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100+ Free CPN(C) Perioperative Practice Questions

Pass your CNA Certification — Perioperative Nursing (CPN(C)) exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: CPN(C) Perioperative Exam

165

Exam Questions

Canadian Nurses Association

4 hours

Exam Duration

Canadian Nurses Association

Angoff Method

Passing Standard

Canadian Nurses Association

CAD $588

Member App Fee

Canadian Nurses Association

CAD $780

Non-Member App Fee

Canadian Nurses Association

CAD $85

Proctoring Fee

Canadian Nurses Association

Prepare for the CNA Perioperative Nursing (CPN(C)) exam. The exam features 165 multiple-choice questions, has a 4-hour time limit, requires a passing score determined by the Angoff method, and costs CAD $588 for members and $780 for non-members plus proctoring fees.

Sample CPN(C) Perioperative Practice Questions

Try these sample questions to test your CPN(C) Perioperative exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient scheduled for an elective laparoscopic cholecystectomy mentions having a severe allergy to avocados and bananas. Which of the following is the most appropriate action for the preoperative nurse?
A.Communicate the potential for latex cross-sensitivity to the surgical team and implement latex-safe precautions.
B.Advise the patient that these food allergies are irrelevant to the surgical procedure.
C.Request a consult from an allergist to perform skin patch testing prior to surgery.
D.Administer prophylactic antihistamines and proceed with standard latex equipment.
Explanation: Avocados, bananas, kiwi, and chestnuts share cross-reactive proteins with natural rubber latex, a phenomenon known as latex-fruit syndrome. Patients with these allergies are at a higher risk of latex hypersensitivity reactions. Communicating this to the team and establishing a latex-safe environment preoperatively is critical to patient safety.
2During the preoperative assessment of a patient scheduled for open-heart surgery, the nurse notes a serum potassium level of 2.8 mmol/L. What is the priority intervention?
A.Notify the surgeon and anesthesiologist immediately, as this level of hypokalemia poses a severe risk of cardiac arrhythmias.
B.Document the finding in the electronic chart and continue checking the remaining lab values.
C.Encourage the patient to drink orange juice to elevate potassium levels before transfer.
D.Administer a rapid intravenous bolus of potassium chloride as per the preoperative standing orders.
Explanation: A normal potassium level is 3.5 to 5.0 mmol/L. Severe hypokalemia (under 3.0 mmol/L) sensitizes the myocardium and increases the risk of life-threatening cardiac arrhythmias, especially under anesthesia. Immediate notification of the anesthesia and surgical teams is required to initiate correction before proceeding.
3According to the Operating Room Nurses Association of Canada (ORNAC) and standard Canadian fasting guidelines, what is the minimum fasting period required for clear liquids prior to elective surgery?
A.2 hours
B.4 hours
C.6 hours
D.8 hours
Explanation: Standard fasting guidelines (NPO guidelines) state that clear liquids (such as water, black coffee without milk, clear tea, and pulp-free juices) may be consumed up to 2 hours before elective surgery in healthy patients. This minimizes the risk of aspiration while preventing excessive dehydration.
4When obtaining informed consent for a surgical procedure, what is the primary role of the preoperative registered nurse?
A.Witnessing the patient's signature on the consent form and verifying their understanding and voluntariness.
B.Explaining the detailed risks, benefits, and alternative treatments of the surgical procedure.
C.Answering technical questions regarding the surgeon's specific technique or modifications.
D.Securing consent on behalf of the surgeon if the surgeon is running late.
Explanation: The primary role of the registered nurse is to witness the patient signing the consent form, confirming that the patient is competent, signs voluntarily, and has a basic understanding of what is being consented to. The professional responsibility to explain the risks, benefits, and alternatives lies solely with the provider performing the procedure.
5Which of the following describes the correct procedure for surgical site marking according to Canadian surgical safety standards?
A.The mark should be made at or near the incision site by the surgeon or designated practitioner performing the procedure, involving the patient when possible.
B.The mark should be made on the patient's room door or chart rather than directly on the skin to prevent cross-contamination.
C.The mark should be completed by the preoperative holding nurse using a temporary pen that will wash off during surgical prep.
D.Surgical site marking is only required for bilateral structures like limbs and is optional for midline abdominal surgeries.
