| Course | NURS 505 Advanced Health / Physical Assessment (NURS505) |
|---|---|
| Module/Week | 3 |
| Assignment | SOAP Note on Skin, Hair, Nails and HEENT |
| Paper type | SOAP note with theory, health promotion, family life stage and cultural sections |
| Length | about 1,143 words, 4 double-spaced pages plus title page and references. Course guide: 3 to 5 pages excluding title and reference pages, with at least 3 scholarly references including the text and 2 peer-reviewed articles from the past 5 years |
| Format | APA 7 student paper |
| Points | 100 |
| School | Liberty University Online |
| Program | MSN |
| Where it sits | Module/Week 3 in Liberty's published NURS 505 course guide; current sections can differ |
| Updated | October 2026 |
Free sample paper for NURS 505 Week 3
SOAP Note: Skin, Hair, Nails, and HEENT Examination of a 34-Year-Old Landscaper With Spring Nasal Symptoms and a New Forearm Spot
[Student Name]
School of Nursing, Liberty University
NURS 505: Advanced Health / Physical Assessment
SOAP Note
[Instructor Name]
[Date]
The volunteer and all findings are composites written for a model SOAP note; no real person is described.
SOAP Note: Skin, Hair, Nails, and HEENT Examination of a 34-Year-Old Landscaper With Spring Nasal Symptoms and a New Forearm Spot
Subjective
Chief Concern
"My nose has been stuffy for a month, and my partner noticed a new dark spot on my arm."
History of Present Illness
The volunteer, a 34-year-old landscaper, reports nasal congestion, clear runny nose, sneezing in bursts and itchy eyes that began about five weeks ago when trees started to bloom and that are worst on mowing days. Symptoms have occurred each spring for about ten years. There is no fever, facial pain, thick nasal discharge or change in smell. An over-the-counter oral antihistamine helps the itching but causes daytime drowsiness at work. Separately, the volunteer's partner noticed a brown spot on the left forearm about two months ago; the volunteer is unsure whether it is new and reports no itching, bleeding or change in size.
Pertinent History
The volunteer has no chronic illnesses, takes no regular medications and has no known drug allergies. There is no history of asthma, eczema or skin cancer. A parent had a basal cell carcinoma removed from the nose at 61. The volunteer works outdoors seven to nine hours a day from March to November, uses sunscreen "sometimes," has had several blistering sunburns, never uses tanning beds and does not smoke.
Review of Systems for the Assigned Areas
Skin: frequent tanning and sunburn on the arms and neck; no rashes or nonhealing sores. Hair: no hair loss. Nails: no changes. Head: no headaches or injury. Eyes: itching and watering in spring; no vision changes or pain; wears no corrective lenses. Ears: no hearing loss, pain or drainage. Nose: congestion, rhinorrhea and sneezing as described; no nosebleeds. Throat: occasional throat clearing from postnasal drip; no sore throat or hoarseness.
Objective
Findings below use the descriptive terms of the course text (Bickley et al., 2021).
Vital signs: temperature 98.2 degrees F, pulse 72, respirations 14, blood pressure 118/74 mm Hg. Skin: tanned skin on the forearms, neck and face with scattered freckles; skin warm and dry with normal turgor. On the dorsal left forearm, a 5 mm round, flat, uniformly light-brown macule with smooth, regular borders and no scaling, bleeding or surrounding redness; no other atypical pigmented lesions on the arms, back, scalp, face or legs. Hair: evenly distributed, normal texture. Nails: pink, smooth, no clubbing or pitting, capillary refill under 2 seconds. Head: normocephalic, no lesions or tenderness. Eyes: Snellen chart reading of 20/20 right and left; mild bilateral conjunctival injection without discharge; pupils equal, round and reactive to light; extraocular movements intact; red reflex present. Ears: canals clear with small amounts of soft cerumen; tympanic membranes pearly gray with visible landmarks; the volunteer repeated whispered words correctly from 2 feet on each side. Nose: nasal mucosa pale and swollen with clear, thin discharge; septum midline; no polyps; no sinus tenderness. Mouth and throat: moist mucosa, good dentition, tonsils 1+ without exudate; posterior pharynx with a cobblestone appearance. Neck: no lymphadenopathy.
