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100+ Free CFPN Practice Questions

Pass your Certified Foundational Perioperative Nurse exam on the first try — instant access, no signup required.

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When is the surgical instrument count first performed?

A
B
C
D
to track
2026 Statistics

Key Facts: CFPN Exam

125-150

Total Questions

CCI CFPN handbook

2h 30m

Exam Time

CCI CFPN handbook

$250

Application Fee

CCI fee schedule

<23 mo

OR Experience Eligibility Window

CCI CFPN handbook

34%

Intraoperative Care Domain

Largest CFPN domain

July 2022

Credential Launched

CCI announcement

PSI

Test Center / Remote Proctor

CCI testing partner

CFPN is a knowledge-based, multiple-choice exam of approximately 125-150 items administered over 2.5 hours through PSI (test center or remote). The $250 fee is paid to CCI. Eligibility requires an active RN license, completion of perioperative orientation, and application within 23 months of initial OR hire. The 2026 outline weights seven domains: Intraoperative Care 34%, Infection Prevention 16%, Pre/Postoperative Assessment 15%, Communication and Documentation 11%, Emergency Situations 10%, Individualized Plan of Care 8%, Professional Accountability 6%.

Sample CFPN Practice Questions

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

1During the closing surgical count, the scrub and circulator find one Raytec sponge missing. The wound is still open. According to AORN guidelines, what is the FIRST action?
A.Close the patient and order a postoperative chest x-ray
B.Notify the surgeon and conduct a thorough search of the field, drapes, trash, and floor
C.Document the discrepancy and continue closing
D.Repeat only the sponge count silently with the scrub
Explanation: AORN's Guideline for Prevention of Unintentionally Retained Surgical Items requires the circulator to immediately notify the surgeon of any count discrepancy and the entire team to perform a deliberate, methodical search of the surgical field, drapes, kick buckets, trash, and floor before closure. The team treats the patient as if the item is in the wound until proven otherwise.
2A patient is scheduled for a 4-hour laparoscopic gynecologic procedure in lithotomy position. Which complication is the patient at HIGHEST risk for related to positioning?
A.Brachial plexus injury from arm hyperabduction
B.Common peroneal nerve injury from lateral leg compression in stirrups
C.Posterior tibial nerve injury from heel pressure
D.Ulnar nerve injury from elbow flexion
Explanation: Lithotomy position places the lateral aspect of the lower leg against the stirrup post, compressing the common peroneal nerve as it crosses the head of the fibula. Prolonged compression (>2-4 hours) causes foot drop. AORN's positioning guideline requires padding between the leg and stirrup and limiting time in lithotomy when possible.
3Which surgical attire item must be worn by ALL personnel entering the semi-restricted and restricted areas of the OR?
A.A bouffant scrub cap that fully covers head and facial hair
B.Shoe covers with non-slip tread
C.A surgical mask with the metal nose strip
D.Sterile gloves
Explanation: AORN's Guideline for Surgical Attire requires that all personnel entering the semi-restricted and restricted areas wear a clean, freshly laundered surgical head cover that fully contains hair and facial hair to reduce shedding of bacteria-laden squames. Masks are required only in restricted areas where open sterile supplies are present.
4A 70-kg adult develops sudden masseter rigidity, hypercarbia (ETCO2 rising to 75 mmHg), and tachycardia after induction with sevoflurane and succinylcholine. After calling for help and the MH cart, what is the correct INITIAL dantrolene dose?
A.1 mg/kg IV (70 mg)
B.2.5 mg/kg IV (175 mg)
C.5 mg/kg IV (350 mg)
D.10 mg/kg IV (700 mg)
Explanation: MHAUS guidelines specify an initial dantrolene dose of 2.5 mg/kg IV bolus, repeated every 5-10 minutes until signs of MH resolve. For a 70-kg patient that is 175 mg. Total dose may exceed 10 mg/kg if needed. Triggers (volatile anesthetics, succinylcholine) must be discontinued immediately.
5The fire safety triangle in the operating room consists of three components. Which combination is correct?
A.Heat, fuel, water
B.Oxidizer, ignition source, fuel
C.Spark, drape, alcohol
D.Electricity, oxygen, suction
