Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
Shadow Health Noah Caputo: School Age Sick Visit
Subjective Information with Complete Solution
Comprehensive Examination - Subjective Data Collection Assessment
Aligned with Shadow Health Digital Clinical Experience (DCE) Grading Rubrics & Pediatric Nursing Standards (2026/2027)
Total Questions: 110 | Sections: 8 | Format: Multiple Choice (A-D) | Cognitive Distribution: 35% Recall, 45% Application, 20% Analysis
Exam Instructions: This comprehensive exam assesses competency in pediatric subjective data collection within the Shadow
Health Digital Clinical Experience (DCE) framework. Each question presents a scenario or concept related to the Noah
Caputo school-age sick visit. Select the single best answer (A, B, C, or D) for each question. The correct answer is marked
with [CORRECT] and followed by a detailed rationale explaining the Shadow Health rubric alignment, therapeutic
communication principles, and pediatric assessment reasoning.
Section 1: Interviewing Technique and Communication
Open-Ended Questions, Active Listening, Empathy, & Therapeutic Communication
Q1: You are beginning the Shadow Health DCE interview with Noah Caputo, an 8-year-old brought in by his
mother for a sick visit. Which opening statement best demonstrates therapeutic communication and earns full
rubric points?
A. Hi Noah, can you tell me why you're here today? Mom, please don't answer for him.
B. Hello, my name is Nurse Smith. I'll be asking Noah and you some questions today. Noah, can you tell me
what's been bothering you, and Mom, please feel free to add anything. [CORRECT]
C. Noah, your mom says you've been sick. Tell me about your symptoms starting from when they began.
D. Hello Noah. I'm going to ask you some questions. Please answer yes or no only.
Correct Answer: B
Rationale: This response demonstrates therapeutic communication by introducing yourself, addressing both the child and
caregiver, and using an open-ended question that invites both to contribute. Shadow Health DCE rubrics award full points for
introductions that establish rapport, identify the patient and caregiver, and use open-ended phrasing. Option A excludes the
caregiver inappropriately; Option C is a leading question that assumes symptoms; Option D restricts the child to closed-ended
responses, which violates therapeutic communication principles.
Q2: During the interview, Noah's mother begins to answer every question before Noah can respond. Which
response by the nurse best aligns with Shadow Health DCE therapeutic communication rubric expectations?
A. Mom, please let Noah answer. He's the patient.
B. I appreciate your input, Mom. Noah, I'd also like to hear from you in your own words. What do you think
about how you've been feeling? [CORRECT]
C. Please stop interrupting, Mom. I need to hear from Noah directly.
D. Noah, ignore your mom and tell me what's wrong.
Correct Answer: B
Rationale: This response validates the caregiver's contribution while redirecting to include the child, demonstrating active listening
and respectful communication. Shadow Health rubrics emphasize building rapport with both patient and caregiver without creating
conflict. Options A, C, and D use confrontational or dismissive language that violates therapeutic communication principles and
Page 1 | Comprehensive Exam - 110 Questions | Nursing Education Resource
,Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
would not earn full points on the DCE interview rubric.
Q3: Noah says, "My throat hurts real bad." Which response by the nurse is an example of active listening that
would earn Shadow Health DCE credit?
A. On a scale of 1 to 10, how bad is the pain?
B. When did the throat pain start?
C. It sounds like your throat is really bothering you. Can you tell me more about what that feels like?
[CORRECT]
D. Have you taken anything for the throat pain?
Correct Answer: C
Rationale: Option C uses reflection and clarification, two active listening techniques that demonstrate empathy and invite the
patient to elaborate. Shadow Health DCE rubrics reward open-ended follow-up questions that explore the patient's experience.
Options A, B, and D are closed-ended questions that, while clinically relevant later in the interview, do not demonstrate active
listening in this moment and would not earn therapeutic communication points.
Q4: Which of the following questions is correctly worded as an open-ended question appropriate for the
Shadow Health Noah Caputo interview?
A. Do you have a fever?
B. You don't have any allergies, right?
C. Can you describe what your symptoms feel like? [CORRECT]
D. Is the pain on the left side or the right side?
Correct Answer: C
Rationale: Option C is an open-ended question that allows the patient to describe symptoms in their own words, which is essential
for subjective data collection in Shadow Health DCE. Option A is closed-ended (yes/no). Option B is a leading question that
suggests the expected answer. Option D is a multiple-choice closed question. Shadow Health rubrics specifically reward
open-ended phrasing during the initial subjective data collection phase.
