NURSING NUR 108 FINAL EXAM 2026
CERTIFICATION STUDY PACK
◉ Identify the teaching need for the use of postoperative pain
medications. Answer: 1. Opioid analgesic agents:
~Commonly prescribed for pain and immediate postoperative
restlessness
~Taken on a schedule (ex: Q6hrs)
2. PCA pumps:
~Pt can push a button every hour to administer pain meds
~Maintains therapeutic drug levels
3. Epidural infusions:
~Used with caution in chest procedures (may affect respiration)
**For all postop pain meds, advise the patient to stand up slowly and
walk with someone to prevent falls (pt may experience dizziness)
◉ Identify the client safety precautions in the preoperative area.
Answer: 1. Have all pts in a hospital gown
2. Remove jewelry/any metal
,3. Tie all long hair back
4. Remove dentures/plates, glasses, any prosthetic devices
5. Have all pts void before going to the OR
6. If preanesthetic medication is given, raise all side rails and
prevent patient from standing/walking alone
7. Assess for medication reactions
8. Assist in verifying patient ID, surgical procedure, and surgical site
**#1: prevent patient from injury!!
◉ Identify the gerontologic considerations related to surgery.
Answer: ~Decreased perspiration leads to dry itchy skin that can
become fragile. Health care providers need to take precautions when
moving an older adult. ~Decreased subcutaneous fat makes older
adults more susceptible to temperature changes. Pt may c/o feeling
cold
The elderly have...
~Less physiologic reserve (the ability for an organ to return to
normal after a disturbance)
~Lower cardiac reserves
~Depressed renal and hepatic function
~Reduced GI function
,**All of these play a role in how the elderly remain stable throughout
surgery and recovery
◉ Identify the nursing considerations related to a surgical client
who is NPO. Answer: Food/drinking fluids are usually withheld to
prevent aspiration during and after surgery
~Normally, restrictions begin 12-24hrs before surgery
~Now, some healthy patients/depending on the procedure, clear
liquids are allowed up to 2hrs before surgery
~If the patient is NPO, they usually are still allowed a sip of water to
take w/ oral meds
◉ Differentiate the post op assessment findings associated with
shock. Answer: Types of shock:
1. Hypovolemic (most common)
~S&S= pallor, cool, moist skin, rapid breathing, cyanosis of the
lips/gums/tongue, rapid/weak pulse, narrowing pulse pressure, low
BP**, concentrated urine
*Primary intervention= volume replacement
2. Cardiogenic
~Heart is unable to pump enough oxygen rich blood to the body
organs
, 3. Neurogenic
~State resulting from loss of sympathetic tone causing hypovolemia
4. Anaphylactic
~Allergic reaction causing acute system vasodilation and
hypovolemia
5. Septic
~Subset of sepsis
~Circulatory/cellular metabolism abnormalities profound enough to
increase mortality
***
*Early phase S&S~ feelings of impending doom, decreased cardiac
output, vascular resistance, labored breathing, pt reports "feeling
cold", tinnitus
*Labs= sharp drop in hemoglobin, hematocrit levels
◉ Describe the purpose of pre-admission testing. Answer: The main
purpose of pre-admission testing is to insure that the patients do not
have any contraindications for surgery
CERTIFICATION STUDY PACK
◉ Identify the teaching need for the use of postoperative pain
medications. Answer: 1. Opioid analgesic agents:
~Commonly prescribed for pain and immediate postoperative
restlessness
~Taken on a schedule (ex: Q6hrs)
2. PCA pumps:
~Pt can push a button every hour to administer pain meds
~Maintains therapeutic drug levels
3. Epidural infusions:
~Used with caution in chest procedures (may affect respiration)
**For all postop pain meds, advise the patient to stand up slowly and
walk with someone to prevent falls (pt may experience dizziness)
◉ Identify the client safety precautions in the preoperative area.
Answer: 1. Have all pts in a hospital gown
2. Remove jewelry/any metal
,3. Tie all long hair back
4. Remove dentures/plates, glasses, any prosthetic devices
5. Have all pts void before going to the OR
6. If preanesthetic medication is given, raise all side rails and
prevent patient from standing/walking alone
7. Assess for medication reactions
8. Assist in verifying patient ID, surgical procedure, and surgical site
**#1: prevent patient from injury!!
◉ Identify the gerontologic considerations related to surgery.
Answer: ~Decreased perspiration leads to dry itchy skin that can
become fragile. Health care providers need to take precautions when
moving an older adult. ~Decreased subcutaneous fat makes older
adults more susceptible to temperature changes. Pt may c/o feeling
cold
The elderly have...
~Less physiologic reserve (the ability for an organ to return to
normal after a disturbance)
~Lower cardiac reserves
~Depressed renal and hepatic function
~Reduced GI function
,**All of these play a role in how the elderly remain stable throughout
surgery and recovery
◉ Identify the nursing considerations related to a surgical client
who is NPO. Answer: Food/drinking fluids are usually withheld to
prevent aspiration during and after surgery
~Normally, restrictions begin 12-24hrs before surgery
~Now, some healthy patients/depending on the procedure, clear
liquids are allowed up to 2hrs before surgery
~If the patient is NPO, they usually are still allowed a sip of water to
take w/ oral meds
◉ Differentiate the post op assessment findings associated with
shock. Answer: Types of shock:
1. Hypovolemic (most common)
~S&S= pallor, cool, moist skin, rapid breathing, cyanosis of the
lips/gums/tongue, rapid/weak pulse, narrowing pulse pressure, low
BP**, concentrated urine
*Primary intervention= volume replacement
2. Cardiogenic
~Heart is unable to pump enough oxygen rich blood to the body
organs
, 3. Neurogenic
~State resulting from loss of sympathetic tone causing hypovolemia
4. Anaphylactic
~Allergic reaction causing acute system vasodilation and
hypovolemia
5. Septic
~Subset of sepsis
~Circulatory/cellular metabolism abnormalities profound enough to
increase mortality
***
*Early phase S&S~ feelings of impending doom, decreased cardiac
output, vascular resistance, labored breathing, pt reports "feeling
cold", tinnitus
*Labs= sharp drop in hemoglobin, hematocrit levels
◉ Describe the purpose of pre-admission testing. Answer: The main
purpose of pre-admission testing is to insure that the patients do not
have any contraindications for surgery
