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CNOR Free Practice Quiz

CNOR Free Practice Quiz
Test your knowledge in this free 25 question practice quiz!

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1. Question

The perioperative nurse must perform Immediate Use Steam Sterilization for a small
instrument set with metal instruments that includes a Yankauer Suction and a small powered
instrument. What cycle should be used?

Follow the manufacturers instructions for the set and container

121.1C (250F) for 10 minutes

132.2C (270F) for 4 minutes

Follow the OSHA standards

Correct
Cleaning and handling instructions recommended by the device manufacturer can vary
widely. Some instruments, especially powered instruments, can require special cleaning
and maintenance procedures.
Reference: 2014 AORN Recommended Practices and Guidelines. P. 541

2. Question

The following patient is at risk for latex allergy and should not have latex products used in
their care:

A 13-year-old boy who is having his tonsils removed after several infections over the
last two years

All patients should have latex free supplies during surgery since a history is not
always possible

A 24-year-old mother during the vaginal delivery of her rst child

A 40-year-old appendectomy patient who reports that she has worked in

healthcare for 17 years

Incorrect
Healthcare workers have in increased risk of latex allergy because of the prolonged
exposure to latex products throughout their careers.

3. Question

Which of the following statements is true for the health care provider treating a patient who
requires contact isolation?

Wear an isolation gown, gloves, and mask.

Wear an isolation gown, gloves, and N95 respirator.

Wear an isolation gown and gloves only if contact with body uids is expected.

Wear an isolation gown and gloves for all patient contact.

Correct
Personal protective equipment is worn for all direct and indirect patient contact. So
touching the skin or removing dirty linens both necessitate wearing gown and gloves
Reference: P. 84

4. Question

An 9-year-old boy is on a preoperative tour of the area to prepare for his surgery. His parents
state that he is fearful of having a urinary catheter post op.

Take the boy to witness the insertion of a urinary catheter and explain the
procedure

Tell the parents not to mention the catheter in the boys presence to minimize
anticipatory anxiety

Tell the boy to be brave and not to worry

Show the boy a urinary catheter and explain what he can expect

Correct
School age children should be given honest gentle information to reduce anxiety.
Reference: Alexanders Text book 15th ed. P. 1010

5. Question

When using bipolar delivery of electrical current, the nurse should remember that..

The dispersive pad is used to return the current to the generator

The dispersive pad should be placed as close to the surgical site as possible

one side of the bipolar forceps returns the current to the generator.

the dispersive electrode should be placed after positioning of the patient is

complete

Incorrect
The current is directed from the generator to a special forceps with one active tip and one
inactive tip. The current ows to the active tip and returns through the inactive tip. There is
no need for a grounding pad

th
 th
Reference: Berry and Kohn 13 ed p. 349

6. Question

The circulator observes the scrub nurse as she picks up a disposable scalpel blade with
gloved ngers and is attempting to attach it to the reusable scalpel handle. How should the
circulator respond?

Say nothing to disrupt the scrub nurse but use this example to reinforce to the OR
manager the need for only disposable scalpels.

Suggest the scrub nurse lay the blade on the Mayo stand and slide the handle onto
the blade.

No response is required. Fingers are more dexterous allowing the blade to be easily
tted onto the handle

Tell the scrub nurse to hold the blade in a clamp or needle holder and advance
it onto the handle.

Incorrect
To avoid injury blades should be placed on handles with heavy instruments like a Kelly.
Never use the ngers. A circulators role is to manage the room and protect the safety of
patient and sta.

th
Reference: Berry and Kohn 13 ed. P. 459

7. Question

The lowest postoperative infection rates are associated with cases where the hair was:

Removed using clippers

Not removed

Shaved

Removed using a depilatory cream

Incorrect
The lowest infection rates are when the hair is left where it is. Even neuro cases can be
done leaving the hair by using a non-ammable gel to spread the hair away from the
incisional site.
Rationale: From the CDC.gov website: https://www.cdc.gov/HAI/pdfs/hai/top-cdc-recs-
factsheet.pdf

8. Question

What gives the patient the right to choose not to be treated for an emergent event
precipitated in response to normal anesthesia during surgery?

