Swift River: Medical-Surgical Exam Questions with Correct
Answers
Question 1
Dana Fitzgerald Scenario 4
Dana FitzgeraldOn the third day post-op, Ms. Fitzgerald's pain is 9 /10, and the patient states it is a stabbing pain that
comes in waves. She has not been eating due to nausea and has only drunk 100 ml in the past 8 hours. The patient states
her last bowel movement was two days before her operation. The nurse needs to perform an abdominal examination and
encourage ambulation. The husband has become very concerned about surgical complications and insists that she be
given pain medication and left alone to rest. The nurse is concerned that she is severely constipated and must rule out
bowel obstruction.
Correct Answer
1- Inspect the patient's abdomen
2- Auscultate starting at the right lower quadrant beginning at the right lower and continuing to all others
3- Percuss and palpate all quadrants as tolerated.
4- Contact provider before administering additional pain medication.
5- Tell the husband and patient you have notified the HCP and are doing further assessments
Page 1 of 56
,Question 2
Carlos Mancia Scenario 5
Carlos ManciaMr. Mancia is holding a Catholic Rosary in his hand and is crying as you enter the room.
Correct Answer
1- Obtain translator
2- Use therapeutic communication/Active Listening
3- Educate patient regarding diagnosis and inform him of potiental for full recovery
4- Evaluate learning
5- Document teaching moment
Question 3
Cameron Daniels | Room 301
Patient Overview
cameron_daniels.jpgCameron Danielsjust turned 18 y/o. She is being admitted from the ER with a diagnosis of pelvic
inflammatory disease (PID). She has heavy vaginal discharge with an unpleasant odor. She is complaining of abdominal
pain and looks pale. She was seen by OBGYN in the ER and a culture was sent to the lab for Chlamydia and Neisseria
Gonorrhea. She was a very difficult IV start and has a 23g saline lock (SL) in her right hand. They have ordered a liter bolus
of LR, but it is running very slowly and the IV is positional. VS BP 96/58, P 116, R 18, T 101.2 PaO2 98%.
Correct Answer
Educational Needs- Increased
Fall Risk- Increased
Health Change- Increased
Neurological- Normal
Pain Level- Increased
Psychological Needs- Normal
Page 2 of 56
,Question 4
John Davis Scenario 2
John DavisThe patient has been made aware that he has advanced basal cell carcinoma and has a poor prognosis. The
largest dressing is saturated with serous sanguineous fluid. The patient is complaining of 8/10 pain from two of the partial
thickness incisions on his back (he will need skin graft soon). Patient states the larger dressings on his back that are full
thickness do not hurt at all. The patient has an order for dressing changes PRN. The patient is awaiting orders for
chemotherapy. VS BP 162/90, P 99, R 20, T 98.9.
Correct Answer
1- Assess the large dressing site (full thickness)
2- Administer pain medication as ordered
3- Assess dressing supply needs and obtain
4- Assess patient's need for emotional support and evaluate effectiveness of pain medication
5- Document color and amount of wound drainage on dressing
Question 5
Carlos Mancia Scenario 3
Carlos ManciaBefore entering Carlos Mancia room to administer his antipyretic medication for his recent temp of 101.2
Correct Answer
1- Obtain translator
2- Wash Hands
3- Put on gown and mask
4- Don Gloves
5- Administer antipyretic medication
Page 3 of 56
, Question 6
Donald Lyles
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
Correct Answer
Knowledge Deficit
Potential for infection
Question 7
Donald Lyles Scenario 3
Donald LylesYou have now been assigned to document the ongoing event as the CODE team continues with the
resuscitation.
Correct Answer
1- Check time from one source.
2- Establish when the cardiac event time began.
3- Document rhythm used to determine medications to be administered.
4- Begin list of medications and time/dose given.
5- Remind CODE team to stop CPR and check for pulse Q5 minutes.
Page 4 of 56
Answers
Question 1
Dana Fitzgerald Scenario 4
Dana FitzgeraldOn the third day post-op, Ms. Fitzgerald's pain is 9 /10, and the patient states it is a stabbing pain that
comes in waves. She has not been eating due to nausea and has only drunk 100 ml in the past 8 hours. The patient states
her last bowel movement was two days before her operation. The nurse needs to perform an abdominal examination and
encourage ambulation. The husband has become very concerned about surgical complications and insists that she be
given pain medication and left alone to rest. The nurse is concerned that she is severely constipated and must rule out
bowel obstruction.
Correct Answer
1- Inspect the patient's abdomen
2- Auscultate starting at the right lower quadrant beginning at the right lower and continuing to all others
3- Percuss and palpate all quadrants as tolerated.
4- Contact provider before administering additional pain medication.
5- Tell the husband and patient you have notified the HCP and are doing further assessments
Page 1 of 56
,Question 2
Carlos Mancia Scenario 5
Carlos ManciaMr. Mancia is holding a Catholic Rosary in his hand and is crying as you enter the room.
Correct Answer
1- Obtain translator
2- Use therapeutic communication/Active Listening
3- Educate patient regarding diagnosis and inform him of potiental for full recovery
4- Evaluate learning
5- Document teaching moment
Question 3
Cameron Daniels | Room 301
Patient Overview
cameron_daniels.jpgCameron Danielsjust turned 18 y/o. She is being admitted from the ER with a diagnosis of pelvic
inflammatory disease (PID). She has heavy vaginal discharge with an unpleasant odor. She is complaining of abdominal
pain and looks pale. She was seen by OBGYN in the ER and a culture was sent to the lab for Chlamydia and Neisseria
Gonorrhea. She was a very difficult IV start and has a 23g saline lock (SL) in her right hand. They have ordered a liter bolus
of LR, but it is running very slowly and the IV is positional. VS BP 96/58, P 116, R 18, T 101.2 PaO2 98%.
Correct Answer
Educational Needs- Increased
Fall Risk- Increased
Health Change- Increased
Neurological- Normal
Pain Level- Increased
Psychological Needs- Normal
Page 2 of 56
,Question 4
John Davis Scenario 2
John DavisThe patient has been made aware that he has advanced basal cell carcinoma and has a poor prognosis. The
largest dressing is saturated with serous sanguineous fluid. The patient is complaining of 8/10 pain from two of the partial
thickness incisions on his back (he will need skin graft soon). Patient states the larger dressings on his back that are full
thickness do not hurt at all. The patient has an order for dressing changes PRN. The patient is awaiting orders for
chemotherapy. VS BP 162/90, P 99, R 20, T 98.9.
Correct Answer
1- Assess the large dressing site (full thickness)
2- Administer pain medication as ordered
3- Assess dressing supply needs and obtain
4- Assess patient's need for emotional support and evaluate effectiveness of pain medication
5- Document color and amount of wound drainage on dressing
Question 5
Carlos Mancia Scenario 3
Carlos ManciaBefore entering Carlos Mancia room to administer his antipyretic medication for his recent temp of 101.2
Correct Answer
1- Obtain translator
2- Wash Hands
3- Put on gown and mask
4- Don Gloves
5- Administer antipyretic medication
Page 3 of 56
, Question 6
Donald Lyles
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
Correct Answer
Knowledge Deficit
Potential for infection
Question 7
Donald Lyles Scenario 3
Donald LylesYou have now been assigned to document the ongoing event as the CODE team continues with the
resuscitation.
Correct Answer
1- Check time from one source.
2- Establish when the cardiac event time began.
3- Document rhythm used to determine medications to be administered.
4- Begin list of medications and time/dose given.
5- Remind CODE team to stop CPR and check for pulse Q5 minutes.
Page 4 of 56
