| Course | NR 302 Health Assessment I |
|---|---|
| Week | 6 |
| Paper type | Cardiovascular assessment write-up |
| Length | About 1,230 words, 6 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 302 Week 6
Cardiovascular Assessment Write-Up: A 69-Year-Old Retired Church Organist With Visible Leg Veins
Student Name
College of Nursing, Chamberlain University
NR 302: Health Assessment I
Instructor Name
Month Day, Year
Cardiovascular Assessment Write-Up: A 69-Year-Old Retired Church Organist With Visible Leg Veins
Setting and How Entries Are Written
The volunteer, Mrs. H., is a 69-year-old retired church organist who played for services and weddings for 40 years and still practices two hours a day. She takes amlodipine for high blood pressure. She came to the skills laboratory at 1100 and agreed to the examination. The examination used a stethoscope with a bell and a diaphragm, a watch with a second hand, a penlight and a tape measure.
Every entry in this record keeps two things apart. The first part says what the student saw, heard or felt, in plain words. Where the course uses a graded scale, the grade follows in brackets with the scale it came from, so a reader using a different form can still read it. Pulse strength is graded on the 0 to 4+ scale in the course text, where 0 is absent, 1+ weak, 2+ normal, 3+ increased and 4+ bounding (Jarvis & Eckhardt, 2024). Words such as good circulation or healthy pulses are not used, because they are conclusions rather than findings.
Heart: Looking and Feeling
Position: supine, with the table head tilted up to 30 degrees.
Neck veins: a faint pulsation seen on the right side of the neck, about 2 centimeters above the collarbone with her head at 30 degrees; it fell when she took a breath in.
Chest wall: no visible pulsation except a small, brief tap under the left breast.
Apical impulse, felt with the fingertips: a small, brief tap, about the size of a nickel, in the 5th intercostal space just inside the left midclavicular line.
Thrills (a buzzing vibration under the hand): none felt at any of the five listening areas.
Heart: Listening
Position: as above, then turned slightly to the left side for the last entry.
Aortic area, 2nd intercostal space right of the breastbone, diaphragm: two sounds, the second louder than the first; nothing between them.
Pulmonic area, 2nd intercostal space left of the breastbone, diaphragm: two sounds, the second louder than the first; on a deep breath in, the second sound seemed to split into two very close sounds, and joined again on the breath out.
Erb's point, 3rd intercostal space left of the breastbone, diaphragm: two sounds of about equal loudness; nothing between them.
Tricuspid area, 4th intercostal space left of the breastbone, diaphragm: two sounds, the first louder than the second; nothing between them.
Mitral area, 5th intercostal space, left midclavicular line, diaphragm then bell: two sounds, the first louder than the second; nothing between them with either part of the stethoscope.
Mitral area, turned partly onto her left side, bell: two sounds; no extra sound heard before the first sound or after the second.
Rate and rhythm, counted at the mitral area: 72 beats in one full minute, even spacing, with no pauses or extra beats heard.
Murmurs: none heard at any area.
Pulses, Right and Left Together
Radial (wrist): right felt easily under two fingers, the same strength as the left; left felt easily [2+ right, 2+ left on the 0 to 4+ scale]. Rate at the right radial: 72 in one minute, matching the apical count.
Brachial (inside of the elbow): felt easily on both sides, equal [2+ right, 2+ left].
Carotid (neck), one side at a time: felt easily, equal, not pressed on both sides at once [2+ right, 2+ left].
Femoral (groin): felt with firm pressure on both sides, equal [2+ right, 2+ left].
Popliteal (behind the knee), knee slightly bent: right felt only with deep pressure and some searching, left felt the same way [1+ right, 1+ left]. The student noted that this pulse is often hard to find in any adult and asked the instructor to check; the instructor also graded both 1+.
Dorsalis pedis (top of the foot): right felt easily; left felt but fainter than the right [2+ right, 1+ left].
Posterior tibial (behind the inner ankle bone): right felt easily; left felt easily [2+ right, 2+ left].
Legs and Feet
Position: lying flat with legs uncovered to the upper thigh.
Skin color: pale pink on both legs; the same color on both feet; no darker brown patches around the ankles.
Veins: raised, twisting, blue veins on the inner side of both calves, more on the left, the longest about 12 centimeters, soft to the touch and not tender; they flattened when she lifted each leg; fine, spidery red and purple veins around both ankles.
Warmth, checked with the back of the hand: both legs warm from thighs to toes, with no side cooler than the other.
Swelling: a shallow dent that filled in within a few seconds after the student pressed a thumb for 5 seconds over the left inner ankle; none on the right. Mrs. H. says her left ankle is sometimes puffy at the end of a day of practice.
Calf size, measured 10 centimeters below the kneecap: right 34 centimeters, left 35 centimeters.
Hair: fine hair present over both shins and on the tops of both big toes.
Nails: toenails pink and smooth, not thickened.
Color return after pressing (capillary refill): the nail of each big toe pressed for 5 seconds at room temperature; pink returned in under 2 seconds on both sides. The fingernails, pressed the same way, returned to pink in under 2 seconds.
Summary of What Was Recorded
Heart sounds were heard at all five areas with no extra sounds or murmurs, and the apical and radial rates matched at 72. Pulses were equal on both sides except the top of the foot, where the left was fainter than the right. The legs showed raised, twisting veins on the inner calves, more on the left, a shallow dent at the left inner ankle after pressing, and a left calf 1 centimeter larger than the right. Those three findings on the left were reported to the instructor together. The student did not name a cause for any of them.
