Shadow Health Health History Exam Actual Exam 2026/2027 |
Version 1 | Complete Solution Guide | Verified Correct
Answers | Pass Guaranteed - A+ Graded
Section 1: Chief Complaint and History of Present Illness (20 Questions: 8
CC + 12 HPI)
Q1: During the Health History exam in Shadow Health, the patient states, "I've been
having these headaches for about a week." Which response by the nurse best
demonstrates the use of the OLDCARTS mnemonic to gather more data?
A. "Have you taken any medication for the headaches?"
B. "On a scale of 0 to 10, how would you rate the pain?" [CORRECT]
C. "Do you have a family history of migraines?"
D. "Are the headaches affecting your ability to work?"
Correct Answer: B
Rationale: The OLDCARTS mnemonic (Onset, Location, Duration, Character, Aggravating
factors, Relieving factors, Timing, Severity) provides a systematic framework for
symptom analysis. Asking for pain severity rating directly addresses the "S" (Severity)
,component, which is essential for establishing baseline pain intensity, tracking
progression, and determining urgency of intervention. This quantified data allows for
objective reassessment and is a Shadow Health documentation requirement. Option A
addresses "R" (Relieving factors) but assumes medication use. Option C addresses
family history, which belongs in the Family History section, not HPI. Option D addresses
functional impact, which while important is typically assessed after characterizing the
symptom itself through OLDCARTS. The systematic approach ensures no critical
symptom characteristics are missed.
Q2: When a patient presents with chest pain, which question would be MOST
appropriate to ask first using the PQRST method?
A. "What were you doing when the pain started?" [CORRECT]
B. "Does the pain radiate to your arm or jaw?"
C. "Is this the worst pain you've ever felt?"
D. "Do you have a history of heart disease?"
Correct Answer: A
Rationale: The PQRST method (Provocation/Palliation, Quality, Region/Radiation,
Severity, Timing) begins with Provocation—what brings on the symptom or makes it
better/worse. This establishes the context and potential etiology immediately. "What
were you doing?" identifies exertional vs. rest symptoms, critical for cardiac vs.
,non-cardiac differentiation. Radiation (B) is "R" in PQRST but typically follows initial
characterization. Severity comparison (C) is useful but secondary to establishing
mechanism. History (D) belongs in Past Medical History. In potentially life-threatening
presentations like chest pain, establishing the circumstances (exertional, postprandial,
at rest) guides immediate clinical decision-making and urgency.
Q3: Select ALL that apply: Which questions would effectively gather the "Character"
component of a patient's abdominal pain using the OLDCARTS framework?
A. "Can you describe what the pain feels like—sharp, dull, burning, or cramping?"
[CORRECT]
B. "Does the pain come and go or is it constant?"
C. "Is the pain similar to previous pain you've experienced?"
D. "Would you say the pain is more like pressure or more like stabbing?" [CORRECT]
E. "On a scale of 0-10, how severe is the pain?"
Correct Answers: A, D
Rationale: Character (C in OLDCARTS) describes the quality or nature of the symptom
using the patient's own descriptors or offered choices (sharp, dull, burning, cramping,
pressure, stabbing, aching, throbbing). These qualitative descriptors help differentiate
pathophysiology: burning suggests GERD or neuropathic pain; colicky suggests
, obstruction; sharp pleuritic suggests peritoneal irritation. Option B addresses Timing
(T), Option C addresses previous history, and Option E addresses Severity (S). Character
is essential for differential diagnosis—similar location pain can have vastly different
etiologies based on quality description.
Q4: Which interviewing technique would be LEAST effective when gathering a patient's
chief complaint?
A. "What brings you in today?"
B. "Tell me about the problem that concerns you most."
C. "I see you're here for follow-up of your diabetes—how is that going?" [CORRECT]
D. "What symptoms have caused you to seek care today?"
Correct Answer: C
Rationale: This option makes assumptions based on chart review without allowing the
patient to identify their current priority concern. The patient may have new, acute
symptoms unrelated to documented chronic conditions, or their diabetes may be
well-controlled while a new concern exists. This technique is chart-centered rather than
patient-centered and may miss the actual reason for the visit. Options A, B, and D are
open-ended, patient-centered questions that allow the patient to define their agenda.
Shadow Health emphasizes patient-centered care where the patient's stated concern
drives the encounter, not provider assumptions.
