HealthcareOctober 3, 202613 min read

CNOR Mnemonics: 12 Memory Tricks for Perioperative Nurses

12 memory hooks for the lists and sequences the CNOR keeps testing, each with when to use it and where it lets you down.

  • 12Mnemonics
  • 4Domains covered
  • 200 itemsReal exam
  • 225 minTime limit
  • $475Exam fee
Perioperative nursing mnemonics and memory tricks for the CNOR exam

Table of Contents

How to use a mnemonic on exam day

A mnemonic is a retrieval cue, not understanding. It gets a list or a sequence back out of memory under time pressure; it does not tell you which item on the list the question wants. Each card below therefore has two extra lines: Use it when — the kind of CNOR question where the hook pays off — and Careful — where the shortcut breaks or the exam sets a trap around it.

Learn the meaning first. Read the expansion until it makes sense, then use the hook to recall it. A mnemonic you cannot unpack is worth nothing on a scenario item.

Emergency Situations

Malignant hyperthermia treatment

“Some Hot Dude Better Give Iced Fluids Fast”

  1. SStop the triggers: turn off volatile agents, no succinylcholine; call for help and the MH cart
  2. HHyperventilate with 100% oxygen at 10 L/min or more
  3. DDantrolene 2.5 mg/kg IV rapidly, repeated until signs subside
  4. BBicarbonate for metabolic acidosis, guided by blood gases
  5. GGlucose and insulin for hyperkalemia (adult: 10 units regular insulin with 50 mL of 50% dextrose); calcium for life-threatening hyperkalemia
  6. IIced fluids and cooling when core temperature is above 39 C; stop cooling below 38 C
  7. FFluid output: diurese to more than 1 mL/kg/h to protect the kidneys from myoglobin
  8. FFast heart rate: treat dysrhythmias with standard drugs, but never calcium channel blockers

Use it when: When a stem describes rising end-tidal CO2, tachycardia, muscle or jaw rigidity, or a temperature spike after a volatile agent or succinylcholine, and asks for the next action or what to bring.

Careful: Fever is often a late sign; an unexplained rise in end-tidal CO2 is usually the earliest. Older cards give a urine target of 2 mL/kg/h, but MHAUS now says more than 1 mL/kg/h. Large doses above 10 mg/kg of dantrolene may be needed, and Ryanodex vials are mixed with 5 mL sterile water without a bacteriostatic agent.

Local anesthetic systemic toxicity (LAST)

“Stop Calling All Bad Locals”

  1. SStop injecting the local anesthetic
  2. CCall for help and get the lipid emulsion kit
  3. AAirway: 100% oxygen and ventilation, because hypoxia and acidosis worsen toxicity
  4. BBenzodiazepine for seizures; avoid large propofol doses in an unstable patient
  5. LLipid emulsion 20%: 1.5 mL/kg bolus over 2-3 minutes (100 mL if over 70 kg), then an infusion

Use it when: When a patient develops a metallic taste, perioral numbness, tinnitus, agitation, seizures or arrhythmias after a nerve block or large local infiltration.

Careful: If cardiac arrest follows, CPR is modified: epinephrine boluses of 1 mcg/kg or less, and no vasopressin, calcium channel blockers, beta blockers or more local anesthetic, so lidocaine is not used for the arrhythmia. Propofol is not a substitute for lipid. Symptoms can be delayed, so monitoring continues after the injection.

Fire triad and who controls each side

“Nurses Fuel, Anesthesia Oxygenates, Surgeons Ignite”

  1. FuelDrapes, gowns, sponges, alcohol-based prep, hair, the endotracheal tube; largely managed by the nursing team
  2. OxidizerOxygen and nitrous oxide; controlled by the anesthesia provider
  3. IgnitionElectrosurgery, lasers, fiberoptic light cords, drills and burs; controlled by the surgeon

Use it when: When asked who controls a fire risk, or which step removes one side of the triangle in a given case.

Careful: The highest-risk case is surgery above the xiphoid with open oxygen delivery (nasal cannula or mask) near an ignition source; ask for the lowest oxygen concentration the patient tolerates, ideally 30% or less, or a secured airway. Alcohol-based prep must be fully dry, with no pooling, before drapes go on. Many facilities add a fire risk score to the time-out.

Fire response and extinguisher use

“RACE, then PASS”

  1. RRescue anyone in immediate danger
  2. AAlarm: activate the alarm and call for help
  3. CConfine: close doors to contain smoke and fire
  4. EExtinguish if it is small, or evacuate
  5. PPull the pin
  6. AAim at the base of the fire
  7. SSqueeze the handle
  8. SSweep side to side

Use it when: Fire in the room or department, evacuation priorities and extinguisher questions.

Careful: A fire on the patient follows its own sequence: stop the flow of airway gases, remove drapes and burning material, put out the fire with saline or water, then care for the patient. In an airway fire the tube is removed and gas flow stopped at once. A CO2 extinguisher can be used on a fire near the patient; medical gas zone valves are shut off only as your protocol directs.

