| Course | NR 302 Health Assessment I |
|---|---|
| Week | 5 |
| Paper type | Respiratory assessment write-up |
| Length | About 1,210 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 302 Week 5
Respiratory Assessment Write-Up: A 47-Year-Old Pastry Baker Recovering From a Chest Cold
Student Name
College of Nursing, Chamberlain University
NR 302: Health Assessment I
Instructor Name
Month Day, Year
Respiratory Assessment Write-Up: A 47-Year-Old Pastry Baker Recovering From a Chest Cold
Setting and Method
The volunteer, Ms. V., is a 47-year-old pastry baker who agreed to be examined in the skills laboratory at 0930. She says she had a chest cold two weeks ago and still has a light cough in the mornings. She has never smoked. She works with flour every day and wears no mask at work. She sat upright on the side of the table with her gown open at the back and her arms resting in her lap.
The order followed the course text: look, then feel, then tap, then listen (Jarvis & Eckhardt, 2024). All counting and looking was done before she was asked to breathe deeply, because deep breathing changes the rate and pattern the opening entries are meant to capture. For listening, the diaphragm of the stethoscope was placed directly on skin, and each spot on the right was followed by the matching spot on the left before moving down. Each sound is described by four things: how loud, how high or low, how long the breath in lasted compared with the breath out, and where the stethoscope was. The sound names follow the standard set of terms proposed by a European Respiratory Society task force (Pasterkamp et al., 2016).
Looking Before Listening
Rate: 16 breaths in one full minute, counted while the student appeared to be taking her pulse, so that Ms. V. did not know her breathing was being counted.
Rhythm: even, with no pauses longer than the others.
Effort: quiet; neck muscles and shoulders not moving with each breath; no pulling in of the skin between the ribs.
Posture: sitting upright without leaning forward or bracing on her hands.
Chest shape: front-to-back width less than side-to-side width, estimated by eye at about one to two.
Chest movement: both sides rose together and to the same height.
Skin and lips: lips pink; nail beds pink; no clubbing of the fingertips.
Cough during the examination: once, short and dry-sounding, at the start; she said the morning cough brings up a small amount of clear mucus.
Feeling and Tapping
Chest expansion, from behind: the student's thumbs placed at the level of the 10th rib, about 5 centimeters apart; on a deep breath, both thumbs moved apart equally, by about 4 centimeters.
Vibration with speech (tactile fremitus), palm of the hand on each spot as she said ninety-nine: felt equally on the right and left at the upper, middle and lower back; slightly less at the lowest spot on both sides, as expected.
Tenderness: none felt or reported anywhere on the chest wall.
Tapping (percussion), back, in pairs from top to bottom: a hollow, low-pitched sound (resonance) at every spot on both sides down to the 9th rib, where the sound became dull on both sides at the same level.
Listening, Back, Right and Left in Pairs
Between the shoulder blades, level with the 3rd rib, right and left: medium loudness, medium pitch; breath in and breath out about equal in length; the same on both sides (bronchovesicular sounds, which belong here).
Below the shoulder blades, 7th intercostal space at the line through the point of the shoulder blade, right and left: soft, low-pitched, with the breath in about three times longer than the breath out, fading early; the same on both sides (vesicular sounds, which belong here).
Lowest spots, 9th intercostal space at the same line, right: soft, low-pitched, breath in longer than breath out; at the end of the breath in, a few brief, fine crackling sounds, like hair rubbed between the fingers near the ear, heard on the first two deep breaths and not heard after she coughed once.
Lowest spots, 9th intercostal space at the same line, left: soft, low-pitched, breath in longer than breath out, with no added sounds.
Side of the chest, 6th intercostal space under the armpit, right and left: soft, low-pitched; breath in longer than breath out; the same on both sides; no added sounds.
Listening, Front, Right and Left in Pairs
Just above the collarbone, right and left: soft to medium, medium pitch; breath in and out about equal; the same on both sides.
2nd intercostal space beside the breastbone, right and left: medium loudness, medium pitch; breath in and breath out about equal; the same on both sides.
Over the windpipe at the base of the neck: loud, high-pitched, harsh; breath out longer than breath in, with a short gap between them (tracheal breath sounds, which belong here).
4th intercostal space at the line through the middle of the collarbone, right and left: soft, low-pitched; breath in longer than breath out; the same on both sides.
6th intercostal space at the same line, right: soft, low-pitched; breath in longer than breath out; no added sounds.
6th intercostal space at the same line, left: heard with difficulty because of heart sounds; soft, low-pitched; breath in longer than breath out as far as could be judged; no added sounds heard.
Summary of What Was Recorded
Rate, rhythm and effort of breathing were even and quiet while Ms. V. sat upright. Chest movement, vibration with speech and the tapping sound were equal on both sides. Breath sounds matched the expected pattern for each position and were equal on the right and left, with one exception: a few fine crackling sounds at the end of the breath in at the lowest right spot on the back, heard on two deep breaths and not heard after one cough. That observation, with the recent chest cold and the morning cough, was reported to the instructor. The student did not name a cause. Bohadana et al. (2014) describe crackles as brief, interrupted sounds whose timing within the breath and response to coughing help a later examiner interpret them, which is why both details appear in the entry rather than the word crackles alone.
What Was Hard
The hard part of this week was the vocabulary for sound. Before the laboratory the student could have described the color of any skin finding, but her first attempt at a lung entry read only clear. Clear does not say anything a second listener could compare, so she wrote out the four features for every spot, even when the sound was expected, which made the record longer and much more useful. Pasterkamp et al. (2016) found wide variation in the terms clinicians use for lung sounds and recommend a small shared set, and using only the names in that set, with plain English beside them, kept this record from drifting into words that sounded technical but meant nothing.
