ATI Capstone Fundamentals Practice Questions and Answers Updated
2026 | Complete ATI Fundamentals of Nursing Study Guide with Verified
Questions, Detailed Rationales, Basic Nursing Skills, Patient Safety,
Infection Control, Documentation, Vital Signs, Mobility, Nutrition,
Delegation, Clinical Judgment & NGN NCLEX-RN/PN Exam Prep
Question 1: A nurse is caring for a client who has just returned from surgery. Which
assessment finding requires immediate intervention?
A. Blood pressure of 110/70 mm Hg
B. Respiratory rate of 16 breaths/min
C. Oxygen saturation of 88% on room air
D. Heart rate of 82 beats/min
CORRECT ANSWER: C. Oxygen saturation of 88% on room air
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention, such as administering supplemental oxygen and assessing the airway.
Normal oxygen saturation should be above 95%. The other vital signs listed are within
normal limits for a postoperative client.
Question 2: When performing hand hygiene, which action by the nurse
demonstrates proper technique?
A. Washing hands for at least 5 seconds
B. Using hot water to kill microorganisms
C. Keeping hands lower than elbows during washing
D. Turning off the faucet with bare hands after washing
CORRECT ANSWER: C. Keeping hands lower than elbows during washing
Rationale: Keeping hands lower than elbows prevents contaminated water from flowing
back onto clean areas of the arms. Handwashing should last at least 20 seconds,
lukewarm water is preferred to prevent skin damage, and faucets should be turned off
using a paper towel to maintain cleanliness.
Question 3: A client is prescribed a clear liquid diet. Which food item is appropriate
for this client?
A. Vanilla pudding
B. Apple juice
C. Mashed potatoes
D. Scrambled eggs
CORRECT ANSWER: B. Apple juice
Rationale: Clear liquids are transparent at room temperature and include items like
apple juice, broth, gelatin, and tea. Pudding, mashed potatoes, and scrambled eggs are
not transparent and belong to full liquid or soft diets.
,Question 4: Which position should the nurse place a client in to facilitate breathing
when the client experiences dyspnea?
A. Supine position
B. Prone position
C. High Fowler's position
D. Trendelenburg position
CORRECT ANSWER: C. High Fowler's position
Rationale: High Fowler's position (60-90 degrees) allows maximum chest expansion and
facilitates breathing by reducing pressure on the diaphragm. The supine and prone
positions may restrict lung expansion, and Trendelenburg position places the head
lower than the feet, which can worsen breathing difficulties.
Question 5: A nurse is preparing to administer medication via the intramuscular
route. Which site is preferred for an adult receiving a large volume injection?
A. Deltoid muscle
B. Ventrogluteal muscle
C. Vastus lateralis muscle
D. Rectus femoris muscle
CORRECT ANSWER: B. Ventrogluteal muscle
Rationale: The ventrogluteal site is preferred for adults receiving large volume IM
injections because it has thick muscle mass, few nerves, and no major blood vessels.
The deltoid is suitable only for small volumes (up to 1 mL). The vastus lateralis is
commonly used for infants and children.
Question 6: Which finding indicates that a client understands proper use of a cane?
A. The client holds the cane on the strong side
B. The client advances the cane and weak leg simultaneously
C. The client places the cane 6 inches in front before stepping
D. The client bears weight on the affected leg first
CORRECT ANSWER: A. The client holds the cane on the strong side
Rationale: The cane should be held on the unaffected (strong) side to provide support
and stability. The cane and affected leg should advance together, followed by the
unaffected leg. The cane should be placed approximately 15-20 cm (6-8 inches) to the
side, not directly in front.
Question 7: A nurse is caring for a client with a nasogastric tube. Which action
should the nurse take to verify proper placement?
