During the preoperative interview, a patient scheduled for a total knee arthroplasty says she is "allergic to kiwi and avocado" and had "lip swelling" after a dental exam with gloves. Which action should the perioperative nurse take first?

Notify the surgical and anesthesia team of a suspected latex allergy so a latex-safe room can be prepared

Ask the pharmacist to recommend an antihistamine to give on call to the OR

Document the food allergies in the dietary section of the record only

Proceed with the standard setup because food allergies do not affect surgical supplies

A patient scheduled for a robotic radical prostatectomy will be placed in steep Trendelenburg for several hours. Which plan element addresses the greatest position- specific risk?

Nonslip padding to prevent sliding, with limited degree and duration of tilt and monitoring for facial and airway edema

Shoulder braces placed against the acromion to prevent sliding

An axillary roll under the dependent chest wall

A footboard with the patient's feet flat against it

Which topical hemostatic agent should be removed or used sparingly when applied near the spinal cord or in a bony foramen because it can swell and compress structures?

Bone wax used only on the cut surface of bone

Fibrin sealant applied as a thin film

A surgical technologist sees that the surgeon is about to close even though the count has not been reconciled. The surgeon dismisses a first mention. Which statement best applies TeamSTEPPS escalation?

"I am concerned. I am uncomfortable. This is a safety issue. We need to stop until the count is reconciled."

"We can do the count after the skin is closed."

Say nothing further to avoid conflict in front of the team

"It's your decision, but I'll document it."

A patient scheduled for a knee arthroscopy lists "ginkgo biloba, garlic tablets, and fish oil" as daily supplements. When asked, she says she took them this morning. What is the nurse's priority?

Report the supplement use to the surgeon and anesthesia professional because these products can increase bleeding risk

Ask the patient to stop the supplements after surgery

Tell the patient that supplements are natural and do not affect surgery

Document the supplements and give no further report

A patient scheduled for an open reduction of a femur fracture is a 5-year-old child. Which element is specific to planning for a pediatric patient?

Weight-based medication dosing and a warmer room to prevent heat loss

Premedication dosed by age rather than by weight

Allowing clear liquids up to 30 minutes before induction to reduce crying

An ambient room temperature of 68°F to reduce sweating under drapes

Which practice reduces the risk of a retained surgical sponge?

Using only radiopaque sponges in the wound and keeping all counted sponges in the room until the end of the case

Using counted sponges as the dressing once the closing count is started

Cutting radiopaque sponges to size for small incisions so fewer sponges are opened

Removing bagged, counted sponges from the room during the case to reduce clutter

A circulating nurse tells the surgeon that the patient's temperature has fallen to 35.4°C and asks to pause so a warming blanket can be placed. The surgeon does not respond. The nurse repeats the concern, and it is again ignored. According to the two-challenge rule, what should the nurse do next?

Take stronger action, such as notifying the charge nurse or anesthesia professional, to resolve the safety concern

Place the warming blanket over the sterile drapes without telling the team

Wait until the end of the case and complete an event report

Drop the concern, because it has been voiced twice

Which intervention is part of an evidence-based SSI prevention bundle?