Assessment
- 1. Seasonal allergic rhinitis with allergic conjunctivitis, supported by a ten-year springtime pattern, sneezing, itching, clear discharge, pale swollen nasal mucosa and cobblestoning of the posterior pharynx. Allergic rhinitis affects an estimated 15% of the U.S. population and commonly presents with congestion, rhinorrhea, sneezing and itchy eyes (Bernstein et al., 2024).
- 2. Benign-appearing acquired nevus of the left forearm, 5 mm, with none of the ABCDE warning features of asymmetry, irregular border, color variation, diameter over 6 mm or reported evolution.
- 3. Chronic occupational sun exposure with a history of blistering sunburns and a first-degree relative with basal cell carcinoma, increasing skin cancer risk.
The examination found two ordinary conditions and one risk that matters more than either over a working lifetime: years of unprotected sun.
Plan
For allergic rhinitis, start an intranasal corticosteroid such as fluticasone propionate, two sprays in each nostril daily, which is first-line therapy for persistent symptoms (Bernstein et al., 2024), and consider replacing the sedating antihistamine with a second-generation one if eye itching persists. Teach correct spray technique, aiming away from the septum, and explain that full effect takes about a week. Suggest saline rinses after mowing and wraparound sunglasses to reduce pollen exposure to the eyes. For the nevus, photograph it with a ruler for comparison and recheck in three months, with prompt return for any change in size, shape or color. For sun exposure, counsel daily broad-spectrum sunscreen of SPF 30 or higher reapplied every two hours outdoors, wide-brimmed hats and long, lightweight sleeves. Routine skin examinations by clinicians for adults without symptoms are not recommended for or against, because the evidence is insufficient (U.S. Preventive Services Task Force, 2023), so the plan focuses on prevention and on evaluating any lesion that changes, with a low threshold for dermatology referral given the family history.
Nursing Theory
Pender's health promotion model explains why the volunteer uses sunscreen only "sometimes." In Pender's account, whether a person takes up a healthy habit depends on past habits and personal traits, on how the person weighs what the habit offers against what it costs, on confidence in carrying it out, and on the people around them (Pender et al., 2015). The volunteer perceives sunscreen as greasy and easy to sweat off, a barrier, and sees little benefit because past sunburns healed. The parent's skin cancer and the partner's concern about the forearm spot are interpersonal influences that can be used to strengthen perceived benefit, and choosing a sweat-resistant stick sunscreen kept in the truck reduces the barrier.
Health Promotion
Beyond sun protection, health promotion for this volunteer includes an annual influenza vaccine, hearing protection while using mowers and leaf blowers, eye protection from debris, hydration and heat illness prevention on summer workdays, and a routine dental visit, which the volunteer had not had in two years.
Family Life Stage
The volunteer lives with a partner and their two-year-old child, a family in the stage of families with young children, in which adults adjust work and relationships to make room for a dependent child. The volunteer's long outdoor workdays and the toddler's needs leave little time for self-care, so health advice should fit into existing routines, such as applying sunscreen while preparing the child for day care.
Cultural Characteristics
The volunteer grew up on a family farm in southwestern Virginia and describes the family's attitude toward health as "you work through it." The volunteer prefers to try simple remedies before medicines and values direct, practical advice. Asked about faith, the volunteer described attending a small country church and finding strength in it. Recommendations were framed in practical terms that respect the volunteer's preference for self-reliance, and no assumptions were made beyond what the volunteer shared.
Evaluation
The examination went well, but I would change two things. I examined the skin of the arms and back thoroughly but initially skipped the scalp and the backs of the ears, areas of heavy sun exposure for outdoor workers, and returned to them only at the end. I also asked about sunscreen before asking about sunburn history, which may have made the volunteer defensive; asking about work and sun first would have been more natural.
References
Bernstein, J. A., Bernstein, J. S., Makol, R., & Ward, S. (2024). Allergic rhinitis: A review. JAMA, 331(10), 866-877. https://doi.org/10.1001/jama.2024.0530
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.
Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health promotion in nursing practice (7th ed.). Pearson.
