20 free CNOR practice questions

Correct answer: B · Treat her as possibly latex allergic and plan a latex-safe procedure

Many people with latex allergy also react to certain foods, and ACAAI lists banana, kiwi, avocado, and chestnut among the foods most likely to cause problems in latex-allergic patients. Food reactions combined with hand reactions to rubber gloves strongly suggest latex sensitivity, so the nurse documents the finding, notifies the surgeon and anesthesia professional, and arranges latex-safe supplies and a latex-safe environment before she enters the OR. Recording only a food allergy misses a risk that can cause intraoperative anaphylaxis. Provocation testing in the holding area could trigger a reaction and is not a nursing screening step. An antihistamine does not prevent latex anaphylaxis.

Look for this next time: Reactions to bananas, kiwi, or avocado plus glove reactions suggest latex allergy; alert the team and plan a latex-safe procedure.

Correct answer: C · Stop, and have the surgeon resolve the discrepancy before she moves on

Preprocedure verification exists to catch this kind of mismatch. Under the Universal Protocol for preventing wrong-site surgery and the WHO Surgical Safety Checklist, the patient's identity, procedure, site, and consent are confirmed before anesthesia and incision, and any discrepancy among the patient's statement, the consent, the schedule, and the records must be resolved before the patient moves forward. The surgeon, who obtains consent and performs the procedure, must clarify the correct side, correct the consent if needed, and mark the site with the patient's involvement. The nurse does not choose a side or mark it on the surgeon's behalf, and two matching documents can share the same original error. A new consent signed without the surgeon's discussion is not valid informed consent.

Look for this next time: When the patient, the consent, and the schedule disagree about the site, stop and have the surgeon resolve it before proceeding.

Correct answer: D · Ask the surgeon and anesthesia team to revisit the DNR with her first

The American College of Surgeons' statement on advance directives and DNR orders in the operating room (2014) rejects automatic cancellation of DNR status for surgery, because it removes the patient from decisions about her own care. It calls instead for required reconsideration: before surgery, the patient or surrogate and the responsible physicians discuss perioperative risks and goals and decide whether to suspend, keep, or modify the order, and the result is documented and shared with the OR team. The nurse advocates for that discussion. A DNR order is not a reason to cancel surgery. She has decision-making capacity, so the decision is hers, not her family's.

Look for this next time: DNR orders are not automatically suspended for surgery; make sure a required-reconsideration discussion happens with the patient first.

Correct answer: A · Keeping glucose below 200 mg/dL lowers SSI risk, with or without diabetes

The CDC's 2017 guideline for preventing surgical site infection recommends perioperative glycemic control with blood glucose targets below 200 mg/dL in patients with and without diabetes (Category IA). The ADA's Standards of Care in Diabetes—2026 add a perioperative range of 100 to 180 mg/dL for people with diabetes, which sits within that limit. Hyperglycemia impairs neutrophil function and wound healing, so the plan includes glucose monitoring and treatment through the perioperative period. Stress hyperglycemia raises risk even in patients who do not take insulin. A target below 80 mg/dL invites hypoglycemia, which anesthesia can mask. Accepting values up to 300 mg/dL leaves a known, modifiable risk untreated.

Look for this next time: Keep perioperative glucose below 200 mg/dL to reduce SSI risk, in patients with or without diabetes (CDC 2017).

Correct answer: B · Skin over pressure points is intact, with no new redness, at PACU discharge

An expected outcome describes a patient result, not a nursing action, and it must be observable and measurable within a stated time frame so it can be evaluated. Intact skin over pressure points with no new redness at PACU discharge names the patient as the subject, gives criteria the nurse can assess, and sets the point of evaluation, which suits a long prone procedure with a high risk of pressure injury. Careful positioning is an intervention, not an outcome. Comfort throughout the procedure cannot be assessed in a patient under general anesthesia and has no criteria. Preventing injury as much as possible is vague and cannot be judged as met or not met.

Look for this next time: Write expected outcomes as measurable patient results with a time frame, not as nursing actions or vague goals.

Correct answer: A · Remove the soaked linen, and drape only once the prep is fully dry

Chlorhexidine-alcohol preps contain 70% isopropyl alcohol and give off flammable vapors. Their FDA-approved labeling, for example ChloraPrep's, says not to drape or use an ignition source such as cautery or a laser until the solution is completely dry (at least 3 minutes on hairless skin and up to 1 hour in hair), not to let the solution pool, and to remove wet materials from the prep area. Soaked linen under the patient is pooled fuel that keeps releasing vapor beneath the drapes, near the electrosurgical unit. Draping now traps that vapor, and covering the linen with a towel leaves the fuel in place. The prep stays flammable until it has dried. The nurse states the concern, removes the wet linen, and confirms that the prep is dry before draping.

Look for this next time: Remove prep-soaked linen, and drape only after an alcohol-based prep is completely dry, as its labeling requires.

