CNOR Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

Notify anesthesia that the toast was eaten less than 6 hours ago: Correct. Toast is a light meal and needs at least 6 hours (0600 to 1100 is 5 hours). Black coffee is a clear liquid needing 2 hours, so that intake is acceptable. Anesthesia decides whether to delay.

Proceed, because toast and black coffee both count as clear liquids: Black coffee without milk counts as a clear liquid, but toast is solid food. It falls under the 6-hour light-meal guideline.

Notify anesthesia that the coffee was less than 4 hours before the start: Clear liquids need 2 hours, not 4. Coffee at 0730 is 3.5 hours before an 1100 start and meets the guideline.

Proceed, because 4 hours of fasting is enough after any light meal: ASA guidance is at least 6 hours after a light meal and 8 hours or more after fried or fatty foods. Four hours applies to breast milk.

ASA fasting minimums for healthy elective patients: clear liquids 2 h, breast milk 4 h, infant formula, nonhuman milk or a light meal 6 h, fried or fatty food 8 h or more.

Answer: C

Document the discrepancy and transfer the patient to PACU as planned: Documentation is required, but transferring the patient without resolving a missing sponge risks a retained item.

Recount only the sponges on the back table and close: A repeat count alone does not resolve a confirmed discrepancy. Closing without imaging accepts the risk of a retained item.

Get intraoperative imaging read before the patient leaves the OR: Correct. When a search does not find the missing item, an X-ray is taken and read (ideally by a radiologist) before the patient leaves the room, if the patient's condition permits.

Plan a postoperative X-ray on the unit within 24 hours: Delaying imaging until after transfer may mean a second surgery or more harm. Imaging is done before the patient leaves the OR when possible.

For an unresolved count, inform the surgeon, search methodically and take intraoperative imaging read before the patient leaves the OR, then document fully.

Answer: D

Agree, because a surgical technologist can circulate under RN supervision: Delegating circulating tasks does not replace the RN's continuous assessment and clinical judgment. A surgical technologist cannot fill the circulating RN role.

Agree, if both cases are minor and the rooms are next to each other: How minor the case is or how close the rooms are does not change the standard of one RN circulator per patient.

Agree, as long as the RN goes back and forth to document in both rooms: Alternating between rooms leaves each patient without continuous RN assessment and advocacy for long stretches.

Decline, because each patient needs a dedicated RN circulator: Correct. AORN's position is that every patient having an operative or invasive procedure has a registered nurse circulator dedicated to that patient throughout the procedure.

One RN circulator is dedicated to each patient for the whole procedure. The circulating role requires RN assessment and judgment and cannot be shared between rooms.

Answer: A

Just before incision, with all team members taking active part: Correct. The Universal Protocol time-out is done immediately before the incision or procedure starts, with every team member pausing to confirm the patient, procedure and site. Anyone can raise concerns.

Before induction, with the patient, surgeon and the preop nurse only: Pre-induction checks (sign-in) are valuable, but the time-out happens later, immediately before incision, and includes the whole procedural team.

At any point before closing, led by whichever team member is free: A time-out at closure cannot prevent wrong-site or wrong-procedure surgery. Its purpose is to stop errors before the procedure starts.

In the holding area, when the surgeon marks the site with the patient: Site marking and preprocedure verification come earlier in the Universal Protocol. They do not replace the time-out in the procedure room.

Universal Protocol: preprocedure verification, then site marking, then a time-out immediately before incision with the entire team actively taking part.

Answer: D

Accept the load because the physical and chemical indicators passed: Physical and chemical indicators do not show microbial kill. A positive BI must be treated as a possible sterilization failure until investigated.

Processing a dropped, needed instrument with no spare, per its IFU: One positive BI means the sterilizer may have failed since the last negative BI. The recall covers every load in that period, not just one.

Retest the BI and wait for its result before taking further action: Repeat testing is part of the investigation, but the sterilizer is taken out of service and the recall begins now, not after waiting.

Take the sterilizer out of service and recall loads since the last negative BI: Correct. Under AAMI ST79, a positive BI calls for removing the sterilizer from service, recalling and reprocessing items processed since the last negative BI, notifying infection prevention, and testing before reuse.

Positive BI: take the sterilizer out of service, recall back to the last negative BI, notify the appropriate people, investigate and retest. Loads with implants are quarantined until BI results are known.

Answer: C

Naloxone to reverse opioid sedation: Naloxone reverses opioids. Perioral numbness, metallic taste and seizure after a local anesthetic point to LAST, not opioid toxicity.

Dantrolene to treat muscle hyperactivity: Dantrolene treats malignant hyperthermia. It has no role in local anesthetic cardiac or CNS toxicity.

Lipid emulsion 20% as an IV bolus: Correct. Intravenous 20% lipid emulsion is the specific therapy for LAST. It is given early, along with seizure control (a benzodiazepine) and airway support, under ASRA guidance.

Flumazenil to reverse benzodiazepines: Flumazenil can lower the seizure threshold and would make LAST worse. It does not treat local anesthetic toxicity.

LAST: perioral numbness, metallic taste, tinnitus, then seizures and cardiovascular collapse. Get 20% lipid emulsion, manage the airway, and control seizures with benzodiazepines.