U.S. Preventive Services Task Force. (2023). Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA, 329(15), 1290-1295. https://doi.org/10.1001/jama.2023.4342
What the NURS 505 Week 3 instructions ask
For the NURS 505 SOAP Note, Liberty's guide asks students to examine a friend or family volunteer, 18 or older and not a current clinical patient, concentrating on the integument and on the structures above the neck that HEENT covers. The document follows the course's SOAP note instructions and includes the SOAP note itself plus sections on a nursing theory, health promotion, family life stage, cultural characteristics and evaluation. Its body runs three to five pages, with the title page and references excluded from that count, follows APA style and cites three or more scholarly sources, among them the textbook and two journal articles that were peer reviewed and are no more than five years old. The bloodborne pathogen form must be on file before the note is accepted, and the assignment is worth 100 points in Module/Week 3.
How this NURS 505 Week 3 example is built
The note keeps the four SOAP parts strictly separate, because mixing reported symptoms with examination findings is the most common error. Subjective data include the chief concern, its history, relevant past history and a focused review of systems. Objective data use the assessment text's terminology and describe each structure examined with measurements and standard terms, including a lesion described by size, color, border and symmetry. The assessment lists diagnoses with the findings that support them, and the plan gives treatment, education and follow-up for each. The remaining sections apply Pender's health promotion model, the family life cycle, the volunteer's own cultural preferences and a short self-evaluation of the examination.
NURS 505 Week 3 grading rubric: where the points go
The NURS 505 SOAP note is typically graded on accurate and complete subjective and objective data for the assigned systems, a logical assessment supported by findings, an appropriate plan, the quality of the theory, health promotion, family life stage and cultural sections, the evaluation, the use of required sources, and APA format within three to five pages. Graders look closely at whether subjective and objective information are kept apart and whether examination findings use correct terminology. The assessment earns full credit when every diagnosis is supported by data in the note. The supplemental sections need to be specific to this volunteer rather than general descriptions of theories or stages.
NURS 505 Week 3 help: mistakes that cost points
The errors that cost the most on this note are mixing the volunteer's statements into the objective section, writing findings in vague terms such as "normal ears" instead of describing the canal and tympanic membrane, and listing diagnoses that no finding supports. Students also write the theory and cultural sections as textbook summaries that never mention the volunteer, or rely on stereotypes about a culture rather than what the volunteer said. Describe any skin lesion by size, shape, color and border, use the textbook's terms, cite the two recent peer-reviewed articles where they inform the plan, and keep the note within five pages.
Related NURS 505 sample papers
Other NURS 505 weeks
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- NURS 505 Week 2: Genomics and Genetics Presentation
- NURS 505 Week 4: Discussion Board Forum 1
- NURS 505 Week 5: Cultural and Spiritual Assessment
- NURS 505 Week 6: Discussion Board Forum 2
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NURS 505 Week 3 questions, answered
What is the NURS 505 SOAP Note assignment?
It is a Module/Week 3 assignment in which students examine an adult volunteer's skin, hair, nails and HEENT and write a 3 to 5 page SOAP note with sections on nursing theory, health promotion, family life stage, culture and evaluation.
Where can I find a free NURS 505 Week 3 sample paper?
The NURS 505 Week 3 SOAP note for a 34-year-old landscaper volunteer, with every required section, references and grading notes, can be read here from first heading to last reference, free.
What goes in the subjective part of a SOAP note?
Everything the patient or volunteer reports: the chief concern, history of present illness, relevant past, family and social history, medications, allergies and the review of systems.
How do you describe a skin lesion in a SOAP note?
Give its location, size in millimeters, shape, color, border, elevation and any surface change, and note the ABCDE features for pigmented lesions: asymmetry, border, color, diameter and evolution.
Which nursing theory fits a health promotion SOAP note?
Pender's health promotion model is a common choice, because it explains how personal factors, perceived benefits and barriers, and self-efficacy shape whether a person adopts a health behavior.
Use it as a model, or ask for your own
This paper is an original model written by our desk for study. It is not a submitted student paper and not an official Liberty University document. Read it for structure and reasoning, then write your own to the instructions in your Canvas course. If you want a version built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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