A. Auscultate over the epigastrium while injecting air
B. Measure the pH of aspirated gastric contents
,C. Observe for bubbling in the water seal chamber
D. Check the external length marking every shift
CORRECT ANSWER: B. Measure the pH of aspirated gastric contents
Rationale: Measuring the pH of aspirated contents is the most reliable bedside method
for verifying NG tube placement. Gastric pH is typically acidic (pH 1-5). Auscultation is
unreliable. Bubbling relates to chest tubes, and checking external markings only
indicates if the tube has moved externally.
Question 8: Which statement by a client indicates understanding of proper insulin
administration?
A. "I will inject insulin into my abdomen and rotate sites."
B. "I will massage the injection site after administering insulin."
C. "I will store opened insulin vials in the freezer."
D. "I will shake the insulin vial vigorously before drawing up the dose."
CORRECT ANSWER: A. "I will inject insulin into my abdomen and rotate sites."
Rationale: Rotating injection sites within the same anatomical area prevents
lipodystrophy and ensures consistent absorption. Massaging the site can alter
absorption rates. Opened insulin should be stored at room temperature or refrigerated,
never frozen. Insulin should be rolled gently, not shaken, to avoid damaging the protein
structure.
Question 9: A client is receiving oxygen therapy via nasal cannula at 2 L/min. Which
nursing action is appropriate?
A. Apply petroleum jelly to the nares to prevent dryness
B. Ensure humidification is added to the oxygen source
C. Assess the nares and surrounding skin for breakdown
D. Increase the flow rate if the client appears anxious
CORRECT ANSWER: C. Assess the nares and surrounding skin for breakdown
Rationale: Regular assessment of the nares and skin is essential to prevent pressure
injuries and irritation from the cannula. Petroleum-based products should not be used
with oxygen due to fire risk. Humidification is typically needed for flows greater than 4
L/min. Flow rates should not be adjusted without a provider's order.
Question 10: Which action should the nurse take first when discovering a fire in a
client's room?
A. Activate the fire alarm
B. Remove the client from the room
C. Close the door to contain the fire
D. Attempt to extinguish the fire
CORRECT ANSWER: B. Remove the client from the room
, Rationale: Following the RACE protocol (Rescue, Alarm, Contain, Extinguish), the first
priority is to rescue clients from immediate danger. After removing the client, the nurse
should activate the alarm, contain the fire by closing doors, and then attempt to
extinguish if safe to do so.
Question 11: A nurse is teaching a client about fall prevention. Which
recommendation is most important?
A. Keep the bed in the lowest position
B. Use restraints to prevent wandering
C. Place personal items out of reach to encourage movement
D. Dim the lights at night to promote sleep
CORRECT ANSWER: A. Keep the bed in the lowest position
Rationale: Keeping the bed in the lowest position reduces the distance of a potential fall
and minimizes injury. Restraints increase fall risk and should be avoided. Personal items
should be within easy reach. Adequate lighting, including nightlights, helps prevent
falls.
Question 12: Which assessment finding requires immediate notification of the
provider for a client receiving IV fluids?
A. Urine output of 35 mL/hr
B. Crackles heard in lung bases
C. Blood pressure of 118/76 mm Hg
D. Capillary refill of 2 seconds
CORRECT ANSWER: B. Crackles heard in lung bases
Rationale: Crackles in the lungs indicate fluid overload or pulmonary edema, which is a
serious complication of IV therapy requiring immediate intervention. Urine output of 35
mL/hr is within acceptable range (minimum 30 mL/hr). The blood pressure and capillary
refill are normal findings.
Question 13: A nurse is preparing to insert an indwelling urinary catheter. Which
action maintains sterile technique?
A. Placing the sterile drape on the client's abdomen
B. Opening the sterile kit with the flap facing away from the body
C. Touching the inside of the sterile glove package with bare hands
D. Pouring sterile solution with the label facing the palm
CORRECT ANSWER: B. Opening the sterile kit with the flap facing away from the
body
Rationale: The first flap of a sterile package should open away from the body to prevent
contamination. The drape should be placed near the perineum, not the abdomen. Bare
hands should never touch the inside of sterile packages. When pouring solutions, the
label should face the palm to prevent dripping on the label.