Maintaining normothermia during the perioperative period

Extending antibiotic prophylaxis for 5 days

Shaving the surgical site the night before surgery

Keeping doors open to improve airflow

CNOR

Free CNOR Practice Questions

10 sample questions for the CNOR, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Pre/Postoperative Patient Assessment And, Physicalandpsychosocialassessment, Scenario, Laboratorystudiesandrisktools, Optimizationandmedicationmanagement, Postoperativeassessment, Individualized Plan Of Care Development, Planning,Evaluation,Anddocumentation, Management Of Intraoperative Activities, Management of Intraoperative Activities, Skinantisepsisandhairremoval, Surgicalpositioning, Hemostasisandenergydevices, Specimens, Medicationsonthesterilefield, Implantsandequipment, Teamrolesandresources, Communication And Documentation, Teamcommunicationtools, Handoffsanddocumentation, Informedconsentandadvocacy, Infection Prevention And Control Of, Spauldingclassificationanddisinfection, Sterilizationmethodsandmonitoring, Surgicalsiteinfectionprevention, Precautionsandenvironmentalcleaning, Emergency Situations, Malignanthyperthermia, Professional Accountabilities, Qualityandevidence-Basedpractice, Professionaldevelopment, Nursingprocessandoutcomes, Implants,Equipment,Andsupportservices, Instrumentsandsutures, Surgicalenvironmentandattire, Surgicalinstrumentsandwoundclosure, Teamcommunicationandhandoffs, Perioperativedocumentation, Microbiologyandtransmission, Hemorrhageandfire, Hemorrhageandtransfusion, Qualityimprovementandprofessionaldevelopment.

