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NUR 6111 Liam Fitzgerald Shadow Health
Telehealth Follow Up Sick Visit: Management of
Cardiovascular Conditions Results Turned In
Questions with Correct and Detailed Solutions
2026 /2027 Update
Question 1 In the Liam Fitzgerald Shadow Health telehealth follow-up visit, what is the primary reason for the encounter? A) Annual physical examination B) Follow-up for newly diagnosed hypertension and medication adjustment C) Pre-operative clearance D) Sports participation physical Answer: B Explanation: Liam Fitzgerald is a 47-year-old male with newly diagnosed hypertension who is following up after starting lisinopril. The visit focuses on medication effectiveness, side effects, and blood pressure control.
Question 2 During a telehealth sick visit, which component must be documented to establish a valid patient-provider relationship? A) Patient's social security number B) Patient's verbal consent for telehealth services C) Patient's employer information D) Patient's next of kin Answer: B Explanation: Verbal or written informed consent for telehealth services must be documented, including risks, benefits, and alternatives to in-person care. Question 3 What is the maximum time frame for documenting a telehealth visit according to standard NP practice? A) Within 72 hours
Explanation: Remote patient monitoring data (home BP readings, weight, etc.) should be included and interpreted in the note to support clinical decision-making. Question 5 In Shadow Health, the "Timothy Jones" button indicates: A) A patient with diabetes B) A computer-generated voice for patient responses C) A medication reference guide D) A clinical calculator Answer: B Explanation: In Shadow Health simulations, clicking the Timothy Jones button plays the patient's spoken responses. It is an accessibility feature. Question 6 When performing a telehealth cardiovascular assessment, which element is NOT possible to perform remotely?
A) Asking about symptoms of dyspnea B) Observing for jugular venous distention C) Palpating for peripheral edema D) Listening to heart sounds with a digital stethoscope (if available) Answer: C Explanation: Palpation (touch) cannot be performed via standard telehealth. JVD observation may be possible if patient can position camera appropriately. Digital stethoscopes allow auscultation. Question 7 In the Liam Fitzgerald scenario, the patient reports "feeling dizzy" since starting lisinopril. What is the most appropriate next question? A) "Have you had any chest pain?" B) "Do you check your blood pressure at home? What are your readings?" C) "Did you take the medication today?" D) "Are you allergic to any foods?"
Question 9 When conducting a telehealth follow-up for hypertension, how often should home BP monitoring be recommended? A) Once per month B) Twice daily (morning and evening) for one week prior to visit C) Only when symptoms occur D) Once per week Answer: B Explanation: For medication adjustment, twice-daily home BP readings (morning before meds and evening) for 5-7 days before the visit provides adequate data for clinical decision-making. Question 10 Which of the following is a valid telehealth platform security requirement under HIPAA? A) Use of FaceTime or Skype without business associate agreement B) Use of a HIPAA-compliant platform with end-to-end encryption
C) Recording all visits on personal phone D) Using public Wi-Fi without VPN Answer: B Explanation: Telehealth platforms must be HIPAA-compliant with encryption, secure data transmission, and a business associate agreement. Public-facing apps (FaceTime, standard Zoom) are not permitted without BAA. Question 11 In the Shadow Health telehealth simulation, which of the following is a correct way to ask about medication adherence? A) "Did you take your medicine every day?" B) "How many days in the past week did you miss a dose of your blood pressure medication?" C) "You didn't miss any doses, right?" D) "Are you taking your medication correctly?" Answer: B
When documenting a telehealth visit, the "History of Present Illness" should include: A) Only objective data from remote monitoring B) A chronological narrative of the patient's symptoms and medication adjustments since last visit C) The patient's entire medical history D) Billing codes only Answer: B Explanation: HPI is a narrative describing the reason for the visit, symptom timeline, medication changes, and relevant context since the last encounter. Question 14 In the Liam Fitzgerald case, the patient's blood pressure at last office visit was 142/92. He was started on lisinopril 10 mg daily. Today he reports home BP readings averaging 128/84. This indicates: A) Poor response to medication B) Adequate blood pressure control (goal typically <130/80 for most adults)
