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Swift River Med-Surg Correct Questions
& Answers
Donald Lyles - ANSWER Educational - increased Fall Risk - normal Health Change - increased Neurological - normal Pain - normal Psychological Needs - normal Donald Lyles - ANSWER Scenario # Establish responsiveness Call for code Check for breathing Begin continuous When help arrives Scenario # Assist with airway Assist with applying Establish large IV Provide pt. hx Provide medical hx Scenario # Check time Establish when the cardiac Document rhythm Begin list of medications Remind CODE Scenario # Ensure cardio pads Charge the monitor Announce to CODE Announce, "CLEAR" Ensure no one Scenario # Give 1mg atropine Reassess its VS Repeat 1mg atropine Prepare for external Document and accompany
Donald Lyles - ANSWER Knowledge deficit Potential for infection Karen Cole - ANSWER Educational - increased Fall Risk - normal Health Change - increased Pain - normal Psychological Needs - normal Sensorium - normal Kate Bradley - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - increased Neurological - increased Cameron Daniels - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - normal Neurological - normal Kenny Barrett - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - normal Sensorium - increased Ann Rails - ANSWER Educational - Increased Fall Risk - Increased Health Change - Increased Pain - Increased Psychological Needs - Increased Dana Fitzgerald - ANSWER Educational - increased Fall Risk - normal Health Change - increased Pain - increased Psychological Needs - normal Neurological - normal
Potential for bleeding Knowledge deficit Potential for falls Potential for infection Kenny Barrett - ANSWER Acute discomfort Knowledge deficit Potential for falls Arthur Thomason - ANSWER Scenario # Assess Replace oxygen Use therapeutic communication Notify Dr. and charge nurse Scenario # Remind physician Explain to physician Assist physician Obtain recent Reassure pt. Scenario # Tap pt. Elevate HOB Call rapid response Start secondary Remain with pt. Scenario # Provide verbal report Emergency intubation Assume role Obtain pt. record Provide information Scenario # You explain that his condition You explain that he is receiving You have them remain with you You escort them with you You call his doctor ASSISTANCE REQUESTED Patient in the next room states, "My IV tubing is tangled in the bed rail." - ANSWER LPN
ASSISTANCE REQUESTED
Patient tells family, "I need my urinal emptied." - ANSWER CNA ASSISTANCE REQUESTED You hear a patient screaming, "My IV site is burning me now." - ANSWER RN ASSISTANCE REQUESTED Call light on. No answer from patient. - ANSWER CNA ASSISTANCE REQUESTED You hear a patient moaning, "I'm too hot. Do something!" - ANSWER CNA ASSISTANCE REQUESTED Patient in other room states, "I would like to speak to your chaplain." - ANSWER CNA ASSISTANCE REQUESTED Patient in the next room states, "My dressing just came off and I need it back on." - ANSWER LPN ASSISTANCE REQUESTED A patient states, "I'm having the worst headache of my life!" - ANSWER RN ASSISTANCE REQUESTED Patient cries, "My pain is worse now! Do something!" - ANSWER LPN Chanthavy Chhet - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - increased Neurological - normal Don Johnson - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - normal Neurological - normal John Duncan - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - normal Sensorium - normal Sarah Getts - ANSWER Educational - increased
Psychological - normal Kathy Gestalt - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - normal Psychological Needs - increased Sensorium - normal Ruth Cummings - ANSWER Educational - increased Fall Risk - increased Health Change - increased Pain - increased Psychological Needs - increased Neurological - normal Chanthavy Chhet - ANSWER Acute discomfort Nausea Potential for alteration in mobility Alteration in verbal communication Cultural competence Knowledge deficit Don Johnson - ANSWER Acute discomfort Potential for alteration in electrolyte balance Potential for altered body image Potential for audiology changes Potential for PTSD Potenial for infection Julia Monroe - ANSWER Acute discomfort Alteration in comfort Alteration in mobility Potential for falls Ramona Stukes - ANSWER Alteration in mobility Potential for bleeding Potential for decrease in fluid volume Potential for falls Potential for infection Kathy Gestalt - ANSWER Alteration in mobility Potential for alteration in skin integrity Anxiety Knowledge deficit Potential for falls
Alteration in body image Decisional Conflict Ruth Cummings - ANSWER Acute discomfort Knowledge deficit Nausea Potential for alteration in mobility John Duncan - ANSWER Decrease in fluid volume Exhaustion Potential for alteration in electrolyte imbalance Potential for falls Noncompliance Wight Goodman - ANSWER Scenario # Wash hands & assess Complete neuro Check the blood Pre-op education Ask surgeon Scenario # Complete neuro Educate pt. Evaluate pt's understanding Administer IV ABX Sign additional Scenario # Complete neuro Educate pt. & family Inform healthcare provider Contact social services Extensive discharge Scenario # Repeat neuro Reemphasize to pt. Approach resident Contact nursing supervisor Document Scenario # Assure patient Take vital signs Restart patients IV
