NSG 521 ADVANCED HEALTH ASSESSMENT (PDF) | 2026
EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. Which of the following statements about toilet training is incorrect?
A) Nighttime continence occurs after daytime
B) Girls develop bladder control faster than boys
C) Children must be able to voice the desire to void prior to starting toilet training
D) Bladder control is present at 1 year of age
Correct Answer: D) Bladder control is present at 1 year of age
Rationale: Bladder control is typically not achieved until around 2 years of age, when toilet
training usually begins. Nighttime continence develops after daytime control, girls generally
develop bladder control faster than boys, and children should be able to communicate the desire
to void before training starts .
2. You are performing a focused assessment on a patient's urinary output. Which of
the following findings does NOT require follow-up?
A) Pain to lower back with urination
B) Urine with mucus in it
C) Discharge from the urinary meatus
D) Urine sample with a pH of 4.8
Correct Answer: D) Urine sample with a pH of 4.8
Rationale: Normal urine pH ranges from 4.6 to 8.2, with typical values around 5-6 . A pH of 4.8
falls within the normal range and does not require follow-up. Lower back pain with urination,
discharge from the meatus, and visible mucus in the urine are all abnormal findings that warrant
further investigation .
3. The nurse is assessing a patient with the following: peaked T waves, irregular
rhythm on the telemetry monitor, and the patient is complaining of fluttering in the
chest. The nurse suspects which electrolyte disorder?
A) Sodium
B) Calcium
C) Magnesium
D) Potassium
Correct Answer: D) Potassium
,Rationale: Elevated potassium (hyperkalemia) is associated with peaked T waves on ECG,
cardiac arrhythmias, and palpitations. Hypokalemia (low potassium) is associated with flattened
T waves, U waves, and can be caused by diuretics, nausea/vomiting, and laxative use .
4. True or False: Patients on a renal diet should eat foods high in potassium and
sodium.
A) True
B) False
Correct Answer: B) False
Rationale: Patients on a renal diet (due to renal failure or dialysis) should restrict foods high in
potassium and sodium. Patients with constipation benefit from a high-fiber diet, including beans
and vegetables .
5. If this electrolyte imbalance is not treated timely, prolonged effects of an elevated
level could cause: kidney stones, kidney failure, osteoporosis, and confusion. Which
electrolyte is described?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: C) Calcium
Rationale: Hypercalcemia (elevated calcium) can cause nausea, vomiting, constipation, bone
pain, excessive urination, thirst, confusion, lethargy, and slurred speech. Complications include
kidney stones, kidney failure, and osteoporosis. Hypocalcemia presents with numbness/tingling,
tetany, muscle cramps, and seizures .
6. Which of the following body systems influence the acid-base balance to produce
compensatory changes for a patient experiencing metabolic acidosis?
A) Vascular/veins
B) Hepatic/liver
C) Renal/kidneys
D) Respiratory/lungs
Correct Answer: D) Respiratory/lungs
Rationale: Metabolic acidosis is an acidotic state originating in the kidneys. The lungs
compensate by increasing respiratory rate to blow off CO2. Conversely, respiratory acidosis
originates in the lungs, with the kidneys compensating by retaining bicarbonate .
, 7. True or False: Hypervolemia is caused by prolonged nausea, vomiting, and
diarrhea.
A) True
B) False
Correct Answer: B) False
Rationale: Hypervolemia is fluid volume excess caused by sodium/water retention.
Hypovolemia (fluid volume deficit) is caused by prolonged nausea, vomiting, and diarrhea. In
hypervolemia, interventions may include diuretics and fluid restriction .
8. True or False: If a patient complains of tenderness to a quadrant of the abdomen,
the nurse should not assess that quadrant for fear of injury to the patient.
A) True
B) False
Correct Answer: B) False
Rationale: The nurse should save the most tender area for last when assessing the four
abdominal quadrants. The order of evaluation is: (1) inspect in supine position, (2) auscultate
(listen for up to 5 minutes in each quadrant, starting in the LRQ and working clockwise), (3)
percuss, and (4) palpate .
9. The nurse is teaching an older adult patient about changes to the GI system that
occur with aging. Which of the following should the nurse NOT include?
A) Stool moves more slowly through the intestine as we age
B) Medication absorption decreases as kidneys and liver function slow down
C) Drooling develops as swallowing becomes impaired
D) Dentition does not affect the digestive process
Correct Answer: D) Dentition does not affect the digestive process
Rationale: Dentition DOES affect the digestive process, as chewing is the first step in
mechanical digestion. Age-related changes include slowed intestinal motility, decreased
medication absorption due to reduced kidney/liver function, and potential swallowing
difficulties .
10. The nurse assesses an abdominal fluid wave. She knows this is likely indicative of
which condition?
