CNOR Operating Room 3 — Questions and Answers
Question 1: Which position is MOST associated with the risk of venous air embolism during neurosurgical procedures?
- Supine
- Prone
- Lateral decubitus
- Sitting (beach chair) (Correct answer)
Correct answer: Sitting (beach chair)
The sitting position elevates the surgical site above the heart, creating negative venous pressure that can draw air into open venous sinuses.
Question 2: When scrubbing for a surgical procedure, how long should the initial hand and forearm scrub last according to AORN standards?
- 1-2 minutes
- 3-5 minutes (Correct answer)
- 10-15 minutes
- 20 minutes
Correct answer: 3-5 minutes
AORN recommends a minimum of 3-5 minutes for the initial surgical hand scrub, though manufacturer instructions should also be followed.
Question 3: A patient in the lithotomy position begins to complain of lower extremity pain after repositioning. What is the priority concern?
- Nerve compression injury
- Compartment syndrome (Correct answer)
- Deep vein thrombosis
- Pressure ulcer formation
Correct answer: Compartment syndrome
Compartment syndrome can result from prolonged lithotomy positioning with legs elevated, causing muscle ischemia due to increased compartment pressure.
Question 4: What does the term 'surgical conscience' mean in perioperative nursing?
- Following hospital policy even when inconvenient
- Personal commitment to maintain sterile technique and report breaks immediately (Correct answer)
- Documenting all intraoperative events accurately
- Advocating for the patient's surgical preferences
Correct answer: Personal commitment to maintain sterile technique and report breaks immediately
Surgical conscience is the internalized ethic of maintaining sterile technique and self-reporting any contamination without waiting to be observed.
Question 5: Which layer of the surgical gown is considered sterile and must be protected from contamination?
- The entire gown including the back
- Only the front from the waist down
- The front from the chest to the sterile field level and sleeves to 2 inches above the elbow (Correct answer)
- The front from the neck to the knees
Correct answer: The front from the chest to the sterile field level and sleeves to 2 inches above the elbow
The sterile area of the gown is considered to be the front from chest to the level of the sterile field, and the sleeves from above the elbow to the cuff.
Question 6: Which action best prevents retained surgical items (RSIs)?
- Relying on surgeon memory of item usage
- Performing counts before, during, and after all procedures per AORN policy (Correct answer)
- Using only reusable instruments
- Limiting the number of team members who handle items
Correct answer: Performing counts before, during, and after all procedures per AORN policy
Standardized counting protocols at key intervals are the primary evidence-based strategy for preventing retained surgical items.
Question 7: During a total knee arthroplasty, a tourniquet is applied. What is the maximum recommended continuous inflation time to minimize complications?
- 30 minutes
- 60 minutes
- 120 minutes (Correct answer)
- 180 minutes
Correct answer: 120 minutes
Tourniquet inflation should generally not exceed 120 minutes; beyond this, the risk of nerve damage, compartment syndrome, and reperfusion injury increases significantly.
CNOR Operating Room 3
Which position is MOST associated with the risk of venous air embolism during neurosurgical procedures?