HIPAA

Self Determination Act

Advance Directives

Patient Bill of Rights

Incorrect
The Patient Self-Determination Act (PSDA) is a federal law, and compliance is mandatory. It
is the purpose of this act to ensure that a patients right to self-determination in health care
decisions be communicated and protected

9. Question

Which of the following medications is a trigger for Malignant Hyperthermia (MH):

Halothane

Vecuronium

Nitrous Oxide

Propofol

Incorrect
Inhaled anesthetics other than Nitrous Oxide and depolarizing paralytics trigger MH.
Halothane is an inhaled anesthetic.

10. Question

Under what circumstance is it permissible to remove the rubber stopper from medication?

Its never okay

 Using sterile gloves and a sterile clamp

Its okay as long as you dont push the stopper down into the bottle

After cleaning the stopper with alcohol

Incorrect
The likelihood of contamination of the contents is very high anytime the rubber stopper is
removed. If you need the powdered form of an antibiotic it should be delivered to you from
the pharmacy in a sterile envelop.
Reference: 2014 AORN Recommended Practices and Guidelines. P. 293

11. Question

You are assisting the pediatric orthopedic surgeon in the application of a Spica cast. You take
special care to diminish pressure to the bular head because valgus molding here can cause:

Pelvic or hip injury

Obturator nerve damage

Mid diaphyseal femoral fractures

Peroneal nerve palsy

Correct
The peroneal nerve runs along the lateral aspect of the knee. A Spica cast is for the
treatment of mid diaphyseal femoral fractures and pelvic or hip injuries not cause by it.
Reference: Handbook of Splinting and Casting: Mobile Medicine Series p. 216

12. Question

Your 87 year old patient reports that she lives independently, works part time and takes
public transportation to work as she stopped driving a year ago. She uses bilateral hearing
aides and glasses. She is being prepared for a lumpectomy and node dissection under
general anesthesia. Her daughter is her medical power of attorney and is with her in the
preoperative area. It is most appropriate to:

Give the patients hearing aides and glasses to her daughter and then allow her
daughter to stay with her until she is anesthetized to answer any questions for her
mother.
 Leave her glasses and hearing aides in place throughout the perioperative process.
There is no need to remove them.

Explain all that will happen in surgery before her hearing aides and glasses are
stored safely in a locker to prevent loss or damage.

Allow her to keep her glasses and hearing aides on until immediately before
she is anesthetized.

Correct
Allow patients who wear hearing aids or glasses to wear them to the OR.

th
Reference: Alexanders Care of the Patient in Surgery 15 ed. P. 636

13. Question

The patient is scheduled for a Radical perineal prostatectomy for prostate cancer. In what
position would the patient be placed for surgery?

Lateral

Kraske's

High lithotomy

Low lithotomy

Correct
A radical perineal prostatectomy is a surgical procedure to completely remove the prostate
from a small incision in the perineum accessed with the patients legs very high in stirrups
with the knees near the ears.

14. Question

The most common source of pathogens in the surgical suite is:

Patient

Surgical Sta

Contaminated Equipment

Ambient Air
Correct
The most common microorganisms causing surgical site infection are Staphylococcus
aureus (25 percent),
Reference: Text book: Barry and Kohn 13th ed. p 250

15. Question

After your 56 year old female patient is induced under general anesthesia for her abdominal
hysterectomy you assist anesthesia personnel in padding the elbows and placing a pillow
under the lower extremities allowing the heals to oat. Padding the elbows protects the
______ nerve.

Popliteal

Radial

Brachial

Ulnar

Incorrect
The ulnar nerve runs on the inside of the elbow. This is also protected by positioning the
patients hands palms up or thumbs up instead of palms down.

th
Reference: Alexanders Care of the Patient in Surgery 15 ed. P. 161

16. Question

How long can the sterile supplies in an unused room be open before it must be discarded?

1 Hour

4 Hours

There is no specic amount of time

2 Hours

Incorrect
Studies show that the longer a eld is open the higher the likelihood of contamination even
when there is no active contamination event. Therefore, the eld should not be established
until immediately before use. However, there is no specied amount of time that opened
sterile supplies in an unused room can remain sterile. Sterility is very much event related.
Reference: 2014 AORN Recommended Practices and Guidelines. P. 100

17. Question

Name that position: It is also known as the Trendelenburg position with legs apart. The basic
angle is a 30-degree Trendelenburg with the hips exed at 15 degrees; this can be adjusted
with leg supports.

Knee-chest position

Fowler's position

Sims' position

Lloyd-Davies position

Incorrect
Lloyd-Davies Position. A common position for surgical procedures involving the pelvis and
lower abdomen. The majority of colorectal and pelvic surgery is conducted with the patient
in the Lloyd-Davis position.

