| Course | NRNP 6531 Primary Care of Adults Across the Lifespan |
|---|---|
| Week | Week 4 |
| Paper type | Case presentation slide deck |
| Length | About 970 words across 9 slides with speaker notes |
| Format | Slide deck with speaker notes, APA 7 |
| School | Walden University |
| Program | MSN Family Nurse Practitioner (FNP) |
| Updated | October 2026 |
Free sample paper for NRNP 6531 Week 4
Case Presentation: Right Upper Abdominal Pain After Fatty Meals in a 38-Year-Old Woman
Student Name
College of Nursing, Walden University
NRNP 6531: Primary Care of Adults Across the Lifespan
Instructor Name
Month Day, Year
Slide 2: One-line summary
38-year-old woman, three weeks of episodic right upper abdominal pain, each episode starting 30 to 60 minutes after a fatty meal
Speaker notes: Our patient, who is a composite, is a 38-year-old office manager with three weeks of episodes of right upper abdominal pain. Every episode has followed a heavy or fatty meal by half an hour to an hour, which is the detail that shapes the rest of this case. She came in the morning after the longest episode yet.
Slide 3: History that changes the differential
Four episodes, each 1 to 4 hours, the last lasting about 5 hours
Pain radiates to right shoulder blade; nausea, one episode of vomiting
No fever, jaundice, dark urine, or pale stools
Urine pregnancy test negative; no alcohol excess; no NSAID use
Speaker notes: I have kept only the history that changes the differential. The episodes are getting longer, the last lasting about five hours, which matters because pain beyond four to six hours raises concern for inflammation rather than simple colic. Radiation to the right scapula supports a biliary source. The absence of fever, jaundice, dark urine, and pale stools argues against cholangitis and a stone in the common duct. A negative pregnancy test and no regular anti-inflammatory use remove two important alternatives. She has a body mass index of 32 and has lost 20 pounds in the past year on a rapid diet, both known gallstone risk factors.
Slide 4: Examination
Afebrile; heart rate 88; blood pressure 124/78
Right upper quadrant tenderness; Murphy sign positive
No jaundice; bowel sounds normal; no guarding or rebound
Lung bases clear; no costovertebral angle tenderness
Speaker notes: She is afebrile with normal vital signs. There is tenderness in the right upper quadrant, and on deep palpation below the right costal margin she stopped her inspiration, a positive Murphy sign. There is no jaundice, guarding, or rebound. I examined the lung bases because right lower lobe pneumonia can mimic this pain; they are clear. No costovertebral angle tenderness, which lowers the likelihood of a renal source.
Slide 5: Differential, ranked
1. Symptomatic cholelithiasis (biliary colic)
2. Acute cholecystitis, early
3. Peptic ulcer disease
4. Acute hepatitis
5. Acute pancreatitis
Speaker notes: Biliary colic leads: postprandial pain, scapular radiation, nausea, and her risk factors all fit. Early acute cholecystitis is a close second because the last episode was longer and the Murphy sign is positive; no single bedside finding confirms or excludes it, so laboratory tests and imaging decide (Gallaher & Charles, 2022). Peptic ulcer disease is less likely without anti-inflammatory use and with pain after, rather than relieved by, meals. Hepatitis is unlikely without jaundice or risk factors but is excluded by liver tests. Pancreatitis is least likely without epigastric pain radiating to the back and without alcohol use, but lipase is cheap and settles it.
Slide 6: Tests ordered, with one reason each
Right upper quadrant ultrasound: stones, wall thickening, fluid
CBC: leukocytosis would suggest inflammation
Liver panel: bilirubin and alkaline phosphatase for duct obstruction
Lipase: pancreatitis
Speaker notes: Ultrasound is the first imaging test for suspected gallbladder disease: it shows stones, gallbladder wall thickening, and pericholecystic fluid, and the sonographer can test for a sonographic Murphy sign (Gallaher & Charles, 2022). The blood count looks for leukocytosis, which with ultrasound findings would support cholecystitis. The liver panel looks for a pattern of obstruction that would suggest a stone in the common bile duct. Lipase rules pancreatitis in or out. All four are ordered today.
Slide 7: Plan and when to escalate
If ultrasound shows stones without inflammation: surgical referral for elective cholecystectomy; low-fat diet meanwhile
Same-day referral if: pain beyond 6 hours, fever, leukocytosis, jaundice, or ultrasound signs of cholecystitis
Return precautions given in writing
Speaker notes: If the ultrasound shows gallstones without signs of inflammation and her labs are normal, this is symptomatic cholelithiasis: I refer her to general surgery for elective cholecystectomy, since symptomatic stones tend to recur, and advise smaller, lower-fat meals in the meantime. The criteria that change outpatient follow-up into same-day emergency referral are pain lasting more than six hours, fever, an elevated white count, jaundice, or ultrasound findings of cholecystitis. She received these warning signs in writing and has a follow-up call scheduled for tomorrow with her results (Dains et al., 2020).
Slide 8: Symptom relief while she waits
Acetaminophen for mild pain; a short course of an NSAID for an episode if kidneys and stomach allow
Avoid large, high-fat meals
No opioids prescribed at this visit
Speaker notes: While she waits for results and surgical review, she needs a plan for the next episode. Acetaminophen is first for mild pain, and a nonsteroidal anti-inflammatory drug can relieve biliary colic effectively for a short episode if she has no kidney or ulcer contraindications. I did not prescribe an opioid: an episode severe enough to need one meets the escalation criteria on the previous slide and should be seen the same day. Smaller, lower-fat meals reduce gallbladder contraction and may prevent episodes.
