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NU 518 EXAM 3: ADVANCED HEALTH ASSESSMENT EXAM
LATEST VERSION QUESTIONS AND ANSWERS 2026 EDITION
NU 518 EXAM 3: Advanced Health Assessment Practice Questions with Rationales
SECTION 1: MUSCULOSKELETAL ASSESSMENT (Questions 1-50)
1. A woman who is 8 months pregnant comments that she has noticed a change in
her posture and is having lower back pain. The nurse tells her that during
pregnancy, women have a posture shift to compensate for the enlarging fetus. This
shift in posture is known as:
A. Lordosis.
B. Scoliosis.
C. Ankylosis.
D. Kyphosis.
Answer: A. Lordosis
Rationale: Lordosis is the inward curvature of the lumbar spine that increases during
pregnancy to compensate for the growing fetus and shifting center of gravity. This
postural change commonly contributes to lower back pain in pregnant women.
Scoliosis is a lateral curvature of the spine. Ankylosis refers to joint stiffness. Kyphosis is
an exaggerated outward curvature of the thoracic spine.
2. An 85-year-old patient comments during his annual physical examination that he
seems to be getting shorter as he ages. The nurse should explain that decreased
height occurs with aging because:
A. Long bones tend to shorten with age.
B. The vertebral column shortens.
C. A significant loss of subcutaneous fat occurs.
D. A thickening of the intervertebral disks develops.
Answer: B. The vertebral column shortens
Rationale: The vertebral column shortens with aging due to thinning of intervertebral
discs, loss of bone density in the vertebrae, and compression fractures. Long bones do
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not typically shorten with age. Loss of subcutaneous fat contributes to changes in
appearance but not height. Intervertebral disks thin rather than thicken with age.
3. A patient has been diagnosed with osteoporosis and asks the nurse, "What is
osteoporosis?" The nurse explains that osteoporosis is defined as:
A. Increased bone matrix.
B. Loss of bone density.
C. New, weaker bone growth.
D. Increased phagocytic activity.
Answer: B. Loss of bone density
Rationale: Osteoporosis is a metabolic bone disease characterized by progressive loss
of bone density and deterioration of bone tissue, leading to increased fracture risk. It
results from an imbalance between bone resorption and bone formation. Increased
bone matrix is not characteristic of osteoporosis, and new bone growth is not the
defining feature.
4. The nurse is teaching a class on preventing osteoporosis to a group of
perimenopausal women. Which of these actions is the best way to prevent or delay
bone loss in this group?
A. Taking calcium and vitamin D supplements
B. Taking medications to prevent osteoporosis
C. Performing physical activity, such as fast walking
D. Assessing bone density annually
Answer: C. Performing physical activity, such as fast walking
Rationale: Weight-bearing physical activity, such as fast walking, is the best way to
prevent or delay bone loss in perimenopausal women. Exercise stimulates bone
formation and slows bone loss. While calcium, vitamin D, and medications are
important, exercise has the most significant impact on maintaining bone density.
5. A teenage girl has arrived complaining of pain in her left wrist. She was playing
basketball when she fell and landed on her left hand. The nurse examines her hand
and would expect a fracture if the girl complains of a:
A. Dull ache.
B. Deep pain in her wrist.
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C. Sharp pain that increases with movement.
D. Dull throbbing pain that increases with rest.
Answer: C. Sharp pain that increases with movement
Rationale: Fracture pain is typically described as sharp and worsens with movement or
weight-bearing. The acute, sharp nature of the pain helps differentiate fractures from
soft tissue injuries, which often present as dull aches.
6. A patient presents with joint pain, swelling, and morning stiffness lasting more
than 30 minutes. Which condition is most consistent with this presentation?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Bursitis
Answer: B. Rheumatoid arthritis
Rationale: Rheumatoid arthritis is an autoimmune inflammatory condition
characterized by symmetric joint pain, swelling, and prolonged morning stiffness lasting
more than 30-60 minutes. Osteoarthritis typically has shorter morning stiffness (<30
minutes). Gout presents with acute, severe pain usually in a single joint. Bursitis
presents with localized tenderness and swelling over bursae.
7. The nurse is assessing a patient with suspected carpal tunnel syndrome. Which
test involves tapping the median nerve at the wrist to elicit symptoms?
