SHADOW HEALTH - TINA JONES, HEALTH HISTORY COMPREHENSIVE ASSESMENT QUESTIONS AND ANSWERS B, Exams of Nursing

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ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Health History Tips & Tricks: - CORRECT ANSWERS TJ Health Interview Student: Hello! - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Diana Shadow: You will complete nursing tasks to protect the patients safety, privacy, and health. You can document your findings,

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Student: So that you understand if there are any problems related to their chief complaint. Also, to help treat their current condition. Diana Shadow: Time to begin. - CORRECT ANSWERS

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Patient Exam - Vital Signs: - CORRECT ANSWERS 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: - CORRECT ANSWERS Student: Hello, my name is Catlain, I am your nurse today. - CORRECT ANSWERS Tina Jones: Hey. Student: Can you confirm your name? - CORRECT ANSWERS Tina Jones: Tina Jones:. Student: Why did you come in today? - CORRECT ANSWERS Tina Jones: I got this scrape on my foot a while ago, and it got really infected. It's killing me. Student: What additional symptoms have you experienced? - CORRECT ANSWERS 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: Can you rate your current pain level on a scale of 0 to 10? - CORRECT ANSWERS Tina Jones: ...Like a 7. It hurts a lot, but whatever pain med the ER gave me is helping a little bit. Student: Please describe the pain. - CORRECT ANSWERS Tina Jones: It's throbbing and like, sharp if I try to put weight on it. Student: How did you hurt your foot? - CORRECT ANSWERS Tina Jones: 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!

