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Questions And Answers
Shift Assessment - chief complaint - correct answer ✅Right foot pain, fever, nausea History of Present Illness - correct answer ✅Ms. Jones is a pleasant 28-year-old African American woman who presented to the emergency department for evaluation of a right foot injury and was admitted for IV antibiotics. She is a good historian. She hurt the ball of her right foot by scraping it on the edge of a metal step while changing a light bulb. The injury occurred about one week ago. Her pain has worsened, and the swelling has persisted. She tried ibuprofen, but it didn't work well. The foot feels better when she rests, and it hurts more when she walks on it. Her pain is a 9 when she tries to ambulate. She took her temperature at home and reports it was 102. She has not been eating much and has been staying in bed the last few days, per patient report. The scrape is red and swollen with exudate and has no odor; she reports the swelling and exudate started two days ago. She reports diarrhea overnight. Pain improved with oxycodone. Stomach upset.
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Pain Assessment - correct answer ✅Pain is rated as 7. Pain is localized to ball of foot related to wound. Dull and constant ache. Patient has tried ibuprofen, but reports it does not work well. Patient states there is relief when foot is elevated, not walking on it. Patient answers questions clearly and consistently. Offers information without hesitation. Vital signs are within range. Allergies - correct answer ✅• Penicillin: rash
- Cats: wheezing, itchy watery eyes, sneezing, asthma exacerbation
- No food allergies
- Not allergic to latex Immunizations - correct answer ✅Up-to-date. Received tetanus and HPV vaccines within the last year. Denies recent flu shot. Medications - correct answer ✅• Albuterol 90 mcg/spray MDI, 1-3 puffs, as needed for wheezing
Questions And Answers
Previous Hospitalizations - correct answer ✅Last hospitalized for asthma exacerbation in high school. Gynecological History - correct answer ✅Not sexually active, first sexual activity at age 18, never pregnant, last Pap smear more than four years ago, tested for STIs at age 22, denies STI symptoms. From age 23 to age 26 took oral contraceptives as only source of birth control, no condom use. Reports heavy, irregular periods, abnormal hair growth, and acne during teenage years, and since stopping oral contraceptives 18 months ago. Family History (3 generations) - correct answer ✅• Father: died at age 58 in a car accident, history of hypertension, high cholesterol, and type 2 diabetes
- Mother: hypertension, high cholesterol
- Brother: healthy
- Sister: asthma
- Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol
Questions And Answers
- Maternal grandfather: died at age 78 of a suspected myocardial infarction, history of hypertension, high cholesterol
- Paternal grandmother: still living, age 82, hypertension
- Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes
- Paternal uncle: alcoholism Social History - correct answer ✅Never married, no children. Lived independently since age 19, currently lives with mother and sister to support family after death of father one year ago, anticipates moving out in a few months. She works 32 hours/week as a supervisor at a printing and shipping company and is in her last semester of a bachelor's of accounting program. She hopes to advance to an accounting position within her company. Has a car, cell phone, and computer. She receives basic health insurance from work, but is deterred from healthcare due to out-of-pocket costs. She is very active in her Baptist church, faith is important to her, and church community is a large part of her social network. No exercise. She wears her seat belt, drives frequently. Guns are locked up. No tobacco. Occasional alcohol (10 - 12 drinks/month). No concerns about alcoholism. Occasional cannabis use from age 15 to age 21. She drinks four caffeinated drinks/day (diet soda). No foreign travel. No pets. Not currently in an intimate relationship, ended a three-
Questions And Answers
blanching in fingertips when exposed to cold. Gastrointestinal: Denies digestive problems, reflux, dysphagia, nausea, vomiting, diarrhea, constipation, changes in bowel habits, jaundice, abdominal pain, and bloody stools. Denies gallbladder and liver disease. Reports polyphagia, polydipsia, nocturia for the past month and polyuria for past few months. Genitourinary: Denies flank pain, dysuria, urgency, and cloudy urine. Denies history of recurrent urinary tract infections and kidney stones. Denies vaginal discharge and vaginal itching. Menses irregular. No history of sexually transmi Why is important to be aware of cultural or societal biases when treating or interviewing this patient? -