Explanation: The fire triangle in the OR is oxidizer (oxygen, nitrous oxide), ignition source (ESU, laser, fiber-optic light cord), and fuel (drapes, prep solutions, hair, GI gases). All three must be present for a fire. AORN's fire-safety guideline emphasizes controlling all three components, especially during head/neck procedures with supplemental oxygen.
6Which step of surgical hand antisepsis using a brushless alcohol-based hand rub is performed FIRST?
A.Apply the alcohol-based product to dry hands
B.Pre-wash hands and forearms with soap and water and dry thoroughly
C.Don sterile gloves immediately after dispensing the product
D.Trim fingernails to less than 2 mm
Explanation: AORN's Guideline for Hand Hygiene specifies that before the first case of the day, personnel pre-wash hands and forearms with plain soap and water, clean under nails, and dry completely before applying an alcohol-based surgical hand antiseptic. Pre-cleaning removes gross soil; alcohol rubs require dry skin to be effective.
7Per CDC and SCIP/SSI prevention bundle guidance, prophylactic IV cefazolin should be administered within what window before surgical incision?
A.Within 30 minutes of incision
B.Within 60 minutes of incision
C.Within 120 minutes of incision
D.At the time of skin closure
Explanation: CDC's surgical site infection prevention guideline and the SCIP measure require beta-lactam prophylactic antibiotics (e.g., cefazolin) to be infused within 60 minutes before incision. Vancomycin and fluoroquinolones use a 120-minute window because they require longer infusion times.
8The Universal Protocol time-out is performed immediately before what event?
A.Patient arrival in the holding area
B.Anesthesia induction
C.Skin incision
D.Wound closure
Explanation: The Joint Commission's Universal Protocol mandates a team time-out immediately before skin incision to verify correct patient, correct procedure, correct site, and required equipment/implants. The whole team pauses; only after agreement does the surgeon incise.
9A patient's preoperative core temperature on arrival to the OR is 35.4 degrees C. According to AORN's Normothermia guideline, what is the recommended target intraoperative core temperature?
A.At least 35.0 degrees C
B.At least 36.0 degrees C
C.At least 37.0 degrees C
D.At least 38.0 degrees C
Explanation: AORN's Guideline for Prevention of Unplanned Patient Hypothermia and the Surgical Care Improvement Project (SCIP) define normothermia as core temperature at or above 36.0 degrees C. Active warming (forced-air, warmed IV fluids, ambient temperature control) should begin preoperatively when temperature is below this threshold.
10A surgical specimen is sent for permanent histopathology only (not frozen section). Which preservation method is correct?
A.Submerge in 10% neutral buffered formalin in a labeled, leak-proof container
B.Place on saline-soaked gauze in a sterile basin
C.Send in dry sterile container with no fixative
D.Refrigerate in a specimen bag with ice
Explanation: Specimens for permanent histopathology are preserved in 10% neutral buffered formalin at a volume ratio of approximately 10:1 (formalin to tissue). The container is labeled with patient identifiers, source, and surgeon, then sealed leak-proof. Frozen-section specimens are sent fresh on saline gauze; cultures are sent dry or in transport media.

About the CFPN Exam

CFPN (Certified Foundational Perioperative Nurse) is CCI's entry-level perioperative credential for RNs with fewer than 24 months of perioperative experience. Launched in July 2022, it validates foundational competencies across intraoperative care, infection prevention, perioperative assessment, communication and documentation, emergency response, individualized plan of care, and professional accountability.

Questions

150 scored questions

Time Limit

2 hours 30 minutes

Passing Score

Scaled passing score (set by CCI)

Exam Fee

$250 (CCI (Competency & Credentialing Institute))

CFPN Exam Content Outline

34%

Management of Intraoperative Activities

Patient care during surgery: positioning, sterile field maintenance, surgical counts, electrosurgery, fire safety, specimen handling, smoke evacuation, time-out, and personnel/services/materials management.

16%

Infection Prevention and Control

Hand antisepsis, surgical attire, traffic patterns, sterilization (steam, EtO, hydrogen peroxide), biological/chemical indicators, SSI prevention bundle, antibiotic prophylaxis timing, and standard/transmission-based precautions.