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: Has your foot been draining any liquids? - CORRECT ANSWERS Tina Jones: Yeah, there's definitely pus. Student: What color was the pus? - CORRECT ANSWERS Tina Jones: It's... white or maybe off-white. Student: How have you treated the wound? - CORRECT ANSWERS Tina Jones: I've been taking Advil for my foot for a few days. Student: What did you do to treat your foot after your accident? - CORRECT ANSWERS Tina Jones: I made sure to clean it and keep it bandaged. And I put Neosporin on it. Student: How effective was the Neosporin? - ANSWERS Tina Jones: Well, I'm here, so I guess it didn't do its job. Student: Can you walk with your foot being injured? - CORRECT ANSWERS Tina Jones: No, I can't. I can't put any weight on it without like, shooting pain. Student: What preexisting medical conditions do you have? - CORRECT ANSWERS 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, but I need to know this information to make sure I take care of the problem correctly. - CORRECT ANSWERS Tina Jones: Thanks. Student: When were you diagnosed with diabetes? - CORRECT ANSWERS Tina Jones: I was diagnosed when I was 24.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: What do you do to manage your asthma? - CORRECT ANSWERS 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? - CORRECT ANSWERS Tina Jones: It was metformin. Student: Do you currently take medicine for your diabetes? - CORRECT ANSWERS Tina Jones: No, I don't take anything for my diabetes anymore. Student: What made you stop taking medication for your diabetes? - CORRECT ANSWERS 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? - CORRECT ANSWERS Tina Jones: I have a monitor at home, but to be honest I don't really use it that often. Student: How frequently do you urinate? - CORRECT ANSWERS Tina Jones: I don't know. Every hour or two when I'm awake? Student: What is your current diet? - CORRECT ANSWERS Tina Jones: It's pretty good, I think. I'm not a huge health nut or anything. Student: Have you had any change in appetite? - CORRECT ANSWERS Tina Jones: Yeah, lately I've definitely been much hungrier than usual.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: Has your weight changed? - CORRECT ANSWERS Tina Jones: Yeah, I've lost some weight recently. Student: Do you know why you lost weight? - CORRECT ANSWERS Tina Jones: I don't know what caused it, I just lost weight. Student: How often do you have asthma exacerbations? - CORRECT ANSWERS Tina Jones: I haven't had a full attack in years. But my breathing definitely acts up.. .not always. Max twice a week. Student: What asthma symptoms have you experienced? - CORRECT ANSWERS Tina Jones: My chest and throat get tight, and I start to wheeze. It feels like I can't take in air, like I can't get enough air into my lungs. Student: How many puffs do you take when using your asthma inhaler? - CORRECT ANSWERS Tina Jones: I usually use two puffs from my inhaler, but sometimes I need three. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] Student: What are some things that trigger your asthma? - CORRECT ANSWERS Tina Jones: Being around cats is the worst, but dust and running up stairs can make my breathing bad, too. Student: What allergies do you have? - CORRECT ANSWERS Tina Jones: I'm allergic to cats. Student: When did you realize you were allergic to cats? - CORRECT ANSWERS Tina Jones: For as long as I've been around.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: How effective was your pain medication at home? - CORRECT ANSWERS 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: What medication allergies do you have? - CORRECT ANSWERS Tina Jones: I'm allergic to penicillin. Student: What food allergies do you have? - CORRECT ANSWERS Tina Jones: I don't have any food allergies that I know of. Student: Are you allergic to dust, mold, or pollen? - CORRECT ANSWERS Tina Jones: Well... I don't know if it's allergies, but sometimes my asthma acts up around dust. Student: What immunizations have you received? - CORRECT ANSWERS Tina Jones: I got a tetanus booster for work about a year ago. For the other kinds, I got all the required ones when I was a kid, and for college...I'm sure I have a record somewhere at home. Student: Have you received a flu vaccine? - CORRECT ANSWERS Tina Jones: No. Student: Have you had any prior hospitalizations? - CORRECT ANSWERS Tina Jones: Well, before this I went a bunch of times when I was little, for asthma attacks. This is the first time I've been in the hospital since I was probably sixteen, though. Student: Have you had any gastrointestinal problems? - CORRECT ANSWERS Tina Jones: No. I've never really had stomach or bowel problems.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: Do you have a family history of psychiatric illness? - CORRECT ANSWERS Tina Jones: No. They're crazy, but nobody's diagnosed with anything. Student: Do you have any neck, throat or gland problems? - CORRECT ANSWERS Tina Jones: No, not that I noticed. Student: Do you have any problems with your head? - CORRECT ANSWERS Tina Jones: I don't think I have any problems. I get headaches sometimes, but that's all. Student: Any problems with your ears? - CORRECT ANSWERS Tina Jones: No. Student: Any problems with your eyes and vision? - CORRECT ANSWERS Tina Jones: I've actually been noticing problems lately. When I'm reading or studying I'll notice that things start to get kind of blurry. Student: Any problems with your nose? - CORRECT ANSWERS Tina Jones: My nose is fine right now. Sometimes it runs, but not very often. Student: Do you have problems with your mouth? - CORRECT ANSWERS Tina Jones: No. Student: Do you have a history of cardiovascular problems? - CORRECT ANSWERS Tina Jones: My heart's fine, thank God! Student: Any problems with your heart? - CORRECT ANSWERS Tina Jones: No, my heart's always been fine.