Q5: Noah's mother expresses worry that her son's illness might be serious. Which response demonstrates
empathy and earns Shadow Health DCE therapeutic communication points?
A. I'm sure it's nothing serious. Kids get sick all the time.
B. Try not to worry. We see this all the time and it's usually fine.
C. I can see you're really worried about Noah. Let's work together to figure out what's going on and how we
can help him feel better. [CORRECT]
D. You shouldn't worry until we have the test results back.
Correct Answer: C
Rationale: Option C demonstrates empathy by acknowledging the mother's feelings ("I can see you're really worried") and offers
partnership, which are core therapeutic communication techniques. Shadow Health rubrics specifically reward responses that
validate caregiver emotions and build collaborative relationships. Options A and B dismiss the caregiver's concern with false
reassurance, a non-therapeutic technique. Option D minimizes the caregiver's feelings and provides premature reassurance.
Q6: Which of the following is a non-therapeutic communication technique that should be avoided in the
Shadow Health DCE interview?
A. Reflecting the patient's feelings back to them
B. Asking the patient to clarify what they mean
Page 2 | Comprehensive Exam - 110 Questions | Nursing Education Resource
,Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
C. Giving advice before the patient finishes speaking [CORRECT]
D. Using silence to allow the patient time to think
Correct Answer: C
Rationale: Giving premature advice is a non-therapeutic technique that blocks communication and prevents the patient from fully
expressing their concerns. Shadow Health DCE rubrics penalize responses that interrupt, give unsolicited advice, or fail to listen
completely. Options A, B, and D are all therapeutic techniques (reflection, clarification, and therapeutic silence) that earn full
points on the communication rubric.
Q7: When communicating with Noah, an 8-year-old school-age child, which approach is most developmentally
appropriate and aligns with Shadow Health DCE pediatric interview standards?
A. Speak only to the mother since Noah is too young to provide reliable information.
B. Use medical terminology to ensure accurate information is collected.
C. Engage Noah directly using simple, concrete language while also involving his mother for additional
history. [CORRECT]
D. Ask Noah complex abstract questions to test his cognitive development.
Correct Answer: C
Rationale: School-age children (6-12 years) can provide valuable subjective data when engaged with developmentally appropriate,
concrete language. Shadow Health DCE pediatric rubrics require engaging the child directly while also obtaining caregiver input
for a comprehensive history. Option A inappropriately excludes the child. Option B uses jargon that is not developmentally
appropriate. Option D exceeds the cognitive abilities of school-age children who think concretely, not abstractly.
Q8: Noah becomes quiet and looks down when you ask about his symptoms. Which response demonstrates
therapeutic use of silence?
A. Noah, you need to answer me so I can help you.
B. Are you not answering because you don't know or because you don't want to?
C. Take your time, Noah. I'm here whenever you're ready to talk. [CORRECT]
D. Mom, can you answer for him since he won't talk?
Correct Answer: C
Rationale: Option C demonstrates therapeutic use of silence by allowing Noah time to process and respond at his own pace without
pressure. Shadow Health DCE rubrics reward patience and the therapeutic use of silence, especially with pediatric patients who
may need additional time. Options A and B apply pressure and could damage rapport. Option D abandons the therapeutic
relationship with the child and undermines his autonomy.
Q9: Which of the following questions is a leading question that would NOT earn points on the Shadow Health
DCE interview rubric?
A. What brings you in today?
B. You don't have any chest pain, do you? [CORRECT]
C. How have you been feeling since the symptoms started?
D. Can you tell me about any medications you've been taking?
Correct Answer: B
Rationale: Option B is a leading question that suggests the expected answer (no chest pain), which is a non-therapeutic technique
that can produce inaccurate data. Shadow Health DCE rubrics specifically penalize leading questions because they bias patient
responses and compromise subjective data accuracy. Options A, C, and D are all appropriately worded open-ended questions that
earn full points on the interview rubric.
Page 3 | Comprehensive Exam - 110 Questions | Nursing Education Resource
, Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
Q10: Noah's mother says, "He's been coughing a lot at night." Which response best demonstrates the
clarification technique?
A. I understand. Let's move on to the next question.
B. When you say 'a lot,' can you tell me approximately how many times per night? [CORRECT]
C. That sounds concerning. Has he had coughing fits before?
D. Coughing at night is common in children his age.
Correct Answer: B
Rationale: Option B uses clarification to obtain specific, quantifiable data about the symptom, which is essential for accurate
subjective data collection in Shadow Health DCE. Rubrics reward clarification of vague terms like "a lot" to ensure precise
documentation. Option A dismisses the need for clarification. Option C changes the subject. Option D provides false reassurance
and dismisses the concern without gathering more data.
