NURS 6560 MIDTERM EXAM 2 LATEST
VERSIONS (VERSION A & B) 2024-2025
ACTUAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES
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Terms in this set (196)
Class 1: benefits outweigh risk, should be
done
Surgery risk classes Class 2a: reasonable to perform
Class 2b: should be considered
Class 3: rarely appropriate
ECG before surgery only if coronary
disease, except when low risk surgery
General rules for
Stress test not indicated before surgery
surgery: testing
Do not do prophylactic coronary
revascularization
, - Diabetic agents: Use insulin therapy to
maintain glycemic goals(iii) Discontinue
biguanides, alpha glucosidase inhibitors,
thiazolidinediones, sulfonylureas, and
GLP-1 agonists
Meds before
- Do not start aspirin before surgery
surgery
- Stop Warfarin 5 days before surgery.
May be bridged with Lovenox.
- Do not stop statin before surgery
- Do not start beta-blocker on day of
surgery, but may continue
- Unstable cardiac condition (recent MI,
active angina, active HF, uncontrolled
HTN, severe valvular disease), concern
with CAD, CHF. arrhythmia, CVD
- patient stable or unstable?
- urgency of the procedure (oncology will
Assessment of
be time sensitive)
surgical risk
- risk of procedure
- nutritional status
- immune competence
- determine functional capacity (need to
be more than 4 METS, more than 10 METs
makes low risk)
catarcts
breast biopsy
Low risk surgeries cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
, Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
intermediate risk Laminectomy
surgeries Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
aortic/ cabg
transplants
High risk surgeries
spinal reconstruction
peripheral vascular surgery
6 points:
High risk surgery = 1
CAD = 1
CHF = 1
Cerebrovascular disease = 1
Lee's revised
DM 1 on insulin = 1
cardiac risk index
Creat greater than 2 = 1
1 = low risk
2 = moderate risk
3 = high risk
, - Prophylactic antibiotics should be
received within 1 h prior to surgical
incision
SCIP pre-operative
- be selected for activity against the most
infection measures
probable antimicrobial contaminants
- be discontinued within 24 h after the
surgery end-time
- pre-op hair removal (clippers)
- wash hands
Postoperative
- normothermia
infection reduction
- maintain euglycemia
methods
- urinary catheters are to be removed
within the first two postoperative days
Slow destruction of bones/ joint followed
by production of replacement collagen
which causes inflammatory changes
- older than 60
- more female after 55
Osteoarthritis: what, - more black than white women
incidence - men and women equal risk between 45 -
55
- abnormal height or weight (obesity)
- repetitive movement
- prior trauma (sprains/ dislocations)
- diabetic neuropathy
- genetic
VERSIONS (VERSION A & B) 2024-2025
ACTUAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES
Leave the first rating
Save
Terms in this set (196)
Class 1: benefits outweigh risk, should be
done
Surgery risk classes Class 2a: reasonable to perform
Class 2b: should be considered
Class 3: rarely appropriate
ECG before surgery only if coronary
disease, except when low risk surgery
General rules for
Stress test not indicated before surgery
surgery: testing
Do not do prophylactic coronary
revascularization
, - Diabetic agents: Use insulin therapy to
maintain glycemic goals(iii) Discontinue
biguanides, alpha glucosidase inhibitors,
thiazolidinediones, sulfonylureas, and
GLP-1 agonists
Meds before
- Do not start aspirin before surgery
surgery
- Stop Warfarin 5 days before surgery.
May be bridged with Lovenox.
- Do not stop statin before surgery
- Do not start beta-blocker on day of
surgery, but may continue
- Unstable cardiac condition (recent MI,
active angina, active HF, uncontrolled
HTN, severe valvular disease), concern
with CAD, CHF. arrhythmia, CVD
- patient stable or unstable?
- urgency of the procedure (oncology will
Assessment of
be time sensitive)
surgical risk
- risk of procedure
- nutritional status
- immune competence
- determine functional capacity (need to
be more than 4 METS, more than 10 METs
makes low risk)
catarcts
breast biopsy
Low risk surgeries cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
, Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
intermediate risk Laminectomy
surgeries Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
aortic/ cabg
transplants
High risk surgeries
spinal reconstruction
peripheral vascular surgery
6 points:
High risk surgery = 1
CAD = 1
CHF = 1
Cerebrovascular disease = 1
Lee's revised
DM 1 on insulin = 1
cardiac risk index
Creat greater than 2 = 1
1 = low risk
2 = moderate risk
3 = high risk
, - Prophylactic antibiotics should be
received within 1 h prior to surgical
incision
SCIP pre-operative
- be selected for activity against the most
infection measures
probable antimicrobial contaminants
- be discontinued within 24 h after the
surgery end-time
- pre-op hair removal (clippers)
- wash hands
Postoperative
- normothermia
infection reduction
- maintain euglycemia
methods
- urinary catheters are to be removed
within the first two postoperative days
Slow destruction of bones/ joint followed
by production of replacement collagen
which causes inflammatory changes
- older than 60
- more female after 55
Osteoarthritis: what, - more black than white women
incidence - men and women equal risk between 45 -
55
- abnormal height or weight (obesity)
- repetitive movement
- prior trauma (sprains/ dislocations)
- diabetic neuropathy
- genetic
