CNOR Certification MCQ 5 — Questions and Answers
Question 1: Which type of suture material is MOST appropriate for closing a contaminated wound where absorption over several weeks is needed?
- Silk (non-absorbable, braided)
- Polydioxanone (PDS) – synthetic absorbable monofilament (Correct answer)
- Stainless steel wire
- Polyester (Mersilene) – non-absorbable braided
Correct answer: Polydioxanone (PDS) – synthetic absorbable monofilament
PDS is a synthetic monofilament absorbable suture that resists infection better than braided materials and maintains tensile strength for 4–6 weeks.
Question 2: A surgeon requests a frozen section during a thyroidectomy. The perioperative nurse's role includes:
- Analyzing the tissue and reporting results to the surgeon
- Properly labeling and transporting the specimen to pathology per institutional protocol (Correct answer)
- Fixing the specimen in formalin before sending it for frozen section
- Discarding the specimen if the surgeon does not specify the analysis needed
Correct answer: Properly labeling and transporting the specimen to pathology per institutional protocol
The perioperative nurse is responsible for correct specimen identification, labeling, and timely transport; frozen sections must NOT be placed in formalin.
Question 3: When sterilizing a complex multi-lumen instrument, the perioperative team must ensure that:
- The instrument is dried externally and placed in a peel pouch without flushing lumens
- All lumens are flushed, the instrument is fully disassembled, and the sterilant contacts all surfaces (Correct answer)
- The instrument can be sterilized in assembled form to save time
- Surface cleaning alone is sufficient if the instrument was used on a low-risk patient
Correct answer: All lumens are flushed, the instrument is fully disassembled, and the sterilant contacts all surfaces
Sterilization efficacy requires direct sterilant contact with every surface; complex instruments must be disassembled and lumens flushed so no bioburden is shielded.
Question 4: The 'clean to dirty' principle in the sterile field means:
- Instruments used on bone are cleaner than those used on soft tissue
- Procedures always progress from the least contaminated area to the most contaminated area (Correct answer)
- Sterile drapes are applied from the outer edge inward toward the operative site
- Only the first instrument used in a procedure is considered clean
Correct answer: Procedures always progress from the least contaminated area to the most contaminated area
Moving from clean to dirty areas prevents cross-contamination — for example, a bowel anastomosis proceeds from mucosa to serosa to avoid spreading luminal contents.
Question 5: A patient receives a peripherally inserted central catheter (PICC) the morning of surgery for IV access. Before induction, the perioperative nurse should verify:
- That the PICC was placed by a surgeon, not a nurse
- Catheter tip position confirmed by chest X-ray and patency of all lumens (Correct answer)
- That the PICC replaces the need for a peripheral IV
- The PICC is used only for blood draws during the case
Correct answer: Catheter tip position confirmed by chest X-ray and patency of all lumens
Central line tip position must be radiographically confirmed before use to prevent complications such as cardiac arrhythmia or perforation from malposition.
Question 6: Which of the following is a correct principle regarding the passage of items across the sterile field boundary?
- Non-sterile team members may reach across the sterile field to pass items quickly
- Non-sterile items are presented to the sterile field by opening packaging so the scrub person retrieves the contents without contamination (Correct answer)
- Sterile items may be handed directly from a non-sterile team member to the scrub person
- The circulator may place non-sterile items on the sterile field if gloved
Correct answer: Non-sterile items are presented to the sterile field by opening packaging so the scrub person retrieves the contents without contamination
The circulator opens outer packaging and presents the inner sterile item for the scrub person to self-retrieve, maintaining sterility without contact across the boundary.
Question 7: Which of the following BEST describes the responsibility of the registered nurse first assistant (RNFA) in the OR?
- Performing independently without surgeon supervision in any state
- Assisting the surgeon intraoperatively by handling tissue, providing hemostasis, and suturing under surgeon direction (Correct answer)
- Replacing the scrub technician when a second scrub is not available
- Administering anesthesia when the CRNA is on break
Correct answer: Assisting the surgeon intraoperatively by handling tissue, providing hemostasis, and suturing under surgeon direction
The RNFA works under surgeon direction to assist with tissue handling, hemostasis, exposure, and closure as an adjunct to — not a replacement of — the surgical team.
CNOR Certification MCQ 5
Which type of suture material is MOST appropriate for closing a contaminated wound where absorption over several weeks is needed?