NU 345 Unit 4 Sample Paper

Health Assessment and Health Promotion Plan for a 68-Year-Old Man With a 32 Pack-Year Smoking History and Untreated Elevated Blood Pressure

[Author Name]

College of Nursing, Herzing University

NU 345 Health Assessment and Promotion Across the Life Span

Unit 4 Assignment

[Instructor Name]

August 11, 2026

Original model document written by our desk. The patient is a composite built for teaching; no real person, family or clinic is described.

What this page is doingThe title sheet names the two facts that drive every later decision, the pack-year history and the untreated elevated readings, so a grader knows before the first paragraph what this plan has to answer. Age and sex appear in the title because both change eligibility for screening. The line under the course name uses the form students type rather than an official name this desk cannot verify, and the composite line at the foot keeps the paper clear of any suggestion that a real patient is being described.

Subjective Data: History, Risk and Life Stage

The patient is a 68-year-old man who came to a community clinic for a wellness visit at the urging of his wife, with no complaint of his own beyond feeling 'slower on the stairs than last year.' He retired 14 months ago after 31 years as a warehouse supervisor. Medical history includes osteoarthritis of both knees, benign prostatic hyperplasia and hyperlipidemia. He takes tamsulosin 0.4 mg daily and ibuprofen 400 mg two or three times most days for knee pain, which he did not list as a medication until asked directly. He smoked about one pack a day for 32 years and stopped six years ago. He drinks two beers on most evenings and more at family gatherings.

Functional history matters more than a symptom list at this age, so it was taken in detail. He climbs 12 stairs to his bedroom and rests at the top, manages all activities of daily living without help, drives in daylight only, and has stopped attending his monthly union breakfast since retiring. He reports two near-falls in the past six months, both on the same uneven porch step, and no fall with injury. He sleeps about six hours and wakes twice to urinate. He denies chest pain, syncope, dyspnea at rest, hemoptysis and unintended weight loss. Life stage is relevant rather than decorative here: this is the review-and-integrity stage of later adulthood, and losing a work role in the same year as a shrinking social circle is a documented risk for both inactivity and low mood.

Social and screening history sets up the plan. He lives with his wife of 41 years in a single-story house with a porch step that has no rail and no outside light. Diet is described as 'whatever is quick,' with a sandwich lunch and a restaurant meal three evenings out of seven. Physical activity is mowing the lawn and walking the dog for about ten minutes at a time. His last colonoscopy was eight years ago with no polyps reported, his last tetanus booster was about twelve years ago, he received an influenza vaccine last autumn, and he has never had an abdominal ultrasound or a lung imaging study. He has no advance directive and has not discussed one.

What this page is doingCredit in a history section comes from what the student asked, not from length. Function, home layout, near-falls and the lost work role are gathered because each one becomes a line in the plan later. The ibuprofen detail is the sharpest move here: it surfaces only because the interview asked about non-prescription medicines directly, and it changes both the kidney reading and the blood pressure discussion. Life stage is stated as a risk factor rather than as a label.

Objective Findings and What They Mean

Vital signs: temperature 36.8 C, heart rate 78 and regular, respiratory rate 16, oxygen saturation 96 percent on room air, height 178 cm, weight 90 kg, body mass index 28.4, waist circumference 104 cm. Blood pressure was 148/88 mm Hg in the right arm after five minutes seated, and 152/86 mm Hg on a repeat in the same arm at the end of the visit. Two readings at one visit are a signal, not a diagnosis. Both sit above the threshold that prompts action, and the next step is confirmation outside the clinic with home or ambulatory readings before any label or medication is attached, because clinic-only elevation is common at this age and would otherwise be treated as disease.

Focused examination, read cluster by cluster. Cardiovascular: S1 and S2 present, no murmur, no third heart sound, no carotid bruit, pedal pulses 2+ and symmetric, no peripheral edema; taken with the elevated readings, the absence of end-organ signs suggests elevation that is recent or intermittent rather than long-standing. Respiratory: symmetric chest expansion, resonant percussion, breath sounds clear with no wheeze or crackles; a clear examination does not remove lung risk in a former smoker, since screening exists precisely because early disease is silent. Musculoskeletal and gait: bilateral knee crepitus with five degrees of flexion loss, gait speed 0.78 meters per second over four meters, nine repetitions on the 30-second chair stand. Those two numbers, read with the near-falls and the unlit step, place him in the group for whom fall prevention is an active plan rather than advice.

Laboratory findings and what the combination means. Total cholesterol 214 mg/dL, low-density lipoprotein 138 mg/dL, high-density lipoprotein 42 mg/dL, triglycerides 168 mg/dL, creatinine 1.1 mg/dL with an estimated glomerular filtration rate of 68 mL/min/1.73 m2. The lipid panel alone says little at 68. The same numbers combined with age, sex, smoking history and the unconfirmed blood pressure produce a ten-year cardiovascular risk high enough to open a statin conversation, and that combination is the finding rather than any single value. The filtration rate matters for a different reason: it is the number that makes daily ibuprofen a risk worth naming out loud, alongside the blood pressure that drug may be raising. Whispered voice screening failed at 60 cm on the left ear.