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: Have you had any problems with your breasts? - CORRECT ANSWERS Tina Jones: I haven't noticed any pain there. Student: Have you had any reproductive problems? - CORRECT ANSWERS Tina Jones: I don't think I have problems in that area. I just get really bad periods, that's all. Student: Have you had any neurological problems? - CORRECT ANSWERS Tina Jones: No, I haven't. Student: Have you had any musculoskeletal problems? - CORRECT ANSWERS Tina Jones: No. Student: Do you have a history of skin disease? - CORRECT ANSWERS Tina Jones: Um, I have acne, if that counts. Student: Does your paternal grandfather have any health problems? - CORRECT ANSWERS Tina Jones: Grandpa Jones had colon cancer, and that caused all kinds of problems for him. Plus, he had high blood pressure, and...I'm pretty sure he had diabetes. And high cholesterol like everyone else in my family. Student: Does your mother have any health problems? - CORRECT ANSWERS Tina Jones: Mom has high cholesterol and blood pressure, I think. She seems to be doing okay though. Student: Does your father have any health problems? - CORRECT ANSWERS Tina Jones: Well, he passed away. But he had a couple things... Type 2 diabetes, like me, and high cholesterol and blood pressure. Student: How did your father die? - CORRECT ANSWERS Tina Jones: He died in a car accident.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: Where is your wound located? - CORRECT ANSWERS Tina Jones: It's on the ball of my foot. Student: Do you get thirsty often? - CORRECT ANSWERS Tina Jones: You know, I did notice lately that I've been really thirsty. Student: What happened with your father's car accident? - CORRECT ANSWERS Tina Jones: It was last year... I guess a little over a year ago. Student: How long ago was your dad's car accident? - CORRECT ANSWERS Tina Jones: It was last year... I guess a little over a year ago. Student: How did you cope with your fathers death? - CORRECT ANSWERS Tina Jones: Well, right after he died, after the funeral and everything, I just tried to get through that. Mom was having such a hard time, crying a lot, everything made her sad, she was kind of depressed. So, I guess at first I just focused on getting things done--groceries, laundry, insurance papers and stuff. Knowing that Mom needed me kind of helped me get through day by day. There was about a month where it was hard for us to get to church. Even getting up and ready for church was too overwhelming. But our church family helped us out and gave us rides to church and brought meals and all that, so they really helped build us back up. Things were only hard like that for a few months. Student: What caused your dads accident? - CORRECT ANSWERS Tina Jones: He was driving to work, and it was raining...and his car hydroplaned. And hit a tree. So, it was really sudden. Student: How is your paternal grandmother's health? - CORRECT ANSWERS Tina Jones: Granny's doing good. She's still living on her own. She's slowing down, but we help her out. She lives down the street from us, and she gets around okay. I think she takes some pills, maybe for blood pressure? She might have high cholesterol too. She seems happy.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: How is your paternal grandfather's health? - CORRECT ANSWERS Tina Jones: Grandpa Jones passed away when I was really little. Student: How is your maternal grandfather's health? - CORRECT ANSWERS Tina Jones: Well, Poppa died about five years ago. Student: How is your maternal grandmother's health? - CORRECT ANSWERS Tina Jones: Nana was 73 when she died of a stroke about five years ago. I think she had high blood pressure and cholesterol, too. Student: How is your brother's health? - CORRECT ANSWERS Tina Jones: He's a healthy guy. Kind of big like me. Student: How is your sister's health? - CORRECT ANSWERS Tina Jones: She's pretty healthy. She has asthma too, but she almost never has attacks. Student: Does your family have a history of obesity? - CORRECT ANSWERS Tina Jones: No, I don't think so. My brother and my dad are kind of big, but I wouldn't say they were obese or anything. Student: Does your family have a history thyroid issue? - CORRECT ANSWERS Tina Jones: No, I don't think so. Student: Does your family have a history of substance abuse? - CORRECT ANSWERS Tina Jones: One person in the family, my dad's brother, has an alcohol problem, but we never see him. Student: Does your family have a history of headaches? - CORRECT ANSWERS Tina Jones: No, not that I know of.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: How much alcohol do you drink? - CORRECT ANSWERS Tina Jones: I only have a few drinks when I go out. Student: What is your level of education? - CORRECT ANSWERS Tina Jones: Well, I'm finishing up my bachelor's degree right now. Student: What are stressors? - CORRECT ANSWERS Tina Jones: I feel really stressed out right now! Honestly, I didn't realize that I'd be admitted to the hospital for my foot. I don't want to miss work or school but now it looks like I'll have to. And I want my foot to stop hurting. I know I need sleep, too. Student: We are going to take care of everything as quickly as possible. - CORRECT ANSWERS Tina Jones: Thanks. Student: Where do you live? - CORRECT ANSWERS Tina Jones: Right now, I'm living at my mom's place, which is out in the suburbs a bit. It's like a half hour from here. Student: What is your belief system? - CORRECT ANSWERS Tina Jones: I'm Baptist. My faith is a big part of my life--when things get hard like they've been this past year, I know I can trust that God's looking out for me. I've been going to the same church since I was a kid, too, so the people at church are practically part of my family. Student: Have you experienced abuse? - CORRECT ANSWERS Tina Jones: I've never had been in any kind of situation like that... It's scary to think about. Student: Have you used illicit drugs? - CORRECT ANSWERS Tina Jones: Well, I used to smoke pot... but I don't do that anymore.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: What type of drugs did you use? - CORRECT ANSWERS Tina Jones: Um...I've smoked pot before. In high school, and after high school... I definitely don't anymore, though. Student: Have you used drugs other than marijuana? - CORRECT ANSWERS Tina Jones: No. Student: When did you last use drugs? - CORRECT ANSWERS Tina Jones: I haven't smoked pot since I was twenty or twenty-one. Student: Have you ever smoked cigarettes? - CORRECT ANSWERS Tina Jones: No. I think it's gross. Student: Have you been around people that are smoking? - CORRECT ANSWERS Tina Jones: Some of my friend's smoke when we go out drinking. But I don't smoke, and nobody at home smokes. Student: How old were you when your father died? - CORRECT ANSWERS Tina Jones: He died last year, so I was 27. Student: Did your father die from any disease? - CORRECT ANSWERS Tina Jones: He died in a car accident. Student: Can you tell me about your father's health? - CORRECT ANSWERS Tina Jones: He had high blood pressure and cholesterol. And diabetes -- we have diabetes in common. Student: I can't even imagine how you feel about losing your father - CORRECT ANSWERS Tina Jones: Thanks.

