Shadow Health Tina Jones Health History Exam | Complete
Solution Guide with Verified Correct Answers
Patient Profile: Tina Jones
Demographics: 28-year-old African American female
Visit Type: Comprehensive Health History for Digital Clinical Experience
Chief Complaint: "I have a problem with my foot"
Key Health Issues: Type 2 Diabetes (diagnosed at age 24), Asthma, Recent skin abscess
on lower leg, Health maintenance concerns
Section 1: Chief Complaint (8 Questions)
Q1: Opening the Interview - Chief Complaint Exploration
When beginning the health history interview with Tina Jones in Shadow Health, she
states she is here today because of a problem with her foot. Which response by the
nurse best demonstrates an appropriate opening question to explore her chief
complaint?
,A. "Is the pain in your foot severe?" [Incorrect - Closed-ended, assumes pain is the issue,
limits response]
B. "Tell me more about the problem you're having with your foot." [CORRECT]
C. "Have you had foot problems in the past?" [Incorrect - Prematurely shifts to past
history before characterizing present complaint]
D. "Did you injure your foot recently?" [Incorrect - Leading question assuming injury
etiology]
Correct Answer: B
Rationale: Using an open-ended statement like "Tell me more about..." is the most
effective way to begin exploring a chief complaint as it allows the patient to describe
their concern in their own words without leading or limiting their response. This aligns
with therapeutic communication principles (specifically the use of open-ended
questions) and the Shadow Health objective of "gathering comprehensive data."
Tina's response to this question reveals: "I have this wound on the bottom of my left foot.
It started as a blister from new shoes, but it's gotten worse over the past week. It's red,
swollen, and draining some yellow fluid." This information is essential for understanding
the diabetic foot ulcer risk.
Option A is a closed-ended question that limits response to yes/no and assumes pain is
present. Option C prematurely explores past history before fully understanding the
current issue. Option D makes an assumption about injury that may not be accurate
(this is a diabetic foot complication, not trauma).
,Q2: Symptom Analysis - OLD CARTS Application
To thoroughly characterize Tina's foot wound using the OLD CARTS mnemonic, which
question sequence is MOST appropriate?
A. "When did the wound start? Where exactly is it? How long have you had it? What does
it look like? What makes it better? Does it spread? When does it bother you most? How
bad is it?" [Incorrect - Too rapid-fire; doesn't allow patient narrative]
B. "When did you first notice the problem with your foot? Can you point to exactly where
it is? How long has it been there? Describe what it looks like and any drainage. What
makes it feel better or worse? Does the pain travel anywhere? Is it constant or does it
come and go? On a scale of 0-10, how would you rate the discomfort?" [CORRECT]
C. "Is the wound painful? Do you have fever? Can you walk on it?" [Incorrect -
Closed-ended, incomplete symptom analysis]
D. "Since you're diabetic, is this a diabetic foot ulcer?" [Incorrect - Leading, diagnostic
labeling premature]
Correct Answer: B
Rationale: OLD CARTS is the systematic framework for symptom analysis:
● O - Onset: "When did you first notice..."
● L - Location: "Can you point to exactly where..."
● D - Duration: "How long has it been there..."
● C - Character: "Describe what it looks like..."
● A - Aggravating/Alleviating: "What makes it feel better or worse..."
● R - Radiation: "Does the pain travel anywhere..."
● T - Timing: "Is it constant or does it come and go..."
● S - Severity: "On a scale of 0-10..."
, This comprehensive approach ensures no critical data is missed. Tina's responses
indicate: Onset 1 week ago, Location plantar surface left foot, Character erythematous,
edematous with purulent drainage, Severity 6/10 pain - all concerning for diabetic foot
infection.
Q3: Associated Symptoms - Diabetic Foot Red Flags
When assessing Tina's foot wound, which associated symptoms should the nurse
specifically ask about to identify complications of diabetes? Select ALL that apply:
A. "Have you noticed any fever or chills?" [CORRECT - Systemic infection signs]
B. "Have you noticed any numbness or tingling in your feet?" [CORRECT - Peripheral
neuropathy screening]
C. "Any changes in your vision recently?" [Incorrect - Important for diabetes but not
directly related to acute foot wound]
D. "Is the area warm to touch compared to your other foot?" [CORRECT - Local
inflammation/infection]
E. "Have you noticed any black or discolored tissue around the wound?" [CORRECT -
Necrosis/gangrene]
F. "Do you have headaches?" [Incorrect - Not relevant to diabetic foot complications]
Correct Answers: A, B, D, E
Rationale: Diabetic foot infections can progress rapidly to cellulitis, abscess,
osteomyelitis, or necrotizing fasciitis. Critical associated symptoms include:
● Systemic signs (fever/chills) indicating spreading infection
Solution Guide with Verified Correct Answers
Patient Profile: Tina Jones
Demographics: 28-year-old African American female
Visit Type: Comprehensive Health History for Digital Clinical Experience
Chief Complaint: "I have a problem with my foot"
Key Health Issues: Type 2 Diabetes (diagnosed at age 24), Asthma, Recent skin abscess
on lower leg, Health maintenance concerns
Section 1: Chief Complaint (8 Questions)
Q1: Opening the Interview - Chief Complaint Exploration
When beginning the health history interview with Tina Jones in Shadow Health, she
states she is here today because of a problem with her foot. Which response by the
nurse best demonstrates an appropriate opening question to explore her chief
complaint?