What Was Hard
The hardest part was keeping verdict words out. The first draft of the leg section said circulation to the feet is good. That sentence reports a conclusion the student is not qualified to reach and hides the one thing that differed, the fainter left foot pulse. Rewriting it as a pair of grades with the plain description in front made the difference visible. The second difficulty was the color return test. Pickard et al. (2011) point out that the result depends on skin temperature, room light and how long and how hard the nail is pressed, and that no single cutoff is agreed across settings. Writing the pressing time and the room temperature into the entry is a small step, but it means the next person can repeat the test the same way.
The popliteal pulses were also humbling. The student spent over a minute behind each knee and was ready to write absent, although Bickley et al. (2021) warn that this pulse is often harder to feel than the others. Asking the instructor to check, and recording that both examiners graded them 1+, turned a doubtful entry into one another reader can trust.
References
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer.
Jarvis, C., & Eckhardt, A. (2024). Physical examination and health assessment (9th ed.). Elsevier.
Pickard, A., Karlen, W., & Ansermino, J. M. (2011). Capillary refill time: Is it still a useful clinical sign? Anesthesia & Analgesia, 113(1), 120-123. https://doi.org/10.1213/ANE.0b013e31821569f9
What the NR 302 Week 6 assignment asks for
The Week 6 assignment asks you to assess the cardiovascular system of a volunteer, including the heart and the peripheral vessels, and document what you found. Expect the form to ask for inspection and palpation of the chest, heart sounds at the standard listening areas, rate and rhythm, peripheral pulses graded on a scale, and the color, warmth, swelling and capillary refill of the limbs, plus a reflection. Name the position, the listening area and the stethoscope part for each heart sound. Record both sides of every pulse together. Print the grading scale you used. Describe findings without verdict words like good circulation. Ask your instructor to check any pulse you could not find before calling it absent.
Inside the NR 302 Week 6 example
The write-up opens with Mrs. H., her 40 years at the organ, her amlodipine and the rule separating observation from grade, with the 0 to 4+ pulse scale printed once. Looking and feeling covers neck vein pulsation 2 centimeters above the collarbone and an apical tap at the 5th intercostal space. Listening entries name each area and stethoscope part, describe a second sound splitting on inspiration and count 72 beats in a minute. Pulses are listed site by site with both sides on one line, showing a fainter left dorsalis pedis. Leg findings include veins up to 12 centimeters, slight left ankle swelling and capillary refill under 2 seconds. A summary and reflection close the paper.
Where the points sit in the NR 302 Week 6 rubric
Cardiovascular rubrics typically grade technique, complete coverage of listening areas and pulse sites, accurate use of grading scales, bilateral comparison, description without conclusions and reflection. Bilateral comparison carries real weight, which is why each pulse site is one line with both sides, so the single difference becomes a finding. Technique scores when position and stethoscope part are named for every heart sound. Grading accuracy depends on printing the scale used. Description without verdicts earns the professionalism points, since the course does not ask for diagnoses. Asking the instructor to check the popliteal pulses shows sound judgment. Capillary refill with its pressing time follows the cited guidance.
Common NR 302 Week 6 mistakes, and how to avoid them
The biggest cost is a verdict word used as an observation: poor circulation, good perfusion or healthy pulses. A bare number with no scale cannot be read by anyone without your form. One foot reported and the other not, heart sounds with no location, extra sounds with no point in the cycle, posture missing, leg warmth and color dropped and findings turned into a named condition all lose points. Grade a pulse only with the scale printed, and describe it first. If you hear an extra sound, describe its timing and place rather than naming it. Send your examination notes, and the desk can draft a cardiovascular write-up with both sides on every line.
Get a NR 302 Week 6 example written to your instructions
Send the Week 6 instructions with whatever cardiovascular form your section issues, and a custom example is written into its rows and ranges and returned inside 24 to 48 hours. The first one is free. The wrist you took a pulse from belongs to a person who let you, and that permission is not something we could supply even if you asked.
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 5: Respiratory Assessment Write-Up
- NR 302 Week 7: Abdominal Assessment
- NR 302 Week 8: Head to Toe Write-up
- NR 304 Week 6: Documentation Exercise
- NR 293 Week 6: Older Adult Opioid Case Response
- NR 324 Week 6: Perioperative Write-up
- NR 283 Week 6: COPD and Heart Failure Case Analysis
NR 302 Week 6 questions, answered
Which of these words count as descriptions?
A word is descriptive when somebody else could have produced it from the same finding without knowing anything about the person. Warm, pink, two centimeters and eighteen in a minute all pass that test. Strong, poor, healthy and adequate do not, because each one carries an opinion about whether the finding is acceptable. The week is largely an exercise in sorting your own vocabulary into those two piles.
Do I grade a pulse or describe it?
Both, if the form has room for both, and in that order. The number comes off the range your section printed and the word comes from you, which lets a grader see whether the two agree. Where they disagree, a marker learns something useful about your calibration, and that is exactly the feedback this assignment exists to generate at the start of a program.
I heard an extra sound. Should I say what it is?
Say where it was, when in the cycle it happened, how loud it was and whether it changed when the person moved. Stop there. Working out which structure produced it is a later course with different marking, and an undergraduate write-up that names a valve usually leaves out the description that would have supported the claim anyway.
Where can I find a free NR 302 Week 6 sample paper?
The full Week 6 cardiovascular write-up on Mrs. H., with heart sounds at five areas, the pulse table and the leg findings, is printed further down this page.
What difference does the NR 302 Week 6 example record?
The left dorsalis pedis pulse was fainter than the right, graded 1+ against 2+ on the 0 to 4+ scale, with slight left ankle swelling and veins more visible on the left calf.