NRNP 6560 MIDTERM EXAM |2025-2026 LATEST UPDATED |REAL
EXAM AND COMPLETE QUESTIONS AND ANSWERS | 100% RATED
CORRECT | 100% VERFIED | ALREADY GRADED A+
Surgery risk classes - (answer)Class 1: benefits outweigh risk, should be done
Class 2a: reasonable to perform
Class 2b: should be considered
Class 3: rarely appropriate
General rules for surgery: testing - (answer)ECG before surgery only if coronary disease, except
when low risk surgery
Stress test not indicated before surgery
Do not do prophylactic coronary revascularization
Meds before surgery - (answer)- Diabetic agents: Use insulin therapy to maintain glycemic
goals(iii) Discontinue biguanides, alpha glucosidase inhibitors, thiazolidinediones, sulfonylureas,
and GLP-1 agonists
- Do not start aspirin before 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
Assessment of surgical risk - (answer)- 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 be time sensitive)
- risk of procedure
- nutritional status
- immune competence
- determine functional capacity (need to be more than 4 METS, more than 10 METs makes low
risk)
Low risk surgeries - (answer)catarcts
breast biopsy
cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
,intermediate risk surgeries - (answer)Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
High risk surgeries - (answer)aortic/ cabg
transplants
spinal reconstruction
peripheral vascular surgery
Lee's revised cardiac risk index - (answer)6 points:
High risk surgery = 1
, CAD = 1
CHF = 1
Cerebrovascular disease = 1
DM 1 on insulin = 1
Creat greater than 2 = 1
1 = low risk
2 = moderate risk
3 = high risk
SCIP pre-operative infection measures - (answer)- Prophylactic antibiotics should be received
within 1 h prior to surgical incision
- be selected for activity against the most probable antimicrobial contaminants
- be discontinued within 24 h after the surgery end-time
Postoperative infection reduction methods - (answer)- pre-op hair removal (clippers)
- wash hands
- normothermia
- maintain euglycemia
EXAM AND COMPLETE QUESTIONS AND ANSWERS | 100% RATED
CORRECT | 100% VERFIED | ALREADY GRADED A+
Surgery risk classes - (answer)Class 1: benefits outweigh risk, should be done
Class 2a: reasonable to perform
Class 2b: should be considered
Class 3: rarely appropriate
General rules for surgery: testing - (answer)ECG before surgery only if coronary disease, except
when low risk surgery
Stress test not indicated before surgery
Do not do prophylactic coronary revascularization
Meds before surgery - (answer)- Diabetic agents: Use insulin therapy to maintain glycemic
goals(iii) Discontinue biguanides, alpha glucosidase inhibitors, thiazolidinediones, sulfonylureas,
and GLP-1 agonists
- Do not start aspirin before 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
Assessment of surgical risk - (answer)- 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 be time sensitive)
- risk of procedure
- nutritional status
- immune competence
- determine functional capacity (need to be more than 4 METS, more than 10 METs makes low
risk)
Low risk surgeries - (answer)catarcts
breast biopsy
cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
,intermediate risk surgeries - (answer)Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
High risk surgeries - (answer)aortic/ cabg
transplants
spinal reconstruction
peripheral vascular surgery
Lee's revised cardiac risk index - (answer)6 points:
High risk surgery = 1
, CAD = 1
CHF = 1
Cerebrovascular disease = 1
DM 1 on insulin = 1
Creat greater than 2 = 1
1 = low risk
2 = moderate risk
3 = high risk
SCIP pre-operative infection measures - (answer)- Prophylactic antibiotics should be received
within 1 h prior to surgical incision
- be selected for activity against the most probable antimicrobial contaminants
- be discontinued within 24 h after the surgery end-time
Postoperative infection reduction methods - (answer)- pre-op hair removal (clippers)
- wash hands
- normothermia
- maintain euglycemia
