CNOR Practice Exam 2024: Questions and Answers with Rationales, Exams of Nursing

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CNOR PRACTICE EXAM 2024/ACTUAL EXAM

QUESTIONS WITH CORRECT DETAILED AND

VERIFIED ANSWERS WITH RATIONALES/CNOR

EXAM 2024- 2025

Autologous bone grafts should be stored at a temperature of: A. 68F (20C) B. 32F (0C) C. - 4F (-20C) D. - 112F (-80C) - C. - 4F (-20C) When providing patient education for a child, it is important to understand which learning characteristics of children?A. Children are self-directed B. Children use intrinsic thought processes C. Children respond to use of activities that follow transitions of maturity. D. Children respond to a trial-and-error approach - D. Children respond to a trial- and-error approach Rationale: When teaching children, using a trial-and-error approach is effective. Child learners are task- oriented, use extrinsic thought processes, and value self- esteem. Which of the following actions would decrease radiation exposure during Maintaining storage temperatures within recommended parameters of - 4F (-20C) helps ensure that autografts are maintained in optimal conditions for successful replantation.

fluoroscopy procedures? A. Positioning the patient as close to the tube as possible B. Positioning the patient as far from the image intensifier as possible C. Positioning the patient as far from the monitor as possible D. Positioning the patient as close to the image intensifier as possible - D. Positioning the patient as close to the image intensifier as possible Rationale: The x-ray beams originate from the tube and are captured by the image intensifier. Multiple studies have demonstrated that positioning the patient closer to the image intensifier results in a significantly decreased dose of radiation. A perioperative nurse is assisting an anesthesia professional with a rapid-sequence induction by providing cricoid pressure using the Sellick maneuver. Which of the following is the most appropriate description of this technique? A. Exerting down-and-up pressure on the cricoid cartilage to compress the trachea B. Palpating for the thyroid cartilage and exerting pressure on it with a dominant index finger and thumb to occlude the esophagus C. Applying pressure on the cricoid cartilage to occlude the esophagus D. Maintaining pressure on the thyroid cartilage until anesthesia verifies placement - C. Applying pressure on the cricoid cartilage to occlude the esophagus Rationale: The Sellick maneuver, more commonly known as cricoid pressure

application, involves exerting downward pressure on the cricoid cartilage with the thumb and index finger of one hand to compress the esophagus. The Sellick maneuver is used to prevent potential aspiration during induction of anesthesia. A diagnostic procedure that replies on radio-frequency waves to reproduce cross- sectional images of the body without exposing the patient to ionizing radiation is: A. Ultrasonography B. Position emission tomography C. Computed tomography D. Magnetic resonance imaging - D. Magnetic resonance imaging Which of the following movements of a powered instrument is used to drill holes or to insert screws, wires, and pins? A. Reciprocating B. Oscillating C. Alternating D. Rotating - D. Rotating Rationale: Rotary movement is used to drill holes or to insert screws, wires, or Magnetic resonance imaging stimulates disequilibrium in the nuclei of hydrogen atoms and the water of body cells. As nuclei return to their original state, they emit radiofrequency signals.

pins. Reciprocating and oscillating movements are used to cut or remove bone. Alternating movement should not be sued. What is the most likely cause of a rapid decrease in blood pressure and heart rate for a patient being infused when 1.5% glycine is used for irrigation? C. TUR syndrome D. Pulmonary embolus - C. TUR syndrome Rationale: The patient is most likely experiencing TUR syndrome associated excessive glycine absorption. Preoperative teaching is most effective when patients have a readiness to learn and the perioperative nurse teaches from different levels. A. Two B. Three C. Four D. Five - B. Three Rationale: There are three different levels of preoperative teaching: information, psychosocial support, and skill training. Information should include explanations of procedure and what to expect throughout the phases of perioperative care. Psychosocial support includes encouraging the patient to share anxiety and A. Anaphylactic reaction B. Myocardial infarction

