NR 509 Abdominal Pain Documentation –
Shadow Health Esther Park Actual Exam
2026/2027 – 100% Verified | Detailed
Rationales
This comprehensive guide covers the complete Shadow Health Esther Park
abdominal pain case study for the NR 509 Advanced Health Assessment course.
All questions and answers are verified for the 2026/2027 testing cycle .
PART 1: CASE BACKGROUND & PATIENT OVERVIEW
Esther Park: Case Background
Esther Park is a 78-year-old Korean American female who presents to the
emergency department with a chief complaint of lower abdominal pain. The pain
is located in the suprapubic area, described as a 6/10, constant, dull,
"crampy" feeling. It began as general discomfort about 5 days ago, with gradual
worsening over the last 2–3 days. She has been constipated for most of the last
five days, passing only small hard stools .
Medical/Surgical History:
• Hypertension (diagnosed at age 54)
• C-section at age 40
• Cholecystectomy (gallbladder removal) at age 42
• No post-operative complications from either surgery
Medications:
• Accupril (10 mg daily at 8 am) for hypertension
, • Denies any OTC medications or laxatives
Allergies:
• Latex allergy (reports rash and itching upon exposure)
• Denies food or medication allergies
Social History:
• Lives with her daughter; strong family support
• Denies smoking or illicit drug use
• Low alcohol consumption (one glass of white wine, one night per week)
• Typically high level of mobility and independence
Constitutional Health:
• Denies recent weight changes
• Denies fever, chills, or night sweats
• Reports low energy
PART 2: SUBJECTIVE DATA COLLECTION (QUESTIONS 1-30)
Section 2.1: Chief Complaint & OLDCARTS
Question 1: What is Esther Park's primary chief complaint at the time of
presentation?
A) "I have been vomiting all morning."
B) "I am having pain in my belly and trouble going to the bathroom."
C) "I have a sharp pain in my chest."
D) "I feel dizzy when I stand up."
✅ Correct Answer: B
Rationale: During the subjective interview, Ms. Park explicitly states she is "having
pain in her belly" and having trouble "going to the bathroom." She identifies
constipation as a primary issue, not vomiting or chest pain .
,Question 2: How long ago did the abdominal pain begin?
A) 1 day ago
B) 2 days ago
C) 5 days ago
D) 2 weeks ago
✅ Correct Answer: C
Rationale: Ms. Park reports that the discomfort started 5 days ago. She notes that
while it has been present for nearly a week, the pain has significantly worsened
over the past 2 to 3 days .
Question 3: On a scale of 0 to 10, what current pain level does Esther Park
report?
A) 2 out of 10
B) 4 out of 10
C) 6 out of 10
D) 10 out of 10
✅ Correct Answer: C
Rationale: When asked about the severity of her pain, Ms. Park rates her current
abdominal pain as a 6 out of 10. She describes the quality of the pain as "dull and
crampy" .
Question 4: Which factor does Ms. Park identify as an aggravating factor for her
abdominal pain?
A) Drinking cold water
B) Resting in a recliner
C) Eating food or physical activity
D) Taking deep breaths
✅ Correct Answer: C
, Rationale: Ms. Park specifically states that her pain gets worse after she eats or
engages in physical activity. Conversely, she reports that resting does help relieve
the pain .
Question 5: Ms. Park reports a sudden bout of diarrhea. When did this occur
relative to her pain?
A) The same day the pain started
B) About 3 days ago
C) One week before the pain started
D) She denies any diarrhea
✅ Correct Answer: B
Rationale: In the Health History Interview, Ms. Park reports that she had a bout of
diarrhea about 3 days ago, describing the stool as "loose and watery." This
occurred after the initial pain started but is relevant to the differential diagnosis .
Question 6: Which of the following medications is Ms. Park currently taking daily?
A) Metformin
B) Ibuprofen
C) Accupril (for hypertension)
D) Laxatives
✅ Correct Answer: C
Rationale: Ms. Park reports taking 10 mg of Accupril daily for her blood pressure.
She explicitly denies taking any laxatives or over-the-counter pain medications .
