Swift River Med-Surg Exam Questions
and Answers 100% Correct(GRADED
A+)
Carlos Mancia
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx.
r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. Airborne
Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi. Blood-tinged
mucous, productive cough. Diet as tolerated. IV maintenance fluids with D5 1/4 NS @ 150
ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear, concern, and desire for
recovery. Need frequent reminder to stay in room and maintain mask precautions. If
family/visitors come, will need education to airborne precautions. Spanish interpreter
available at extension 61178. Dr. Rondeau - ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Normal
Physiological-
Dysfunctional Gastrointestinal Motility: False
Electrolyte Imbalance: False
Fatigue: True
Impaired Gas Exchange: True
Impaired Mobility: False
Ineffective Airway Clearance: True
Esteem-
Decisional Conflict: False
Noncompliance: True
,Safety-
Anxiety: True
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident. She
is in a traction splint, and will be going for surgical repair today. Vital signs are BP 120/62 P
88 R 20 T 98.9 F, 37.2 C, PaO2 99. She has been in a lot of pain, and has been receiving 25
mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her last Fentanyl dose, and
the Dr. Ordered an additional 4mg IVP, Zofran. She has a history of exercise induced
asthma, and uses a rescue inhaler, Albuterol. Her parents are on their way; they are flying in
today. She was on a ski trip with some of her friends from college; her best friend has been
camped out with her. We were able to get her on a bed pan earlier, but it took a lot of work.
We just received an order for a foley catheter. There was some concern that she may have
sustained a head injury as she has an abrasion to her forehead, but she denies ever losing -
ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Increased
Pain Level: Normal
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Mobility, Risk for: True
Nausea: True
Safety-
Deficient Knowledge: True
Grieving: False
Peripheral Neurovascular Dysfunction: False
Wight Goodman
Wight Goodman, Patient was admitted to the floor last night from the ER for an orbital
fracture. He was hit in the left eye by a softball yesterday. Apparently he was pitching, and
the batter hit a line drive hitting him in the right side of the face. They applied some ice to his
face, and he decided to go to the post game keg party instead of coming to the ER. The
patient stated that there was significant swelling, but his vision was fine, and the pain was
controlled with beer and 800mg of Motrin. He was unable to sleep later in the evening as the
, pain became worse, and his vision became more impaired. The Maxillofacial surgeon was
consulted, and they will see him this morning. They were not concerned as his intraocular
pressure was normal in the ER. There is significant edema and discoloration to the left side
of his face, and his left eye is almost completely swollen shut. His visual acuity is dimin -
ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Comfort: True
Safety-
Deficient Knowledge: True
Infection, Risk for: True
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. - ANSWER-Educational Needs: Increased
Fall Risk: Normal
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Increased
and Answers 100% Correct(GRADED
A+)
Carlos Mancia
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx.
r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. Airborne
Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi. Blood-tinged
mucous, productive cough. Diet as tolerated. IV maintenance fluids with D5 1/4 NS @ 150
ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear, concern, and desire for
recovery. Need frequent reminder to stay in room and maintain mask precautions. If
family/visitors come, will need education to airborne precautions. Spanish interpreter
available at extension 61178. Dr. Rondeau - ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Normal
Physiological-
Dysfunctional Gastrointestinal Motility: False
Electrolyte Imbalance: False
Fatigue: True
Impaired Gas Exchange: True
Impaired Mobility: False
Ineffective Airway Clearance: True
Esteem-
Decisional Conflict: False
Noncompliance: True
,Safety-
Anxiety: True
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident. She
is in a traction splint, and will be going for surgical repair today. Vital signs are BP 120/62 P
88 R 20 T 98.9 F, 37.2 C, PaO2 99. She has been in a lot of pain, and has been receiving 25
mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her last Fentanyl dose, and
the Dr. Ordered an additional 4mg IVP, Zofran. She has a history of exercise induced
asthma, and uses a rescue inhaler, Albuterol. Her parents are on their way; they are flying in
today. She was on a ski trip with some of her friends from college; her best friend has been
camped out with her. We were able to get her on a bed pan earlier, but it took a lot of work.
We just received an order for a foley catheter. There was some concern that she may have
sustained a head injury as she has an abrasion to her forehead, but she denies ever losing -
ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Increased
Pain Level: Normal
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Mobility, Risk for: True
Nausea: True
Safety-
Deficient Knowledge: True
Grieving: False
Peripheral Neurovascular Dysfunction: False
Wight Goodman
Wight Goodman, Patient was admitted to the floor last night from the ER for an orbital
fracture. He was hit in the left eye by a softball yesterday. Apparently he was pitching, and
the batter hit a line drive hitting him in the right side of the face. They applied some ice to his
face, and he decided to go to the post game keg party instead of coming to the ER. The
patient stated that there was significant swelling, but his vision was fine, and the pain was
controlled with beer and 800mg of Motrin. He was unable to sleep later in the evening as the
, pain became worse, and his vision became more impaired. The Maxillofacial surgeon was
consulted, and they will see him this morning. They were not concerned as his intraocular
pressure was normal in the ER. There is significant edema and discoloration to the left side
of his face, and his left eye is almost completely swollen shut. His visual acuity is dimin -
ANSWER-Educational Needs: Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Comfort: True
Safety-
Deficient Knowledge: True
Infection, Risk for: True
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. - ANSWER-Educational Needs: Increased
Fall Risk: Normal
Health Change: Increased
Neurological: Normal
Pain Level: Increased
Psychological Needs: Increased
