WGU D117 | ADVANCED HEALTH ASSESSMENT | 2026–2027
Patient Interview & Diagnostic Reasoning Workbook
16 applied case exercises plus 57 interview and clinical -reasoning questions
.
Interview framework: presenting concern to reasoned plan
• Start broad; define onset, location, duration, characteristics, aggravating/relieving factors and progression.
• Use focused relevant positive/negative review of systems and ask about risks, medicines and functional impact.
• Summarize a problem representation with age/context, tempo, key symptoms, findings and instability clues.
• Generate a short prioritized differential; ask what findings might disprove the leading explanation.
• Close the loop: discuss tests and results, follow-up ownership, and urgent return precautions.
Sixteen fictional clinical reasoning cases
Case 01 — Acute chest discomfort
History: 54-year-old with 40 minutes of heavy substernal discomfort, sweating and nausea
Objective data: BP 90/56, pulse 112, pale and diaphoretic
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Potential acute coronary syndrome or other life-threatening
cardiopulmonary condition. Stop routine assessment and trigger emergency stabilization and evaluation; record
symptom onset and vital signs.
Case 02 — Severe sudden headache
History: 43-year-old describes a headache that reached peak severity in seconds
Objective data: Alert with initially nonfocal brief neurologic exam
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Subarachnoid hemorrhage and other secondary thunderclap headache
causes. Urgent emergency evaluation despite an initially nonfocal exam; obtain key timing and accompanying
symptoms.
Case 03 — Flank pain with fever
History: 29-year-old has dysuria for three days followed by fever, vomiting, and unilateral flank pain
Objective data: T 39.0 C, pulse 116, flank tenderness
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
INDEPENDENT STUDY RESOURCE • NOT A WGU ASSESSMENT
, WGU D117 | ADVANCED HEALTH ASSESSMENT | 2026–2027
Instructor check / expected priority: Upper urinary infection with possible systemic involvement; obstruction is a
competing concern. Assess stability and arrange urgent evaluation with appropriate urine studies and further
testing as indicated.
Case 04 — Dizziness and dark stools
History: 67-year-old reports black stools, fatigue, and near-syncope
Objective data: BP 94/60, pulse 115, pale conjunctivae
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible gastrointestinal bleeding with symptomatic volume loss. Prioritize
hemodynamic assessment and urgent referral; document stool history and medication exposures.
Case 05 — Dyspnea with unilateral swelling
History: 39-year-old reports acute shortness of breath and new painful swollen calf after immobility
Objective data: Pulse 118, RR 27, oxygen saturation 92% on room air
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible venous thromboembolism and pulmonary embolism. Escalate
urgently; avoid falsely excluding serious illness based on any single examination finding.
Case 06 — Pelvic pain and pregnancy
History: 26-year-old with missed period, one-sided pelvic pain, spotting and lightheadedness
Objective data: Positive pregnancy test; BP 98/58; pulse 110
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible ectopic pregnancy and hemorrhage. Urgent emergency evaluation;
discuss examinations and testing with informed consent.
Case 07 — Acute scrotal pain
History: 19-year-old has sudden unilateral testicular pain with nausea
Objective data: Uncomfortable, elevated tender hemiscrotum reported
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible testicular torsion. Urgent emergency surgical evaluation; do not
delay for routine follow-up.
Case 08 — Persistent cough
History: 63-year-old with three-week cough, former smoker, exertional dyspnea
INDEPENDENT STUDY RESOURCE • NOT A WGU ASSESSMENT
, WGU D117 | ADVANCED HEALTH ASSESSMENT | 2026–2027
Objective data: Afebrile, mild scattered wheezes, oxygen saturation 95%
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Multiple possible pulmonary and cardiac causes; consider alarm features.
Take exposure, medication, weight-loss and hemoptysis history; evaluate red flags and appropriate testing.
Case 09 — Falls and medication burden
History: 81-year-old reports two falls and new difficulty managing home medications
Objective data: Orthostatic symptoms, uses a cane; multiple prescriptions
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Multifactorial fall risk with possible orthostasis/medication contribution.
Review medications, gait, blood pressure change, cognition, vision and home hazards.
Case 10 — New focal weakness
History: 72-year-old develops slurred speech and right arm weakness 30 minutes before arrival
Objective data: Right pronator drift, speech change, BP 174/96
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible acute stroke. Activate emergency stroke response immediately,
note last-known-well time.
Case 11 — Painful red eye
History: 33-year-old has severe unilateral eye pain, photophobia and blurred vision
Objective data: Injected eye, patient avoids light
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Vision-threatening ocular inflammation, pressure problem, or corneal
process. Urgent ophthalmic evaluation rather than routine conjunctivitis reassurance.
Case 12 — Acute monoarthritis
History: 58-year-old has a very swollen, red, painful knee and fever
Objective data: T 38.4 C, cannot comfortably bear weight
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
INDEPENDENT STUDY RESOURCE • NOT A WGU ASSESSMENT
Patient Interview & Diagnostic Reasoning Workbook
16 applied case exercises plus 57 interview and clinical -reasoning questions
.
