I HUMAN WEEK 10 NUR 2026 62 YEAR OLD
MALE DAVID CHEN PRESENTING WITH
SEVERE ABDOMINAL PAIN AND VOM
Case
,Simulated Patient Case: NUR 2026 Week 10
Setting: Outpatient Clinic with Laboratory Capabilities
Learner Level: Advanced Nursing/Medical Student
I. Patient Information & Chief Complaint
• Name: David Chen
• Age: 62-year-old male
• Chief Complaint (CC): "Severe stomach pain and vomiting for the last 6 hours."
• History of Present Illness (HPI):
Mr. Chen is a 62-year-old male who presents to the outpatient clinic
accompanied by his wife. He reports the sudden onset of severe, constant,
"boring" epigastric and right upper quadrant abdominal pain approximately 6
hours ago. The pain began shortly after a large family dinner. It radiates straight
through to his mid-back. He describes the pain as 9/10 in severity, unrelieved by
changing position or antacids.
He has experienced 4 episodes of non-bilious, non-bloody vomiting, which
provided minimal and transient relief. He denies fever or chills but admits to
feeling sweaty and nauseated.
o SOCRATES: Site (Epigastric/RUQ), Onset (Sudden, 6 hrs ago), Character
(Constant, boring, severe), Radiation (To mid-back), Associated symptoms
(Nausea, vomiting, diaphoresis), Timing (Constant), Exacerbating/Relieving
factors (None, vomiting slight transient relief), Severity (9/10).
• Past Medical History (PMH):
o Hyperlipidemia (diet-controlled, per patient).
, o Symptomatic Gallstones diagnosed via ultrasound 18 months ago. He
declined elective cholecystectomy at that time due to work commitments.
o Hypertension (well-controlled with lisinopril 10mg daily).
o No known diabetes, CAD, or COPD.
• Past Surgical History (PSH): Tonsillectomy (age 10), Appendectomy (age 22).
• Medications:
o Lisinopril 10mg daily.
o Multivitamin daily.
o No NSAIDs, anticoagulants, or herbal supplements.
• Allergies: No known drug allergies (NKDA).
• Social History:
o Married, father of two. Works as an accountant.
o Smoking: 15-pack-year history, quit 5 years ago.
o Alcohol: Socially, 1-2 glasses of wine on weekends.
o Diet: Reports a typical "Western" diet. Admits the dinner last night was
high in fat (fried foods, creamy sauces).
• Family History: Father: MI at age 70. Mother: Type 2 Diabetes. No family history
of GI malignancies.
II. Comprehensive Physical Assessment
• General Appearance: A 62-year-old male appearing uncomfortable, pale, and
diaphoretic. He is lying still on the exam table, knees slightly flexed, reluctant to
move. Anxious but cooperative.
• Vital Signs:
o BP: 152/94 mmHg (Right arm, sitting)
o HR: 112 bpm (regular, tachycardic)
o RR: 22 breaths/min (slightly tachypneic)
o Temp: 37.8°C (100.0°F) (oral, low-grade fever)
o SpO2: 98% on room air
o Pain: 9/10
• Systems Examination:
o Abdominal:
▪ Inspection: Abdomen is not distended. No visible scars (aside from
old appendectomy scar RLQ), masses, or peristaltic waves.
MALE DAVID CHEN PRESENTING WITH
SEVERE ABDOMINAL PAIN AND VOM
Case
,Simulated Patient Case: NUR 2026 Week 10
Setting: Outpatient Clinic with Laboratory Capabilities
Learner Level: Advanced Nursing/Medical Student
I. Patient Information & Chief Complaint
• Name: David Chen
• Age: 62-year-old male
• Chief Complaint (CC): "Severe stomach pain and vomiting for the last 6 hours."
• History of Present Illness (HPI):
Mr. Chen is a 62-year-old male who presents to the outpatient clinic
accompanied by his wife. He reports the sudden onset of severe, constant,
"boring" epigastric and right upper quadrant abdominal pain approximately 6
hours ago. The pain began shortly after a large family dinner. It radiates straight
through to his mid-back. He describes the pain as 9/10 in severity, unrelieved by
changing position or antacids.
He has experienced 4 episodes of non-bilious, non-bloody vomiting, which
provided minimal and transient relief. He denies fever or chills but admits to
feeling sweaty and nauseated.
o SOCRATES: Site (Epigastric/RUQ), Onset (Sudden, 6 hrs ago), Character
(Constant, boring, severe), Radiation (To mid-back), Associated symptoms
(Nausea, vomiting, diaphoresis), Timing (Constant), Exacerbating/Relieving
factors (None, vomiting slight transient relief), Severity (9/10).
• Past Medical History (PMH):
o Hyperlipidemia (diet-controlled, per patient).
, o Symptomatic Gallstones diagnosed via ultrasound 18 months ago. He
declined elective cholecystectomy at that time due to work commitments.
o Hypertension (well-controlled with lisinopril 10mg daily).
o No known diabetes, CAD, or COPD.
• Past Surgical History (PSH): Tonsillectomy (age 10), Appendectomy (age 22).
• Medications:
o Lisinopril 10mg daily.
o Multivitamin daily.
o No NSAIDs, anticoagulants, or herbal supplements.
• Allergies: No known drug allergies (NKDA).
• Social History:
o Married, father of two. Works as an accountant.
o Smoking: 15-pack-year history, quit 5 years ago.
o Alcohol: Socially, 1-2 glasses of wine on weekends.
o Diet: Reports a typical "Western" diet. Admits the dinner last night was
high in fat (fried foods, creamy sauces).
• Family History: Father: MI at age 70. Mother: Type 2 Diabetes. No family history
of GI malignancies.
II. Comprehensive Physical Assessment
• General Appearance: A 62-year-old male appearing uncomfortable, pale, and
diaphoretic. He is lying still on the exam table, knees slightly flexed, reluctant to
move. Anxious but cooperative.
• Vital Signs:
o BP: 152/94 mmHg (Right arm, sitting)
o HR: 112 bpm (regular, tachycardic)
o RR: 22 breaths/min (slightly tachypneic)
o Temp: 37.8°C (100.0°F) (oral, low-grade fever)
o SpO2: 98% on room air
o Pain: 9/10
• Systems Examination:
o Abdominal:
▪ Inspection: Abdomen is not distended. No visible scars (aside from
old appendectomy scar RLQ), masses, or peristaltic waves.
