1
NRNP 6560 Midterm exam 2026
Questions and Answers (100% Correct
Answers) Already Graded A+
Surgery risk classes Ans: Class 1: benefits outweigh risk,
should be done
Class 2a: reasonable to perform
© 2026 Assignment
Class 2b: should be considered
Guru01 - Stuvia
Expert
Class 3: rarely appropriate
General rules for surgery: testing Ans: 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 Ans: - 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
, 2
- Do not start beta-blocker on day of surgery, but may
continue
Assessment of surgical risk Ans: - Unstable cardiac
condition (recent MI, active angina, active HF, uncontrolled
HTN, severe valvular disease), concern with CAD, CHF.
arrhythmia, CVD
- patient stable or unstable?
© 2026 Assignment
- urgency of the procedure (oncology will be time
sensitive)
Guru01 - Stuvia
Expert
- 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 Ans: catarcts
breast biopsy
cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
, 3
intermediate risk surgeries Ans: Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
© 2026 Assignment
Hip/ knee
Guru01 - Stuvia
Hysterectomy
Expert
cholecystectomy
nephrectomy
non majot intrathoracic
High risk surgeries Ans: aortic/ cabg
transplants
spinal reconstruction
peripheral vascular surgery
Lee's revised cardiac risk index Ans: 6 points:
High risk surgery = 1
, 4
CAD = 1
CHF = 1
Cerebrovascular disease = 1
DM 1 on insulin = 1
Creat greater than 2 = 1
© 2026 Assignment
1 = low risk
Guru01 - Stuvia
2 = moderate risk
Expert
3 = high risk
SCIP pre-operative infection measures Ans: - 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 Ans: - pre-op
hair removal (clippers)
- wash hands
- normothermia
NRNP 6560 Midterm exam 2026
Questions and Answers (100% Correct
Answers) Already Graded A+
Surgery risk classes Ans: Class 1: benefits outweigh risk,
should be done
Class 2a: reasonable to perform
© 2026 Assignment
Class 2b: should be considered
Guru01 - Stuvia
Expert
Class 3: rarely appropriate
General rules for surgery: testing Ans: 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 Ans: - 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
, 2
- Do not start beta-blocker on day of surgery, but may
continue
Assessment of surgical risk Ans: - Unstable cardiac
condition (recent MI, active angina, active HF, uncontrolled
HTN, severe valvular disease), concern with CAD, CHF.
arrhythmia, CVD
- patient stable or unstable?
© 2026 Assignment
- urgency of the procedure (oncology will be time
sensitive)
Guru01 - Stuvia
Expert
- 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 Ans: catarcts
breast biopsy
cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
, 3
intermediate risk surgeries Ans: Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
© 2026 Assignment
Hip/ knee
Guru01 - Stuvia
Hysterectomy
Expert
cholecystectomy
nephrectomy
non majot intrathoracic
High risk surgeries Ans: aortic/ cabg
transplants
spinal reconstruction
peripheral vascular surgery
Lee's revised cardiac risk index Ans: 6 points:
High risk surgery = 1
, 4
CAD = 1
CHF = 1
Cerebrovascular disease = 1
DM 1 on insulin = 1
Creat greater than 2 = 1
© 2026 Assignment
1 = low risk
Guru01 - Stuvia
2 = moderate risk
Expert
3 = high risk
SCIP pre-operative infection measures Ans: - 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 Ans: - pre-op
hair removal (clippers)
- wash hands
- normothermia
