogenated anesthetic agents and succinylcholine (Correct answer)
- Nitrous oxide and propofol
Correct answer: Volatile halogenated anesthetic agents and succinylcholine
MH is a pharmacogenetic disorder triggered by volatile inhalation agents (e.g., sevoflurane) and the depolarizing agent succinylcholine.
Question 7: The surgical time-out is performed primarily to:
- Confirm the patient's NPO status before incision
- Verify correct patient identity, procedure, and operative site before incision (Correct answer)
- Document antibiotic administration timing in the chart
- Ensure anesthesia equipment has been checked
Correct answer: Verify correct patient identity, procedure, and operative site before incision
The time-out, per The Joint Commission Universal Protocol, verifies correct patient, correct procedure, and correct site/side immediately before the procedure begins.
CNOR Certification MCQ 2
Which principle guides the CNOR's role in maintaining the sterile field during a surgical procedure?