Swift River Med-Surg Exam Questions and Verified Answers
Page 1 of 38
,Question 1
Mary Barkley
Mary Barkley, 74y/o female has been admitted to your floor with a respiratory infection and she has tested positive for
COVID19. She resides in an assisted living facility which has seen four deaths related to COVID19. She is exhibiting the
same initial signs and symptoms as the other patients and her primary care provider would like to start aggressively
treating her. She is running a low-grade fever 99.8 and has a sore scratchy throat which is causing an unproductive cough.
She also is complaining of chills, muscle pain and headache. She is an at-risk patient because of her age. She also suffers
from Lupus and is already taking Hydroxychloroquine, a first-line lupus therapy, but there is no conclusive evidence of its
benefits for coronavirus yet. She is very fearful and is requesting to see her family. She states that she does not want to die
alone.
Correct Answer
Educational Needs: Increased
Fall Risk: Normal
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Increased
Physiological-
Acute Pain: True
Deficient Knowledge: True
Grieving: True
Impaired Comfort: True
Safety:
Infection: True
Page 2 of 38
,Question 2
Lithia Monson
Scenario 1
You arrive in room to find Ms. Monson talking to herself. Upon assessment, you determined that she is confused to person,
time, and place but is easily directable.
Scenario 2
A special lowbed has been ordered that will lower to the ground. The bed arrives tomorrow. You are concerned about
preventing the patient from falling.
Scenario 3
A few hours after speaking with the sitter about the patient needing complete observation, you notice the sitter outside of
the room talking on the phone. Upon entering the room, the patient appears to be trying to get out of bed
Scenario 4
Prior to changing shift, you enter the patient's room to complete a full assessment, and Ms. Monson is now crying asking
to for someone to take her home!
Scenario 5
When completing the shift change neuro check, you notice the patient's left pupil is sluggish. You also notice the patient is
more difficult to orient.
Correct Answer
Scenario 1
-Perform neuro assess
-Reorient Patient to person, place, & time
-Assess for fall risk
-Offer nutrition/toilet
-Discuss effectiveness of sitter
Scenario 2
Page 3 of 38
, -Complete neuro checks as ordered
-Discuss and determine sitter availability
-Check on patient/sitter hourly
-Advise sitter to notify nurse when leaving the room
-Determine when a hospital provided sitter will be necessary
Scenario 3
-Reassess patient
-Ensure patients is positioned in bed properly
-Discuss with sitter that patient needs continual observation
-Discuss with family sitter if there are any other family members who can help with monitoring Lithia
-Document and contact nursing supervisor/Charge nurse
Scenario 4
-Complete full assessment, to include neuro
-Use therapeutic communication/active listening
-Attempt to orient to person, place, and time
-Offer nutrition and/ or toileting
-Ensure bed is in lowest position, and rails are in place
Scenario 5
-Notify HCP of neuro findings
-Notify charge nurse of patient's deteriorating condition
-Begin q15 minute neuro checks
-Have patient remain in bed, head elevated 30 degrees
-Ensure IV is patent
Page 4 of 38
Page 1 of 38
,Question 1
Mary Barkley
Mary Barkley, 74y/o female has been admitted to your floor with a respiratory infection and she has tested positive for
COVID19. She resides in an assisted living facility which has seen four deaths related to COVID19. She is exhibiting the
same initial signs and symptoms as the other patients and her primary care provider would like to start aggressively
treating her. She is running a low-grade fever 99.8 and has a sore scratchy throat which is causing an unproductive cough.
She also is complaining of chills, muscle pain and headache. She is an at-risk patient because of her age. She also suffers
from Lupus and is already taking Hydroxychloroquine, a first-line lupus therapy, but there is no conclusive evidence of its
benefits for coronavirus yet. She is very fearful and is requesting to see her family. She states that she does not want to die
alone.
Correct Answer
Educational Needs: Increased
Fall Risk: Normal
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Increased
Physiological-
Acute Pain: True
Deficient Knowledge: True
Grieving: True
Impaired Comfort: True
Safety:
Infection: True
Page 2 of 38
,Question 2
Lithia Monson
Scenario 1
You arrive in room to find Ms. Monson talking to herself. Upon assessment, you determined that she is confused to person,
time, and place but is easily directable.
Scenario 2
A special lowbed has been ordered that will lower to the ground. The bed arrives tomorrow. You are concerned about
preventing the patient from falling.
Scenario 3
A few hours after speaking with the sitter about the patient needing complete observation, you notice the sitter outside of
the room talking on the phone. Upon entering the room, the patient appears to be trying to get out of bed
Scenario 4
Prior to changing shift, you enter the patient's room to complete a full assessment, and Ms. Monson is now crying asking
to for someone to take her home!
Scenario 5
When completing the shift change neuro check, you notice the patient's left pupil is sluggish. You also notice the patient is
more difficult to orient.
Correct Answer
Scenario 1
-Perform neuro assess
-Reorient Patient to person, place, & time
-Assess for fall risk
-Offer nutrition/toilet
-Discuss effectiveness of sitter
Scenario 2
Page 3 of 38
, -Complete neuro checks as ordered
-Discuss and determine sitter availability
-Check on patient/sitter hourly
-Advise sitter to notify nurse when leaving the room
-Determine when a hospital provided sitter will be necessary
Scenario 3
-Reassess patient
-Ensure patients is positioned in bed properly
-Discuss with sitter that patient needs continual observation
-Discuss with family sitter if there are any other family members who can help with monitoring Lithia
-Document and contact nursing supervisor/Charge nurse
Scenario 4
-Complete full assessment, to include neuro
-Use therapeutic communication/active listening
-Attempt to orient to person, place, and time
-Offer nutrition and/ or toileting
-Ensure bed is in lowest position, and rails are in place
Scenario 5
-Notify HCP of neuro findings
-Notify charge nurse of patient's deteriorating condition
-Begin q15 minute neuro checks
-Have patient remain in bed, head elevated 30 degrees
-Ensure IV is patent
Page 4 of 38
