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The safety rules and numbers that recur on the CNOR. Skim before test day, then prove it with
practice questions.
Exam facts
- 200 questions (185 scored), 3 hours 45 minutes
- Scaled 200–800; pass = 620
- Biggest area: Patient Care and Safety (25%)
Patient safety quick hits
- Incorrect count — recount, then methodical search of wound/field/floor;
if not found, intraoperative radiograph - Universal Protocol — correct patient, site, procedure verified at a
time-out before incision; everyone stops and participates - Specimen — verbally confirm name/site/laterality with surgeon; label
precisely; handle per requested study (fresh, frozen, fixative)
Electrosurgery & fire safety
- Return electrode — clean, dry, well-vascularized muscle near the site;
use lowest effective power - Fire triangle — oxidizer (O2/N2O) + fuel (drapes, prep, hair) + ignition
(ESU, laser); minimize open oxygen in head/neck cases - Fire on the patient — stop oxidizers, remove burning material, extinguish on
the patient, then care for the patient
Positioning & asepsis
- Lithotomy — common peroneal nerve at risk; pad the fibular head
- Supine — protect the ulnar nerve at the elbow; arms <90° abduction
- Sterile field — 1-inch border is non-sterile; anything below waist/table level
is contaminated; never reach over the field
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Frequently asked questions
What do you do when the surgical count is wrong?
Recount, then perform a methodical search of the wound, surgical field, drapes, and floor. If the item is still missing, notify the surgeon and obtain an intraoperative radiograph.
Where should the electrosurgery return electrode (grounding pad) be placed?
On clean, dry, well-vascularized muscle close to the operative site — never over bony prominences, scar, or hair — and use the lowest effective generator power.
What nerve is at risk in the lithotomy position?
The common peroneal nerve, where it crosses the fibular head against the stirrup; pad the lateral fibular head and avoid direct pressure to prevent foot drop.
Sources & references
The exam facts on this page are drawn from official certifying-body materials, reviewed 2026-06-18 by the DrCertifications exam-prep team (10+ years in exam preparation and publishing).