Shadow Health Cardiovascular
Assessment: Rochelle Joseph (DCE) | 2026
Update with complete solutions.
SECTION A: SUBJECTIVE DATA COLLECTION (History Taking)
1. What is the best open-ended question to begin the cardiovascular
assessment?
• A) "Are you having chest pain?"
• B) "Tell me about the reason for your visit today."
• C) "When were you diagnosed with mitral valve prolapse?"
• D) "Do you feel short of breath?"
Answer: B – Open-ended questions allow the patient to narrate her concerns in
her own words, establishing rapport and revealing unexpected information.
Options A, C, and D are leading or closed-ended.
2. Rochelle states she was diagnosed with mitral valve prolapse 2 weeks ago.
What is the most therapeutic follow-up question?
• A) "That must have been very scary for you. How are you feeling about
that diagnosis?"
• B) "Did the doctor prescribe any medication for that?"
• C) "You should see a cardiologist immediately."
• D) "Many people have that; it's not a big deal."
,Answer: A – This validates the patient's emotions and uses therapeutic
communication. B is closed-ended; C is prescriptive; D dismisses her feelings.
3. Using OLD CARTS, which question assesses the "Onset" of her fatigue?
• A) "What does the fatigue feel like?"
• B) "When did you first notice this fatigue?"
• C) "How severe is the fatigue on a scale of 0 to 10?"
• D) "What makes the fatigue worse?"
Answer: B – Onset specifically asks when the symptom began. A assesses
Character, C assesses Severity, and D assesses Aggravating factors.
4. What question best evaluates for paroxysmal nocturnal dyspnea (PND)?
• A) "Do you get short of breath during exercise?"
• B) "Do you ever wake up from sleep suddenly feeling like you can't
breathe?"
• C) "Do you need to prop yourself up with pillows to sleep?"
• D) "Does your heart race when you stand up?"
Answer: B – PND is defined as sudden awakening from sleep with severe shortness
of breath. C assesses orthopnea, A assesses exertional dyspnea.
5. To assess for orthopnea, which question is most appropriate?
• A) "How many pillows do you use to sleep at night?"
• B) "Do you sleep on your back or side?"
• C) "Do you snore at night?"
, • D) "Do you feel dizzy when you lie down?"
Answer: A – The number of pillows needed to breathe comfortably is a
quantitative measure of orthopnea severity. Increasing pillows indicates worsening
left-sided heart failure.
6. Rochelle denies chest pain. Which question should you ask next to explore
associated cardiac symptoms?
• A) "Have you noticed any palpitations or a racing heartbeat?"
• B) "Are you sure you don't have chest pain?"
• C) "Do your arms ever go numb?"
• D) "Do you have a family history of heart attacks?"
Answer: A – Palpitations are a classic associated symptom with MVP. Asking a
closed "are you sure" question is confrontational and non-therapeutic.
7. What question assesses for peripheral vascular compromise in her lower
extremities?
• A) "Have you noticed any swelling in your feet or ankles?"
• B) "Do your legs hurt when you walk?"
• C) "Have you had any blood clots before?"
• D) "Do you wear compression stockings?"
Answer: A – Peripheral edema is a key sign of right-sided heart failure or venous
insufficiency. While B is relevant (claudication), edema is more directly related to
her current fatigue and pregnancy.
8. Which question is essential to ask given her pregnancy and new MVP
diagnosis to rule out a hypercoagulable state?
, • A) "Do you smoke cigarettes or vape?"
• B) "Have you had any recent long flights or car rides?"
• C) "Have you noticed any redness, warmth, or pain in one calf?"
• D) "All of the above."
Answer: D – Pregnancy + MVP are risk factors for thrombosis. Smoking (A),
immobility (B), and unilateral calf pain (C) are all critical components of a
thromboembolic risk assessment.
9. What is the best question to ask about her medication history relevant to the
cardiovascular system?
• A) "Do you take any prenatal vitamins?"
• B) "Are you taking any blood thinners, blood pressure pills, or heart
medications?"
• C) "Have you taken any over-the-counter cold medicines?"
• D) "Do you take herbal supplements for energy?"
Answer: B – This directly screens for cardiac-specific pharmacotherapy. While
prenatal vitamins are important for pregnancy, they are not primary
cardiovascular drugs.
10. Rochelle mentions she is a former smoker. What is the most appropriate
response?
• A) "Good for you for quitting. How long ago did you quit?"
• B) "Smoking is terrible for your heart and baby."
• C) "You should never start again."
• D) "That doesn't matter anymore since you quit."
