Shadow Health Cardiovascular
Assessment: Rochelle Joseph (DCE) |
2026 Update with complete solutions.
SECTION 1: PATIENT SCENARIO & CHIEF COMPLAINT
Question 1
Rochelle Joseph presents for a follow-up appointment at 32 weeks gestation.
According to the Shadow Health scenario, what is her chief complaint?
A) Chest pain and shortness of breath
B) Fatigue following a recent diagnosis of mitral valve prolapse (MVP)
C) Palpitations and dizziness
D) Leg swelling and headaches
Correct Answer: B
Rationale: The scenario states Rochelle Joseph is a 41-year-old female who presents to the
OB-GYN office 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 driving this focused cardiovascular assessment .
,Question 2
Rochelle Joseph's current pregnancy is at how many weeks gestation?
A) 28 weeks
B) 30 weeks
C) 32 weeks
D) 34 weeks
Correct Answer: C
Rationale: According to the Shadow Health scenario, Rochelle Joseph is presenting for her
32-week pregnancy follow-up. Third-trimester pregnancy brings significant hemodynamic
changes that can influence cardiovascular symptoms such as fatigue, dyspnea, and lower
extremity edema .
Question 3
Rochelle Joseph was recently diagnosed with which cardiac condition?
A) Aortic stenosis
B) Hypertrophic cardiomyopathy
C) Mitral valve prolapse (MVP)
D) Atrial septal defect
Correct Answer: C
Rationale: 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 .
Question 4
,Rochelle Joseph's fatigue should be considered in the context of:
A) Normal pregnancy changes only
B) Mitral valve prolapse only
C) Both normal pregnancy changes AND her MVP diagnosis
D) Neither—fatigue is unrelated to her pregnancy or MVP
Correct Answer: C
Rationale: Rochelle's fatigue has a multifactorial etiology. Pregnancy is a high-output
state that increases heart rate and blood volume, which can cause fatigue. At the same
time, the recent diagnosis of MVP means that any associated mitral regurgitation could be
contributing to reduced cardiac efficiency. A comprehensive assessment must consider
both factors .
Question 5
What is Rochelle Joseph's age?
A) 35 years old
B) 38 years old
C) 41 years old
D) 44 years old
Correct Answer: C
Rationale: According to the Shadow Health scenario, Rochelle Joseph is a 41-year-old
female. Her age is relevant as it places her in the advanced maternal age category, which
carries additional pregnancy-related risks .
Question 6
What is Rochelle Joseph's setting for this encounter?
A) Cardiology clinic
B) OB-GYN office
, C) Emergency department
D) Primary care clinic
Correct Answer: B
Rationale: Rochelle Joseph presents to the OB-GYN office for her routine 32-week
pregnancy follow-up. This setting is important because the assessment must consider both
her cardiac condition and her pregnancy status .
Question 7
Why is Rochelle Joseph's MVP diagnosis significant in the context of her
pregnancy?
A) Pregnancy has no effect on MVP
B) Pregnancy increases blood volume and cardiac output, which may affect MVP
symptoms
C) Pregnancy cures MVP
D) MVP prevents normal pregnancy progression
Correct Answer: B
Rationale: The increased blood volume and cardiac output of pregnancy can exacerbate
previously asymptomatic MVP. If mitral regurgitation worsens, the patient may develop
progressive dyspnea on exertion, new-onset palpitations, or other signs of heart failure .
Question 8
What is the most important initial step when beginning the focused cardiovascular
assessment of Rochelle Joseph?
A) Auscultate the heart immediately
B) Perform a complete blood count
C) Review her medical history and establish a therapeutic dialogue
D) Order an echocardiogram
Assessment: Rochelle Joseph (DCE) |
2026 Update with complete solutions.
SECTION 1: PATIENT SCENARIO & CHIEF COMPLAINT
Question 1
Rochelle Joseph presents for a follow-up appointment at 32 weeks gestation.
According to the Shadow Health scenario, what is her chief complaint?
A) Chest pain and shortness of breath
B) Fatigue following a recent diagnosis of mitral valve prolapse (MVP)
C) Palpitations and dizziness
D) Leg swelling and headaches
Correct Answer: B
Rationale: The scenario states Rochelle Joseph is a 41-year-old female who presents to the
OB-GYN office 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 driving this focused cardiovascular assessment .
,Question 2
Rochelle Joseph's current pregnancy is at how many weeks gestation?
A) 28 weeks
B) 30 weeks
C) 32 weeks
D) 34 weeks
Correct Answer: C
Rationale: According to the Shadow Health scenario, Rochelle Joseph is presenting for her
32-week pregnancy follow-up. Third-trimester pregnancy brings significant hemodynamic
changes that can influence cardiovascular symptoms such as fatigue, dyspnea, and lower
extremity edema .
Question 3
Rochelle Joseph was recently diagnosed with which cardiac condition?
A) Aortic stenosis
B) Hypertrophic cardiomyopathy
C) Mitral valve prolapse (MVP)
D) Atrial septal defect
Correct Answer: C
Rationale: 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 .
Question 4
,Rochelle Joseph's fatigue should be considered in the context of:
A) Normal pregnancy changes only
B) Mitral valve prolapse only
C) Both normal pregnancy changes AND her MVP diagnosis
D) Neither—fatigue is unrelated to her pregnancy or MVP
Correct Answer: C
Rationale: Rochelle's fatigue has a multifactorial etiology. Pregnancy is a high-output
state that increases heart rate and blood volume, which can cause fatigue. At the same
time, the recent diagnosis of MVP means that any associated mitral regurgitation could be
contributing to reduced cardiac efficiency. A comprehensive assessment must consider
both factors .
Question 5
What is Rochelle Joseph's age?
A) 35 years old
B) 38 years old
C) 41 years old
D) 44 years old
Correct Answer: C
Rationale: According to the Shadow Health scenario, Rochelle Joseph is a 41-year-old
female. Her age is relevant as it places her in the advanced maternal age category, which
carries additional pregnancy-related risks .
Question 6
What is Rochelle Joseph's setting for this encounter?
A) Cardiology clinic
B) OB-GYN office
, C) Emergency department
D) Primary care clinic
Correct Answer: B
Rationale: Rochelle Joseph presents to the OB-GYN office for her routine 32-week
pregnancy follow-up. This setting is important because the assessment must consider both
her cardiac condition and her pregnancy status .
Question 7
Why is Rochelle Joseph's MVP diagnosis significant in the context of her
pregnancy?
A) Pregnancy has no effect on MVP
B) Pregnancy increases blood volume and cardiac output, which may affect MVP
symptoms
C) Pregnancy cures MVP
D) MVP prevents normal pregnancy progression
Correct Answer: B
Rationale: The increased blood volume and cardiac output of pregnancy can exacerbate
previously asymptomatic MVP. If mitral regurgitation worsens, the patient may develop
progressive dyspnea on exertion, new-onset palpitations, or other signs of heart failure .
Question 8
What is the most important initial step when beginning the focused cardiovascular
assessment of Rochelle Joseph?
A) Auscultate the heart immediately
B) Perform a complete blood count
C) Review her medical history and establish a therapeutic dialogue
D) Order an echocardiogram
