| Course | NU 610 Advanced Health Assessment |
|---|---|
| Unit | Unit 8 |
| Paper type | Comprehensive physical examination record |
| Length | About 1,160 words, 7 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Family Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 610 Unit 8
Comprehensive Physical Examination of a 42-Year-Old Woman Establishing Primary Care
Student Name
Department of Nursing, Herzing University
NU 610: Advanced Health Assessment
Instructor Name
April 6, 2026
Comprehensive Physical Examination of a 42-Year-Old Woman Establishing Primary Care
Record Conventions
This is the objective record for Ms. T., a composite 42-year-old accountant establishing care, built for teaching. Her history was documented separately. The examination follows a fixed head-to-toe order, and each system is described physically whether or not it produced anything unexpected, because a new patient's first comprehensive record becomes the baseline against which every later finding is compared (Bickley et al., 2021). Positions are stated wherever a finding depends on one, and paired structures carry sides. Unexpected findings are left in the system where they were found and gathered only in the summary at the end, following the organization recommended by Jarvis and Eckhardt (2024).
General Survey
Appears stated age. Well groomed, dressed appropriately for the weather, makeup applied evenly, nails clean and trimmed. Sitting upright and relaxed on the examination table, making steady eye contact, speech fluent at a normal rate and volume with clear articulation. No distress, no tremor, no unusual movements. Gait on entering is smooth and symmetric with normal arm swing and a narrow base. Body habitus is evenly distributed with some central adiposity.
Vital Signs and Measurements
BP 136/86 left arm and 138/88 right arm, seated after five minutes of rest, adult cuff. Pulse 74 per minute, regular, radial. Respirations 16 per minute, even and unlabored. Temperature 98.1 F, temporal. Oxygen saturation 98% breathing room air. Height 65 inches, weight 176 pounds, body mass index 29.3. Waist circumference 36 inches at the iliac crest. Pain 0 of 10.
Skin, Hair, and Nails
Skin warm and dry, even light brown color, turgor with prompt recoil over the clavicle. Velvety, darker, slightly thickened skin in a band at the back of the neck and in both axillae. Three flat, uniformly tan macules under 4 mm on the upper back with smooth borders. No rashes, ulcers, or bruising. Scalp hair evenly distributed, fine texture, no areas of loss. Nails pink with capillary refill under 2 seconds, no clubbing, no pitting or ridging.
Head, Eyes, Ears, Nose, and Throat
Head normocephalic, scalp without lesions or tenderness. Face symmetric at rest and with expression. Visual acuity by Snellen chart without correction 20/25 in the right eye and 20/20 in the left. Conjunctivae pink, sclerae white. Pupils 4 mm, round, equal, constricting briskly to direct and consensual light; accommodation present. Extraocular movements full in all six directions without nystagmus. Funduscopic examination: red reflex present bilaterally; optic discs with sharp margins and yellow-orange color, cup-to-disc ratio about 0.3 on both sides; no arteriovenous nicking, hemorrhages, or exudates seen.
External ears without lesions. Canals clear; tympanic membranes pearly gray and translucent with visible bony landmarks and a cone of light at five o'clock on the right and seven o'clock on the left. Whispered voice heard at arm's length in each ear. Nasal mucosa pink and moist, septum midline, no discharge. Frontal and maxillary sinuses nontender. Lips moist without lesions. Oral mucosa pink, dentition in good repair with two posterior fillings, gums without swelling or bleeding. Tongue midline on protrusion. Uvula rises in the midline with phonation; tonsils 1+ bilaterally without exudate.
Neck and Lymph Nodes
Trachea midline. Full range of motion without pain. Thyroid examined from behind with the patient seated, neck slightly flexed, during swallowing of water: the isthmus is palpable; at the inferior end of the right lobe the fingers find a firm, smooth, nontender nodule of roughly 1.5 cm that rises with each swallow; the left lobe is smooth without nodules. No thyroid bruit. No palpable preauricular, postauricular, occipital, tonsillar, submandibular, submental, cervical, or supraclavicular lymph nodes on either side.
