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Please submit your post work to Canvas within 24 hours of the completion of your VCBC Experience.  Please refer to the Experiential Learning Orientation for further questions and a reminder on how to ensure your assignment is properly saved.

Please complete the Concept Notebook (Map) for the concept of Assessment linked to your clients for the day.

Rubric

205/225 Concept Notebook Rubric205/225 Concept Notebook RubricCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeRelated Concept1 ptsSatisfactoryDocumented at least 2 concepts, related to the client with a detailed explanation of each related concept and how the related concept is impacted by the main concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented at least 1 concept, 1 concept is related to the client, or only minimal explanation of each related concept and how the related concept is impacted by the main concept, or incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no related concept, did not relate the concept to the client, no explanation of each related concept and how the related concept is impacted by the main concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeExemplar1 ptsSatisfactoryDocumented at least 3 Exemplars, related to the client and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 Exemplars, 1-2 concepts are related to the client, or incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no Exemplars , did not relate the concept to the client and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeAssessment1 ptsSatisfactoryDocumented at least 3 assessments used to find and rule out alterations with the main concept and are all related to the client, a detailed explanation of each assessment and why one would do that assessment relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 assessments used to find and rule out alterations with the main concept and 1-2 relate to the client, minimal explanation of why one would do that assessment relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no assessments used to find and rule out alterations with the main concept and did not relate to the client, no explanation of why one would do that assessment relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeLab & Diagnostic1 ptsSatisfactoryDocumented at least 3 lab or diagnostic test used to find and rule out alterations with the main concept and all related to the client, a detailed explanation of each lab/test and why one would do that lab/test relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 lab or diagnostic test used to find and rule out alterations with the main concept, 1-2 relate to the client, minimal explanation of each lab/test and why one would do that lab/test relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no lab or diagnostic test used to find and rule out alterations with the main concept and did not relate to the client, no explanation of each lab/test and why one would do that lab/test relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeInterventions1 ptsSatisfactoryDocumented at least 3 nursing interventions needed to care for clients with alterations to the main concept and all related to the client, a detailed explanation of each intervention and why one would perform the interventions relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 nursing interventions needed to care for clients with alterations to the main concept, 1-2 relate to the client, minimal explanation of each intervention and why one would perform the interventions relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no nursing interventions needed to care for clients with alterations to the main concept and did not relate to the client, no explanation of each intervention and why one would perform the interventions relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeMedications1 ptsSatisfactoryDocumented at least 3 medications administered to clients to treat or prevent alterations to the main concept and all related to the client, a detailed explanation of each medication and why one would administer the medication relating o the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2medications administered to clients to treat or prevent alterations to the main concept, 1-2 relate to the client, minimal explanation of each medication and why one would administer the medication relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no medications administered to clients to treat or prevent alterations to the main concept and did not relate to the client, no explanation of each medication and why one would administer the medication relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomePotential Complications1 ptsSatisfactoryDocumented at least 2 potential problems that could occur if alterations to the main concept are not addressed/treated and all related to the client, a detailed explanation of each complication and how it could occur relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1 potential problem that could occur if alterations to the main concept are not addressed/treated, 1 concept is related to the client, minimal explanation of each complication and how it could occur relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no potential problems that could occur if alterations to the main concept are not addressed/treated, did not relate the concept to the client, no explanation of each complication and how it could occur relating to the concept, and incorrect APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeCollaborative Care1 ptsSatisfactoryDocumented at least 1 department/ancillary staff that may be needed to treat clients who have or are at risk for alterations with the main concept and is related to the client, a detailed explanation of each how that department/ancillary staff could assist the client relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented at least 1 department/ancillary staff that may be needed to treat clients who have or are at risk for alterations with the main concept and is related to the client, minimal explanation of each how that department/ancillary staff could assist the client relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no department/ancillary staff that may be needed to treat clients who have or are at risk for alterations with the main concept, did not relate the concept to the client, no explanation of each how that department/ancillary staff could assist the client relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeSpelling and Grammar1 ptsSatisfactory0- 2 mistakes in spelling or grammar.0.5 ptsNeeds Improvement3 -4 mistakes in spelling or grammar.0 ptsUnsatisfactory5 or more mistakes in spelling or grammar.1 pts
This criterion is linked to a Learning OutcomeReferences1 ptsSatisfactoryCorrect APA references.0.5 ptsNeeds ImprovementIncorrect APA references.0 ptsUnsatisfactoryNo APA references.1 pts
Total Points: 10

Musculoskeletal Results | Turned In Patient Assessment and

Experience Overview

Patient: Tina Jones

Digital Clinical Experience Score

100% This score measures your performance on the Student Performance Index in relation to other  students in comparable academic programs. Your instructor has chosen to scale your Student  Performance Index score so that the average score on the index is a 80.0%. This score may not be  your final grade if your instructor chooses to include additional components, such as documentation  or time spent. 

Student Performance Index

50.6  out of 

51  Proficiency Level:

Proficient

 Beginning

 Developing

 Proficient

Students rated as “beginning” are starting to develop their nursing competencies and clinical  reasoning skills. In comparable nursing programs, 50% of students perform at the level of a  beginning nurse. Review your results in the tabs on the left side of the page to identify areas for  improvement.  Students rated as “developing” demonstrate increasing clinical reasoning abilities as they apply their  nursing knowledge. In comparable nursing programs, 25% of students perform at the level of a  developing nurse. Review your results in the tabs on the left side of the page to identify areas for  improvement.  Students rated as “proficient” demonstrate entry­level expertise in nursing competencies and clinical  reasoning skills. In comparable nursing programs, the top 25% of students perform at the level of a  proficient nurse. 