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Student: Tell me about your father. - CORRECT ANSWERS Tina Jones: Dad was a little stricter than Mom growing up... he would sometimes get kind of mad at us when we did something wrong. But he never hit us or anything. He would just get really calm and quiet and tell us to go to our rooms without supper, or that we were grounded when we were older. Or like, he'd make us rake the yard or wash his car or something. It's pretty sad to Student: How old was your father when he died? - CORRECT ANSWERS Tina Jones: Last year when Dad passed, he was only 58. Subjective Data Collection - Checklist: - CORRECT ANSWERS Chief Complaint - CORRECT ANSWERS Finding: Established chief complaint - CORRECT ANSWERS Finding: Reports pain (Found)Pro Tip: Initially establishing a chief complaint allows the patient to express their reason for seeking care, primary concerns, or condition they are presenting with. - CORRECT ANSWERS Example Question: Do you have any pain? Finding: Reports foot wound (Found)Pro Tip: If a patient mentions pain, it's important to determine what specifically is causing her pain, if she knows. - CORRECT ANSWERS Example Question: What's causing your pain? History of Presenting Illness - CORRECT ANSWERS Finding: Asked to rate current pain level on a scale - CORRECT ANSWERS

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports current pain is 7/10 (Found)Pro Tip: Asking your patient to rate her pain on a scale of 0 to 10 is important to gauge how it ebbs and flows while she is in your care. - CORRECT ANSWERS Example Question: Can you rate the pain on a scale of 0 to 10? Finding: Asked for details about the pain - CORRECT ANSWERS Finding: Reports pain is throbbing (Found)Pro Tip: Determining how your patient describes the characteristics of the pain can be important data to support the cause of the pain. - CORRECT ANSWERS Example Question: Can you please describe the pain? Finding: Reports pain is sharp when she attempts to stand (Found)Pro Tip: Determining what physical activities and movements exacerbate the patient's pain can help you better understand the problems and assess treatment needs. This can also alert you if a patient's activities of daily living are hindered.

