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NU 518 EXAM 1: ADVANCED HEALTH ASSESSMENT EXAM
LATEST VERSION QUESTIONS AND ANSWERS 2026 EDITION
NU 518 EXAM 1: ADVANCED NURSING ASSESSMENT
QUESTIONS 1-50: FOUNDATIONS AND HEALTH HISTORY
1. A new patient presents to the clinic with the chief complaint of "I am here to
establish care." For which type of health history is this patient most appropriate?
A. Focused health history addressing only the present illness
B. Comprehensive health history including all components
C. Interim health history with review of systems only
D. Problem-oriented health history addressing chief complaint
Correct Answer: B
Rationale: A comprehensive health history is appropriate for new patients establishing
care. It includes the full health history components: chief complaint, present illness,
past medical history, family history, personal and social history, and review of systems.
A focused history would be appropriate for specific acute problems. A comprehensive
history provides the baseline needed for ongoing care .
2. Which of the following is NOT a component of a standard health history?
A. Review of systems
B. Present illness
C. Personal and social history
D. Thorax and lungs
Correct Answer: D
Rationale: The components of a health history include chief complaint, present illness,
past medical history, family history, personal and social history, and review of systems.
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"Thorax and lungs" is a component of the physical examination, not the health history.
The physical exam findings are documented separately from the health history .
3. A patient reports, "I have had shortness of breath for the past 10 days; it is worse
with activity and relieved by rest." This information is classified as:
A. Objective data
B. Subjective data
C. Reflective data
D. Introspective data
Correct Answer: B
Rationale: Subjective data are information the patient reports—symptoms, feelings,
perceptions, and personal history. The patient's description of shortness of breath, its
duration, and aggravating/relieving factors is subjective because it reflects the patient's
experience. Objective data are observable and measurable (e.g., respiratory rate of 32
breaths per minute) .
4. A patient has a respiratory rate of 32 breaths per minute and a pulse rate of 120
beats per minute. This information is classified as:
A. Subjective data
B. Objective data
C. Reflective data
D. Diagnostic data
Correct Answer: B
Rationale: Objective data are observable, measurable, and verifiable through physical
examination, vital signs, and laboratory findings. A respiratory rate of 32 and pulse rate
of 120 are objective measurements obtained during the physical assessment. These
findings can be confirmed by another examiner, unlike subjective symptoms the patient
describes .
5. The following information is documented: "The patient has had abdominal pain
for 1 week. The pain lasts for 30 minutes at a time; it comes and goes. The severity
is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is
located in the midepigastric area." This belongs in which category?
A. Chief complaint
B. Present illness
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C. Personal and social history
D. Review of systems
Correct Answer: B
Rationale: The present illness (or history of present illness—HPI) section describes the
patient's current health problem in detail, including onset, duration, location, severity,
character, timing, aggravating/relieving factors, and associated symptoms. This is the
detailed expansion of the chief complaint. The chief complaint would be a brief
statement like "abdominal pain" .
6. "Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal
dyspnea." This statement belongs in which category of the health history?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems
Correct Answer: D
Rationale: The review of systems (ROS) is a systematic review of body systems to
identify symptoms the patient may not have mentioned spontaneously. Documenting
that the patient denies cardiac symptoms is part of the cardiovascular ROS. The ROS
covers all major body systems and documents the presence or absence of relevant
symptoms .
7. Which of the following is considered a first-level priority problem?
A. Patient with postoperative pain
B. Newly diagnosed diabetic patient who needs teaching
C. Patient with a small laceration on the sole of the foot
D. Patient with shortness of breath and respiratory distress
Correct Answer: D
Rationale: First-level priority problems are immediate, life-threatening concerns
requiring urgent intervention. Respiratory distress and shortness of breath indicate
airway, breathing, or circulation compromise, making it a first-level priority.
Postoperative pain, diabetes teaching, and lacerations are second-level or third-level
priorities .
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8. Second-level priority problems include which of the following?
A. Low self-esteem
B. Lack of knowledge
C. Abnormal laboratory values
D. Severely abnormal vital signs
Correct Answer: C
Rationale: Second-level priority problems are those that require prompt intervention
but are not immediately life-threatening. Abnormal laboratory values (e.g., elevated
glucose, electrolyte imbalances) fall into this category. Low self-esteem and lack of
knowledge are third-level priorities (long-term health problems). Severely abnormal vital
signs would be first-level priorities .
9. Which critical thinking skill helps the nurse recognize relationships among
assessment data?
A. Intuition
B. Diagnostic reasoning
C. Clinical judgment
D. Analytical reasoning
Correct Answer: B
Rationale: Diagnostic reasoning is the process of analyzing and interpreting
assessment data to identify patterns, relationships, and potential diagnoses. It involves
moving from data collection through hypothesis generation and testing to diagnosis.
Intuition is the automatic recognition of patterns without conscious reasoning, but
diagnostic reasoning is the deliberate analytical process .