Chest and Lungs
Patient seated. Chest symmetric, anteroposterior diameter less than transverse. Respiratory expansion equal bilaterally on palpation at the tenth rib level. Tactile fremitus equal on both sides. Percussion resonant throughout both lung fields posteriorly and anteriorly; diaphragmatic excursion about 5 cm bilaterally. Breath sounds vesicular over the peripheral fields and bronchovesicular near the upper sternum, with no crackles, wheezes, or rubs.
Breasts and Axillae
Examined with a chaperone present, patient seated and then supine with the ipsilateral arm raised. Breasts symmetric in size and contour, no skin dimpling or retraction with arms raised or hands pressed on hips. Nipples everted without discharge. Palpation of all four quadrants and the tail of Spence on both sides by vertical strip pattern reveals no masses or tenderness. Axillae: skin changes noted above; no palpable nodes.
Cardiovascular
Carotid upstrokes brisk and equal, no bruits. Jugular venous pressure estimated at 7 cm, trunk raised to 30 degrees. Apical impulse in the left fifth interspace, midclavicular, about 2 cm across and tapping in quality. No heaves or thrills. S1 and S2 crisp, physiologic splitting of S2 at the left second interspace with inspiration, no S3 or S4, no murmurs, rubs, or gallops in any area with the diaphragm or bell. Pulses are 2+ at every site checked (radial, femoral, popliteal, posterior tibial, then dorsalis pedis), equal right and left. No edema.
Abdomen
Patient supine with knees slightly flexed. Abdomen rounded, symmetric, with fine silver striae on both lower quadrants and no scars. Bowel sounds normoactive, auscultated before palpation. No aortic, renal, or iliac bruits. Tympany over most of the abdomen. Liver span about 9 cm at the right midclavicular line by percussion; edge felt 1 cm below the costal margin on deep inspiration, smooth and nontender. Spleen not palpable. Light and deep palpation without tenderness or masses. No costovertebral angle tenderness on either side.
Musculoskeletal
Spine straight on inspection from behind, no scoliosis on forward bend. Full active range of motion of the cervical and lumbar spine, shoulders, elbows, wrists, hands, hips, knees, and ankles, without pain, crepitus, or swelling. Muscle bulk symmetric. Strength 5 of 5 in shoulder abduction, elbow flexion and extension, grip, hip flexion, knee extension, and ankle dorsiflexion and plantar flexion, bilaterally.
Neurologic
Alert and oriented to person, place, date, and purpose of the visit. Recalls three of three words at five minutes. Cranial nerves II through XII intact, tested individually. Light touch, pinprick, and vibration at the great toes intact and symmetric. Deep tendon reflexes 2+ and equal at the biceps, triceps, brachioradialis, patellar, and Achilles; plantar responses flexor. Finger-to-nose and heel-to-shin smooth. Rapid alternating movements intact. Romberg negative. Tandem gait steady.
Summary of Unexpected Findings
Three findings depart from what was expected, gathered here in the order they were found. First, blood pressure of 136/86 and 138/88 on a single visit, above the normal range, to be confirmed with repeat measurements, including readings outside the clinic, before any label is applied (Krist et al., 2021). Second, velvety thickened skin at the back of the neck and axillae, consistent with acanthosis nigricans, recorded with body mass index of 29.3 and waist circumference of 36 inches. Third, a firm, smooth, mobile 1.5 cm nodule at the inferior end of the right thyroid lobe. All other systems were examined and described above as the baseline for this patient.
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. L. (2024). Physical examination and health assessment (9th ed.). Elsevier.
Krist, A. H., Davidson, K. W., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Kubik, M., Li, L., Ogedegbe, G., Pbert, L., Silverstein, M., Stevermer, J., Tseng, C.-W., & Wong, J. B. (2021). Screening for hypertension in adults: US Preventive Services Task Force reaffirmation recommendation statement. JAMA, 325(16), 1650-1656. https://doi.org/10.1001/jama.2021.4987
NU 610 Unit 8 instructions, in plain terms
The Unit 8 assignment asks for a complete written physical examination of an adult, usually a composite or volunteer, documented system by system in a consistent order. Expect to include a general survey, full vital signs with measurements such as body mass index, and each body system with inspection, palpation, percussion and auscultation as they apply. Findings must be described rather than labeled normal, and patient position and technique should appear where they affect results. Many sections ask for a summary of abnormal or unexpected findings at the end, with a brief note on follow-up. Sensitive examinations may be documented as deferred or done with a chaperone according to the course rules. The record should read like chart documentation, with APA references for the techniques and any screening recommendation used. Check the classroom for a required template or length.