Explanation: Canadian safety standards mandate that surgical site marking must be done directly on the patient's skin at or near the incision site by the practitioner performing the procedure. The marking should be done before the patient enters the operating room and must involve the patient to verify the correct site.
6A preoperative patient taking chronic warfarin therapy is scheduled for an elective total hip arthroplasty. The nurse should verify that the patient followed which typical instruction regarding warfarin discontinuation?
A.Stopped taking warfarin approximately 5 days prior to surgery, with bridge therapy managed as ordered.
B.Taken the usual dose of warfarin on the morning of surgery with a small sip of water.
C.Switched to oral aspirin therapy the day before surgery without checking the INR.
D.Stopped warfarin 24 hours prior to surgery and self-administered a double dose of vitamin K.
Explanation: Warfarin has a long half-life and typically must be discontinued approximately 5 days prior to major surgery to allow the International Normalized Ratio (INR) to return to a safe range (usually under 1.5). Patients at high risk for thromboembolism may require bridge therapy with low-molecular-weight heparin (LMWH).
7A patient with advanced dementia is scheduled for emergency bowel resection. The patient is unable to sign the consent form, and no family members can be reached. How should the surgical team proceed?
A.Proceed with the surgery under the legal doctrine of emergency exception, documenting the emergency in the medical record.
B.Delay the surgery until a court-appointed public guardian can be contacted and a formal review completed.
C.Have the nurse sign as the patient's surrogate decision-maker to expedite the surgery.
D.Obtain consent from the patient's roommate at the long-term care facility.
Explanation: Under Canadian law, emergency medical treatment can be provided without formal consent if the patient is incapable, immediate intervention is necessary to preserve life or prevent serious harm, and no substitute decision-maker is available. The circumstances must be fully documented by the attending physicians.
8To effectively reduce the risk of surgical site infections (SSIs), when is the optimal time to administer prophylactic intravenous antibiotics?
A.Within 60 minutes prior to the surgical incision.
B.Directly upon the patient's arrival to the preoperative holding area, typically 2 to 3 hours before surgery.
C.Immediately after the surgical specimen is sent to pathology.
D.In the PACU during the first hour of recovery.
Explanation: National standards (such as ORNAC and SCIP guidelines) state that prophylactic antibiotics should be administered within 60 minutes prior to surgical incision (or 120 minutes for vancomycin/fluoroquinolones). This timing ensures that tissue and serum concentrations of the antibiotic are at their bactericidal peak when the incision is made.
9A patient scheduled for spinal fusion has a history of severe obstructive sleep apnea (OSA). Which preoperative assessment finding is of greatest concern to the anesthesia provider?
A.A Mallampati class IV airway assessment, indicating a highly restricted view of the tonsils and soft palate.
B.The patient's report of using a continuous positive airway pressure (CPAP) machine at home at a setting of 8 cm H2O.
C.A neck circumference of 35 cm in a female patient.
D.A documented allergy to sulfur drugs.
Explanation: A Mallampati class IV airway classification indicates that only the hard palate is visible during airway assessment, which is a strong predictor of a difficult intubation and airway management challenges, particularly in patients with pre-existing OSA. This represents a significant safety risk that requires preparation for a difficult airway.
10A preoperative nurse is reviewing a patient's home medication list. The patient states they take ginseng and garlic supplements daily. What instruction should have been provided regarding these supplements?
A.Discontinue these supplements 1 to 2 weeks before surgery, as both can significantly increase the risk of bleeding.
B.Increase the dosage of these supplements to boost immune function and accelerate postoperative healing.
C.Take them only on the morning of surgery with a small sip of water to maintain vascular tone.
D.Switch to ginkgo biloba supplements starting the week of surgery.
Explanation: Ginseng and garlic supplements inhibit platelet aggregation and can prolong bleeding times. Standard guidelines recommend discontinuing these and other herbal products (like ginkgo biloba and feverfew) at least 7 to 14 days before elective surgery to minimize the risk of intraoperative hemorrhage.

About the CPN(C) Perioperative Exam

The Certified in Perioperative Nursing (Canada) (CPN(C)) designation is the national standard of excellence for perioperative nursing in Canada. It validates the specialized knowledge, clinical skills, and professional judgment required to provide safe, ethical care across the preoperative, intraoperative, and postoperative phases of surgery, aligned with ORNAC guidelines and CSA Z314 reprocessing standards.

