Shadow Health Cardiovascular Assessment:
Rochelle Joseph (DCE)| 2026 UPDATE |
QUESTIONS AND ANSWERS | 100%
CORRECT.-NIGHTINGALE COLLEGE
SECTION 1: PATIENT SCENARIO & CHIEF
COMPLAINT (Questions 1-8)
Question 1
Rochelle Joseph presents for a follow-up appointment at 32 weeks gestation.
According to the Shadow Health scenario, what is her chief complaint?
A. Chest pain and shortness of breath
B. Fatigue following a recent diagnosis of mitral valve prolapse (MVP)
C. Palpitations and dizziness
D. Leg swelling and headaches
Correct Answer: B. Fatigue following a recent diagnosis of mitral valve
prolapse (MVP)
Rationale: The scenario states that Rochelle Joseph is a 41-year-old female
who presents to the OB-GYN office for her 32-week pregnancy follow-up,
complaining of fatigue following a recent mitral valve prolapse (MVP)
diagnosis . Her pregnancy and MVP are the contextual factors that drive this
focused cardiovascular assessment.
Subtopic: Patient Scenario
Question 2
Rochelle Joseph's current pregnancy is at how many weeks gestation?
A. 28 weeks
B. 30 weeks
,C. 32 weeks
D. 34 weeks
Correct Answer: C. 32 weeks
Rationale: According to the Shadow Health scenario, Rochelle Joseph is
presenting for her 32-week pregnancy follow-up . Third-trimester pregnancy
brings significant hemodynamic changes that can influence cardiovascular
symptoms such as fatigue, dyspnea, and lower extremity edema.
Subtopic: Patient Scenario
Question 3
Rochelle Joseph was recently diagnosed with which cardiac condition?
A. Aortic stenosis
B. Hypertrophic cardiomyopathy
C. Mitral valve prolapse (MVP)
D. Atrial septal defect
Correct Answer: C. Mitral valve prolapse (MVP)
Rationale: According to the Shadow Health scenario, Rochelle Joseph was
recently diagnosed with mitral valve prolapse (MVP) . This valvular condition
involves the displacement of an abnormally thickened mitral valve leaflet
into the left atrium during systole, sometimes accompanied by mitral
regurgitation.
Subtopic: Patient History
Question 4
Rochelle Joseph's fatigue should be considered in the context of:
A. Normal pregnancy changes only
B. Mitral valve prolapse only
C. Both normal pregnancy changes AND her MVP diagnosis
D. Neither—fatigue is unrelated to her pregnancy or MVP
Correct Answer: C. Both normal pregnancy changes AND her MVP diagnosis
Rationale: Rochelle's fatigue has a multifactorial etiology. Pregnancy is a
high-output state that increases heart rate and blood volume, which can
cause fatigue. At the same time, the recent diagnosis of MVP means that any
associated mitral regurgitation could be contributing to reduced cardiac
efficiency. A comprehensive assessment must consider both factors.
Subtopic: Clinical Reasoning
, Question 5
What is the purpose of the Shadow Health Cardiovascular DCE for Rochelle
Joseph?
A. To diagnose a new cardiac condition
B. To assess a pregnant patient with a known cardiac condition, including
auscultation of a mitral murmur
C. To replace a physical examination
D. To complete a health history without examination
Correct Answer: B. To assess a pregnant patient with a known cardiac
condition, including auscultation of a mitral murmur
Rationale: The Shadow Health Cardiovascular DCE is designed to assess a
pregnant patient with a known cardiac condition. Students will perform a
focused history and physical examination, including auscultation of a mitral
murmur, while also considering the physiological changes of pregnancy . The
goal is to collect subjective and objective information to guide care.
Subtopic: DCE Overview
Question 6
According to the scenario, how soon was Rochelle Joseph diagnosed with
mitral valve prolapse?
A. Many years ago
B. Recently (not long ago)
C. At the beginning of her pregnancy
D. During a previous pregnancy
Correct Answer: B. Recently (not long ago)
Rationale: The Shadow Health scenario specifies that Rochelle Joseph was
diagnosed "recently" with MVP . This is an important detail because a recent
diagnosis means she may still be adjusting to the condition and may have
questions about how it affects her pregnancy and delivery.
Subtopic: Patient History
Question 7
Which additional assessment finding in a pregnant patient could indicate
worsening of MVP-related regurgitation?