2026 | Complete ATI Fundamentals of Nursing Study Guide with Verified
Questions, Detailed Rationales, Basic Nursing Skills, Patient Safety,
Infection Control, Documentation, Vital Signs, Mobility, Nutrition,
Delegation, Clinical Judgment & NGN NCLEX-RN/PN Exam Prep
Question 1: A nurse is caring for a client who has just returned from surgery. Which
assessment finding requires immediate intervention?
A. Blood pressure of 110/70 mm Hg
B. Respiratory rate of 16 breaths/min
C. Oxygen saturation of 88% on room air
D. Heart rate of 82 beats/min
CORRECT ANSWER: C. Oxygen saturation of 88% on room air
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention, such as administering supplemental oxygen and assessing the airway.
Normal oxygen saturation should be above 95%. The other vital signs listed are within
normal limits for a postoperative client.
Question 2: When performing hand hygiene, which action by the nurse
demonstrates proper technique?
A. Washing hands for at least 5 seconds
B. Using hot water to kill microorganisms
C. Keeping hands lower than elbows during washing
D. Turning off the faucet with bare hands after washing
CORRECT ANSWER: C. Keeping hands lower than elbows during washing
Rationale: Keeping hands lower than elbows prevents contaminated water from flowing
back onto clean areas of the arms. Handwashing should last at least 20 seconds,
lukewarm water is preferred to prevent skin damage, and faucets should be turned off
using a paper towel to maintain cleanliness.
Question 3: A client is prescribed a clear liquid diet. Which food item is appropriate
for this client?
A. Vanilla pudding
B. Apple juice
C. Mashed potatoes
D. Scrambled eggs
CORRECT ANSWER: B. Apple juice
Rationale: Clear liquids are transparent at room temperature and include items like
apple juice, broth, gelatin, and tea. Pudding, mashed potatoes, and scrambled eggs are
not transparent and belong to full liquid or soft diets.
,Question 4: Which position should the nurse place a client in to facilitate breathing
when the client experiences dyspnea?
A. Supine position
B. Prone position
C. High Fowler's position
D. Trendelenburg position
CORRECT ANSWER: C. High Fowler's position
Rationale: High Fowler's position (60-90 degrees) allows maximum chest expansion and
facilitates breathing by reducing pressure on the diaphragm. The supine and prone
positions may restrict lung expansion, and Trendelenburg position places the head
lower than the feet, which can worsen breathing difficulties.
Question 5: A nurse is preparing to administer medication via the intramuscular
route. Which site is preferred for an adult receiving a large volume injection?
A. Deltoid muscle
B. Ventrogluteal muscle
C. Vastus lateralis muscle
D. Rectus femoris muscle
CORRECT ANSWER: B. Ventrogluteal muscle
Rationale: The ventrogluteal site is preferred for adults receiving large volume IM
injections because it has thick muscle mass, few nerves, and no major blood vessels.
The deltoid is suitable only for small volumes (up to 1 mL). The vastus lateralis is
commonly used for infants and children.
Question 6: Which finding indicates that a client understands proper use of a cane?
A. The client holds the cane on the strong side
B. The client advances the cane and weak leg simultaneously
C. The client places the cane 6 inches in front before stepping
D. The client bears weight on the affected leg first
CORRECT ANSWER: A. The client holds the cane on the strong side
Rationale: The cane should be held on the unaffected (strong) side to provide support
and stability. The cane and affected leg should advance together, followed by the
unaffected leg. The cane should be placed approximately 15-20 cm (6-8 inches) to the
side, not directly in front.
Question 7: A nurse is caring for a client with a nasogastric tube. Which action
should the nurse take to verify proper placement?
