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Shadow Health - Tina Jones, Health
History| Certified Questions With
Comprehensive Rationales 2026
Acute pain - correct-answer-Priority: High Priority Pro Tip: Managing acute pain is
an immediate high priority, because other health concerns cannot be effectively
addressed while a patient experiences severe pain. Evidence - Relevant: "...Like a
7. It hurts a lot, but whatever pain med the ER gave me is helping a little bit." "It's
throbbing and like, sharp if I try to put weight on it." Evidence Pro Tip: Tina
expresses pain, which is the strongest evidence for this problem. She reports
intense pain on a numerical scale and describes pain characteristics. The presence
of a physical injury supports her susceptibility to acute pain. Planning - Relevant:
Assess - Pain: Assess the patient's pain at regular intervals and with each
assessment of vital signs. Assess - Pain: Assess the patient's response to pain
medication. Educate - Medication: Educate the patient on medications used for
pain relief. Educate - Pain: Educate the patient on non-pharmaceutical methods
to reduce pain intensity. Intervene - Pain: Administer non-pharmacologic
interventions to reduce pain. Intervene - Pain: Administer prescribed analgesics to
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provide optimal pain relief. Planning Pro Tip: To reduce the patient's pain, assess
her current rating. Provide an appropriate intervention (pharmaceutical or
otherwise) and educate the patient. After an appropriate time interval, assess
pain levels again to see how the intervention affected the pain.
Impaired skin integrity - correct-answer-Priority: High Priority Pro Tip: This is a
high priority. The infection is the most immediate threat to the patient's health,
and the wound is at risk for delayed healing because of the patient's uncontrolled
blood glucose. Evidence - Relevant: Evidence Pro Tip: As Tina discusses symptoms
of her wound, including symptoms such as discharge, redness, warmth, and
swelling, she reports strong evidence of impaired skin integrity. Planning -
Relevant: Planning Pro Tip: Because wound infections impact the patient's overall
health, it's important to assess perfusion, hydration, and swelling. Assess the
status of the wound itself and ensure proper cleaning and dressing per the
physician's order. Prevent worsening infection by educating the patient about
wound care and self-monitoring.
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Impaired walking - correct-answer-Priority - High Priority Pro Tip: This is a high
priority. The patient is unable to bear weight on her affected leg, which prevents
walking. This impacts her daily life and increases her risk for falls and deep-vein
thrombosis. Evidence - Relevant: "I mean, it's all red and swollen, and there's pus,
it feels hot, it hurts like hell... It's got all that going on." "I got this scrape on my
foot a while ago, and it got really infected. It's killing me." "No, I can't. I can't put
any weight on it without like, shooting pain." Evidence Pro Tip: The strongest
evidence of impaired walking is that Tina directly reports she can't bear weight or
walk on her affected foot. Other supporting data points are the presence of her
foot wound and her general reports of pain. Planning - Relevant: Assess -
Musculoskeletal: Assess the patient's ability to bear weight and gait. Assess -
Musculoskeletal: Assess the patient's mobility. Consult / Refer: Consult with
physical therapist to develop a plan to improve the patient's mobility. Intervene -
Mobility: Assist the patient as needed with mobility. Intervene - Mobility: Provide
assistive devices to facilitate mobility (crutches, therapeutic boot to minimize
pressure on plantar surface, wheelchair). Planning Pro Tip: Assess how well the
patient can bear weight and walk. While the patient is in your care, work with
other healthcare professionals to keep the pain managed and improve the
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patient's mobility. Provide assistance with activities such as toileting and ensure
that the patient can access and use assistive devices.
