Shadow Health Actual Exam 2026/2027 | Version 1 | DCE
Standards Q&A | AACN Essentials Aligned | Pass
Guaranteed - A+ Graded
Section 1: Health History Interview (15 Questions)
Q1: Therapeutic Communication - Opening Assessment
During a Shadow Health assignment, a patient reports occasional chest discomfort.
Which question is most appropriate for the nurse to ask next?
A. "Have you taken any nitroglycerin for this?"
B. "Can you describe what the discomfort feels like?" [CORRECT]
C. "Does anyone in your family have heart problems?"
D. "When was your last electrocardiogram?"
Correct Answer: B
Rationale: Using the OLDCARTS mnemonic (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Related symptoms, Treatment, Severity), asking the
patient to describe the sensation (Quality/Characteristics) is the priority to fully
characterize the chest discomfort. This open-ended question aligns with therapeutic
communication principles in the Shadow Health platform and allows the patient to
describe quality (pressure, sharp, burning), which helps differentiate cardiac vs.
non-cardiac causes. Option A assumes a diagnosis and medication history; Option C
explores family history which is important but not immediate; Option D focuses on
diagnostics rather than patient symptom description .
,Q2: Health History Components - Select-All-That-Apply
When gathering a comprehensive health history in Shadow Health, which components
are essential for the subjective data collection phase? (Select all that apply)
A. ✓ Chief complaint and history of present illness [CORRECT]
B. ✓ Past medical history and current medications [CORRECT]
C. ✓ Family history and social history [CORRECT]
D. ✓ Review of systems [CORRECT]
E. ✗ Vital signs measurement
F. ✓ Health promotion activities [CORRECT]
Correct Answers: A, B, C, D, F
Rationale: Subjective data collection in Shadow Health's DCE includes all
patient-reported information: chief complaint, HPI (using OLDCARTS), past medical
history, medications/allergies, family history, social history (occupation, habits, support
systems), review of systems (ROS), and health promotion (exercise, diet, screening).
Vital signs (E) are objective data collected during the physical examination phase, not
the interview portion. Shadow Health's Conversation Concept Lab emphasizes these
components as foundational to building the digital patient encounter .
Q3: Medication Reconciliation
A patient in Shadow Health states they take "a little white pill for blood pressure and a
water pill." Which nursing response demonstrates best practice for medication
reconciliation?
,A. "I understand you take hydrochlorothiazide and lisinopril. Do you take them every
day?"
B. "Can you show me the pill bottles or tell me the exact names on the labels? It's
important I document the correct medications and doses." [CORRECT]
C. "Those are probably diuretics and ACE inhibitors. How long have you been on them?"
D. "The white pill is likely lisinopril 10mg. Do you have any side effects?"
Correct Answer: B
Rationale: Medication reconciliation requires verification of exact medication names,
doses, routes, frequencies, and adherence. Assuming medication identity (Options A, D)
or class (Option C) can lead to documentation errors in the Shadow Health EHR system.
The correct approach asks the patient to verify actual pill bottles or names, ensuring
accurate data entry into the electronic health record. This prevents medication errors
and supports patient safety .
Q4: Cultural Competence
A Shadow Health patient from a different cultural background seems hesitant to make
eye contact. Which response demonstrates cultural humility?
A. "I notice you're not looking at me. In America, we make eye contact to show respect."
B. "I want you to feel comfortable. Please let me know if there are any cultural practices
I should be aware of to better care for you." [CORRECT]
C. "Don't be shy. You can trust me—I'm here to help."
D. "I'll continue the assessment since you seem uncomfortable speaking."
, Correct Answer: B
Rationale: Cultural humility involves self-reflection, recognizing power imbalances, and
partnering with patients regarding their cultural practices. Option B acknowledges
potential cultural differences without judgment and invites patient expertise. Option A
imposes Western cultural norms; Option C dismisses cultural context; Option D
abandons therapeutic communication. Shadow Health's diverse patient scenarios
require culturally sensitive care .
Q5: Pain Assessment - OLDCARTS Application
A patient reports headache. Which follow-up question best assesses the "A"
(Aggravating/Alleviating factors) in OLDCARTS?
A. "When did the headache start?"
B. "What makes the headache worse or better?" [CORRECT]
C. "On a scale of 0-10, how severe is it?"
D. "Is the pain sharp or dull?"
Correct Answer: B
Rationale: The "A" in OLDCARTS specifically addresses aggravating and alleviating
factors—what makes symptoms worse or better. This helps identify triggers (stress,
food, position) and relief measures (rest, medication, darkness) that inform differential
diagnosis. Option A addresses Onset; Option C addresses Severity; Option D addresses
Characteristics .