• CORRECT ANSWERS Example Question: What is the pain like when you stand on your foot? Finding: Reports pain has increased in the past 2 days (Available)Pro Tip:Finding out how the patient's pain has changed will give you insight into the acceleration of infection. - CORRECT ANSWERS Example Question: How has the pain changed over time? Finding: Reports feeling pain radiating into ankle (Available)Pro Tip: Asking about where else the patient's pain radiates can help determine the progression of infection. - CORRECT ANSWERS Example Question: Does the pain radiate anywhere else? Finding: Reports pain prevents bearing weight on foot (Found)Pro Tip: Determining if your patient can bear weight on an injury is important to determine their risk for falls while in your care. - CORRECT ANSWERS Example Question: Can you bear weight on your foot? Finding: Asked location of wound - CORRECT ANSWERS

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports right foot is injured (Found)Pro Tip: Confirming which extremity an injury is located is a best practice for your patient's safety. - CORRECT ANSWERS Example Question: Which foot is in pain? Finding: Reports wound is on the plantar surface of her foot (Found)Pro Tip: Confirming where a wound is located ensures you are aware of your patient's biggest complaint. - CORRECT ANSWERS Example Question: Where is the wound? Finding: Asked details of the injury - CORRECT ANSWERS Finding: Reports she scraped foot on bottom rung of a step stool (Found)Pro Tip: Discovering how an injury happened helps to assess your patient's risk factors for injury. - CORRECT ANSWERS Example Question: How did your injury happen? Finding: Reports injury occurred 1 week ago (Available)Pro Tip: Discovering how long ago the pain began is the first step in understanding whether the pain is chronic or acute. - CORRECT ANSWERS Example Question: When did your injury occur? Finding: Denies other injuries besides foot wound (Available)Pro Tip: Discovering additional injuries can reveal more information about the circumstances that caused the presenting injury. - CORRECT ANSWERS Example Question: Did you injure anything besides your foot? Finding: Reports being barefoot at the time of injury (Available)Pro Tip: Asking about clothing, footwear, and other protective elements being worn at the time of injury helps you discover the totality of the circumstances. - CORRECT ANSWERS Example Question: Were you wearing shoes when you fell?

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Denies seeing a healthcare provider for the injury until now (Available)Pro Tip: It's crucial to ask whether your patient has seen another provider for the injury, because any previous medical intervention will help you understand the progression of the wound. - CORRECT ANSWERS Example Question: Have you seen a healthcare provider for this injury? Finding: Asked about drainage from the foot wound - CORRECT ANSWERS Finding: Reports that the wound bled a little after sustaining the injury (Available)Pro Tip: Asking about bleeding helps you determine the characteristics of a wound. - CORRECT ANSWERS Example Question: Did your foot bleed? Finding: Reports seeing pus draining from wound (Found)Pro Tip: Asking about discharge helps you determine the characteristics of a wound. - CORRECT ANSWERS Example Question: Did you notice any discharge from the wound? Finding: Reports noticing pus 2 days ago (Available)Pro Tip: Pinpointing exactly when the patient noticed the arrival of pus gives you an important data point for when an active infection began. - CORRECT ANSWERS Example Question: When did you first notice the pus? Finding: Followed up on drainage - CORRECT ANSWERS Finding: Reports pus as white or yellow (Found)Pro Tip: The color of discharge from a wound can provide insight into its severity and characteristics. - CORRECT ANSWERS Example Question: What color is the drainage from your wound? Finding: Denies odor from the wound (Available)Pro Tip: The odor of discharge from a wound can provide insight into its severity and characteristics. - CORRECT ANSWERS Example Question: Does the wound have an odor?

