Intermediate Patient Case Results Tina Jones Shadow Health
Actual Exam 2026/2027 – Complete Health Assessment &
Clinical Reasoning with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Case Context: Tina Jones is a 28-year-old African American woman admitted to the
medical-surgical unit for management of type 2 diabetes mellitus and evaluation of a
non-healing wound on the plantar surface of her right foot. The student nurse conducts
a comprehensive admission history and focused physical examination in the Shadow
Health digital clinical environment.
Section A: Subjective Data Collection – History & Interview
Q1: At the start of the Shadow Health encounter, the student should first perform which
action before beginning the interview with Tina?
A. Immediately perform a head-to-toe physical examination
B. Perform hand hygiene, introduce self with name and role, verify patient identity, and
ensure privacy [CORRECT]
C. Review the chart silently without speaking to the patient
D. Ask the family to leave and begin rapid-fire questions
Correct Answer: B
Rationale: Standard practice and the Shadow Health rubric require hand hygiene, a
professional introduction, patient identification, and privacy before data collection.
Beginning with the exam (A) skips the history; ignoring the patient (C) and abruptly
dismissing family (D) harm rapport and violate professional standards.
Q2: Tina states, "I ran out of my metformin about a month ago, and my sugar has been
running in the 300s." Which response best demonstrates therapeutic communication to
explore this adherence cue?
,A. "Why would you stop a medication your doctor prescribed?"
B. "Running out of medication happens; what made it hard for you to refill it?"
[CORRECT]
C. "That's very irresponsible of you."
D. "Let's talk about something else — do you smoke?"
Correct Answer: B
Rationale: A nonjudgmental, open-ended question explores barriers (cost, access, side
effects) that drive the plan of care. "Why" questions (A) sound accusatory, labeling (C) is
judgmental, and abrupt topic change (D) dismisses a critical safety cue.
Q3: When Tina describes her foot sore, she says, "It started as a blister from new shoes,
and it just got worse." Which follow-up question best completes the symptom analysis
of this chief complaint?
A. "What size shoe do you wear?"
B. "How has the sore changed over time, and what makes it feel better or worse?"
[CORRECT]
C. "Do you like your new shoes?"
D. "Have you always had foot problems?"
Correct Answer: B
Rationale: Characterizing change over time and aggravating/relieving factors is core HPI
analysis (OLDCARTS). Shoe size (A) and preference (C) are irrelevant, and "always had"
(D) is vague and closed.
Q4: Which patient statement by Tina requires the student to ask a priority follow-up
question about suicidality?
A. "Diabetes runs in my family."
B. "Sometimes I feel hopeless about ever getting my sugar under control." [CORRECT]
C. "I don't love hospital food."
D. "My feet feel numb sometimes."
Correct Answer: B
Rationale: Expressions of hopelessness are depressive cues requiring direct, caring
assessment of suicidal ideation. Family history (A), food preference (C), and neuropathy
symptoms (D) do not trigger the suicide-risk protocol.
Q5: The student asks Tina about her health literacy before teaching. Which question is
the most effective screening approach?
, A. "You can read, right?"
B. "How confident are you filling out medical forms by yourself?" [CORRECT]
C. "Did you graduate from high school?"
D. "Would you rather I just talk to your sister instead?"
Correct Answer: B
Rationale: Single-item confidence screening (e.g., "How often do you have someone
help you read hospital materials?") is a validated, respectful health-literacy screen.
Questions A, C, and D are stigmatizing, proxy-based, or exclude the patient.
Q6: Tina says, "My last A1c was 9.1%, but I don't really know what that number means."
The student explains that A1c reflects:
A. Fasting glucose on the morning of the test only
B. Average blood glucose control over approximately the previous 2–3 months
[CORRECT]
C. Kidney function over the past week
D. The highest glucose reading from the previous day
Correct Answer: B
Rationale: Hemoglobin A1c reflects the percentage of glycated hemoglobin,
representing average glycemia over the ~120-day red cell lifespan. It is not a single
reading, a renal marker, or a daily maximum.
Q7: During the psychosocial history, Tina reveals she lost her job and pharmacy
insurance three months ago. How should the student categorize this information?
A. Irrelevant social gossip not belonging in a health record
B. A psychosocial and financial determinant of health directly relevant to medication
adherence and discharge planning [CORRECT]
C. A physical examination finding
D. A laboratory value
Correct Answer: B
Rationale: Employment and insurance loss explain medication nonadherence and must
inform the care plan (prescription assistance, social work referral). It is subjective
psychosocial data — not a physical finding, lab value, or irrelevant gossip.
Q8: Which interview closing technique best summarizes the encounter and validates
accuracy with Tina?
