| Course | NS310 Nutritional Assessment |
|---|---|
| Unit | Unit 7 |
| Paper type | Clinical observation write-up |
| Length | About 930 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Nutrition Science |
| Updated | October 2026 |
Free sample paper for NS310 Unit 7
Six Signs, No Diagnosis: A Unit 7 Clinical Observation Write-Up Reading a Course Case From Temples to Fingernails
[Student Name]
Purdue University Global
NS310: Nutritional Assessment
Unit 7 Clinical Observation Write-Up
[Instructor Name]
[Date]
The course case and its photographs are composite; the consensus statement, physical assessment review and nail review cited are real.
Source of the Observations
The observations come from a written case and six photographs supplied by the course: a 64-year-old woman seen in an outpatient clinic, with a stable weight over three months, poor appetite and fatigue. The writer performed no examination. Every description below is of a photograph or of the case text, and confidence is rated with that in mind.
Method
Signs are read head to toe, the convention of a nutrition-focused physical examination, so that none is chosen because it fits a theory. For each sign the write-up gives five things: a description in standard terms, the nutrients associated with it, non-nutritional explanations, further evidence that would help and a confidence rating of low, moderate or high that the sign reflects nutrition.
Sign 1: Temporal Hollowing
Description: mild concavity at both temples, visible in the frontal photograph. Nutrient association: loss of muscle from protein and energy deficit, since the temporalis is one of the sites the Academy and ASPEN consensus statement lists for assessing muscle loss (White et al., 2012). Other explanations: normal aging and a naturally lean face. Helpful evidence: an older photograph, and examination of other muscle sites. Confidence: moderate.
Sign 2: Prominent Clavicles
Description: clavicles clearly visible with hollowing above and below. Nutrient association: loss of muscle and fat around the shoulder girdle, another consensus site (White et al., 2012). Other explanations: body build, and posture in the photograph. Helpful evidence: palpation of the deltoids and pectorals, and grip strength. Confidence: moderate.
Sign 3: Angular Cheilitis
Description: cracking and redness at both corners of the mouth. Nutrient association: riboflavin, niacin, pyridoxine and iron deficiency have all been linked to it (Esper, 2015). Other explanations: ill-fitting dentures, which the case mentions; drooling or lip licking; yeast infection. Helpful evidence: a dental check of denture fit, and a dietary record of B vitamin and iron intake. Confidence: low, because the dentures are a ready explanation.
Sign 4: Smooth, Red Tongue
Description: loss of the papillae on the upper surface of the tongue, which appears smooth and beefy red. Nutrient association: iron, folate, vitamin B12, riboflavin and niacin deficiency (Esper, 2015). Other explanations: dry mouth from medicines, oral yeast infection. Helpful evidence: complete blood count, ferritin, B12 and folate. Confidence: moderate, because it occurs with sign 6.
Sign 5: Pitting Edema at Both Ankles
Description: a 2+ pit at both ankles, recovering slowly after pressure in the case description. Nutrient association: severe protein deficiency can contribute, and fluid accumulation is one of the consensus characteristics of malnutrition (White et al., 2012). Other explanations: heart failure, kidney or liver disease, venous insufficiency and calcium channel blockers such as amlodipine, which she takes. Helpful evidence: her medication list reviewed by a clinician, and kidney and liver tests. Confidence: low as a nutrition sign.
The edema row carries an extra point. Fluid in the legs adds weight, so her stable weight may hide a loss of tissue. Edema matters twice: once as a sign, and once as a reason to distrust the scale.
Because fluid can replace lost tissue on the scale, the stable weight in this case is not evidence against malnutrition, and the muscle signs at the temples and clavicles deserve more weight than the number on the scale.
Sign 6: Spoon-Shaped Nails
Description: koilonychia on several fingers, with nail plates thin and concave enough to hold a drop of water. Nutrient association: iron deficiency is the best-known cause in adults (Walker et al., 2016). Other explanations: the condition can be hereditary, can follow trauma or repeated contact with water and solvents, and occurs with some other disorders (Walker et al., 2016). Helpful evidence: ferritin and hemoglobin, and a history of her hands' work and her family. Confidence: moderate.
Reading the Signs Together
Two clusters emerge. The temples and clavicles suggest muscle loss, which is relevant to protein and energy intake. The tongue and nails suggest a micronutrient problem, with iron the common link. The cheilitis and edema each have strong non-nutritional explanations in this case and are given low confidence.
No single sign establishes anything. Together they justify a full nutrition assessment, laboratory tests for iron status and B vitamins, and a dental review.
How the Findings Would Be Documented
A chart note built from this write-up would describe, not conclude. A suitable entry might read: "Bilateral mild temporal hollowing and prominent clavicles on photographs. Cracking at both oral commissures; patient wears dentures, fit not assessed. Smooth red dorsal tongue. Koilonychia, several fingers. 2+ pitting edema both ankles; on amlodipine. Recommend in-person nutrition-focused physical exam, CBC, ferritin, B12, folate, and dental review of denture fit."
Each sentence names what was seen and where. None uses the words deficiency, malnutrition or wasting, because those are conclusions the evidence does not yet support. Medication and dental facts sit beside the signs they could explain, so a later reader does not mistake a drug effect for a nutrition finding. Recommendations follow from the gaps in the evidence rather than from a suspected diagnosis.
