NURS 6512 Advanced Health Assessment i-Human Case
Study (Week 7) – 28-Year-Old Male: Cough and Fatigue
2026 | Complete SOAP Note, Differential Diagnoses, and
Plan of Care
Q001: While obtaining the history of present illness, the patient reports a 3-week
productive cough with yellow sputum and worsening fatigue. Which question should the
NP ask FIRST to narrow the differential?
Options:
A. "Do you have seasonal allergies?"
B. "Have you experienced any fever or night sweats?"
C. "Are you taking any over-the-counter supplements?"
D. "Do you get heartburn after eating?"
(Correct Answer: B)
Q002: The patient states his cough is worse at night and often wakes him from sleep.
Which associated symptom would MOST suggest asthma as the etiology?
Options:
A. Concomitant nasal congestion
B. Inspiratory wheeze heard by patient
C. Chest tightness and prolonged expiratory phase
D. Sore throat and rhinorrhea
(Correct Answer: C)
Q003: On reviewing systems, the patient denies fever but reports a 5-lb weight loss
since the cough began. Which exposure history is MOST critical to obtain next?
Options:
A. Recent camping trips
B. Daycare center volunteer work
C. Consumption of raw shellfish
D. Use of a hot tub spa
(Correct Answer: B)
, Q004: The patient admits to vaping THC products daily for 2 years. Which additional
respiratory symptom would MOST raise concern for vaping-associated lung injury
(EVALI)?
Options:
A. Intermittent rhinorrhea
B. Bilateral chest discomfort with deep breaths
C. Heartburn after spicy meals
D. Clear sputum production
(Correct Answer: B)
Q005: Vital signs: BP 118/74 mmHg, HR 88 bpm, RR 18/min, O₂ sat 96% on room air, T
37.1 °C. Which finding on general survey is MOST concerning for a serious respiratory
pathology?
Options:
A. Mild nasal flaring
B. Visible accessory muscle use at rest
C. Occasional throat clearing
D. Dry mucous membranes
(Correct Answer: B)
Q006: On anterior thoracic inspection, you note decreased chest expansion bilaterally.
Which condition would this MOST support?
Options:
A. Pneumonia
B. Chronic asthma with air trapping
C. Acute bronchitis
D. Viral pharyngitis
(Correct Answer: B)
Q007: Percussion over the right lower lobe reveals hyper-resonance. Which diagnosis is
MOST likely?
Options:
A. Lobar pneumonia
B. Pleural effusion
C. Emphysema or air trapping
D. Lung consolidation
(Correct Answer: C)
Study (Week 7) – 28-Year-Old Male: Cough and Fatigue
2026 | Complete SOAP Note, Differential Diagnoses, and
Plan of Care
Q001: While obtaining the history of present illness, the patient reports a 3-week
productive cough with yellow sputum and worsening fatigue. Which question should the
NP ask FIRST to narrow the differential?
Options:
A. "Do you have seasonal allergies?"
B. "Have you experienced any fever or night sweats?"
C. "Are you taking any over-the-counter supplements?"
D. "Do you get heartburn after eating?"
(Correct Answer: B)
Q002: The patient states his cough is worse at night and often wakes him from sleep.
Which associated symptom would MOST suggest asthma as the etiology?
Options:
A. Concomitant nasal congestion
B. Inspiratory wheeze heard by patient
C. Chest tightness and prolonged expiratory phase
D. Sore throat and rhinorrhea
(Correct Answer: C)
Q003: On reviewing systems, the patient denies fever but reports a 5-lb weight loss
since the cough began. Which exposure history is MOST critical to obtain next?
Options:
A. Recent camping trips
B. Daycare center volunteer work
C. Consumption of raw shellfish
D. Use of a hot tub spa
(Correct Answer: B)
, Q004: The patient admits to vaping THC products daily for 2 years. Which additional
respiratory symptom would MOST raise concern for vaping-associated lung injury
(EVALI)?
Options:
A. Intermittent rhinorrhea
B. Bilateral chest discomfort with deep breaths
C. Heartburn after spicy meals
D. Clear sputum production
(Correct Answer: B)
Q005: Vital signs: BP 118/74 mmHg, HR 88 bpm, RR 18/min, O₂ sat 96% on room air, T
37.1 °C. Which finding on general survey is MOST concerning for a serious respiratory
pathology?
Options:
A. Mild nasal flaring
B. Visible accessory muscle use at rest
C. Occasional throat clearing
D. Dry mucous membranes
(Correct Answer: B)
Q006: On anterior thoracic inspection, you note decreased chest expansion bilaterally.
Which condition would this MOST support?
Options:
A. Pneumonia
B. Chronic asthma with air trapping
C. Acute bronchitis
D. Viral pharyngitis
(Correct Answer: B)
Q007: Percussion over the right lower lobe reveals hyper-resonance. Which diagnosis is
MOST likely?
Options:
A. Lobar pneumonia
B. Pleural effusion
C. Emphysema or air trapping
D. Lung consolidation
(Correct Answer: C)
