PROFESSIONAL PRACTICE MATERIALS
NRNP 6560 Midterm exam
190+ (2026) Exam Kit | Verified Q&A with Rationales
Verified Answers Exam Ready With Rationales 196 Questions
DOCUMENT OVERVIEW
This document, "NRNP 6560 Midterm exam," covers surgical risk classes, general rules for
surgery, medications before surgery, assessment of surgical risk, and specific low and
intermediate risk surgeries, as well as complications and indications for liver and lung
transplantation. The 196 questions with correct answers and detailed explanations provide a
comprehensive review of surgical concepts for exam preparation. Students can use this
document to study, review, and understand surgical concepts, leveraging the provided
explanations to reinforce their knowledge and improve retention.
EXAM QUESTIONS
Q1.
Surgery risk classes
CORRECT ANSWER
Class 1: benefits outweigh risk, should be done
Class 2a: reasonable to perform
Class 2b: should be considered
Class 3: rarely appropriate
, RATIONALE
These surgery risk classes represent a systematic approach to evaluating the trade-off between
potential benefits and risks of surgical procedures, allowing clinicians to make informed decisions.
By using a tiered system, healthcare professionals can objectively assess the likelihood of success
and potential complications for each procedure, enabling them to prioritize care and manage patient
expectations accordingly.
Q2.
General rules for surgery: testing
CORRECT 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
RATIONALE
This answer reflects current medical guidelines emphasizing the judicious use of preoperative
testing to avoid unnecessary delays and costs, reserving invasive testing for patients with
established coronary disease undergoing high-risk surgery. By limiting testing to those with known
coronary disease and low-risk surgery, healthcare providers can minimize the potential risks and
complications associated with unnecessary medical procedures.
Q3.
Meds before surgery
CORRECT 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
, RATIONALE
This set of instructions prioritizes patient safety and optimal outcomes during surgery by adjusting
medications that may increase bleeding risk, interfere with surgical procedures, or cause
hypoglycemia. By stopping or modifying these medications, healthcare providers can minimize
complications and ensure a stable patient condition before, during, and after surgery.
Q4.
Assessment of surgical risk
CORRECT 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)
RATIONALE
This correct answer assesses surgical risk by evaluating various patient factors that can impact the
outcome of a surgical procedure, including the patient's cardiac health, overall stability, and
functional capacity, which are critical considerations in determining the likelihood of successful
recovery. The specific factors evaluated, such as unstable cardiac conditions and nutritional status,
help to stratify patients into different risk categories, enabling healthcare providers to make
informed decisions about the timing and feasibility of the procedure.
Q5.
Low risk surgeries
CORRECT ANSWER
, catarcts
breast biopsy
cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
RATIONALE
These surgeries are considered low-risk due to their relatively minor and localized nature, typically
involving small incisions and minimal disruption to surrounding tissues, which reduces the likelihood
of complications. Additionally, they often involve outpatient procedures, less anesthesia, and
shorter recovery times, contributing to their classification as low-risk surgeries.
Q6.
intermediate risk surgeries
CORRECT ANSWER
Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
RATIONALE
These surgeries are classified as intermediate risk because they carry a moderate level of
perioperative morbidity and mortality, often requiring careful patient selection, preoperative
optimization, and postoperative monitoring to minimize complications and ensure optimal
outcomes. Intermediate risk surgeries typically involve complex anatomical structures and organ
NRNP 6560 Midterm exam
190+ (2026) Exam Kit | Verified Q&A with Rationales
Verified Answers Exam Ready With Rationales 196 Questions
DOCUMENT OVERVIEW
This document, "NRNP 6560 Midterm exam," covers surgical risk classes, general rules for
surgery, medications before surgery, assessment of surgical risk, and specific low and
intermediate risk surgeries, as well as complications and indications for liver and lung
transplantation. The 196 questions with correct answers and detailed explanations provide a
comprehensive review of surgical concepts for exam preparation. Students can use this
document to study, review, and understand surgical concepts, leveraging the provided
explanations to reinforce their knowledge and improve retention.
EXAM QUESTIONS
Q1.
Surgery risk classes
CORRECT ANSWER
Class 1: benefits outweigh risk, should be done
Class 2a: reasonable to perform
Class 2b: should be considered
Class 3: rarely appropriate
, RATIONALE
These surgery risk classes represent a systematic approach to evaluating the trade-off between
potential benefits and risks of surgical procedures, allowing clinicians to make informed decisions.
By using a tiered system, healthcare professionals can objectively assess the likelihood of success
and potential complications for each procedure, enabling them to prioritize care and manage patient
expectations accordingly.
Q2.
General rules for surgery: testing
CORRECT 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
RATIONALE
This answer reflects current medical guidelines emphasizing the judicious use of preoperative
testing to avoid unnecessary delays and costs, reserving invasive testing for patients with
established coronary disease undergoing high-risk surgery. By limiting testing to those with known
coronary disease and low-risk surgery, healthcare providers can minimize the potential risks and
complications associated with unnecessary medical procedures.
Q3.
Meds before surgery
CORRECT 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
, RATIONALE
This set of instructions prioritizes patient safety and optimal outcomes during surgery by adjusting
medications that may increase bleeding risk, interfere with surgical procedures, or cause
hypoglycemia. By stopping or modifying these medications, healthcare providers can minimize
complications and ensure a stable patient condition before, during, and after surgery.
Q4.
Assessment of surgical risk
CORRECT 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)
RATIONALE
This correct answer assesses surgical risk by evaluating various patient factors that can impact the
outcome of a surgical procedure, including the patient's cardiac health, overall stability, and
functional capacity, which are critical considerations in determining the likelihood of successful
recovery. The specific factors evaluated, such as unstable cardiac conditions and nutritional status,
help to stratify patients into different risk categories, enabling healthcare providers to make
informed decisions about the timing and feasibility of the procedure.
Q5.
Low risk surgeries
CORRECT ANSWER
, catarcts
breast biopsy
cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
RATIONALE
These surgeries are considered low-risk due to their relatively minor and localized nature, typically
involving small incisions and minimal disruption to surrounding tissues, which reduces the likelihood
of complications. Additionally, they often involve outpatient procedures, less anesthesia, and
shorter recovery times, contributing to their classification as low-risk surgeries.
Q6.
intermediate risk surgeries
CORRECT ANSWER
Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
RATIONALE
These surgeries are classified as intermediate risk because they carry a moderate level of
perioperative morbidity and mortality, often requiring careful patient selection, preoperative
optimization, and postoperative monitoring to minimize complications and ensure optimal
outcomes. Intermediate risk surgeries typically involve complex anatomical structures and organ