Subjective Data Collection

23  out of https://app.shadowhealth.com/assignment_attempts/4721684#beginning-contenthttps://app.shadowhealth.com/assignment_attempts/4721684#proficient-contenthttps://app.shadowhealth.com/assignment_attempts/4721684#developing-content

23 

Objective Data Collection

27.6  out of  28 

Time

43 minutes total spent in assignment 

Interaction with patient

35 minutes 

Post-exam activities

8 minutes 

Transcript

Started:Mar 29, 2019 | Patient Exam Time:35 min

All Lines (136)Interview Questions (56)Statements (0)Exam Actions (80)

Hello! 

Question 03/29/19  2:22 PM  EDT 

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. 

What is the situation? 

Question 03/29/19  2:22 PM  EDT 

It’s 8 a.m. on Tina Jones’ second morning as a patient here at Shadow General Hospital. Ms.  Jones has a physical therapy consultation later today. Your role in this simulation is that of  healthcare provider who will perform a full  musculoskeletal system exam on Ms. Jones so that her therapist can understand Ms.  Jones’ musculoskeletal health and customize  therapy accordingly. 

What are my objectives in this assessment? 

Question 03/29/19  2:22 PM  EDT 

In your interview with Ms. Jones, you will ask  about her musculoskeletal system and  identify any risk factors or complications.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. You will also inquire into the health history of Ms.  Jones’ family with regards to the  musculoskeletal system so you can  determine her genetic predisposition to any  diseases. Regardless of whether you have  assessed Tina previously, ask all questions  that are medically relevant to her  musculoskeletal system.In addition to  collecting subjective data, you will perform a  physical exam on Ms. Jones’  musculoskeletal system to gather objective  data about the system’s health and physiology.

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. 

What else will this exam involve? 

Question 03/29/19  2:23 PM  EDT 

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. Activities other than Subjective  and Objective Data Collection, such as  Documentation and Education and Empathy,  provide valuable practice for their real­world  counterparts. However, they are not  automatically graded by the simulation. 

How will I be evaluated? 

Question 03/29/19  2:24 PM  EDT 

In this assignment, you will be evaluated on  your Subjective and Objective Data  Collection.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.The evaluation of your  physical exam is based on how successfully  you report on your physical findings by  selecting among clinical terms in the  Electronic Health Record.This assignment  takes on average between 50 and 60  minutes. You can pause and resume the  assignment at any time; your work is always  saved automatically. 

How does this assignment prepare me for the  real world? 

Question 03/29/19  2:24 PM  EDT 

In this assessment, you will become  familiarized with the structure and content of  musculoskeletal exams so that with real­life  patients, you can: º ask effective and  comprehensive questions º use therapeutic language º evaluate the patient’s risk of  disease, infection, injury, and  complications º and obtain and assess  objective data.

In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: What  precautions should you take with a patient that is a fall risk? 

With a patient in a fall risk, you should have  them only get up when there is someone with  them, use bed alarm and have them wear a  fall risk band. 

Statement 03/29/19  2:26 PM  EDT 

Time to begin. 

Good Morning Tina, My name is jenn i will be your  nurse today 

Greet 03/29/19  2:28 PM  EDT 

Hey. 

Can you tell me your name and date of birth 

Question 03/29/19  2:28 PM  EDT 

My name’s Tina Jones, and my birthday’s  February 17th. 

Vitals measured 

Exam  Action 03/29/19  2:29 PM  EDT 

ON a 0­10 scale, how would you rate your pain right now tina 

Question 03/29/19  2:29 PM  EDT 

I’d give it a 5 or 6 out of 10 right now. 

do you have any problems with your joints 

Question 03/29/19  2:30 PM  EDT 

No, my joints are fine. 

do you have any pain in your joints 

Question 03/29/19  2:30 PM  EDT 

My joints don’t hurt. 

have you noticed any swelling in your joints 

Question 03/29/19  2:31 PM  EDT 

No, I’ve never had joint problems. 

do you have any muscle pain 

Question 03/29/19  2:31 PM  EDT 

My muscles don’t hurt. 

do you have any muscle weakness 

Question 03/29/19  2:31 PM  EDT 

No, I wouldn’t say I feel weak. 

do you have any bone pain 

Question 03/29/19  2:31 PM  EDT 

My bones aren’t hurting me, no. 

have you had any recent injury or trauma to  your bones 

Question 03/29/19  2:32 PM  EDT 

I haven’t had anything really serious before. I  think my foot right now is the worst injury I’ve  had! 

are you able o bathe yourself normally (No  matching questions found.) 

Question 03/29/19  2:32 PM  EDT 

are you able to bathe yourself 

Question 03/29/19  2:32 PM  EDT 

I’ve been stuck sitting on my butt for the last  few days with my foot hurting so much. I could  get out of bed, but my walk was basically a  hobble so I stayed at home. 

have you needed any help pto shower 

Question 03/29/19  2:33 PM  EDT 

I don’t need anything right now, thanks. 

do you have chronic health issues 

Question 03/29/19  2:33 PM  EDT 

I’ve had asthma since I was little, and I have  sugar diabetes, too. 

do you have family history of joint disease  (Clarified to Any family member with  degenerative joint disorder?.) 

Question 03/29/19  2:34 PM  EDT 

No, I don’t think so. (Clarified to if I have a  family history of degenerative joint disease.) 

do you have any history of arthritis (Clarified to Has anyone in your family had arthritis?.) 

Question 03/29/19  2:34 PM  EDT 

No, I don’t know about that. (Clarified to if  anyone in my family has arthritis.) 

do you have a history with arthritis 

Question 03/29/19  2:35 PM  EDT 

No, I don’t have arthritis! I’m a little young for  that. . . 

do you have any family history of hip  replacements (Clarified to Does obesity run in  your family?.) 

Question 03/29/19  2:35 PM  EDT 

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. (Clarified to if obesity runs in my  family.) 

Have you been able to function normally  (Clarified to Can you change positions?.) 

Question 03/29/19  2:36 PM  EDT 

I can sit up and everything, but I’d definitely  need some help to stand up or walk since my  foot is still hurting so bad. (Clarified to if I can  change positions.) 

have you been able to do normal activities on  your own (Clarified to Have you been able to  work?.) 