Assessment

165 multiple-choice questions (CBT, closed book)

Time Limit

4 hours

Passing Score

Angoff Method

Exam Fee

CNA Member: CAD $588. Non-member: CAD $780. Online proctoring fee: $85. (Canadian Nurses Association (CNA))

CPN(C) Perioperative Exam Content Outline

15%

Preoperative Care

Patient assessment, NPO guidelines, informed consent, surgical site marking, preoperative medications, and patient safety checks.

35%

Intraoperative Care

Sterile field maintenance, surgical counts, positioning, safety checklists, electrosurgery and laser safety, anesthesia monitoring, and specimen handling.

15%

Postoperative Care

PACU recovery, airway complications, hemodynamic stability, pain and PONV management, handover communication, and discharge criteria.

20%

Infection Prevention, Control & Safety

CSA Z314 reprocessing standards, sterilization monitoring, airflow/pressure, PPE and sterile attire, skin prep, and waste disposal.

15%

Professional Practice & Advocacy

ORNAC guidelines, legal/ethical issues, team communication, quality improvement, patient advocacy, and nursing documentation.

How to Pass the CPN(C) Perioperative Exam

What You Need to Know

  • Passing score: Angoff Method
  • Assessment: 165 multiple-choice questions (CBT, closed book)
  • Time limit: 4 hours
  • Exam fee: CNA Member: CAD $588. Non-member: CAD $780. Online proctoring fee: $85.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CPN(C) Perioperative Study Tips from Top Performers

1Familiarize yourself thoroughly with the ORNAC Guidelines for Perioperative Practice in Canada, focusing on modules related to patient safety, positioning, and sterile technique.
2Understand the key parameters and sterile assurance monitoring requirements (physical, chemical, biological indicators) defined in the CSA Z314 standards for medical device reprocessing.
3Review the physiological effects and nerve protection strategies for major surgical positions, including Trendelenburg, prone, lithotomy, and lateral decubitus.
4Review emergency protocols, particularly the signs, pathophysiology, and management of Malignant Hyperthermia (including Dantrolene reconstitution and dosing).
5Understand standard fasting (NPO) guidelines for clear liquids, breast milk, formula, and solid meals.
6Study patient safety protocols, specifically the components and timing of the surgical safety checklist (Sign In, Time Out, Sign Out) and wrong-site surgery prevention.

Frequently Asked Questions

What is the passing score for the CPN(C) exam?

The passing score for the CPN(C) exam is not a fixed percentage. It is determined by an exam committee using the modified Angoff method, which evaluates question difficulty. Candidates receive a result of either 'pass' or 'unsuccessful' rather than a numerical score.

How many questions are on the CPN(C) exam and what is the duration?

The exam consists of 165 multiple-choice questions. Candidates are given 4 hours (240 minutes) to complete the test, which is computer-based.

What are the eligibility requirements for the CPN(C) certification?

Candidates must hold an active, unrestricted registered nurse (RN) license in a Canadian province or territory. Additionally, they must meet one of two practice hour pathways: Option 1 requires a minimum of 1,950 hours of practice in perioperative nursing within the last 5 years; Option 2 requires a minimum of 1,000 hours of practice within the last 5 years plus a recognized post-basic course in perioperative nursing.

What are the fees for the CNA Perioperative Nursing certification?

As of the 2026 schedule, the application fee is CAD $588 for CNA members and CAD $780 for non-members. An additional proctoring fee is paid at the time of booking: $85 for online proctoring (ProctorU) or $110 for in-person testing center (Meazure Learning). Applicable taxes are extra.

What standards are tested on the CPN(C) exam?

The exam heavily tests the national standards established in the Operating Room Nurses Association of Canada (ORNAC) Guidelines for Perioperative Practice, as well as the CSA Z314 standards for medical device reprocessing.

How often does the CPN(C) certification need to be renewed?

CNA specialty certifications are valid for 5 years. They can be renewed either by submitting proof of 250 hours of specialty practice plus continuous learning hours (100 hours of professional development) or by retaking and passing the certification exam.