Question 1 · Pre/Postoperative Patient Assessment And
During the preoperative interview, a patient scheduled for a total knee arthroplasty says she is "allergic to kiwi and avocado" and had "lip swelling" after a dental exam with gloves. Which action should the perioperative nurse take first?
- A.Ask the pharmacist to recommend an antihistamine to give on call to the OR
- B.Notify the surgical and anesthesia team of a suspected latex allergy so a latex-safe room can be prepared
- C.Document the food allergies in the dietary section of the record only
- D.Proceed with the standard setup because food allergies do not affect surgical supplies
Show answer and explanation
Answer: B. Notify the surgical and anesthesia team of a suspected latex allergy so a latex-safe room can be prepared
Allergies to kiwi, avocado, banana, and chestnut cross-react with latex proteins, and angioedema after a glove exam strongly suggests latex sensitivity. The team must be told so that the room is prepared latex-safe, ideally as the first case, before the patient arrives. Premedication does not replace a latex-safe environment.
Question 2 · Scenario
A patient scheduled for a robotic radical prostatectomy will be placed in steep Trendelenburg for several hours. Which plan element addresses the greatest position- specific risk?
- A.Shoulder braces placed against the acromion to prevent sliding
- B.An axillary roll under the dependent chest wall
- C.Nonslip padding to prevent sliding, with limited degree and duration of tilt and monitoring for facial and airway edema
- D.A footboard with the patient's feet flat against it
Show answer and explanation
Answer: C. Nonslip padding to prevent sliding, with limited degree and duration of tilt and monitoring for facial and airway edema
Steep Trendelenburg can cause sliding, increased intracranial and intraocular pressure, and airway and facial edema. Nonslip devices, limiting the angle and time, and monitoring are recommended. Shoulder braces cause brachial plexus injury, and axillary rolls and footboards apply to other positions.
Question 3 · Hemostasisandenergydevices
Which topical hemostatic agent should be removed or used sparingly when applied near the spinal cord or in a bony foramen because it can swell and compress structures?
- A.Bone wax used only on the cut surface of bone
- B.Topical thrombin solution
- C.Fibrin sealant applied as a thin film
- D.Oxidized regenerated cellulose
Show answer and explanation
Answer: D. Oxidized regenerated cellulose
Oxidized regenerated cellulose and gelatin products swell as they absorb fluid, which can compress nerves or the spinal cord in a confined space, so excess is removed once hemostasis is achieved. Thrombin solution and a thin film of sealant do not create bulk.
Question 4 · Communication And Documentation
A surgical technologist sees that the surgeon is about to close even though the count has not been reconciled. The surgeon dismisses a first mention. Which statement best applies TeamSTEPPS escalation?
- A."We can do the count after the skin is closed."
- B.Say nothing further to avoid conflict in front of the team
- C."It's your decision, but I'll document it."
- D."I am concerned. I am uncomfortable. This is a safety issue. We need to stop until the count is reconciled."
Show answer and explanation
Answer: D. "I am concerned. I am uncomfortable. This is a safety issue. We need to stop until the count is reconciled."
CUS (Concerned, Uncomfortable, Safety issue) is a TeamSTEPPS tool to escalate a safety concern with increasing urgency and a clear request to stop. Staying silent or deferring the count undermines patient safety.
Question 5 · Surgicalsiteinfectionprevention
A patient had a total hip arthroplasty. For how long after surgery are signs of infection counted as a surgical site infection under NHSN surveillance?
- A.90 days
- B.14 days
- C.7 days
- D.1 year
Show answer and explanation
Answer: A. 90 days
NHSN surveillance for most procedures is 30 days, but for many procedures that involve implants, such as hip and knee arthroplasty, the surveillance period is 90 days.
Question 6 · Pre/Postoperative Patient Assessment And
A patient scheduled for a knee arthroscopy lists "ginkgo biloba, garlic tablets, and fish oil" as daily supplements. When asked, she says she took them this morning. What is the nurse's priority?
- A.Ask the patient to stop the supplements after surgery
- B.Tell the patient that supplements are natural and do not affect surgery
- C.Document the supplements and give no further report
- D.Report the supplement use to the surgeon and anesthesia professional because these products can increase bleeding risk
Show answer and explanation
Answer: D. Report the supplement use to the surgeon and anesthesia professional because these products can increase bleeding risk
Ginkgo, garlic, and fish oil can impair platelet function and increase bleeding, which matters for surgery and neuraxial anesthesia. Herbal supplements are usually stopped 1 to 2 weeks before surgery, so the physicians must be told to decide whether to proceed.
Question 7 · Scenario
A patient scheduled for an open reduction of a femur fracture is a 5-year-old child. Which element is specific to planning for a pediatric patient?
- A.Premedication dosed by age rather than by weight
- B.Allowing clear liquids up to 30 minutes before induction to reduce crying
- C.Weight-based medication dosing and a warmer room to prevent heat loss
- D.An ambient room temperature of 68°F to reduce sweating under drapes
Show answer and explanation
Answer: C. Weight-based medication dosing and a warmer room to prevent heat loss
Children lose heat quickly and need weight-based dosing, so planning includes a warmer room, warming devices, and dosing by weight. Parents or guardians are part of communication and consent.
Question 8 · Specimens
Which practice reduces the risk of a retained surgical sponge?
- A.Using only radiopaque sponges in the wound and keeping all counted sponges in the room until the end of the case
- B.Using counted sponges as the dressing once the closing count is started
- C.Cutting radiopaque sponges to size for small incisions so fewer sponges are opened
- D.Removing bagged, counted sponges from the room during the case to reduce clutter
Show answer and explanation
Answer: A. Using only radiopaque sponges in the wound and keeping all counted sponges in the room until the end of the case
Radiopaque sponges can be seen on x-ray, and keeping all counted items in the room allows reconciliation. Sponges are never cut or used as dressings before the final count, and nothing counted leaves the room.
Question 9 · Communication And Documentation
A circulating nurse tells the surgeon that the patient's temperature has fallen to 35.4°C and asks to pause so a warming blanket can be placed. The surgeon does not respond. The nurse repeats the concern, and it is again ignored. According to the two-challenge rule, what should the nurse do next?
- A.Place the warming blanket over the sterile drapes without telling the team
- B.Wait until the end of the case and complete an event report
- C.Take stronger action, such as notifying the charge nurse or anesthesia professional, to resolve the safety concern
- D.Drop the concern, because it has been voiced twice
Show answer and explanation
Answer: C. Take stronger action, such as notifying the charge nurse or anesthesia professional, to resolve the safety concern
Under the two-challenge rule, a concern voiced twice without acknowledgment calls for stronger action, such as moving up the chain of command.
Question 10 · Surgicalsiteinfectionprevention
Which intervention is part of an evidence-based SSI prevention bundle?
- A.Extending antibiotic prophylaxis for 5 days
- B.Shaving the surgical site the night before surgery
- C.Keeping doors open to improve airflow
- D.Maintaining normothermia during the perioperative period
Show answer and explanation
Answer: D. Maintaining normothermia during the perioperative period
Normothermia, correctly timed antibiotics, alcohol-based skin antisepsis, clipper hair removal when needed, and glycemic control are core bundle elements. Shaving, open doors, and prolonged antibiotics increase risk.

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