SWIFT RIVER MED SURG PT SCENARIOS EXAM | ACTUAL QUESTIONS WITH VERIFIED ANSWERS | LATEST UPDATED 2026/2027 | GRADED A+ | 100% ASSURED PASS.

SWIFT RIVER MED SURG PT SCENARIOS EXAM | ACTUAL QUESTIONS WITH VERIFIED ANSWERS | LATEST UPDATED 2026/2027 | GRADED A+ | 100% ASSURED PASS. Virginia Smith, 57-year-old who has elected to have a total mastectomy based on consultation with her surgeon, a total mastectomy removes all breast tissue but leaves all or most of axillary lymph nodes and chest muscles intact. She is also to receive radiation, chemotherapy, and hormone therapy post operatively. She is with her physician. She is also investigating bone marrow transplantation. She has arrived in pre-op and about to have surgery this morning. Her husband and two grown children are also with her as she is prepared with gown and head cap awaiting transport to the operating room. She has IV access and has received a small dose of Valium to reduce apprehension. Temperature is 98.3, HR is 87, RR is16, BP is 121/74, pao2 is 98%. – ANSWER _Educational Needs Increased acuity Health Change Increased acuity LOC Normal acuity Pain Level Increased acuity Psychological Needs Normal acuity Safety Increased acuity Virginia Smith – ANSWER _Physiological Bleeding False Impaired Gas Exchange False Ineffective breathing pattern False Pain, Acute True Physical Mobility, Impaired True Skin integrity, impaired True Safety Acute Confusion False Knowledge Deficit True Esteem Disturbed Body Image True Hopelessness False Virginia Smith Scenario 1 Mrs. Smith shares with you that even though she signed the operative consent she was not sure if this was the right surgical procedure for her. Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." Scenario 2 It is now two weeks later; Mrs. Smith has returned. You question her while reviewing her operative consent and determine that everything is correct. She receives the pre-op medication. Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Scenario 3 Mrs. Smith's surgery has now ended. You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. Her chart reports she was extubated upon arrival to the recovery area, received three units (3000 ml) of fluid, receiving O2 @ 4L via nasal cannula, has Foley Catheter in place draining QS clear yellow urine, r – ANSWER_Scenario 1 Ask patient to explain to you what procedure she was expecting to have this morning. If patient statement differs from the surgical consent she has signed, notify surgeon immediately Stay with patient for surgeon's arrival to explain intended surgical procedure Contact head nurse or supervisor in the OR to evaluate new situation Procedure is canceled for the day and rescheduled later allowing for new consent. Scenario 2 Therapeutic communicationt Validate NPO Status Encourage to ambulate with assistance to void if needed Connect telemetry Provide a few chairs if possible for her family to also be comfortable Scenario 3 Vital signs taken by automatic B/P Cuff q 15 minutes Assess Talk with her stating surgery is over and she did great. Allow husband to come into recovery for a quick one-minute visit. Document and prepare to transfer to Surgical ICU Scenario 4 Provide Operative summary of type of procedure, IV fluid and pain status. Present health assessment including B/P and LOC and dressing. Report current urinary output quantify per hour and color of urine Request time she can arrive and staff to help with transfer Explain to her family and provide contact information. Scenario 5 Full assessment of patient. Provide for physical and thermal comfort. Therapeutic communication. Begin post op education for day one Notify family as to when they may come and visit. John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. No known allergies (NKA). Non-significant past medical Hx. Vital signs Temp 99.4, BP 106/72, P 96, RR 20, sao2 91%. Neuro WNL's, alert and cooperative. IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. C/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. Stools are decreasing but patient remains very weak. Wife at bedside. Diet as tolerated. Dr. Jones. - ANSWER_Educational Needs Increased acuity Fall Risk Increased acuity Health Change Increased acuity Pain Level Increased acuity Psychological Needs Normal acuity Sensorium Normal acuity John Duncan - ANSWER_Physiological Deficient Fluid Volume True Electrolyte Imbalance, Risk for True Excess Fluid Volume, Risk for False Fatigue True Nausea False Self-Care Deficit False Safety Fall, Risk for True Infection, Risk for False Esteem Ineffective Coping False Noncompliance True John Duncan Scenario 1 As you enter the room, Mr. Duncan is refusing to eat foods from bland diet. Scenario 2 Mr. Duncan is now complaining of feeling "dizzy" when he stands. Scenario 3 Several hours later, Mr. Duncan is now complaining of nausea. Scenario 4 Two hours later, Mr. Duncan is asked how frequent his stools have been today. He replies, "six times in the past four hours". He also states he is feeling weak. Scenario 5 Mr. Duncan's wife meets you in hall asking what she could bring her husband to eat from home. – ANSWER_Scenario 1 Assess intake and output and possible reasoning Construct dietary consult (plan) Acquire daily weight and food intake Evaluate outcome of dietary plan Scenario 2 Full assessment including both lying/standing Check input/output for possible dehydration Teach patient about safety when getting out of bed Document findings Scenario 3 Wash and glove hands