SWIFT RIVER MEDICAL-SURGICAL:
EXAM, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
Sarah Getts Scenario 1
Sarah GettsMs. Getts is requesting water to drink. Her pitcher has
already been filled three times this shift.
1- Wash and glove hands
2- Full assessment
3- Monitor and evaluate fluid intake
4- Educate patient
5- Document results
Sarah Getts Scenario 2
Sarah GettsThree hours later, Ms. Getts is unsteady when
standing by her bedside.
1- Wash and glove hands
2- Full assessment
3- Apply fall risk bracelet
4- Document results
Sarah Getts Scenario 3
Sarah GettsYou observe Ms. Getts being assisted by another
nurse who is being blatantly rude and disrespectful to her.
1- Offer assistance
2- Remain with patient
3- Therapeutic Communication
4- Notify lead nurse
5- Document results
,Sarah Getts Scenario 4
Sarah GettsMs. Getts is now complaining of sudden sharp,
substernal chest pain, very short of breath and is profusely
diaphoretic.
1- Visual assess
2- Call rapid response
3- Apply oxygen
4- Establish second IV
5- Remain with patient
Sarah Getts Scenario 5
Sarah GettsMs. Getts is being transferred as an emergency to
Critical Care. Your responsibilities are:
1- Give verbal report
2- Escort patient
3- Notify family
4- Document results
Paul Greer
Paul Greer is a 57 y/o who has been admitted for a radical
prostatectomy. He was recently diagnosed with stage III prostate
cancer. His original lymph node biopsy was negative. He has a
history of hypertension and is not compliant with medication.
Until the recent diagnosis of cancer, the patient had only seen a
physician once in the last ten years. He has a 20-year one pack
history of smoking. However, he quit three years ago when he
remarried; he and his wife have a nine-month-old baby. His
difficulty voiding finally motivated him to seek care.
Alteration in comfort
Knowledge deficit
Potential for ineffective sexuality patterns
Sarah Getts
Sarah Getts 77 yr-old, Dx- Chronic Renal Failure, admitted with
,hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). No known
allergies (NKA). Vital signs -Temp 98.8, BP 102/76, P 102-
irregular, RR 22, SaO2 90%, cardiovascular on telemetry with
Sinus irregular rhythm. Disoriented to time and place, speech
slurred. Pupils PERRLA, eyes clear. 20 ga. Hep-Lock in right
forearm, skin warm and dry, generalized weakness with recent
weight loss. 50% intake. High fall risk. Renal diet. Family in room
with patient very concerned. Dr. Brown
Electrolyte Imbalance
Ineffectual renal perfusion, risk for
Potential for imbalanced fluid volume
Acute Confusion
Potential for falls
Failure to Thrive
Calvin Umbyuma Scenario 1
Calvin UmbyumaThe nurse is doing the admission and has trouble
pronouncing the patient's name. He tells the nurse to call him U.
Mr. U starts coughing, his sputum is greenish-yellow with blood
tinge. He tells the nurse that it is very painful to cough. The nurse
asks him if he has night sweats, and he says yes, for the past 4
weeks. Mr. U has traveled back to Kenya twice this year as his
mother has been very ill. He tried to convince her to seek medical
attention, but his family is very traditional and believes in other
methods of treatment. Mr. U admitted he also has been using
traditional methods to treat his HIV. The nurse has an order for an
IV with antibotics q6hr., blood cultures x2, and Tylenol for pain
and fever.
1- Place on respiratory isolation
2- Ask Mr. U about the traditional methods he is currently
receiving
3- Obtain blood cultures x2
4- Start IV and antibotics
5-Collect sputum culture and remind the provider that a sputum
, culture order is needed. This will allow check sputum for acid-fast
bacilli
Calvin Umbyuma Scenario 2
Calvin UmbyumaMr. U calls the nurse to his room complaining of
severe pain when he coughs, and his shortness of breath has
become worse. A visitor is in the room without a mask and has
delivered Mr. U's medication from home to include his traditional
herbal remedies. Mr. U admits that he was trying to take his
medicine when he experienced an episode of uncontrollable
cough. Upon review of Mr. U's previous chest X-ray, you have
identified an abnormal chest X-ray showing a patchy shadowing in
the right upper lobe.
1- Wash hands, don PPE
2- Explain to the visitor that a mask must be worn, and they need
to wash their hands
3- Respiratory assessment and assess vital signs
4- Ask Mr. U for his medication and explain to Mr. U why he can't
take his other medication while admitted to the hospital
5- Place signage on door and above bed reminder to wear a mask
and wash hands
Calvin Umbyuma Scenario 3
Calvin UmbyumaMr. U does not want to give up his traditional
herbal medications. He tells the nurse that his father died in the
best hospital in Kenya receiving the newest treatment. The nurse
inquires as to the father's illness and Mr. U tells the nurse that he
believes it was Tuberculosis. He does not know what his mother is
suffering from as she refuses to seek modern treatment. Mr. U is
also concerned about his wife as she has been having difficulty
with her Visa and is still trying to come back to the US
1- Ask patient what he knows about Tuberculosis
2- Ask patient what his mother's symptoms are
3- Educate patient to the signs/symptoms of Tuberculosis
EXAM, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
Sarah Getts Scenario 1
Sarah GettsMs. Getts is requesting water to drink. Her pitcher has
already been filled three times this shift.