A. Auscultate over the epigastrium while injecting air
B. Measure the pH of aspirated gastric contents
,C. Observe for bubbling in the water seal chamber
D. Check the external length marking every shift
CORRECT ANSWER: B. Measure the pH of aspirated gastric contents
Rationale: Measuring the pH of aspirated contents is the most reliable bedside method
for verifying NG tube placement. Gastric pH is typically acidic (pH 1-5). Auscultation is
unreliable. Bubbling relates to chest tubes, and checking external markings only
indicates if the tube has moved externally.
Question 8: Which statement by a client indicates understanding of proper insulin
administration?
A. "I will inject insulin into my abdomen and rotate sites."
B. "I will massage the injection site after administering insulin."
C. "I will store opened insulin vials in the freezer."
D. "I will shake the insulin vial vigorously before drawing up the dose."
CORRECT ANSWER: A. "I will inject insulin into my abdomen and rotate sites."
Rationale: Rotating injection sites within the same anatomical area prevents
lipodystrophy and ensures consistent absorption. Massaging the site can alter
absorption rates. Opened insulin should be stored at room temperature or refrigerated,
never frozen. Insulin should be rolled gently, not shaken, to avoid damaging the protein
structure.
Question 9: A client is receiving oxygen therapy via nasal cannula at 2 L/min. Which
nursing action is appropriate?
A. Apply petroleum jelly to the nares to prevent dryness
B. Ensure humidification is added to the oxygen source
C. Assess the nares and surrounding skin for breakdown
D. Increase the flow rate if the client appears anxious
CORRECT ANSWER: C. Assess the nares and surrounding skin for breakdown
Rationale: Regular assessment of the nares and skin is essential to prevent pressure
injuries and irritation from the cannula. Petroleum-based products should not be used
with oxygen due to fire risk. Humidification is typically needed for flows greater than 4
L/min. Flow rates should not be adjusted without a provider's order.
Question 10: Which action should the nurse take first when discovering a fire in a
client's room?
A. Activate the fire alarm
B. Remove the client from the room
C. Close the door to contain the fire
D. Attempt to extinguish the fire
CORRECT ANSWER: B. Remove the client from the room
, Rationale: Following the RACE protocol (Rescue, Alarm, Contain, Extinguish), the first
priority is to rescue clients from immediate danger. After removing the client, the nurse
should activate the alarm, contain the fire by closing doors, and then attempt to
extinguish if safe to do so.
Question 11: A nurse is teaching a client about fall prevention. Which
recommendation is most important?
A. Keep the bed in the lowest position
B. Use restraints to prevent wandering
C. Place personal items out of reach to encourage movement
D. Dim the lights at night to promote sleep
CORRECT ANSWER: A. Keep the bed in the lowest position
Rationale: Keeping the bed in the lowest position reduces the distance of a potential fall
and minimizes injury. Restraints increase fall risk and should be avoided. Personal items
should be within easy reach. Adequate lighting, including nightlights, helps prevent
falls.
Question 12: Which assessment finding requires immediate notification of the
provider for a client receiving IV fluids?
A. Urine output of 35 mL/hr
B. Crackles heard in lung bases
C. Blood pressure of 118/76 mm Hg
D. Capillary refill of 2 seconds
CORRECT ANSWER: B. Crackles heard in lung bases
Rationale: Crackles in the lungs indicate fluid overload or pulmonary edema, which is a
serious complication of IV therapy requiring immediate intervention. Urine output of 35
mL/hr is within acceptable range (minimum 30 mL/hr). The blood pressure and capillary
refill are normal findings.
Question 13: A nurse is preparing to insert an indwelling urinary catheter. Which
action maintains sterile technique?
A. Placing the sterile drape on the client's abdomen
B. Opening the sterile kit with the flap facing away from the body
C. Touching the inside of the sterile glove package with bare hands
D. Pouring sterile solution with the label facing the palm
CORRECT ANSWER: B. Opening the sterile kit with the flap facing away from the
body
Rationale: The first flap of a sterile package should open away from the body to prevent
contamination. The drape should be placed near the perineum, not the abdomen. Bare
hands should never touch the inside of sterile packages. When pouring solutions, the
label should face the palm to prevent dripping on the label.
