NR 509 Week 8 i-Human Dorothy Jones Abdominal Pain Full
Case Solution Complete Guide Chamberlain 2026
,1. PATIENT BIODATA, REASON FOR ENCOUNTER
Field Value
Patient Name Dorothy Jones
Age 54 years
Sex Female
Ethnicity African American (varies by version)
Height 5'5" - 5'6" (165-168 cm)
Weight 165 lb (75 kg)
BMI 26.6 - 26.7 (Overweight)
Setting Outpatient primary care clinic / Emergency Department
Source of Information Patient (reliable historian)
Reason for Encounter "My stomach hurts. It started 2 days ago and has gotten worse."
2. CASE INTRODUCTION
Dorothy Jones is a 54-year-old female presenting with a 2-3 day history of acute abdominal pain, nausea,
vomiting, and obstipation. She describes the pain as crampy and intermittent, located in the periumbilical
region, progressively worsening over time. She reports bilious emesis (greenish liquid), inability to pass
gas for 2 days, and abdominal bloating. Her history is significant for prior abdominal surgeries including
cholecystectomy (gallbladder removal) and hysterectomy with fibroid removal, placing her at increased
risk for adhesive small bowel obstruction. She has a history of hypertension, hyperlipidemia, and known
gallstones. The patient is afebrile but tachycardic with mild abdominal distention on examination. This
case requires comprehensive history-taking and physical assessment to differentiate between small
bowel obstruction, acute cholecystitis, biliary disease, pancreatitis, and other abdominal emergencies.
3. CHIEF COMPLAINT (CC)
"My stomach hurts. It started 2 days ago and has gotten worse."
,4. QUESTIONS AND ANSWERS DURING FULL HISTORY
Question Category Question Patient Response
Open-Ended How can I help you today? "My stomach hurts."
Open-Ended Do you have any other symptoms or concerns? "I've thrown up some too."
Onset When did your abdominal pain start? "About 2 days ago, after dinner."
Onset Did it come on suddenly or gradually? "It came on suddenly. I thought it was something I ate,
but it kept getting worse."
Location Where exactly is the pain located? "In the middle of my abdomen, around my belly
button."
Radiation Does the pain radiate anywhere? "No, it stays in my belly."
Duration How long does each episode last? "Several minutes each time."
Duration Does the pain come and go? "Yes. It comes on pretty quickly then increases and
decreases in intensity. Like waves."
Character What does the pain feel like? "It's like an ache or maybe like a cramp. It feels like
someone is squeezing my stomach from the inside."
Character Has the pain changed since it began? "Yes, it's getting worse."
Character What does your vomit look like? "The first time it was the dinner I just ate. The last time
it was greenish liquid."
Character What is the color of your urine? "It's dark orange right now."
Character What is the color of your stool? "They are pale."
Character Do you have any abdominal bloating? "Yes... my stomach is bigger than normal. I feel
really bloated."
Aggravating What makes the pain worse? "Eating, especially fatty foods. Also when I press on my
belly."
Aggravating Does breathing make it worse? "No."
Relieving What makes the pain better? "I felt better after I threw up."
Relieving Does rest or changing position help? "Not really. The pain is still there."
, Timing How often does the pain occur? "I haven't really made a note of how often, but the waves are
becoming more frequent."
Treatments What treatments have you tried? "Nothing."
Treatments When was your last bowel movement? "Two days ago. I haven't farted in days either.
That's not normal for me."
Treatments Are you unable to pass gas? "I haven't farted in days."
Severity On a scale of 0-10, how severe is the pain? "8 or 9 out of 10 at its worst."
Associated Have you had any fever or chills? "I feel warm but haven't checked my
temperature."
Associated Have you had any bloody vomit or blood in your stool? "No."
Associated Have you had this pain before? "I've had gallbladder pain before, but never like this or
for this long."
PMH What medical conditions do you have? "High blood pressure, high cholesterol. I used to have
gallstones."
PSH Have you had any surgeries? "Yes. I had my gallbladder taken out 15 years ago and my female
parts and fibroids taken out 2 years ago."
Medications What medications are you taking? "Lipitor for my cholesterol (20 mg daily).
Metformin for diabetes. Lisinopril for blood pressure. Citrucel as needed."
Allergies Do you have any allergies? "No."
Social Do you smoke? "I used to smoke, but quit 15 years ago. I smoked for about 20 years, half a pack
per day."
Social Do you drink alcohol? "Occasionally at social events, but that's not very often."
Social Do you use recreational drugs? "Nope."
Family Tell me about your family health history. "I don't have much to say there. No one has had cancer
of the stomach or colon or anything bad like that."