supporting coping mechanisms. Skill training allows the patient to learn the skills required to function after the procedure and provides confidence and understanding. When caring for a patient with sickle cell anemia, the perioperative nurse should: A. Raise the temperature in the operating room to between 26.7C and 29.4C (80F and 85F).** B. Have relaxing music playing in the operating room to avoid overstimulation C. Administer a liter of normal saline prior to surgery to ensure that the patient is well hydrated D. Allow a family member or friend to sit with the patient in the preoperative area and in the post anesthesia care unit. - A. Raise the temperature in the operating room to between 26.7C and 29.4C (80F and 85F). Rationale: The sickle cell patient must be kept warm to prevent hypothermia and meet increased demands for oxygen. A type of fire extinguisher should be used in an operating or procedure room. A. Wet chemical B. Carbon dioxide C. Halogen D. Dry powder - B. Carbon dioxide

Rationale: The National Fire Protection Association recommends using either a water mist or carbon dioxide extinguisher for extinguishing fires in the operating room. requires purposeful, outcomes-directed thought and is driven by patient need. A. Critical thinking B. Assessment C. Diagnosis D. Planning - A. Critical thinking Scientific nursing interventions, critical thinking and clinical reasoning, and caring, comforting behaviors are at the heart of perioperative nursing. Critical thinking is a thoughtful process important in the performance of perioperative nursing care versus being part of the nursing process. A hemoglobin value considered to be within normal limits for an adult woman is: A. 10 g/dL to 14 g/dL B. 12 g/dL to 16 g/dL C. 14 g/dL to 18 g/dL D. 16 g/dL to 20 g/dL - B. 12 g/dL to 16 g/dL Normal hemoglobin values are 12 g/dL to 16 g/dL for women and 14 g/dL to 18 g/dL for men.

What technique is the safest to use when securing the arms at the patient's sides? A. Drawing a sheet under the arms, over the patient, and using non-penetrating clamps to secure it to the opposite side B. Drawing a sheet over the arm and then sliding it between the mattress and the bed C. Drawing a sheet over the arm and tucking it between the patient and the mattress D. Wrapping the patient's arm with padding and securing it to the body with a safety strap - C. Drawing a sheet over the arm and tucking it between the patient and the mattress A safe and effective way to prevent nerve injury of the upper extremities is to secure the patient's arms by smoothly wrapping the draw sheet over the arm and then tucking it under the patient's body to prevent arm slippage during surgery. Which of the following intraoperative medication orders would prompt a perioperative nurse to have a urinary catheter readily available? A. Levetiracetam 1gm IV after incision B. Cefepime 2g/100mL IV infusion within 30 minutes of incision C. Ketorolac 20mg IV push before incision D. Mannitol 10% 10g/100mL after incision - D. Mannitol 10% 10g/100mL after incision

Hypertonic mannitol is a nonosmotic diuretic that is often used during brain surgery to promote diuresis and therefore decrease intracranial pressure. Which of the following is defined as the process of teaching adults? A. Pedagogy B. Andragogy C. Cognition D. Orientation - B. Andragogy Teaching and learning processes related to mature adults are known as andragogy. Personal protective equipment that must be worn when mixing and inserting methyl methacrylate bone cement includes: A. Head coverings B. Latex gloves C. Googles D. Shoe covers - C. Googles Methyl methacrylate can penetrate many latex compounds. Methyl methacrylate

fumes may irritate the eyes; therefore, eye protection must be worn when mixing and inserting methyl and impervious clothing. Which of the following nursing actions would be best support a positive outcome for a nursing diagnosis of potential for alteration in skin integrity? A. Place a warming blanket on the OR bed prior to the patient coming into the operating room B. Obtain an appropriate positioning device that will aid in redistribution of pressure C. Place several layers of linen material on the OR bed D. Position the patient in a supine position with arms tucked at sides and palms facing down to protect the ulcer nerve - B. Obtain an appropriate positioning device that will aid in redistribution of pressure Warming blankets and extra layers of material should not be placed under the patient. The goal is to use equipment that is designed to redistribute pressure and that decreases the risk for positioning injuries. Palms should face the patient when the arms are tucked. Which of the following describes point-of-use cleaning of a surgical instrument? methacrylate bone cement. PPE is defined as any clothing or other equipment that protects a person from exposure to chemicals. PPE may include gloves, aprons, chemical splash goggles,

