CNOR Nursing MCQ 4 — Questions and Answers
Question 1: A patient with a BMI of 48 kg/m² is scheduled for a laparoscopic bariatric procedure. Which pressure injury site requires PRIORITY padding assessment before positioning?
- Sacrum and heels (Correct answer)
- Occiput and ears
- Elbows and knees
- Chin and forehead
Correct answer: Sacrum and heels
Obese patients in supine position are at highest risk for pressure injuries at the sacrum and heels due to concentrated body weight over bony prominences.
Question 2: When setting up a sterile back table, which area of a sterile gown is considered non-sterile?
- Chest panel from axilla to table level
- Sleeves from cuff to 2 inches above elbow
- The back of the gown (Correct answer)
- Front panel below the waist
Correct answer: The back of the gown
The back of the surgical gown is considered non-sterile because it cannot be continuously visualized by the scrubbed team member.
Question 3: Which pathogen is responsible for surgical site infections most frequently caused by a break in sterile technique?
- Pseudomonas aeruginosa
- Staphylococcus aureus (Correct answer)
- Escherichia coli
- Clostridium difficile
Correct answer: Staphylococcus aureus
Staphylococcus aureus, particularly MRSA, is the most common cause of surgical site infections related to breaks in aseptic technique.
Question 4: A surgeon uses a monopolar ESU near a patient's pacemaker. Which nursing intervention is MOST critical?
- Use the lowest possible ESU setting
- Place the dispersive electrode on the patient's back
- Use bipolar ESU instead of monopolar (Correct answer)
- Ensure the pacemaker is set to asynchronous mode prior to incision
Correct answer: Use bipolar ESU instead of monopolar
Bipolar electrosurgery is preferred for patients with pacemakers or ICDs because current passes only between two tips and does not travel through the patient's body.
Question 5: Which type of wound closure is used for contaminated or dirty wounds to reduce infection risk?
- Primary intention (primary closure)
- Secondary intention (healing by granulation)
- Delayed primary closure (tertiary intention) (Correct answer)
- Subcuticular absorbable suture closure
Correct answer: Delayed primary closure (tertiary intention)
Delayed primary closure (tertiary intention) is used for contaminated wounds, leaving them open initially and closing after 3-5 days once infection risk decreases.
Question 6: During the time-out, the CNOR identifies that the surgeon has marked the wrong extremity. The appropriate response is to:
- Proceed if two team members verify the correct site from the consent form
- Halt the procedure and clarify with the patient before anesthesia induction (Correct answer)
- Notify the charge nurse to resolve the discrepancy
- Allow the surgeon to correct the mark and proceed immediately
Correct answer: Halt the procedure and clarify with the patient before anesthesia induction
Wrong-site marking requires halting all preparation and verifying the correct site with the conscious patient before proceeding, per universal protocol.
Question 7: Which suture type is MOST appropriate for approximating the bowel anastomosis in a colorectal resection?
- Silk (non-absorbable, braided)
- Nylon monofilament (non-absorbable)
- Polyglycolic acid (absorbable, braided) (Correct answer)
- Polypropylene monofilament (non-absorbable)
Correct answer: Polyglycolic acid (absorbable, braided)
Polyglycolic acid (e.g., Vicryl) is an absorbable braided suture ideal for GI anastomoses, providing adequate tensile strength during healing and then absorbing.
CNOR Nursing MCQ 4
A patient with a BMI of 48 kg/m² is scheduled for a laparoscopic bariatric procedure.
Which pressure injury site requires PRIORITY padding assessment before positioning?