Exam (elaborations)
Swift River Week 1- Medical-Surgical Exam Questions and Answers
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Swift River Week 1- Medical-Surgical Exam Questions and Answers
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Swift River: Week 1- Medical-SurgicalExam Questions and Answers
Nathaniel Gonzalez | Room 301
Patient Overview
Nathaniel_Gonzalez.jpgNathaniel Gonzalez, a 58-year-old male patient presents to the
ER CO CP 10/10. He is pale, weak, diaphoretic, and appears anxious. He has a history
of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums. He
also has a history of hypertension and takes Tenormin (Atenolol) and Atorvastatin
(Lipitor). He was recently treated for a URI with a Z pack, prednisone, and Motrin for
pain. BP 154/89, P 94 F, R 22, T - Correct Answers -Educational- Increased
Fall Risk- Increased
Health Change- Increased
Pain Level- Increased
Neurological Status- Normal
Psychological Needs- Increased
Kathy Gestalt Scenario 2
Kathy GestaltMs. Gestalt is now complaining of fever and chills. - Correct Answers -1-
Wash and glove hands
2- Vital sign assessment
3- Administer antipyretic meds
4- Verify call light/bed safety precautions
5- Document results/findings
Kathy Gestalt Scenario 3
Kathy GestaltAfter 24 hours, Ms. Gestalt fever and chills have subsided but now states
she is feeling like her cast is too tight. - Correct Answers -1- Inspect cast site
2- Assess toe movement and capillary refilling
3- Notify doctor if condition is abnormal
4- Document Results/Findings
Kathy Gestalt Scenario 4
Kathy GestaltMs. Gestalt capillary refilling is now 6 secs below cast site. The extremity
is swollen and cold to the touch. - Correct Answers -1- Assess pain
2- Elevate extremity
3- Educate patient regarding condition
, 4- Notify lead nurse/doctor
5- Retrieve cast removal tool
Kathy Gestalt Scenario 5
You enter room and find Ms. Gestalt crying because she has just learned her medical
insurance has lapsed and she is already two months behind on her car payments. -
Correct Answers -1- Use therapeutic communication/Active Listening
2- Notify lead nurse/doctor
3- Consult Social Service
4- Evaluation patient after consult
5- Document Results
Nathaniel Gonzalez
Nathaniel Gonzalez , a 58-year-old male patient presents to the ER CO CP 10/10. He is
pale, weak, diaphoretic, and appears anxious. He has a history of well controlled GERD
with over-the-counter Tagamet (Cimetidine), and Tums. He also has a history of
hypertension and takes Tenormin (Atenolol) and Atorvastatin (Lipitor). He was recently
treated for a URI with a Z pack, prednisone, and Motrin for pain. BP 154/89, P 94 F, R
22, T 98.3F, SaO2 95% on room air. The patient was plac - Correct Answers -Acute
discomfort
Knowledge deficit
Potential for falls
Nathaniel Gonzalez Scenario 1
Nathaniel GonzalezMr. Gonzalez has been admitted to the floor to determine that his
chest pain is not related to a cardiac event. The ER nurse reports that his cardiac
enzymes were borderline and the GI cocktail given in the ER did relieve his CP but not
completely. - Correct Answers -1- Tell the patient that they are being admitted to r/o any
cardiac issues
2- Remove the lunch tray from patient and reinforce the risk if patient has not been NPO
and ask the patient when the last time they ate.
3- Tell the patient to call immediately if the chest pain gets worse or they become short
of breath
4- Explain to the patient that because of his weakness and unknown cardiac status as
well as the IV, he is a fall risk and should not get out of bed without assistance.
5- Ensure pre-operative consent has been signed. Remind the nursing staff that the
patient is NPO.
Nathaniel Gonzalez Scenario 2
Nathaniel GonzalezMr. Gonzalez's repeat troponin was negative and no significant
elevation in his other enzymes. He has been ruled out for an MI. He told the nurse that
he has had some changes in his bowel habits and his stools have been very dark. The
patient has been scheduled for an EGD today and has an order for Omeprazole
(Prilosec) and Carafate (sucralfate). When the nurse enters the room later that day to
inform him that the procedure is scheduled for 1430, t - Correct Answers -1- Explain to
the patient that he has a procedure, and he cannot eat.
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