FUNDAMENTAL SWIFTRIVER
EXAM 2025 QUESTIONS AND
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. Post CVA, he has developed some aphasia and is having difficulty with
verbal communication. He has orders for dressing changes q daily and pain medications
before the dressing change. - ....ANSWER ...-You responded correctly to 5 out of 6
evaluations:
CategoryYour responseExplanationCommunication Incorrect acuityPatient has aphasia
and sensory deficitsCognition Correct acuityPatient is having difficulty with verbal
communication.Sensory perception Correct acuityPost CVA sensory deficitMobility
Correct acuityPatient is a fall risk due to post CVA muscle weaknessGlucose regulation
Incorrect acuityNo indication at this timeDiversity Incorrect acuityNo indication at this
time
Charlie Raymond Room 302
Charlie Raymond, 65-year-old male who was admitted to a negative pressure room on
Med-Surg for COVID precautions. He has a history of COPD, hypertension, diabetes
....FOR STUDY PURPOSES...©️2025 ALL RIGHTS RESERVED... 1
,type II, and a recent myocardial infarction. He is a retired postal worker who lives at
home with his wife. He is on Claforan (cefotaxime) 2 g IV BID hr and sliding scale
insulin. Initially this cardiologist was concerned about congestive heart failure and Mr.
Raymond is receiving Furosemide (Lasix) 20 mg IV twice a day for pulmonary edema.
Vital Signs: BP is 145/78, Pulse 89 Respirations 24 and slightly labored, Temperature
100.2 SaO2 94% on 2L nasal cannula. The patient/family is fearing the worst due to
COVID-19 Pandemic. - ....ANSWER ...-You responded correctly to 5 out of 6
evaluations:
CategoryYour responseExplanationPerfusion Correct acuityCardiovascular disease and
diabetes.Gas exchange Correct acuityCOPD and COVID-19 positiveInfection Correct
acuityCOVID-19 positive, at risk for opportunistic disease because of diabetesSensory
perception Incorrect acuityNo indication at this timeAddiction Incorrect acuityNo
indication at this timeMetabolism Incorrect acuityDiabetes
Hildegard Lowe Room 303
Hildegard Lowe, 68 y/o female, newly admitted after a rough night in the ER after
coughing for the last 2 months. Patient is alert and cooperative, visually limited and
declining. She is on Oxygen at 2L. She has an IV 0.9 normal saline, 125 an hour. Chest x-
ray upon admission showed right middle lobe pneumonia. Vital signs are BP: 128/86, P:
105, R: 32, T: 99.8 F, 37.7 C, SaO2: 93%. Plan of care is antibiotic therapy, incentive
spirometry, O2 supplementation, and pending labs and blood cultures from the ER.
Patient is receiving Rocephin and received Zithromax in the ER. Patient does have a
history of Granulomatosis with Polyangiitis but has been stable for 5 years w/o
treatment. She is widowed and came to us from the retirement community. She has one
daughter who is on her way from out of state; she will be arriving sometime today.
....FOR STUDY PURPOSES...©️2025 ALL RIGHTS RESERVED... 2
, Patient states she is allergic to mangos. - ....ANSWER ...-You responded correctly
to 4 out of 6 evaluations:
CategoryYour responseExplanationGas exchange Correct acuityPatient's oxygen
perfusion is compromised at right middle lobe pneumoniaInfection Correct
acuityEvidence by infection in lungsSensory perception Incorrect acuityPatient is
visually impairedPain Incorrect acuityNo indication of pain at this timeCognition
Incorrect acuityPatient is alert and orientedPsychosis Correct acuityNo evidence of
increased need
Roger Clinton Room 304
Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a
partial thyroidectomy to determine if he has cancer. His past symptoms for three months
have been that he noticed a slight hoarseness in speaking, a slight dry cough not related
to a cold, and upon examination had a "pea-size" lump on the center of his neck. His
Endocrinologist had a radioiodine scan performed that showed a suspicious area. The
plan is to obtain a biopsy from several areas of the thyroid gland, and hopefully to leave
as much as possible in place. Roger knows that it will take three days after surgery to
determine if he has cancer but does not understand the implications resulting from a
thyroidectomy. (Lifetime thyroid replacement medication.) - ....ANSWER ...-You
responded correctly to 3 out of 6 evaluations:
CategoryYour responseExplanationPatient Education Correct acuityPatient may need
lifelong thyroid replacement.Comfort Correct acuityNeck pain is common post-
thyroidectomyMetabolism Incorrect acuityThyroid hormones regulate the basal
metabolic ratePerfusion Incorrect acuityAlthough rare, post-op hemorrhage is a risk. If
....FOR STUDY PURPOSES...©️2025 ALL RIGHTS RESERVED... 3
EXAM 2025 QUESTIONS AND
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. Post CVA, he has developed some aphasia and is having difficulty with
verbal communication. He has orders for dressing changes q daily and pain medications
before the dressing change. - ....ANSWER ...-You responded correctly to 5 out of 6
evaluations:
CategoryYour responseExplanationCommunication Incorrect acuityPatient has aphasia
and sensory deficitsCognition Correct acuityPatient is having difficulty with verbal
communication.Sensory perception Correct acuityPost CVA sensory deficitMobility
Correct acuityPatient is a fall risk due to post CVA muscle weaknessGlucose regulation
Incorrect acuityNo indication at this timeDiversity Incorrect acuityNo indication at this
time
Charlie Raymond Room 302
Charlie Raymond, 65-year-old male who was admitted to a negative pressure room on
Med-Surg for COVID precautions. He has a history of COPD, hypertension, diabetes
....FOR STUDY PURPOSES...©️2025 ALL RIGHTS RESERVED... 1
,type II, and a recent myocardial infarction. He is a retired postal worker who lives at
home with his wife. He is on Claforan (cefotaxime) 2 g IV BID hr and sliding scale
insulin. Initially this cardiologist was concerned about congestive heart failure and Mr.
