SWIFT RIVER MEDICAL SURGICAL STUDY EXAM
GUIDE QUESTIONS AND ANSWERS SURE A+
Ramona Stukes, 69 yr-old, third day post-op cholecystectomy. Non-significant past
✔✔Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No
known allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%,
alert and cooperative. Wound site clean, dry and intact NPO, NG-tube to low continuous
suction. IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm.
Ambulates with minimal assistance. Family at beside. Dr. Sangerstien - ✔✔Educational
Needs Increased acuity
Fall Risk Increased Acuity
Health Change Increased Acuity
Pain Level Increased Acuity
Psychological Needs Normal Acuity
Sensorium Normal Acuity
✔✔Estelle Hatcher - ✔✔Physiological
Activity Intolerance False
Acute Pain True
Diarrhea False
Electrolyte Imbalance, Risk for True
Impaired Comfort True
Impaired Mobility False
Safety
Deficient Knowledge True
Fall, Risk for True
Fear False
Ineffective Self-Health Management False
Infection, Risk for True
,Sleep Deprivation False
✔✔Estelle Hatcher
Senario 1
Ms. Hatcher is second day post-op and has a nasogastric tube set to gravity drainage
only. She presses call light with questions about who her nurse will be and her NG-tube.
Senario 2
During the follow up nursing assessment, Ms. Hatcher complains about the nasogastric
tube causing her pain in her nasal area. She has active bowel sounds.
Senario 3
Dr. Brown gives orders to remove nasogastric tube set to gravity and to begin a clear
liquid diet.
Senario 4
Mrs. Hatcher appears restless, diaphoretic and calls nurse for help. Upon entering
room, what order of appropriate steps do you take?
Senario 5
Several hours later, Mrs. Hatcher is feeling much better. She puts on her call light and
asks to see a nurse. Upon entering the room, she asks you if she will be able to drive
when she gets home tomorrow. - ✔✔Senario 1
Introduce Yourself/Identify Patient
Full Assessment
Educate Patient
Evaluate Understanding
Provide Comfort
Senario 2
Wash/Glove Hands
Inspect Pain Location
Check Proper Positioning
Verify Call Light/Bed Safety precautions
Notify Doctor (for possible Removal)
Senario 3
Educate patient of procedure
Evaluate Understanding
Remove NG-Tube
Administer Diet Order
Document Results
Senario 4
, Wash/Glove hands
full assessment
encourage incentive spirometry
Verify call light/bed safety precautions
Document Results
Senario 5
Use therapeutic communication/active listening
Educate patient
Evaluate Understanding
Verify call light.bed safety
Document results
✔✔Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Vital
sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. Normal Sinus Rhythm on
telemetry. Alert and cooperative. No weight bearing today. Skin warm and dry, may sit
up on edge of bed today. Needs frequent reminding due to determination to do things
herself without assistance. Wound clean dry and intact. Regular diet. Dr. Starks -
✔✔Educational Needs Increased acuity
Fall Risk Increased acuity
Health Change Increased acuity
Pain Level Increased acuity
Psychological Needs Normal acuity
Sensorium Normal acuity
✔✔Viola Cumble - ✔✔Physiological
Acute Pain True
Bleeding, Risk for True
Constipation False
Impaired Mobility True
Impaired Skin Integrity, False
Ineffective Peripheral Tissue Perfusion False
Safety
Acute Confusion False
Deficient Knowledge False
Fall, Risk for True
Ineffective Self-Health Management True
Infection, Risk for True
Peripheral Neurovascular Dysfunction False
✔✔Viola Cumble
GUIDE QUESTIONS AND ANSWERS SURE A+
Ramona Stukes, 69 yr-old, third day post-op cholecystectomy. Non-significant past
✔✔Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No
known allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%,
alert and cooperative. Wound site clean, dry and intact NPO, NG-tube to low continuous
suction. IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm.
Ambulates with minimal assistance. Family at beside. Dr. Sangerstien - ✔✔Educational
Needs Increased acuity
Fall Risk Increased Acuity
Health Change Increased Acuity
Pain Level Increased Acuity
Psychological Needs Normal Acuity
Sensorium Normal Acuity
✔✔Estelle Hatcher - ✔✔Physiological
Activity Intolerance False
Acute Pain True
Diarrhea False
Electrolyte Imbalance, Risk for True
Impaired Comfort True
Impaired Mobility False
Safety
Deficient Knowledge True
Fall, Risk for True
Fear False
Ineffective Self-Health Management False
Infection, Risk for True
,Sleep Deprivation False
✔✔Estelle Hatcher
Senario 1
Ms. Hatcher is second day post-op and has a nasogastric tube set to gravity drainage
only. She presses call light with questions about who her nurse will be and her NG-tube.
Senario 2
During the follow up nursing assessment, Ms. Hatcher complains about the nasogastric
tube causing her pain in her nasal area. She has active bowel sounds.
Senario 3
Dr. Brown gives orders to remove nasogastric tube set to gravity and to begin a clear
liquid diet.
Senario 4
Mrs. Hatcher appears restless, diaphoretic and calls nurse for help. Upon entering
room, what order of appropriate steps do you take?
Senario 5
Several hours later, Mrs. Hatcher is feeling much better. She puts on her call light and
asks to see a nurse. Upon entering the room, she asks you if she will be able to drive
when she gets home tomorrow. - ✔✔Senario 1
Introduce Yourself/Identify Patient
Full Assessment
Educate Patient
Evaluate Understanding
Provide Comfort
Senario 2
Wash/Glove Hands
Inspect Pain Location
Check Proper Positioning
Verify Call Light/Bed Safety precautions
Notify Doctor (for possible Removal)
Senario 3
Educate patient of procedure
Evaluate Understanding
Remove NG-Tube
Administer Diet Order
Document Results
Senario 4
, Wash/Glove hands
full assessment
encourage incentive spirometry
Verify call light/bed safety precautions
Document Results
Senario 5
Use therapeutic communication/active listening
Educate patient
Evaluate Understanding
Verify call light.bed safety
Document results
✔✔Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Vital
sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. Normal Sinus Rhythm on
telemetry. Alert and cooperative. No weight bearing today. Skin warm and dry, may sit
up on edge of bed today. Needs frequent reminding due to determination to do things
herself without assistance. Wound clean dry and intact. Regular diet. Dr. Starks -
✔✔Educational Needs Increased acuity
Fall Risk Increased acuity
Health Change Increased acuity
Pain Level Increased acuity
Psychological Needs Normal acuity
Sensorium Normal acuity
✔✔Viola Cumble - ✔✔Physiological
Acute Pain True
Bleeding, Risk for True
Constipation False
Impaired Mobility True
Impaired Skin Integrity, False
Ineffective Peripheral Tissue Perfusion False
Safety
Acute Confusion False
Deficient Knowledge False
Fall, Risk for True
Ineffective Self-Health Management True
Infection, Risk for True
Peripheral Neurovascular Dysfunction False
✔✔Viola Cumble