18. Question

When witnessing the patient signature, you are verifying what?

The signature was made by the person whose name is written

The patient understands the procedure, possible complications and alternatives to

surgery

The patient is under contract with the surgeon to undergo the procedure

The patient agrees to the procedure written on the consent form

Incorrect
The witness to the patient signature is only verifying that the person whose name is signed
is the person who signed it. So, the wife cannot sign her husbands name.

19. Question

The safest option for drapes during a laser procedure are?

 Moistened surgical drapes

Clear, adhesive drapes

Standard Surgical Drapes

Moistened woven materials such as towels

Incorrect
The area around the site should be draped with moist towels or sponges to decrease the
potential for re. Since standard surgical drapes are resistant to penetration of uids they
will not stay moist and protect the site.
Reference: 2014 AORN Recommended Practices and Guidelines. P. 148

20. Question

The limit for exposure to eythlene oxide are _____________of airborne ethylene oxide
expressed as a time weighted average for an eight hour work shift in a 40 hour work week.

1 parts per million

0.5 parts per million

1.5 parts per million

5 parts per million

Incorrect
Ethylene Oxide is a known human carcinogen the permissible exposure limits are regulated
by the National Institute for Occupational Safety and Health. (OSHA)
Reference: 2017 AORN Recommended Practices and Guidelines. P. 875

21. Question

Trauma patient is unconscious and needs emergent surgery. The family is 2 hours away but
on the way. The circulating nurse should:

Have the family sign the consent for surgery once they arrive

Have the surgeon and anesthesiologist sign the consent together

Have the surgeon document the case is emergent and proceed with the set up
 Complete the consent form and write Not Applicable on the line for patient
signature

Correct
If the injury is life or limb threatening, implied surgical consent is assumed. The location of
the family is irrelevant. Even if they were present you would still have implied consent as
long as the sta notes include the threat to life or limb.
Reference: Alexanders text book 15th ed. P. 1112

22. Question

The perioperative nurse is preparing the room for a Femoropopliteal Bybass. All of the
following supplies and equipment should be available except:

Mobile X-ray equipment

Grafts of multiple sizes and shapes

Hemoclips and applicators

Fogarty catheters

Incorrect
While an arteriogram has been done and the report and lms should be available there
should not be any need for an x-ray during the procedure. Unless you just dropped the
patient onto the oor
Reference: Competencies for Safe Patient Care During Operative and Invasive Procedures
p. 347

23. Question

What is the Nursing Practice Act?

It is a body of State law that mandates the State Nursing Board to set out the
scope of practice and responsibilities for RNs in that state.

A Federal Law that is designed to protect the public from incompetent nursing
caregivers

is charged with tracking and investigating public health trends

A detailed list of activities carried out by nurses during their daily work.
Correct
Every state has a Nursing Practice Act that mandates that your State Board dene what
your nursing practice looks like.
Reference: National Council of State Boards of Nursing. https://www.ncsbn.org/1455.htm

24. Question

During a bilateral lower extremity debridement and skin graft the surgeon requests that the
drapes be repositioned farther apart to achieve better surgical access. According to the
AORN standards the scrub nurses most appropriate response is:

Use sterile towels to cover the edges of the original drape

Tell the surgeon that the drapes should not be repositioned

Move the drapes to best accommodate the surgeons access

Re-drape the patient with a new laparotomy drape

Incorrect
This is a tough one but the answer is to tell the surgeon that he drapes should not be re-
positioned. You cant remove the old drapes and re-drape while the patient is open. You
cant move the drapes around once placed (according to standards) and what good will
covering the edges with a towel do? Soyou have to tell the surgeon, nope, not moving
them and then run:)

25. Question

An OR Manager notices a circulating nurse removing her jacket to perform the surgical skin
prep for them patient. The manager requests that the circulator put the jacket back on and
snap it closed to prepare the patients skin. This request is made because:

Normally, bare arms would be okay but today there is a wound on the circulators
arm

The circulator wore the scrub shirt and pants to a meeting prior to the case and so
should be covered to return to patient care

To prevent contamination of the prep area by the circulator caused by

shedding
 The room the circulator was assigned was cold

Correct
Those who will not be sterile team members should wear long sleeved jackets with front
closures over their scrubs.
Reference: Text book Berry and Kohn 13th ed. P. 266

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