NURS 334 Exam 1 UPDATED Exam
Questions and CORRECT Answers
Surgery (from a safety perspective) - CORRECT ANSWER - Art and science of treating
diseases, injuries, and deformities by operation and instrumentation
Surgery Performed for: - CORRECT ANSWER - · Diagnosis-biopsy, scope, like colon clean,
obstruction of bronchi, etc.
· Cure- repair of ACL, tear, ligament, appendectomy, etc.
· Palliation- cutting nerve root, like with back, neck pain, or resecting a section inflamed like
ulcerative colitis pt.
· Prevention- potential mastectomy like being positive for BRCA gene and having breast tissue,
removed,
· Exploration- colonoscopy and remove polyp right them and there
· Cosmetic improvement- plastic surgery for looks or for cancerous reasons, scar revision, burns-
medically necessary vs not
Surgical Setting - CORRECT ANSWER - Elective vs Emergency- like having a surgery fit in
schedule vs an emergency that comes in
Inpatient vs outpatient- also called ambulatory care
- Same day admission
Inpatient vs. Ambulatory
-Ambulatory (same day or outpatient)-
Your role in preop - CORRECT ANSWER - · Have knowledge of the nature of the disorder
requiring surgery
· Identify the individual patient's response to the stress of surgery
· Have knowledge of the result of preoperative diagnostic tests
· Identify potential risks and complications associated with surgery- ex: know there is research
that the longer the bone that is fractured the greater risk for blood clot- pt with ankle fracture vs.
femur, immobility, age, etc. increases risk factor
,· Patient interview- need good communication skills, how to relate
o Wrong procedure is called never events, hospitals are required to have doctors have a preop
chat and mark and initial surgical site and if they don't they are not allowed to start procedure
Nursing Assessment: (preop) - CORRECT ANSWER - Determine psychological and
physiological factors that may contribute to risk with surgery
Possible fears - CORRECT ANSWER - Fears:
· Death
· Pain
· Anesthesia- that they have too much or too little
· Mutilation- what the scar will look like, how will it be
· Disruption of life- can't take time off
**Ask pt. if previous surgery if haven't they don't know what to relate it with, fear is real, think
about perception and understanding, knowledge level, what do older people do that have a
hearing deficit- shake the head yes when they don't understand, ask them to tell you what they
understand of what will happen today, if anxious or nervous info goes over them, sometimes
have a follow up call because they forget or are too nervous to ask**
Additional nursing assessment questions - CORRECT ANSWER - Additional nursing
assessment: allergies
· Current medications
o Prescription and over the counter (OTC)
o Herbs
o Vitamins
o Recreational
§ Drugs
§ Alcohol
§ Tobacco
o Health Hx
,o Ask them to bring it all in and be detailed with questions, St. johns' horn, vitamin E, fish oil,
garlic, known for thinning blood, inceds have anti platelet, sometimes recommend Tylenol for
inceds before procedure instead,
Health Hx (preop) - CORRECT ANSWER - · Diagnosed medical conditions
· Previous surgeries and problems
· Menstrual/obstetric history
· Familial diseases/Conditions
· Reactions/problems to anesthesia (patient or family)
-Allergies (drug and non-drug)
- Tape allergy
Latex allergy
Review of systems: Cardiovascular function - CORRECT ANSWER - know if Hx of HTN,
MI, CHF, heart attack, etc
Respiratory System - CORRECT ANSWER - - do they have a Hx of pneumonia, upper resp
infection, spasm,- affect airway preop and post op, Increased risk for laryngospasm,
bronchospasm, SOB, chronic cough
Nervous System - CORRECT ANSWER - -Evaluation of neurologic functioning, do they
have deficits,
May be affected by vision or hearing loss
-Evaluation of neurological functioning, fine motor skills, gross motor skills
Urinary System - CORRECT ANSWER - -make sure they can void, Hx of renal disease (for
older pt do baseline of renal test)
-Hx of frequent UTI, risk for fluid and electrolyte imbalance
, Integumentary System - CORRECT ANSWER - are they at risk for skin breakdown/had
issues with that?
-Risk for skin breakdown, weight, activity
Musculoskeletal System - CORRECT ANSWER - - have they had Fx, Hx of osteoporosis,
etc.
GI - CORRECT ANSWER - hx of constipation, GI motility concerns
Endocrine System - CORRECT ANSWER - If diabetic will watch blood glucose levels, are
they on insulin, Type 1 or 2 if diabetic
Immune System - CORRECT ANSWER - -Compromised = Increased risk for infection, as pt.
age the immune system is less effected, worry about elderly during flu, influenza, covid, some
meds can suppress immune system
-Compromised patients have an increased risk for infection and wound healing
Fluid and Electrolyte Status - CORRECT ANSWER - NPO (nothing by mouth) before
surgery, shortened time of NPO now used to be 12 nothing after midnight hours now 4-5, keep
hydrated
Depending on age some may have more lab work than others,
Obesity in relation to surgery - CORRECT ANSWER - Over 2/3 of US adults are overweight
or obese (BMI > 25)
1/3 of adults age 20 and above are obese (BMI > 30)
Children-estimated 16.9% of children and adolescents aged 2-19 years are obese
Stresses cardiac and pulmonary systems
Can predict who will have tougher airway
Nutritional status R/T surgery
Questions and CORRECT Answers
Surgery (from a safety perspective) - CORRECT ANSWER - Art and science of treating
diseases, injuries, and deformities by operation and instrumentation
Surgery Performed for: - CORRECT ANSWER - · Diagnosis-biopsy, scope, like colon clean,
obstruction of bronchi, etc.