The second difficulty was hearing the lowest left spot at the front, where the heart sounds covered the breath. Rather than write no added sounds as though the spot were as clear as the others, the student recorded that it was difficult to hear and why. Writing that down honestly felt like admitting a weakness, but it tells the next examiner which spot is worth listening to again with the patient leaning forward.
References
Bohadana, A., Izbicki, G., & Kraman, S. S. (2014). Fundamentals of lung auscultation. New England Journal of Medicine, 370(8), 744-751. https://doi.org/10.1056/NEJMra1302901
Jarvis, C., & Eckhardt, A. (2024). Physical examination and health assessment (9th ed.). Elsevier.
Pasterkamp, H., Brand, P. L. P., Everard, M., Garcia-Marcos, L., Melbye, H., & Priftis, K. N. (2016). Towards the standardisation of lung sound nomenclature. European Respiratory Journal, 47(3), 724-732. https://doi.org/10.1183/13993003.01132-2015
What the NR 302 Week 5 assignment asks for
For Week 5 you assess the respiratory system of a volunteer and document the findings, typically in the order of inspection, palpation, percussion and auscultation. Expect the form to ask for rate, rhythm and effort, chest shape and movement, fremitus, percussion notes and breath sounds at set positions, plus a reflection. Count breathing before the volunteer knows you are watching it. Listen in pairs, comparing right and left at each level. Give each position as an intercostal space and a line. Describe each sound by loudness, pitch, the length of breath in and out and any added sounds with their timing. Record anything you had difficulty hearing instead of calling it normal.
How this NR 302 Week 5 example is built
The write-up opens with Ms. V., her job in flour dust, her recent cold and the order used, citing Jarvis and Eckhardt (2024). Looking before listening comes first: a rate of 16, even rhythm, quiet effort and a short morning cough. Feeling and tapping follow, with 4 centimeters of expansion and resonance down to the 9th rib. Back and front sections list positions in pairs, naming each by space and line. At the right 9th intercostal space, a few fine crackles at the end of the breath in, like hair rubbed near the ear, cleared after a cough, described with Pasterkamp et al. (2016). A summary reports without deciding, and the reflection covers the word clear.
NR 302 Week 5 rubric: what full points look like
Respiratory rubrics usually grade correct technique and sequence, complete coverage of positions, precise description of breath sounds, bilateral comparison, recognition of abnormal findings and reflection. Description carries the most weight, so each sound has loudness, pitch, timing and a place. Sequence is credited when looking and counting come before deep breaths, as stated at the top. Coverage scores when every position on the form has an entry in both sides. Bilateral comparison is written into each line. The added sound earns credit because its timing, quality and response to coughing are recorded. Naming the spot that was hard to hear protects accuracy. Current sources on lung sounds support the vocabulary.
NR 302 Week 5 help: mistakes that cost points
The reliable loss is a sound with nowhere to be: clear or normal describes the writer's confidence, not the noise. Finishing one side before starting the other throws away the reason for listening in pairs. A rate with no rhythm or effort, entries with a description and no position, positions given as upper back instead of a space and a line, sides never compared in writing and adjectives that fit any sound all cost points. Writing a sound for a row you never listened to cannot be recovered. If everything sounded alike, describe it anyway at each position. Bring your recorded findings, and a respiratory write-up can be organized by space and line.
Get a NR 302 Week 5 example written to your instructions
Send the Week 5 instructions and the respiratory form your section uses, and a custom example is written into its blocks with your own landmarks, back inside 24 to 48 hours. The first one is free. The chest you listened to belongs to somebody who agreed to be listened to, and that part is yours alone.
More NR 302 papers and pre-licensure samples
- NR 302 Week 1: Describing a Finding Discussion Post
- NR 302 Week 2: Health History Interview Write-Up
- NR 302 Week 3: Skin Assessment Write-Up
- NR 302 Week 4: Head and Neck Assessment Write-Up
- NR 302 Week 6: Cardiovascular Assessment
- NR 302 Week 7: Abdominal Assessment
- NR 302 Week 8: Head to Toe Write-up
- NR 304 Week 5: Case Study Analysis
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NR 302 Week 5 questions, answered
Everything sounded the same on my volunteer. What am I supposed to write?
Put down the place and the sound at every stop, with the four descriptors filled in each time. Equal loudness on both sides at every level is a finding and a complete one. The week is testing whether you can describe an ordinary sound, which is harder than describing an unusual one and is the reason the assignment exists at this point in the term.
Do I need to know the proper names for the normal breath sounds?
Use them where your text has already introduced them, and describe the sound plainly where it has not. The two proper names for ordinary breathing carry a lot of information in very little space, which is why they are taught early, but a beginner who attaches the wrong one to the wrong part of the chest loses more than the space was worth. Accuracy first, compression afterward.
My describing words all sound the same. Is that a problem?
It is the problem this week was designed around, and the fix is mechanical rather than creative. Build a short list of the sound terms your text uses before you start listening, keep it beside you, and choose from it. Beginners who write from memory reach for the same two adjectives all the way down the page, and a grader can see the whole document was written by somebody working from one word.
Where can I find a free NR 302 Week 5 sample paper?
The complete Week 5 respiratory write-up on Ms. V., with paired breath sounds front and back and the crackles that cleared after a cough, is published on this page.
How are the crackles described in the NR 302 Week 5 example?
As a few brief, fine crackling sounds at the end of the breath in at the right 9th intercostal space, like hair rubbed between the fingers near the ear, gone after she coughed.