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Asked about home treatment of foot wound - CORRECT ANSWERS Finding: Reports wound care regimen of bandaging (Available)Pro Tip: Asking specifically how often a patient changed a bandage will let you know if an infection spread through improper hygiene, or for other reasons such as uncontrolled blood sugar. - CORRECT ANSWERS Example Question: How often do you change your bandage? Finding: Reports cleaning wound twice a day (Available)Pro Tip: Asking specifically how often a patient cleaned a wound will let you know if an infection spread through improper hygiene, or for other reasons such as uncontrolled blood sugar. - CORRECT ANSWERS Example Question: How often did you clean the wound? Finding: Reports applying bacitracin, neomycin and polymyxin B (Neosporin) (Found)Pro Tip: Determining what products a patient used to sterilize or treat a wound establishes home care routines and health literacy. - CORRECT ANSWERS Example Question: Did you use any ointment on the wound? Finding: Followed up on effectiveness of ointment - CORRECT ANSWERS Finding: Reports bacitracin, neomycin and polymyxin B (Neosporin) was ineffective (Found)Pro Tip: Understanding the effect of a home medication can help you determine the severity of the wound. Tina's diabetes diagnosis will have a large impact on her body's healing ability, which should be taken into consideration during your exam. - CORRECT ANSWERS Example Question: Did the ointment help? Finding: Asked about other foot wound symptoms - CORRECT ANSWERS

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports swelling around foot wound (Found)Pro Tip: Asking about the presence of swelling helps you gather information about your patient's complaint, as well as potential related illnesses. - CORRECT ANSWERS Example Question: Is there swelling around the wound? Finding: Reports swelling worsened in the past 2 days (Available)Pro Tip:Finding out how long swelling appeared will help you understand the timeline for the infection progression. - CORRECT ANSWERS Example Question: How long have you noticed swelling around the wound? Finding: Reports redness around the wound (Found)Pro Tip: Asking about redness will help you understand the timeline for the infection progression. - CORRECT ANSWERS Example Question: Did you notice any redness around the wound? Finding: Reports that the wound feels warm (Found)Pro Tip: Asking about warmth will help you understand the timeline for the infection progression. - CORRECT ANSWERS Example Question: Does the wound feel warm? Finding: Explored impact of patient's foot injury on activities of daily living - CORRECT ANSWERS Finding: Reports pain affects ability to walk (Available)Pro Tip: Understanding the impact of your patient's wound on daily activities helps inform your plan for care. With a foot wound, it is imperative to discern if a patient can walk or not, as a lack of mobility can compromise quality of life.

• CORRECT ANSWERS Example Question: Does your injury impact your ability to walk? Finding: Reports pain affects ability to stand at work for long periods of time (Available)Pro Tip: Understanding the impact of your patient's wound on daily activities helps inform your plan for care. With a foot wound, it is imperative to discern if a patient can stand or not, as this can compromise quality of life and impact job performance. - CORRECT ANSWERS Example Question: Does your foot pain affect your work?

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports pain prevented her from being able to walk to class (Available)Pro Tip: For patients who are also students, you can find out what schoolwork they are missing, and help them make accommodations so they don't fall behind. - CORRECT ANSWERS Example Question: Has your injury prevented you from going to class? Past Medical History - CORRECT ANSWERS Finding: Asked about preexisting medical conditions - CORRECT ANSWERS Finding: Reports diabetes (Found)Pro Tip: It is important to identify any existing medical conditions, as that information is an integral part of a complete health history. Existing conditions can also inform your treatment and understanding of the patient's current health issues. In Tina's case, it is important to identify her diabetes diagnosis because that condition has a direct relationship with her current foot infection. - CORRECT ANSWERS Example Question: Do you have any existing conditions? Finding: Reports asthma (Found)Pro Tip: It is important to identify any existing medical conditions, such as Tina's asthma, because that information is an integral part of her health history. Existing conditions can also inform your treatment and understanding of the patient's current health issues. - CORRECT ANSWERS Example Question: Do you have any other conditions? Finding: Followed up on diabetes diagnosis - CORRECT ANSWERS Finding: Reports specific age of diagnosis was 24 (Found)Pro Tip: Learning the diagnosis date of your patient's illness is an essential element of the illnesses history. - CORRECT ANSWERS Example Question: At what age were you diagnosed with diabetes?