Family Have you had a colonoscopy? "Yes. About three years ago and it was normal."
Case Solution Complete Guide Chamberlain 2026
,1. PATIENT BIODATA, REASON FOR ENCOUNTER
Field Value
Patient Name Dorothy Jones
Age 54 years
Sex Female
Ethnicity African American (varies by version)
Height 5'5" - 5'6" (165-168 cm)
Weight 165 lb (75 kg)
BMI 26.6 - 26.7 (Overweight)
Setting Outpatient primary care clinic / Emergency Department
Source of Information Patient (reliable historian)
Reason for Encounter "My stomach hurts. It started 2 days ago and has gotten worse."
2. CASE INTRODUCTION
Dorothy Jones is a 54-year-old female presenting with a 2-3 day history of acute abdominal pain, nausea,
vomiting, and obstipation. She describes the pain as crampy and intermittent, located in the periumbilical
region, progressively worsening over time. She reports bilious emesis (greenish liquid), inability to pass
gas for 2 days, and abdominal bloating. Her history is significant for prior abdominal surgeries including
cholecystectomy (gallbladder removal) and hysterectomy with fibroid removal, placing her at increased
risk for adhesive small bowel obstruction. She has a history of hypertension, hyperlipidemia, and known
gallstones. The patient is afebrile but tachycardic with mild abdominal distention on examination. This
case requires comprehensive history-taking and physical assessment to differentiate between small
bowel obstruction, acute cholecystitis, biliary disease, pancreatitis, and other abdominal emergencies.
3. CHIEF COMPLAINT (CC)
"My stomach hurts. It started 2 days ago and has gotten worse."
,4. QUESTIONS AND ANSWERS DURING FULL HISTORY
Question Category Question Patient Response
Open-Ended How can I help you today? "My stomach hurts."
Open-Ended Do you have any other symptoms or concerns? "I've thrown up some too."
Onset When did your abdominal pain start? "About 2 days ago, after dinner."
Onset Did it come on suddenly or gradually? "It came on suddenly. I thought it was something I ate,
but it kept getting worse."
Location Where exactly is the pain located? "In the middle of my abdomen, around my belly
button."
Radiation Does the pain radiate anywhere? "No, it stays in my belly."
Duration How long does each episode last? "Several minutes each time."
Duration Does the pain come and go? "Yes. It comes on pretty quickly then increases and
decreases in intensity. Like waves."
Character What does the pain feel like? "It's like an ache or maybe like a cramp. It feels like
someone is squeezing my stomach from the inside."
Character Has the pain changed since it began? "Yes, it's getting worse."
Character What does your vomit look like? "The first time it was the dinner I just ate. The last time
it was greenish liquid."
Character What is the color of your urine? "It's dark orange right now."
Character What is the color of your stool? "They are pale."
Character Do you have any abdominal bloating? "Yes... my stomach is bigger than normal. I feel
really bloated."
Aggravating What makes the pain worse? "Eating, especially fatty foods. Also when I press on my
belly."
Aggravating Does breathing make it worse? "No."
Relieving What makes the pain better? "I felt better after I threw up."
Relieving Does rest or changing position help? "Not really. The pain is still there."
, Timing How often does the pain occur? "I haven't really made a note of how often, but the waves are
becoming more frequent."
Treatments What treatments have you tried? "Nothing."
Treatments When was your last bowel movement? "Two days ago. I haven't farted in days either.
That's not normal for me."
Treatments Are you unable to pass gas? "I haven't farted in days."
Severity On a scale of 0-10, how severe is the pain? "8 or 9 out of 10 at its worst."
Associated Have you had any fever or chills? "I feel warm but haven't checked my
temperature."
Associated Have you had any bloody vomit or blood in your stool? "No."
Associated Have you had this pain before? "I've had gallbladder pain before, but never like this or
for this long."
PMH What medical conditions do you have? "High blood pressure, high cholesterol. I used to have
gallstones."
PSH Have you had any surgeries? "Yes. I had my gallbladder taken out 15 years ago and my female
parts and fibroids taken out 2 years ago."
Medications What medications are you taking? "Lipitor for my cholesterol (20 mg daily).
Metformin for diabetes. Lisinopril for blood pressure. Citrucel as needed."
Allergies Do you have any allergies? "No."
Social Do you smoke? "I used to smoke, but quit 15 years ago. I smoked for about 20 years, half a pack
per day."
Social Do you drink alcohol? "Occasionally at social events, but that's not very often."
Social Do you use recreational drugs? "Nope."
Family Tell me about your family health history. "I don't have much to say there. No one has had cancer
of the stomach or colon or anything bad like that."
Family Have you had a colonoscopy? "Yes. About three years ago and it was normal."
