| Course | NR 306 Health Assessment |
|---|---|
| Week | 8 |
| Paper type | Head-to-toe examination write-up |
| Length | About 1,350 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 8
Head to Toe Write-Up: A 57-Year-Old Church Custodian Examined Sitting, Then Lying, Then Standing
Student Name
College of Nursing, Chamberlain University
NR 306: Health Assessment
Instructor Name
Month Day, Year
Head to Toe Write-Up: A 57-Year-Old Church Custodian Examined Sitting, Then Lying, Then Standing
Identifying Data, Consent and Route
Mr. R. is a 57-year-old custodian at a large church, where he sets up and breaks down chairs and tables several times a week. He has high cholesterol treated with atorvastatin 20 milligrams daily and no other diagnoses. He volunteered for a complete examination in the skills laboratory on a Thursday from 1330 to 1435, and gave verbal consent at 1325 after the route and the draping were explained. He declined the genitourinary and rectal examinations, which the template marks optional, and they are recorded as declined.
The examination ran in three postures to limit how often Mr. R. had to move: sitting for the upper body, lying for the heart, abdomen and legs, and standing for the spine, gait and balance (Bickley et al., 2021). The regions are reported below in the order the examination actually ran, and the position at the start of each block is stated. Terminology and grading scales follow the course text (Jarvis & Eckhardt, 2024): pulses 0 to 4+, reflexes 0 to 4+, strength 0 to 5 and edema 1+ to 4+.
Sitting: General Survey and Measurements
Position: seated at the table's edge in a gown with feet resting on the step, from 1330.
General survey: well-groomed; alert; speech clear; answered questions fully; moved onto the table without assistance; no distress.
Vital signs, 1335, after 5 minutes seated: temperature 36.7 degrees Celsius, tympanic, right ear; pulse 72, right radial, 60 seconds, regular; respirations 14, 60 seconds; blood pressure 134/86 right arm, 132/84 left arm, adult cuff; oxygen saturation 97 percent, room air, left index finger.
Height and weight, measured before sitting, no shoes, gown only: 175 centimeters; 90.4 kilograms; body mass index 29.5.
Waist circumference, standing, at the top of the iliac crests: 102 centimeters.
Pain: 0 of 10 at rest; reports a 2 of 10 ache in the low back after a day of stacking chairs.
Sitting: Skin, Head, Eyes, Ears, Nose, Mouth, Neck
Skin, face, scalp, arms and upper trunk: light olive, even; warm; dry; turgor over the sternum returns in under 2 seconds; a 5-millimeter, flat, round, uniformly tan macule on the left upper back; small yellowish, soft, flat plaques on the inner corners of both upper eyelids, about 4 by 2 millimeters each.
Head: normocephalic; no tenderness; scalp clear; hair thinning at the crown.
Eyes: acuity 20/30 each eye at 14 inches with his reading glasses; conjunctivae pink; sclerae white; a gray-white ring at the outer edge of each cornea; pupils 3 millimeters, equal, round, reactive to light and accommodation; extraocular movements full in six positions; fundi not examined (no ophthalmoscope).
Ears (otoscope): canals clear; tympanic membranes pearly gray with the cone of light and malleus visible bilaterally; whispered voice test correct at arm's length each side.
Nose: patent bilaterally; mucosa pink; septum midline; frontal and maxillary sinuses nontender.
Mouth: lips pink; 26 teeth, a bridge in the upper left; gums pink; tongue midline; pharynx pink; tonsils 1+; uvula rises midline.
Neck: trachea midline; thyroid smooth, not enlarged, rises with swallowing; no palpable nodes in any of the ten cervical chains; full range of motion; carotids 2+ bilaterally, no bruits.
Sitting: Posterior and Anterior Chest, Upper Limbs, Cranial Nerves
Posterior chest: spine straight; excursion 5 centimeters at T10, symmetric; tactile fremitus equal at three levels; resonant throughout; vesicular breath sounds, equal at each level compared right then left; no adventitious sounds.
Anterior chest: no deformity; resonant; vesicular sounds at the bases and bronchovesicular at the 2nd intercostal spaces, equal; no adventitious sounds.
Upper limbs: full range of motion at shoulders, elbows and wrists; no joint swelling; radial pulses 2+ bilaterally; strength 5 of 5 throughout; biceps, triceps and brachioradialis reflexes 2+ bilaterally; light touch and vibration intact in both hands.