A. Prior to the procedure, the instrument is cleaned with a moist sponge B. During the procedure, the instrument is cleaned with a moist sponge after each use C. After the procedure, the instrument is cleaned with a moist sponge in the sterile processing area D. Continually clean the instrument with a sponge moistened with saline - B. During the procedure, the instrument is cleaned with a moist sponge after each use procedure. Saline should not be used for point-of-care cleaning. Cleaning at the point of use prevents bioburden from building up on the instrument and helps maintain the life of the instrument. Venous air embolism is most likely to occur when the patient is in the position. A. Supine B. Sitting C. Lithotomy D. Lateral - B. Sitting One type of point-of-use cleaning of a surgical instrument is when the instrument is cleaned with a sterile, water-soaked sponge after each use during the procedure. Point-of-use cleaning also occurs when an instrument is cleaned at the point of use immediately following the

in the sitting or semi-sitting position. A subjective sign of the existence and intensity of postoperative pain is the patient's: A. Self-report B. Change in blood pressure C. Facial expression D. Protective guarding behavior - A. Self-report A subjective sign is what the patient states. Objective signs include results from physical assessment or observation. A nursing diagnosis that considers a patient is at risk means the nursing interventions: A. Are directed at prevention D. May put the patients at risk - A. Are directed at prevention B. Will not affect the patient's outcome C. Should be performed only as needed Venous air embolism can occur when air or gas is drawn into the circulation by the veins above the level of the heart and is most likely to occur during neurosurgery or open shoulder surgery

Signs of a blood transfusion reaction include which of the following? A. Hypotension, hemoglobinuria, hyperthermia B. Weak pulse, hemoglobinuria, hypertension C. Hypothermia, weak pulse, tachycardia D. Hypothermia, hemoglobinuria, tachycardia - A. Hypotension, hemoglobinuria, hyperthermia A blood transfusion reaction reflects vasomotor instability and is evidenced by hypotension, hemoglobinuria, and hyperthermia. Many common signs are not readily obvious when a patient is under anesthesia. Aseptic technique is also known as: C. Sterilization D. Decontamination - A. Clean technique Aseptic technique refers to clean methods of containing microbial contamination in the environment. The environment cannot be sterilized. For perioperative patients, nursing diagnoses that consider a patient at risk for an outcome mean the problem has not yet occurred, and the interventions are directed at prevention. A. Clean technique B. Sterile technique

An intrinsic factor that contributes to the development of a pressure injury is: A. Pressure B. Hypothermia C. Diabetes mellitus D. General anesthesia - C. Diabetes mellitus An intrinsic factor is related to the health of the patient. Diabetes mellitus is an intrinsic factor that contributes to the development of a pressure injury. Which of the following helps determine a patient's discharge destination? A. Written discharge instructions from anesthesiology and medical staff B. Risk of postoperative complications C. Standardized pain scoring D. General condition and readiness for discharge - B. Risk of postoperative complications The choice of discharge site is based on patient acuity, access to follow-up care, and the potential for postoperative complications. Central nervous system (CNS) signs and symptoms of local anesthetic systemic toxicity (LAST) include:

