i-Human Case Week 7: 28-Year-Old Male – Reason for
Encounter: Cough and Fatigue 2026 | Full Case Study,
Assessment & Plan | NURS 6512 Walden University |
Advanced Health Assessment Simulation
Q001: A 28-year-old male presents to the urgent care clinic with a 2-week history of
productive cough and progressive fatigue. He reports the cough is worse at night and
produces yellow-green sputum. He also notes intermittent low-grade fevers, chills, and
pleuritic chest pain. He has no chronic medical conditions and takes no regular
medications. He smokes 1 pack of cigarettes daily for the past 8 years. He denies
recent travel, sick contacts, or known TB exposure. What is your first priority question to
ask regarding his social history to assess risk for communicable respiratory diseases?
Options:
A. "Do you live in a rural or urban area?"
B. "What is your occupation and have you had any recent occupational exposures to
chemicals?"
C. "Have you had any close contact with individuals who have been diagnosed with
tuberculosis, influenza, or COVID-19 in the past 3 weeks?" - CORRECT
D. "Do you have any pets at home?"
(Correct Answer: C)
Q002: The patient reports that his cough began 14 days ago after a brief period of nasal
congestion and sore throat. He initially thought it was a "cold" but symptoms have
worsened. He now produces approximately 2 tablespoons of yellow-green sputum daily.
He rates his fatigue as 7/10 and notes that it prevents him from completing his usual
8-hour work shifts. He reports occasional wheezing but no hemoptysis. What additional
history regarding his cough is most critical to obtain at this point in the interview?
Options:
A. "Does the cough worsen when you are lying flat?"
B. "Have you measured your temperature at home, and if so, what were the readings?" -
CORRECT
C. "Does anyone in your household smoke?"
D. "Have you tried any over-the-counter cough suppressants?"
(Correct Answer: B)
, Q003: The patient's vital signs are: Temperature 100.8°F, Blood Pressure 128/76 mmHg,
Heart Rate 92 bpm, Respiratory Rate 22/min, O2 Saturation 94% on room air. He
appears tired but is in no acute distress. You note he is using accessory muscles
minimally. Based on his presentation and vital signs, which focused body system should
be prioritized for your physical examination?
Options:
A. Cardiovascular system with emphasis on murmurs and peripheral edema
B. Respiratory system including lung auscultation, percussion, and assessment of
respiratory effort - CORRECT
C. Abdominal system to assess for organomegaly
D. Neurological system with comprehensive cranial nerve testing
(Correct Answer: B)
Q004: During your focused respiratory exam, you note decreased breath sounds in the
right lower lobe with coarse crackles. There is dullness to percussion in the same area.
The patient reports pleuritic chest pain localized to the right lower chest wall. Which
physical examination technique should you perform next to further characterize this
finding?
Options:
A. Bronchophony and egophony testing - CORRECT
B. Assessment of tactile fremitus only in the anterior chest
C. Spirometry testing at the bedside
D. Peak expiratory flow measurement
(Correct Answer: A)
Q005: Bronchophony is positive with increased vocal resonance and egophony reveals
an "E-to-A" change in the right lower lobe. The patient's cough remains productive.
Based on these physical exam findings, which pathophysiological process is most likely
present?
Options:
A. Pneumothorax
B. Consolidation from pneumonia - CORRECT
C. Asthma exacerbation
D. Pulmonary embolism
(Correct Answer: B)
Q006: You perform a comprehensive review of systems. The patient reports mild night
sweats for the past 3 nights, occasional pleuritic chest pain, and shortness of breath
Encounter: Cough and Fatigue 2026 | Full Case Study,
Assessment & Plan | NURS 6512 Walden University |
Advanced Health Assessment Simulation
Q001: A 28-year-old male presents to the urgent care clinic with a 2-week history of
productive cough and progressive fatigue. He reports the cough is worse at night and
produces yellow-green sputum. He also notes intermittent low-grade fevers, chills, and
pleuritic chest pain. He has no chronic medical conditions and takes no regular
medications. He smokes 1 pack of cigarettes daily for the past 8 years. He denies
recent travel, sick contacts, or known TB exposure. What is your first priority question to
ask regarding his social history to assess risk for communicable respiratory diseases?
Options:
A. "Do you live in a rural or urban area?"
B. "What is your occupation and have you had any recent occupational exposures to
chemicals?"
C. "Have you had any close contact with individuals who have been diagnosed with
tuberculosis, influenza, or COVID-19 in the past 3 weeks?" - CORRECT
D. "Do you have any pets at home?"
(Correct Answer: C)
Q002: The patient reports that his cough began 14 days ago after a brief period of nasal
congestion and sore throat. He initially thought it was a "cold" but symptoms have
worsened. He now produces approximately 2 tablespoons of yellow-green sputum daily.
He rates his fatigue as 7/10 and notes that it prevents him from completing his usual
8-hour work shifts. He reports occasional wheezing but no hemoptysis. What additional
history regarding his cough is most critical to obtain at this point in the interview?
Options:
A. "Does the cough worsen when you are lying flat?"
B. "Have you measured your temperature at home, and if so, what were the readings?" -
CORRECT
C. "Does anyone in your household smoke?"
D. "Have you tried any over-the-counter cough suppressants?"
(Correct Answer: B)
, Q003: The patient's vital signs are: Temperature 100.8°F, Blood Pressure 128/76 mmHg,
Heart Rate 92 bpm, Respiratory Rate 22/min, O2 Saturation 94% on room air. He
appears tired but is in no acute distress. You note he is using accessory muscles
minimally. Based on his presentation and vital signs, which focused body system should
be prioritized for your physical examination?
Options:
A. Cardiovascular system with emphasis on murmurs and peripheral edema
B. Respiratory system including lung auscultation, percussion, and assessment of
respiratory effort - CORRECT
C. Abdominal system to assess for organomegaly
D. Neurological system with comprehensive cranial nerve testing
(Correct Answer: B)
Q004: During your focused respiratory exam, you note decreased breath sounds in the
right lower lobe with coarse crackles. There is dullness to percussion in the same area.
The patient reports pleuritic chest pain localized to the right lower chest wall. Which
physical examination technique should you perform next to further characterize this
finding?
Options:
A. Bronchophony and egophony testing - CORRECT
B. Assessment of tactile fremitus only in the anterior chest
C. Spirometry testing at the bedside
D. Peak expiratory flow measurement
(Correct Answer: A)
Q005: Bronchophony is positive with increased vocal resonance and egophony reveals
an "E-to-A" change in the right lower lobe. The patient's cough remains productive.
Based on these physical exam findings, which pathophysiological process is most likely
present?
Options:
A. Pneumothorax
B. Consolidation from pneumonia - CORRECT
C. Asthma exacerbation
D. Pulmonary embolism
(Correct Answer: B)
Q006: You perform a comprehensive review of systems. The patient reports mild night
sweats for the past 3 nights, occasional pleuritic chest pain, and shortness of breath