Limits
Photographs flatten depth and cannot be palpated. Lighting changes how red a tongue looks. The writer cannot test grip, press an ankle or feel muscle. The confidence ratings are the writer's judgment, offered to be checked by an examiner in person.
References
Esper, D. H. (2015). Utilization of nutrition-focused physical assessment in identifying micronutrient deficiencies. Nutrition in Clinical Practice, 30(2), 194-202. https://doi.org/10.1177/0884533615573054
Walker, J., Baran, R., Velez, N., & Jellinek, N. (2016). Koilonychia: An update on pathophysiology, differential diagnosis and clinical relevance. Journal of the European Academy of Dermatology and Venereology, 30(11), 1985-1991. https://doi.org/10.1111/jdv.13610
White, J. V., Guenter, P., Jensen, G., Malone, A., Schofield, M., Academy Malnutrition Work Group, A.S.P.E.N. Malnutrition Task Force, & A.S.P.E.N. Board of Directors. (2012). Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). Journal of Parenteral and Enteral Nutrition, 36(3), 275-283. https://doi.org/10.1177/0148607112440285
The Purdue Global NS310 Unit 7 instructions
The Unit 7 assignment asks students to observe or read physical signs relevant to nutrition and to interpret them cautiously. Prompts usually provide a case, photographs or a supervised observation. State the source of the observations and whether you examined anyone. Work head to toe so no sign is chosen to fit a theory. Describe each sign in standard terms before linking it to nutrients. List more than one nutrient where the literature does. Always give non-nutritional explanations, including medicines and dental problems. Rate your confidence for each sign and explain the rating. Say what further evidence would help. Avoid naming a deficiency as a conclusion. Expect three to four pages.
How this NS310 Unit 7 example is built
An opening note says the observations come from a written case and six photographs and that no examination was performed. A method section sets the five headings used for each sign. The temples and clavicles are linked to muscle loss using the consensus statement's sites. Cheilitis is rated low because of ill-fitting dentures. The tongue and nails are linked to iron and B vitamins, with a nail review supplying other causes. The edema row explains how fluid can mask weight loss. The highlighted sentence draws that inference. Signs are grouped into two clusters. A documentation section gives a sample chart note. A limits section explains what photographs cannot show. Each sign closes with a confidence rating and the reason for it.
Where the points sit in the NS310 Unit 7 rubric
Marks for this unit generally reward precise wording, even-handed interpretation and caution about what the evidence allows. Standard terms for each sign earn credit for precision. Points go to listing several associated nutrients and at least one non-nutritional explanation for every sign. Confidence ratings should be explained, not just assigned. Recognizing how one sign affects the reading of another, such as edema and weight, shows integration. Sources for each association are expected. Organization and APA style are also scored. Write-ups that jump to a diagnosis usually lose credit for scope. Suggesting specific further evidence, such as a blood count, often lifts the analysis. Noting a medicine that could explain a sign is often what separates strong write-ups from average ones.
NS310 Unit 7 help from the desk
Observation write-ups often name a deficiency for each sign as if the link were certain. Another weakness is describing signs in casual terms that a clinician could not use. Some writers skip non-nutritional explanations, such as dentures or medicines. Confidence is rarely rated, so every sign seems equally important. Signs are read in isolation instead of in clusters. The limits of photographs are seldom acknowledged. Documentation examples, where included, often contain conclusions rather than descriptions. If you have the case but are unsure how cautious to be, rate each sign's confidence before writing anything else. Those ratings give a writer the frame for the rest of the paper.
Get an NS310 Unit 7 example written to your instructions
Your NS310 Unit 7 case may describe different signs or a different age, or come with photographs. Forward the case materials as supplied, plus the rubric and any required assessment form. Each sign comes back described in standard terms, weighed against ordinary causes and left short of a diagnosis; the free first custom sample takes 24-48 hours. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NS310 Unit 7 questions, answered
Am I expected to examine a real person for this unit?
Usually not. Nutrition-focused physical examination is a clinical skill taught under supervision, and most sections supply described or photographed signs instead. Where a prompt does involve observing someone, it typically limits the task to visible features with consent. The example states its source in the first sentence so there is no doubt about what the writer did.
How should confidence in each sign be rated?
By how specific the sign is and how clearly it was observed. A single sign with many possible causes rates low; several signs pointing the same way, with supporting history, rate higher. The example uses a three-level scale and explains each rating in a phrase, which graders tend to prefer over unexplained percentages or scores.
Can the write-up say which nutrient is most likely low?
It can say which associations are more common in the literature and what further evidence would test them, such as a blood count for the nail and tongue findings. It should not settle on one deficiency as a conclusion. That judgment needs laboratory results and clinical assessment, and the example leaves it explicitly with the care team.
Where can I find a free NS310 Unit 7 sample paper?
This page has a complete Unit 7 clinical observation write-up reading six physical signs head to toe, with nutrient associations, other explanations and confidence ratings.
What causes spoon-shaped nails?
Iron deficiency is the best-known cause in adults, but koilonychia can also be hereditary, follow trauma or repeated contact with water and solvents, or occur with other conditions.