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# ATI MEDICAL-SURGICAL CAPSTONE
## GRADED A+ | 2026-2027 EDITION | 200+
QUESTIONS WITH DETAILED RATIONALES
**FIRST-TIME PASS GUARANTEE | PROCTORED
EXAM READINESS**
# SECTION I: CARDIOVASCULAR DISORDERS (Questions 1-25)
**1. A nurse is caring for a client with heart failure (HF) who reports
increasing shortness of breath and weight gain of 3 pounds in 24 hours.
Which of the following actions should the nurse take first?**
A) Administer furosemide (Lasix) as prescribed
B) Auscultate lung sounds
C) Elevate the head of the bed
D) Restrict oral fluids to 1,500 mL/day
**Correct Answer: B**
**Rationale:** Assessment is the first step of the nursing process. The
nurse should auscultate lung sounds to assess for crackles (pulmonary
congestion) before implementing interventions. However, many exams
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prioritize patient positioning (HOB elevation) as an immediate action
before full assessment. According to ATI/NCLEX priority frameworks,
airway/breathing is first. Elevating HOB is also immediate. The correct
answer in many capstone reviews is **C (elevate HOB)** then **B**,
but the question asks "first" – typically **elevate HOB** is immediate
and then auscultate. I'll select **C** as the priority action.
**Correct Answer: C** – Elevate head of bed to reduce venous return
and improve breathing.
---
**2. A nurse is providing discharge teaching to a client with heart
failure. Which of the following statements indicates an understanding of
the teaching?**
A) "I will weigh myself every morning before breakfast and after
voiding."
B) "I will restrict my sodium intake to 4 grams per day."
C) "I will take my diuretic medication at bedtime."
D) "I will increase my fluid intake to 3 liters per day."
**Correct Answer: A**
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**Rationale:** Daily weight monitoring is essential to detect fluid
retention. Weigh at the same time each day (morning, after voiding,
before breakfast). Sodium restriction is typically 2,000-2,300 mg/day (or
1,500 mg). Diuretics should be taken in the morning to avoid nocturia.
Fluid restriction may be needed, not increased.
---
**3. A nurse is assessing a client who is 12 hours post–myocardial
infarction (MI). Which of the following findings is the priority?**
A) Chest pain rated 3/10
B) Frequent premature ventricular contractions (PVCs) – 10 per minute
C) Blood pressure 130/80 mmHg
D) Heart rate 88 bpm
**Correct Answer: B**
**Rationale:** Frequent PVCs (>5-6 per minute, especially multifocal
or R-on-T) after MI indicate ventricular irritability and risk of
ventricular tachycardia/fibrillation. This is a priority finding requiring
immediate intervention (lidocaine or amiodarone as per protocol).
---
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**4. A nurse is caring for a client with a new diagnosis of hypertension.
Which of the following lifestyle modifications should the nurse
recommend? (Select all that apply.)**
A) Limit alcohol intake to 3 drinks per day
B) Reduce sodium intake to less than 2,300 mg/day (or 1,500 mg for
certain populations)
C) Engage in aerobic exercise for 30 minutes most days
D) Maintain a body mass index (BMI) less than 25
E) Increase intake of potassium-rich foods (bananas, oranges)
**Correct Answer: B, C, D, E**
**Rationale:** Lifestyle modifications for HTN: DASH diet (low
sodium, high potassium), weight loss (BMI <25), exercise (30 min most
days), moderate alcohol (≤2 drinks men, ≤1 women), smoking cessation.
Potassium-rich foods help lower BP.
---
**5. A client with atrial fibrillation is prescribed warfarin (Coumadin).
Which of the following laboratory values indicates a therapeutic
response?**
# ATI MEDICAL-SURGICAL CAPSTONE
## GRADED A+ | 2026-2027 EDITION | 200+
QUESTIONS WITH DETAILED RATIONALES
**FIRST-TIME PASS GUARANTEE | PROCTORED
EXAM READINESS**
# SECTION I: CARDIOVASCULAR DISORDERS (Questions 1-25)
**1. A nurse is caring for a client with heart failure (HF) who reports
increasing shortness of breath and weight gain of 3 pounds in 24 hours.
Which of the following actions should the nurse take first?**
A) Administer furosemide (Lasix) as prescribed
B) Auscultate lung sounds
C) Elevate the head of the bed
D) Restrict oral fluids to 1,500 mL/day
**Correct Answer: B**
**Rationale:** Assessment is the first step of the nursing process. The
nurse should auscultate lung sounds to assess for crackles (pulmonary
congestion) before implementing interventions. However, many exams
,2|Page
prioritize patient positioning (HOB elevation) as an immediate action
before full assessment. According to ATI/NCLEX priority frameworks,
airway/breathing is first. Elevating HOB is also immediate. The correct
answer in many capstone reviews is **C (elevate HOB)** then **B**,
but the question asks "first" – typically **elevate HOB** is immediate
and then auscultate. I'll select **C** as the priority action.
**Correct Answer: C** – Elevate head of bed to reduce venous return
and improve breathing.
---
**2. A nurse is providing discharge teaching to a client with heart
failure. Which of the following statements indicates an understanding of
the teaching?**
A) "I will weigh myself every morning before breakfast and after
voiding."
B) "I will restrict my sodium intake to 4 grams per day."
C) "I will take my diuretic medication at bedtime."
D) "I will increase my fluid intake to 3 liters per day."
**Correct Answer: A**
,3|Page
**Rationale:** Daily weight monitoring is essential to detect fluid
retention. Weigh at the same time each day (morning, after voiding,
before breakfast). Sodium restriction is typically 2,000-2,300 mg/day (or
1,500 mg). Diuretics should be taken in the morning to avoid nocturia.
Fluid restriction may be needed, not increased.
---
**3. A nurse is assessing a client who is 12 hours post–myocardial
infarction (MI). Which of the following findings is the priority?**
A) Chest pain rated 3/10
B) Frequent premature ventricular contractions (PVCs) – 10 per minute
C) Blood pressure 130/80 mmHg
D) Heart rate 88 bpm
**Correct Answer: B**
**Rationale:** Frequent PVCs (>5-6 per minute, especially multifocal
or R-on-T) after MI indicate ventricular irritability and risk of
ventricular tachycardia/fibrillation. This is a priority finding requiring
immediate intervention (lidocaine or amiodarone as per protocol).
---
, 4|Page
**4. A nurse is caring for a client with a new diagnosis of hypertension.
Which of the following lifestyle modifications should the nurse
recommend? (Select all that apply.)**
A) Limit alcohol intake to 3 drinks per day
B) Reduce sodium intake to less than 2,300 mg/day (or 1,500 mg for
certain populations)
C) Engage in aerobic exercise for 30 minutes most days
D) Maintain a body mass index (BMI) less than 25
E) Increase intake of potassium-rich foods (bananas, oranges)
**Correct Answer: B, C, D, E**
**Rationale:** Lifestyle modifications for HTN: DASH diet (low
sodium, high potassium), weight loss (BMI <25), exercise (30 min most
days), moderate alcohol (≤2 drinks men, ≤1 women), smoking cessation.
Potassium-rich foods help lower BP.
---
**5. A client with atrial fibrillation is prescribed warfarin (Coumadin).
Which of the following laboratory values indicates a therapeutic
response?**
