| Course | NR 306 Health Assessment |
|---|---|
| Week | 3 |
| Paper type | Head and neck examination write-up |
| Length | About 1,120 words, 6 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | RN-to-BSN |
| Updated | October 2026 |
Free sample paper for NR 306 Week 3
Head and Neck Write-Up: A 41-Year-Old Tow Truck Operator With a Two-Week Stuffy Left Nostril
Student Name
College of Nursing, Chamberlain University
NR 306: Health Assessment
Instructor Name
Month Day, Year
Head and Neck Write-Up: A 41-Year-Old Tow Truck Operator With a Two-Week Stuffy Left Nostril
Setting, Equipment and Consent
The volunteer, Mr. S., is a 41-year-old tow truck operator who agreed to be examined in the program's skills laboratory at 1830 after his shift. He reports a stuffy left nostril for about two weeks since a cold, with no fever, no facial pain and no nosebleeds. He takes no regular medicines and has no allergies. He gave verbal consent at 1825.
Equipment: penlight; otoscope with a 4-millimeter speculum and a broad nasal speculum tip; tongue blade; gloves; a Snellen pocket card; cotton wisp. No ophthalmoscope was available, so the fundi were not examined. He sat on the examination table for the whole examination. Terms and sequence follow the course text (Jarvis & Eckhardt, 2024), and each internal finding names the instrument that produced it.
Head and Face
Skull (inspection and palpation): normocephalic; no masses, depressions or tenderness.
Scalp: no lesions or scaling; hair brown, evenly distributed.
Face (inspection): symmetric at rest; nasolabial folds equal.
Temporal arteries (palpation): soft, nontender, pulsation equal bilaterally.
Temporomandibular joints (palpation during opening and closing): smooth motion bilaterally; no crepitus or tenderness.
Eyes
Visual acuity (Snellen pocket card at 14 inches, uncorrected): right 20/25, left 20/25.
Eyelids and lashes (inspection): no ptosis; lid margins without crusting; lashes evenly distributed.
Conjunctivae (inspection with penlight, lower lids everted gently): pink, moist, no discharge.
Sclerae: white.
Corneas (penlight at an oblique angle): clear, smooth.
Pupils (penlight, room lights dimmed): 5 millimeters bilaterally, round, equal; direct response to light, each constricting to 3 millimeters; consensual response present bilaterally; constricted and converged on a near object brought to 10 centimeters from the nose (accommodation present).
Extraocular movements: followed the examiner's finger through the six cardinal positions; eyes moved in parallel; no nystagmus except two beats at extreme lateral gaze on each side, which stopped when the finger moved back slightly.
Corneal light reflex (penlight at 30 centimeters): reflection at the same position on both corneas.
Fundi: not examined, because the station had no ophthalmoscope; the row is left blank on purpose rather than filled with an assumed finding.
Ears
Auricles (inspection and palpation): symmetric, no lesions; no tenderness on moving the auricle or pressing the tragus, bilaterally.
External canals (otoscope): right, pink, small amount of soft tan cerumen; left, pink, small amount of soft tan cerumen; no erythema, edema or drainage bilaterally.
Tympanic membranes (otoscope): right, pearly gray, translucent, cone of light at 5 o'clock, handle of the malleus visible, no bulging or retraction; left, pearly gray, translucent, cone of light at 7 o'clock, handle of the malleus visible, no bulging or retraction.
Hearing (whispered voice test): the examiner stood behind him at arm's length, occluded and rubbed the opposite tragus, exhaled and whispered a combination of three numbers and letters; he repeated all three correctly on each side on the first attempt.
Nose and Sinuses
External nose (inspection): straight; no lesions.
Patency: occluding each nostril in turn, he could sniff easily through the right and with effort through the left.
Nasal mucosa and turbinates (otoscope with nasal speculum tip, head tilted back): right, mucosa deep pink, moist; inferior turbinate pink, not swollen. Left, mucosa pale pink and swollen; inferior turbinate swollen, touching the septum in its anterior part; clear, thin mucus along the floor of the nostril.
Septum: midline in its visible anterior portion; no perforation or bleeding.
Frontal and maxillary sinuses (palpation and percussion): nontender bilaterally.
Smell (cranial nerve I), eyes closed, one nostril at a time: identified coffee and peppermint through the right nostril; identified coffee but not peppermint through the left.
Mouth and Throat
Lips: pink, moist, no lesions.
Buccal mucosa (penlight and tongue blade): pink, moist; Stensen ducts visible, no redness.
Teeth: 30 present; a chipped left lower incisor; no obvious caries on inspection.
Gingivae: pink, firm; no bleeding or recession.
Tongue: pink, moist; papillae present; midline on protrusion; moved side to side symmetrically.
Floor of the mouth: pink; Wharton ducts visible; no masses on bimanual palpation.
Hard and soft palate: hard palate pale pink, intact; soft palate pink, rose symmetrically on phonation.
Uvula: midline, rose in the midline.
Tonsils: 1+ bilaterally, pink, no exudate.
Posterior pharynx: pink; a small amount of clear mucus visible on the posterior wall.
Gag reflex: not tested, per the instructor's protocol for well volunteers.
Neck
Inspection: symmetric; trachea appears midline; no visible masses.
Range of motion: full flexion, extension, rotation and lateral bending without pain.
Trachea (palpation at the suprasternal notch): midline; equal spaces bilaterally.
Thyroid (posterior approach, fingers either side of the trachea below the cricoid cartilage, with a sip of water): isthmus felt rising on swallowing; lobes smooth, not enlarged, no nodules felt bilaterally.