Scenario # Reassess lung sounds Empty foley bag Administer pain meds Notify HCP Document Scenario # Elevate HOB Assess pt's sputum Reassure the pt. Assure the pt. Contact respiratory therapy Scenario # Obtain doppler pulse Adjust rate of IV Ask for available tech Change dressing Determine if the pt. Scenario # Obtain bear hugger Explain to the pt. Notify nursing supervisor Contact nutritionist Allow visitors to enter Julia Monroe - ANSWER Scenario # Perform initial Ask the pt. if she Ask the pt about Ask if the pt. understands Ensure informed consent Scenario # Comfort the pt Provide education Explain the TX Evaluate pt. Document Scenario # Assist the pt. Perform Draw digoxin
Request order Place call light Scenario # Assess the pt. Establish an IV Administer digoxin Monitor for adverse Request repeat Scenario # Check leads Perform Start O Call RRT Educate pt Ramona Stukes - ANSWER Scenario # Wash & glove Full assessment Allow expression Educate pt. Evaluate understanding Scenario # Wash & glove Full assessment Check NG tube Administer IV antiemetic Scenario # Full assessment Educate pt. Evaluate understanding Notify lead RN Consult wound care Scenario # Discuss w/ pt. Notify lead RN Contact social services Update pt. Scenario # Follow HIPAA Explain HIPAA
Describe to pt Explain Practice Reinforce Evaluate Scenario # Ask Ensure Take VS Check for IV Disconnect Scenario # Receive Assess/inspect Elevate Take VS Give pt Scenario # Assist pt Ensure Notify charge nurse Notify HCP Complete John Duncan - ANSWER Scenario # Assess I&O Construct dietary consult Acquire daily weight Evaluate outcome Scenario # Full assessment Check I&O Teach pt. about safety Document Scenario # Wash/glove hands Provide emesis basin VS assessment Administer antiemetic Evaluate medication
Scenario # VS assessment Assessment of bowel Administer protocol Document results Include pt. condition Scenario # Inform & educate spouse Evaluate/modify Assess food Document Cameron Daniels - ANSWER Scenario # Give tylenol Start another IV Initiate bolus Request additional pain med Reasses temp in 1 hour Scenario # Sit at an eye level Teach Cameron Evaluate understanding Contact charge nurse Document pt's statements Scenario # Provide emotional support Assure pt. Explain to pt. Stress importance Inform pt. Scenario # Make sure accurate wt. Explain reason for medication Tell the mother that you understand Tell the mother that visitors are welcome Be honest with Cameron Scenario # Assess pt. Perform rapid assessment Ask pt. Inform charge nurse
Explain to wife Reassess pt Call GI Explain to pt Scenario # Identify the client Check the client Document Check vs Recheck VS Scenario # Repeat H&H Administer Explain Verify with blood Verify soft Scenario # Stop the platelets Reassess Notify HCP Call charge Initiate incident "I don't want anymore visitors" - ANSWER RN ASSISTANCE REQUESTED Patient tells aid, "I need something for sleep." - ANSWER LPN Wight Goodman - ANSWER Scenario # Wash hands & assess Complete neuro Check the blood Pre-op education Ask surgeon Scenario # Complete neuro Educate pt. Evaluate pt's understanding Administer IV ABX Sign additional Scenario #
Complete neuro Educate pt. & family Inform healthcare provider Contact social services Extensive discharge Scenario # Repeat neuro Reemphasize to pt. Approach resident Contact nursing supervisor Document Scenario # Assure pt. Take VS Restart pt's IV Obtain surgical Remain with pt. ASSISTANCE REQUESTED As you are passing medication, you hear a patient say, "My dressing bandage is oozing blood." - ANSWER LPN ASSISTANCE REQUESTED Patient tells family, "Please call my doctor. I need him now!" - ANSWER RN Nathaniel Gonzalez - ANSWER Scenario # Tell the pt. that Remove the lunch Tell the pt. to call Explain to the pt. Ensure the bed Scenario # Explain the the pt Remove the lunch tray Administer the med Assess if the contents Ensure pre-op Scenario # Assess pt's LOC Elevate HOB Reapply NC Remove the dinner tray
Remove infiltrated IV Don new gloves Insert new IV Scenario # Assess pt. & family Provide pt. post MI Pt. & family should Schedule cardiac Document Kate Bradley - ANSWER Scenario # Secure help Complete full Medicate Complete bed bath Contact Nursing Sup Scenario # Verify VS Notify HCP Contact IV team Report discrepancy Document Scenario # Explain to surgeon Check on labs Contact charge nurse Meet with daughter Assess pt. Scenario # Provide therapeutic Assess last medication Assist the IV team Explain to daughter Update surgeon Scenario # 88 y/o female Former nursing home pt Pt has a foley Have the daughter stay Kenny Barrett - ANSWER Scenario #
Perform hand hygiene Reassess BP & P Evaluate pt's understanding Administer Document Scenario # Retake VS Perform comfort Instruct pt Request CNA Notify the healthcare Scenario # Pt. Kenny Barrett Pt. was admitted Current VS Request possible change Scenario # Take VS not Maintain strice 500 mL NS Hold next dose Contact HCP Scenario # Assess stress level Communicate Educate pt. Discuss willingness Contact HCP Sarah Getts - ANSWER Scenario # Wash and glove Full assessment Monitor and evaluate Educate pt. Document Scenario # Wash and glove Full assessment Apply fall risk Document
