Swift River Medical Surgical Exam

Swift River Medical Surgical Exam V1 Scenarios (Latest Update 2025 / 2026) Questions and Verified Answers | Grade A | 100% Correct

Question:

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 1 / 4

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.

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 -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

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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

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Question:

Lithia Monson

Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Hx of dementia, from nursing home, fall one day ago. No known allergies (NKA).Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. Neuro- confusion to time and place, but oriented to self, speech clear, poor historian, did not recognize son today which is new for her; Neuro assessment and vital signs q1 hr. Skin warm dry, bruises on forehead with small laceration. Increased fall risk. DSD (dry sterile dressing), forehead laceration clean and dry intact.20ga. Hep-Lock in place left AC. GI WNL. Cardiovascular has pacer with rate of 82bpm on demand. Strict I&O, regular diet, intake 50%. Waist belt restraint PRN; family sitter at bedside, assist with bath. Dr. Altace

Answer:

Physiological-

Bleeding, Risk for: True

Decreased Cardiac/perfusion: False

Imbalanced Nutrition: True

Nausea: False

Self-Care Deficit: True

Shock, Risk for: False

Safety-

Acute Confusion: True

Fall, risk for: True

Peripheral Neurovascular Dysfunction: False

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