ATI Capstone Comprehensive Review
Practice Questions with Rationales
2026/27 | Instant Pdf Download
The ATI Capstone Comprehensive Review is designed to assess
your readiness for the NCLEX-RN by integrating knowledge
from all nursing content areas. Below is a 100-question practice
exam that mirrors the breadth and depth of the Capstone
assessment. Each question includes the correct answer and a
detailed rationale.
1. A nurse is caring for a client with heart failure who has
crackles in the lungs, 3+ pitting edema, and a weight gain
of 5 lb in 3 days. Which of the following interventions
should the nurse implement first?
A. Restrict oral fluids to 1 L/day.
B. Administer furosemide 40 mg IV push.
C. Place the client in high-Fowler’s position.
D. Notify the provider of the weight gain.
,Answer: C
Rationale: High-Fowler’s position improves lung expansion and
oxygenation, and reduces venous return. This is the priority
before administering diuretics or notifying the provider.
2. A nurse is reviewing laboratory results for a client
receiving heparin infusion. Which of the following values
indicates the heparin is at a therapeutic level?
A. INR 2.5
B. aPTT 75 seconds (control 25 seconds)
C. Platelet count 100,000/mm³
D. PT 15 seconds
Answer: B
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times the
control value (e.g., 37.5–62.5 seconds if control 25). 75 seconds
is supratherapeutic but indicates the drug is active. INR
monitors warfarin.
3. A nurse is providing discharge teaching to a client with a
new colostomy. Which of the following statements
indicates a need for further teaching?
A. “I will change the pouch when it is one-third full of stool.”
B. “I can expect the stoma to be red and moist.”
,C. “I will cut the skin barrier opening slightly larger than the
stoma.”
D. “I will use alcohol wipes to clean the peristomal skin.”
Answer: D
Rationale: Alcohol wipes dry and irritate peristomal skin. Mild
soap and water are recommended. The other statements are
correct.
4. A nurse is caring for a client with a new prescription for
enoxaparin. Which of the following actions is correct?
A. Administer the medication intramuscularly.
B. Expel the air bubble from the prefilled syringe.
C. Inject the medication into the abdomen.
D. Massage the injection site after administration.
Answer: C
Rationale: Enoxaparin is given subcutaneously in the abdomen.
The air bubble should not be expelled (it prevents medication
loss). Do not massage the site (risk of bruising).
5. A nurse is assessing a client who is 2 hours post-cardiac
catheterization via the femoral artery. Which finding
requires immediate action?
, A. The client reports back pain.
B. The groin site has a small amount of dried blood.
C. The toes on the affected leg are pale and cool.
D. The pedal pulse is 2+ bilaterally.
Answer: C
Rationale: Pale, cool toes indicate arterial occlusion, a
limb-threatening emergency. Notify the provider immediately.
6. A nurse is teaching a client with type 2 diabetes about
foot care. Which statement indicates understanding?
A. “I will soak my feet in warm water for 20 minutes each day.”
B. “I will use a heating pad to warm my cold feet at night.”
C. “I will check the inside of my shoes before putting them on.”
D. “I will trim my toenails in a rounded shape.”
Answer: C
Rationale: Check shoes for foreign objects. Soaking can dry
skin; heating pads risk burns; nails should be cut straight across.
7. A client with bipolar disorder is taking lithium. The nurse
notes a coarse tremor, nausea, and vomiting. What is the
priority action?
A. Administer an antiemetic.
Practice Questions with Rationales
2026/27 | Instant Pdf Download
The ATI Capstone Comprehensive Review is designed to assess
your readiness for the NCLEX-RN by integrating knowledge
from all nursing content areas. Below is a 100-question practice
exam that mirrors the breadth and depth of the Capstone
assessment. Each question includes the correct answer and a
detailed rationale.
1. A nurse is caring for a client with heart failure who has
crackles in the lungs, 3+ pitting edema, and a weight gain
of 5 lb in 3 days. Which of the following interventions
should the nurse implement first?
A. Restrict oral fluids to 1 L/day.
B. Administer furosemide 40 mg IV push.
C. Place the client in high-Fowler’s position.
D. Notify the provider of the weight gain.
,Answer: C
Rationale: High-Fowler’s position improves lung expansion and
oxygenation, and reduces venous return. This is the priority
before administering diuretics or notifying the provider.
2. A nurse is reviewing laboratory results for a client
receiving heparin infusion. Which of the following values
indicates the heparin is at a therapeutic level?
A. INR 2.5
B. aPTT 75 seconds (control 25 seconds)
C. Platelet count 100,000/mm³
D. PT 15 seconds
Answer: B
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times the
control value (e.g., 37.5–62.5 seconds if control 25). 75 seconds
is supratherapeutic but indicates the drug is active. INR
monitors warfarin.
3. A nurse is providing discharge teaching to a client with a
new colostomy. Which of the following statements
indicates a need for further teaching?
A. “I will change the pouch when it is one-third full of stool.”
B. “I can expect the stoma to be red and moist.”
,C. “I will cut the skin barrier opening slightly larger than the
stoma.”
D. “I will use alcohol wipes to clean the peristomal skin.”
Answer: D
Rationale: Alcohol wipes dry and irritate peristomal skin. Mild
soap and water are recommended. The other statements are
correct.
4. A nurse is caring for a client with a new prescription for
enoxaparin. Which of the following actions is correct?
A. Administer the medication intramuscularly.
B. Expel the air bubble from the prefilled syringe.
C. Inject the medication into the abdomen.
D. Massage the injection site after administration.
Answer: C
Rationale: Enoxaparin is given subcutaneously in the abdomen.
The air bubble should not be expelled (it prevents medication
loss). Do not massage the site (risk of bruising).
5. A nurse is assessing a client who is 2 hours post-cardiac
catheterization via the femoral artery. Which finding
requires immediate action?
, A. The client reports back pain.
B. The groin site has a small amount of dried blood.
C. The toes on the affected leg are pale and cool.
D. The pedal pulse is 2+ bilaterally.
Answer: C
Rationale: Pale, cool toes indicate arterial occlusion, a
limb-threatening emergency. Notify the provider immediately.
6. A nurse is teaching a client with type 2 diabetes about
foot care. Which statement indicates understanding?
A. “I will soak my feet in warm water for 20 minutes each day.”
B. “I will use a heating pad to warm my cold feet at night.”
C. “I will check the inside of my shoes before putting them on.”
D. “I will trim my toenails in a rounded shape.”
Answer: C
Rationale: Check shoes for foreign objects. Soaking can dry
skin; heating pads risk burns; nails should be cut straight across.
7. A client with bipolar disorder is taking lithium. The nurse
notes a coarse tremor, nausea, and vomiting. What is the
priority action?
A. Administer an antiemetic.