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports that her diabetes is Type 2 (Available)Pro Tip: The type of diabetes your patient has will drastically affect how you care for her. - CORRECT ANSWERS Example Question: Do you know what type of diabetes you have? Finding: Asked about diabetes management through lifestyle changes - CORRECT ANSWERS Finding: Reports staying away from sweets (Available)Pro Tip: Asking your patient specifically about sugar intake can help you understand the history of her diabetes as well as her health literacy. - CORRECT ANSWERS Example Question: Tell me more about any sugars you consume. Finding: Reports drinking diet coke instead of regular (Available)Pro Tip: Particularly for diabetic patients, asking about intake of drinks that contain sugar can reveal additional sources of carbohydrates that the patient may not consider. - CORRECT ANSWERS Example Question: Do you drink sugary drinks? Finding: Asked about current diabetes medication use - CORRECT ANSWERS Finding: Reports that she does not currently take medication for diabetes (Found)Pro Tip: Asking about diabetes medication is important to understanding if your patient's disease is under control. - CORRECT ANSWERS Example Question: Do you take prescribed medication for your diabetes? Finding: Asked about past diabetes medication use - CORRECT ANSWERS Finding: Reports that she used to take diabetes medication (Found)Pro Tip: Asking about Tina's medication history for asthma will provide a timeline of treatment. You will be able to see what has been effective and ineffective in the past, which will allow you to make a more informed decision about current treatment. - CORRECT ANSWERS Example Question: Have you ever taken medication for your diabetes?

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports previous medication was prescription metformin (Found)Pro Tip: Asking about a patient's medication history for a particular condition, such as Tina's past prescription for metformin, will provide a timeline of her asthma treatment. You will be able to see what has been effective and ineffective in the past, which will allow you to make a more informed decision about current treatment. - CORRECT ANSWERS Example Question: Do you remember what you were prescribed for diabetes? Finding: Reports last use of medication was 3 years ago (Available)Pro Tip: It important to discover when Tina stopped taking any medications and what caused her to stop. Discovering her reason for noncompliance will allow you to make a more informed decision about current treatment. - CORRECT ANSWERS Example Question: When was the last time you took your diabetes medication on a regular basis? Finding: Followed up on stopping diabetes regimen - CORRECT ANSWERS Finding: Reports disliking diabetes medication side effects (Found)Pro Tip: Asking about side effects from medication can provide information about your patient's reaction to treatment. - CORRECT ANSWERS Example Question: Did the metformin cause any side effects? Finding: Reports that she didn't like checking sugar and taking daily pills (Found)Pro Tip: Asking reasons for noncompliance can reveal information about your patient's health literacy, side effects, financial situation, and more. - CORRECT ANSWERS Example Question: What's preventing you from taking your diabetes medication? Finding: Asked about blood glucose monitoring - CORRECT ANSWERS

