Shadow Health Cardiovascular
Assessment: Rochelle Joseph (DCE) |
2026 Update with complete solutions.
Section 1: Patient Scenario & Chief Complaint
(Questions 1-15)
1. According to the Shadow Health scenario, what is Rochelle Joseph's chief
complaint?
A) Shortness of breath and chest pain
B) Fatigue following a recent diagnosis of mitral valve prolapse (MVP)
, C) Palpitations and dizziness
D) Peripheral edema and weight gain
Correct Answer: B
Rationale: The scenario states that Rochelle Joseph presents for her 32-week pregnancy
follow-up complaining of fatigue following a recent mitral valve prolapse (MVP) diagnosis.
Her pregnancy and MVP are the contextual factors directing this focused cardiovascular
assessment.
2. What is Rochelle Joseph's current gestational age?
A) 28 weeks gestation
B) 30 weeks gestation
C) 32 weeks gestation
D) 36 weeks gestation
Correct Answer: C
Rationale: According to the scenario, Rochelle Joseph is presenting for her 32-week
pregnancy follow-up. Third-trimester pregnancy brings significant hemodynamic
changes—increased blood volume (up to 50%), increased cardiac output (30-50%), and
increased heart rate (10-20 bpm)—that can influence cardiovascular symptoms such as
fatigue, dyspnea, and lower extremity edema.
3. What cardiac condition was Rochelle Joseph recently diagnosed with?
A) Aortic stenosis
B) Mitral valve prolapse (MVP)
, C) Pulmonary hypertension
D) Hypertrophic cardiomyopathy
Correct Answer: B
Rationale: According to the scenario, Rochelle Joseph was recently diagnosed with mitral
valve prolapse (MVP). This valvular condition involves the displacement of an abnormally
thickened mitral valve leaflet into the left atrium during systole, sometimes accompanied
by mitral regurgitation. The diagnosis was confirmed via echocardiogram.
4. What diagnostic tests did Rochelle Joseph report having 2 weeks ago?
A) Stress test and coronary angiogram
B) Echocardiogram and EKG
C) Chest X-ray and cardiac MRI
D) Holter monitor and stress test
Correct Answer: B
Rationale: According to the subjective data collection, Rochelle reports having had an
echocardiogram and an EKG two weeks ago. The echocardiogram confirmed the MVP
diagnosis. She denies having a stress test, coronary artery CT scan, or heart
catheterization.
5. What symptoms does Rochelle Joseph explicitly DENY during the assessment?
A) Palpitations, chest pain, and shortness of breath
B) Fatigue and lower extremity edema
C) Orthopnea and paroxysmal nocturnal dyspnea
, D) Both A and C
Correct Answer: D
Rationale: Rochelle denies palpitations, arrhythmias, hypertension, peripheral edema, and
cyanosis. She also denies orthopnea, nighttime waking, and leg cramping. These denials
suggest that despite her MVP diagnosis and third-trimester pregnancy, she is not currently
demonstrating signs of cardiac decompensation.
6. Which symptom is Rochelle Joseph's primary concern?
A) Chest pain
B) Palpitations
C) Fatigue
D) Shortness of breath
Correct Answer: C
Rationale: Rochelle's chief complaint is fatigue, which she rates as 5/10 on a 0-10 scale.
This fatigue began around the time of her MVP diagnosis and has persisted since then.
7. Rochelle Joseph's fatigue should be considered in the context of what?
A) Only her MVP diagnosis
B) Only normal pregnancy changes
C) Both normal pregnancy changes AND her MVP diagnosis
D) Only her medication side effects
Assessment: Rochelle Joseph (DCE) |
2026 Update with complete solutions.
Section 1: Patient Scenario & Chief Complaint
(Questions 1-15)
1. According to the Shadow Health scenario, what is Rochelle Joseph's chief
complaint?
A) Shortness of breath and chest pain
B) Fatigue following a recent diagnosis of mitral valve prolapse (MVP)
, C) Palpitations and dizziness
D) Peripheral edema and weight gain
Correct Answer: B
Rationale: The scenario states that Rochelle Joseph presents for her 32-week pregnancy
follow-up complaining of fatigue following a recent mitral valve prolapse (MVP) diagnosis.
Her pregnancy and MVP are the contextual factors directing this focused cardiovascular
assessment.
2. What is Rochelle Joseph's current gestational age?
A) 28 weeks gestation
B) 30 weeks gestation
C) 32 weeks gestation
D) 36 weeks gestation
Correct Answer: C
Rationale: According to the scenario, Rochelle Joseph is presenting for her 32-week
pregnancy follow-up. Third-trimester pregnancy brings significant hemodynamic
changes—increased blood volume (up to 50%), increased cardiac output (30-50%), and
increased heart rate (10-20 bpm)—that can influence cardiovascular symptoms such as
fatigue, dyspnea, and lower extremity edema.
3. What cardiac condition was Rochelle Joseph recently diagnosed with?
A) Aortic stenosis
B) Mitral valve prolapse (MVP)
, C) Pulmonary hypertension
D) Hypertrophic cardiomyopathy
Correct Answer: B
Rationale: According to the scenario, Rochelle Joseph was recently diagnosed with mitral
valve prolapse (MVP). This valvular condition involves the displacement of an abnormally
thickened mitral valve leaflet into the left atrium during systole, sometimes accompanied
by mitral regurgitation. The diagnosis was confirmed via echocardiogram.
4. What diagnostic tests did Rochelle Joseph report having 2 weeks ago?
A) Stress test and coronary angiogram
B) Echocardiogram and EKG
C) Chest X-ray and cardiac MRI
D) Holter monitor and stress test
Correct Answer: B
Rationale: According to the subjective data collection, Rochelle reports having had an
echocardiogram and an EKG two weeks ago. The echocardiogram confirmed the MVP
diagnosis. She denies having a stress test, coronary artery CT scan, or heart
catheterization.
5. What symptoms does Rochelle Joseph explicitly DENY during the assessment?
A) Palpitations, chest pain, and shortness of breath
B) Fatigue and lower extremity edema
C) Orthopnea and paroxysmal nocturnal dyspnea
, D) Both A and C
Correct Answer: D
Rationale: Rochelle denies palpitations, arrhythmias, hypertension, peripheral edema, and
cyanosis. She also denies orthopnea, nighttime waking, and leg cramping. These denials
suggest that despite her MVP diagnosis and third-trimester pregnancy, she is not currently
demonstrating signs of cardiac decompensation.
6. Which symptom is Rochelle Joseph's primary concern?
A) Chest pain
B) Palpitations
C) Fatigue
D) Shortness of breath
Correct Answer: C
Rationale: Rochelle's chief complaint is fatigue, which she rates as 5/10 on a 0-10 scale.
This fatigue began around the time of her MVP diagnosis and has persisted since then.
7. Rochelle Joseph's fatigue should be considered in the context of what?
A) Only her MVP diagnosis
B) Only normal pregnancy changes
C) Both normal pregnancy changes AND her MVP diagnosis
D) Only her medication side effects