How this NU 610 Unit 8 example is built
The record opens with a short conventions paragraph stating the order of systems and that the history appears elsewhere. The general survey describes grooming, posture, speech and affect in concrete terms. Vital signs list blood pressure in both arms after rest, with the cuff size, and include weight, height and body mass index. Each system follows with findings described precisely: Snellen values for each eye, a thyroid examined from behind during swallowing with a firm nodule at the lower right lobe, apical impulse location and size, and bowel sounds heard before palpation. Skin findings include darker velvety patches at the neck and axillae. The summary then gathers the three departures from the expected, an elevated blood pressure to confirm, the thyroid nodule and the skin change, and pairs each with a plan and a cited source.
Reading the NU 610 Unit 8 rubric
Herzing rubrics for the comprehensive exam usually allocate points for completeness, systematic organization, descriptive accuracy, identification of abnormal findings and professional documentation. Completeness points require every system to be present with appropriate techniques, not just a list of headings. Organization is scored on a consistent head-to-toe order that another clinician could follow. Descriptive accuracy is often weighted highest, with full credit for measured or specific findings such as numbers, locations and sizes instead of the word normal. Identification of abnormal findings is credited when they are summarized clearly and linked to a sensible next step. Documentation points include correct terminology, approved abbreviations and appropriate notes on chaperones or deferred exams. APA citations for the examination conventions and any guideline cited are usually checked under the writing criterion.
NU 610 Unit 8 help before you submit
The largest loss on this record is the word normal used as a finding, which hides what was actually assessed. Students also skip vital sign details such as arm, position or cuff size, which matter when a value is borderline. Some records drift out of order, placing lung findings inside the cardiac section, and the grader loses the thread. Abnormal findings scattered through the record without a closing summary often lose identification points. Another mistake is copying the earlier focused write-up into this one without updating it for a different patient. Sensitive exams should not be invented; if they were not performed, document them as deferred with a reason. Finally, an overlong record full of repeated phrases can still lose points for readability, so keep descriptions specific and brief.
Get a NU 610 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NU 610 classroom, plus the template your section requires and any case or patient profile you were given. We write a custom example that holds the descriptive standard across every system and returns the abnormal findings in a closing summary, delivered in 24 to 48 hours. The first custom sample is free.
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NU 610 Unit 8 questions, answered
Do I have to perform a full examination on a real person?
That depends entirely on your instructions, and sections differ. Where a live examination is required, the encounter, your clinical hours and any form your preceptor signs are yours alone and are never produced for you by anyone. What can be shown is the finished record: how a complete write-up is ordered, how each system is described and where the abnormal findings are gathered at the end.
Can I reuse my earlier focused write-up inside this one?
Reuse the standard, not the text. The focused record justified a narrow examination, while this one has to cover everything at a consistent depth, so lifting paragraphs usually produces a document with one unusually detailed system and several thin ones. Rewrite the region at the same descriptive level as its neighbors and let the closing summary carry the emphasis instead.
How is a comprehensive record kept readable at this length?
Through order and headings rather than compression. A fixed head to toe sequence with visible headings lets a reader jump to any system, which is what keeps length from becoming a burden. Sentences stay short and physical, one finding at a time. What you should not do is buy readability by replacing descriptions with summary words, since that is precisely what the criterion penalizes.
Where can I find a free NU 610 Unit 8 sample paper?
This page gives the entire NU 610 Unit 8 head-to-toe record free, with every system documented and the closing summary of unexpected findings. Working from another patient or a set template? Request a custom record, free, usually ready in 24 to 48 hours.
What order should a NU 610 comprehensive exam follow?
Follow a fixed head-to-toe sequence: general survey, vital signs, skin, head and neck, chest and lungs, breasts, heart, abdomen, musculoskeletal and neurologic. Keeping the same order every time lets the next reader find a system quickly, and the summary of unexpected findings goes at the end.