Swift River Medical Surgical Exam

Swift River Medical Surgical Exam V2 Scenarios (Latest Update 2025 / 2026) Questions and Verified Answers | Grade A | 100% Correct

Question:

Cameron Daniels Cameron Daniels just 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%.

Answer:

Acute discomfort Alteration in mobility Knowledge deficit Potential for falls Potential for infection

• / 4

Question:

Cameron Daniels Scenario 1 Cameron Daniels Cameron is on the Med-Surg floor and complaining of 9/10 abdominal pain. Her pregnancy test is positive, and the provider is concerned that it may be ectopic and has scheduled an ultrasound. She has an order for Tylenol 1 gm for T > 99.0. The IV barely running and the IV pump keeps alarming occluded. She has only received 500 ml of her Liter bolus. She also has an order for Cefotan (Cefotetan) 2 g intravenously IV every 12 hours and Oracea (Doxycycline) 100 mg by mouth every 12 hours. VS BP 96/58, P 116, R 18, T 101.2 PaO2 98%.

Answer:

1- Give Tylenol 1g 2- Start another IV then DC the first.3- Initiate bolus and medications 4- Request additional pain med order from the HCP 5- Reassess temperature in 1hr

Question:

Cameron Daniels Scenario 2 Cameron DanielsThe nurse is speaking with the Cameron about her diagnosis. The cultures were positive for chlamydia and gonorrhea. She asks the nurse how she got this infection. The patient had denied being sexually active in the ER. Cameron finally tells the nurse that she has been seeing an older married man from their church for few years, and they are in love. Once realizing the patient just turned 18 the nurse asks her how many years this relationship has been going and the patient tells her 3 years. 2 / 4

Answer:

1- Sit at an eye level with the patient using nonjudgmental therapeutic communication 2- Teach Cameron concerning the complications of PID, STIs, and infectious disease.3- Evaluate patient understanding of STIs and unprotected sex 4- Contact the charge nurse / law enforcement and inform them about the potential legal issues.5- Document patients' statement and prepare a written report.

Question:

Cameron Daniels Scenario 3 Cameron DanielsThe provider is visiting with Cameron and informs her that her pregnancy test is positive, and they are concerned that it may be ectopic.The patient becomes very upset and admits that she has been also seeing more than one individual as she also had sex with a boy from her high school, "but it was just one time". She asks the nurse not to tell her mother. Later that day Cameron is visited by a young man who brings her flowers. The nurse overhears the patient telling her visitor that she had appendicitis and she will be well soon.

Answer:

1- Provide emotional support and ask open ended nonjudgmental questions.The nurse should establish trust first.2- Assure patient that as an adult her medical information is private unless she gives consent for release to other individuals. Cameron has just turned 18 3 / 4

but still lives at home, therefore she is transitioning into the mindset off an adult.3- Explain to the patient that she has a sexually transmitted infection and while her patient information is private this type of infection is required to be reported to the Department of Health. As an adult she she has the right to privacy but this disease has consequences.4- Stress the importance of informing any sexual partners of her STI as they may transmit the infection.5- Inform patient that you will set-up a one-on-one with a pregnancy counselor to discuss her pregnancy to include a description of an ectopic pregnancy

Question:

Cameron Daniels Scenario 4 Cameron DanielsThe ultrasound was positive for an ectopic pregnancy and the provider has ordered methotrexate 1.0 mg/kg in two divided doses.Cameron's' mother comes to visit and is insisting that she be allowed to talk to the doctor in private. She also asks if she can spend the night. The mother states that they are very religious, and she has invited their pastor to come by to pray for her daughter. The mother does not know about the ectopic pregnancy nor understand Cameron's diagnosis or social circumstances. She is requesting information about Cameron's diagnosis.

Answer:

1- Make sure you have an accurate weight on the patient and verify the prescribed dosing.

• / 4