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.
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.