A. Increased energy
B. Progressive dyspnea on exertion or new-onset palpitations
C. Decreased heart rate
D. Improved exercise tolerance
Rochelle Joseph (DCE)| 2026 UPDATE |
QUESTIONS AND ANSWERS | 100%
CORRECT.-NIGHTINGALE COLLEGE
SECTION 1: PATIENT SCENARIO & CHIEF
COMPLAINT (Questions 1-8)
Question 1
Rochelle Joseph presents for a follow-up appointment at 32 weeks gestation.
According to the Shadow Health scenario, what is her chief complaint?
A. Chest pain and shortness of breath
B. Fatigue following a recent diagnosis of mitral valve prolapse (MVP)
C. Palpitations and dizziness
D. Leg swelling and headaches
Correct Answer: B. Fatigue following a recent diagnosis of mitral valve
prolapse (MVP)
Rationale: The scenario states that Rochelle Joseph is a 41-year-old female
who presents to the OB-GYN office for her 32-week pregnancy follow-up,
complaining of fatigue following a recent mitral valve prolapse (MVP)
diagnosis . Her pregnancy and MVP are the contextual factors that drive this
focused cardiovascular assessment.
Subtopic: Patient Scenario
Question 2
Rochelle Joseph's current pregnancy is at how many weeks gestation?
A. 28 weeks
B. 30 weeks
,C. 32 weeks
D. 34 weeks
Correct Answer: C. 32 weeks
Rationale: According to the Shadow Health scenario, Rochelle Joseph is
presenting for her 32-week pregnancy follow-up . Third-trimester pregnancy
brings significant hemodynamic changes that can influence cardiovascular
symptoms such as fatigue, dyspnea, and lower extremity edema.
Subtopic: Patient Scenario
Question 3
Rochelle Joseph was recently diagnosed with which cardiac condition?
A. Aortic stenosis
B. Hypertrophic cardiomyopathy
C. Mitral valve prolapse (MVP)
D. Atrial septal defect
Correct Answer: C. Mitral valve prolapse (MVP)
Rationale: According to the Shadow Health scenario, Rochelle Joseph was
recently diagnosed with mitral valve prolapse (MVP) . This valvular condition
involves the displacement of an abnormally thickened mitral valve leaflet
into the left atrium during systole, sometimes accompanied by mitral
regurgitation.
Subtopic: Patient History
Question 4
Rochelle Joseph's fatigue should be considered in the context of:
A. Normal pregnancy changes only
B. Mitral valve prolapse only
C. Both normal pregnancy changes AND her MVP diagnosis
D. Neither—fatigue is unrelated to her pregnancy or MVP
Correct Answer: C. Both normal pregnancy changes AND her MVP diagnosis
Rationale: Rochelle's fatigue has a multifactorial etiology. Pregnancy is a
high-output state that increases heart rate and blood volume, which can
cause fatigue. At the same time, the recent diagnosis of MVP means that any
associated mitral regurgitation could be contributing to reduced cardiac
efficiency. A comprehensive assessment must consider both factors.
Subtopic: Clinical Reasoning
, Question 5
What is the purpose of the Shadow Health Cardiovascular DCE for Rochelle
Joseph?
A. To diagnose a new cardiac condition
B. To assess a pregnant patient with a known cardiac condition, including
auscultation of a mitral murmur
C. To replace a physical examination
D. To complete a health history without examination
Correct Answer: B. To assess a pregnant patient with a known cardiac
condition, including auscultation of a mitral murmur
Rationale: The Shadow Health Cardiovascular DCE is designed to assess a
pregnant patient with a known cardiac condition. Students will perform a
focused history and physical examination, including auscultation of a mitral
murmur, while also considering the physiological changes of pregnancy . The
goal is to collect subjective and objective information to guide care.
Subtopic: DCE Overview
Question 6
According to the scenario, how soon was Rochelle Joseph diagnosed with
mitral valve prolapse?
A. Many years ago
B. Recently (not long ago)
C. At the beginning of her pregnancy
D. During a previous pregnancy
Correct Answer: B. Recently (not long ago)
Rationale: The Shadow Health scenario specifies that Rochelle Joseph was
diagnosed "recently" with MVP . This is an important detail because a recent
diagnosis means she may still be adjusting to the condition and may have
questions about how it affects her pregnancy and delivery.
Subtopic: Patient History
Question 7
Which additional assessment finding in a pregnant patient could indicate
worsening of MVP-related regurgitation?
A. Increased energy
B. Progressive dyspnea on exertion or new-onset palpitations
C. Decreased heart rate
D. Improved exercise tolerance
