SWIFT RIVER- ATI EXAM WITH
CORRECT ANSWERS
2025
Arthur Thomason 56-year-old MVA victim, fourth day post op with a
splenectomy
femur repair. and
He is experiencing new onset of shortness of breath and l
has a nasa
cannula with 2L of Oxygen in place. He is restless with slight confusion
but is easily
orientated with attempts from nurse. Temperature spiked during the night
to 102.4,
now 146/94 BP which is slightly elevated, respirations at 30 bpm and
slightly
heart rate
labored,
102 versus 84 from last night shift. Skin cool to touch and
appears pale.
coughing, to clear
His his airway, appears ineffective. Recent chest X-ray
shows diffuse
bilateral interstitial infiltrates in all lobes. Recent blood gases
demonstrate
PaO2 (hypoxemia)fallingand increasing CO2 (Hypercapnia). Mr. Thomason is
anxious and
obviously worsened
is from the shift before in overall condition. ( Correct
answers ) in comfort:
Alteration
Alteration in gas exchange:
True
Ineffectual airway clearance:
True
True
Potential for shock:
True
Prolonged confusion:
True
Anxiety/fear:
True
Potential for failure to thrive:
True
Charlie Raymond 65-year-old male who was admitted to a negative
pressure room
Med-Surg on
for COVID precautions.. He has a history of COPD,
hypertension,
type II, and a recent
diabetes
myocardial infarction. He is a retired postal worker
who lives
home withathis wife. He is on Claforan (cefotaxime) 2 g IV q4hr and sliding
scale insulin.
Initially this cardiologist was concerned about congestive heart
failure andisMr.
Raymond receiving Furosemide (Lasix) 20 mg IV twice a day for
pulmonary
Vital Signs: edema.
BP is 145/78, Pulse 89 Respirations 24 and slightly labored,
100.2 SaO2 94% on 2L nasal cannula. The patient/family is fearing the
Temperature
worst due Pandemic.
COVID-19 to ( Correct answers ) 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
uncontrolled type
his II diabetes. He is married, and his wife is requesting
to stay
side. HisatHbgA1c
his is 10.6%. He has a history of a Myocardial Infarction, MI,
one has
and yearrefused
ago, all cardiac rehab, and has not had another cardiac event.
Hecomply
to refuseswith dietary recommendations. His BMI is 37. Vital signs are:
BP: R:
88, 146/94,
22, T: P:99.2, PaO2: 94% Blood glucose upon admission is 340
mg/dl ( Correct
answers ) Select appropriate nursing concerns below based upon
patient report
abov
e:
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;
allergies (NKA); Vital
No known
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
IV maintenance suction.
fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in
left forearm.with minimal assistance. Family at beside. Dr. Sangerstien
Ambulates
( Correct ) Select appropriate nursing concerns below based upon
answers
patient report
abov
e:
Physiologic
al
, Acute discomfort
Alteration in bowel elimination:
False
diarrhea: false
Alteration in comfort:
true
Alteration in mobility:
true
Decreased activity tolerance:
Potential for alteration in electrolyte
false
balance: true
Safety
Fear:
Ineffectual self-health management:
false
Knowledge deficit:
false
Potential for falls:
true
Potential for infection:
true
Sleep deficit: false
true
Tom Richardson 46yr-old. Dx- urinary stones with 3 episodes/5yrs.
AllergicVital
drugs. to sulfa
signs -Temp 98.4,BP 175/105, P 112, RR 28, SaO2 94%;
Neuro-and
warm WNL's.
pale.Skin
Generalized weakness, blood tinged urine and severe
pain upon GI- n/v. Clear liquid diet. Strict I&O and strain all urine, filters in
urination,
bathroom.
Patient demonstrates urine strain procedure. Severe pain (10/10)
medicated
minutes x4qwith
30 IV Morphine 2mg with little relief. IV D5 1/2 NS @100ml/hr.
Dr. Smallwith
bedside at patient and family. Stat lithotripsy treatment ordered.
