CNOR Operating Room 2 — Questions and Answers
Question 1: Which zone of the operating room suite requires the highest level of air cleanliness and restricted access?
- Semi-restricted zone
- Unrestricted zone
- Restricted zone (Correct answer)
- Transition zone
Correct answer: Restricted zone
The restricted zone includes the operating rooms and requires masks, surgical attire, and the highest level of access control.
Question 2: A surgeon requests that a bovie electrosurgical unit be used near a patient with a pacemaker. What is the perioperative nurse's priority action?
- Refuse to use the ESU entirely
- Notify the biomedical engineer
- Place the dispersive electrode as close to the surgical site as possible and use the lowest effective setting
- Use bipolar electrosurgery instead of monopolar when possible (Correct answer)
Correct answer: Use bipolar electrosurgery instead of monopolar when possible
Bipolar electrosurgery limits current flow to the tissue between the two tips, minimizing electromagnetic interference with the pacemaker.
Question 3: During a laparoscopic procedure, the patient's end-tidal CO2 suddenly rises to 65 mmHg. What should the perioperative nurse suspect first?
- Pulmonary embolism
- CO2 gas embolism (Correct answer)
- Malignant hyperthermia
- Subcutaneous emphysema
Correct answer: CO2 gas embolism
A sudden, severe rise in end-tidal CO2 during laparoscopy is a classic sign of CO2 gas embolism.
Question 4: What is the recommended minimum number of air exchanges per hour in an operating room?
- 5-10
- 15-20 (Correct answer)
- 25-30
- 35-40
Correct answer: 15-20
AORN guidelines recommend a minimum of 15 air changes per hour in the OR, with at least 3 of those being fresh outside air.
Question 5: Which type of anesthesia is most appropriate for a patient undergoing a cesarean section who desires to remain awake?
- General anesthesia with endotracheal intubation
- Monitored anesthesia care (MAC)
- Spinal or epidural anesthesia (Correct answer)
- Intravenous sedation with propofol
Correct answer: Spinal or epidural anesthesia
Spinal or epidural (regional) anesthesia allows the patient to remain conscious and is the standard of care for cesarean sections.
Question 6: What is the purpose of the 'time-out' procedure performed immediately before a surgical incision?
- To allow the surgeon to review the operative report
- To verify patient identity, surgical site, procedure, and consent (Correct answer)
- To confirm anesthesia medications have been given
- To ensure the instrument count has been completed
Correct answer: To verify patient identity, surgical site, procedure, and consent
The time-out is a final safety check to prevent wrong-site, wrong-patient, and wrong-procedure errors.
Question 7: A sterile team member contaminates their glove by touching the back table below table level. What is the correct response?
- Continue the procedure if the contamination was minor
- Re-glove using open gloving technique
- Re-gown and re-glove using closed gloving technique (Correct answer)
- Apply a sterile glove over the contaminated one
Correct answer: Re-gown and re-glove using closed gloving technique
Any break in sterility requires re-gowning and re-gloving; closed gloving technique maintains sterility of the new gloves.
CNOR Operating Room 2
Which zone of the operating room suite requires the highest level of air cleanliness and restricted access?