A. Phalen's test
B. Tinel's sign
C. Finkelstein's test
D. Allen's test
Answer: B. Tinel's sign
Rationale: Tinel's sign is performed by tapping over the median nerve at the wrist. A
positive test reproduces tingling or paresthesia in the distribution of the median nerve,
suggesting carpal tunnel syndrome. Phalen's test involves wrist flexion. Finkelstein's
test assesses for De Quervain's tenosynovitis. Allen's test evaluates arterial circulation.
8. A patient with rheumatoid arthritis is at increased risk for which of the following
extra-articular manifestations?
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A. Osteoporosis
B. Uveitis
C. Pericarditis
D. All of the above
Answer: D. All of the above
Rationale: Rheumatoid arthritis is a systemic autoimmune disease that can affect
multiple organ systems. Osteoporosis may occur due to chronic inflammation and
corticosteroid use. Uveitis is an inflammatory eye condition associated with RA.
Pericarditis is a cardiac manifestation of RA. All of these are recognized extra-articular
manifestations.
9. A patient is diagnosed with gout. Which dietary modification should the nurse
recommend to help prevent future attacks?
A. Increase intake of organ meats and shellfish
B. Increase intake of red meat and alcohol
C. Avoid purine-rich foods such as organ meats and shellfish
D. Increase intake of dairy products and vitamin C
Answer: C. Avoid purine-rich foods such as organ meats and shellfish
Rationale: Gout is caused by hyperuricemia, and purine-rich foods contribute to
increased uric acid levels. Avoiding organ meats, shellfish, and red meat helps reduce
uric acid levels. Alcohol, particularly beer, should also be limited. Increasing dairy
products and vitamin C may help reduce uric acid levels but avoiding purine-rich foods
is the primary dietary intervention.
10. A patient presents with pain and swelling at the base of the thumb. The nurse
suspects De Quervain's tenosynovitis. Which test would the nurse perform to
confirm this diagnosis?
A. Tinel's sign
B. Phalen's test
C. Finkelstein's test
D. McMurray's test
Answer: C. Finkelstein's test
Rationale: Finkelstein's test is used to diagnose De Quervain's tenosynovitis, which
affects the tendons of the abductor pollicis longus and extensor pollicis brevis. The test
involves having the patient make a fist with the thumb inside the fingers and ulnarly
NU 518 EXAM 3: ADVANCED HEALTH ASSESSMENT EXAM
LATEST VERSION QUESTIONS AND ANSWERS 2026 EDITION
NU 518 EXAM 3: Advanced Health Assessment Practice Questions with Rationales
SECTION 1: MUSCULOSKELETAL ASSESSMENT (Questions 1-50)
1. A woman who is 8 months pregnant comments that she has noticed a change in
her posture and is having lower back pain. The nurse tells her that during
pregnancy, women have a posture shift to compensate for the enlarging fetus. This
shift in posture is known as:
A. Lordosis.
B. Scoliosis.
C. Ankylosis.
D. Kyphosis.
Answer: A. Lordosis
Rationale: Lordosis is the inward curvature of the lumbar spine that increases during
pregnancy to compensate for the growing fetus and shifting center of gravity. This
postural change commonly contributes to lower back pain in pregnant women.
Scoliosis is a lateral curvature of the spine. Ankylosis refers to joint stiffness. Kyphosis is
an exaggerated outward curvature of the thoracic spine.
2. An 85-year-old patient comments during his annual physical examination that he
seems to be getting shorter as he ages. The nurse should explain that decreased
height occurs with aging because:
A. Long bones tend to shorten with age.
B. The vertebral column shortens.
C. A significant loss of subcutaneous fat occurs.
D. A thickening of the intervertebral disks develops.
Answer: B. The vertebral column shortens
Rationale: The vertebral column shortens with aging due to thinning of intervertebral
discs, loss of bone density in the vertebrae, and compression fractures. Long bones do
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not typically shorten with age. Loss of subcutaneous fat contributes to changes in
appearance but not height. Intervertebral disks thin rather than thicken with age.
3. A patient has been diagnosed with osteoporosis and asks the nurse, "What is
osteoporosis?" The nurse explains that osteoporosis is defined as:
A. Increased bone matrix.
B. Loss of bone density.
C. New, weaker bone growth.
D. Increased phagocytic activity.
Answer: B. Loss of bone density
Rationale: Osteoporosis is a metabolic bone disease characterized by progressive loss
of bone density and deterioration of bone tissue, leading to increased fracture risk. It
results from an imbalance between bone resorption and bone formation. Increased
bone matrix is not characteristic of osteoporosis, and new bone growth is not the
defining feature.
