Page 1 of 27
Swift River Fundamentals LATEST UPDATED
VERSION THIS YEAR WITH COMPLETE 180
QUESTIONS AND SOLUTIONS JUST RELEASED
Linda Yu Scenario 1
You have orders to take labs, vital signs, check IV pump and hang antibiotics, and turn the
patient. You requested lab come at 5am, but they are now here at 4am and the patient is still
sleeping.
Enter patient's room quietly
Obtain vital signs and turn patient during lab draw
Check IV pump and hang antibiotics while patient is sleeping
Linda Yu Room 301
Linda Yu, was admitted to your unit after surgery on her left hip due to a fall. She is 2 days
post-op. She is 85 years old and has a history of osteoarthritis and cataracts. PT has been
getting the patient up with a walker and she is able to take a few steps. She is aware of herself
and the situation, but no time or day. She is also anxious as a result of recent surgery. Her
family lives out of state, but the daughter was here for the surgery, she left yesterday. The
plan is to discharge Ms. Yu back to her assisted living facility. Her daily medications at home
include: Prednisone 5 mg, Furosemide 20 mg, and ASA 81 mg daily. The surgeon added
oxycodone 5mg q 4-6 hours prn pain. NKDA.
Anxiety
Care coordination
Stress and coping
Linda Yu Scenario 1
When making patient rounds at 10pm, you enter Ms. Yu's room and she is sleeping. Ms. Yu's
vital signs have been stable throughout her post-op period.
, Page 2 of 27
Enter room quietly
Observe breathing pattern
Ensure call light is in reach
Linda Yu Scenario 2
Ms. Yu calls the nurse at 12am requesting assistance to the bedside commode. This is your
first night taking care of Ms. Yu and you are not sure how well she does transferring to the
commode.
Inform patient that you will turn on the light
Ensure bed is in the lowest position and the bedside commode is next to the bed
Have patient sit on edge of the bed and place gait belt around waist
Call for 2nd assistance, if needed
Linda Yu Scenario 4
Ms. Yu has been sleeping a lot during the day after receiving her pain medication. Your
concerned about patient's current sleep pattern and are performing a sleep assessment.
Ask Ms. Yu if what sleep aids she takes at home
Ask patient how well she sleeps at night when at home
Assess patient's anxiety/depression related to sleep deprivation
Review time/dose of patient's pain medication
Linda Yu Scenario 5
Request PureWick catheter so patient's sleep is not disrupted by voiding during the night.
Adjust comfort measures for Ms. Yu prior to sleep, and ensure she receives pain medication
on schedule during the night.
Place PureWick catheter
Give patient a bed bath and offer a back rub
Administer pain medication throughout the night
, Page 3 of 27
Kenny Barrett Room 302
Kenny Barrett, 64 years old, was admitted for observation of initial administering of BP his
treatment with blood pressure of 220/124 after visiting his doctor for a routine physical. ECG
was unremarkable. No past history of HTN. Past medical history includes hyperlipidemia,
current elevated triglycerides, and a history of 1 pack a day smoker for the past 20 years. Vital
signs are Temp 98.9F, BP 178/90, P 88, RR 18 SaO2 95% on Room air. IV with NS @ 125 mL/ hr.
Patient has been complaining of a headache and dizziness. He is a patient of Dr. Adams.
Addiction
Perfusion
Kenny Barrett Scenario 1
When reviewing your patients' vital signs, taken by the UAP, you notice Kenny has a blood
pressure of 190/110 and a pulse of 105. What actions by the nurse are appropriate?
Educate UAP regarding notification of abnormal range of vital signs
Reassess blood pressure and pulse
Kenny Barrett Scenario 2
When re-taking the patient's BP, you get a reading of 184/108 and a pulse of 102. Report
finding to Dr. Adams using SBAR. What should be included in the "S"?
Current elevated BP
State patients name and date of birth
Kenny Barrett Scenario 3
In continuing with the SBAR, what should be included in the "B"?
