SHADOWHEALTH ABDOMINAL PAIN ESTHER PARK
ACTUAL COMPLETE SOLUTION 2026/2027 | Clinical
Reasoning | Care Plan | A+ Graded - Pass Guaranteed
Patient Profile: Esther Park, 78-year-old Korean-American female, presents with
abdominal pain and constipation. History includes cholecystectomy (2009), C-section
(1980), hypertension managed with Accupril (lisinopril). Lives independently, daughter
checks in weekly. Primary concern: "My stomach hurts and I haven't gone to the
bathroom in days."
Section 1: Subjective Data Collection (10 Questions)
Q1: When interviewing Esther Park about her abdominal pain, which question is MOST
appropriate to ask first to establish the chief complaint?
● A. "Have you taken anything for the pain?"
● B. "Can you tell me more about the discomfort you've been experiencing?"
[CORRECT]
● C. "When was your last bowel movement?"
● D. "Does the pain radiate to your back?"
Correct Answer: B
Rationale: The opening question should use open-ended inquiry to allow the patient to
describe her experience in her own words, establishing the chief complaint without
leading or assuming. Option B follows therapeutic communication principles and
patient-centered care (QSEN: Patient-Centered Care). Option A assumes pain
management has occurred. Option C immediately focuses on bowel habits without
exploring the broader symptom picture. Option D suggests a specific radiation pattern
that may bias the patient's response. For Korean-American elders, allowing the patient
,to speak first demonstrates respect and may reveal culturally specific descriptions of
discomfort (e.g., "bloating" vs. "pain").
Q2: Select ALL that apply: Which questions are ESSENTIAL to ask Esther Park when
characterizing her abdominal pain using the OLDCARTS mnemonic? (Select all that
apply)
● A. "Onset: When did the discomfort start?" [CORRECT]
● B. "Location: Can you point to where it hurts?" [CORRECT]
● C. "Duration: Has this been constant or does it come and go?" [CORRECT]
● D. "Character: Can you describe what it feels like—sharp, dull, cramping?"
[CORRECT]
● E. "Aggravating factors: What makes it worse?" [CORRECT]
● F. "Relieving factors: What have you tried that helps?" [CORRECT]
● G. "Timing: Is it worse at certain times of day?" [CORRECT]
● H. "Severity: On a scale of 0-10, how bad is it?" [CORRECT]
Correct Answer: A, B, C, D, E, F, G, H (All apply)
Rationale: OLDCARTS (Onset, Location, Duration, Character, Aggravating/Relieving
factors, Timing, Severity) provides a comprehensive framework for pain assessment.
For Esther Park, each element is critical: Onset helps differentiate acute vs. chronic
issues (constipation vs. new obstruction); Location (LLQ) suggests diverticular disease;
Character (cramping vs. constant) indicates colonic vs. peritoneal pathology; Timing
(post-meal) suggests gastrointestinal origin. Severity using 0-10 scale enables objective
tracking, though consider health literacy—ensure Esther understands the numeric scale
or use verbal descriptor scale as backup. Missing any component creates gaps in
clinical reasoning for differential diagnosis.
, Q3: Esther mentions she hasn't had a bowel movement in "several days." Which
follow-up question is MOST important to determine if this represents constipation
requiring intervention or a potential intestinal obstruction?
● A. "Are you still passing gas?"
● B. "What color is your urine?"
● C. "Have you been eating normally?"
● D. "Do you feel dizzy when you stand up?"
Correct Answer: A
Rationale: The ability to pass flatus (gas) is the critical differentiator between simple
constipation and mechanical intestinal obstruction. In obstruction, both stool and gas
passage cease ("obstipation"), accompanied by progressive distension and vomiting.
Option A directly assesses for this red flag. While Options C and D assess nutritional
intake and orthostasis (relevant for dehydration), they don't differentiate obstruction
from constipation. Option B assesses hydration via urine color but is less specific. If
Esther answers "no" to passing gas, immediate physician notification is required for
potential surgical intervention. This question exemplifies safety competency (QSEN:
Safety) through red flag identification.
Q4: When asking about her surgical history, which question demonstrates culturally
sensitive communication given Esther Park's Korean-American background?
● A. "I see you had your gallbladder out. Did you use any Korean traditional
medicine before the surgery?"
● B. "Your cholecystectomy in 2009—was that done here in the US or in Korea?"
● C. "Many Korean patients prefer herbal remedies. Did you try any before seeing
the doctor?"
