CNOR Practice Test Review
The Competency & Credentialing Institute offers the CNOR (Certified Nurse Operating Room) exam as way to certify that a nurse is qualified to work in an operating room setting. It shows that a nurse is familiar with the best practices for patient care before, during, and after surgery.
Prerequisites for taking the CNOR include two years and 2400 hours of professional practice as an operating room nurse. Applicants must also be a licensed registered nurse and be currently working as a nurse in an operating room setting. A bachelor of science degree in nursing is not necessary.
The Competency and Credentialing Institute (CCI) developed the CNOR exam with Prometric, a subsidiary of Educational Testing Service. Prometric offers the computer-based exam throughout the United States and Canada. The test includes 200 multiple-choice questions that must be completed within four hours.
Individual versions of the CNOR exam may vary in difficulty, but this is taken into account during the scoring process. About 90% of the CNOR questions concern patient care management, and the remaining 10% focus on management of operating room materials, personnel, and services.
Typical topics include asepsis maintenance; healthy workplace practices; instrument selection and processing; patient freedom from harm; sponges, sharps, and instruments; patient assessment and diagnosis; patient positioning; pharmacology (including anesthetics); education and support of patient and family; ambulatory surgery; special populations; and legal, regulatory, legislative, and professional issues.
After applying for and scheduling the CNOR test, Prometric sends an authorization to test. Registrants receive an authorization number as well as the web address and telephone number for scheduling the CNOR exam. When taking the exam, registrants must present two forms of identification.
Test-takers should try to answer all questions and leave nothing blank on the CNOR exam. On the computer, users can mark certain questions and return to them later during the exam. People who are not familiar with computerized tests may take a tutorial on a computer before taking the actual exam.
Critical test results become available immediately after the CNOR exam. Users will be informed immediately if they have passed the test, although they will not receive any scoring details. Additional scoring information will be included with the official, mailed notification that the user passed the CNOR exam.
Persons who fail the exam receive more information when the exams are scored. This includes a look at how close they came to passing and information about what areas they need to improve.
1. A patient's lab reports shows a slightly elevated total white blood cell count with equal elevations of all types of white blood cells, an elevated hemoglobin and hematocrit, normal creatinine but elevated blood urea nitrogen (BUN), increased urine specific gravity, and increased serum sodium. The most likely nursing diagnosis is:
- Risk of infection
- Deficient fluid volume
- Excess fluid volume
- Imbalanced nutrition
2. Metoclopramide may be given as a preoperative medication in order to:
- Relieve apprehension
- Reduce risk of aspiration
- Relieve discomfort
- To control secretions
3. A do-not-resuscitate order is most likely to be suspended and CPR performed if the patient experiences cardiac arrest in the preoperative period because of:
- Acute myocardial infarction
- Drug reaction
- Advanced cancer
4. A patient with an Aldrete score of 7 in the PACU will generally be:
- Transferred out of the PACU to the surgical unit
- Transferred out of the PACU into the ICU
- Returned to the OR
- Retained in the PACU until condition improves
5. All of the following can result from overpressurization during abdominal insufflation with CO2 except:
- Postoperative neck and shoulder pain
- Decreased respiratory effort and cardiac output
- Regurgitation and aspiration
1. Answer: B
These laboratory findings are consistent with deficient fluid volume. An increased WBC indicating infection results from 1 or 2 cell types, but if all cell types show equal elevations, this results from concentration of the blood. Both hemoglobin and hematocrit increase as the blood volume decreases. An elevation of both BUN and creatinine indicates kidney disease, but elevated BUN alone may indicate dehydration. Serum sodium increases with dehydration. The most common cause of increased urine specific gravity is dehydration.
2. Answer: B
Metoclopramide is often given as a preoperative medication in order to speed emptying of the stomach and prevent nausea and vomiting to reduce the risk of aspiration. An antacid or H2 receptor blocker (such as ranitidine or famotidine) may be given to reduce production of gastric acids or decrease acidity. Midazolam is given to relieve anxiety and apprehension prior to surgery as well as to provide amnesia. Anticholinergics (atropine, glycopyrrolate) are given to control secretions, resulting in the "dry mouth" associated with surgery.
3. Answer: B
The DNR order is most likely to be suspended and CPR performed if a cardiac arrest is medically induced or directly relates to treatment, such as a drug reaction, rather than to a physical disorder, such as an acute MI, or the progress of a disease, such as advanced cancer or sepsis. Surgery in itself is an effort to improve health, so reasonable steps to ensure a positive outcome are usually undertaken. Medications and anesthetic agents may be the cause of cardiac arrest that would not otherwise occur; however, this is a complex ethical issue.
4. Answer: D
A patient with an Aldrete score of 7 will usually remain in the PACU until the score is 8 to 20. The Aldrete score, commonly used in PACUs, is based on 5 parameters-activity, respiration, circulation, consciousness, and oxygen saturation-scored 0 to 2 (optimal). The patient is usually scored on admission to the PACU and at least every 30 minutes during the stay and again on discharge. Those 3 points below baseline are usually maintained with one-on-one nursing care with vital signs checked every 5 minutes, 2 points below baseline checked every 15 minutes, and 1 point below baseline checked every 15 to 30 minutes.
5. Answer: A
Overpressurization during abdominal insufflation with CO2 for a laparoscopic procedure may result in hypercarbia (not hypocarbia) as excess CO2 diffuses into the blood. Pressure on the phrenic nerve may cause postoperative neck and shoulder pain, and pressure against the diaphragm may cause gastric regurgitation and aspiration. The reduction in intrathoracic space may cause decreased respiratory effort and cardiac output. Pressure should be constantly monitored and maintained between 14 and 16 mm Hg.
CNOR Exam Overview
Last Updated: 10/10/2016