Version 1 | Complete Solution Guide | Verified Correct
Answers | Pass Guaranteed - A+ Graded
Section 1: Chief Complaint and History of Present Illness (20 Questions: 8
CC + 12 HPI)
Q1: During the Health History exam in Shadow Health, the patient states, "I've been
having these headaches for about a week." Which response by the nurse best
demonstrates the use of the OLDCARTS mnemonic to gather more data?
A. "Have you taken any medication for the headaches?"
B. "On a scale of 0 to 10, how would you rate the pain?" [CORRECT]
C. "Do you have a family history of migraines?"
D. "Are the headaches affecting your ability to work?"
Correct Answer: B
Rationale: The OLDCARTS mnemonic (Onset, Location, Duration, Character, Aggravating
factors, Relieving factors, Timing, Severity) provides a systematic framework for
symptom analysis. Asking for pain severity rating directly addresses the "S" (Severity)
,component, which is essential for establishing baseline pain intensity, tracking
progression, and determining urgency of intervention. This quantified data allows for
objective reassessment and is a Shadow Health documentation requirement. Option A
addresses "R" (Relieving factors) but assumes medication use. Option C addresses
family history, which belongs in the Family History section, not HPI. Option D addresses
functional impact, which while important is typically assessed after characterizing the
symptom itself through OLDCARTS. The systematic approach ensures no critical
symptom characteristics are missed.
Q2: When a patient presents with chest pain, which question would be MOST
appropriate to ask first using the PQRST method?
A. "What were you doing when the pain started?" [CORRECT]
B. "Does the pain radiate to your arm or jaw?"
C. "Is this the worst pain you've ever felt?"
D. "Do you have a history of heart disease?"
Correct Answer: A
Rationale: The PQRST method (Provocation/Palliation, Quality, Region/Radiation,
Severity, Timing) begins with Provocation—what brings on the symptom or makes it
better/worse. This establishes the context and potential etiology immediately. "What
were you doing?" identifies exertional vs. rest symptoms, critical for cardiac vs.
,non-cardiac differentiation. Radiation (B) is "R" in PQRST but typically follows initial
characterization. Severity comparison (C) is useful but secondary to establishing
mechanism. History (D) belongs in Past Medical History. In potentially life-threatening
presentations like chest pain, establishing the circumstances (exertional, postprandial,
at rest) guides immediate clinical decision-making and urgency.
Q3: Select ALL that apply: Which questions would effectively gather the "Character"
component of a patient's abdominal pain using the OLDCARTS framework?
A. "Can you describe what the pain feels like—sharp, dull, burning, or cramping?"
[CORRECT]
B. "Does the pain come and go or is it constant?"
C. "Is the pain similar to previous pain you've experienced?"
D. "Would you say the pain is more like pressure or more like stabbing?" [CORRECT]
E. "On a scale of 0-10, how severe is the pain?"
Correct Answers: A, D
Rationale: Character (C in OLDCARTS) describes the quality or nature of the symptom
using the patient's own descriptors or offered choices (sharp, dull, burning, cramping,
pressure, stabbing, aching, throbbing). These qualitative descriptors help differentiate
pathophysiology: burning suggests GERD or neuropathic pain; colicky suggests
, obstruction; sharp pleuritic suggests peritoneal irritation. Option B addresses Timing
(T), Option C addresses previous history, and Option E addresses Severity (S). Character
is essential for differential diagnosis—similar location pain can have vastly different
etiologies based on quality description.
Q4: Which interviewing technique would be LEAST effective when gathering a patient's
chief complaint?
A. "What brings you in today?"
B. "Tell me about the problem that concerns you most."
C. "I see you're here for follow-up of your diabetes—how is that going?" [CORRECT]
D. "What symptoms have caused you to seek care today?"
Correct Answer: C
Rationale: This option makes assumptions based on chart review without allowing the
patient to identify their current priority concern. The patient may have new, acute
symptoms unrelated to documented chronic conditions, or their diabetes may be
well-controlled while a new concern exists. This technique is chart-centered rather than
patient-centered and may miss the actual reason for the visit. Options A, B, and D are
open-ended, patient-centered questions that allow the patient to define their agenda.
Shadow Health emphasizes patient-centered care where the patient's stated concern
drives the encounter, not provider assumptions.
