Swift River 2.0

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Sample questions from Swift River 2.0

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical unit, report is given on four clients. Which client should the RN assess first?

   • A.A 75-year-old awaiting discharge instructions after an uncomplicated procedure
   • B.A 31-year-old with diabetes whose premeal glucose is 178 mg/dL
   • C.A 68-year-old with pneumonia whose SpO2 decreased from 94% to 88% on 2 L/min oxygen
   • D.A 42-year-old with a fracture requesting prescribed pain medication

   Rationale: The falling oxygen saturation despite supplemental oxygen signals worsening gas exchange and requires immediate assessment. Pain, discharge teaching, and a glucose of 178 mg/dL are important but do not take priority over respiratory deterioration. The exam takeaway is to prioritize acute threats to airway and breathing.

2. 2.In a rehabilitation hospital, an RN is assigning care for four clients. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess a client who reports new unilateral calf pain
   • B.Obtain routine vital signs for a stable client before morning care
   • C.Evaluate whether a PRN analgesic relieved a client's pain
   • D.Teach a client with a new colostomy how to change the pouch

   Rationale: Obtaining routine vital signs for a stable client is a predictable task that can be delegated to a competent UAP. Teaching, assessment of a new symptom, and evaluation require nursing judgment and remain the RN's responsibility. The RN should specify reporting parameters and follow up on abnormal findings.

3. 3.During a clinic visit, a 58-year-old client says, "I do not understand why I need this procedure." The consent form is unsigned, and transport has arrived. What should the nurse do?

   • A.Explain the risks and benefits and witness the client's signature
   • B.Ask a family member to sign because the client appears anxious
   • C.Ask the client to sign because the provider already explained the procedure
   • D.Pause transport and notify the provider that the client needs further explanation

   Rationale: The provider performing the procedure is responsible for explaining its risks, benefits, and alternatives. The nurse should stop the process and contact the provider when the client indicates inadequate understanding. The nurse should not obtain a signature by pressure, substitute for the provider's explanation, or have family sign for a capable adult.

4. 4.Refer to the client's chart. Which actions should the charge nurse take in response to the change in condition? Select all that apply.

   • A.Wait for the next scheduled vital-sign check before escalating
   • B.Increase oxygen to the prescribed maximum and reassess while awaiting help
   • C.Document the change and interventions with times
   • D.Assess the client's respiratory status immediately
   • E.Notify the rapid response team according to facility criteria

   Answer and rationale are in the full material.

5. 5.A 46-year-old client scheduled for surgery tells the preoperative nurse that the surgeon discussed a different procedure than the one listed on the consent. What is the nurse's priority action?

   • A.Stop preparation and contact the surgeon to resolve the discrepancy
   • B.Ask the client to cross out the listed procedure and write in the discussed procedure
   • C.Ask the client's spouse to confirm which procedure was discussed
   • D.Proceed because the client has signed the consent form

   Answer and rationale are in the full material.