CNOR Certification

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In 1978, the Association of Perioperative Registered Nurses (AORN) voted to begin a voluntary certification program for operating room nurses. The certification council created as a result of this vote eventually evolved into the Competency & Credentialing Institute (CCI), an incorporated organization which develops and maintains the CNOR and CRNFA certifications.[1]

CNOR is not an acronym. Rather, the CNOR certification is defined as "the documented validation of the professional achievement of identified standards of practice by an individual registered nurse providing care for patients before, during and after surgery."[2]

The CNOR exam is updated continuously. Throughout the year, CNOR-certified nurses convene to participate in question writing and review workshops, and the questions developed at these workshops enter the pool of possible CNOR exam questions. At any given time, several forms of the exam exist, and new forms are developed and statistically validated every year to reflect current practice.[3] Occasionally, the examination is overhauled more thoroughly, most recently in 2013.[4]

Function of the Test

CNOR Study Guide

The CNOR exam is one part of the CNOR certification process for operating room nurses. CCI defines CNOR certification as a "the documented validation of the professional achievement of identified standards of practice by an individual registered nurse providing care for patients before, during and after surgery."[5]

Candidates for the CNOR certificate must have a current, unrestricted RN license and be working at least part-time in perioperative nursing, whether in nursing education, administration, research, or clinical practice. Candidates must also have completed a minimum of two years and 2,400 hours of experience in perioperative nursing, including a minimum of 1,200 hours in the intraoperative setting.[6]

Over 34,250 individuals currently hold the CNOR credential,[2] and about 70% of operating room nurses who take the examination pass.[3]

Test Administration

CNOR Flashcards

The CNOR exam is administered by computer. Test takers are allowed three hours and 45 minutes to complete the exam.

The CNOR exam is offered continuously year-round. Once a candidate applies, he or she may take the examination during any of the three following months. For example, a candidate who applies in February may take the test in March, April, or May.[6]

The CNOR exam is normally administered at test center locations run by Prometric Inc. Candidates are not required to take the examination in the United States; special accommodations may be made to help overseas nurses find a testing center within five hundred miles of their current location.[3]

Members of the AORN may take the examination for $310. Non-members must pay $385.[7] Some discounting programs are available. CCI also participates in the Department of Veterans Affairs and Defense's "Let's Get Certified" program and offers a price of $270 for VA and DoD perioperative nurses.[8]

Candidates who wish to retake the examination may reapply after their original testing window. There is no limit to the number of times a candidate may take the examination, but every time a candidate takes the examination, he or she will see a different version of the exam. CCI does not offer refunds or retesting discounts to candidates who do not pass the CNOR exam.[3]

Test Format

Sections of the CNOR Test[9]
CNOR Exam Topic Areas  % of Questions
Preop Patient Assessment and Diagnosis 14%
Develop Individualized Plan Of Care 9%
Intraoperative Activities 31%
Communication 9%
Transfer of Care 5%
Cleaning, Disinfecting, Packaging, Sterilization,
Transporting & Storing Instruments, Supplies
Emergency Situations 8%
Management of Personnel, Services, & Materials 6%
Professional Accountability 6%

Test Environment

The CNOR Exam is offered at Prometric Testing Facilities. At these facilities, a valid ID must be presented by every test taker. A log book must also be signed. Each test taker will be given a locker to store their things while the test is being taken. The TCA facilities may also provide test-takers with scratch paper, pencils, and any other supplies needed. Only the locker key and valid ID are allowed into the testing rooms.[10]

Test Structure

The CNOR exam is made up of 200 questions, 15 of which are unscored, pretest questions. These pretest questions will be dispersed throughout the test, so every question still needs to be answered. The 200 questions will cover nine different topic areas with three hours and forty-five minutes to complete them. The topics covered are Preop Patient Assessment and Diagnosis; Develop Individualized Plan of Care; Intraoperative Activities; Communication; Transfer of Care; Cleaning, Disinfecting, Packaging, Sterilization, Transporting & Storing Instruments, Supplies; Emergency Situation; Management of Personnel, Services, and Materials; Professional Accountability. Test takers will find out immediately following the test whether they pass or fail.[11]

Sample Questions


Of the 200 questions on the CNOR examination, 185 are used to calculate the test score. The remaining 15 questions, which do not count toward the test score, are pretest questions scattered throughout the examination. Because the raw test score is the total number of questions answered correctly, it is advantageous to answer every question. Guessing is not penalized.[12]

Because there are many different forms of the CNOR examination, there is no single raw score cutoff to pass the exam. Rather, the raw scores of any given form of the examination are converted to a standardized scaled score. The passing score of the CNOR exam is a scaled score of 620.[10]

CCI does not publish specific test statistics, but they report that approximately 70% of test takers pass the examination.[3]

Recent Developments

The CNOR exam was substantially revised as of July 1st, 2013 to address the 2013 AORN Perioperative Standards and Recommended Practices.[4]


  1. ^ CCI: History March 2 2014
  2. ^ a b CCI: About CNOR March 2 2014
  3. ^ a b c d e CCI: Frequently Asked Questions March 2 2014
  4. ^ a b CCI: CNOR Exam Preparation Resources March 2 2014
  5. ^ Description of CNOR 22 March 2018
  6. ^ a b CNOR Certification Handbook March 23 2018
  7. ^ CCI: CNOR Fees March 2 2014
  8. ^ Let's Get Certified 23 March 2018
  9. ^ CNOR Test Outline 13 June 2014
  10. ^ a b CNOR About the Exam 13 June 2014
  11. ^ CNOR Test Outline 13 June 2014
  12. ^ Guessing Penalty 22 March 2018

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