Question 7: The patient describes her abdominal pain as:
A) Sharp, stabbing, and radiating to her back
B) A constant, dull, crampy feeling
C) A burning sensation in her upper stomach
D) Coming in waves, like a contraction
Shadow Health Esther Park Actual Exam
2026/2027 – 100% Verified | Detailed
Rationales
This comprehensive guide covers the complete Shadow Health Esther Park
abdominal pain case study for the NR 509 Advanced Health Assessment course.
All questions and answers are verified for the 2026/2027 testing cycle .
PART 1: CASE BACKGROUND & PATIENT OVERVIEW
Esther Park: Case Background
Esther Park is a 78-year-old Korean American female who presents to the
emergency department with a chief complaint of lower abdominal pain. The pain
is located in the suprapubic area, described as a 6/10, constant, dull,
"crampy" feeling. It began as general discomfort about 5 days ago, with gradual
worsening over the last 2–3 days. She has been constipated for most of the last
five days, passing only small hard stools .
Medical/Surgical History:
• Hypertension (diagnosed at age 54)
• C-section at age 40
• Cholecystectomy (gallbladder removal) at age 42
• No post-operative complications from either surgery
Medications:
• Accupril (10 mg daily at 8 am) for hypertension
, • Denies any OTC medications or laxatives
Allergies:
• Latex allergy (reports rash and itching upon exposure)
• Denies food or medication allergies
Social History:
• Lives with her daughter; strong family support
• Denies smoking or illicit drug use
• Low alcohol consumption (one glass of white wine, one night per week)
• Typically high level of mobility and independence
Constitutional Health:
• Denies recent weight changes
• Denies fever, chills, or night sweats
• Reports low energy
PART 2: SUBJECTIVE DATA COLLECTION (QUESTIONS 1-30)
Section 2.1: Chief Complaint & OLDCARTS
Question 1: What is Esther Park's primary chief complaint at the time of
presentation?
A) "I have been vomiting all morning."
B) "I am having pain in my belly and trouble going to the bathroom."
C) "I have a sharp pain in my chest."
D) "I feel dizzy when I stand up."
✅ Correct Answer: B
Rationale: During the subjective interview, Ms. Park explicitly states she is "having
pain in her belly" and having trouble "going to the bathroom." She identifies
constipation as a primary issue, not vomiting or chest pain .
,Question 2: How long ago did the abdominal pain begin?
A) 1 day ago
B) 2 days ago
C) 5 days ago
D) 2 weeks ago
✅ Correct Answer: C
Rationale: Ms. Park reports that the discomfort started 5 days ago. She notes that
while it has been present for nearly a week, the pain has significantly worsened
over the past 2 to 3 days .
Question 3: On a scale of 0 to 10, what current pain level does Esther Park
report?
A) 2 out of 10
B) 4 out of 10
C) 6 out of 10
D) 10 out of 10
✅ Correct Answer: C
Rationale: When asked about the severity of her pain, Ms. Park rates her current
abdominal pain as a 6 out of 10. She describes the quality of the pain as "dull and
crampy" .
Question 4: Which factor does Ms. Park identify as an aggravating factor for her
abdominal pain?
A) Drinking cold water
B) Resting in a recliner
C) Eating food or physical activity
D) Taking deep breaths
✅ Correct Answer: C
, Rationale: Ms. Park specifically states that her pain gets worse after she eats or
engages in physical activity. Conversely, she reports that resting does help relieve
the pain .
Question 5: Ms. Park reports a sudden bout of diarrhea. When did this occur
relative to her pain?
A) The same day the pain started
B) About 3 days ago
C) One week before the pain started
D) She denies any diarrhea
✅ Correct Answer: B
Rationale: In the Health History Interview, Ms. Park reports that she had a bout of
diarrhea about 3 days ago, describing the stool as "loose and watery." This
occurred after the initial pain started but is relevant to the differential diagnosis .
Question 6: Which of the following medications is Ms. Park currently taking daily?
A) Metformin
B) Ibuprofen
C) Accupril (for hypertension)
D) Laxatives
✅ Correct Answer: C
Rationale: Ms. Park reports taking 10 mg of Accupril daily for her blood pressure.
She explicitly denies taking any laxatives or over-the-counter pain medications .
Question 7: The patient describes her abdominal pain as:
A) Sharp, stabbing, and radiating to her back
B) A constant, dull, crampy feeling
C) A burning sensation in her upper stomach
D) Coming in waves, like a contraction