Question 03/29/19  2:36 PM  EDT 

I’ve had to miss work for sure­­I’m on my feet  all day for my job, and that obviously wouldn’t  work with my foot the way it is, if I could even  get over there. (Clarified to if I have been able  to work.) 

Inspected front of neck 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected left side of neck 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected back of neck 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected right side of neck 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected front of neck 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected shoulders from the front 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected left shoulder 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected upper back 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected right shoulder 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected shoulders from the front 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected left arm 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected right arm 

Exam  Action 03/29/19  2:37 PM  EDT 

Inspected left elbow 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected right elbow 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected left wrist 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected both wrists 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected right wrist 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected both hands 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected left hand 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected right hand 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected front of hips 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected left side of hips 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected back of hips 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected right side of hips 

Exam  Action 03/29/19  2:38 PM  EDT 

Inspected front of thighs 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected left thigh 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected back of thighs 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected right thigh 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected front of knees 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected left knee 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected back of knees 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected right knee 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected front of legs 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected left leg 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected back of legs 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected right leg 

Exam  Action 03/29/19  2:39 PM  EDT 

Inspected left ankle 

Exam  Action 03/29/19  2:40 PM  EDT 

Inspected both ankles 

Exam  Action 03/29/19  2:40 PM  EDT 

Inspected right ankle 

Exam  Action 03/29/19  2:40 PM  EDT 

Inspected left foot 

Exam  Action 03/29/19  2:40 PM  EDT 

Inspected soles of feet: Right: Laceration and  swelling, expected curvature. Left: No visible  abnormal findings, expected curvature. 

Exam  Action 03/29/19  2:40 PM  EDT 

Inspected right foot 

Exam  Action 03/29/19  2:40 PM  EDT 

Tested ROM of neck ­ extension: Expected 

Exam  Action 03/29/19  2:41 PM  EDT 

Tested ROM of neck ­ flexion: Expected 

Exam  Action 03/29/19  2:41 PM  EDT 

Tested ROM of neck ­ lateral bending: Expected 

Exam  Action 03/29/19  2:41 PM  EDT 

Tested ROM of neck ­ rotation: Expected 

Exam  Action 03/29/19  2:41 PM  EDT 

Tested ROM of shoulders ­ adduction: Expected 

Exam  Action 03/29/19  2:41 PM  EDT 

Tested ROM of shoulders ­ extension: Expected 

Exam  Action 03/29/19  2:42 PM  EDT 

Tested ROM of shoulders ­ flexion: Expected 

Exam  Action 03/29/19  2:42 PM  EDT 

Tested ROM of elbows ­ flexion and extension:  Expected 

Exam  Action 03/29/19  2:42 PM  EDT 

Tested ROM of elbows ­ supination and pronation:  Expected 

Exam  Action 03/29/19  2:42 PM  EDT 

Tested ROM of wrists ­ ulnar and radial deviation:  Expected 

Exam  Action 03/29/19  2:43 PM  EDT 

Tested ROM of wrists ­ extension: Expected 

Exam  Action 03/29/19  2:43 PM  EDT 

Tested ROM of wrists ­ flexion: Expected 

Exam  Action 03/29/19  2:43 PM  EDT 

Tested spinal ROM ­ extension: Expected 

Exam  Action 03/29/19  2:43 PM  EDT 

Tested spinal ROM ­ flexion: Expected 

Exam  Action 03/29/19  2:43 PM  EDT 

Tested spinal ROM ­ lateral bending: Expected 

Exam  Action 03/29/19  2:44 PM  EDT 

Tested spinal ROM ­ rotation to the left: Expected 

Exam  Action 03/29/19  2:44 PM  EDT 

Tested spinal ROM ­ rotation to the right: Expected 

Exam  Action 03/29/19  2:44 PM  EDT 

Tested ROM of hips ­ abduction: Expected 

Exam  Action 03/29/19  2:44 PM  EDT 

Tested ROM of hips ­ adduction: Expected 

Exam  Action 03/29/19  2:45 PM  EDT 

Tested ROM of hips ­ extension: Expected 

Exam  Action 03/29/19  2:45 PM  EDT 

Tested ROM of hips ­ flexion: Expected 

Exam  Action 03/29/19  2:45 PM  EDT 

Tested ROM of knees ­ extension: Expected 

Exam  Action 03/29/19  2:46 PM  EDT 

Tested ROM of knees ­ flexion: Expected 

Exam  Action 03/29/19  2:46 PM  EDT 

Tested ROM of ankles ­ inversion and eversion:  Expected 

Exam  Action 03/29/19  2:46 PM  EDT 

Tested ROM of ankles ­ dorsiflexion and plantar  flexion: Right, reduced dorsi­ and plantar flexion;  Left, expected 

Exam  Action 03/29/19  2:47 PM  EDT 

Tested neck strength ­ head down: 5/5 

Exam  Action 03/29/19  2:47 PM  EDT 

Tested neck strength ­ head turned to the left: 5/5 

Exam  Action 03/29/19  2:47 PM  EDT 

Tested neck strength ­ head tilted to the left: 5/5 

Exam  Action 03/29/19  2:48 PM  EDT 

Tested neck strength ­ head turned to the right: 5/5 

Exam  Action 03/29/19  2:48 PM  EDT 

Tested neck strength ­ head tilted to the right: 5/5 

Exam  Action 03/29/19  2:48 PM  EDT 

Tested right and left shoulder strength: 5/5 

Exam  Action 03/29/19  2:48 PM  EDT 

Tested elbow strength during extension: 5/5 

Exam  Action 03/29/19  2:49 PM  EDT 

Tested wrist strength during extension ­ down: 5/5 

Exam  Action 03/29/19  2:49 PM  EDT 

Tested right and left hand strength with grip test:  5/5 

Exam  Action 03/29/19  2:49 PM  EDT 

Tested right and left hip strength: 5/5 

Exam  Action 03/29/19  2:50 PM  EDT 

Tested right and left knee strength: 5/5 

Exam  Action 03/29/19  2:50 PM  EDT 

Tested right and left ankle strength: Right 4/5, Left  5/5 

Exam  Action 03/29/19  2:50 PM  EDT 

Thank you for your time tina 

Question 03/29/19  2:51 PM  EDT 

Alright, thanks. 

