ATI RN Capstone Proctored
Comprehensive Assessment 2026
Test Bank | Forms A & B | Verified
Real Exam Questions, Answers, and
Rationales | Graded A+
1. A nurse is caring for a client who has just returned from the post-anesthesia care
unit (PACU) following a right colectomy. Which assessment finding requires
immediate intervention?
A. Oxygen saturation of 92% on 2 L nasal cannula
B. Temperature of 36.2°C (97.2°F)
C. Respiratory rate of 10 breaths per minute
D. Blood pressure 110/70 mm Hg
Correct Answer: C. Respiratory rate of 10 breaths per minute
Rationale: A respiratory rate of 10 is below the expected range (12–20) and may
indicate opioid-induced respiratory depression, a life-threatening complication. The
nurse should stimulate the client and prepare to administer naloxone if indicated.
The other findings are stable or expected postoperatively.
2. A charge nurse is assigning client care for a medical-surgical unit. Which client
should be assigned to a licensed practical nurse (LPN)?
A. A client with diabetic ketoacidosis receiving continuous IV insulin
,B. A client 2 hours post-cardiac catheterization with a groin dressing
C. A client with new-onset confusion and a fever of 39°C (102.2°F)
D. A client with a chest tube for a pneumothorax with continuous bubbling in the
water seal chamber
Correct Answer: B. A client 2 hours post-cardiac catheterization with a groin
dressing
Rationale: This client is stable and requires routine assessment and monitoring,
which is within the LPN scope of practice. The other clients are unstable (DKA,
confusion/fever, chest tube complication) and require RN assessment.
3. A nurse is providing discharge teaching to a client with heart failure. Which
statement indicates an understanding of daily weight monitoring?
A. "I will weigh myself at the same time each day after breakfast."
B. "I will call my doctor if I gain more than 1 pound in a week."
C. "I will weigh myself daily before breakfast and after voiding."
D. "I will wear different shoes each time I weigh myself."
Correct Answer: C. "I will weigh myself daily before breakfast and after voiding."
Rationale: Consistent conditions (same scale, same time of day, after voiding,
before eating) provide accurate comparison. A weight gain of 2–3 pounds in 24
hours or 5 pounds in a week should be reported.
4. A nurse is assessing a client who is receiving a blood transfusion. Which finding
indicates a hemolytic transfusion reaction?
A. Urticaria and itching
B. Low back pain and dark urine
,C. Fever and chills
D. Wheezing and dyspnea
Correct Answer: B. Low back pain and dark urine
Rationale: Hemolytic reactions occur from ABO incompatibility. Symptoms include
low back pain, dark urine (hemoglobinuria), fever, and hypotension. Urticaria
suggests allergic reaction; fever/chills suggest febrile reaction; wheezing suggests
anaphylaxis.
5. A nurse is caring for a client with bipolar disorder who is taking lithium. Which
laboratory value should the nurse report immediately?
A. Lithium level 0.8 mEq/L
B. Sodium level 130 mEq/L
C. Potassium level 4.0 mEq/L
D. Creatinine 0.9 mg/dL
Correct Answer: B. Sodium level 130 mEq/L
Rationale: Hyponatremia increases lithium reabsorption in the kidneys, raising
lithium levels and increasing toxicity risk. Normal lithium level is 0.6–1.2 mEq/L.
Low sodium is more urgent than the other values.
6. A nurse is preparing to administer enoxaparin subcutaneously. Which action is
correct?
A. Expel the air bubble from the prefilled syringe before injection.
B. Insert the needle at a 45-degree angle.
C. Massage the injection site after administration.
D. Aspirate before injecting the medication.
, Correct Answer: B. Insert the needle at a 45-degree angle.
Rationale: Enoxaparin is given subcutaneously at a 45- to 90-degree angle. The air
bubble should not be expelled (it prevents medication loss). Do not massage (risk
of bruising/hematoma). Do not aspirate.
7. A nurse is providing teaching to a client with a new prescription for warfarin.
Which over-the-counter medication should the client avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
Correct Answer: B. Ibuprofen
Rationale: NSAIDs like ibuprofen increase bleeding risk when taken with warfarin.
Acetaminophen is safer but should be used in limited amounts. Antihistamines do
not significantly interact.
8. A nurse is caring for a client who has a percutaneous endoscopic gastrostomy
(PEG) tube. Which action should the nurse take before each feeding?
A. Flush the tube with 30 mL of warm water.
B. Verify tube placement by aspirating gastric contents.
C. Warm the formula to body temperature.
D. Position the client flat on the back.
Correct Answer: B. Verify tube placement by aspirating gastric contents.
