CNOR Certification MCQ 3 — Questions and Answers
Question 1: Which wound classification is assigned to a colorectal resection performed for cancer without gross spillage of bowel contents?
- Class I – Clean
- Class II – Clean-Contaminated (Correct answer)
- Class III – Contaminated
- Class IV – Dirty/Infected
Correct answer: Class II – Clean-Contaminated
Elective colorectal surgery with controlled entry into the GI tract but no gross spillage is classified as Clean-Contaminated (Class II).
Question 2: During a laparoscopic procedure, the circulator notices the patient's end-tidal CO2 is rising rapidly and the capnography waveform changes. The FIRST priority is:
- Increase pneumoperitoneum pressure to improve visualization
- Alert the surgeon and anesthesiologist immediately (Correct answer)
- Administer IV sodium bicarbonate per standing orders
- Document the finding and reassess in five minutes
Correct answer: Alert the surgeon and anesthesiologist immediately
Rapidly rising EtCO2 may indicate CO2 embolism or inadvertent subcutaneous emphysema; immediate notification of the surgical team is the priority action.
Question 3: The recommended method for verifying instrument counts before and after surgery is:
- The scrub person counts alone and reports totals verbally
- Two individuals count together and record counts on a count sheet (Correct answer)
- The circulator counts instruments while the surgeon closes
- Counts are performed only if the scrub person suspects a discrepancy
Correct answer: Two individuals count together and record counts on a count sheet
AORN guidelines require two-person concurrent counting with results recorded to ensure accuracy and accountability.
Question 4: A patient who has a documented latex allergy should be scheduled as which type of case whenever possible?
- Last case of the day to allow full room turnover
- First case of the morning before latex particles accumulate in room air (Correct answer)
- Any case time is equally safe with a latex-safe cart present
- Mid-day after high-traffic latex cases have finished
Correct answer: First case of the morning before latex particles accumulate in room air
Scheduling latex-allergic patients as the first case of the day minimizes airborne latex allergen exposure that accumulates from prior cases.
Question 5: When using a monopolar electrosurgical unit (ESU), the dispersive electrode (patient return electrode) should be placed:
- On a bony prominence closest to the operative site
- On a well-vascularized muscle mass between the ESU site and the grounding pad (Correct answer)
- Over a metal orthopedic implant to improve conductivity
- As far from the operative site as possible to reduce current density
Correct answer: On a well-vascularized muscle mass between the ESU site and the grounding pad
Placement over a well-vascularized muscle mass near but not over implants ensures low current density and adequate heat dispersal to prevent burns.
Question 6: The term 'retained surgical item' (RSI) refers to:
- Only sponges and needles accidentally left inside the patient
- Any foreign object unintentionally left in a patient after surgery (Correct answer)
- Instruments left at the sterile field after the case ends
- Items documented as missing from the count sheet
Correct answer: Any foreign object unintentionally left in a patient after surgery
An RSI is any foreign object — including sponges, instruments, needles, or devices — unintentionally left inside a patient after surgery.
Question 7: Which of the following best describes the CNOR's advocacy role in the perioperative setting?
- Representing the surgical team's interests to hospital administration
- Acting as the patient's voice and ensuring safe, evidence-based care when the patient cannot speak for themselves (Correct answer)
- Documenting surgeon preferences to streamline case setup
- Supervising sterile processing technicians in instrument reprocessing
Correct answer: Acting as the patient's voice and ensuring safe, evidence-based care when the patient cannot speak for themselves
Advocacy means acting in the patient's best interest and speaking on their behalf — especially critical when patients are sedated or anesthetized and cannot self-advocate.
CNOR Certification MCQ 3
Which wound classification is assigned to a colorectal resection performed for cancer without gross spillage of bowel contents?