What this page is doingInterpretation sits in the same paragraph as the finding, which is what separates an assessment write-up from a checklist. The blood pressure line refuses the easy conclusion and names the next step, which is the single sentence most rubrics reward. Normal findings are interpreted too: a clear chest is explained as consistent with silent early disease rather than treated as reassurance. Gait speed and the chair stand are read together with the near-falls rather than left as isolated measures.

Health Promotion Plan: Screening, Immunization and Teaching

Screening is written with the rule that makes him eligible and the interval that follows. Colorectal cancer: the U.S. Preventive Services Task Force recommends screening adults aged 45 to 75, so he qualifies for seven more years; his colonoscopy eight years ago with no polyps places the next examination at the ten-year mark in two years, with annual fecal immunochemical testing offered as the alternative. Lung cancer: annual low-dose computed tomography is recommended for adults aged 50 to 80 with a 20 pack-year history who currently smoke or who quit within the past 15 years; at 68, with 32 pack-years and six years since quitting, he meets every part of that rule and has never been screened. Abdominal aortic aneurysm: one ultrasound is recommended for men aged 65 to 75 who have ever smoked, and he is inside that band now.

Immunization and follow-up carry intervals of their own. The adult schedule places influenza vaccine annually, a tetanus and diphtheria booster every ten years, which is overdue by about two years here, recombinant zoster vaccine as two doses for adults 50 and older, and pneumococcal vaccination for adults 65 and older who have not completed a series. Blood pressure is not treated at this visit. He leaves with a validated upper-arm monitor, written instruction to take two readings each morning and two each evening for seven days, and an appointment in 14 days to bring the log. Daily ibuprofen is addressed at the same visit, with a plan to move to scheduled acetaminophen and a topical agent for the knees.

Teaching is written as actions with numbers attached, because instructions without numbers cannot be measured at the next visit. Physical activity builds toward 150 minutes of moderate activity spread across at least five of every seven days, starting from three ten-minute walks a day, with two sessions of lower-body strength work added because muscle strength is what the chair-stand result identified as weak. Fall prevention is specific: a handrail and a light on the porch step, a safety check of the two rooms he moves through at night, and a repeat gait-speed measure in three months. Two behavior goals were set with him rather than for him: alcohol to no more than one drink on most evenings, and one social activity restarted before the next visit.

What this page is doingEvery screening line carries three things: the eligible age band, the condition that qualifies this patient, and the interval that follows. That structure lets a reader check the recommendation against the source instead of taking it on trust. Immunizations are given with their intervals, including the booster that is overdue. Teaching is converted into counted behavior with a follow-up measure attached, so the next visit can tell whether the plan worked.

References

Centers for Disease Control and Prevention. (2025). Recommended adult immunization schedule, United States, 2025. U.S. Department of Health and Human Services. https://www.cdc.gov/vaccines/hcp/imz-schedules/index.html

Jarvis, C., & Eckhardt, A. (2024). Physical examination and health assessment (9th ed.). Elsevier.

U.S. Preventive Services Task Force. (2019). Abdominal aortic aneurysm: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

U.S. Preventive Services Task Force. (2021). Colorectal cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

U.S. Preventive Services Task Force. (2021). Hypertension in adults: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening

U.S. Preventive Services Task Force. (2021). Lung cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening

How this NU 345 Unit 4 example is structured

In many sections this unit asks for a health assessment write-up with a promotion plan attached; your classroom's instructions and rubric decide the exact form, so read the assignment page before you use this NU 345 Unit 4 example as a shape. The paper runs in the order the nursing process runs. Subjective data comes first, including the life stage and the recent role change, because those facts explain findings that would otherwise look like isolated numbers. Objective data follows, and each cluster of findings is read for meaning in the same paragraph where it appears rather than left for a summary. The plan comes last and is written as decisions: what is screened, how often, who qualifies, and what the patient is taught to do between visits.

NU 345 Unit 4 questions, answered

What does it mean to interpret a finding instead of recording it?

Recording says the blood pressure was 148/88. Interpreting says what two elevated readings at one visit do and do not establish, and names the next step. The test is simple: after each cluster of findings, answer the question so what in one sentence a reader could act on. Normal findings need that sentence as much as abnormal ones.

How specific do screening recommendations have to be?

Specific enough to check. Name the eligible age band, the risk condition that qualifies your patient, the test and the interval, then say which of those your patient meets. Annual low-dose computed tomography for adults 50 to 80 with a 20 pack-year history is checkable; recommend cancer screening is not, and graders read the difference quickly.

Do I have to use a real patient for this write-up?

Sections differ, so read the assignment page first. Many ask for a composite or a volunteer adult rather than a clinical patient, and none of them want identifiable details in a submitted paper. Build the case from a realistic history, keep the numbers internally consistent, and state once in the paper that the person described is a composite.

Write yours, or have the desk draft it

This paper is an original model document written by our desk, not a submitted student paper and not an official Herzing University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.

NU 345 Unit 4: sample paper, in real form