Correct answer: D · Tell the surgeon now, search, and get imaging if the sponge is not found

A count discrepancy is treated as a possible retained item until it is resolved. The ACS statement on preventing retained surgical items (2016) calls for methodical wound exploration before closure, X-ray or other technology as indicated, and documentation of the actions taken. Standard count-discrepancy procedures add telling the surgeon at once, while the wound is still open, recounting, searching the field, floor, linen, and waste, and obtaining imaging before the patient leaves the OR if the sponge is not found. Recording an unreconciled count as correct falsifies the record and leaves the patient at risk. Searching after the patient leaves, or only reporting the next day, misses the safest time to find the sponge.

Look for this next time: When a count does not reconcile, notify the surgeon at once, search, and obtain imaging before the patient leaves the OR.

Correct answer: A · Pass sharps hands-free, through a designated neutral zone

The American College of Surgeons' statement on needlestick and sharps safety (revised June 2026) recommends a hands-free technique or neutral zone, in which instruments are not handed directly between the scrub person and the surgeon, to reduce sharps injuries. It also recommends blunt-tip suture needles for closing fascia and muscle when appropriate, and double gloving with an indicator glove. Recapping needles by hand is a classic cause of needlesticks. Announcing a pass helps, but handing a sharp point-first still exposes both people. Single gloving gives up the protection that double gloving provides against glove perforation.

Look for this next time: Use a neutral zone and hands-free passing for sharps, plus double gloving, to reduce needlestick injuries.

Correct answer: B · Label it now with drug name, strength, and amount; both verify it

Perioperative medication safety practice, long required by a Joint Commission patient safety goal, calls for labeling every medication and solution on and off the sterile field, even when only one is present, as soon as it is prepared, with the drug name, strength, and amount, plus expiration information when it applies. When the person preparing the medication is not the person giving it, two qualified people check the label against the original container aloud and visually. Unlabeled containers are a known cause of wrong-drug errors. Labeling at the end of the case defeats the purpose, and relying on memory fails as soon as another person becomes involved or the scrub is relieved.

Look for this next time: Label every medication and solution on the sterile field, even a single one, as soon as it is prepared.

Correct answer: C · Raise and lower both legs slowly and at the same time

Moving the legs together and slowly, with one person at each leg, avoids torsion of the lumbar spine and hips and limits sudden shifts in blood volume. Raising the legs returns blood to the central circulation, and lowering them at the end of the case can cause hypotension as blood pools in the legs, so lowering is done slowly while the anesthesia professional watches the blood pressure. Raising one leg at a time twists the pelvis and can strain the hip and back. Pressure from the stirrup post on the lateral knee can injure the common peroneal (fibular) nerve and cause foot drop, so padding and positioning keep the area over the fibular head free of pressure.

Look for this next time: In lithotomy, raise and lower the legs slowly and together, and keep pressure off the lateral knee.

Correct answer: C · Decline: the representative may advise but not scrub in or touch the patient

The American College of Surgeons' statement on health care industry representatives in the operating room (revised 2016) allows representatives to give technical support and advice, including remote calibration of devices, but says they may not scrub in, have direct patient contact, or practice surgery, nursing, or medical decision-making. Their presence is approved under facility policy, the patient is informed, and the surgeon or perioperative nurse monitors their activities. A staffing shortage does not change that limit; the nurse asks the charge nurse for qualified staff. The surgeon's agreement does not make it acceptable. Credentialed representatives are permitted in the room, so asking this one to leave is unnecessary.

Look for this next time: Industry representatives may advise and give technical support, but they never scrub in or touch the patient.

Correct answer: D · Treat it as contaminated and send the item for reprocessing

Sterility is event-related. The CDC's Guideline for Disinfection and Sterilization in Healthcare Facilities explains that contamination of a sterile item depends on events, not time, and that a package is considered compromised when the packaging becomes wet, is torn, or has a broken seal. A water stain means moisture reached the package, which can wick microorganisms through it, so the item is no longer sterile and must be reprocessed. A date that has not passed does not override a breach. Drying the package does not restore sterility, and opening it onto the field risks introducing contamination to the patient.

Look for this next time: Sterility is event-related: a wet, torn, or broken-seal package is contaminated, whatever its date.

Correct answer: D · Class IV, dirty-infected

The CDC surgical wound classification defines Class IV, dirty-infected, as old traumatic wounds with retained devitalized tissue and wounds that involve existing clinical infection or perforated viscera, meaning the organisms were present before the operation. A perforated appendix with pus meets that definition. An uncomplicated appendectomy with no infection or major break in technique would be Class II, clean-contaminated. Class III covers gross spillage from the GI tract, major breaks in sterile technique, and acute nonpurulent inflammation. Class I applies when no tract is entered and there is no inflammation. NHSN's 2026 manual notes that the class is assigned by someone involved in the procedure, such as the surgeon or the circulating nurse.

Look for this next time: Existing infection or a perforated viscus makes a surgical wound Class IV, dirty-infected.

