Streamline evaluations with detailed assessment checklists. Ensure accuracy, consistency, and efficiency in academic, workplace, and project reviews.

Assessment Checklists

This comprehensive nursing assessment guide provides a structured checklist to support nurses in performing accurate, complete patient evaluations. It covers all major body systems—neurological, cardiovascular, respiratory, gastrointestinal, musculoskeletal, integumentary, and genitourinary—along with vital signs, pain assessment, and psychosocial factors. Designed to improve documentation, ensure continuity of care, and promote early detection of health issues in clinical settings.

Thorough nursing assessment checklist covering all body systems and patient care areas to ensure accurate, consistent, and holistic patient evaluation.

Comprehensive Nursing Assessment Checklist

Confirm patient identity using two identifiers (e.g. name, date of birth)

Assess level of consciousness / orientation (person, place, time, situation)

Note general appearance (hygiene, dress, posture, distress)

Observe behavior, mood, communication (speech clarity, affect)

Assess mobility, gait, ability to reposition, use of assistive devices

Note respiratory effort (e.g. labored breathing, use of accessory muscles)

Assess signs of distress (e.g. diaphoresis, pallor, cyanosis)

Check nutritional state (weight, BMI, muscle wasting, edema)

Assess hydration status (skin turgor, mucous membranes, capillary refill)

Ask about chief complaint / presenting symptoms (onset, location, severity, pattern)

Patient Overview / General Survey

Measure temperature, heart rate, respiratory rate, blood pressure, oxygen saturation

Assess pain: use a pain scale (0–10, faces, etc.)

Use pain assessment mnemonic (e.g. PQRST or SOCRATES) to characterize pain

Check pulse (rate, rhythm, amplitude) at peripheral sites

Monitor for changes/trends compared to baseline

Assess for presence of fever, hypothermia, abnormal vital patterns

Document time, method, conditions of measurement (position, rest)

Reassess pain after analgesic intervention or over time

Report critical vital sign values immediately (per protocol)

Vital Signs & Pain Assessment

Inspect skin color, moisture, temperature, texture

Check for lesions, rashes, bruises, scars, pressure areas

Check for edema (pitting, nonpitting) and note grade

Assess integrity of skin in pressure points (heels, sacrum, elbows, occiput)

Assess wounds, incisions, drains: location, size, depth, exudate, odor

Inspect hair distribution, scalp condition, lice, alopecia

Inspect nails (color, shape, capillary refill, clubbing)

Assess for signs of skin breakdown or moisture-associated damage

Check for signs of infection (redness, warmth, swelling, pain)

Skin, Hair, Nails & Integumentary System

Inspect head shape, symmetry, scalp, facial features

Inspect eyes: eyelids, conjunctiva, sclera, pupils (size, equality)

Test pupillary reaction to light (PERRLA: Pupils Equal, Round, Reactive to Light and Accommodation)

Assess extraocular movements (six directions)

Inspect ears: external appearance, canal, discharge, hearing (whisper test)

Inspect nose: symmetry, patency, mucous membranes, septum

Inspect mouth, lips, gums, tongue, mucosa, teeth, throat, uvula

Check swallowing ability, gag reflex (if indicated)

Head, Eyes, Ears, Nose, Mouth, Throat

Inspect neck symmetry, skin, visible pulsations

Palpate trachea for position and deviation

Palpate thyroid gland (size, nodules, tenderness)

Check range of motion of neck (flexion, extension, rotation, lateral flexion)

Palpate for lymph nodes (preauricular, postauricular, submandibular, cervical, supraclavicular)

Assess carotid pulses one side at a time, listen for bruits

Observe jugular venous pressure / distention (JVP)

Check for signs of endocrine dysfunction (goiter, tremor, dry skin)

Note any swelling, masses, tenderness in neck structures

Assess accessory muscle strength (e.g. shrug resistance)

Neck, Lymphatic, Endocrine

Auscultate heart sounds (S1, S2, extra sounds, murmurs)

Check bilateral peripheral pulses (radial, brachial, dorsalis pedis, posterior tibial)

