Nursing (NURS) 518

Advanced Health Assessment for Nurse Practitioners


Delivery Mode: Paced/home-study online

Credits: 3

Area of Study: Applied Studies

Prerequisite: NURS 000 and NURS 516 and NURS 517 OR NURS 519
NURS 517 can be taken as a co-requisite

Precluded: NURS 520

Centre: Centre for Nursing and Health Studies


NURS 518 reviews principles of physical examination and introduces concepts and principles on which the clinical nurse practitioner role is based. These include advanced physical examination techniques, clinical decision-making principles, communication, client education and documentation.

Course Goals

At the end of this course, the student should be able to:

  1. complete a comprehensive physical examination of an adult client, including appropriate psychosocial, developmental and cultural elements;
  2. complete a focused physical examination of an adult client based on priority presenting symptoms including appropriate psychosocial, developmental and cultural elements;
  3. identify and interpret both normal and abnormal physical assessment finding;
  4. use appropriate interviewing techniques to complete a comprehensive health history
  5. synthesize health assessment information to diagnose health risks and states of health/illness;
  6. formulate preliminary differential diagnoses through the integration of client information;
  7. articulate the fundamental principles of health promotion and prevention as they relate to their individual clients, client groups, and /or the population as a whole;
  8. apply epidemiologic principles in the process of clinical decision making;
  9. apply evidenced based decision making principles to the ordering and interpretation of lab and diagnostic testing;
  10. discuss the approach to the client when conferring a diagnosis with sensitivity to the patient experience and within the philosophy of client-centered care;
  11. explore patient experiences of illness and integrate this knowledge into the context of client-centered care;
  12. explore elements within family culture and personal experiences that affect change -behaviours and outcomes in health care;
  13. communicate effectively in order to support, educate, coach and counsel clients;
  14. appropriately complete consultations/referrals for clients to other health-care providers;
  15. appropriately document clinical data, assessment findings, and differential diagnoses;
  16. explore the legalities of documentation and professional liability as they pertain to nurse practitioner practice;
  17. adhere to federal and provincial/territorial legislation, policies and standards related to privacy, documentation and information management; and
  18. practice (in the student role) in accordance with federal and provincial/territorial legislation, professional and ethical standards, and policy relevant to nurse practitioner practice.

Course Materials


Registration in this course includes an electronic textbook. For more information on electronic textbooks, please refer to our eText Initiative site.

Bickley, L. S, Szilagyi, P. G., & Hoffman, R. M. (Eds). (2020). Bates' guide to physical examination and history-taking (13th ed.). Wolters Kluwer.

Online Materials

Bickley, L. (2013). Bates' visual guide to physical examination (5th ed.). Philadelphia, PA: Wolters Kluwer.

Course Structure

NURS 518 is an asynchronous online course. Students are expected to connect to an Internet Service Provider at their own expense.

Technical Requirements

In order to successfully complete this course, you must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the Centre for Nursing and Health Studies technical site.

Course Outline

NURS 518 consists of 13 weeks grouped into four themed units:

Unit 1: Clinical Decision Making

This unit focuses on synthesizing health assessment information using critical inquiry and clinical reasoning to diagnose health risk and states of health/illness. Students will learn to apply decision-making frameworks and skills that are used in the provision of clinical services to individuals of all life stages. The unit focuses on providing the students with the fundamentals of clinical decision making in order to build a successful personal clinical decision-making framework. Students will learn the processes of formulating differential diagnoses, as well as incorporating epidemiological and health promotion principles. Students will gain an understanding of behavioral sciences and the health/illness experience.

Unit 2: Health History and Documentation

This unit focuses on the essential elements required for history taking and documentation. Students will apply advanced knowledge and skills relating to collecting appropriate health history (focused vs. complete) and completing patient documentation using SOAP format.

Unit 3: Physical Examination Principles

This unit focuses on physical examination techniques. Building on the competencies of a registered nurse, NP students will review basic health assessment principles. Students will learn advanced techniques and select diagnostic tests. Students will be introduced to the concepts of complete vs. focused physical examination and identifying and interpreting normal and abnormal findings. Using problem-based learning, students will gain an understanding of the physical examination and special tests required to accurately assess and diagnose common conditions seen in primary care.

Unit 4: Communication and Standards

The final unit focuses on the principles of collaboration, consultation and referral. Intraprofessional consultation and referrals will be introduced along with topics in patient communication. Lastly, this unit focuses on the professional role, responsibility and accountability relating to jurisdictional scope of practice.

Assessment Structure

Assessment Item Percentage of Total Grade
Problem-Based Learning Exercises and participation in Adobe sessions 10%
Assignment 1 - Health History & Documentation 15%
Assignment 2 - Case Study 25%
Exam 1 25%
Exam 2 25%
Student Physical Assessment Demonstrations Pass/Fail
Total 100%

In order to pass NURS 518, you must achieve a minimum mark of 70% on conference participation, a combined minimum average mark of 70% on the two written assignments and a combined minimum average mark of 70% on the two written examinations, and pass the Student Physical Assessment Demonstrations..

If the minimum mark is not achieved on any element of the assessment structure (conference participation, written assignments, exams or student physical assessment demonstrations component), then a failing grade will be assigned for NURS 518. In the event that the student either fails or withdraws and then re-registers in NURS 518, all elements of the course must be repeated (conference participation, written assignments, examination, and student physical assessment demonstrations component).

Problem Based Learning Exercises (10%)
Feedback regarding problem-based learning exercises will be ongoing. Quality of input (not quantity) is the goal. Feedback will focus on the student's ability to provide organized and original contributions that reflect analysis and synthesis of the material presented.

Assignment 1 – Health History and Documentation (15%) 
Assignment 2 – Case Study (25%)

Exam 1 (25%)
Exam is a multiple-choice examination at midterm. The focuses of this examination are the principles of a complete physical examination, including abnormal findings and special tests.

Exam 2 (25%)
Exam 2 consists of a of multiple choice and is written in the final week of the course using ProctorU.

Student Physical Assessment Demonstrations (Pass/Fail)
The Student Physical Assessment Demonstrations Component (including participation and successful completion of a physical assessment evaluation) is marked on a pass/fail basis. Students must pass this Component in order to pass NURS 518.

* As of Spring 2020, there have been no in-person NURS 518 physical assessment residencies. As an alternative, we have delivered physical assessment demonstrations and mentorship via virtual “lab” groups using Microsoft Teams®. Students are separated into 3 lab groups each lead by a separate instructor. Lab instructors, via Microsoft Teams, guide students through system based physical assessments and discuss office-based procedures. Unlike past in-person residencies, there is not a dedicated lab week – rather, lab activities take place weekly throughout the 13-week course. Lab activities are in addition to required PBL postings, assignments and exams led by course instructors. Please note – you MUST have access to a partner (e.g., spouse, other adult or adult sized teen) to practice assessments and for testing.

Athabasca University reserves the right to amend course outlines occasionally and without notice. Courses offered by other delivery methods may vary from their individualized-study counterparts.

Opened in Revision 2, April 2017