Correct answer: B · Politely decline to share information, following the patient's wishes

Under the HIPAA Privacy Rule, a provider may share relevant information with family members or friends involved in a patient's care when the patient agrees or does not object after having the chance to do so; when a patient with capacity objects, the information is not shared. This patient limited updates to her husband, so the nurse politely declines and can suggest that the sister contact the husband. Being a close relative does not override the patient's choice. Knowing a birth date verifies identity, not permission. Routing the call into the OR disrupts the procedure and still discloses information against her wishes.

Look for this next time: Share information with family only as the patient allows; if a patient with capacity objects, do not disclose it.

Correct answer: A · High-level disinfection, since it contacts mucous membranes

The Spaulding classification sorts items by infection risk. Critical items enter sterile tissue or the vascular system and must be sterile. Semicritical items contact mucous membranes or nonintact skin and minimally require high-level disinfection. Noncritical items touch only intact skin and need low-level disinfection. The CDC's Guideline for Disinfection and Sterilization in Healthcare Facilities lists laryngoscope blades among semicritical items, so high-level disinfection after thorough cleaning is the minimum; sterilization is acceptable and sometimes preferred, but it is not the minimum. A blade touches oral and pharyngeal mucosa, so low-level disinfection or cleaning alone is not enough.

Look for this next time: Semicritical items, such as laryngoscope blades, contact mucous membranes and need at least high-level disinfection.

Correct answer: C · Decline: implants are not flash sterilized for convenience or to save time

The CDC's Guideline for Disinfection and Sterilization in Healthcare Facilities says not to flash sterilize implanted surgical devices unless doing so is unavoidable, and not to use flash sterilization for convenience, as an alternative to buying additional instrument sets, or to save time. It also calls for a biological indicator in every load containing implants, with the items quarantined until results are available whenever possible. A tight schedule is a planning problem, solved by spacing the cases or obtaining more sets. Quarantining an item after it has been implanted is meaningless. Repeating a cycle does not make an inappropriate process appropriate.

Look for this next time: Do not flash sterilize implants unless unavoidable, and never for convenience or scheduling; plan sets and cases instead.

Correct answer: C · Remove hair immediately before surgery, preferably with electric clippers

The CDC's 1999 Guideline for Prevention of Surgical Site Infection recommends not removing hair unless it will interfere with the operation and, if it is removed, removing it immediately before the operation, preferably with electric clippers (both Category IA); these recommendations remain standard practice. Razors cause tiny cuts that bacteria colonize, and shaving the night before gives those cuts hours to become contaminated, which is why razor shaving is linked to higher infection rates. Shaving in the OR still causes skin injury. Routine hair removal when hair does not interfere adds risk without benefit.

Look for this next time: Remove hair only if it interferes, immediately before surgery, and preferably with clippers rather than a razor.

Correct answer: B · Call for help and the MH cart with dantrolene, and ask the surgeon to stop

MHAUS lists four actions to take as soon as possible in a suspected crisis: notify the surgeon to halt the procedure and stop volatile agents and succinylcholine; call for help and get the dantrolene and MH cart; hyperventilate with 100% oxygen at high flows to flush volatile agents and lower end-tidal CO2; and give IV dantrolene rapidly. A rising end-tidal CO2 despite more ventilation, tachycardia, and rigidity after triggering agents are typical early findings, while fever often comes later, so waiting for it delays treatment. Laboratory tests guide ongoing care but must not delay dantrolene. A nondepolarizing relaxant does not treat the hypermetabolic process inside the muscle.

Look for this next time: In suspected malignant hyperthermia, stop triggers, call for help and dantrolene, and hyperventilate with 100% oxygen without waiting for fever.

Correct answer: A · At least 2 inches deep at 100 to 120 per minute, with full recoil

The 2025 American Heart Association adult basic life support guidelines recommend compressions at least 2 inches (5 cm) deep in an average adult, avoiding depths greater than 2.4 inches (6 cm), at a rate of 100 to 120 per minute, with complete chest recoil between compressions. A 1-inch depth at 80 per minute is too shallow and too slow to circulate blood well, and concern about rib fractures does not justify it. Compressions of 3 inches or more at over 140 per minute fall outside the recommended depth and rate. Stopping every 30 seconds to feel for a pulse interrupts blood flow; compressions continue until the defibrillator is ready for a planned rhythm check. The OR table gives the firm surface that effective compressions need.

Look for this next time: For adult CPR, compress at least 2 inches deep at 100 to 120 per minute, and allow full chest recoil.

Correct answer: D · Keep him out of the case and report to the charge nurse now

Patient safety comes first. The ANA Code of Ethics for Nurses (2025) holds nurses responsible for protecting patients when a colleague's practice may be impaired, and facility policies set out a chain of command for removing an impaired worker from duty and arranging evaluation and support. Signs of intoxication before a case mean he should not take part, so the nurse acts now and reports to the charge nurse or manager rather than confronting him alone or waiting. Watching him during the case still exposes the patient to harm, and talking after the case is too late. A different reporting line does not remove the nurse's duty to act.

Look for this next time: If a team member appears impaired, keep him from patient care and report through the chain of command immediately.