C) Need to double the lisinopril dose D) Inaccurate home monitor Answer: B Explanation: ACC/AHA guidelines recommend BP <130/80 for most adults with hypertension. A reduction from 142/92 to 128/84 is a therapeutic response. Dizziness should be evaluated separately. Question 15 What is the most appropriate action if a patient reports severe dizziness or fainting during a telehealth visit? A) Schedule an in-person visit for next week B) Advise the patient to stop all medications immediately C) Instruct the patient to seek emergency care or call 911 D) Increase the medication dose Answer: C
In the Shadow Health platform, which of the following is a "red flag" symptom in a patient with hypertension? A) Mild headache B) Sudden, severe chest pain or pressure radiating to the jaw C) Fatigue after exercise D) Occasional palpitations with caffeine Answer: B Explanation: Severe chest pain (especially with radiation to jaw/arm), sudden severe headache, vision changes, or shortness of breath at rest are red flags requiring emergency evaluation. Question 18 When a patient reports missing several doses of lisinopril, the NP should: A) Prescribe a different medication B) Determine the reason for non-adherence (cost, side effects, forgetfulness) and address it
C) Double the next dose to catch up D) Discontinue the medication Answer: B Explanation: Assessing barriers to adherence (cost, side effects, regimen complexity, forgetfulness) is essential before changing therapy. Patient education and simplifying regimens improve adherence. Question 19 The "SOAP" note format includes which components? A) Subjective, Objective, Assessment, Plan B) Symptoms, Observations, Analysis, Prescription C) Summary, Orders, Actions, Progress D) Subjective, Objective, Action, Protocol Answer: A
When the patient reports "my ankles are swollen," the NP should ask all of the following EXCEPT: A) "Is the swelling worse at the end of the day?" B) "Do you have shortness of breath when lying flat?" C) "What color is your urine?" D) "Does the swelling pit when you press on it?" (if patient can do so) Answer: C Explanation: Urine color is not directly relevant to new-onset edema in a hypertension follow-up. Questions should assess heart failure (orthopnea, PND), venous insufficiency, and medication side effects (CCB-induced edema). Question 22 The "Plan" section of a telehealth follow-up note must include: A) Only medication changes B) Medications, patient education, follow-up interval, and when to seek emergent care C) Billing codes only
D) Physical exam findings Answer: B Explanation: The Plan should be comprehensive: medication adjustments, lifestyle counseling, monitoring instructions, follow-up timing, and red flag warning signs. Question 23 In Shadow Health, selecting "Ask about smoking history" is appropriate for a patient with hypertension because: A) Smoking is unrelated to hypertension B) Smoking increases cardiovascular risk and should be addressed C) The software requires it for completion D) Smoking lowers blood pressure Answer: B Explanation: Smoking is a major cardiovascular risk factor. Smoking cessation counseling is part of comprehensive hypertension management.
B) Specific topics discussed (e.g., "Educated on signs of angioedema including lip/tongue swelling, instructed to stop lisinopril and seek care if occurs") C) Not required for telehealth visits D) "Education given per protocol" Answer: B Explanation: Specific documentation of education content, patient response, and any teach-back performed is necessary for legal and quality purposes. ================================================================== ============== SECTION 2: HYPERTENSION MANAGEMENT & PHARMACOLOGY (Questions 26-
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Question 26
What is the ACC/AHA 2017 definition of Stage 1 hypertension? A) Systolic BP ≥140 or diastolic BP ≥ B) Systolic BP 130-139 or diastolic BP 80- 89 C) Systolic BP 120-129 and diastolic < D) Systolic BP ≥160 or diastolic ≥ Answer: B Explanation: ACC/AHA guidelines: Normal (<120/80), Elevated (120-129/<80), Stage 1 HTN (130-139/80-89), Stage 2 HTN (≥140/90). Treatment threshold is lower for high- risk patients. Question 27 Liam Fitzgerald's blood pressure at diagnosis was 142/92. According to guidelines, what is the recommended initial treatment? A) Lifestyle modifications alone for 6 months B) Monotherapy with a thiazide diuretic, ACE inhibitor, ARB, or CCB C) Triple therapy immediately