1- Wash and glove hands
2- Full assessment
3- Monitor and evaluate fluid intake
4- Educate patient
5- Document results
Sarah Getts Scenario 2
Sarah GettsThree hours later, Ms. Getts is unsteady when
standing by her bedside.
1- Wash and glove hands
2- Full assessment
3- Apply fall risk bracelet
4- Document results
Sarah Getts Scenario 3
Sarah GettsYou observe Ms. Getts being assisted by another
nurse who is being blatantly rude and disrespectful to her.
1- Offer assistance
2- Remain with patient
3- Therapeutic Communication
4- Notify lead nurse
5- Document results
,Sarah Getts Scenario 4
Sarah GettsMs. Getts is now complaining of sudden sharp,
substernal chest pain, very short of breath and is profusely
diaphoretic.
1- Visual assess
2- Call rapid response
3- Apply oxygen
4- Establish second IV
5- Remain with patient
Sarah Getts Scenario 5
Sarah GettsMs. Getts is being transferred as an emergency to
Critical Care. Your responsibilities are:
1- Give verbal report
2- Escort patient
3- Notify family
4- Document results
Paul Greer
Paul Greer is a 57 y/o who has been admitted for a radical
prostatectomy. He was recently diagnosed with stage III prostate
cancer. His original lymph node biopsy was negative. He has a
history of hypertension and is not compliant with medication.
Until the recent diagnosis of cancer, the patient had only seen a
physician once in the last ten years. He has a 20-year one pack
history of smoking. However, he quit three years ago when he
remarried; he and his wife have a nine-month-old baby. His
difficulty voiding finally motivated him to seek care.
Alteration in comfort
Knowledge deficit
Potential for ineffective sexuality patterns
Sarah Getts
Sarah Getts 77 yr-old, Dx- Chronic Renal Failure, admitted with
,hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). No known
allergies (NKA). Vital signs -Temp 98.8, BP 102/76, P 102-
irregular, RR 22, SaO2 90%, cardiovascular on telemetry with
Sinus irregular rhythm. Disoriented to time and place, speech
slurred. Pupils PERRLA, eyes clear. 20 ga. Hep-Lock in right
forearm, skin warm and dry, generalized weakness with recent
weight loss. 50% intake. High fall risk. Renal diet. Family in room
with patient very concerned. Dr. Brown
Electrolyte Imbalance
Ineffectual renal perfusion, risk for
Potential for imbalanced fluid volume
Acute Confusion
Potential for falls
Failure to Thrive
Calvin Umbyuma Scenario 1
Calvin UmbyumaThe nurse is doing the admission and has trouble
pronouncing the patient's name. He tells the nurse to call him U.
Mr. U starts coughing, his sputum is greenish-yellow with blood
tinge. He tells the nurse that it is very painful to cough. The nurse
asks him if he has night sweats, and he says yes, for the past 4
weeks. Mr. U has traveled back to Kenya twice this year as his
mother has been very ill. He tried to convince her to seek medical
attention, but his family is very traditional and believes in other
methods of treatment. Mr. U admitted he also has been using
traditional methods to treat his HIV. The nurse has an order for an
IV with antibotics q6hr., blood cultures x2, and Tylenol for pain
and fever.
1- Place on respiratory isolation
2- Ask Mr. U about the traditional methods he is currently
receiving
3- Obtain blood cultures x2
4- Start IV and antibotics
5-Collect sputum culture and remind the provider that a sputum
, culture order is needed. This will allow check sputum for acid-fast
bacilli
Calvin Umbyuma Scenario 2
Calvin UmbyumaMr. U calls the nurse to his room complaining of
severe pain when he coughs, and his shortness of breath has
become worse. A visitor is in the room without a mask and has
delivered Mr. U's medication from home to include his traditional
herbal remedies. Mr. U admits that he was trying to take his
medicine when he experienced an episode of uncontrollable
cough. Upon review of Mr. U's previous chest X-ray, you have
identified an abnormal chest X-ray showing a patchy shadowing in
the right upper lobe.
1- Wash hands, don PPE
2- Explain to the visitor that a mask must be worn, and they need
to wash their hands
3- Respiratory assessment and assess vital signs
4- Ask Mr. U for his medication and explain to Mr. U why he can't
take his other medication while admitted to the hospital
5- Place signage on door and above bed reminder to wear a mask
and wash hands
Calvin Umbyuma Scenario 3
Calvin UmbyumaMr. U does not want to give up his traditional
herbal medications. He tells the nurse that his father died in the
best hospital in Kenya receiving the newest treatment. The nurse
inquires as to the father's illness and Mr. U tells the nurse that he
believes it was Tuberculosis. He does not know what his mother is
suffering from as she refuses to seek modern treatment. Mr. U is
also concerned about his wife as she has been having difficulty
with her Visa and is still trying to come back to the US
1- Ask patient what he knows about Tuberculosis
2- Ask patient what his mother's symptoms are
3- Educate patient to the signs/symptoms of Tuberculosis