Rationale: Checking placement (by aspirating gastric contents and checking pH <
Comprehensive Assessment 2026
Test Bank | Forms A & B | Verified
Real Exam Questions, Answers, and
Rationales | Graded A+
1. A nurse is caring for a client who has just returned from the post-anesthesia care
unit (PACU) following a right colectomy. Which assessment finding requires
immediate intervention?
A. Oxygen saturation of 92% on 2 L nasal cannula
B. Temperature of 36.2°C (97.2°F)
C. Respiratory rate of 10 breaths per minute
D. Blood pressure 110/70 mm Hg
Correct Answer: C. Respiratory rate of 10 breaths per minute
Rationale: A respiratory rate of 10 is below the expected range (12–20) and may
indicate opioid-induced respiratory depression, a life-threatening complication. The
nurse should stimulate the client and prepare to administer naloxone if indicated.
The other findings are stable or expected postoperatively.
2. A charge nurse is assigning client care for a medical-surgical unit. Which client
should be assigned to a licensed practical nurse (LPN)?
A. A client with diabetic ketoacidosis receiving continuous IV insulin
,B. A client 2 hours post-cardiac catheterization with a groin dressing
C. A client with new-onset confusion and a fever of 39°C (102.2°F)
D. A client with a chest tube for a pneumothorax with continuous bubbling in the
water seal chamber
Correct Answer: B. A client 2 hours post-cardiac catheterization with a groin
dressing
Rationale: This client is stable and requires routine assessment and monitoring,
which is within the LPN scope of practice. The other clients are unstable (DKA,
confusion/fever, chest tube complication) and require RN assessment.
3. A nurse is providing discharge teaching to a client with heart failure. Which
statement indicates an understanding of daily weight monitoring?
A. "I will weigh myself at the same time each day after breakfast."
B. "I will call my doctor if I gain more than 1 pound in a week."
C. "I will weigh myself daily before breakfast and after voiding."
D. "I will wear different shoes each time I weigh myself."
Correct Answer: C. "I will weigh myself daily before breakfast and after voiding."
Rationale: Consistent conditions (same scale, same time of day, after voiding,
before eating) provide accurate comparison. A weight gain of 2–3 pounds in 24
hours or 5 pounds in a week should be reported.
4. A nurse is assessing a client who is receiving a blood transfusion. Which finding
indicates a hemolytic transfusion reaction?
A. Urticaria and itching
B. Low back pain and dark urine
,C. Fever and chills
D. Wheezing and dyspnea
Correct Answer: B. Low back pain and dark urine
Rationale: Hemolytic reactions occur from ABO incompatibility. Symptoms include
low back pain, dark urine (hemoglobinuria), fever, and hypotension. Urticaria
suggests allergic reaction; fever/chills suggest febrile reaction; wheezing suggests
anaphylaxis.
5. A nurse is caring for a client with bipolar disorder who is taking lithium. Which
laboratory value should the nurse report immediately?
A. Lithium level 0.8 mEq/L
B. Sodium level 130 mEq/L
C. Potassium level 4.0 mEq/L
D. Creatinine 0.9 mg/dL
Correct Answer: B. Sodium level 130 mEq/L
Rationale: Hyponatremia increases lithium reabsorption in the kidneys, raising
lithium levels and increasing toxicity risk. Normal lithium level is 0.6–1.2 mEq/L.
Low sodium is more urgent than the other values.
6. A nurse is preparing to administer enoxaparin subcutaneously. Which action is
correct?
A. Expel the air bubble from the prefilled syringe before injection.
B. Insert the needle at a 45-degree angle.
C. Massage the injection site after administration.
D. Aspirate before injecting the medication.
, Correct Answer: B. Insert the needle at a 45-degree angle.
Rationale: Enoxaparin is given subcutaneously at a 45- to 90-degree angle. The air
bubble should not be expelled (it prevents medication loss). Do not massage (risk
of bruising/hematoma). Do not aspirate.
7. A nurse is providing teaching to a client with a new prescription for warfarin.
Which over-the-counter medication should the client avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
Correct Answer: B. Ibuprofen
Rationale: NSAIDs like ibuprofen increase bleeding risk when taken with warfarin.
Acetaminophen is safer but should be used in limited amounts. Antihistamines do
not significantly interact.
8. A nurse is caring for a client who has a percutaneous endoscopic gastrostomy
(PEG) tube. Which action should the nurse take before each feeding?
A. Flush the tube with 30 mL of warm water.
B. Verify tube placement by aspirating gastric contents.
C. Warm the formula to body temperature.
D. Position the client flat on the back.
Correct Answer: B. Verify tube placement by aspirating gastric contents.
Rationale: Checking placement (by aspirating gastric contents and checking pH <