Cranial nerves I to XII: smelled coffee each nostril; fields full; pupils as above; face symmetric on smiling and eye closure; light touch intact on the forehead, cheeks and jaw; palate rises midline; shoulder shrug 5 of 5; tongue midline.
Lying: Heart, Neck Veins, Abdomen
Position: supine, backrest raised to 30 degrees, from 1400, then flat with a pillow under the knees for the abdomen from 1410.
Jugular venous pulsation at 30 degrees: top of pulsation 1 centimeter above the sternal angle.
Heart: apical impulse small and brief, located where the left fifth interspace meets the midclavicular line; no thrill or heave felt; S1 and S2 heard at all five areas; no murmurs, gallops or rubs in supine or left lateral positions; apical rate 70, regular.
Abdomen, inspection: rounded; symmetric; umbilicus midline; no scars.
Abdomen, auscultation, 1 minute per quadrant: bowel sounds present in all four quadrants, 6 to 10 per minute; no bruits.
Abdomen, percussion: tympany in all quadrants; liver span 10 centimeters at the right midclavicular line.
Abdomen, palpation: soft on light and deep palpation in all four quadrants; nontender; liver edge felt at the costal margin on inspiration, smooth; spleen and kidneys not palpable.
Lying: Lower Limbs and Peripheral Vessels
Skin: warm, even color bilaterally; hair present to the toes; no ulcers or varicosities.
Pulses, 0 to 4+: femoral 2+ bilaterally; popliteal 1+ bilaterally; dorsalis pedis 2+ right, 2+ left; posterior tibial 2+ right, 2+ left.
Edema: none over the tibias, dorsum of the feet or ankles after 5 seconds of pressure.
Capillary refill: 2 seconds at both great toes.
Joints: full range at hips, knees and ankles; no crepitus; no effusion at either knee.
Strength: 5 of 5 in both legs at the hip, knee and ankle, against resistance in each direction tested.
Straight leg raise: to 80 degrees on each side without pain in the back or legs.
Reflexes: patellar 2+ bilaterally; Achilles 2+ bilaterally; plantar response flexor bilaterally.
Sensation: light touch and vibration intact on both feet; 10-gram monofilament felt at all sites tested.
Standing: Spine, Gait, Balance
Position: standing barefoot from 1425.
Spine, inspection from behind and the side: shoulders and iliac crests level; normal cervical and lumbar curves.
Spine, palpation: spinous processes nontender; mild tenderness in the right lumbar paraspinal muscles at the level of L3 to L4, 2 of 10.
Spine, range of motion: flexion to fingertips 10 centimeters from the floor; extension, lateral bending and rotation full, with the low-back ache on flexion only.
Gait: even stride, normal arm swing; heel-to-toe along a line; walked on heels and toes.
Romberg: stable for 30 seconds with eyes closed.
Summary
A 65-minute examination in three postures found blood pressure of 134/86 on the right, a body mass index of 29.5 and a waist circumference of 102 centimeters; soft, yellowish plaques on both upper eyelids and a gray-white ring at the edge of each cornea; a small tan macule on the left upper back; and mild right lumbar paraspinal tenderness with an ache on forward flexion. All other regions were examined and recorded in full. The student reports these findings and does not interpret them, and they were reviewed with the instructor. Genitourinary and rectal examinations were declined and are recorded as declined.
Reflection
This was the first time I examined one person from head to toe without a reason to focus on anything. I noticed my entries shrinking as I reached the legs, and caught it because the template printed the same number of rows for the lower limbs as for the eyes. Ball et al. (2023) describe the comprehensive examination as a way of building a baseline for future comparison, and a baseline that is detailed at the head and vague at the feet is only half useful. Recording posture changes also showed me how often my work notes leave position out. The findings on Mr. R.'s eyelids and corneas were the ones I would most likely have missed at work, because I rarely look at a patient's eyes closely unless something is wrong.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel's guide to physical examination: An interprofessional approach (10th ed.). Elsevier.
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.
Reading the NR 306 Week 8 instructions
The last NR 306 assignment covers one volunteer from head to foot in a single sitting, with every form row filled. Expect the form to require identifying data, consent, a general survey with vital signs and measurements, every system and a summary, sometimes with a reflection. Plan a route that limits position changes and state it, so readers can tell the record came from one encounter. Name the posture at the top of each block. Keep the same detail for late regions as for early ones. Include units with every measurement. Record anything declined. The summary lists findings that stood out and stops short of a diagnosis or plan.