4. The nurse is teaching a class on preventing osteoporosis to a group of
perimenopausal women. Which of these actions is the best way to prevent or delay
bone loss in this group?
A. Taking calcium and vitamin D supplements
B. Taking medications to prevent osteoporosis
C. Performing physical activity, such as fast walking
D. Assessing bone density annually
Answer: C. Performing physical activity, such as fast walking
Rationale: Weight-bearing physical activity, such as fast walking, is the best way to
prevent or delay bone loss in perimenopausal women. Exercise stimulates bone
formation and slows bone loss. While calcium, vitamin D, and medications are
important, exercise has the most significant impact on maintaining bone density.
5. A teenage girl has arrived complaining of pain in her left wrist. She was playing
basketball when she fell and landed on her left hand. The nurse examines her hand
and would expect a fracture if the girl complains of a:
A. Dull ache.
B. Deep pain in her wrist.
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C. Sharp pain that increases with movement.
D. Dull throbbing pain that increases with rest.
Answer: C. Sharp pain that increases with movement
Rationale: Fracture pain is typically described as sharp and worsens with movement or
weight-bearing. The acute, sharp nature of the pain helps differentiate fractures from
soft tissue injuries, which often present as dull aches.
6. A patient presents with joint pain, swelling, and morning stiffness lasting more
than 30 minutes. Which condition is most consistent with this presentation?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Bursitis
Answer: B. Rheumatoid arthritis
Rationale: Rheumatoid arthritis is an autoimmune inflammatory condition
characterized by symmetric joint pain, swelling, and prolonged morning stiffness lasting
more than 30-60 minutes. Osteoarthritis typically has shorter morning stiffness (<30
minutes). Gout presents with acute, severe pain usually in a single joint. Bursitis
presents with localized tenderness and swelling over bursae.
7. The nurse is assessing a patient with suspected carpal tunnel syndrome. Which
test involves tapping the median nerve at the wrist to elicit symptoms?
A. Phalen's test
B. Tinel's sign
C. Finkelstein's test
D. Allen's test
Answer: B. Tinel's sign
Rationale: Tinel's sign is performed by tapping over the median nerve at the wrist. A
positive test reproduces tingling or paresthesia in the distribution of the median nerve,
suggesting carpal tunnel syndrome. Phalen's test involves wrist flexion. Finkelstein's
test assesses for De Quervain's tenosynovitis. Allen's test evaluates arterial circulation.
8. A patient with rheumatoid arthritis is at increased risk for which of the following
extra-articular manifestations?
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A. Osteoporosis
B. Uveitis
C. Pericarditis
D. All of the above
Answer: D. All of the above
Rationale: Rheumatoid arthritis is a systemic autoimmune disease that can affect
multiple organ systems. Osteoporosis may occur due to chronic inflammation and
corticosteroid use. Uveitis is an inflammatory eye condition associated with RA.
Pericarditis is a cardiac manifestation of RA. All of these are recognized extra-articular
manifestations.
9. A patient is diagnosed with gout. Which dietary modification should the nurse
recommend to help prevent future attacks?
A. Increase intake of organ meats and shellfish
B. Increase intake of red meat and alcohol
C. Avoid purine-rich foods such as organ meats and shellfish
D. Increase intake of dairy products and vitamin C
Answer: C. Avoid purine-rich foods such as organ meats and shellfish
Rationale: Gout is caused by hyperuricemia, and purine-rich foods contribute to
increased uric acid levels. Avoiding organ meats, shellfish, and red meat helps reduce
uric acid levels. Alcohol, particularly beer, should also be limited. Increasing dairy
products and vitamin C may help reduce uric acid levels but avoiding purine-rich foods
is the primary dietary intervention.
10. A patient presents with pain and swelling at the base of the thumb. The nurse
suspects De Quervain's tenosynovitis. Which test would the nurse perform to
confirm this diagnosis?
A. Tinel's sign
B. Phalen's test
C. Finkelstein's test
D. McMurray's test
Answer: C. Finkelstein's test
Rationale: Finkelstein's test is used to diagnose De Quervain's tenosynovitis, which
affects the tendons of the abductor pollicis longus and extensor pollicis brevis. The test
involves having the patient make a fist with the thumb inside the fingers and ulnarly
