Swift River Exam Newest Version Practice Exam Questions With Correct Detailed Answer (A+ Solution Guide)

Swift River Exam Newest Version Practice Exam Questions With Correct Detailed Answer (A+ Solution Guide) JOYCE WORKMAN REPORT/ ACCUITY Joyce Workman, Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. She has been documented as being obese, new onset hypertension, polyuria, and a rash on her abdomen. She was asymptomatic upon arrival. She was admitted yesterday for stabilization of her glucose levels, and assist her with lifestyle modification. She states she leads a sedentary lifestyle as a bank officer. Her HbA1C is 10%. SCENARIO 1: Mrs. Workman presented to the diabetes clinic and provided a 24- hour food recall. She was then sent to the lab for ordered lab tests. She is to notify the nurse upon return to the clinic from the lab. Patient has requested more information on her diabetes and states she does not understand why she "should be concerned" with blood glucose control in both the short and long term. SCENARIO 2: The nurse is providing information on - Answer - Educational Needs increased Fall Risk normal Health increased Neurological normal Pain level normal Psychological Needs normaL sensorium normal NURSING CONSIDERATIONS: Physiological: Enhanced readiness for learning T Ineffective health maintenance T Safety: Deficient fluid volume F Imbalanced Nutrition T Risk for injury T Social isolation F ACTIONS 1: Ask Mrs. Workman to explain what she knows about diabetes. Explain in layman terms what Diabetes is and how it can adversely affect the body if left untreated. Discuss lifestyle choices that can lead to type II diabetes. Discuss lifestyle changes that can be beneficial in the management of type II diabetes. Document teaching and understanding of teaching using teach back process. ACTIONS 2: Assess Mrs. Workman's knowledge of nutrition and preferred foods. Ask Mrs. Workman for a 24- hour diet recall. Educate Mrs. Workman on healthier options based on the 24-hour diet recall. Provide Mrs. Workman with a Mediterranean style diet plan Ask Mrs. Workman to demonstrate understanding using the teach back method. ACTIONS 3: Assess the patient's preferred exercise regimen. Ensure the patient does not have pre-existing conditions that would limit exercise routines. Provide an exercise routine that has been developed in conjunction with Mrs. Workman. Review with Mrs. Workman safety measures related to blood glucose levels when exercising Use teach back method and document education provided. actions 4 Assess patient's blood glucose level. Provide a 20 -gram carbohydrate liquid for consumption. Provide another 20-gram carbohydrate liquid for consumption in 15 minutes for unresolved symptoms. Reassess the blood glucose level in 15 minutes. Provide additional teaching to the patient regarding prevention strategies for hypoglycemia. ACTIONS5; Assess Mrs. Workman' s understanding of JOSE MARTINEZ REPORT / ASSIGN ACCUITY Jose Martinez, Jose Martinez, 43- year old male experiencing chest pain while watching a state rival football game earlier in the evening. Chest pain became progressively worse, so he called for an ambulance to bring him to the Emergency Department. Once the ambulance arrived, he reported his pain as 10/10. The 12-lead EKG showed ST elevation. Vital signs were HR 160, BP 145/102, Respirations 23, and Pulse Ox 89%. He was given nitroglycerin during transport to the hospital with little relief. He complained of feeling "light- headed". He has been admitted to the unit, and the pain has subsided. He does have a 10-year history of hypertension. He was transferred here to the cardiac stepdown unit from the ER, because no beds were open in cardiac ICU. Ambulance report: Nitroglycerin SL x 3, 12-lead EKG, Blood drawn for cardiac enzymes, Peripheral IV started to left forearm. SCENARIO - Answer - Educational Needs increased Fall Risk increased Health increased Neurological normal Pain level normal Psychological Needs normal NURSING CONCERNS: Physiological: Acute Pain T Altered body image F Anxiety T Disturbed thought process F Impaired gas exchange T Impaired tissue perfusion T Ineffective health maintenance T Powerlessness T Safety: Drug therapy T Risk for social isolation F ACTIONS IN ORDER:1 Assess airway, breathing, circulation. Administer oxygen therapy to make sure oxygen saturation is greater than 90%. Ensure continuous EKG monitoring. Provide Morphine Sulfate IVP as prescribed. Reassess patient's vital signs and pain level ACTIONS IN ORDER:2 Assess for the abrupt cessation of pain Initiate IV Heparin. Give ASA. Observe for bleeding. Monitor aPTT ACTIONS IN ORDER:3 Provide emotional support. Assess Mr. Martinez's willingness to learn. Provide introductory information on prescribed antithrombotic medication. Report Mr. Martinez's emotional distress to Case Management. Document all findings. ACTIONS IN ORDER:4 Troponin 1.0 mg/mL. CPK: 360 mcg/mL. CK-MB6.8 Serum Potassium 4.2 mEq/L. Serum Sodium 142 mEq/L. ACTIONS IN ORDER:5 Clarify with Mrs. Martinez that she is asking if it is okay to resume sexual relations with her husband upon discharge Promote open communication between Mr. and Mrs. Martinez. Explain to Mr. and Mrs. Martinez the disease process following a myocardial infarction. Discuss physical limitations following a myocardial infarction. Provide information to Mr. and Mrs. Martinez regarding support groups.