Ineffective diabetes management - correct-answer-Priority - High Priority Pro Tip:
Poorly managed diabetes and uncontrolled blood glucose complicate wound
healing. As the underlying cause for delayed healing and infection, they must be
addressed. Evidence - Relevant: "No, I don't take anything for my diabetes
anymore." "I guess I just got sick of feeling sick and gassy all the time, and it was
overwhelming, remembering to take pills and check my sugar. I feel a lot better
now that I'm just eating healthier than I did when I was taking the pills." "I have a
monitor at home, but to be honest I don't really use it that often." Evidence Pro
Tip: Tina directly reports ineffective diabetes management when discussing her
lack of treatment. She expresses gaps in health literacy about the risk of ceasing
prescribed medication and blood glucose monitoring. Supporting evidence comes
from her inability to incorporate meaningful dietary changes or increase her
exercise. Planning - Relevant: Assess - Health Literacy and Patterns: Assess the
patient's knowledge related to diabetic disease process, assess personal/social
supports. Assess - Health Literacy and Patterns: Assess the patient's perceived
Shadow Health - Tina Jones, Health
History| Certified Questions With
Comprehensive Rationales 2026
Acute pain - correct-answer-Priority: High Priority Pro Tip: Managing acute pain is
an immediate high priority, because other health concerns cannot be effectively
addressed while a patient experiences severe pain. Evidence - Relevant: "...Like a
7. It hurts a lot, but whatever pain med the ER gave me is helping a little bit." "It's
throbbing and like, sharp if I try to put weight on it." Evidence Pro Tip: Tina
expresses pain, which is the strongest evidence for this problem. She reports
intense pain on a numerical scale and describes pain characteristics. The presence
of a physical injury supports her susceptibility to acute pain. Planning - Relevant:
Assess - Pain: Assess the patient's pain at regular intervals and with each
assessment of vital signs. Assess - Pain: Assess the patient's response to pain
medication. Educate - Medication: Educate the patient on medications used for
pain relief. Educate - Pain: Educate the patient on non-pharmaceutical methods
to reduce pain intensity. Intervene - Pain: Administer non-pharmacologic
interventions to reduce pain. Intervene - Pain: Administer prescribed analgesics to
,2|Page
provide optimal pain relief. Planning Pro Tip: To reduce the patient's pain, assess
her current rating. Provide an appropriate intervention (pharmaceutical or
otherwise) and educate the patient. After an appropriate time interval, assess
pain levels again to see how the intervention affected the pain.
Impaired skin integrity - correct-answer-Priority: High Priority Pro Tip: This is a
high priority. The infection is the most immediate threat to the patient's health,
and the wound is at risk for delayed healing because of the patient's uncontrolled
blood glucose. Evidence - Relevant: Evidence Pro Tip: As Tina discusses symptoms
of her wound, including symptoms such as discharge, redness, warmth, and
swelling, she reports strong evidence of impaired skin integrity. Planning -
Relevant: Planning Pro Tip: Because wound infections impact the patient's overall
health, it's important to assess perfusion, hydration, and swelling. Assess the
status of the wound itself and ensure proper cleaning and dressing per the
physician's order. Prevent worsening infection by educating the patient about
wound care and self-monitoring.
,3|Page
Impaired walking - correct-answer-Priority - High Priority Pro Tip: This is a high
priority. The patient is unable to bear weight on her affected leg, which prevents
walking. This impacts her daily life and increases her risk for falls and deep-vein
thrombosis. Evidence - Relevant: "I mean, it's all red and swollen, and there's pus,
it feels hot, it hurts like hell... It's got all that going on." "I got this scrape on my
foot a while ago, and it got really infected. It's killing me." "No, I can't. I can't put
any weight on it without like, shooting pain." Evidence Pro Tip: The strongest
evidence of impaired walking is that Tina directly reports she can't bear weight or
walk on her affected foot. Other supporting data points are the presence of her
foot wound and her general reports of pain. Planning - Relevant: Assess -
Musculoskeletal: Assess the patient's ability to bear weight and gait. Assess -
Musculoskeletal: Assess the patient's mobility. Consult / Refer: Consult with
physical therapist to develop a plan to improve the patient's mobility. Intervene -
Mobility: Assist the patient as needed with mobility. Intervene - Mobility: Provide
assistive devices to facilitate mobility (crutches, therapeutic boot to minimize
pressure on plantar surface, wheelchair). Planning Pro Tip: Assess how well the
patient can bear weight and walk. While the patient is in your care, work with
other healthcare professionals to keep the pain managed and improve the
, 4|Page
patient's mobility. Provide assistance with activities such as toileting and ensure
that the patient can access and use assistive devices.
Ineffective diabetes management - correct-answer-Priority - High Priority Pro Tip:
Poorly managed diabetes and uncontrolled blood glucose complicate wound
healing. As the underlying cause for delayed healing and infection, they must be
addressed. Evidence - Relevant: "No, I don't take anything for my diabetes
anymore." "I guess I just got sick of feeling sick and gassy all the time, and it was
overwhelming, remembering to take pills and check my sugar. I feel a lot better
now that I'm just eating healthier than I did when I was taking the pills." "I have a
monitor at home, but to be honest I don't really use it that often." Evidence Pro
Tip: Tina directly reports ineffective diabetes management when discussing her
lack of treatment. She expresses gaps in health literacy about the risk of ceasing
prescribed medication and blood glucose monitoring. Supporting evidence comes
from her inability to incorporate meaningful dietary changes or increase her
exercise. Planning - Relevant: Assess - Health Literacy and Patterns: Assess the
patient's knowledge related to diabetic disease process, assess personal/social
supports. Assess - Health Literacy and Patterns: Assess the patient's perceived