Tina I have a few more question for you  (Clarified to I would like to ask questions about your medical history?.) 

Question 03/29/19  3:05 PM  EDT 

Ok. What about? (Clarified to you would like to ask about my medical history.) 

Do you have any mobility issues 

Question 03/29/19  3:05 PM  EDT 

I can walk on my foot now, but it still hurts a  lot. 

do you have a history of walking problems 

Question 03/29/19  3:05 PM  EDT 

I could walk fine before I hurt my foot. 

how have you been since being in the hospital  ambulating (No matching questions found.) 

Question 03/29/19  3:06 PM  EDT 

do you have any pain while walking 

Question 03/29/19  3:06 PM  EDT 

I can walk on my foot now, but it still hurts a  lot. 

how much does it hurt when you walk 

Question 03/29/19  3:07 PM  EDT 

It still hurts a lot to put weight on my foot, but I  can do it now without help, at least. 

can you stand on your own 

Question 03/29/19  3:07 PM  EDT 

Last time I tried to stand normally it really hurt  my foot, but at least I was able to stand on it.  I’m hoping it’ll be better soon. 

on a scale 0­10 how bad does it hurt when you walk (Clarified to Can you rate the pain when  walking on a scale from 1 to 10?.) 

Question 03/29/19  3:07 PM  EDT 

It still hurts a lot to walk on. I’d say at least 7,  maybe 8. (Clarified to how I would rate my  pain when walking.) 

Do you have any history of muscle soreness 

Question 03/29/19  3:08 PM  EDT 

My muscles don’t really get sore ever. 

Do you have any ankle issues 

Question 03/29/19  3:08 PM  EDT 

My ankles are fine. 

IS your work dangerous? 

Question 03/29/19  3:08 PM  EDT 

I never feel like I’m in danger at work. I’m  mostly just walking around with a clipboard,  anyway. 

Have you ever had any difficulty bathing 

Question 03/29/19  3:09 PM  EDT 

I was having trouble doing that stuff before, but my foot’s getting better now, so I think I’m fine. 

Do you have any difficulty going from a sitting  position to a standing position (Clarified to Do  you have trouble standing up?.) 

Question 03/29/19  3:09 PM  EDT 

I was having trouble doing that stuff before, but my foot’s getting better now, so I think I’m fine.  (Clarified to if I have trouble standing up.) 

DO you have any joint stiffness 

Question 03/29/19  3:09 PM  EDT 

No, I’m not stiff anywhere now. 

do you have back pain 

Question 03/29/19  3:10 PM  EDT 

No, I don’t usually have back pain. 

do you have a history of back pain 

Question 03/29/19  3:10 PM  EDT 

I don’t usually have any back pain. Sometimes  it aches a little, but nothing bad. 

do you have any history of muscle injury 

Question 03/29/19  3:10 PM  EDT 

No, I don’t think so. 

do you have any current muscle injuries  (Clarified to Do you have any muscle  injuries?.) 

Question 03/29/19  3:10 PM  EDT 

No, I don’t think so. (Clarified to if I have  muscle injuries.) 

do you ave any joint injuries 

Question 03/29/19  3:11 PM  EDT 

No, not really. 

Do you have a history of joint injury 

Question 03/29/19  3:11 PM  EDT 

No, not really. 

do you have any history of sprains? 

Question 03/29/19  3:11 PM  EDT 

I can’t remember spraining anything before. . .  maybe in grade school? I did something to one of my fingers playing tether ball, I think. But  nothing since then. 

Do you have any history of bone problems? 

Question 03/29/19  3:12 PM  EDT 

I don’t know of any bone problems in the  family. 

do you have any neck injuries 

Question 03/29/19  3:12 PM  EDT 

No. 

do you have any range of motion issues  (Clarified to Do you have limited movement?.) 

Question 03/29/19  3:12 PM  EDT 

Well. . . my foot is maybe feeling a little better,  but I still wouldn’t want to put weight on it or try to walk anywhere just yet. (Clarified to if I have limited range of motion.) 

Do you have any decreased range of motion  anywhere in your body (Clarified to Do you  have full range of motion of your legs?.) 

Question 03/29/19  3:13 PM  EDT 

It hurts to move my foot, but I can do it. And  everything else seems fine. [AUDIO COMING  SOON] (Clarified to if I have full range motion  of my legs.) 

have you ever fallen 

Question 03/29/19  3:13 PM  EDT 

I didn’t fall onto the ground. . . it was like, my  foot just slipped as I stepped onto the ladder,  but I caught my balance before I could topple  over or anything. 

when did you last fall 

Question 03/29/19  3:13 PM  EDT 

Well, I mean, I sort of fell on the ladder a week ago, but before that I can’t remember the last  time I fell or hurt myself. 

do you have a family history of bone cancer 

Question 03/29/19  3:14 PM  EDT 

Oh wow ­­ no, not that I know of. 

do you have family history of osteoarthritis 

Question 03/29/19  3:14 PM  EDT 

No one in the family has osteoporosis that I  know of. 

thank you for your time tina 

Question 03/29/19  3:14 PM  EDT 

Alright, thanks. 

Subjective Data Collection: 23 of 23 (100.0%) Hover To Reveal…

Hover over the Patient Data items below to reveal important information, including Pro Tips and  Example Questions. 

 Found:

Indicates an item that you found. 

 Available:

Indicates an item that is available to be found. 

Category

Scored Items

Experts selected these topics as essential components of a strong, thorough interview with this  patient.

Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are  facts of the patient’s case.

Relevant Medical History  Finding:

Asked about joint problems 

 Finding:

Denies joint pain 

(Found)

Pro Tip: Uncovering if Tina has any joint pain is important, as they could be a result of her  recent foot injury and could contribute to impaired mobility.