A) Appendicitis
B) Ascites
EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. Which of the following statements about toilet training is incorrect?
A) Nighttime continence occurs after daytime
B) Girls develop bladder control faster than boys
C) Children must be able to voice the desire to void prior to starting toilet training
D) Bladder control is present at 1 year of age
Correct Answer: D) Bladder control is present at 1 year of age
Rationale: Bladder control is typically not achieved until around 2 years of age, when toilet
training usually begins. Nighttime continence develops after daytime control, girls generally
develop bladder control faster than boys, and children should be able to communicate the desire
to void before training starts .
2. You are performing a focused assessment on a patient's urinary output. Which of
the following findings does NOT require follow-up?
A) Pain to lower back with urination
B) Urine with mucus in it
C) Discharge from the urinary meatus
D) Urine sample with a pH of 4.8
Correct Answer: D) Urine sample with a pH of 4.8
Rationale: Normal urine pH ranges from 4.6 to 8.2, with typical values around 5-6 . A pH of 4.8
falls within the normal range and does not require follow-up. Lower back pain with urination,
discharge from the meatus, and visible mucus in the urine are all abnormal findings that warrant
further investigation .
3. The nurse is assessing a patient with the following: peaked T waves, irregular
rhythm on the telemetry monitor, and the patient is complaining of fluttering in the
chest. The nurse suspects which electrolyte disorder?
A) Sodium
B) Calcium
C) Magnesium
D) Potassium
Correct Answer: D) Potassium
,Rationale: Elevated potassium (hyperkalemia) is associated with peaked T waves on ECG,
cardiac arrhythmias, and palpitations. Hypokalemia (low potassium) is associated with flattened
T waves, U waves, and can be caused by diuretics, nausea/vomiting, and laxative use .
4. True or False: Patients on a renal diet should eat foods high in potassium and
sodium.
A) True
B) False
Correct Answer: B) False
Rationale: Patients on a renal diet (due to renal failure or dialysis) should restrict foods high in
potassium and sodium. Patients with constipation benefit from a high-fiber diet, including beans
and vegetables .
5. If this electrolyte imbalance is not treated timely, prolonged effects of an elevated
level could cause: kidney stones, kidney failure, osteoporosis, and confusion. Which
electrolyte is described?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: C) Calcium
Rationale: Hypercalcemia (elevated calcium) can cause nausea, vomiting, constipation, bone
pain, excessive urination, thirst, confusion, lethargy, and slurred speech. Complications include
kidney stones, kidney failure, and osteoporosis. Hypocalcemia presents with numbness/tingling,
tetany, muscle cramps, and seizures .
6. Which of the following body systems influence the acid-base balance to produce
compensatory changes for a patient experiencing metabolic acidosis?
A) Vascular/veins
B) Hepatic/liver
C) Renal/kidneys
D) Respiratory/lungs
Correct Answer: D) Respiratory/lungs
Rationale: Metabolic acidosis is an acidotic state originating in the kidneys. The lungs
compensate by increasing respiratory rate to blow off CO2. Conversely, respiratory acidosis
originates in the lungs, with the kidneys compensating by retaining bicarbonate .
, 7. True or False: Hypervolemia is caused by prolonged nausea, vomiting, and
diarrhea.
A) True
B) False
Correct Answer: B) False
Rationale: Hypervolemia is fluid volume excess caused by sodium/water retention.
Hypovolemia (fluid volume deficit) is caused by prolonged nausea, vomiting, and diarrhea. In
hypervolemia, interventions may include diuretics and fluid restriction .
8. True or False: If a patient complains of tenderness to a quadrant of the abdomen,
the nurse should not assess that quadrant for fear of injury to the patient.
A) True
B) False
Correct Answer: B) False
Rationale: The nurse should save the most tender area for last when assessing the four
abdominal quadrants. The order of evaluation is: (1) inspect in supine position, (2) auscultate
(listen for up to 5 minutes in each quadrant, starting in the LRQ and working clockwise), (3)
percuss, and (4) palpate .
9. The nurse is teaching an older adult patient about changes to the GI system that
occur with aging. Which of the following should the nurse NOT include?
A) Stool moves more slowly through the intestine as we age
B) Medication absorption decreases as kidneys and liver function slow down
C) Drooling develops as swallowing becomes impaired
D) Dentition does not affect the digestive process
Correct Answer: D) Dentition does not affect the digestive process
Rationale: Dentition DOES affect the digestive process, as chewing is the first step in
mechanical digestion. Age-related changes include slowed intestinal motility, decreased
medication absorption due to reduced kidney/liver function, and potential swallowing
difficulties .
10. The nurse assesses an abdominal fluid wave. She knows this is likely indicative of
which condition?
A) Appendicitis
B) Ascites