Interview framework: presenting concern to reasoned plan
• Start broad; define onset, location, duration, characteristics, aggravating/relieving factors and progression.
• Use focused relevant positive/negative review of systems and ask about risks, medicines and functional impact.
• Summarize a problem representation with age/context, tempo, key symptoms, findings and instability clues.
• Generate a short prioritized differential; ask what findings might disprove the leading explanation.
• Close the loop: discuss tests and results, follow-up ownership, and urgent return precautions.
Sixteen fictional clinical reasoning cases
Case 01 — Acute chest discomfort
History: 54-year-old with 40 minutes of heavy substernal discomfort, sweating and nausea
Objective data: BP 90/56, pulse 112, pale and diaphoretic
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Potential acute coronary syndrome or other life-threatening
cardiopulmonary condition. Stop routine assessment and trigger emergency stabilization and evaluation; record
symptom onset and vital signs.
Case 02 — Severe sudden headache
History: 43-year-old describes a headache that reached peak severity in seconds
Objective data: Alert with initially nonfocal brief neurologic exam
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Subarachnoid hemorrhage and other secondary thunderclap headache
causes. Urgent emergency evaluation despite an initially nonfocal exam; obtain key timing and accompanying
symptoms.
Case 03 — Flank pain with fever
History: 29-year-old has dysuria for three days followed by fever, vomiting, and unilateral flank pain
Objective data: T 39.0 C, pulse 116, flank tenderness
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
INDEPENDENT STUDY RESOURCE • NOT A WGU ASSESSMENT
, WGU D117 | ADVANCED HEALTH ASSESSMENT | 2026–2027
Instructor check / expected priority: Upper urinary infection with possible systemic involvement; obstruction is a
competing concern. Assess stability and arrange urgent evaluation with appropriate urine studies and further
testing as indicated.
Case 04 — Dizziness and dark stools
History: 67-year-old reports black stools, fatigue, and near-syncope
Objective data: BP 94/60, pulse 115, pale conjunctivae
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible gastrointestinal bleeding with symptomatic volume loss. Prioritize
hemodynamic assessment and urgent referral; document stool history and medication exposures.
Case 05 — Dyspnea with unilateral swelling
History: 39-year-old reports acute shortness of breath and new painful swollen calf after immobility
Objective data: Pulse 118, RR 27, oxygen saturation 92% on room air
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible venous thromboembolism and pulmonary embolism. Escalate
urgently; avoid falsely excluding serious illness based on any single examination finding.
Case 06 — Pelvic pain and pregnancy
History: 26-year-old with missed period, one-sided pelvic pain, spotting and lightheadedness
Objective data: Positive pregnancy test; BP 98/58; pulse 110
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible ectopic pregnancy and hemorrhage. Urgent emergency evaluation;
discuss examinations and testing with informed consent.
Case 07 — Acute scrotal pain
History: 19-year-old has sudden unilateral testicular pain with nausea
Objective data: Uncomfortable, elevated tender hemiscrotum reported
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible testicular torsion. Urgent emergency surgical evaluation; do not
delay for routine follow-up.
Case 08 — Persistent cough
History: 63-year-old with three-week cough, former smoker, exertional dyspnea
INDEPENDENT STUDY RESOURCE • NOT A WGU ASSESSMENT
, WGU D117 | ADVANCED HEALTH ASSESSMENT | 2026–2027
Objective data: Afebrile, mild scattered wheezes, oxygen saturation 95%
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Multiple possible pulmonary and cardiac causes; consider alarm features.
Take exposure, medication, weight-loss and hemoptysis history; evaluate red flags and appropriate testing.
Case 09 — Falls and medication burden
History: 81-year-old reports two falls and new difficulty managing home medications
Objective data: Orthostatic symptoms, uses a cane; multiple prescriptions
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Multifactorial fall risk with possible orthostasis/medication contribution.
Review medications, gait, blood pressure change, cognition, vision and home hazards.
Case 10 — New focal weakness
History: 72-year-old develops slurred speech and right arm weakness 30 minutes before arrival
Objective data: Right pronator drift, speech change, BP 174/96
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Possible acute stroke. Activate emergency stroke response immediately,
note last-known-well time.
Case 11 — Painful red eye
History: 33-year-old has severe unilateral eye pain, photophobia and blurred vision
Objective data: Injected eye, patient avoids light
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
Instructor check / expected priority: Vision-threatening ocular inflammation, pressure problem, or corneal
process. Urgent ophthalmic evaluation rather than routine conjunctivitis reassurance.
Case 12 — Acute monoarthritis
History: 58-year-old has a very swollen, red, painful knee and fever
Objective data: T 38.4 C, cannot comfortably bear weight
Your problem representation: __________________________________________________________
Two additional diagnoses to evaluate: __________________________________________________
Red flags, next examination and safety plan: ______________________________________________
INDEPENDENT STUDY RESOURCE • NOT A WGU ASSESSMENT