Example Question:

Do you have joint pain?

 Finding:

Denies joint swelling 

(Found)

Pro Tip: Uncovering if Tina has any swollen joints is important, as they could be a result of  her recent foot injury and could contribute to impaired mobility.

Example Question:

Do you have swollen joints?

 Finding:

Asked about mobility 

 Finding:

Denies history of walking problems 

(Found)

Pro Tip: Discovering if Tina has a history of walking problems is imperative because it could  show that her mobility issues predate the foot wound. 

Example Question:

Have you ever had problems walking?

 Finding:

Reports recent foot wound hindered mobility 

(Found)

Pro Tip: People with severe pain might find that they are limited in their movements. Asking  Tina whether the pain makes it hard for her to walk would illustrate whether her pain is  preventing her from some of the activities that comprise her daily life.

Example Question:

Has your wound affected your mobility?

 Finding:

Reports ability to walk on foot has recently improved 

(Found)

Pro Tip: Determining if Tina’s mobility has recently improved will provide key information as  to the healing process and what further steps are needed.

Example Question:

Has your mobility changed lately?

 Finding:

Asked pain rating when walking 

 Finding:

Reports pain as a 7 or 8/10 when walking 

(Found)

Pro Tip: People with severe pain might find that they are limited in their movements. Having  Tina rank her pain on a scale will help you judge the severity of the wound and help you  determine treatment needs.

Example Question:

How would you rate your pain when walking?

 Finding:

Asked about ability to stand 

 Finding:

Denies trouble standing before foot problems 

(Available)

Pro Tip: Asking Tina if she has a history of standing problems will reveal the severity of her  injury and whether her standing problem predated her foot injury.

Example Question:

Do you have a history of standing problems?

 Finding:

Reports recent foot wound hindered standing 

(Found)

Pro Tip: Asking Tina if she can stand on her foot will reveal the severity of her injury and  whether or not she is able to put weight on her foot.

Example Question:

Has your wound affected your ability to stand?

 Finding:

Reports improved ability to stand on injured foot 

(Found)

Pro Tip: Asking Tina if she can stand on her foot will reveal the severity of her injury and  whether or not she is able to put weight on her foot.

Example Question:

Are you able to stand on your foot?

 Finding:

Asked pain rating when standing 

 Finding:

Reports pain as a 7 or 8/10 when bearing weight on foot 

(Available)

Pro Tip: Asking Tina about the pain if she’s standing will reveal the severity of her injury and  whether or not standing exacerbates her pain.

Example Question:

How would you rate your pain on a scale of 1 to 10 when you are standing?

 Finding:

Asked about muscle soreness 

 Finding:

Denies history of muscle soreness 

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she has ever had muscle soreness specifies the way her symptoms and pain manifest.

Example Question:

Have you ever had muscle soreness?

 Finding:

Denies current muscle soreness 

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she is having muscle  soreness specifies the way her symptoms and pain manifest.

Example Question:

Are you having muscle soreness?

 Finding:

Asked about joints in proximity of injury 

 Finding:

Denies current ankle problems 

(Found)

Pro Tip: Ankle problems can greatly affect a patient’s mobility. Asking Tina if she has  problems with her ankles can reveal a major health concern.

Example Question:

Are your ankles giving you trouble?

 Finding:

Asked about occupational impact on injury 

 Finding:

Denies work being dangerous 

(Found)

Pro Tip: Determining if Tina’s workplace is safe will allow you to establish any occupational  dangers that could exacerbate her current health issues or pose further risks. 

Example Question:

Is your work dangerous?

 Finding:

Denies work involving repetitive motion 

(Available)

Pro Tip: Establishing if Tina’s job requires repetitive motion, such as picking up boxes, can  help you determine if those motions have had an impact on her health or pose potential risks.

Example Question:

Does your work involve repetitive motion?

 Finding:

Reports foot wound prevented her from working 

(Found)

Pro Tip: People with severe pain might find that they are unable to perform all of their daily  activities. Asking Tina whether she has been able to work in spite of the pain would illustrate  whether her pain is preventing her from activities that constitute her daily life.

Example Question:

Did your wound prevent you from working?

 Finding:

Asked about activities of daily living 

 Finding:

Denies difficulty transferring from sitting to standing 

(Found)

Pro Tip: As a result of Tina’s foot would, there is the risk that certain activities of daily living  have been compromised. It is important to identify any difficulties with transferring so her  quality of life does not suffer.

Example Question:

Are you able to go from sitting to standing?

 Finding:

Denies difficulty bathing 

(Found)

Pro Tip: As a result of Tina’s foot would, there is the risk that certain activities of daily living  have been compromised. It is important to identify any difficulties with bathing so her quality  of life does not suffer.

Example Question:

Can you bathe yourself?

Review of Systems  Finding:

Asked about joint stiffness 

 Finding:

Denies joint stiffness 

(Available)

Pro Tip: Because Tina’s foot wound has recently impaired mobility, which often leads to joint  stiffness, it is important to ask Tina about her joints to ascertain the impact of her wound and  what treatment she may require.

Example Question:

Do you feel stiff anywhere?

 Finding:

Asked about back pain 

 Finding:

Denies history of back pain 

(Found)

Pro Tip: Back pain can be a serious complaint that compromises a patient’s quality of life. It  is important to determine Tina has suffered from back pain so you can most effectively treat  the issue.

Example Question:

Have you had back pain before?

 Finding:

Denies current back pain 

(Found)

Pro Tip: Back pain can be a serious complaint that compromises a patient’s quality of life. It  is important to determine if Tina is currently suffering from back pain so you can most  effectively treat the issue.

Example Question:

Are you having back pain?

 Finding:

Asked about muscle injury 

 Finding:

Denies history of muscle injury 

(Found)

Pro Tip: It is important to establish if Tina has a history of muscle injuries because it may  contribute to her recent mobility issues. 

Example Question:

Have you ever had a muscle injury?

