Shadow Health - Tina Jones, Health
History Exam Questions and Answers
100% Accurate
Medications - ANSWER-Albuterol MDI, 2 puffs every 4 hours as needed for wheezing
Acetaminophen 325 mg tabs by mouth, 2 tabs every 4 hours as needed for fever
greater than 38.6C /101.5F
Clindamycin 600mg/50ml every 6 hours intravenously
0.9 NaCl intravenously 100 ml/hr continuously x2 Liters
Lortab 5mg 1-2 tabs by mouth as needed for pain
Oxycodone 5mg 1 tab by mouth as needed
Insulin glargine 10 units at bedtime
Health History Tips & Tricks: - ANSWER-
Student: Hello! - ANSWER-Diana Shadow: Hi. I'm Preceptor Diana. I will explain the
details of this assignment and your objectives, just as a preceptor would in real life. Pay
close attention to this information as it will help guide your exam. At the end of this
prebrief, you will answer a short question about the upcoming assignment. During the
simulation, you may return to these instructions at any time by scrolling to the top of
your transcript.
Student: What is the situation? - ANSWER-Diana Shadow: Your patient is Tina Jones:,
a 28-year-old African American woman who has just been admitted to Shadow General
Hospital for a painful foot wound. Your role in this simulation is that of a healthcare
provider who will take Ms. Jones' health history, a key component of her admission
process.
Student: What are my objectives in this assessment? - ANSWER-Diana Shadow: A
health history requires you to ask questions related to Ms. Jones' past and present
health, from her current foot wound to her pre-existing conditions. You will also want to
review Ms. Jones' systems, psychosocial history, and family medical history. These
assessments together will give you a comprehensive picture of Ms. Jones' overall
health. If you discover any disease states, ask about symptoms and the patient's
experiences of them. Your questioning should cover a broad array of the symptoms'
characteristics. Throughout the conversation, you should educate and empathize with
Ms. Jones when appropriate to increase her health literacy and sense of well-being.
Regardless of whether you have assessed Ms. Jones previously, ask all questions that
are necessary for obtaining a complete health history. While you should communicate
with patients using accessible, everyday language, it is standard practice to use
professional medical terminology everywhere else, such as in documenting physical
,findings and nursing notes. You may complete the exam activities in any order and
move between them as needed. After obtaining Ms. Jones' health history, you will
complete an information processing activity. You will identify and prioritize diagnoses,
then create a plan to address the identified diagnoses.
Student: What else will this exam involve? - ANSWER-Diana Shadow: You will
complete nursing tasks to protect the patients safety, privacy, and health. You can
document your findings, including vital signs, in the Electronic Health Record. This
record provides necessary information for healthcare professionals who will continue
patient care. Besides Subjective Data Collection, and Education and Empathy, there are
activities within the simulation that provide valuable practice for their real-world
counterparts, but they are not automatically graded by the simulation.
Student: How will I be evaluated? - ANSWER-Diana Shadow: In this assignment, you
will be evaluated on your Subjective Data Collection, as well as your Education and
Empathy. Your success in Education and Empathy is based on whether you promptly
respond after identifying a moment worthy of therapeutic communication. The
evaluation of your interview is dependent on how you word your questions
therapeutically and precisely and explore all relevant topics with comprehensive breadth
and depth. You will also be evaluated on your ability to collect data and form nursing
diagnoses in the information processing activity. This assignment takes on average
between 90 and 110 minutes. This exam may take longer than in real life, because in
this safe simulation, students of all experience levels can take time to hone and review
their skills. You can pause and resume the assignment at any time; your work is always
saved automatically.
Student: How does this assignment prepare me for the real world? - ANSWER-Diana
Shadow: In this assessment, you will become familiarized with the structure and content
of a health history exam so that with real-life patients, you can: º ask effective and
comprehensive questions º obtain a thorough health history º evaluate the patient's risk
of disease, infection, injury, and complications º educate and empathize º reflect on your
experience and identify areas to improve º identify and prioritize nursing diagnoses º
and develop a plan to address nursing diagnoses.
Diana Shadow: In 1 or 2 sentences, answer this question to help prepare for the
upcoming exam: Why is it important to obtain a patient's complete health history? -
ANSWER-Student: Getting a complete health history enables the nurse to make
informed judgments about the client including formulating nursing diagnoses requiring
nursing care, identifying collaborative problems requiring interdisciplinary care, medical
issues requiring immediate referral, and the need for client teaching.
Diana Shadow: Time to begin. - ANSWER-
Patient Exam - Vital Signs: - ANSWER-Height: 170 cm, Weight: 90 kg, BMI: 31,
Random blood glucose: 238, Temperature: 102.4° F, Blood pressure: 138/90 mmHg,
Heart rate: 90, Respiratory rate: 18, O2 sat: 98%
Patient Exam - Interview: - ANSWER-
,Student: Hello, my name is Rachel and I am your nurse today. - ANSWER-Tina Jones:
Hey.