Reason the patient was admitted
Patient has past medical history includes hyperlipidemia
History of smoking
Swift River Fundamentals LATEST UPDATED
VERSION THIS YEAR WITH COMPLETE 180
QUESTIONS AND SOLUTIONS JUST RELEASED
Linda Yu Scenario 1
You have orders to take labs, vital signs, check IV pump and hang antibiotics, and turn the
patient. You requested lab come at 5am, but they are now here at 4am and the patient is still
sleeping.
Enter patient's room quietly
Obtain vital signs and turn patient during lab draw
Check IV pump and hang antibiotics while patient is sleeping
Linda Yu Room 301
Linda Yu, was admitted to your unit after surgery on her left hip due to a fall. She is 2 days
post-op. She is 85 years old and has a history of osteoarthritis and cataracts. PT has been
getting the patient up with a walker and she is able to take a few steps. She is aware of herself
and the situation, but no time or day. She is also anxious as a result of recent surgery. Her
family lives out of state, but the daughter was here for the surgery, she left yesterday. The
plan is to discharge Ms. Yu back to her assisted living facility. Her daily medications at home
include: Prednisone 5 mg, Furosemide 20 mg, and ASA 81 mg daily. The surgeon added
oxycodone 5mg q 4-6 hours prn pain. NKDA.
Anxiety
Care coordination
Stress and coping
Linda Yu Scenario 1
When making patient rounds at 10pm, you enter Ms. Yu's room and she is sleeping. Ms. Yu's
vital signs have been stable throughout her post-op period.
, Page 2 of 27
Enter room quietly
Observe breathing pattern
Ensure call light is in reach
Linda Yu Scenario 2
Ms. Yu calls the nurse at 12am requesting assistance to the bedside commode. This is your
first night taking care of Ms. Yu and you are not sure how well she does transferring to the
commode.
Inform patient that you will turn on the light
Ensure bed is in the lowest position and the bedside commode is next to the bed
Have patient sit on edge of the bed and place gait belt around waist
Call for 2nd assistance, if needed
Linda Yu Scenario 4
Ms. Yu has been sleeping a lot during the day after receiving her pain medication. Your
concerned about patient's current sleep pattern and are performing a sleep assessment.
Ask Ms. Yu if what sleep aids she takes at home
Ask patient how well she sleeps at night when at home
Assess patient's anxiety/depression related to sleep deprivation
Review time/dose of patient's pain medication
Linda Yu Scenario 5
Request PureWick catheter so patient's sleep is not disrupted by voiding during the night.
Adjust comfort measures for Ms. Yu prior to sleep, and ensure she receives pain medication
on schedule during the night.
Place PureWick catheter
Give patient a bed bath and offer a back rub
Administer pain medication throughout the night
, Page 3 of 27
Kenny Barrett Room 302
Kenny Barrett, 64 years old, was admitted for observation of initial administering of BP his
treatment with blood pressure of 220/124 after visiting his doctor for a routine physical. ECG
was unremarkable. No past history of HTN. Past medical history includes hyperlipidemia,
current elevated triglycerides, and a history of 1 pack a day smoker for the past 20 years. Vital
signs are Temp 98.9F, BP 178/90, P 88, RR 18 SaO2 95% on Room air. IV with NS @ 125 mL/ hr.
Patient has been complaining of a headache and dizziness. He is a patient of Dr. Adams.
Addiction
Perfusion
Kenny Barrett Scenario 1
When reviewing your patients' vital signs, taken by the UAP, you notice Kenny has a blood
pressure of 190/110 and a pulse of 105. What actions by the nurse are appropriate?
Educate UAP regarding notification of abnormal range of vital signs
Reassess blood pressure and pulse
Kenny Barrett Scenario 2
When re-taking the patient's BP, you get a reading of 184/108 and a pulse of 102. Report
finding to Dr. Adams using SBAR. What should be included in the "S"?
Current elevated BP
State patients name and date of birth
Kenny Barrett Scenario 3
In continuing with the SBAR, what should be included in the "B"?
Reason the patient was admitted
Patient has past medical history includes hyperlipidemia
History of smoking