 Finding:

Denies current muscle injury 

(Found)

Pro Tip: It is important to establish if Tina has a muscle injury because it might contribute to  her recent mobility issues. 

Example Question:

Do you have a muscle injury?

 Finding:

Asked about joint injury 

 Finding:

Denies past joint injury 

(Found)

Pro Tip: It is important to establish if Tina has a history of joint injuries because it may  contribute to her recent mobility issues. 

Example Question:

Have you experienced a joint injury in the past?

 Finding:

Denies current joint injury 

(Found)

Pro Tip: It is important to establish if Tina has a joint injury because it might contribute to her  recent mobility issues. 

Example Question:

Do you have a joint injury?

 Finding:

Asked history of fracture 

 Finding:

Denies history of fractures 

(Found)

Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a  patient’s chief complaint. Asking Tina whether she’s ever broken a bone might reveal  relevant concerns she’d previously experienced.

Example Question:

Have you ever broken a bone?

 Finding:

Asked history of sprains 

 Finding:

Denies history of sprains 

(Found)

Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a  patient’s chief complaint. Asking Tina whether she has a history of getting sprains might  reveal relevant concerns she’d previously experienced.

Example Question:

Do you have a history of getting sprains?

 Finding:

Asked about bone problems 

 Finding:

Denies history of bone problems 

(Available)

Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a  patient’s chief complaint. Asking Tina whether she ever had bone problems might reveal  relevant concerns she’d previously experienced.

Example Question:

Have you ever had bone problems?

 Finding:

Denies current bone problems 

(Found)

Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a  patient’s chief complaint. Asking Tina whether she has bone problems might reveal relevant  concerns she’d previously experienced.

Example Question:

Do you have bone problems?

 Finding:

Asked about neck 

 Finding:

Denies history of neck problems 

(Found)

Pro Tip: A history of neck problems may imply an illness or a problematic behavior in the  patient. Asking Tina whether she has had neck problems in the past could prompt you to  follow up on potential causes.

Example Question:

Have you had neck problems?

 Finding:

Denies current neck problems 

(Available)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she  may be experiencing with her injury, like neck pain, details the way her individual symptoms  and pain manifest.

Example Question:

Do you have neck problems?

 Finding:

Asked about range of motion of body parts 

 Finding:

Reports normal range of motion 

(Found)

Pro Tip: People with severe pain might find that they are limited in their movements. Asking  Tina whether she is limited in her movements would illustrate whether her pain is preventing  her from some of the activities that comprise her daily life.

Example Question:

Do you have full range of motion?

 Finding:

Asked about muscle problems 

 Finding:

Denies muscle weakness 

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her injury, like muscle weakness, details the way her individual symptoms  and pain manifest.

Example Question:

Are you experiencing any muscle weakness?

 Finding:

Denies muscle cramping 

(Available)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her injury, like muscle cramping, details the way her individual symptoms  and pain manifest.

Example Question:

Are you experiencing any muscle cramping?

Risk Factors  Finding:

Asked fall history 

 Finding:

Reports fall 

(Found)

Pro Tip: Changes in bone composition can leave a patient more at risk for falling. Asking  Tina about her history of falling could provide you with information about her bone density.

Example Question:

Have you fallen before?

 Finding:

Reports fall was one week ago 

(Found)

Pro Tip: Changes in bone composition can leave a patient more at risk for falling. Asking  Tina about her history of falling could provide you with information about her bone density.

Example Question:

When was the last time you fell?

 Finding:

Reports belief that she is not particularly prone to falls 

(Found)

Pro Tip: Changes in bone composition can leave a patient more at risk for falling. Asking  Tina if she is prone to falling could provide you with information about her bone density.

Example Question:

Are you prone to falling?

Relevant Family History  Finding:

Asked family history of osteoporosis 

 Finding:

Denies family history of osteoporosis 

(Found)

Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her  family has osteoporosis can indicate a potential predisposition.

Example Question:

Does anyone in your family have osteoporosis?

 Finding:

Asked family history of joint problems 

 Finding:

Denies family history of joint problems 

(Available)

Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her  family has had joint problems can indicate a potential predisposition.

Example Question:

Has anyone in your family had joint problems?

 Finding:

Denies family history of arthritis 

(Found)

Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her  family has arthritis can indicate a potential predisposition.

Example Question:

Does arthritis run in your family?

 Finding:

Asked family history of bone cancer 

 Finding:

Denies family history of bone cancer 

(Found)

Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her  family has a history of bone cancer can indicate a potential predisposition.

Example Question:

Has anyone in your family had bone cancer?

Objective Data Collection: 27.6 of 28 (98.57%)