Assessment: Rochelle Joseph (DCE) | 2026
Update with complete solutions.
SECTION A: SUBJECTIVE DATA COLLECTION (History Taking)
1. What is the best open-ended question to begin the cardiovascular
assessment?
• A) "Are you having chest pain?"
• B) "Tell me about the reason for your visit today."
• C) "When were you diagnosed with mitral valve prolapse?"
• D) "Do you feel short of breath?"
Answer: B – Open-ended questions allow the patient to narrate her concerns in
her own words, establishing rapport and revealing unexpected information.
Options A, C, and D are leading or closed-ended.
2. Rochelle states she was diagnosed with mitral valve prolapse 2 weeks ago.
What is the most therapeutic follow-up question?
• A) "That must have been very scary for you. How are you feeling about
that diagnosis?"
• B) "Did the doctor prescribe any medication for that?"
• C) "You should see a cardiologist immediately."
• D) "Many people have that; it's not a big deal."
,Answer: A – This validates the patient's emotions and uses therapeutic
communication. B is closed-ended; C is prescriptive; D dismisses her feelings.
3. Using OLD CARTS, which question assesses the "Onset" of her fatigue?
• A) "What does the fatigue feel like?"
• B) "When did you first notice this fatigue?"
• C) "How severe is the fatigue on a scale of 0 to 10?"
• D) "What makes the fatigue worse?"
Answer: B – Onset specifically asks when the symptom began. A assesses
Character, C assesses Severity, and D assesses Aggravating factors.
4. What question best evaluates for paroxysmal nocturnal dyspnea (PND)?
• A) "Do you get short of breath during exercise?"
• B) "Do you ever wake up from sleep suddenly feeling like you can't
breathe?"
• C) "Do you need to prop yourself up with pillows to sleep?"
• D) "Does your heart race when you stand up?"
Answer: B – PND is defined as sudden awakening from sleep with severe shortness
of breath. C assesses orthopnea, A assesses exertional dyspnea.
5. To assess for orthopnea, which question is most appropriate?
• A) "How many pillows do you use to sleep at night?"
• B) "Do you sleep on your back or side?"
• C) "Do you snore at night?"
, • D) "Do you feel dizzy when you lie down?"
Answer: A – The number of pillows needed to breathe comfortably is a
quantitative measure of orthopnea severity. Increasing pillows indicates worsening
left-sided heart failure.
6. Rochelle denies chest pain. Which question should you ask next to explore
associated cardiac symptoms?
• A) "Have you noticed any palpitations or a racing heartbeat?"
• B) "Are you sure you don't have chest pain?"
• C) "Do your arms ever go numb?"
• D) "Do you have a family history of heart attacks?"
Answer: A – Palpitations are a classic associated symptom with MVP. Asking a
closed "are you sure" question is confrontational and non-therapeutic.
7. What question assesses for peripheral vascular compromise in her lower
extremities?
• A) "Have you noticed any swelling in your feet or ankles?"
• B) "Do your legs hurt when you walk?"
• C) "Have you had any blood clots before?"
• D) "Do you wear compression stockings?"
Answer: A – Peripheral edema is a key sign of right-sided heart failure or venous
insufficiency. While B is relevant (claudication), edema is more directly related to
her current fatigue and pregnancy.
8. Which question is essential to ask given her pregnancy and new MVP
diagnosis to rule out a hypercoagulable state?
, • A) "Do you smoke cigarettes or vape?"
• B) "Have you had any recent long flights or car rides?"
• C) "Have you noticed any redness, warmth, or pain in one calf?"
• D) "All of the above."
Answer: D – Pregnancy + MVP are risk factors for thrombosis. Smoking (A),
immobility (B), and unilateral calf pain (C) are all critical components of a
thromboembolic risk assessment.
9. What is the best question to ask about her medication history relevant to the
cardiovascular system?
• A) "Do you take any prenatal vitamins?"
• B) "Are you taking any blood thinners, blood pressure pills, or heart
medications?"
• C) "Have you taken any over-the-counter cold medicines?"
• D) "Do you take herbal supplements for energy?"
Answer: B – This directly screens for cardiac-specific pharmacotherapy. While
prenatal vitamins are important for pregnancy, they are not primary
cardiovascular drugs.
10. Rochelle mentions she is a former smoker. What is the most appropriate
response?
• A) "Good for you for quitting. How long ago did you quit?"
• B) "Smoking is terrible for your heart and baby."
• C) "You should never start again."
• D) "That doesn't matter anymore since you quit."