Slide 9: Teaching point
Duration of pain is the bedside clue that separates colic from inflammation
A positive Murphy sign raises suspicion but does not settle it
Speaker notes: The teaching point from this case is that the history, especially the duration of pain, carries most of the diagnostic weight at the first visit, and that bedside signs such as Murphy's raise or lower suspicion without deciding the diagnosis; a systematic review of the clinical examination found that no single finding reliably establishes or excludes acute cholecystitis (Trowbridge et al., 2003). Laboratory tests and ultrasound are what move a patient from the colic column to the cholecystitis column, and knowing the escalation criteria in advance is what keeps outpatient management safe.
Slide 10: References
APA 7 list
Speaker notes: Full references are on this slide.
References
Dains, J. E., Baumann, L. C., & Scheibel, P. (2020). Advanced health assessment and clinical diagnosis in primary care (6th ed.). Elsevier.
Gallaher, J. R., & Charles, A. (2022). Acute cholecystitis: A review. JAMA, 327(10), 965-975. https://doi.org/10.1001/jama.2022.2350
Trowbridge, R. L., Rutkowski, N. K., & Shojania, K. G. (2003). Does this patient have acute cholecystitis? JAMA, 289(1), 80-86. https://doi.org/10.1001/jama.289.1.80
Reading the NRNP 6531 Week 4 instructions
The fourth week of NRNP 6531 often asks for a case presentation, usually as narrated slides, on a patient seen in practicum or a provided case. You present the key history, examination, differential, diagnostics and plan in a limited number of slides, with speaker notes or narration. Expect a cap of around ten to fifteen slides and an APA 7 reference slide. Faculty grade selection and sequence: what you chose to include and in what order. A teaching point is often required. Recording length limits are common. Patient identifiers must be removed. NRNP 6531 sections often want the one-line summary on the second slide so the audience knows the case before the details. Each test on the slide should carry the reason it was ordered. Say what happens if fever or jaundice appears while waiting for results. Speaker notes should be written in full sentences, ready to read aloud.
How the NRNP 6531 Week 4 example is put together
Slide one is a single sentence: age, sex, the complaint, its duration, and the one detail that shapes everything, pain after fatty meals. The history slide keeps only findings that change the differential, including a negative pregnancy test and no fever. Exam findings follow on their own slide, with the positive Murphy sign stated plainly and the lung bases noted as clear. The differential slide shows five causes in ranked order, biliary colic leading, then cholecystitis, peptic ulcer, hepatitis, and pancreatitis beneath. Labs and imaging requested appear next with a one-line reason for each. The last content slide is the plan, including the criteria that would turn outpatient follow-up into same-day referral. Speaker notes run underneath every slide. The patient does not exist.
NRNP 6531 Week 4 rubric: what earns full marks
Selection and sequence count as heavily as content in a case presentation, and a deck that reads the entire history aloud has shown recall without judgment. The one-line opening and the pruned history earn most of the organization credit in this example. Clinical reasoning is graded through the differential slide, where a ranking without supporting findings reads as a guess. Graders commonly expect ectopic pregnancy to be addressed whenever a woman who could be pregnant presents with abdominal pain, and its absence costs even when the final answer is biliary. Presentations also lose credit for plans that stop at imaging, for slide text too dense to read aloud, and for timing that runs well past the limit the prompt sets.
NRNP 6531 Week 4 help from the desk
Presentations lose credit when they read the entire history aloud, which shows recall without judgment. Choose the details that change the differential. Another frequent fault is slides packed with sentences; keep the slide short and put reasoning in the notes. Writers also list tests without reasons, so give each one a sentence. Include escalation criteria, since a patient with gallstones can become acutely ill. Ask about pregnancy, which matters for imaging and diagnosis. Keep timing within the limit. Check that references follow APA 7 on the final slide. Another frequent problem is a differential slide with no ranking, which leaves the audience to guess what the presenter believes. Number the items. Writers also forget symptom relief while the patient waits for imaging; one slide on diet and pain control shows practical care. Keep the teaching point to a single sentence.
Get a NRNP 6531 Week 4 example written to your instructions
Tell the desk the time limit, the slide count, and the case in your Week 4 prompt, along with the rubric. A presentation built to those limits comes back with speaker notes and sources beneath each slide. Your first custom sample is free and turns around in 24-48 hours, ready to rehearse against.
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NRNP 6531 Week 4 questions, answered
Is the example a slide deck or a written paper?
It is a slide deck with full speaker notes, which is how most case presentation prompts in primary care courses are set. Some sections instead ask for a recorded narration or a written version following the same order. The structure transfers either way: one-line summary, selected history, exam, ranked differential, workup, and a plan that carries its escalation criteria.
How many slides does the example use?
Nine, including a title slide and a reference slide, which fits a presentation of about seven minutes. The count matters less than pace. A presentation that crowds each slide will run over no matter how few there are, and timing is usually graded. When your prompt sets a different limit, the sample is sized to that limit instead.
Why include a pregnancy test in the history?
Because ectopic pregnancy sits on the list of causes graders expect to see addressed whenever a woman of reproductive age presents with abdominal pain, however typical the rest of the picture looks. The example reports the result as a pertinent negative on the history slide. Rubrics in this area often check for it by name, and leaving it out reads as a safety gap.
Where can I find a free NRNP 6531 Week 4 sample paper?
The ten-slide abdominal pain presentation is shown here with speaker notes, the ranked differential, tests with reasons and the escalation plan.
What is the first test for suspected biliary colic in NRNP 6531 Week 4?
Right upper quadrant ultrasound. The example orders it first, along with basic laboratory tests, and explains which findings would need same-day referral.