 Correct 

 Partially correct 

 Incorrect 

 Missed 

Inspected neck  1 of 1 point

Inspected shoulders  1 of 1 point

Inspected arms  1 of 1 point

Inspected elbows  1 of 1 point

Inspected wrists  1 of 1 point

Inspected hands and fingers  1 of 1 point

Inspected hips  1 of 1 point

Inspected thighs  1 of 1 point

Inspected knees  1 of 1 point

Inspected lower legs  1 of 1 point

Inspected ankles https://app.shadowhealth.com/assignment_attempts/4721684#43a6496b-eae6-4b40-812d-5152124af26fhttps://app.shadowhealth.com/assignment_attempts/4721684#f16eaf41-c61f-463c-8212-ab86664b5d54https://app.shadowhealth.com/assignment_attempts/4721684#f16eaf41-c61f-463c-8212-ab86664b5d54https://app.shadowhealth.com/assignment_attempts/4721684#6aded3dc-cf7b-4456-a5e3-e7a0cf568b81https://app.shadowhealth.com/assignment_attempts/4721684#6aded3dc-cf7b-4456-a5e3-e7a0cf568b81https://app.shadowhealth.com/assignment_attempts/4721684#71fadeaa-df88-4a1f-88e8-90bad371018chttps://app.shadowhealth.com/assignment_attempts/4721684#71fadeaa-df88-4a1f-88e8-90bad371018chttps://app.shadowhealth.com/assignment_attempts/4721684#5a13418c-e09b-4519-bb81-c24b04166e46https://app.shadowhealth.com/assignment_attempts/4721684#5a13418c-e09b-4519-bb81-c24b04166e46https://app.shadowhealth.com/assignment_attempts/4721684#df6af328-42cd-46db-86bf-6455164180bahttps://app.shadowhealth.com/assignment_attempts/4721684#df6af328-42cd-46db-86bf-6455164180bahttps://app.shadowhealth.com/assignment_attempts/4721684#8de7cc79-7e6b-4a65-b742-a95faf355bb9https://app.shadowhealth.com/assignment_attempts/4721684#8de7cc79-7e6b-4a65-b742-a95faf355bb9https://app.shadowhealth.com/assignment_attempts/4721684#6dc4f272-da0c-442c-bbdd-f780dc04b098https://app.shadowhealth.com/assignment_attempts/4721684#6dc4f272-da0c-442c-bbdd-f780dc04b098https://app.shadowhealth.com/assignment_attempts/4721684#dec3fbf6-f5fa-4af6-a05a-69f9dd108e59https://app.shadowhealth.com/assignment_attempts/4721684#dec3fbf6-f5fa-4af6-a05a-69f9dd108e59https://app.shadowhealth.com/assignment_attempts/4721684#2bbb38eb-50ef-4025-972b-cdada2a2c2d0https://app.shadowhealth.com/assignment_attempts/4721684#2bbb38eb-50ef-4025-972b-cdada2a2c2d0https://app.shadowhealth.com/assignment_attempts/4721684#f2f7ead2-21f7-4533-9574-fab7d9de7660https://app.shadowhealth.com/assignment_attempts/4721684#f2f7ead2-21f7-4533-9574-fab7d9de7660

1 of 1 point

Inspected feet  0.6 of 1 point

Tested neck range of motion  1 of 1 point

Tested shoulder range of motion  1 of 1 point

Tested elbow range of motion  1 of 1 point

Tested wrist range of motion  1 of 1 point

Tested spine range of motion  1 of 1 point

Tested hip range of motion  1 of 1 point

Tested knee range of motion  1 of 1 point

Tested ankle range of motion  1 of 1 point

Tested neck strength  1 of 1 pointhttps://app.shadowhealth.com/assignment_attempts/4721684#ca73e7b1-7a6d-414f-b7c2-fca6479abb7fhttps://app.shadowhealth.com/assignment_attempts/4721684#ca73e7b1-7a6d-414f-b7c2-fca6479abb7fhttps://app.shadowhealth.com/assignment_attempts/4721684#30c5f8b2-9d2a-439f-b89c-76bbc9c0f339https://app.shadowhealth.com/assignment_attempts/4721684#30c5f8b2-9d2a-439f-b89c-76bbc9c0f339https://app.shadowhealth.com/assignment_attempts/4721684#fd0653ab-fd38-499d-8e9d-d5277403e904https://app.shadowhealth.com/assignment_attempts/4721684#fd0653ab-fd38-499d-8e9d-d5277403e904https://app.shadowhealth.com/assignment_attempts/4721684#6ca97da7-a9fa-4d68-9c0c-23ca840afc2ahttps://app.shadowhealth.com/assignment_attempts/4721684#6ca97da7-a9fa-4d68-9c0c-23ca840afc2ahttps://app.shadowhealth.com/assignment_attempts/4721684#5c7fee30-3497-4987-a608-20cc94afcb8dhttps://app.shadowhealth.com/assignment_attempts/4721684#5c7fee30-3497-4987-a608-20cc94afcb8dhttps://app.shadowhealth.com/assignment_attempts/4721684#f0144d55-d1c6-479d-92c7-d53f22229042https://app.shadowhealth.com/assignment_attempts/4721684#f0144d55-d1c6-479d-92c7-d53f22229042https://app.shadowhealth.com/assignment_attempts/4721684#62d3430a-e04c-4881-ab15-28ec74ceaed6https://app.shadowhealth.com/assignment_attempts/4721684#62d3430a-e04c-4881-ab15-28ec74ceaed6https://app.shadowhealth.com/assignment_attempts/4721684#0d09dfa4-63bf-4ecc-9b1c-ad71c9003f96https://app.shadowhealth.com/assignment_attempts/4721684#0d09dfa4-63bf-4ecc-9b1c-ad71c9003f96https://app.shadowhealth.com/assignment_attempts/4721684#46049f2a-5754-49a0-9661-f05754b8a0ebhttps://app.shadowhealth.com/assignment_attempts/4721684#46049f2a-5754-49a0-9661-f05754b8a0ebhttps://app.shadowhealth.com/assignment_attempts/4721684#22a61225-34c9-4aae-88fa-6c40f4d1a6cbhttps://app.shadowhealth.com/assignment_attempts/4721684#22a61225-34c9-4aae-88fa-6c40f4d1a6cbhttps://app.shadowhealth.com/assignment_attempts/4721684#43a6496b-eae6-4b40-812d-5152124af26f

Tested shoulder strength  1 of 1 point

Tested elbow strength  1 of 1 point

Tested wrist strength  1 of 1 point

Tested hand strength  1 of 1 point

Tested hip strength  1 of 1 point

Tested knee strength  1 of 1 point

Tested ankle strength  1 of 1 point

Documentation / Electronic Health Record

The Documentation is loading. (Est 5 min) Please contact Support if this fails to load.

