AN INSIDER’S LOOK AT THE CNOR EXAM

YOUR HOSTS FOR TONIGHT’S WEBINAR

Jim Stobinski, PhD, RN, CNOR Director, Credentialing and Education

Julie Mower, MSN, RN, CNS, CNS-CP,CNORand

Dawn Whiteside, MSN, RN, CNOR, RNFANurse Managers, Credentialing and Education

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COURSE OBJECTIVES

1. Review study prep materials.2. Discuss successful study strategies. 3. Identify the main components of a multiple-choice

question.4. Apply test-taking strategies to sample test questions.

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RESOURCES ON CCI WEBSITE www.cc-institute.org

• Handbook• CNOR Task and Knowledge Statements

• Study plan• CNOR learner readiness survey• Sample test questions• Contact information for prep-for-cert courses

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EXAM PREPARATION TEXT BOOKS

• Current edition of AORN’s Guidelines for Perioperative Practice

• Perioperative reference books• Phillips, N. (2017). Berry and Kohn’s Operating

room technique (13th ed.). St. Louis, MO: Elsevier.

• Rothrock, J.C. (2015). Alexander’s care of the patient in surgery (15th ed.). St. Louis, MO. Elsevier.

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OPTIONAL REFERENCES

• Pathophysiology textbook• Medical dictionary• Lab/ diagnostic test reference manual• Drug reference-check hospital formulary or Epocrates at

www.epocrates.com  • AORN Journal• AAMI standards• Websites

• The Joint Commission at www.jointcomission.org• CDC at www.cdc.gov

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CCI STUDY AIDS

• CNOR Exam Study Guide• Flash cards• On-line practice exam

Go to our bookstore at https://store.cc-institute.org for a list of all CCI study prep items. NOTE: The CNOR Practice Test is not required to sit for the exam. Your performance on the practice test does not imply successful performance on the CNOR exam.

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CNOR EXAM CONTENT

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The Candidate Handbook is found at http://www.cc-institute.org/cnor/prepare/handbook-plan

See table to right for subject area breakdown on the CNOR exam (information is subject to change)

Subject Area % of Questions

1. Preoperative Patient Assessment and Diagnosis

12%

2. Develop Individualized Plan of Care 10%

3. Intraoperative Activities 27%

4. Communications 10%

5. Transfer of Care 6%

6. Cleaning, Disinfecting, Packaging and Sterilization 9%

7. Emergency Situations 11%

8. Management of Personnel Services and Materials 6%

9. Professional Accountability 9%

Total 100%

TIME-SAVING STRATEGIES

• Do a self-assessment; start and build on what you already know, rather than from the beginning.

• Use the subject areas to organize your study plan.• Start with the areas that have the highest % of

numbers or

• With the subjects that are least familiar.

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STUDY TIPS

• Average study time prior to exam: 3 months. • Turn off text messages, TV and e-mail while you

study.• Break content and time into bite-size chunks.• Review, review, review.• Be able to apply broad concepts versus memorizing

facts and figures.

From: Shellenbarger, Sue. Toughest Exam Question: What is the Best Way to Study? Wall Street Journal, 26 OCT 2011, p. D1, D2.

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CNOR EXAM

• 200 multiple choice questions• 3 hours and 45 minutes• Tests ability to apply knowledge to perioperative

practice setting• Questions are developed by pool of CNOR nurses• Administered by Prometric• May be taken Monday – Saturday, except holidays

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COMPONENTS OF A MULTIPLE CHOICE QUESTION

• Stem • Will provide all the information needed to answer the

question.

• Question may be either:• open-ended (fill in the blank)

or • close-ended (ends with a question mark)

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COMPONENTS OF A MULTIPLE CHOICE QUESTION (cont.)

• 4 possible answers• There is only one correct answer.• The other 3 “distractors” are plausible but not correct.

• Question often contains a quantifier, such as first, best, or most important.

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ANALYZING THE QUESTION

• Eliminate the distractors by identifying why they are incorrect.

• Question should be answered according to current best practice as published in the literature, not necessarily by past experience or facility’s present practice.

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CHOOSING THE CORRECT ANSWER

• Try to answer the question without looking at the options.

• Eliminate distractors with absolutes such as “always” or “never”.

• Review your answers at the end and change answers judiciously.

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COMMON ERRORS IN ANALYZING QUESTIONS

• “Reading into” the stem. • “Overthinking”-using experience beyond 2 years • Taking too much time/question. • Missing the quantifier.• Changing answers to multiple questions.• Leaving questions blank.• Looking for the same questions on the exam that

were on practice tests/flash cards.

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SAMPLE QUESTION #1A

The patient population which accounts for the greatest number of eye muscle procedures is:

A. PediatricB. AdolescentC. AdultD. Geriatric

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ANALYSIS OF TEST QUESTION

• What did you need to know to answer this question?• If you were unfamiliar with the content of this

question, where could you go to find out more information ?

• Type answer in chat window.

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ANSWER QUESTION #1A

Correct answer is: A. Pediatric

Rationale: Strabismus correction requires early recognition and is the third most common performed pediatric procedure between the ages of 6 months and 6 years.

• Reference: Phillips, Nancy. (2017). Berry and Kohn’s Operating room technique, p. 142. St. Louis: Elsevier.

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SAMPLE QUESTION #1B

The most effective way to evaluate a patient’s comprehension of her upcoming surgery is to:

A. have the patient describe the procedure in her own words. B. witness her signing her consent form.C. ask yes/no questions.D. document that the patient has received a patient education brochure.

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ANALYSIS OF TEST QUESTION

• How did you choose which answer you thought was correct?

• Type response in chat window.

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ANSWER QUESTION #1B

Correct answer is: A. have the patient describe her procedure in her own words.

Rationale: To evaluate understanding, have the patient repeat in her own words what has been explained.

Reference: Phillips, N. (2017). Berry and Kohn’s operating room technique, p. 371. St. Louis: Mosby.

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SAMPLE QUESTION #1C

The perioperative nurse discovers that a sponge is missing during the closing count for a left lung lobectomy. The nurse’s first action would be to:

A. repeat the count.B. notify the surgeon.C. document the count as incorrect.D. notify the supervisor.

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ANALYSIS OF THE TEST QUESTION

Prioritization: All of the options could have been correct-how did you choose your answer? (type answer in chat window)

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ANSWER QUESTION #1C

Correct answer is: B. notify the surgeon.

Rationale: The RN circulator should inform and receive verbal acknowledgement from the surgeon and surgical team as soon as a discrepancy in a surgical count is identified.

Reference: AORN. (2016). Prevention of retained surgical items. In Guidelines for perioperative practice, p. 396. Denver, CO: Author.

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UPCOMING CCI WEBINARS

• Sept. 14: Last Minute Tips for a Painless Testing Experience

• Oct. 12th: Essentials of Certification • Recorded sessions will be available via our YouTube

Channel at https://www.youtube.com/channel/UC8qq9R2GcQls7-KAytxqtJA (link at the top right hand side of our website) and on our website at http://bit.ly/CCIWebinars

• Slides will be available for download at http://www.slideshare.net/OR_Nurses

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QUESTIONS?

Type your questions in the chat window-we’re happy to answer them!

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Please know that the CCI staff is here to help you achieve your goal of CNOR certification.

If you have questions, please contact us at 888-257-2667 or info@cc-institute.org

www.cc-institute.org