● D. "Can you tell me about your experience with the gallbladder surgery and any
treatments you've used?" [CORRECT]
Correct Answer: D
ACTUAL COMPLETE SOLUTION 2026/2027 | Clinical
Reasoning | Care Plan | A+ Graded - Pass Guaranteed
Patient Profile: Esther Park, 78-year-old Korean-American female, presents with
abdominal pain and constipation. History includes cholecystectomy (2009), C-section
(1980), hypertension managed with Accupril (lisinopril). Lives independently, daughter
checks in weekly. Primary concern: "My stomach hurts and I haven't gone to the
bathroom in days."
Section 1: Subjective Data Collection (10 Questions)
Q1: When interviewing Esther Park about her abdominal pain, which question is MOST
appropriate to ask first to establish the chief complaint?
● A. "Have you taken anything for the pain?"
● B. "Can you tell me more about the discomfort you've been experiencing?"
[CORRECT]
● C. "When was your last bowel movement?"
● D. "Does the pain radiate to your back?"
Correct Answer: B
Rationale: The opening question should use open-ended inquiry to allow the patient to
describe her experience in her own words, establishing the chief complaint without
leading or assuming. Option B follows therapeutic communication principles and
patient-centered care (QSEN: Patient-Centered Care). Option A assumes pain
management has occurred. Option C immediately focuses on bowel habits without
exploring the broader symptom picture. Option D suggests a specific radiation pattern
that may bias the patient's response. For Korean-American elders, allowing the patient
,to speak first demonstrates respect and may reveal culturally specific descriptions of
discomfort (e.g., "bloating" vs. "pain").
Q2: Select ALL that apply: Which questions are ESSENTIAL to ask Esther Park when
characterizing her abdominal pain using the OLDCARTS mnemonic? (Select all that
apply)
● A. "Onset: When did the discomfort start?" [CORRECT]
● B. "Location: Can you point to where it hurts?" [CORRECT]
● C. "Duration: Has this been constant or does it come and go?" [CORRECT]
● D. "Character: Can you describe what it feels like—sharp, dull, cramping?"
[CORRECT]
● E. "Aggravating factors: What makes it worse?" [CORRECT]
● F. "Relieving factors: What have you tried that helps?" [CORRECT]
● G. "Timing: Is it worse at certain times of day?" [CORRECT]
● H. "Severity: On a scale of 0-10, how bad is it?" [CORRECT]
Correct Answer: A, B, C, D, E, F, G, H (All apply)
Rationale: OLDCARTS (Onset, Location, Duration, Character, Aggravating/Relieving
factors, Timing, Severity) provides a comprehensive framework for pain assessment.
For Esther Park, each element is critical: Onset helps differentiate acute vs. chronic
issues (constipation vs. new obstruction); Location (LLQ) suggests diverticular disease;
Character (cramping vs. constant) indicates colonic vs. peritoneal pathology; Timing
(post-meal) suggests gastrointestinal origin. Severity using 0-10 scale enables objective
tracking, though consider health literacy—ensure Esther understands the numeric scale
or use verbal descriptor scale as backup. Missing any component creates gaps in
clinical reasoning for differential diagnosis.
, Q3: Esther mentions she hasn't had a bowel movement in "several days." Which
follow-up question is MOST important to determine if this represents constipation
requiring intervention or a potential intestinal obstruction?
● A. "Are you still passing gas?"
● B. "What color is your urine?"
● C. "Have you been eating normally?"
● D. "Do you feel dizzy when you stand up?"
Correct Answer: A
Rationale: The ability to pass flatus (gas) is the critical differentiator between simple
constipation and mechanical intestinal obstruction. In obstruction, both stool and gas
passage cease ("obstipation"), accompanied by progressive distension and vomiting.
Option A directly assesses for this red flag. While Options C and D assess nutritional
intake and orthostasis (relevant for dehydration), they don't differentiate obstruction
from constipation. Option B assesses hydration via urine color but is less specific. If
Esther answers "no" to passing gas, immediate physician notification is required for
potential surgical intervention. This question exemplifies safety competency (QSEN:
Safety) through red flag identification.
Q4: When asking about her surgical history, which question demonstrates culturally
sensitive communication given Esther Park's Korean-American background?
● A. "I see you had your gallbladder out. Did you use any Korean traditional
medicine before the surgery?"
● B. "Your cholecystectomy in 2009—was that done here in the US or in Korea?"
● C. "Many Korean patients prefer herbal remedies. Did you try any before seeing
the doctor?"
● D. "Can you tell me about your experience with the gallbladder surgery and any
treatments you've used?" [CORRECT]
Correct Answer: D