Patient Care and Safety

Universal Protocol

“Verify, Mark, Pause”

  1. VerifyPre-procedure verification: right patient, procedure and site; consent, H&P, imaging, implants and blood products available
  2. MarkSite marking by the practitioner doing the procedure (or a permitted delegate), with an unambiguous mark that stays visible after prep and draping, involving the patient when possible
  3. PauseTime-out immediately before the incision: the whole team stops, confirms patient, site and procedure, and anyone can speak up

Use it when: Items on what must happen before incision, who marks the site, or what to do when a team member disagrees during the time-out.

Careful: The time-out happens in the room immediately before the incision, not in pre-op holding. The Joint Commission exempts some cases from marking, such as single-organ cases like cesarean section and premature infants for whom a mark might be permanent; facility policy then sets the alternative. Do a separate time-out for each procedure done by a different team or at a different site.

Pressure injury risk (Scott Triggers)

“Four A's”

  1. Age62 years or older
  2. AlbuminSerum albumin below 3.5 g/dL, or a BMI below 19 or above 40
  3. ASAASA physical status 3 or higher
  4. Anesthesia timeEstimated surgery time over 3 hours

Use it when: Pre-op assessment and positioning questions about which patient is at highest risk of an intraoperative pressure injury.

Careful: Two or more triggers mark a patient as high risk, so pressure-redistributing surfaces, extra padding and documentation start before the patient enters the room. Operating-room pressure injuries may not appear until 1-3 days later, so a normal skin check in PACU does not rule one out.

Specimen handling

“Very Lucky Patients Trust Documentation”

  1. VVerify the specimen's name, site and laterality with the surgeon and read it back
  2. LLabel the container (not the lid) in the room with two patient identifiers, specimen name and side
  3. PPreserve correctly: formalin for routine pathology; fresh for frozen sections, cultures and other fresh requests; stones sent dry
  4. TTransport promptly, keeping chain of custody for forensic items such as bullets
  5. DDocument the specimen, any preservative, the time and the hand-off

Use it when: When asked what to do with a specimen passed off the field, which specimen must not go into formalin, or how to handle evidence.

Careful: A frozen section or culture placed in formalin is ruined. Breast tissue for cancer should reach formalin within 1 hour of removal, with the time recorded. Handle bullets with gloved fingers or rubber-shod instruments to preserve their markings, and never label only the lid, which can be separated from the container.

Labeling medications on the sterile field

“No Syringe Ain't Exempt”

  1. NName of the medication or solution
  2. SStrength
  3. AAmount, if not obvious from the container
  4. EExpiration date if not used within 24 hours (expiration time if it expires sooner)

Use it when: When a stem asks what must be on a label for a drug or solution on the field, or what to do with an unlabeled cup or syringe.

Careful: Label each container as soon as it is filled, one medication at a time, and verify it aloud and visually with the scrub when the person preparing it is not the one giving it. Discard any unlabeled container on the field, keep the original containers until the procedure ends, and review all medications and labels with relief staff at a hand-off.

Infection Prevention and Control

Sterile field rules

“SIGHT”

  1. SSterile touches only sterile
  2. IIf in doubt, throw it out
  3. GGowns are sterile only in front from chest to the level of the sterile field, and on the sleeves from 2 inches above the elbow to the cuff
  4. HHorizontal surfaces only: table tops are sterile; anything below table level is not
  5. TTables and trays stay in sight: a sterile field is never left unattended

Use it when: Break-in-technique questions: which part of a gown or table is still sterile and what to do after a possible contamination.

Careful: The edge of a sterile wrapper, about 1 inch, is not sterile. Scrubbed people pass each other face to face or back to back, and the circulator never reaches over the field. Set up the sterile field as close as possible to the time it will be used.

Surgical attire by zone

“Street, Scrubs, Scrubs plus Mask”

  1. UnrestrictedStreet clothes allowed: entrances, offices, locker rooms
  2. Semi-restrictedSurgical attire and a head cover: corridors to the ORs, sterile storage, processing areas
  3. RestrictedSurgical attire, head cover and a mask where open sterile supplies or scrubbed people are present: operating and procedure rooms

Use it when: When asked what attire is required in a named area or what a visitor must wear to enter.

Careful: The mask requirement belongs to restricted areas with open sterile supplies or scrubbed people, not to the whole semi-restricted corridor. AORN recommends that scrubs be laundered by a health care-accredited laundry rather than at home, and that the head cover contain all hair.

Pre/postoperative Assessment

Herbal supplements that raise bleeding risk

“The 4 G's”

  1. GGarlic
  2. GGinger
  3. GGinkgo
  4. GGinseng

Use it when: Medication reconciliation items in which a patient lists supplements and you must spot the bleeding risk to report.