10. Novice nurses, without a background of skills and experience, are more likely to
make clinical decisions based on:
A. Intuition
B. A set of rules and guidelines
C. Published research articles
D. Advice from supervisors
Correct Answer: B
Rationale: Novice nurses typically use rule-based clinical decision-making, applying
learned guidelines and algorithms to patient situations. Expert nurses develop the
ability to recognize patterns and use intuition based on extensive experience. Novices
NU 518 EXAM 1: ADVANCED HEALTH ASSESSMENT EXAM
LATEST VERSION QUESTIONS AND ANSWERS 2026 EDITION
NU 518 EXAM 1: ADVANCED NURSING ASSESSMENT
QUESTIONS 1-50: FOUNDATIONS AND HEALTH HISTORY
1. A new patient presents to the clinic with the chief complaint of "I am here to
establish care." For which type of health history is this patient most appropriate?
A. Focused health history addressing only the present illness
B. Comprehensive health history including all components
C. Interim health history with review of systems only
D. Problem-oriented health history addressing chief complaint
Correct Answer: B
Rationale: A comprehensive health history is appropriate for new patients establishing
care. It includes the full health history components: chief complaint, present illness,
past medical history, family history, personal and social history, and review of systems.
A focused history would be appropriate for specific acute problems. A comprehensive
history provides the baseline needed for ongoing care .
2. Which of the following is NOT a component of a standard health history?
A. Review of systems
B. Present illness
C. Personal and social history
D. Thorax and lungs
Correct Answer: D
Rationale: The components of a health history include chief complaint, present illness,
past medical history, family history, personal and social history, and review of systems.
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"Thorax and lungs" is a component of the physical examination, not the health history.
The physical exam findings are documented separately from the health history .
3. A patient reports, "I have had shortness of breath for the past 10 days; it is worse
with activity and relieved by rest." This information is classified as:
A. Objective data
B. Subjective data
C. Reflective data
D. Introspective data
Correct Answer: B
Rationale: Subjective data are information the patient reports—symptoms, feelings,
perceptions, and personal history. The patient's description of shortness of breath, its
duration, and aggravating/relieving factors is subjective because it reflects the patient's
experience. Objective data are observable and measurable (e.g., respiratory rate of 32
breaths per minute) .
4. A patient has a respiratory rate of 32 breaths per minute and a pulse rate of 120
beats per minute. This information is classified as:
A. Subjective data
B. Objective data
C. Reflective data
D. Diagnostic data
Correct Answer: B
Rationale: Objective data are observable, measurable, and verifiable through physical
examination, vital signs, and laboratory findings. A respiratory rate of 32 and pulse rate
of 120 are objective measurements obtained during the physical assessment. These
findings can be confirmed by another examiner, unlike subjective symptoms the patient
describes .
5. The following information is documented: "The patient has had abdominal pain
for 1 week. The pain lasts for 30 minutes at a time; it comes and goes. The severity
is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is
located in the midepigastric area." This belongs in which category?
A. Chief complaint
B. Present illness
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C. Personal and social history
D. Review of systems
Correct Answer: B
Rationale: The present illness (or history of present illness—HPI) section describes the
patient's current health problem in detail, including onset, duration, location, severity,
character, timing, aggravating/relieving factors, and associated symptoms. This is the
detailed expansion of the chief complaint. The chief complaint would be a brief
statement like "abdominal pain" .
6. "Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal
dyspnea." This statement belongs in which category of the health history?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems
Correct Answer: D
Rationale: The review of systems (ROS) is a systematic review of body systems to
identify symptoms the patient may not have mentioned spontaneously. Documenting
that the patient denies cardiac symptoms is part of the cardiovascular ROS. The ROS
covers all major body systems and documents the presence or absence of relevant
symptoms .
7. Which of the following is considered a first-level priority problem?
A. Patient with postoperative pain
B. Newly diagnosed diabetic patient who needs teaching
C. Patient with a small laceration on the sole of the foot
D. Patient with shortness of breath and respiratory distress
Correct Answer: D
Rationale: First-level priority problems are immediate, life-threatening concerns
requiring urgent intervention. Respiratory distress and shortness of breath indicate
airway, breathing, or circulation compromise, making it a first-level priority.
Postoperative pain, diabetes teaching, and lacerations are second-level or third-level
priorities .
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8. Second-level priority problems include which of the following?
A. Low self-esteem
B. Lack of knowledge
C. Abnormal laboratory values
D. Severely abnormal vital signs
Correct Answer: C
Rationale: Second-level priority problems are those that require prompt intervention
but are not immediately life-threatening. Abnormal laboratory values (e.g., elevated
glucose, electrolyte imbalances) fall into this category. Low self-esteem and lack of
knowledge are third-level priorities (long-term health problems). Severely abnormal vital
signs would be first-level priorities .
9. Which critical thinking skill helps the nurse recognize relationships among
assessment data?
A. Intuition
B. Diagnostic reasoning
C. Clinical judgment
D. Analytical reasoning
Correct Answer: B
Rationale: Diagnostic reasoning is the process of analyzing and interpreting
assessment data to identify patterns, relationships, and potential diagnoses. It involves
moving from data collection through hypothesis generation and testing to diagnosis.
Intuition is the automatic recognition of patterns without conscious reasoning, but
diagnostic reasoning is the deliberate analytical process .
10. Novice nurses, without a background of skills and experience, are more likely to
make clinical decisions based on:
A. Intuition
B. A set of rules and guidelines
C. Published research articles
D. Advice from supervisors
Correct Answer: B
Rationale: Novice nurses typically use rule-based clinical decision-making, applying
learned guidelines and algorithms to patient situations. Expert nurses develop the
ability to recognize patterns and use intuition based on extensive experience. Novices