A. Hypertension B. Numbness of lips and tongue C. Respiratory depression D. Elevated temperature - B. Numbness of lips and tongue CNS symptoms of LAST include circumoral and tongue numbness. All other options are not considered part of the CNS. When performing time out, which of the following should be verified? A. Laboratory studies B. Instruments C. Suture D. Procedure - D. Procedure Ensuring correct-site surgery requires affirmation of the following: correct patient, position, site, procedures, equipment, images, and implants (if required). Pneumatic tourniquets should be deflated under the direction of: A. The surgeon and the scrub person B. The anesthesia professional and the circulating nurse C. The circulating nurse and the surgeon D. The surgeon and the anesthesia professional - D. The surgeon and the

anesthesia professional Hemodynamic changes may occur when the tourniquet is deflated. As the tourniquet cuff deflates, the anesthetic agent may be released into the circulatory system, causing systemic effects. Coordination among members of the perioperative team under the direction of the surgeon and the anesthesia professional can facilitate management of the patient's physiologic status during this period of rapid change. Which organization should be consulted about a perioperative RN's scope of practice related to administration of medications for moderate sedation? A. Association of periOperative Registered Nurses B. The Joint Commission C. State Board of Nursing D. Centers for Medicare & Medicaid Services - C. State Board of Nursing The professional registered nurse's scope of practice is defined by the individual state board of nursing. A perioperative nurse is monitoring a patient under local anesthesia during a hernia repair when the patient reports a strange taste in the mouth. What is the most appropriate response by the perioperative nurse?

A. Reassure the patient that it is a common sensation and will resolve soon after surgery

B. Check the patient's hemoglobin and hematocrit C. Ask the patient to confirm nothing by mouth status D. Call for help - D. Call for help The patient's symptom may represent a local anesthetic systemic toxicity (LAST), which would require urgent treatment under the direction of a qualified health care provider such as an cardiovascular collapse (eg, bradycardia/hypotension). A 47 - year-old Spanish-speaking male presents with abdominal pain. He does not speak or understand English. How should the nurse communicate with the patient? A. Use a family member to interpret B. Use a trained medical interpreter trained medical interpreter Using a trained medical interpreter decreases errors and misunderstanding of the explanation of care. Using a family member may cause either the family member or patient to not be truthful to the care provider due to embarrassment. Using a bystander to interpret is a violation of HIPAA. anesthesia professional or a code team. In addition to altered taste (eg, metallic taste), other symptoms of LAST are consistent with neurologic (eg, numbness, confusion, seizures) and/or C. Speak loudly and slowly to the patient D. Ask a bystander to interpret - B. Use a

Which of the following actions terminates the direct perioperative nurse-patient relationship? A. Evaluating the degree of attainment of expected outcomes B. Performing the postoperative assessment or follow-up telephone call C. Attending conferences with the patient's physician and/or other caregivers D. Suggesting comfort measures to help calm the patient - B. Performing the postoperative assessment or follow-up telephone call The postoperative assessment or follow-up telephone call terminates the direct perioperative nurse-patient relationship. Operating room floors should be cleaned with: A. Dry mops B. Brooms C. Vacuums D. Damp or wet mops - D. Damp or wet mops Wet and moist mopping produce fewer aerosols and are most effective in reducing organic soil in the environment.

A coworker in the operating room asks to see the patient's chart for the nurse's next case, stating that the patient is her neighbor. The nurse should: A. State this would be a violation of the patient's privacy B. Hand over the patient's chart because they are neighbors C. Consult with the doctor about letting the coworker see the chart D. Ask their director to make the decision - A. State this would be a violation of the patient's privacy The federal Health Insurance Portability and Accountability Act (HIPAA) granted patients significant rights in respect to how their health information is used. Only health care personnel involved in direct patient care should have access to patient information. Surgery of the liver requires incising the external covering referred to as: A. Glisson's capsule B. Gerota's fascia C. Porta hepatis D. Hepatic fascia - A. Glisson's capsule The covering of the liver is made up of dense connective tissue called Glisson's capsule.