Careful: Ginseng can also lower blood glucose. St. John's wort is not a G but matters, because it induces liver enzymes and changes drug levels, and kava and valerian can deepen sedation. Report every supplement to the anesthesia provider and surgeon; patients are commonly told to stop herbal products about 2 weeks before surgery.

Modified Aldrete score for PACU discharge

“All Recovering Clients Can Oxygenate”

  1. AActivity: moves all four limbs on command (2)
  2. RRespiration: breathes deeply and coughs freely (2)
  3. CCirculation: blood pressure within 20% of the pre-anesthetic level (2)
  4. CConsciousness: fully awake (2)
  5. OOxygen saturation: above 92% on room air (2)

Use it when: Post-op assessment items asking whether a patient can leave phase I recovery, or what a given score means.

Careful: Each item scores 0 to 2, for a total of 10, and 9 or more is the usual discharge threshold for phase I. The original 1970 score used skin color; the modified version replaced it with oxygen saturation. Facilities often add pain, nausea and surgical-site checks on top of the score.

Numbers worth memorising

Some perioperative nursing facts have no shortcut — they are just numbers the exam expects you to know cold. These are the ones that show up most often in the item bank.

FactValueWhy it gets tested
Dantrolene for malignant hyperthermia2.5 mg/kg IV, repeated until signs subsideMore than 10 mg/kg may be needed
MH cooling thresholdsCool when core temperature is above 39 C; stop below 38 COvercooling causes its own problems
MH urine output targetMore than 1 mL/kg/hOlder cards say 2 mL/kg/h
Lipid emulsion 20% for LAST1.5 mL/kg bolus over 2-3 min (100 mL if over 70 kg), then infusion; upper limit about 12 mL/kgRepeat bolus and double the infusion if the patient stays unstable
Epinephrine during LAST arrest1 mcg/kg or less per bolusStandard doses can worsen arrhythmias
Oxygen near ignition sources30% or less when tolerated, with open delivery near the head or neckOxygen-enriched air under drapes fuels surgical fires
Alcohol-based skin prep dry timeAt least 3 minutes on hairless skin; up to 1 hour in hair (CHG-alcohol label)Drape only when fully dry with no pooling
Operating room temperature and humidity68-75 F (20-24 C); 20-60% relative humidityASHRAE 170 design ranges
Operating room air changesAt least 20 total per hour, 4 of them outdoor air, positive pressureWhy doors stay closed during cases
Breast cancer specimen fixationInto formalin within 1 hour; fixed 6-72 hours in 10% neutral buffered formalinAffects hormone receptor and HER2 testing
Pressure injury risk (Scott Triggers)2 or more triggers = high riskAge 62+, low albumin or BMI extremes, ASA 3+, surgery over 3 hours
CNOR exam format200 questions (185 scored) in 3 hours 45 minutes; pass at 620 scaled (200-800)15 pretest items cannot be identified

Build your own in three steps

The best mnemonic is the one you made, because making it is half the memorising.

  1. 1Pick a list the outline tests as a sequence or a set — steps, signs, contraindications. Single facts do not need a hook.
  2. 2Take the first letter of each item and build a phrase that is vivid or absurd. Odd sticks; sensible fades.
  3. 3Test it cold the next day on practice questions. If you recalled the phrase but missed the item, the hook is fine and the understanding is not.

Now test the hooks on real questions

The CNOR app has 1,026 exam-style questions with explanations. Mnemonics stick when you use them to answer something — drill by domain and see which ones hold up.

App StoreGoogle PlayFree CNOR practice test

FAQ

What is the mnemonic for malignant hyperthermia treatment?

'Some Hot Dude Better Give Iced Fluids Fast': stop triggers, hyperventilate with 100% oxygen, dantrolene 2.5 mg/kg, bicarbonate, glucose and insulin, iced fluids and cooling, fluid output above 1 mL/kg/h, and treat the fast heart rate without calcium channel blockers.

What do RACE and PASS stand for in the OR?

RACE is Rescue, Alarm, Confine and Extinguish or Evacuate. PASS is Pull, Aim, Squeeze and Sweep for using an extinguisher. A fire on the patient has its own sequence: stop airway gases, remove burning material, extinguish, then care for the patient.

What are the three parts of the Universal Protocol?

Pre-procedure verification, site marking and a time-out immediately before the incision. 'Verify, Mark, Pause' keeps them in order, and anyone on the team can stop the case during the time-out.

Will these CNOR mnemonics still work after the 2027 outline change?

Yes. CCI is consolidating seven subject areas into six from 2027, but emergency management, infection prevention, patient safety and assessment all remain. Mnemonics only help you recall lists, so pair them with scenario practice questions.

Sources

Exam facts come from CCI; clinical content was checked against the references below.

Checked October 3, 2026. Outlines, fees and clinical guidance change — confirm with CCI and your program before test day.