| Course | DNP 643 Developmentally Based Care of the Well Child |
|---|---|
| Module | Module 5 |
| Paper type | Case study response with peer reply |
| Length | About 498 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for DNP 643 Module 5
Case Study 5: Stomachaches Every School Morning
Stomachaches Every School Morning: Anxiety, a Family Separation and a Stepped Plan for a 10-Year-Old Who Is Missing School
The Case
A., a 10-year-old girl, has complained of stomachaches and nausea on most school mornings for two months, and she has missed nine days of school. On weekends she feels fine. Her parents separated three months ago, and she now moves between two homes. She worries that something will happen to her mother when they are apart, has trouble falling asleep and asks repeatedly about plans. Her growth is normal, her abdominal examination is benign and she has no weight loss, blood in her stool or night waking with pain.
Case Study Response
Assessment
The pattern of symptoms on school days, relief on weekends and worry focused on separation suggests an anxiety disorder, likely separation anxiety with features of generalized anxiety, presenting as somatic complaints. I would use a validated screening tool such as the SCARED, completed by both the child and a parent, to measure symptoms and track response. The absence of red flags makes an organic abdominal cause unlikely, though a urinalysis and a brief celiac screen are reasonable if the family is concerned.
Adverse Childhood Experiences and Relational Health
Parental separation is one of the original adverse childhood experiences. Its effect depends heavily on the relationships around the child. The AAP describes safe, stable and nurturing relationships as the buffer that keeps stress from becoming toxic (Garner et al., 2021). I would ask about conflict between the parents, each parent's own coping and whether A. has a trusted adult at school, and I would screen for other adversities such as food insecurity or exposure to violence.
Plan
The AACAP guideline recommends cognitive behavioral therapy as first-line treatment for childhood anxiety, with an SSRI considered for more severe anxiety or for a child whose symptoms persist despite therapy (Walter et al., 2020). In a large trial, the combination of CBT and sertraline outperformed either alone, and each alone outperformed placebo (Walkup et al., 2008). For A., I would refer to a therapist trained in CBT for children, work with the school counselor on a gradual return plan that avoids letting her stay home for symptoms and coach both parents to give consistent, calm reassurance and predictable handoffs between homes. I would see her in four weeks with a repeat SCARED and consider an SSRI if symptoms remain moderate to severe despite therapy, with monitoring for suicidal thinking during the first weeks.
Safety
Even in a child this age, I would ask directly about thoughts of self-harm and about safety in each home.
Reply to a Classmate (On Starting an SSRI First)
Marcus, you suggested starting sertraline at the first visit. The guideline supports medication for moderate to severe anxiety, but for A. the stressor is recent and she has not yet had therapy, so I would start with CBT and school planning and reassess in four weeks. What symptom level would make you start medication sooner?
References
Garner, A., Yogman, M., & Committee on Psychosocial Aspects of Child and Family Health, Section on Developmental and Behavioral Pediatrics, Council on Early Childhood. (2021). Preventing childhood toxic stress: Partnering with families and communities to promote relational health. Pediatrics, 148(2), Article e2021052582. https://doi.org/10.1542/peds.2021-052582
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., Ginsburg, G. S., Rynn, M. A., McCracken, J., Waslick, B., Iyengar, S., March, J. S., & Kendall, P. C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New England Journal of Medicine, 359(26), 2753-2766. https://doi.org/10.1056/NEJMoa0804633
Walter, H. J., Bukstein, O. G., Abright, A. R., Keable, H., Ramtekkar, U., Ripperger-Suhler, J., & Rockhill, C. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107-1124. https://doi.org/10.1016/j.jaac.2020.05.005
What the DNP 643 Module 5 instructions ask for
The final DNP 643 case study arrives in Week 10, a broad module on adverse childhood experiences, pediatric injuries and maltreatment, pediatric mental health and palliative care, due the same week as the second healthy lifestyle reflection. The case opens Sunday; you post a referenced APA response midweek and answer a classmate before the week ends. Because the module covers several topics, the case may join a mental health concern with an adversity in the child's life, so plan to address the clinical problem, the child's environment and safety together. Worth 10 points, it completes the case study category. Read the case for clues about home, school and safety as closely as for symptoms.