(Awaiting
Correct transport.
answers ) Select appropriate nursing concerns below based
upon patient
report
above:
Physiologic
al
Acute
discomfort:inT
Alteration
nutrition: Fin urinary
Alteration
elimination: T
Electrolyte
Imbalance:
Potential forF alteration in
mobility: T
Potential for alteration in skin
integrity: F
Safet
y
Potential for
falls: T Sleep
deficit: T
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
CORRECT ANSWERS
2025
Arthur Thomason 56-year-old MVA victim, fourth day post op with a
splenectomy
femur repair. and
He is experiencing new onset of shortness of breath and l
has a nasa
cannula with 2L of Oxygen in place. He is restless with slight confusion
but is easily
orientated with attempts from nurse. Temperature spiked during the night
to 102.4,
now 146/94 BP which is slightly elevated, respirations at 30 bpm and
slightly
heart rate
labored,
102 versus 84 from last night shift. Skin cool to touch and
appears pale.
coughing, to clear
His his airway, appears ineffective. Recent chest X-ray
shows diffuse
bilateral interstitial infiltrates in all lobes. Recent blood gases
demonstrate
PaO2 (hypoxemia)fallingand increasing CO2 (Hypercapnia). Mr. Thomason is
anxious and
obviously worsened
is from the shift before in overall condition. ( Correct
answers ) in comfort:
Alteration
Alteration in gas exchange:
True
Ineffectual airway clearance:
True
True
Potential for shock:
True
Prolonged confusion:
True
Anxiety/fear:
True
Potential for failure to thrive:
True
Charlie Raymond 65-year-old male who was admitted to a negative
pressure room
Med-Surg on
for COVID precautions.. He has a history of COPD,
hypertension,
type II, and a recent
diabetes
myocardial infarction. He is a retired postal worker
who lives
home withathis wife. He is on Claforan (cefotaxime) 2 g IV q4hr and sliding
scale insulin.
Initially this cardiologist was concerned about congestive heart
failure andisMr.
Raymond receiving Furosemide (Lasix) 20 mg IV twice a day for
pulmonary
Vital Signs: edema.
BP is 145/78, Pulse 89 Respirations 24 and slightly labored,
100.2 SaO2 94% on 2L nasal cannula. The patient/family is fearing the
Temperature
worst due Pandemic.
COVID-19 to ( Correct answers ) 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
uncontrolled type
his II diabetes. He is married, and his wife is requesting
to stay
side. HisatHbgA1c
his is 10.6%. He has a history of a Myocardial Infarction, MI,
one has
and yearrefused
ago, all cardiac rehab, and has not had another cardiac event.
Hecomply
to refuseswith dietary recommendations. His BMI is 37. Vital signs are:
BP: R:
88, 146/94,
22, T: P:99.2, PaO2: 94% Blood glucose upon admission is 340
mg/dl ( Correct
answers ) Select appropriate nursing concerns below based upon
patient report
abov
e:
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;
allergies (NKA); Vital
No known
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
IV maintenance suction.
fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in
left forearm.with minimal assistance. Family at beside. Dr. Sangerstien
Ambulates
( Correct ) Select appropriate nursing concerns below based upon
answers
patient report
abov
e:
Physiologic
al
, Acute discomfort
Alteration in bowel elimination:
False
diarrhea: false
Alteration in comfort:
true
Alteration in mobility:
true
Decreased activity tolerance:
Potential for alteration in electrolyte
false
balance: true
Safety
Fear:
Ineffectual self-health management:
false
Knowledge deficit:
false
Potential for falls:
true
Potential for infection:
true
Sleep deficit: false
true
Tom Richardson 46yr-old. Dx- urinary stones with 3 episodes/5yrs.
AllergicVital
drugs. to sulfa
signs -Temp 98.4,BP 175/105, P 112, RR 28, SaO2 94%;
Neuro-and
warm WNL's.
pale.Skin
Generalized weakness, blood tinged urine and severe
pain upon GI- n/v. Clear liquid diet. Strict I&O and strain all urine, filters in
urination,
bathroom.
Patient demonstrates urine strain procedure. Severe pain (10/10)
medicated
minutes x4qwith
30 IV Morphine 2mg with little relief. IV D5 1/2 NS @100ml/hr.
Dr. Smallwith
bedside at patient and family. Stat lithotripsy treatment ordered.
(Awaiting
Correct transport.
answers ) Select appropriate nursing concerns below based
upon patient
report
above:
Physiologic
al
Acute
discomfort:inT
Alteration
nutrition: Fin urinary
Alteration
elimination: T
Electrolyte
Imbalance:
Potential forF alteration in
mobility: T
Potential for alteration in skin
integrity: F
Safet
y
Potential for
falls: T Sleep
deficit: T
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