How this NR 306 Week 8 example is built
The write-up opens with Mr. R., his work stacking chairs, his atorvastatin, consent with declined parts and the three-posture route. Sitting blocks cover vital signs, a body mass index of 29.5 and a waist of 102 centimeters, then skin, head, eyes with corneal rings, ears, nose, mouth and all ten node chains. Posterior and anterior chest, upper limbs and cranial nerves follow. Lying blocks cover jugular pulsation, heart sounds, the abdomen with a liver span of 10 centimeters and lower limbs with paired pulses and a straight leg raise to 80 degrees. Standing covers the spine, gait and Romberg. The summary lists what stood out, and the reflection notes entries shrinking by the legs.
NR 306 Week 8 rubric: what full points look like
Head-to-toe rubrics in this course usually grade completeness of every form row, consistency of detail, organization and documented positions, measurements with units, professional documentation of consent and a summary without diagnosis. Completeness carries a large share, so every row has an entry or a stated reason. Consistency is credited when the legs carry the same density of terms as the head. Organization scores when the route is explained and each block names its posture. Measurements earn credit with units and methods. Consent and declined parts meet the professional criterion. A summary that lists findings, including the eyelid plaques and back tenderness, without concluding fits the course scope. Stating the time each posture began confirms one continuous encounter.
NR 306 Week 8 help from the desk
The heaviest loss is the assembled document, regions copied from earlier weeks so measurements disagree. Next is a missing region, an empty row the grader spots at once. Position never stated, terminology changing between blocks, a summary that turns into a diagnosis, consent left out, measurements without units and late regions shrinking to a word all cost points. Writing up a region you never examined is the one fault no revision fixes. Earlier weeks cannot be reused. The summary needs findings, not a plan. If your volunteer declined part of the exam, record which part and why. Send the notes from your one visit, and the complete record can be set out posture by posture.
Get a NR 306 Week 8 example written to your instructions
Send the Week 8 instructions and the full template, and a custom head to toe example is written into every row it prints, in your section's terms, returned inside 24 to 48 hours. The first one is free. The encounter itself, and the person who agreed to sit through it, are not something anyone else can supply for you.
More NR 306 papers and RN-to-BSN samples
- NR 306 Week 1: Unexamined Region Discussion Post
- NR 306 Week 2: Skin Hair and Nails Write-Up
- NR 306 Week 3: Head Neck and Sinus Exam Write-Up
- NR 306 Week 4: Respiratory Exam Write-Up
- NR 306 Week 5: Heart and Vascular Exam Write-Up
- NR 306 Week 6: Abdominal Exam Write-Up
- NR 306 Week 7: Neurological Exam Write-Up
- NR 307A Week 8: Reflection
- NR 305 Week 8: Documentation Practice Reflection
- NR 351 Week 8: Reflection
- NR 300A Week 8: Independent Study Final Reflection
NR 306 Week 8 questions, answered
Can I reuse my earlier weeks in this one?
Reuse the format, not the findings. The write-up is meant to report a single continuous examination, and pasted paragraphs give themselves away because the measurements and the small details do not line up. Examining the same volunteer again is fine and often easier. What the earlier weeks genuinely provide is the wording you already know works, which saves time without importing anything untrue.
Does the summary need a diagnosis or a plan?
Not in this course. The closing section reports what the examination produced and flags anything that would be passed on, which is a different act from naming a condition or writing a plan. Courses further along take findings into a differential and a management decision; this one stops at an accurate account of where you went and what was there.
My volunteer would not undress for some of it. What do I record?
Record the limit where the region sits, name what was and was not done, and carry on. Boundaries are ordinary in a course examination and a document that shows them reads as accurate. Substituting a plausible finding for a region you never reached is the single thing that converts a mark deduction into an integrity matter, and it is easy to spot.
Where can I find a free NR 306 Week 8 sample paper?
Every block of the Week 8 examination of Mr. R., organized sitting, lying and standing, with every system and the summary, is reproduced on this page.
Why is the NR 306 Week 8 exam done in three postures?
To limit how often Mr. R. had to move: sitting for the upper body, lying for the heart, abdomen and legs, and standing for the spine, gait and balance, while still covering every row.