Assess pulse symmetry, rate, rhythm, strength

Inspect extremities for color, temperature, edema

Assess for venous insufficiency signs: varicosities, stasis changes

Check for peripheral perfusion (coolness, pallor)

Assess for skin changes (hair loss on extremities, ulcerations)

Monitor for signs of deep vein thrombosis (pain, swelling, redness)

Cardiovascular & Peripheral Vascular System

Inspect chest shape, symmetry, use of accessory muscles

Assess chest expansion / symmetry (palpation)

Auscultate lung fields (anterior, posterior, lateral) comparing side-to-side

Note breath sounds (vesicular, bronchial, crackles, wheezes, rhonchi)

Ask about cough, sputum (color, quantity, consistency)

Assess for shortness of breath, orthopnea, dyspnea on exertion

Monitor respiratory rate, oxygen saturation, and use of supplemental O₂

Percuss lung fields if indicated (resonance, dullness)

Check for signs of respiratory distress (retractions, nasal flaring)

Assess for risk of aspiration (swallowing, gag reflex)

Respiratory / Pulmonary System

Ask about appetite, nausea, vomiting, dysphagia

Inspect abdomen (contour, symmetry, distension, scars)

Auscultate bowel sounds in all four quadrants

Palpate lightly then more deeply for tenderness, masses, organomegaly

Ask about bowel habits (frequency, consistency, color, change)

Assess urinary function (frequency, dysuria, incontinence, retention)

Monitor intake and output (urine, stool, drains)

Inspect genitalia/perineum (if indicated) for lesions, discharge

Assess for signs of fluid overload or dehydration (ascites, edema)

Gastrointestinal / Abdominal / Genitourinary

Assess range of motion (active / passive) in joints (upper & lower extremities)

Evaluate muscle strength / tone bilaterally

Assess gait, balance, ability to ambulate

Check for joint swelling, redness, tenderness, crepitus

Assess coordination, fine motor skills (e.g. finger-to-nose)

Evaluate sensation (light touch, pain, temperature) in extremities

Assess risk for falls (e.g. previous falls, weakness)

Check any assistive device function (walker, cane, braces)

Musculoskeletal / Neuromuscular / Mobility

Assess level of consciousness (alert, lethargic, stuporous, comatose)

Orientation to person, place, time, situation

Assess speech clarity, language comprehension

Test cranial nerve functions (if indicated)

Assess mood, affect, emotional state, coping, support system

Ask about sleep patterns, fatigue, restlessness

Evaluate risk of self-harm, safety, environment hazards

Assess ability to make decisions, insight, judgment

Document changes in mental status, delirium signs, or confusion

Neurological / Cognitive / Psychosocial / Safety

Track your toddler’s growth and progress with this detailed developmental assessment checklist. It covers key milestones across physical coordination, cognitive skills, language development, social interaction, and emotional responses. Designed for parents and educators, this checklist helps identify strengths and areas needing support to ensure healthy, balanced early childhood development.

Comprehensive toddler milestone checklist covering physical, cognitive, language, social, and emotional development for early growth tracking.

Toddler Assessment Checklist for Developmental Milestones

Climbs stairs with assistance or holding railing.

Can bend down to pick up toys without falling.

Begins to throw a small ball with direction.

Begins to climb onto low furniture safely.

Physical Development (Gross Motor Skills)

Picks up small objects using thumb and forefinger (pincer grasp).

Turns pages of a board book one at a time.

Attempts to use a spoon without spilling too much.

Holds a cup with both hands and drinks independently.

Starts to unzip or pull off clothing items.

Manipulates toys with buttons, levers, or moving parts.

Fine Motor Skills

Understands simple instructions like "give me the ball."

Imitates daily activities (e.g., talking on the phone).

Begins problem-solving through trial and error.

Shows curiosity and explores surroundings.

Matches shapes, colors, or sizes in simple puzzles.

Engages in pretend play (e.g., feeding a doll).

Can follow a two-step command ("pick up the toy and put it away").

Cognitive Development

Uses gestures such as pointing or waving to communicate.

Begins combining two words (e.g., "more juice").