Q6: Mental Health Screening
Standards Q&A | AACN Essentials Aligned | Pass
Guaranteed - A+ Graded
Section 1: Health History Interview (15 Questions)
Q1: Therapeutic Communication - Opening Assessment
During a Shadow Health assignment, a patient reports occasional chest discomfort.
Which question is most appropriate for the nurse to ask next?
A. "Have you taken any nitroglycerin for this?"
B. "Can you describe what the discomfort feels like?" [CORRECT]
C. "Does anyone in your family have heart problems?"
D. "When was your last electrocardiogram?"
Correct Answer: B
Rationale: Using the OLDCARTS mnemonic (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Related symptoms, Treatment, Severity), asking the
patient to describe the sensation (Quality/Characteristics) is the priority to fully
characterize the chest discomfort. This open-ended question aligns with therapeutic
communication principles in the Shadow Health platform and allows the patient to
describe quality (pressure, sharp, burning), which helps differentiate cardiac vs.
non-cardiac causes. Option A assumes a diagnosis and medication history; Option C
explores family history which is important but not immediate; Option D focuses on
diagnostics rather than patient symptom description .
,Q2: Health History Components - Select-All-That-Apply
When gathering a comprehensive health history in Shadow Health, which components
are essential for the subjective data collection phase? (Select all that apply)
A. ✓ Chief complaint and history of present illness [CORRECT]
B. ✓ Past medical history and current medications [CORRECT]
C. ✓ Family history and social history [CORRECT]
D. ✓ Review of systems [CORRECT]
E. ✗ Vital signs measurement
F. ✓ Health promotion activities [CORRECT]
Correct Answers: A, B, C, D, F
Rationale: Subjective data collection in Shadow Health's DCE includes all
patient-reported information: chief complaint, HPI (using OLDCARTS), past medical
history, medications/allergies, family history, social history (occupation, habits, support
systems), review of systems (ROS), and health promotion (exercise, diet, screening).
Vital signs (E) are objective data collected during the physical examination phase, not
the interview portion. Shadow Health's Conversation Concept Lab emphasizes these
components as foundational to building the digital patient encounter .
Q3: Medication Reconciliation
A patient in Shadow Health states they take "a little white pill for blood pressure and a
water pill." Which nursing response demonstrates best practice for medication
reconciliation?
,A. "I understand you take hydrochlorothiazide and lisinopril. Do you take them every
day?"
B. "Can you show me the pill bottles or tell me the exact names on the labels? It's
important I document the correct medications and doses." [CORRECT]
C. "Those are probably diuretics and ACE inhibitors. How long have you been on them?"
D. "The white pill is likely lisinopril 10mg. Do you have any side effects?"
Correct Answer: B
Rationale: Medication reconciliation requires verification of exact medication names,
doses, routes, frequencies, and adherence. Assuming medication identity (Options A, D)
or class (Option C) can lead to documentation errors in the Shadow Health EHR system.
The correct approach asks the patient to verify actual pill bottles or names, ensuring
accurate data entry into the electronic health record. This prevents medication errors
and supports patient safety .
Q4: Cultural Competence
A Shadow Health patient from a different cultural background seems hesitant to make
eye contact. Which response demonstrates cultural humility?
A. "I notice you're not looking at me. In America, we make eye contact to show respect."
B. "I want you to feel comfortable. Please let me know if there are any cultural practices
I should be aware of to better care for you." [CORRECT]
C. "Don't be shy. You can trust me—I'm here to help."
D. "I'll continue the assessment since you seem uncomfortable speaking."
, Correct Answer: B
Rationale: Cultural humility involves self-reflection, recognizing power imbalances, and
partnering with patients regarding their cultural practices. Option B acknowledges
potential cultural differences without judgment and invites patient expertise. Option A
imposes Western cultural norms; Option C dismisses cultural context; Option D
abandons therapeutic communication. Shadow Health's diverse patient scenarios
require culturally sensitive care .
Q5: Pain Assessment - OLDCARTS Application
A patient reports headache. Which follow-up question best assesses the "A"
(Aggravating/Alleviating factors) in OLDCARTS?
A. "When did the headache start?"
B. "What makes the headache worse or better?" [CORRECT]
C. "On a scale of 0-10, how severe is it?"
D. "Is the pain sharp or dull?"
Correct Answer: B
Rationale: The "A" in OLDCARTS specifically addresses aggravating and alleviating
factors—what makes symptoms worse or better. This helps identify triggers (stress,
food, position) and relief measures (rest, medication, darkness) that inform differential
diagnosis. Option A addresses Onset; Option C addresses Severity; Option D addresses
Characteristics .
Q6: Mental Health Screening
