Swift River Med-Surg Exam Questions
and Answers 100% Correct
Carlos Mancia
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx.
r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. Airborne
Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi. Blood-tinged
mucous, productive cough. Diet as tolerated. IV maintenance fluids with D5 1/4 NS @ 150
ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear, concern, and desire for
recovery. Need frequent reminder to stay in room and maintain mask precautions. If
family/visitors come, will need education to airborne precautions. Spanish interpreter
available at extension 61178. Dr. Rondeau - ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Normal
Physiological-
Dysfunctional Gastrointestinal Motility: False
Electrolyte Imbalance: False
Fatigue: True
Impaired Gas Exchange: True
Impaired Mobility: False
Ineffective Airway Clearance: True
Esteem-
Decisional Conflict: False
Noncompliance: True
Safety-
Anxiety: True
,Deficient Knowledge: True
Fall, Risk for: True
Fear: True
Hypothermia: False
Impaired Home Maintenance Management: False
Self-Actualization-
Readiness for Self-Care Enhancement: True
Spiritual Distress: False
Love and Belonging-
Chronic Sorrow: False
Social Isolation, Risk for: True
Mary Barkley
Mary Barkley, 74y/o female has been admitted to your floor with a respiratory infection and
she has tested positive for COVID19. She resides in an assisted living facility which has
seen four deaths related to COVID19. She is exhibiting the same initial signs and symptoms
as the other patients and her primary care provider would like to start aggressively treating
her. She is running a low-grade fever 99.8 and has a sore scratchy throat which is causing
an unproductive cough. She also is complaining of chills, muscle pain and headache. She is
an at-risk patient because of her age. She also suffers from Lupus and is already taking
Hydroxychloroquine, a first-line lupus therapy, but there is no conclusive evidence of its
benefits for coronavirus yet. She is very fearful and is requesting to see her family. She
states that she does not want to die alone. - ANSWER-Educational Needs: Increased
Fall Risk: Normal
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Increased
Physiological-
Acute Pain: True
, ‘Deficient Knowledge: True
Grieving: True
Impaired Comfort: True
Safety:
Infection: True
Jody Rush
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident. She
is in a traction splint, and will be going for surgical repair today. Vital signs are BP 120/62 P
88 R 20 T 98.9 F, 37.2 C, PaO2 99. She has been in a lot of pain, and has been receiving 25
mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her last Fentanyl dose, and
the Dr. Ordered an additional 4mg IVP, Zofran. She has a history of exercise induced
asthma, and uses a rescue inhaler, Albuterol. Her parents are on their way; they are flying in
today. She was on a ski trip with some of her friends from college; her best friend has been
camped out with her. We were able to get her on a bed pan earlier, but it took a lot of work.
We just received an order for a foley catheter. There was some concern that she may have
sustained a head injury as she has an abrasion to her forehead, but she denies ever losing -
ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Increased
Pain Level: Normal
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Mobility, Risk for: True
Nausea: True
Safety-
Deficient Knowledge: True
Grieving: False
Peripheral Neurovascular Dysfunction: False
and Answers 100% Correct
Carlos Mancia
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx.
r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. Airborne
Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi. Blood-tinged
mucous, productive cough. Diet as tolerated. IV maintenance fluids with D5 1/4 NS @ 150
ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear, concern, and desire for
recovery. Need frequent reminder to stay in room and maintain mask precautions. If
family/visitors come, will need education to airborne precautions. Spanish interpreter
available at extension 61178. Dr. Rondeau - ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Normal
Physiological-
Dysfunctional Gastrointestinal Motility: False
Electrolyte Imbalance: False
Fatigue: True
Impaired Gas Exchange: True
Impaired Mobility: False
Ineffective Airway Clearance: True
Esteem-
Decisional Conflict: False
Noncompliance: True
Safety-
Anxiety: True
,Deficient Knowledge: True
Fall, Risk for: True
Fear: True
Hypothermia: False
Impaired Home Maintenance Management: False
Self-Actualization-
Readiness for Self-Care Enhancement: True
Spiritual Distress: False
Love and Belonging-
Chronic Sorrow: False
Social Isolation, Risk for: True
Mary Barkley
Mary Barkley, 74y/o female has been admitted to your floor with a respiratory infection and
she has tested positive for COVID19. She resides in an assisted living facility which has
seen four deaths related to COVID19. She is exhibiting the same initial signs and symptoms
as the other patients and her primary care provider would like to start aggressively treating
her. She is running a low-grade fever 99.8 and has a sore scratchy throat which is causing
an unproductive cough. She also is complaining of chills, muscle pain and headache. She is
an at-risk patient because of her age. She also suffers from Lupus and is already taking
Hydroxychloroquine, a first-line lupus therapy, but there is no conclusive evidence of its
benefits for coronavirus yet. She is very fearful and is requesting to see her family. She
states that she does not want to die alone. - ANSWER-Educational Needs: Increased
Fall Risk: Normal
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Increased
Physiological-
Acute Pain: True
, ‘Deficient Knowledge: True
Grieving: True
Impaired Comfort: True
Safety:
Infection: True
Jody Rush
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident. She
is in a traction splint, and will be going for surgical repair today. Vital signs are BP 120/62 P
88 R 20 T 98.9 F, 37.2 C, PaO2 99. She has been in a lot of pain, and has been receiving 25
mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her last Fentanyl dose, and
the Dr. Ordered an additional 4mg IVP, Zofran. She has a history of exercise induced
asthma, and uses a rescue inhaler, Albuterol. Her parents are on their way; they are flying in
today. She was on a ski trip with some of her friends from college; her best friend has been
camped out with her. We were able to get her on a bed pan earlier, but it took a lot of work.
We just received an order for a foley catheter. There was some concern that she may have
sustained a head injury as she has an abrasion to her forehead, but she denies ever losing -
ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Increased
Pain Level: Normal
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Mobility, Risk for: True
Nausea: True
Safety-
Deficient Knowledge: True
Grieving: False
Peripheral Neurovascular Dysfunction: False
