NSG 6420 WEEK 2 DISCUSSION
ACTUAL EXAM 2026/2027 | Erin Bradley
i-Human Case Study | Comprehensive
SOAP Note & Clinical Reasoning | Verified
Q&A | Pass Guaranteed - A+ Graded
PART 1: CHIEF COMPLAINT & HISTORY OF PRESENT
ILLNESS ANALYSIS
Discussion Prompt 1: What is the CC in this case study? What are important
questions to ask the patient to formulate the history of present illness and what
did the patient tell you?
Chief Complaint (CC):
"Nausea, vomiting, feeling shaky and hot, fluttering in chest"
Important Questions to Formulate HPI (OLDCARTS Framework):
Table
Component Key Questions for Erin Bradley
Onset When did the nausea and vomiting start? Was it sudden or gradual?
Location Where exactly is the discomfort? Epigastric? Diffuse?
Duration How long do episodes last? Constant or intermittent?
Character Describe the nausea—constant queasiness or sudden urge to vomit?
, Aggravating What makes it worse? Eating? Movement? Stress? Exertion?
Relieving What helps? Rest? Cool environment? Any medications tried?
Timing Is there a pattern? Worse at certain times of day? Related to meals?
Severity Rate 0-10. How many vomiting episodes? Able to keep fluids down?
Additional Critical Questions:
1. Cardiovascular: "Tell me more about the fluttering in your chest—does it feel like racing,
skipping, or pounding?" "Does it happen with activity or at rest?"
2. Infectious Symptoms: "You mentioned a recent flu-like illness—did you have fever, cough, body
aches?"
3. Thyroid-Specific: "Have you noticed any neck swelling? Changes in your hair or nails? Eye
symptoms?"
4. Metabolic: "You mentioned feeling hot—any sweating? Heat intolerance? Unexplained weight
changes?"
5. Reproductive: "You noted lighter periods and a skipped period—any possibility of pregnancy?"
What the Patient Told You:
Erin Bradley is a 28-year-old female presenting with:
● Constitutional: Persistent fatigue, fever (101°F), diaphoresis, heat intolerance, unintentional
weight loss (10 lbs), insomnia
● Cardiovascular: Palpitations described as "fluttering in chest," worse with exertion, extreme
tachycardia
● Gastrointestinal: Nausea and vomiting (onset 24 hours prior), increased appetite despite
weight loss
● Neuromuscular: Shakiness/tremors, anxiety, agitation, weakness, decreased exercise
tolerance
● Reproductive: Lighter menses x6 months, skipped period (not pregnant)
● Respiratory: Recent flu-like illness with cough, decreased breath sounds with fine crackles
(RLL)
Clinical Pearl: In young women with multi-system complaints including weight loss with
increased appetite, heat intolerance, menstrual irregularities, and new-onset anxiety, always
prioritize thyroid dysfunction in your differential. The combination of cardiovascular
(tachycardia), gastrointestinal (nausea/vomiting), and neuropsychiatric symptoms (anxiety,
ACTUAL EXAM 2026/2027 | Erin Bradley
i-Human Case Study | Comprehensive
SOAP Note & Clinical Reasoning | Verified
Q&A | Pass Guaranteed - A+ Graded
PART 1: CHIEF COMPLAINT & HISTORY OF PRESENT
ILLNESS ANALYSIS
Discussion Prompt 1: What is the CC in this case study? What are important
questions to ask the patient to formulate the history of present illness and what
did the patient tell you?
Chief Complaint (CC):
"Nausea, vomiting, feeling shaky and hot, fluttering in chest"
Important Questions to Formulate HPI (OLDCARTS Framework):
Table
Component Key Questions for Erin Bradley
Onset When did the nausea and vomiting start? Was it sudden or gradual?
Location Where exactly is the discomfort? Epigastric? Diffuse?
Duration How long do episodes last? Constant or intermittent?
Character Describe the nausea—constant queasiness or sudden urge to vomit?
, Aggravating What makes it worse? Eating? Movement? Stress? Exertion?
Relieving What helps? Rest? Cool environment? Any medications tried?
Timing Is there a pattern? Worse at certain times of day? Related to meals?
Severity Rate 0-10. How many vomiting episodes? Able to keep fluids down?
Additional Critical Questions:
1. Cardiovascular: "Tell me more about the fluttering in your chest—does it feel like racing,
skipping, or pounding?" "Does it happen with activity or at rest?"
2. Infectious Symptoms: "You mentioned a recent flu-like illness—did you have fever, cough, body
aches?"
3. Thyroid-Specific: "Have you noticed any neck swelling? Changes in your hair or nails? Eye
symptoms?"
4. Metabolic: "You mentioned feeling hot—any sweating? Heat intolerance? Unexplained weight
changes?"
5. Reproductive: "You noted lighter periods and a skipped period—any possibility of pregnancy?"
What the Patient Told You:
Erin Bradley is a 28-year-old female presenting with:
● Constitutional: Persistent fatigue, fever (101°F), diaphoresis, heat intolerance, unintentional
weight loss (10 lbs), insomnia
● Cardiovascular: Palpitations described as "fluttering in chest," worse with exertion, extreme
tachycardia
● Gastrointestinal: Nausea and vomiting (onset 24 hours prior), increased appetite despite
weight loss
● Neuromuscular: Shakiness/tremors, anxiety, agitation, weakness, decreased exercise
tolerance
● Reproductive: Lighter menses x6 months, skipped period (not pregnant)
● Respiratory: Recent flu-like illness with cough, decreased breath sounds with fine crackles
(RLL)
Clinical Pearl: In young women with multi-system complaints including weight loss with
increased appetite, heat intolerance, menstrual irregularities, and new-onset anxiety, always
prioritize thyroid dysfunction in your differential. The combination of cardiovascular
(tachycardia), gastrointestinal (nausea/vomiting), and neuropsychiatric symptoms (anxiety,