· Cure- repair of ACL, tear, ligament, appendectomy, etc.
· Palliation- cutting nerve root, like with back, neck pain, or resecting a section inflamed like
ulcerative colitis pt.
· Prevention- potential mastectomy like being positive for BRCA gene and having breast tissue,
removed,
· Exploration- colonoscopy and remove polyp right them and there
· Cosmetic improvement- plastic surgery for looks or for cancerous reasons, scar revision, burns-
medically necessary vs not
Surgical Setting - CORRECT ANSWER - Elective vs Emergency- like having a surgery fit in
schedule vs an emergency that comes in
Inpatient vs outpatient- also called ambulatory care
- Same day admission
Inpatient vs. Ambulatory
-Ambulatory (same day or outpatient)-
Your role in preop - CORRECT ANSWER - · Have knowledge of the nature of the disorder
requiring surgery
· Identify the individual patient's response to the stress of surgery
· Have knowledge of the result of preoperative diagnostic tests
· Identify potential risks and complications associated with surgery- ex: know there is research
that the longer the bone that is fractured the greater risk for blood clot- pt with ankle fracture vs.
femur, immobility, age, etc. increases risk factor
,· Patient interview- need good communication skills, how to relate
o Wrong procedure is called never events, hospitals are required to have doctors have a preop
chat and mark and initial surgical site and if they don't they are not allowed to start procedure
Nursing Assessment: (preop) - CORRECT ANSWER - Determine psychological and
physiological factors that may contribute to risk with surgery
Possible fears - CORRECT ANSWER - Fears:
· Death
· Pain
· Anesthesia- that they have too much or too little
· Mutilation- what the scar will look like, how will it be
· Disruption of life- can't take time off
**Ask pt. if previous surgery if haven't they don't know what to relate it with, fear is real, think
about perception and understanding, knowledge level, what do older people do that have a
hearing deficit- shake the head yes when they don't understand, ask them to tell you what they
understand of what will happen today, if anxious or nervous info goes over them, sometimes
have a follow up call because they forget or are too nervous to ask**
Additional nursing assessment questions - CORRECT ANSWER - Additional nursing
assessment: allergies
· Current medications
o Prescription and over the counter (OTC)
o Herbs
o Vitamins
o Recreational
§ Drugs
§ Alcohol
§ Tobacco
o Health Hx
,o Ask them to bring it all in and be detailed with questions, St. johns' horn, vitamin E, fish oil,
garlic, known for thinning blood, inceds have anti platelet, sometimes recommend Tylenol for
inceds before procedure instead,
Health Hx (preop) - CORRECT ANSWER - · Diagnosed medical conditions
· Previous surgeries and problems
· Menstrual/obstetric history
· Familial diseases/Conditions
· Reactions/problems to anesthesia (patient or family)
-Allergies (drug and non-drug)
- Tape allergy
Latex allergy
Review of systems: Cardiovascular function - CORRECT ANSWER - know if Hx of HTN,
MI, CHF, heart attack, etc
Respiratory System - CORRECT ANSWER - - do they have a Hx of pneumonia, upper resp
infection, spasm,- affect airway preop and post op, Increased risk for laryngospasm,
bronchospasm, SOB, chronic cough
Nervous System - CORRECT ANSWER - -Evaluation of neurologic functioning, do they
have deficits,
May be affected by vision or hearing loss
-Evaluation of neurological functioning, fine motor skills, gross motor skills
Urinary System - CORRECT ANSWER - -make sure they can void, Hx of renal disease (for
older pt do baseline of renal test)
-Hx of frequent UTI, risk for fluid and electrolyte imbalance
, Integumentary System - CORRECT ANSWER - are they at risk for skin breakdown/had
issues with that?
-Risk for skin breakdown, weight, activity
Musculoskeletal System - CORRECT ANSWER - - have they had Fx, Hx of osteoporosis,
etc.
GI - CORRECT ANSWER - hx of constipation, GI motility concerns
Endocrine System - CORRECT ANSWER - If diabetic will watch blood glucose levels, are
they on insulin, Type 1 or 2 if diabetic
Immune System - CORRECT ANSWER - -Compromised = Increased risk for infection, as pt.
age the immune system is less effected, worry about elderly during flu, influenza, covid, some
meds can suppress immune system
-Compromised patients have an increased risk for infection and wound healing
Fluid and Electrolyte Status - CORRECT ANSWER - NPO (nothing by mouth) before
surgery, shortened time of NPO now used to be 12 nothing after midnight hours now 4-5, keep
hydrated
Depending on age some may have more lab work than others,
Obesity in relation to surgery - CORRECT ANSWER - Over 2/3 of US adults are overweight
or obese (BMI > 25)
1/3 of adults age 20 and above are obese (BMI > 30)
Children-estimated 16.9% of children and adolescents aged 2-19 years are obese
Stresses cardiac and pulmonary systems
Can predict who will have tougher airway
Nutritional status R/T surgery