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Reports infrequent blood glucose monitoring (Found)Pro Tip: Your patient's blood sugar monitoring habits are an important part of her health literacy and home treatment. - CORRECT ANSWERS Example Question: Tell me about your blood sugar monitoring. Finding: Reports she last checked blood sugar a month ago (Available)Pro Tip: Your patient's blood sugar monitoring habits are an important part of her health literacy and home treatment. - CORRECT ANSWERS Example Question: How often do you check your blood sugar? Finding: Reports confusion about what the numbers mean (Available)Pro Tip: Your patient's blood sugar monitoring habits are an important part of her health literacy and home treatment. If you find gaps in the patient's literacy, that is your opportunity to provide education. - CORRECT ANSWERS Example Question: What are your usual blood sugar levels? Finding: Asked about thirst - CORRECT ANSWERS Finding: Reports increased thirst (Found)Pro Tip: Your patient's thirst can offer insight into underlying medical conditions. Knowing that Tina is diabetic, you will want to explore this classic symptom of the condition. - CORRECT ANSWERS Example Question: Have you been more thirsty lately? Finding: Reports increased water intake (Available)Pro Tip: Your patient's fluid intake can offer insight into underlying medical conditions. Knowing that Tina is diabetic, you will want to explore this classic symptom of the condition. - CORRECT ANSWERS Example Question: Are you drinking more water than normal? Finding: Asked about frequency of urination - CORRECT ANSWERS Finding: Reports more frequent urination (Found)Pro Tip: Your patient's urination habits can offer insight into underlying medical conditions and general health. Knowing that Tina is diabetic, you will

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

want to explore this classic symptom of the condition. - CORRECT ANSWERS Example Question: Have you been urinating more often than usual? Finding: Reports urinating every hour or two during the day (Found)Pro Tip: Your patient's urination habits can offer insight into underlying medical conditions and general health. Knowing that Tina is diabetic, you will want to explore this classic symptom of the condition. - CORRECT ANSWERS Example Question: How often do you urinate during the day? Finding: Reports urinating 2 to 3 times during the night (Available)Pro Tip: Discovering if Tina has nocturia can offer insight into underlying medical conditions and general health. - CORRECT ANSWERS Example Question: How often do you wake up at night to urinate? Finding: Asked about diet - CORRECT ANSWERS Finding: Reports eating a bowl of cereal for breakfast yesterday (Available)Pro Tip: In a health history, it is important to get an idea of a patient's typical dietary patterns. This can be achieved by asking for a 24-hour diet recall. - CORRECT ANSWERS Example Question: What did you eat for breakfast yesterday? Finding: Reports eating mac and cheese for lunch yesterday (Available)Pro Tip: In a health history, it is important to get an idea of a patient's typical dietary patterns. This can be achieved by asking for a 24-hour diet recall. - CORRECT ANSWERS Example Question: What did you eat for lunch yesterday? Finding: Reports eating chicken and roll for dinner yesterday (Available)Pro Tip:Finding out the foods a patient last ate can provide evidence for any current stomach upset and for their current level of hunger and blood sugar status and can affect medications given while in your care. - CORRECT ANSWERS Example Question: What did you eat for your last meal?

ASSESMENT QUESTIONS AND ANSWERS BEST GRADED A+

Finding: Asked about change in appetite - CORRECT ANSWERS Finding: Reports increased appetite (Found)Pro Tip: Identifying if a patient has recently experienced a change in appetite is important, as it could indicate an underlying endocrine or psychiatric condition. - CORRECT ANSWERS Example Question: Have you noticed an increase in appetite? Finding: Reports change in appetite began a month ago (Available)Pro Tip: Determining the onset of appetite change can reveal important details about underlying health conditions. - CORRECT ANSWERS Example Question: When did you notice the increase in your appetite? Finding: Asked about weight change - CORRECT ANSWERS Finding: Reports recent loss of 10 lbs (Available)Pro Tip: Determining the exact amount of weight loss can indicate whether it's within expected ranges, or extreme, which may indicate an underlying health problem. Example Question: How much weight have you lost? - CORRECT ANSWERS Finding: Reports weight loss occurred over the past month (Available)Pro Tip:Finding out the timeline for weight loss can indicate if it's sudden or gradual. - CORRECT ANSWERS Example Question: How long did it take you to lose 10 pounds? Finding: Followed up on reason for weight change - CORRECT ANSWERS Finding: Reports weight loss was unintentional (Found)Pro Tip: Unintentional weight loss can be a sign of underlying medical conditions or a reflection of unhealthy lifestyle choices. Asking your patient about this can inform your care plan. - CORRECT ANSWERS Example Question: Was your weight loss intentional?