Inside the DNP 643 Module 5 example
The sample summarizes the case and answers under four headings. The assessment interprets the pattern of symptoms as anxiety presenting with somatic complaints, names a validated screening tool and explains why a large medical workup is unnecessary. A section on adverse childhood experiences places the parental separation within the AAP framework of relational health and lists the questions that show whether the child is buffered. The plan follows the AACAP guideline, cites a landmark trial on therapy, medication and their combination and sets specific steps with school and both parents and a follow-up with a repeat measure. A short safety section covers self-harm and safety in both homes. The reply discusses when to begin medication.
Where the marks sit in the DNP 643 Module 5 rubric
Ten points ride on this last case. For mental health cases, faculty typically credit recognition of the likely disorder, a validated screening tool and a plan to repeat it, attention to adversities and to what protects the child, a stepped plan that starts with evidence-based therapy and adds medication when indicated, coordination with school and family, safety questions and current references. A thoughtful reply to a classmate is part of the grade. Responses lose credit for extensive medical testing of functional symptoms, for medication without therapy, for ignoring the family stressor and for leaving out safety. Responses that name a screening tool, give its score and plan to repeat it show measurement rather than impression.
DNP 643 Module 5 help from the desk
Treating the stomachache alone is the most common miss; ask what happens on weekends and holidays and measure anxiety with a tool. Discuss adverse experiences by asking what buffers the child, not only by counting events. Put school attendance in the plan, because avoidance feeds anxiety. If you include medication, say when you would start it, which drug and how you would monitor it. Ask about self-harm and safety in each home. Rely on the AACAP guideline and AAP policy, and keep the child's details de-identified. The desk can help you organize the response if you send the case from Canvas.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More DNP 643 and Doctor of Nursing Practice sample papers
- DNP 643 Module 1: Case Study 1: Care of the Newborn (Developmental Dysplasia of the Hip)
- DNP 643 Module 2: Case Study 2: Care of the Infant (Positional Plagiocephaly and Torticollis)
- DNP 643 Module 3: Case Study 3: Care of the Preschooler (Failed Vision Screen and Amblyopia)
- DNP 643 Module 4: Case Study 4: Care of the School-Aged Child (Nocturnal Enuresis)
- DNP 643 Module 6: Developmental/Behavioral Health Concern Presentation: ADHD in Preschool Children
- DNP 647 Module 5: Evidence-Based Practice Presentation: A Complex Chronic Case Off the Guideline (Pediatric Hypertension)
- DNP 713 Module 9: Culture Model Final Presentation
- DNP 645 Module 4: Case Study 4: Reproductive Disorders (Heavy Menstrual Bleeding in an Adolescent)
- DNP 709 Module 2: Leader Reflection Mind Map
DNP 643 Module 5 questions, answered
Where can I find a free DNP 643 Module 5 sample paper?
The full DNP 643 Module 5 sample is posted here: a case study response on anxiety and school avoidance in a 10-year-old after her parents separated, with a stepped plan and a reply.
How does childhood anxiety present in primary care?
Often as stomachaches, headaches, trouble sleeping or school avoidance, with symptoms on school days and relief on weekends or holidays.
What is the first-line treatment for anxiety in children?
Cognitive behavioral therapy comes first under the AACAP guideline, with an SSRI added if anxiety is moderate to severe or therapy by itself does not help enough.
What buffers the effect of adverse childhood experiences?
Safe, stable and nurturing relationships with caregivers and other trusted adults, which the AAP describes as the foundation of relational health.
What topics does Week 10 of DNP 643 cover?
Adverse childhood experiences, pediatric injuries and maltreatment, pediatric mental health and palliative care, with Case Study 5 due.