15%

Pre/Postoperative Patient Assessment and Diagnosis

Preoperative history and physical, ASA classification, medication reconciliation, allergy verification, normothermia, VTE risk, frailty assessment, PACU assessment using Aldrete scoring, and discharge readiness.

11%

Communication and Documentation

SBAR handoff, closed-loop communication, PNDS terminology, operative record completeness, implant traceability, medication labeling at the field, and discharge education with teach-back.

10%

Emergency Situations

Recognition and first response for malignant hyperthermia, anaphylaxis, OR fire, hemorrhage/massive transfusion, airway emergencies, and venous air embolism.

8%

Individualized Plan of Care Development

Nursing process application, measurable outcomes (PNDS), risk-stratified pressure injury and fall prevention, cultural competence, and individualized planning for vulnerable populations (geriatric, pediatric).

6%

Professional Accountability

ANA Code of Ethics, AORN guidelines, scope of practice, sentinel events, near-miss reporting, drug diversion reporting, controlled substance management, and CCI credentialing/recertification.

How to Pass the CFPN Exam

What You Need to Know

  • Passing score: Scaled passing score (set by CCI)
  • Exam length: 150 questions
  • Time limit: 2 hours 30 minutes
  • Exam fee: $250

Keys to Passing

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

CFPN Study Tips from Top Performers

1Master AORN's Guidelines for Perioperative Practice — they form the basis of nearly every CFPN question
2Learn the surgical count procedure cold: initial, added items, cavity, first closing, final closing — and the response to a discrepancy
3Drill positioning risks for supine, prone, lithotomy, lateral, Trendelenburg, and sitting — including specific nerve injuries
4Memorize the malignant hyperthermia response: trigger discontinuation, dantrolene 2.5 mg/kg IV, cooling, MHAUS hotline
5Know the OR fire triangle (oxidizer, ignition, fuel) and head/neck/upper-chest fire risk under MAC with open oxygen
6Study antibiotic prophylaxis timing: cefazolin within 60 minutes of incision, vancomycin/fluoroquinolones within 120 minutes
7Practice SBAR handoff and closed-loop communication — both are tested in scenarios
8Review CDC standard precautions, transmission-based precautions, and the SSI prevention bundle (normothermia, glucose <200, hair clipping, prophylaxis)

Frequently Asked Questions

How many questions are on the CFPN exam?

The CFPN exam consists of approximately 125-150 multiple-choice items administered over 2 hours and 30 minutes through PSI test center or remote secure proctoring. Verify the current count in the CCI CFPN Candidate Handbook.

What score do I need to pass CFPN?

CCI uses a scaled scoring system for CFPN with a passing point set through standard psychometric methods. The exact scaled threshold and any pretest items are detailed in the current CCI CFPN Candidate Handbook.

How much does CFPN certification cost?

The CFPN application fee is $250 paid to CCI. Application fees are non-refundable per the CFPN Candidate Handbook. Retests require a new application and fee.

What are the CFPN content domain weights for 2026?

The 2026 CFPN outline weights: Management of Intraoperative Activities 34%, Infection Prevention and Control 16%, Pre/Postoperative Assessment and Diagnosis 15%, Communication and Documentation 11%, Emergency Situations 10%, Individualized Plan of Care 8%, Professional Accountability 6%.

What are the eligibility requirements for CFPN?

Eligibility requires: an active unrestricted RN license, completion of a perioperative nursing orientation program (didactic and clinical), application submitted within 23 months of initial OR hire, and current employment in perioperative nursing (clinical, education, administration, or research).

How is CFPN different from CNOR?

CFPN is the entry-level credential for RNs with fewer than 24 months of perioperative experience. CNOR requires 2 years (2,400 hours) of perioperative practice with at least 1,200 intraoperative hours. CFPN was launched by CCI in July 2022 specifically to credential novice perioperative nurses earlier in their careers.

How long is CFPN certification valid?

CFPN certification is valid for 2 years per the CCI CFPN Candidate Handbook, with an optional 1-year extension available. Confirm renewal/transition pathways (including transition to CNOR) in the current handbook.