A. "Okay, we're done. Thanks."
Actual Exam 2026/2027 – Complete Health Assessment &
Clinical Reasoning with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Case Context: Tina Jones is a 28-year-old African American woman admitted to the
medical-surgical unit for management of type 2 diabetes mellitus and evaluation of a
non-healing wound on the plantar surface of her right foot. The student nurse conducts
a comprehensive admission history and focused physical examination in the Shadow
Health digital clinical environment.
Section A: Subjective Data Collection – History & Interview
Q1: At the start of the Shadow Health encounter, the student should first perform which
action before beginning the interview with Tina?
A. Immediately perform a head-to-toe physical examination
B. Perform hand hygiene, introduce self with name and role, verify patient identity, and
ensure privacy [CORRECT]
C. Review the chart silently without speaking to the patient
D. Ask the family to leave and begin rapid-fire questions
Correct Answer: B
Rationale: Standard practice and the Shadow Health rubric require hand hygiene, a
professional introduction, patient identification, and privacy before data collection.
Beginning with the exam (A) skips the history; ignoring the patient (C) and abruptly
dismissing family (D) harm rapport and violate professional standards.
Q2: Tina states, "I ran out of my metformin about a month ago, and my sugar has been
running in the 300s." Which response best demonstrates therapeutic communication to
explore this adherence cue?
,A. "Why would you stop a medication your doctor prescribed?"
B. "Running out of medication happens; what made it hard for you to refill it?"
[CORRECT]
C. "That's very irresponsible of you."
D. "Let's talk about something else — do you smoke?"
Correct Answer: B
Rationale: A nonjudgmental, open-ended question explores barriers (cost, access, side
effects) that drive the plan of care. "Why" questions (A) sound accusatory, labeling (C) is
judgmental, and abrupt topic change (D) dismisses a critical safety cue.
Q3: When Tina describes her foot sore, she says, "It started as a blister from new shoes,
and it just got worse." Which follow-up question best completes the symptom analysis
of this chief complaint?
A. "What size shoe do you wear?"
B. "How has the sore changed over time, and what makes it feel better or worse?"
[CORRECT]
C. "Do you like your new shoes?"
D. "Have you always had foot problems?"
Correct Answer: B
Rationale: Characterizing change over time and aggravating/relieving factors is core HPI
analysis (OLDCARTS). Shoe size (A) and preference (C) are irrelevant, and "always had"
(D) is vague and closed.
Q4: Which patient statement by Tina requires the student to ask a priority follow-up
question about suicidality?
A. "Diabetes runs in my family."
B. "Sometimes I feel hopeless about ever getting my sugar under control." [CORRECT]
C. "I don't love hospital food."
D. "My feet feel numb sometimes."
Correct Answer: B
Rationale: Expressions of hopelessness are depressive cues requiring direct, caring
assessment of suicidal ideation. Family history (A), food preference (C), and neuropathy
symptoms (D) do not trigger the suicide-risk protocol.
Q5: The student asks Tina about her health literacy before teaching. Which question is
the most effective screening approach?
, A. "You can read, right?"
B. "How confident are you filling out medical forms by yourself?" [CORRECT]
C. "Did you graduate from high school?"
D. "Would you rather I just talk to your sister instead?"
Correct Answer: B
Rationale: Single-item confidence screening (e.g., "How often do you have someone
help you read hospital materials?") is a validated, respectful health-literacy screen.
Questions A, C, and D are stigmatizing, proxy-based, or exclude the patient.
Q6: Tina says, "My last A1c was 9.1%, but I don't really know what that number means."
The student explains that A1c reflects:
A. Fasting glucose on the morning of the test only
B. Average blood glucose control over approximately the previous 2–3 months
[CORRECT]
C. Kidney function over the past week
D. The highest glucose reading from the previous day
Correct Answer: B
Rationale: Hemoglobin A1c reflects the percentage of glycated hemoglobin,
representing average glycemia over the ~120-day red cell lifespan. It is not a single
reading, a renal marker, or a daily maximum.
Q7: During the psychosocial history, Tina reveals she lost her job and pharmacy
insurance three months ago. How should the student categorize this information?
A. Irrelevant social gossip not belonging in a health record
B. A psychosocial and financial determinant of health directly relevant to medication
adherence and discharge planning [CORRECT]
C. A physical examination finding
D. A laboratory value
Correct Answer: B
Rationale: Employment and insurance loss explain medication nonadherence and must
inform the care plan (prescription assistance, social work referral). It is subjective
psychosocial data — not a physical finding, lab value, or irrelevant gossip.
Q8: Which interview closing technique best summarizes the encounter and validates
accuracy with Tina?
A. "Okay, we're done. Thanks."