Student: Can you confirm your name? - ANSWER-Tina Jones: Tina Jones:.
Student: What brings you in today? - ANSWER-Tina Jones: I got this scrape on my foot
a while ago, and it got really infected. It's killing me.
Student: Where is your wound located? - ANSWER-Tina Jones: It's on the ball of my
foot.
Student: Which foot is injured? - ANSWER-Tina Jones: My right foot.
Student: I'm sorry to hear that. I'm glad you came in to get your foot evaluated. -
ANSWER-Tina Jones: Thanks a lot.
Student: Can you tell me how you scraped your foot? - ANSWER-I was changing a light
bulb, and I had to use our little stepstool to reach it. My foot slid off the bottom step and
it got all scraped up. I didn't realize how sharp the edge was!
Student: Can you rate your current pain level on a scale of 0 to 10? - ANSWER-Tina
Jones: ...Like a 7. It hurts a lot, but whatever pain med the ER gave me is helping a little
bit.
Student: Can you describe the pain? - ANSWER-Tina Jones: It's throbbing and like,
sharp if I try to put weight on it.
Student: Have you had any other symptoms? - ANSWER-Tina Jones: I mean, it's all red
and swollen, and there's pus, it feels hot, it hurts like hell... It's got all that going on.
Student: When did you first notice the pus? - ANSWER-Tina Jones: I noticed it about 2
days ago.
Student: What color was the pus? - ANSWER-Tina Jones: It's... white or maybe off-
white.
Student: Did your foot bleed? - ANSWER-Tina Jones: It bled a little after I injured it.
Student: How have you been treating your foot? - ANSWER-Tina Jones: I made sure to
clean it and keep it bandaged. And I put Neosporin on it.
Student: How have you treated the wound? - ANSWER-Tina Jones: I've been taking
Advil for my foot for a few days.
Student: Was the Neosporin effective? - ANSWER-Tina Jones: Well, I'm here, so I
guess it didn't do its job.
Student: Can you walk on your injured foot? - ANSWER-Tina Jones: No, I can't. I can't
put any weight on it without like, shooting pain.
Student: How effective was your pain medication at home? - ANSWER-Tina Jones:
Whatever pain medication the ER gave me is helping. Before I came in, I was just
, taking Advil. For the past few days, the Advil wasn't doing much for me -- it would only
last a couple of hours.
Student: Have you had any fever at home? - ANSWER-Tina Jones: Yeah, I started to
have one yesterday, and then it was a little better this morning. It kinda crept up all day.
Student: Do you have any preexisting medical conditions? - ANSWER-Tina Jones: I
mean, I have asthma and diabetes, but right I now I just care about my foot!
Student: I understand your foot hurts. We have to ask a lot of questions, but it's to
ensure we treat your injury and anything else that could contribute to the problem. -
ANSWER-Tina Jones: That's kind of you.
Student: When were you diagnosed with diabetes? - ANSWER-Tina Jones: I was
diagnosed when I was 24.
Student: How do you manage your asthma? - ANSWER-Tina Jones: I try to avoid things
that give me breathing problems, but when my asthma starts to act up, I just use my
inhaler.
Student: What medications did you take for your diabetes? - ANSWER-Tina Jones: It
was metformin.
Student: Do you currently take medicine for your diabetes? - ANSWER-Tina Jones: No,
I don't take anything for my diabetes anymore.
Student: What made you stop taking medication for your diabetes? - ANSWER-Tina
Jones: I guess I just got sick of feeling sick and gassy all the time, and it was
overwhelming, remembering to take pills and check my sugar. I feel a lot better now that
I'm just eating healthier than I did when I was taking the pills.
Student: Do you monitor your blood glucose? - ANSWER-Tina Jones: I have a monitor
at home, but to be honest I don't really use it that often.
Student: Do you get thirsty often? - ANSWER-Tina Jones: You know, I did notice lately
that I've been really thirsty.
Student: How frequently do you urinate? - ANSWER-Tina Jones: I don't know. Every
hour or two when I'm awake?
Student: What is your current diet? - ANSWER-Tina Jones: It's pretty good, I think. I'm
not a huge health nut or anything.
Student: Have you had a change in appetite? - ANSWER-Tina Jones: Yeah, lately I've
definitely been much hungrier than usual.
Student: Have you had any changes in your weight? - ANSWER-Tina Jones: Yeah, I've
lost some weight recently.
Student: Do you know what caused your weight loss? - ANSWER-Tina Jones: I don't
know what caused it, I just lost weight.
