| Course | NR 306 Health Assessment |
|---|---|
| Week | 6 |
| Paper type | Abdominal examination write-up |
| Length | About 1,110 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | RN-to-BSN |
| Updated | October 2026 |
Free sample paper for NR 306 Week 6
Abdominal Assessment Write-Up: A 36-Year-Old Hair Stylist Fourteen Months After Her Second Baby, Listening Before Touching
Student Name
College of Nursing, Chamberlain University
NR 306: Health Assessment
Instructor Name
Month Day, Year
Abdominal Assessment Write-Up: A 36-Year-Old Hair Stylist Fourteen Months After Her Second Baby, Listening Before Touching
Setting, Position and Sequence
Ms. C. is a 36-year-old hair stylist whose second child was born by vaginal delivery 14 months ago. She reports that her belly "still sticks out in the middle" when she sits up from lying down, but she has no pain, normal bowel movements every day, and no urinary symptoms. She was examined at 1130 in the skills laboratory, about three hours after breakfast, with an empty bladder, and gave verbal consent at 1125.
Position, stated once for every entry below: supine, one pillow under the head, a rolled towel under the knees, arms at the sides, abdomen exposed from the xiphoid process to the symphysis pubis.
Quadrants used in every row: right upper (RUQ), left upper (LUQ), right lower (RLQ), left lower (LLQ).
Sequence: inspection, auscultation, percussion, palpation. The abdomen is the one region where auscultation comes before percussion and palpation, because pressing on the abdomen can stimulate or change bowel activity and alter what is then heard (Jarvis & Eckhardt, 2024). She reported no tender area, so palpation followed the order RLQ, RUQ, LUQ, LLQ.
Inspection
Contour (viewed from her right side at abdominal level): rounded below the umbilicus; flat above it.
Symmetry (viewed from the foot of the table): symmetric at rest.
Skin: silvery-white, slightly depressed, linear marks, 3 to 7 centimeters long and 2 to 5 millimeters wide, across the RLQ and LLQ and extending onto both flanks; no rashes, lesions or scars; a line of darker pigment 4 millimeters wide running from the umbilicus to the symphysis pubis.
Umbilicus: inverted, midline, no bulge or discharge.
Movement: no visible peristalsis; no visible pulsation.
On raising her head and shoulders off the pillow (curl-up), viewed from the side: a ridge-shaped bulge along the midline from about 3 centimeters above to 4 centimeters below the umbilicus. With her head raised and the examiner's fingers placed across the midline just above the umbilicus, a gap between the two bands of muscle admitted two fingertip widths, about 3 centimeters, with a soft floor. The bulge flattened when she lay back.
Inguinal and femoral areas, with a cough: no bulges bilaterally.
Auscultation
Diaphragm, warmed, light pressure, at least 1 minute per quadrant:
RLQ: high-pitched gurgles and clicks, irregular, about 12 per minute.
RUQ: gurgles, about 7 per minute.
LUQ: gurgles, about 9 per minute.
LLQ: gurgles, about 8 per minute.
Bell, over the aorta (midline above the umbilicus), both renal arteries (either side of the midline just above the umbilicus), both iliac arteries (either side below the umbilicus) and both femoral arteries: no bruits.
Friction rubs over the liver (right costal margin) and spleen (left costal margin, anterior axillary line): none.
Percussion
General, all four quadrants: tympany predominant in all four quadrants; a small area of dullness in the LLQ just above the inguinal ligament.
Liver span, right midclavicular line: upper border of dullness at the 5th intercostal space; lower border at the costal margin; span 9 centimeters.
Spleen, lowest intercostal space at the left anterior axillary line: tympanic on full expiration and on full inspiration.
Bladder (suprapubic): tympanic, consistent with an empty bladder.
Costovertebral angles (sitting, fist percussion over the examiner's other hand): no tenderness bilaterally.
Palpation
Light (1 centimeter depth), RLQ, RUQ, LUQ, LLQ in that order: soft in every quadrant; no guarding; no tenderness; no masses; abdominal wall relaxed under the hand, except along the midline, where the wall felt thinner and softer than on either side.
Deep (about 5 centimeters, bimanual where indicated), same order:
RLQ: soft; no masses; no tenderness.
RUQ, liver (right hand below the costal margin, left hand under the 11th and 12th ribs, patient taking a deep breath): liver edge not felt.
LUQ, spleen (right hand below the left costal margin, left hand under the lower left ribs, deep breath): spleen not felt.
LLQ: a soft, tubular, slightly mobile structure about 2 centimeters wide felt along the left side, nontender, in the area of the dullness noted on percussion.
Kidneys (bimanual capture on deep inspiration): not felt bilaterally.
Aorta (deep palpation above the umbilicus, slightly left of the midline): pulsation felt, about 2 centimeters wide, directed forward.
Rebound tenderness: not tested; she reported no pain and had no tenderness on deep palpation.
Summary
Ms. C.'s abdomen was rounded below the umbilicus, with silvery linear marks in both lower quadrants and flanks, a pigmented line below the umbilicus, and a midline bulge from above to below the umbilicus on curling up, over a 3-centimeter gap between the two muscle bands. Bowel sounds were present in all quadrants, with no bruits. Percussion was tympanic except a small dull area in the LLQ, where a soft, mobile, tubular structure was felt; liver span was 9 centimeters. No tenderness, no masses other than the LLQ structure, and no enlargement of the liver, spleen or kidneys were found. The instructor reviewed the midline gap and the LLQ structure with the student at the bedside, and neither was given a name in the record. Ms. C. asked whether exercise could help the midline bulge, and was encouraged to ask her women's health provider.