Raymond is receiving Furosemide (Lasix) 20 mg IV twice a day for pulmonary edema.
Vital Signs: BP is 145/78, Pulse 89 Respirations 24 and slightly labored, Temperature
100.2 SaO2 94% on 2L nasal cannula. The patient/family is fearing the worst due to
COVID-19 Pandemic. - ....ANSWER ...-You responded correctly to 5 out of 6
evaluations:
CategoryYour responseExplanationPerfusion Correct acuityCardiovascular disease and
diabetes.Gas exchange Correct acuityCOPD and COVID-19 positiveInfection Correct
acuityCOVID-19 positive, at risk for opportunistic disease because of diabetesSensory
perception Incorrect acuityNo indication at this timeAddiction Incorrect acuityNo
indication at this timeMetabolism Incorrect acuityDiabetes
Hildegard Lowe Room 303
Hildegard Lowe, 68 y/o female, newly admitted after a rough night in the ER after
coughing for the last 2 months. Patient is alert and cooperative, visually limited and
declining. She is on Oxygen at 2L. She has an IV 0.9 normal saline, 125 an hour. Chest x-
ray upon admission showed right middle lobe pneumonia. Vital signs are BP: 128/86, P:
105, R: 32, T: 99.8 F, 37.7 C, SaO2: 93%. Plan of care is antibiotic therapy, incentive
spirometry, O2 supplementation, and pending labs and blood cultures from the ER.
Patient is receiving Rocephin and received Zithromax in the ER. Patient does have a
history of Granulomatosis with Polyangiitis but has been stable for 5 years w/o
treatment. She is widowed and came to us from the retirement community. She has one
daughter who is on her way from out of state; she will be arriving sometime today.
....FOR STUDY PURPOSES...©️2025 ALL RIGHTS RESERVED... 2
, Patient states she is allergic to mangos. - ....ANSWER ...-You responded correctly
to 4 out of 6 evaluations:
CategoryYour responseExplanationGas exchange Correct acuityPatient's oxygen
perfusion is compromised at right middle lobe pneumoniaInfection Correct
acuityEvidence by infection in lungsSensory perception Incorrect acuityPatient is
visually impairedPain Incorrect acuityNo indication of pain at this timeCognition
Incorrect acuityPatient is alert and orientedPsychosis Correct acuityNo evidence of
increased need
Roger Clinton Room 304
Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a
partial thyroidectomy to determine if he has cancer. His past symptoms for three months
have been that he noticed a slight hoarseness in speaking, a slight dry cough not related
to a cold, and upon examination had a "pea-size" lump on the center of his neck. His
Endocrinologist had a radioiodine scan performed that showed a suspicious area. The
plan is to obtain a biopsy from several areas of the thyroid gland, and hopefully to leave
as much as possible in place. Roger knows that it will take three days after surgery to
determine if he has cancer but does not understand the implications resulting from a
thyroidectomy. (Lifetime thyroid replacement medication.) - ....ANSWER ...-You
responded correctly to 3 out of 6 evaluations:
CategoryYour responseExplanationPatient Education Correct acuityPatient may need
lifelong thyroid replacement.Comfort Correct acuityNeck pain is common post-
thyroidectomyMetabolism Incorrect acuityThyroid hormones regulate the basal
metabolic ratePerfusion Incorrect acuityAlthough rare, post-op hemorrhage is a risk. If
....FOR STUDY PURPOSES...©️2025 ALL RIGHTS RESERVED... 3