Lymph nodes, palpated chain by chain with the pads of the fingers, bilaterally: preauricular, not palpable; posterior auricular, not palpable; occipital, not palpable; tonsillar, not palpable; submandibular, one node on the left, 7 millimeters, soft, mobile, nontender, and none on the right; submental, not palpable; superficial cervical, not palpable; posterior cervical, not palpable; deep cervical chain, not palpable; supraclavicular, not palpable.
Summary and Reflection
Findings differing from the rest of the examination: pale, swollen left nasal mucosa and inferior turbinate with clear mucus; reduced airflow through the left nostril; peppermint not identified through the left nostril; a single small, soft, mobile left submandibular node; and a chipped incisor. No condition was named, and the findings were shared with the instructor and with Mr. S., who was advised to see his primary care provider if the stuffiness lasted beyond a few more weeks or if facial pain or fever developed.
I use a penlight on almost every patient at work and an otoscope almost never. Examining the nose with the otoscope's nasal tip was new, and it was the step that turned a complaint of a stuffy nostril into a description of what the inside of the nostril looked like. Pirozzo et al. (2003) reviewed studies of the whispered voice test and found it an accurate screening test for hearing loss in adults when the technique is standardized, which is why I wrote out each step of the technique in the ear entry. Bickley et al. (2021) describe testing smell one nostril at a time with familiar, nonirritating odors, which is how it was done here. I would have skipped it if the form had not printed a row for cranial nerve I, and yet it produced one of the findings that matched his complaint.
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.
Pirozzo, S., Papinczak, T., & Glasziou, P. (2003). Whispered voice test for screening for hearing impairment in adults and children: Systematic review. BMJ, 327(7421), 967. https://doi.org/10.1136/bmj.327.7421.967
NR 306 Week 3 instructions, in plain terms
The Week 3 assignment asks you to examine and document the head, eyes, ears, nose, sinuses, mouth, throat and neck of a volunteer. Expect the template to want each structure with the technique and instrument used, findings on both sides and a summary and reflection. Name the instrument for every internal finding. Give pupils a size and a response. Report ear canals and eardrums separately. Describe the hearing test as you performed it. List each lymph node chain by name and side instead of writing no lymphadenopathy. Check the thyroid with a swallow. If an instrument was not available, leave that row marked as not examined and say why.
How the NR 306 Week 3 example is put together
The write-up opens with Mr. S., his complaint, consent at 1830 and the equipment, noting there was no ophthalmoscope. Head and face entries cover the skull, temporal arteries and jaw. Eye entries give acuity of 20/25, pupils of 5 millimeters constricting to 3, six cardinal positions and the blank fundi row. Ear entries separate canals and membranes for each side and describe the whispered voice test, citing Pirozzo et al. (2003). The nose section records reduced airflow and a swollen left turbinate touching the septum, with peppermint missed on the left. Mouth, throat and neck follow, with node chains listed one by one and a 7-millimeter left submandibular node.
NR 306 Week 3 rubric: what full points look like
Head and neck rubrics generally grade systematic technique, correct terminology and spelling, complete coverage of each structure, use of instruments, bilateral comparison and a summary without diagnosis. Coverage and instrument use carry the most points, so every internal finding names the otoscope or penlight that produced it. Terminology scores when each structure is named correctly, which matters in a region full of anatomical terms. Bilateral comparison is credited when sides sit in the same entry. Listing node chains shows the neck was covered. Giving the nose the same detail as the eyes earns credit because it is the region tied to his complaint. Marking the fundi as not examined protects accuracy.
Common NR 306 Week 3 mistakes, and how to avoid them
The largest loss this week is the vague structure: ears normal covers a canal and a membrane that may not have been seen. An internal finding with no instrument costs next. Node chains summarized, the thyroid recorded without a swallow, pupils sized without a response, eye movements asserted rather than described, sinuses skipped and sides merged all lose points. Misspelled anatomical terms read as unfamiliarity. If you have no otoscope, record that the canals and membranes were not examined. Most templates list ten or more node chains. Neurological cranial nerve testing comes later, so keep this week to structure. Send your notes and equipment list for a write-up drafted structure by structure.
Get a NR 306 Week 3 example written to your instructions
Send the Week 3 instructions and the head and neck template your section posted, and a custom example is written into it, at the level of naming this week rewards, inside 24 to 48 hours. The first one is free. The person who sat for the examination, and what they consented to, stay entirely on your side of that.
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NR 306 Week 3 questions, answered
What if I do not have an otoscope at home?
Record the external examination fully and name the internal part as not performed, with the reason. Sections differ on equipment, and several run this week with inspection only. The graded fault is a canal or membrane described in a document where no instrument existed, which is invented data. An honest gap in one row costs a fraction of what a fabricated finding does.
How many node chains does the record need?
Whatever list your template prints, and in that order. The marking looks for the chains themselves rather than for findings, since almost all of them will be unremarkable on a well volunteer. Writing them out one at a time is tedious, and it is also the entire point of the row, because the chain names are the only proof of where your fingers actually went.
Does this week overlap with the neurological one?
Slightly, and the overlap is useful to name in the write-up. Several cranial nerves are tested by things you do here anyway: pupils, eye movement, facial symmetry, hearing, the palate rising. Record them as head and neck findings in this week and let the numbered battery wait for its own assignment, unless your template asks for the numbers now.
Where can I find a free NR 306 Week 3 sample paper?
The complete Week 3 head and neck write-up on Mr. S., with the nasal speculum findings, the whispered voice test and every node chain listed, is posted on this page.
What nose findings does the NR 306 Week 3 example record?
Pale, swollen left nasal mucosa with a swollen inferior turbinate touching the septum, clear mucus, reduced airflow through the left nostril and peppermint not identified on that side.