Imitates animal sounds or familiar noises.

Tries to repeat new words heard from adults.

Can identify objects when named in books or pictures.

Asks simple questions using rising intonation ("mama?").

Language & Communication

Shows attachment to parents and familiar caregivers.

Displays affection through hugs, kisses, or smiles.

Plays alongside other children (parallel play).

Begins showing independence ("me do it").

Demonstrates separation anxiety but can be comforted.

Copies adult actions during daily routines.

Expresses different emotions like joy, frustration, or fear.

Starts to share toys or food with encouragement.

Uses comfort objects (e.g., blanket or toy) for reassurance.

Seeks approval or praise for achievements.

Social & Emotional Development

Tries to feed self using a spoon or fork.

Drinks from an open cup with little spilling.

Attempts to put on simple clothing (e.g., hat, jacket).

Points to or walks to the potty when needed.

Helps with simple cleanup (putting toys away).

Indicates hunger or thirst verbally or through gestures.

Recognizes familiar household routines (bedtime, meals).

Self-Help & Daily Living Skills

Reacts to loud sounds or music appropriately.

Enjoys touching different textures (sand, fabric, toys).

Shows interest in bright colors and lights.

Notices temperature differences (hot/cold).

Dislikes certain textures or sounds (sensitivity check).

Tracks moving objects visually across the room.

Explores toys using multiple senses (touch, taste, sound).

Enjoys motion activities (swinging, rocking).

Reacts consistently to familiar smells or tastes.

Sensory Processing & Awareness

Eats a balanced diet including fruits, vegetables, and proteins.

Follows recommended meal and snack routines.

Shows steady weight and height growth on the growth chart.

Sleeps 10–12 hours per night plus naps.

Has regular pediatric checkups and vaccinations.

Exhibits healthy bowel and bladder habits.

Shows no prolonged coughing, fatigue, or appetite loss.

Maintains good posture and energy throughout the day.

Health & Nutrition

Recognizes and avoids simple hazards (hot stove, stairs).

Uses safety gates or stays in designated play areas.

Avoids small objects that can cause choking.

Stays close to caregiver in public spaces.

Learns to hold hand when crossing the street.

Responds to "don't touch" when near unsafe items.

Identifies safe adults or caregivers in familiar settings.

Safety Awareness & Environment

Pays attention to a story for 2–5 minutes.

Responds well to praise or gentle correction.

Transitions from one activity to another with minimal upset.

Begins to imitate counting or singing songs.

Displays curiosity and exploration during play.

Engages in short structured activities (e.g., puzzles).

Begins identifying colors, shapes, or animals.

Behavior & Learning Readiness

Complete head to toe physical assessment checklist covering all essential body systems including preparation and safety, integumentary system, head and scalp examination, ENT assessment, neck and thyroid evaluation, respiratory and cardiovascular systems, abdominal examination, musculoskeletal assessment, and comprehensive neurological evaluation for thorough patient health evaluation.

Comprehensive head to toe physical assessment checklist covering preparation, integumentary, head, ENT, neck, respiratory, cardiovascular, abdomen, musculoskeletal, and neurological systems.

Head to Toe Assessment Checklist: Step-by-Step Nursing Guide

Perform hand hygiene and don gloves / PPE as needed

Verify patient identity using two identifiers

Explain the procedure and obtain consent / cooperation

Check the environment for safety and comfort (bed, rails, clutter)

Ask if patient has any immediate needs (pain, restroom, hearing aids)

Observe general appearance: posture, grooming, hygiene

Note level of consciousness, orientation, and speech

Assess visible signs of distress, pallor, diaphoresis

Obtain baseline vital signs (temperature, pulse, respiration, BP, SpO₂)

Assessment Checklists

Comprehensive Nursing Assessment Checklist

Toddler Assessment Checklist for Developmental Milestones

Head to Toe Assessment Checklist: Step-by-Step Nursing Guide

Complete Kindergarten Assessment Checklist for Teachers & Parents

Preschool Assessment Checklist for Teachers & Parents

Environmental Site Assessment Checklist (Phase 1)