SWIFT RIVER MED SURG CLINICAL:
EXAM, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
Preston Wright, 73- year old male, patient of Dr. Greene, status
post CVA 4 weeks ago. He has been readmitted for a red spot on
his sacrum of 1 cm and a 2 cm blister on his right heel. IV fluids of
D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Mr.
Wright is pleasant and cooperative, but needs to be reminded to
avoid pressure on his heel and sacrum. He has orders for dressing
changes q daily, and pain medications prior to the dressing
change. - CORRECT ANSWERS- Educational needs increased
Fall risk increased
Health change increased
Neurological normal
Pain level increased
Psychological need normal
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 - CORRECT ANSWERS-
Educational Needs Increased
,Fall Risk Increased
Health Change Increased
Pain Level Increased
Psychological Needs Normal
Sensorium Normal
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%. - CORRECT ANSWERS- Educational
needs increased
Fall risk normal
Health change increased
Neurological normal
Pain level normal
Psychological need normal
Sensorium Normal
Tom Richardson, 46yr-old. Dx- urinary stones with 3
episodes/5yrs. Allergic to sulfa drugs. Vital signs -Temp 98.4,BP
178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Skin warm and
pale. Generalized weakness, blood tinged urine and severe pain
upon urination, GI- n/v. Clear liquid diet. Strict I&O and strain all
, urine, filters in bathroom. Patient demonstrates urine strain
procedure. Severe pain (10/10) medicated q 30 minutes x4 with
IV Morphine 2mg with little relief. IV D5 1/2 NS @150ml/hr. Dr.
Small at bedside with patient and family. Stat lithotripsy
treatment ordered. Awaiting transport. - CORRECT ANSWERS-
Educational needs increased
Fall risk increased
Health change increased
Pain level increased
Psychological need normal
Sensorium Normal
56-year-old MVA victim, fourth day post op with a splenectomy
and femur repair. He is experiencing new onset of shortness of
breath and has a nasal cannula with 2L of Oxygen in place. He is
restless with slight confusion but is easily orientated with
attempts from nurse. Temperature spiked during the night to
102.4, BP now 146/94 which is slightly elevated, respirations at 30
bpm and slightly labored, heart rate 102 versus 84 from last night
shift. Skin cool to touch and appears pale. His coughing, to clear
his airway, appears ineffective. Recent chest X-ray shows diffuse
bilateral interstitial infiltrates in all lobes. Recent blood gases
demonstrate falling PaO2 (hypoxemia) and increasing CO2
(Hypercapnia). Mr. Thomason is anxious and is obviously
worsened from the shift before in overall condition. - CORRECT
ANSWERS-
Ann Rails, 38 years old, c/o back pain, non-significant past
medical history. No known allergies (NKA). Vital signs -BP 124/82,
EXAM, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
Preston Wright, 73- year old male, patient of Dr. Greene, status
post CVA 4 weeks ago. He has been readmitted for a red spot on
his sacrum of 1 cm and a 2 cm blister on his right heel. IV fluids of
D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Mr.
Wright is pleasant and cooperative, but needs to be reminded to
avoid pressure on his heel and sacrum. He has orders for dressing
changes q daily, and pain medications prior to the dressing
change. - CORRECT ANSWERS- Educational needs increased
Fall risk increased
Health change increased
Neurological normal
Pain level increased
Psychological need normal
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 - CORRECT ANSWERS-
Educational Needs Increased
,Fall Risk Increased
Health Change Increased
Pain Level Increased
Psychological Needs Normal
Sensorium Normal
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%. - CORRECT ANSWERS- Educational
needs increased
Fall risk normal
Health change increased
Neurological normal
Pain level normal
Psychological need normal
Sensorium Normal
Tom Richardson, 46yr-old. Dx- urinary stones with 3
episodes/5yrs. Allergic to sulfa drugs. Vital signs -Temp 98.4,BP
178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Skin warm and
pale. Generalized weakness, blood tinged urine and severe pain
upon urination, GI- n/v. Clear liquid diet. Strict I&O and strain all
, urine, filters in bathroom. Patient demonstrates urine strain
procedure. Severe pain (10/10) medicated q 30 minutes x4 with
IV Morphine 2mg with little relief. IV D5 1/2 NS @150ml/hr. Dr.
Small at bedside with patient and family. Stat lithotripsy
treatment ordered. Awaiting transport. - CORRECT ANSWERS-
Educational needs increased
Fall risk increased
Health change increased
Pain level increased
Psychological need normal
Sensorium Normal
56-year-old MVA victim, fourth day post op with a splenectomy
and femur repair. He is experiencing new onset of shortness of
breath and has a nasal cannula with 2L of Oxygen in place. He is
restless with slight confusion but is easily orientated with
attempts from nurse. Temperature spiked during the night to
102.4, BP now 146/94 which is slightly elevated, respirations at 30
bpm and slightly labored, heart rate 102 versus 84 from last night
shift. Skin cool to touch and appears pale. His coughing, to clear
his airway, appears ineffective. Recent chest X-ray shows diffuse
bilateral interstitial infiltrates in all lobes. Recent blood gases
demonstrate falling PaO2 (hypoxemia) and increasing CO2
(Hypercapnia). Mr. Thomason is anxious and is obviously
worsened from the shift before in overall condition. - CORRECT
ANSWERS-
Ann Rails, 38 years old, c/o back pain, non-significant past
medical history. No known allergies (NKA). Vital signs -BP 124/82,