Which of the following is the most appropriate recommendation for hair removal prior to surgery? A. A depilatory should be used in the operating room B. The patient should shave at home the night before surgery C. A wet shave should be done in the operating room D. The patient's hair should be clipped in the preoperative area - D. The patient's hair should be clipped in the preoperative area When necessary, hair at the surgical site should be removed in the area outside of the procedure room and in a manner that minimizes injury to the skin, such as by clipping or depilatory methods. Joey is a 4 - year-old scheduled to have surgery. During preoperative teaching, the perioperative nurse knows that Joey's age-specific needs can best be met by: A. Allowing his parent or caregiver to explain what will happen B. Providing him privacy whenever possible C. Allowing him to handle the oxygen mask and ride in the wagon that will later take him to the OR D. Giving him a thorough explanation of everything that will happen - C. Allowing him to handle the oxygen mask and ride in the wagon that will later take him to

the OR

The preschooler needs to explore and interact with his environment. Allowing him to familiarize himself ahead of time with some objects he may encounter can help ease anxiety. "Flammable" antiseptic solutions differ from "combustible" ones in that: A. Flammable solutions have a flash point above 101.5F B. Flammable solutions will not ignite C. Combustible solutions have a flash point above 100.0F D. Combustible solutions will not ignite - C. Combustible solutions have a flash point above 100.0F Which of the following is the most important action by the circulating nurse to reduce specimen error? A. Seeking clarification from the surgeon about the specimen site and side B. Calling the laboratory to confirm the proper storage solution for the specimen C. Asking the scrub person to verify the specimen D. Paging the surgical assistant postoperatively to identify the specimen - A. Seeking clarification from the surgeon about the specimen The threshold between flammable and combustible solutions is the flash point of 100.0F, with flammable ones being below this temperature and combustible ones being above. All saturated flammable solutions should be removed prior to draping the patient. Fumes from volatile or combustible solutions may ignite without a direct connection to the source of ignition.

site and side The surgeon is the person with the most accurate information about the site/side of the specimen, how the specimen should be handled (eg, specific storage solution), and what kinds of tests should be requested of the pathology department. Using the nursing process, nursing interventions lead to: A. Planning B. Implementation C. Assessment D. Outcome identification - D. Outcome identification Outcome identification describes the desired patient condition that can be achieved through nursing interventions. Which of the following statements on wearing safety glasses is true? A. Eye protection must be worn if splashes, spray, or droplets of potentially hazardous materials can be reasonably anticipated

B. Corrective lenses fulfill the personal protective equipment requirements for ocular safety C. Safety glasses enhance the visual field of the wearer D. Wearers of corrective lenses are not permitted to wear either contacts or eyeglasses with their safety glasses - A. Eye protection must be worn if splashes, spray, or droplets of potentially hazardous materials can be reasonably anticipated Health care personnel must wear eye protection when splashes, spray, spatter, or droplets of blood or other potentially infectious materials can be reasonably anticipated. When delegating a task, the circulating nurse should: A. Verify the task is within the scope of practice of the designee B. Provide a minimum of instructions on how to complete the task C. Give feedback to the designee based on personal experiences D. Assume the designee has the skills to perform the task - A.Verify the task is within the scope of practice of the designee When delegating tasks, the circulating nurse must verify that the person being assigned the task can perform them within their scope of practice. Clear instructions and appropriate feedback are vital to ensuring safe execution of the

task being delegated. A medication that should be administered for treatment of local anesthetic systemic toxicity crisis is: A. Lidocaine B. Epinephrine C. 20% Lipid emulsion D. Propofol - C. 20% Lipid emulsion A medication that should be administered for treatment of local anesthetic systemic toxicity is 20% lipid emulsion. The lipid emulsion is used to draw the local anesthetic out of the bloodstream. Hospital policy should include the requirement of PPE for all personnel that are likely to come in contact with blood or infectious materials based on: A. OSHA regulations B. TJC standards C. AORN Guidelines D. CDC recommendations - A. OSHA regulations OSHA regulations require the use of PPE for any person that may encounter blood