Hallway Activity Time: 3 min

Ron Registered Nursehttps://app.shadowhealth.com/assignment_attempts/4721684#57f77bcb-010f-4f87-8d1b-d8f6899a8138https://app.shadowhealth.com/assignment_attempts/4721684#57f77bcb-010f-4f87-8d1b-d8f6899a8138https://app.shadowhealth.com/assignment_attempts/4721684#1709ffd7-2865-4e23-bbc0-d7c77be31c31https://app.shadowhealth.com/assignment_attempts/4721684#1709ffd7-2865-4e23-bbc0-d7c77be31c31https://app.shadowhealth.com/assignment_attempts/4721684#4ceda293-33e6-4be8-8273-d2b810823c4dhttps://app.shadowhealth.com/assignment_attempts/4721684#4ceda293-33e6-4be8-8273-d2b810823c4dhttps://app.shadowhealth.com/assignment_attempts/4721684#d192baad-0f30-4d29-b440-5a43026cb66dhttps://app.shadowhealth.com/assignment_attempts/4721684#d192baad-0f30-4d29-b440-5a43026cb66dhttps://app.shadowhealth.com/assignment_attempts/4721684#dcb2767c-f3b4-4449-a61d-41bd0413e6e3https://app.shadowhealth.com/assignment_attempts/4721684#dcb2767c-f3b4-4449-a61d-41bd0413e6e3https://app.shadowhealth.com/assignment_attempts/4721684#f7703253-c403-4b98-ae7f-2e0599cb2ac0https://app.shadowhealth.com/assignment_attempts/4721684#f7703253-c403-4b98-ae7f-2e0599cb2ac0https://app.shadowhealth.com/assignment_attempts/4721684#dc14fab0-7633-4107-930f-8a1c18568213https://app.shadowhealth.com/assignment_attempts/4721684#dc14fab0-7633-4107-930f-8a1c18568213

Hey, I heard you just finished Ms. Jones’ musculoskeletal exam. I’m headed to her room now; what do I need to know?

This is you.

Ms. Jones has a healthy muscolskeletal system. The only thing that needs to be  monitored is her right foot where her wound is. She is a fall risk due to this wound. 

Arun Physical Therapist

Hi there, I’m Arun, the physical therapist. We’re conducting fall prevention checks on  patients on this floor. Ms. Jones was selected because she will be here for a few days.  What do you think puts her at risk for falling? How do you plan to keep her safe? 

This is you.

I thik what puts her at risk for a fall risk is her foot wound and her decreased strength on that leg due to the wound. I plan to keep her safe by making the alarms be on in her  bed, as well as making her a standby assist to ensure that she has someone with her at all times when she ambulates. 

Diana Your Preceptor

Hopefully, you took note that Tina Jones needs assistance walking due to the pain from  her infected foot wound. What goals would you set for Tina Jones’ impaired walking,  and what evidence­based practice would you implement to help her achieve those  objectives? How will you know if your intervention worked?

This is you.

I would make the goal of trying to lessen the infection. I would ensure she is getting  proper wound care and eating healthy to help with her nutritional status to have proper  wound healing. 

Lifespan Activity Time: 2 min

A 3-year-old child with Down’s syndrome is in the cardiac ICU of

Shadow General Hospital following open heart surgery. Which of the

following musculoskeletal physical exam findings would you expect

to find on this child?

Correct:Children with Down’s syndrome often have palmar simian crease, hyperextensible joints,  and short, broad extremities. 

 Fixed joints 

 Lordosis 

 Hyperextensible joints (Correct Response) 

 Scoliosis 

An 86-year-old woman has been admitted to the Shadow General

surgical floor after a knee replacement. She has a history of

degenerative joint disease (DJD). What physical exam findings would

you expect to find?

Correct:Persons with DJD have limitations in strength and range of motion, joint crepitus, and pain  with activity that is relieved with rest. Humpback, or kyphosis, is commonly due to osteoporosis,  while shuffling gait and postural instability are commonly seen in those with Parkinson’s disease. 

 Joint deformity (Correct Response) 

 Shuffling gait 

 Postural instability 

 Humpback 

Review Questions Activity Time: 2 min

If Tina had displayed limited abduction of the left shoulder, it would

mean that:

Correct:Abduction is defined as a motion in which a body part is moved away from the body’s  midline. 

 She has limited movement forward 

 She has limited movement in a circular motion 

 She has limited movement toward her body 

 She has limited movement away from her body (Correct Response) 

Suppose you noted that Tina’s left knee was swollen. Which of the

following tests should be done?

Correct:The bulge sign is a test for excess fluid accumulation in the knee. It is performed by rubbing the knee capsule in upward strokes to displace fluid and observing for the creation of a bulge when  the fluid returns to its original position. 

 Balloon test 

 Fluid wave 

 Bulge sign (Correct Response) 

 Tinel’s sign 

Imagine that Tina was unable to move her right ankle. You notice

that her muscles contract as she attempts to dorsiflex her ankle, but

no movement occurs. How would you grade her ankle strength?

Correct:According to the Oxford Scale, a muscle group that has no mobility but displays visible  muscle contraction is graded as a 1/5 strength. 

 1/5 (Correct Response) 

 2/5 

 4/5 

 3/5 

When assessing Tina’s uninjured ankle, what range of motion would

you expect of this joint? Student Response:I would expect 5/5 range of motion in her uninjured ankle.  Model Note:Normal range of motion of the ankle joint includes dorsiflexion and plantarflexion,  inversion and eversion, and abduction and adduction. 

When assessing Tina’s wrist, what range of motion would you

expect? Student Response:I would expect 5/5 range of motion in her wrist.  Model Note:Normal range of motion of the wrist joint includes flexion and extension, and abduction  and adduction (also known as radial and ulnar movements). 

Because of her injury, Tina’s right ankle is inflamed. What are the

characteristics of inflammation? Student Response:Redness, heat, swelling and pain. THese are the four basic characteristics of  inflammation.  Model Note:The classic local signs of inflammation are heat, redness, edema, pain, and loss of  function. Systemic signs of inflammation can include fever, leukocytosis, and increased plasma  protein synthesis such as increased C­reactive protein and erythrocyte sedimentation rate. 

Self-Reflection Activity Time: 1 min

After completing this assessment, what goals can you set for

yourself for the next time you complete a similar assessment? Think

about efficiency, organization, time management, and holistic care

of the patient. Student Response: I think I would try to ask the questions as i am doing the physical assessment  that way the time is cut in half and i can coordinate my questions for each system. 


 

 
******IN NEED OF THE ANSWER TO THE ABOVE QUESTION, KINDLY HIT ORDER NOW*******."

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