,A. "Is the pain in your foot severe?" [Incorrect - Closed-ended, assumes pain is the issue,
limits response]
B. "Tell me more about the problem you're having with your foot." [CORRECT]
C. "Have you had foot problems in the past?" [Incorrect - Prematurely shifts to past
history before characterizing present complaint]
D. "Did you injure your foot recently?" [Incorrect - Leading question assuming injury
etiology]
Correct Answer: B
Rationale: Using an open-ended statement like "Tell me more about..." is the most
effective way to begin exploring a chief complaint as it allows the patient to describe
their concern in their own words without leading or limiting their response. This aligns
with therapeutic communication principles (specifically the use of open-ended
questions) and the Shadow Health objective of "gathering comprehensive data."
Tina's response to this question reveals: "I have this wound on the bottom of my left foot.
It started as a blister from new shoes, but it's gotten worse over the past week. It's red,
swollen, and draining some yellow fluid." This information is essential for understanding
the diabetic foot ulcer risk.
Option A is a closed-ended question that limits response to yes/no and assumes pain is
present. Option C prematurely explores past history before fully understanding the
current issue. Option D makes an assumption about injury that may not be accurate
(this is a diabetic foot complication, not trauma).
,Q2: Symptom Analysis - OLD CARTS Application
To thoroughly characterize Tina's foot wound using the OLD CARTS mnemonic, which
question sequence is MOST appropriate?
A. "When did the wound start? Where exactly is it? How long have you had it? What does
it look like? What makes it better? Does it spread? When does it bother you most? How
bad is it?" [Incorrect - Too rapid-fire; doesn't allow patient narrative]
B. "When did you first notice the problem with your foot? Can you point to exactly where
it is? How long has it been there? Describe what it looks like and any drainage. What
makes it feel better or worse? Does the pain travel anywhere? Is it constant or does it
come and go? On a scale of 0-10, how would you rate the discomfort?" [CORRECT]
C. "Is the wound painful? Do you have fever? Can you walk on it?" [Incorrect -
Closed-ended, incomplete symptom analysis]
D. "Since you're diabetic, is this a diabetic foot ulcer?" [Incorrect - Leading, diagnostic
labeling premature]
Correct Answer: B
Rationale: OLD CARTS is the systematic framework for symptom analysis:
● O - Onset: "When did you first notice..."
● L - Location: "Can you point to exactly where..."
● D - Duration: "How long has it been there..."
● C - Character: "Describe what it looks like..."
● A - Aggravating/Alleviating: "What makes it feel better or worse..."
● R - Radiation: "Does the pain travel anywhere..."
● T - Timing: "Is it constant or does it come and go..."
● S - Severity: "On a scale of 0-10..."
, This comprehensive approach ensures no critical data is missed. Tina's responses
indicate: Onset 1 week ago, Location plantar surface left foot, Character erythematous,
edematous with purulent drainage, Severity 6/10 pain - all concerning for diabetic foot
infection.
Q3: Associated Symptoms - Diabetic Foot Red Flags
When assessing Tina's foot wound, which associated symptoms should the nurse
specifically ask about to identify complications of diabetes? Select ALL that apply:
A. "Have you noticed any fever or chills?" [CORRECT - Systemic infection signs]
B. "Have you noticed any numbness or tingling in your feet?" [CORRECT - Peripheral
neuropathy screening]
C. "Any changes in your vision recently?" [Incorrect - Important for diabetes but not
directly related to acute foot wound]
D. "Is the area warm to touch compared to your other foot?" [CORRECT - Local
inflammation/infection]
E. "Have you noticed any black or discolored tissue around the wound?" [CORRECT -
Necrosis/gangrene]
F. "Do you have headaches?" [Incorrect - Not relevant to diabetic foot complications]
Correct Answers: A, B, D, E
Rationale: Diabetic foot infections can progress rapidly to cellulitis, abscess,
osteomyelitis, or necrotizing fasciitis. Critical associated symptoms include:
● Systemic signs (fever/chills) indicating spreading infection