Reflection
On a medical floor I listen to bowel sounds in four quadrants and chart them as present, and I rarely count or describe them. Felder et al. (2014) found that clinicians listening to recorded bowel sounds agreed poorly on what they heard, which makes me more willing to write a rate and a character than a single word that sounds more certain than it is. The curl-up maneuver was new to me. Without asking Ms. C. to lift her head, I would have seen a normal abdomen at rest and missed the finding she came in worried about. Bickley et al. (2021) describe having the patient raise the head and shoulders to bring out a bulge in the abdominal wall, and doing it turned her worry into a measurement she can take to her provider. The LLQ entry taught me something too. My first instinct was to leave the soft tubular structure out, because I assumed it was ordinary and did not want to raise a concern that might be nothing. Recording it with its size, mobility and the matching dull area on percussion lets a reader decide what it is, and leaving it out would have made the palpation row less complete than the percussion row above it.
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.
Felder, S., Margel, D., Murrell, Z., & Fleshner, P. (2014). Usefulness of bowel sound auscultation: A prospective evaluation. Journal of Surgical Education, 71(5), 768-773. https://doi.org/10.1016/j.jsurg.2014.02.003
Jarvis, C., & Eckhardt, A. (2024). Physical examination and health assessment (9th ed.). Elsevier.
What the NR 306 Week 6 assignment asks for
For Week 6 you examine a volunteer's abdomen and write it up in the sequence your course teaches: inspection, auscultation, percussion and palpation. Expect the template to ask for contour, symmetry, skin, umbilicus and movement; bowel sounds and vascular sounds; percussion notes, liver span and spleen; light and deep palpation by quadrant; and a summary. State the position and quadrant names once. Explain why listening comes before pressing. Count bowel sounds and describe their character instead of writing present. Separate light and deep palpation rows. Place and size anything you feel. Where a maneuver was skipped, give the reason. Describe findings without naming a cause.
Inside the NR 306 Week 6 example
The write-up opens with Ms. C., her second birth 14 months ago and her observation that her belly sticks out when she sits up. Position, quadrants and sequence are set, citing Jarvis and Eckhardt (2024). Inspection measures silvery striae, a pigmented line and a ridge-shaped midline bulge on a curl-up with a 3-centimeter gap. Auscultation counts gurgles per quadrant and checks six arterial sites for bruits. Percussion gives tympany, a liver span of 9 centimeters and an empty bladder. Light and deep palpation are separate rows, with a tubular structure in the left lower quadrant and an aortic pulsation measured. Rebound is named as not indicated. A reflection cites Felder et al. (2014).
Where the points sit in the NR 306 Week 6 rubric
Abdominal rubrics generally grade correct sequence, complete quadrant coverage, precise description of sounds, percussion and palpation, measurement of findings and a summary without diagnosis. Sequence carries specific weight because it is what this week teaches, so listening clearly comes before touching. Coverage scores when all four quadrants appear in every technique. Precision is credited when bowel sounds have a rate and character and palpation rows have a touch word. Measurement earns points for the striae, the bulge and the gap between muscles. Naming a test that was not indicated, with its reason, shows judgment. Questioning how much a bowel sound count can tell anyone, as the reflection does, shows careful use of evidence. Keeping the same four quadrant names in every row lets a grader follow each one.
NR 306 Week 6 help: mistakes that cost points
The unmistakable failure is palpating before listening, because the order is visible on the page. Next is a quadrant that disappears partway down the record. Bowel sounds written as present, tympany and dullness never told apart, position not stated, deep palpation where it was forbidden, tenderness without a site and a liver edge claimed without method all cost points. A description that slides into a named cause costs most. Order matters even when findings are correct, because pressing first changes what is heard. Listen for at least a full minute per quadrant before calling sounds absent. Use the quadrant system your section teaches. Send your quadrant notes, and the abdominal record can be laid out in the listening-first order.
Get a NR 306 Week 6 example written to your instructions
Send the Week 6 instructions and the abdominal template from your classroom, and a custom example is written into it in the technique order your section teaches, returned inside 24 to 48 hours. The first one is free. The abdomen belonged to a person who agreed to let you examine it, and nothing about that transfers to us.
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- NR 307A Week 6: Inclusive Communication Plan
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- NR 351 Week 6: Article Summary
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NR 306 Week 6 questions, answered
Does the technique order really matter if my findings are right?
It matters because the order is one of the graded items. A record showing palpation ahead of auscultation reports sounds that the pressing itself may have changed, so the finding is no longer trustworthy regardless of what it says. Writing the sequence out explicitly, and stating the reason in a line, converts a silent compliance into something a grader can award.
How long should I listen before writing absent?
Longer than feels natural, and your classroom text will give the interval it expects, so cite that rather than a number you remember. Report the time you spent along with the result, in every area you listened to. Absent bowel sounds on a well volunteer are far more likely to mean a short listen than a real finding, and a grader who sees the interval can tell which.
Should I use four quadrants or nine regions?
Use whichever your template prints, and use it everywhere. Some forms divide the abdomen into four areas and some into nine, and the two are not mixed inside one document. If the form leaves the choice open, take four, name them in full the first time, and keep the same names in every row so that nothing has to be matched up by the reader.
Where can I find a free NR 306 Week 6 sample paper?
The full Week 6 abdominal write-up on Ms. C., with listening before touching, counted bowel sounds and the measured midline gap, is shown on this page.
What does the NR 306 Week 6 curl-up test show?
A ridge-shaped bulge along the midline from 3 centimeters above to 4 centimeters below the umbilicus, over a gap about 3 centimeters wide between the two muscle bands.