Q11: When building rapport with Noah during the Shadow Health DCE interview, which action would the
rubric most likely reward?
A. Begin with personal medical history questions to establish clinical context.
B. Sit at eye level with Noah, use his name, and start with non-threatening questions about school or interests.
[CORRECT]
C. Stand over the exam table while asking questions to maintain authority.
D. Ask all medical questions first, then engage in casual conversation at the end.
Correct Answer: B
Rationale: Building rapport with pediatric patients involves positioning at eye level, using the child's name, and beginning with
non-threatening topics to establish trust before addressing sensitive medical history. Shadow Health DCE pediatric rubrics
specifically reward rapport-building techniques that reduce anxiety and encourage cooperation. Options A and D jump directly
into medical questioning without establishing rapport. Option C creates a power imbalance that can intimidate a child.
Q12: Which statement by the nurse demonstrates the reflection technique in therapeutic communication?
A. So what you're saying is that the pain started two days ago.
B. You mentioned feeling scared. Tell me more about what's making you feel scared. [CORRECT]
C. Why do you think you're feeling this way?
D. I think you should rest more and drink plenty of fluids.
Correct Answer: B
Rationale: Option B demonstrates reflection by mirroring the patient's stated emotion ("feeling scared") and inviting further
exploration. Shadow Health DCE rubrics reward reflection as a therapeutic technique that validates the patient's feelings and
encourages deeper communication. Option A is summarization, not reflection. Option C uses a "why" question, which can feel
interrogative. Option D gives unsolicited advice, a non-therapeutic technique.
Q13: At the end of the Shadow Health interview, which action best demonstrates summarization and earns
DCE rubric points?
A. Immediately leave the room to document the findings.
B. Say thank you and end the interview without reviewing what was discussed.
C. Review the key points discussed with Noah and his mother, ask if there's anything else to add, and explain
next steps. [CORRECT]
D. Tell the mother she can add anything else to the chart later.
Page 4 | Comprehensive Exam - 110 Questions | Nursing Education Resource
Shadow Health Noah Caputo: School Age Sick Visit
Subjective Information with Complete Solution
Comprehensive Examination - Subjective Data Collection Assessment
Aligned with Shadow Health Digital Clinical Experience (DCE) Grading Rubrics & Pediatric Nursing Standards (2026/2027)
Total Questions: 110 | Sections: 8 | Format: Multiple Choice (A-D) | Cognitive Distribution: 35% Recall, 45% Application, 20% Analysis
Exam Instructions: This comprehensive exam assesses competency in pediatric subjective data collection within the Shadow
Health Digital Clinical Experience (DCE) framework. Each question presents a scenario or concept related to the Noah
Caputo school-age sick visit. Select the single best answer (A, B, C, or D) for each question. The correct answer is marked
with [CORRECT] and followed by a detailed rationale explaining the Shadow Health rubric alignment, therapeutic
communication principles, and pediatric assessment reasoning.
Section 1: Interviewing Technique and Communication
Open-Ended Questions, Active Listening, Empathy, & Therapeutic Communication
Q1: You are beginning the Shadow Health DCE interview with Noah Caputo, an 8-year-old brought in by his
mother for a sick visit. Which opening statement best demonstrates therapeutic communication and earns full
rubric points?
A. Hi Noah, can you tell me why you're here today? Mom, please don't answer for him.
B. Hello, my name is Nurse Smith. I'll be asking Noah and you some questions today. Noah, can you tell me
what's been bothering you, and Mom, please feel free to add anything. [CORRECT]
C. Noah, your mom says you've been sick. Tell me about your symptoms starting from when they began.
D. Hello Noah. I'm going to ask you some questions. Please answer yes or no only.
Correct Answer: B
Rationale: This response demonstrates therapeutic communication by introducing yourself, addressing both the child and
caregiver, and using an open-ended question that invites both to contribute. Shadow Health DCE rubrics award full points for
introductions that establish rapport, identify the patient and caregiver, and use open-ended phrasing. Option A excludes the
caregiver inappropriately; Option C is a leading question that assumes symptoms; Option D restricts the child to closed-ended
responses, which violates therapeutic communication principles.
Q2: During the interview, Noah's mother begins to answer every question before Noah can respond. Which
response by the nurse best aligns with Shadow Health DCE therapeutic communication rubric expectations?
