SWIFT RIVER EXAM SCRIPT PREMIUM
QUESTIONS AND SOLUTIONS GRADED A+
●● 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 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 q4hr 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: Acute discomfort False
Alteration in body image False
Alteration in gas exchange True
Alteration in physical mobility True
Alteration in skin integrity False
,.Bleeding False
Death anxiety True
Esteem False
.Ineffectual breathing pattern True
Knowledge deficit True
Sudden confusion False
●● Donald Lyles 52-year old male, was admitted yesterday evening for
stabilization of his uncontrolled type II diabetes. He is married, and his
wife is requesting to stay at his side. His HbgA1c is 10.6%. He has a
history of a Myocardial Infarction, MI, one year ago, and has refused all
cardiac rehab, and has not had another cardiac event. He refuses to
comply with dietary recommendations. His BMI is 37. Vital signs are:
BP: 146/94, P: 88, R: 22, T: 99.2, PaO2: 94% Blood glucose upon
admission is 340 mg/dl
Answer: Select appropriate nursing concerns below based upon patient
report above:
Acute discomfort False
,Alteration in comfort False
Knowledge Deficit True
Nausea False
Potential for falls False
Potential for infection True
●● Estelle Hatcher
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
Answer: Select appropriate nursing concerns below based upon patient
report above:
Physiological
, Acute discomfort False
Alteration in bowel elimination: diarrhea: false
Alteration in comfort: true
Alteration in mobility: true
Decreased activity tolerance: false
Potential for alteration in electrolyte balance: true
Safety
Fear: false
Ineffectual self-health management: false
Knowledge deficit: true
Potential for falls: true
Potential for infection: true
Sleep deficit: false
●● Tom Richardson 46yr-old. Dx- urinary stones with 3 episodes/5yrs.
Allergic to sulfa drugs. Vital signs -Temp 98.4,BP 175/105, 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 @100ml/hr. Dr. Small at bedside with patient and family. Stat
lithotripsy treatment ordered. Awaiting transport.
QUESTIONS AND SOLUTIONS GRADED A+
●● 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 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 q4hr 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: Acute discomfort False
Alteration in body image False
Alteration in gas exchange True
Alteration in physical mobility True
Alteration in skin integrity False
,.Bleeding False
Death anxiety True
Esteem False
.Ineffectual breathing pattern True
Knowledge deficit True
Sudden confusion False
●● Donald Lyles 52-year old male, was admitted yesterday evening for
stabilization of his uncontrolled type II diabetes. He is married, and his
wife is requesting to stay at his side. His HbgA1c is 10.6%. He has a
history of a Myocardial Infarction, MI, one year ago, and has refused all
cardiac rehab, and has not had another cardiac event. He refuses to
comply with dietary recommendations. His BMI is 37. Vital signs are:
BP: 146/94, P: 88, R: 22, T: 99.2, PaO2: 94% Blood glucose upon
admission is 340 mg/dl
Answer: Select appropriate nursing concerns below based upon patient
report above:
Acute discomfort False
,Alteration in comfort False
Knowledge Deficit True
Nausea False
Potential for falls False
Potential for infection True
●● Estelle Hatcher
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
Answer: Select appropriate nursing concerns below based upon patient
report above:
Physiological
, Acute discomfort False
Alteration in bowel elimination: diarrhea: false
Alteration in comfort: true
Alteration in mobility: true
Decreased activity tolerance: false
Potential for alteration in electrolyte balance: true
Safety
Fear: false
Ineffectual self-health management: false
Knowledge deficit: true
Potential for falls: true
Potential for infection: true
Sleep deficit: false
●● Tom Richardson 46yr-old. Dx- urinary stones with 3 episodes/5yrs.
Allergic to sulfa drugs. Vital signs -Temp 98.4,BP 175/105, 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 @100ml/hr. Dr. Small at bedside with patient and family. Stat
lithotripsy treatment ordered. Awaiting transport.
