nurs572 midterm questions and answers 2025-2026
update
most important part of a pre-op screen - ✔✔ANS h & p
key elements of a good pre-op PE - ✔✔ANS • complete CV exam
• comprehensive pulse assessment
• BP in both arms
• pulm exam
• abd exam
• pacemaker/ICD presence
• PVD presence >> occult CAD?
most important part of pre-op hematology eval - ✔✔ANS med review for anticoagulants
(Hx of bleeding is also important)
surgical stepwise approach - ✔✔ANS 1. determine urgency of procedure
2. evaluate if pt has any active cardiac conditions (major clinical risk)
3. evaluate if pt is undergoing a low risk procedure (<1% M&M)
4. evaluate pt's fxnal capacity
5. if 4 is poor/unknown >> presence of clinical risk factors will determine need for further testing
ASA classification 1 - ✔✔ANS healthy patient
ASA classificiation 2 - ✔✔ANS pt w/ mild systemic disease and no limitations to ADLs
ASA classification 3 - ✔✔ANS pt w/ severe dz that limits ability but does not incapacitate
ASA classification 4 - ✔✔ANS pt w/ incapacitating dz that is a constant threat to life
,ASA classification 5 - ✔✔ANS a moribund pt not expected to survive 24 hrs w/ or w/o the surgery
ASA classification 6 - ✔✔ANS brain dead pt whose organs are being removed for transplant
addition of "E" to any ASA classification - ✔✔ANS emergent
(can be added to any class)
anesthesia is cardio_______ - ✔✔ANS suppressant.
what is the RCRI? - ✔✔ANS relative cardiac risk index
(a multivariate risk indices)
+1 for:
- elevated-risk surgery (intraperitoneal; intrathoracic; suprainguinal)
- Hx of ischemic heart dz
- Hx of CHF
- Hx of cerebrovasc dz
- pre-op Tx w/ insulin
- pre-op Cr >2
POSSUM scoring tool - ✔✔ANS POSSUM for Operative Morbidity and Mortality Risk
- estimates morbidity and mortality for general surgery pts using age, VS, EKG, labs
active cardiac conditions that require eval/Tx prior to non-cardiac surgery - ✔✔ANS valvular disorders:
- AS/MS
- AR/MR
may require hemodynamic monitoring
DM heightens risk for also having: - ✔✔ANS CAD
how long after a cardiac stent should a pt wait for elective surgery? - ✔✔ANS 4-6 weeks
HOCM pts have increased risk for surgery because: - ✔✔ANS they cannot accommodate in drops i
volume
pulmonary dz pre-op optimization - ✔✔ANS - CXR
- PFTs w/ bronchodilator response
, - pre-op bronchodilators/steroids
post-op management includes: - ✔✔ANS - fluids/electrolytes
- pulmonary toilet
- wounds/drains
- DVT/PUD ppx
- pain, n/v
- bleeding
- fever
- infection
- geriatric considerations
during the post-op exam, it is important to evaluate for: - ✔✔ANS • splenomegaly
• hepatomegaly
• petechiae
• ecchymosis
most common post-op arrhythmia - ✔✔ANS afib
goal of treatment for post-op afib - ✔✔ANS rate control
how to tx post-op afib - ✔✔ANS - BB
- CCB
- dig least effective
- amio can convert when rate control is needed, otherwise can flip back into arrhythmia
what is included in post-op pulmonary hygiene? - ✔✔ANS - cough and deep breath q1h
- incentive spirometer q2h
- early mobilization
- pain control
- splinting as needed
should immediate post-op hypokalemia be replaced? - ✔✔ANS NO
(condition is transient - K+ hides in cell during surgery, will correct itself)
exceptions:
- GI losses
update
most important part of a pre-op screen - ✔✔ANS h & p
key elements of a good pre-op PE - ✔✔ANS • complete CV exam
• comprehensive pulse assessment
• BP in both arms
• pulm exam
• abd exam
• pacemaker/ICD presence
• PVD presence >> occult CAD?
most important part of pre-op hematology eval - ✔✔ANS med review for anticoagulants
(Hx of bleeding is also important)
surgical stepwise approach - ✔✔ANS 1. determine urgency of procedure
2. evaluate if pt has any active cardiac conditions (major clinical risk)
3. evaluate if pt is undergoing a low risk procedure (<1% M&M)
4. evaluate pt's fxnal capacity
5. if 4 is poor/unknown >> presence of clinical risk factors will determine need for further testing
ASA classification 1 - ✔✔ANS healthy patient
ASA classificiation 2 - ✔✔ANS pt w/ mild systemic disease and no limitations to ADLs
ASA classification 3 - ✔✔ANS pt w/ severe dz that limits ability but does not incapacitate
ASA classification 4 - ✔✔ANS pt w/ incapacitating dz that is a constant threat to life
,ASA classification 5 - ✔✔ANS a moribund pt not expected to survive 24 hrs w/ or w/o the surgery
ASA classification 6 - ✔✔ANS brain dead pt whose organs are being removed for transplant
addition of "E" to any ASA classification - ✔✔ANS emergent
(can be added to any class)
anesthesia is cardio_______ - ✔✔ANS suppressant.
what is the RCRI? - ✔✔ANS relative cardiac risk index
(a multivariate risk indices)
+1 for:
- elevated-risk surgery (intraperitoneal; intrathoracic; suprainguinal)
- Hx of ischemic heart dz
- Hx of CHF
- Hx of cerebrovasc dz
- pre-op Tx w/ insulin
- pre-op Cr >2
POSSUM scoring tool - ✔✔ANS POSSUM for Operative Morbidity and Mortality Risk
- estimates morbidity and mortality for general surgery pts using age, VS, EKG, labs
active cardiac conditions that require eval/Tx prior to non-cardiac surgery - ✔✔ANS valvular disorders:
- AS/MS
- AR/MR
may require hemodynamic monitoring
DM heightens risk for also having: - ✔✔ANS CAD
how long after a cardiac stent should a pt wait for elective surgery? - ✔✔ANS 4-6 weeks
HOCM pts have increased risk for surgery because: - ✔✔ANS they cannot accommodate in drops i
volume
pulmonary dz pre-op optimization - ✔✔ANS - CXR
- PFTs w/ bronchodilator response
, - pre-op bronchodilators/steroids
post-op management includes: - ✔✔ANS - fluids/electrolytes
- pulmonary toilet
- wounds/drains
- DVT/PUD ppx
- pain, n/v
- bleeding
- fever
- infection
- geriatric considerations
during the post-op exam, it is important to evaluate for: - ✔✔ANS • splenomegaly
• hepatomegaly
• petechiae
• ecchymosis
most common post-op arrhythmia - ✔✔ANS afib
goal of treatment for post-op afib - ✔✔ANS rate control
how to tx post-op afib - ✔✔ANS - BB
- CCB
- dig least effective
- amio can convert when rate control is needed, otherwise can flip back into arrhythmia
what is included in post-op pulmonary hygiene? - ✔✔ANS - cough and deep breath q1h
- incentive spirometer q2h
- early mobilization
- pain control
- splinting as needed
should immediate post-op hypokalemia be replaced? - ✔✔ANS NO
(condition is transient - K+ hides in cell during surgery, will correct itself)
exceptions:
- GI losses