A. Mom, please let Noah answer. He's the patient.
B. I appreciate your input, Mom. Noah, I'd also like to hear from you in your own words. What do you think
about how you've been feeling? [CORRECT]
C. Please stop interrupting, Mom. I need to hear from Noah directly.
D. Noah, ignore your mom and tell me what's wrong.
Correct Answer: B
Rationale: This response validates the caregiver's contribution while redirecting to include the child, demonstrating active listening
and respectful communication. Shadow Health rubrics emphasize building rapport with both patient and caregiver without creating
conflict. Options A, C, and D use confrontational or dismissive language that violates therapeutic communication principles and
Page 1 | Comprehensive Exam - 110 Questions | Nursing Education Resource
,Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
would not earn full points on the DCE interview rubric.
Q3: Noah says, "My throat hurts real bad." Which response by the nurse is an example of active listening that
would earn Shadow Health DCE credit?
A. On a scale of 1 to 10, how bad is the pain?
B. When did the throat pain start?
C. It sounds like your throat is really bothering you. Can you tell me more about what that feels like?
[CORRECT]
D. Have you taken anything for the throat pain?
Correct Answer: C
Rationale: Option C uses reflection and clarification, two active listening techniques that demonstrate empathy and invite the
patient to elaborate. Shadow Health DCE rubrics reward open-ended follow-up questions that explore the patient's experience.
Options A, B, and D are closed-ended questions that, while clinically relevant later in the interview, do not demonstrate active
listening in this moment and would not earn therapeutic communication points.
Q4: Which of the following questions is correctly worded as an open-ended question appropriate for the
Shadow Health Noah Caputo interview?
A. Do you have a fever?
B. You don't have any allergies, right?
C. Can you describe what your symptoms feel like? [CORRECT]
D. Is the pain on the left side or the right side?
Correct Answer: C
Rationale: Option C is an open-ended question that allows the patient to describe symptoms in their own words, which is essential
for subjective data collection in Shadow Health DCE. Option A is closed-ended (yes/no). Option B is a leading question that
suggests the expected answer. Option D is a multiple-choice closed question. Shadow Health rubrics specifically reward
open-ended phrasing during the initial subjective data collection phase.
Q5: Noah's mother expresses worry that her son's illness might be serious. Which response demonstrates
empathy and earns Shadow Health DCE therapeutic communication points?
A. I'm sure it's nothing serious. Kids get sick all the time.
B. Try not to worry. We see this all the time and it's usually fine.
C. I can see you're really worried about Noah. Let's work together to figure out what's going on and how we
can help him feel better. [CORRECT]
D. You shouldn't worry until we have the test results back.
Correct Answer: C
Rationale: Option C demonstrates empathy by acknowledging the mother's feelings ("I can see you're really worried") and offers
partnership, which are core therapeutic communication techniques. Shadow Health rubrics specifically reward responses that
validate caregiver emotions and build collaborative relationships. Options A and B dismiss the caregiver's concern with false
reassurance, a non-therapeutic technique. Option D minimizes the caregiver's feelings and provides premature reassurance.
Q6: Which of the following is a non-therapeutic communication technique that should be avoided in the
Shadow Health DCE interview?
A. Reflecting the patient's feelings back to them
B. Asking the patient to clarify what they mean
Page 2 | Comprehensive Exam - 110 Questions | Nursing Education Resource
,Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
C. Giving advice before the patient finishes speaking [CORRECT]
D. Using silence to allow the patient time to think
Correct Answer: C
Rationale: Giving premature advice is a non-therapeutic technique that blocks communication and prevents the patient from fully
expressing their concerns. Shadow Health DCE rubrics penalize responses that interrupt, give unsolicited advice, or fail to listen
completely. Options A, B, and D are all therapeutic techniques (reflection, clarification, and therapeutic silence) that earn full
points on the communication rubric.
Q7: When communicating with Noah, an 8-year-old school-age child, which approach is most developmentally
appropriate and aligns with Shadow Health DCE pediatric interview standards?
A. Speak only to the mother since Noah is too young to provide reliable information.
B. Use medical terminology to ensure accurate information is collected.
C. Engage Noah directly using simple, concrete language while also involving his mother for additional
history. [CORRECT]
D. Ask Noah complex abstract questions to test his cognitive development.
Correct Answer: C
Rationale: School-age children (6-12 years) can provide valuable subjective data when engaged with developmentally appropriate,
concrete language. Shadow Health DCE pediatric rubrics require engaging the child directly while also obtaining caregiver input
for a comprehensive history. Option A inappropriately excludes the child. Option B uses jargon that is not developmentally
appropriate. Option D exceeds the cognitive abilities of school-age children who think concretely, not abstractly.
Q8: Noah becomes quiet and looks down when you ask about his symptoms. Which response demonstrates
therapeutic use of silence?
A. Noah, you need to answer me so I can help you.
B. Are you not answering because you don't know or because you don't want to?
C. Take your time, Noah. I'm here whenever you're ready to talk. [CORRECT]
D. Mom, can you answer for him since he won't talk?
Correct Answer: C
Rationale: Option C demonstrates therapeutic use of silence by allowing Noah time to process and respond at his own pace without
pressure. Shadow Health DCE rubrics reward patience and the therapeutic use of silence, especially with pediatric patients who
may need additional time. Options A and B apply pressure and could damage rapport. Option D abandons the therapeutic
relationship with the child and undermines his autonomy.
Q9: Which of the following questions is a leading question that would NOT earn points on the Shadow Health
DCE interview rubric?
A. What brings you in today?
B. You don't have any chest pain, do you? [CORRECT]
C. How have you been feeling since the symptoms started?
D. Can you tell me about any medications you've been taking?
Correct Answer: B
Rationale: Option B is a leading question that suggests the expected answer (no chest pain), which is a non-therapeutic technique
that can produce inaccurate data. Shadow Health DCE rubrics specifically penalize leading questions because they bias patient
responses and compromise subjective data accuracy. Options A, C, and D are all appropriately worded open-ended questions that
earn full points on the interview rubric.
Page 3 | Comprehensive Exam - 110 Questions | Nursing Education Resource
, Shadow Health DCE | Noah Caputo - School Age Sick Visit | Subjective Data Collection Exam
Q10: Noah's mother says, "He's been coughing a lot at night." Which response best demonstrates the
clarification technique?
A. I understand. Let's move on to the next question.
B. When you say 'a lot,' can you tell me approximately how many times per night? [CORRECT]
C. That sounds concerning. Has he had coughing fits before?
D. Coughing at night is common in children his age.
Correct Answer: B
Rationale: Option B uses clarification to obtain specific, quantifiable data about the symptom, which is essential for accurate
subjective data collection in Shadow Health DCE. Rubrics reward clarification of vague terms like "a lot" to ensure precise
documentation. Option A dismisses the need for clarification. Option C changes the subject. Option D provides false reassurance
and dismisses the concern without gathering more data.
Q11: When building rapport with Noah during the Shadow Health DCE interview, which action would the
rubric most likely reward?
A. Begin with personal medical history questions to establish clinical context.
B. Sit at eye level with Noah, use his name, and start with non-threatening questions about school or interests.
[CORRECT]
C. Stand over the exam table while asking questions to maintain authority.
D. Ask all medical questions first, then engage in casual conversation at the end.
Correct Answer: B
Rationale: Building rapport with pediatric patients involves positioning at eye level, using the child's name, and beginning with
non-threatening topics to establish trust before addressing sensitive medical history. Shadow Health DCE pediatric rubrics
specifically reward rapport-building techniques that reduce anxiety and encourage cooperation. Options A and D jump directly
into medical questioning without establishing rapport. Option C creates a power imbalance that can intimidate a child.
Q12: Which statement by the nurse demonstrates the reflection technique in therapeutic communication?
A. So what you're saying is that the pain started two days ago.
B. You mentioned feeling scared. Tell me more about what's making you feel scared. [CORRECT]
C. Why do you think you're feeling this way?
D. I think you should rest more and drink plenty of fluids.
Correct Answer: B
Rationale: Option B demonstrates reflection by mirroring the patient's stated emotion ("feeling scared") and inviting further
exploration. Shadow Health DCE rubrics reward reflection as a therapeutic technique that validates the patient's feelings and
encourages deeper communication. Option A is summarization, not reflection. Option C uses a "why" question, which can feel
interrogative. Option D gives unsolicited advice, a non-therapeutic technique.
Q13: At the end of the Shadow Health interview, which action best demonstrates summarization and earns
DCE rubric points?
A. Immediately leave the room to document the findings.
B. Say thank you and end the interview without reviewing what was discussed.
C. Review the key points discussed with Noah and his mother, ask if there's anything else to add, and explain
next steps. [CORRECT]
D. Tell the mother she can add anything else to the chart later.
Page 4 | Comprehensive Exam - 110 Questions | Nursing Education Resource
