ATI Capstone Comprehensive Exam V1 |
2026 Q&A with Rationale (ATI Capstone
Comprehensive Exam 2026)
1. A nurse is monitoring a client who has a prescription for lithium carbonate for bipolar
disorder. Which of the following findings should the nurse recognize as a sign of lithium
toxicity?
A. Fine hand tremors and mild thirst
B. Coarse hand tremors and mental confusion
C. Polyuria and increased appetite
D. Constipation and weight gain
Correct Answer: B
Rationale: Coarse hand tremors and mental confusion are advanced signs of lithium
toxicity. The nurse must prioritize holding the medication and notifying the provider to
prevent seizures. Fine tremors are considered a common side effect rather than a sign of
acute toxicity.
2. A nurse is assessing a client who is 4 hours post-thyroidectomy. Which of the following
findings is the priority for the nurse to report?
A. Small amount of serosanguineous drainage on the dressing
B. Sore throat and painful swallowing
,C. Laryngeal stridor and respiratory distress
D. Client reports thirst and dry mouth
Correct Answer: C
Rationale: Laryngeal stridor indicates an airway obstruction, often due to edema or
hypocalcemia-related tetany. This is a life-threatening emergency that requires immediate
intervention and notification of the surgical team. Sore throat and minor drainage are
expected findings following this procedure.
3. A nurse is initiating a blood transfusion for a client. Which of the following actions should
the nurse take within the first 15 minutes?
A. Instruct the client to remain in a supine position
B. Increase the flow rate to the prescribed hourly amount
C. Administer diphenhydramine to prevent a reaction
D. Monitor the client for fever, chills, and lower back pain
Correct Answer: D
Rationale: The first 15 minutes are critical for detecting hemolytic or allergic transfusion
reactions. Symptoms like fever, chills, and back pain indicate a potential incompatibility or
acute reaction. The nurse must stay with the client and maintain a slow rate initially to
ensure safety.
,4. [SATA] A nurse is caring for a client with pre-eclampsia. Which of the following clinical
manifestations should the nurse identify as signs of worsening condition? (Select all that
apply)
A. Epigastric pain
B. Blurred vision
C. Hyperreflexia
D. Polyuria
E. Severe headache
F. Hypotension
Correct Answer: A,B,C,E
Rationale: Epigastric pain, blurred vision, hyperreflexia, and severe headaches are
hallmark signs of pre-eclampsia progression toward eclampsia. These symptoms indicate
neurological involvement and hepatic swelling. Polyuria and hypotension are not typical
findings of worsening pre-eclampsia.
5. A nurse is reviewing the plan of care for a client who is receiving total parenteral nutrition
(TPN). Which of the following laboratory values should the nurse prioritize?
A. Serum sodium level
B. Hemoglobin level
C. Serum creatinine level
, D. Blood glucose level
Correct Answer: D
Rationale: TPN has a very high dextrose concentration, making hyperglycemia a common
and significant complication. Blood glucose should be monitored every 4 to 6 hours to
guide insulin therapy and adjust the TPN formula. Sodium and creatinine are important but
less critical for acute TPN management than glucose.
6. A nurse is evaluating an 18-month-old toddler during a well-child visit. Which of the
following developmental milestones should the nurse expect?
A. The toddler can jump in place with both feet
B. The toddler can build a tower of six blocks
C. The toddler can state their full name and age
D. The toddler uses a spoon without rotation
Correct Answer: D
Rationale: By 18 months, a toddler is expected to use a spoon independently without
spilling most of the contents. Building a six-block tower is usually achieved by 24 months.
Jumping in place is typically a 30-month milestone.
7. A nurse is assessing a client with a chest tube connected to a water-seal drainage system.
Which of the following findings indicates a potential air leak?
A. Fluctuation of fluid levels with the client’s respirations
2026 Q&A with Rationale (ATI Capstone
Comprehensive Exam 2026)
1. A nurse is monitoring a client who has a prescription for lithium carbonate for bipolar
disorder. Which of the following findings should the nurse recognize as a sign of lithium
toxicity?
A. Fine hand tremors and mild thirst
B. Coarse hand tremors and mental confusion
C. Polyuria and increased appetite
D. Constipation and weight gain
Correct Answer: B
Rationale: Coarse hand tremors and mental confusion are advanced signs of lithium
toxicity. The nurse must prioritize holding the medication and notifying the provider to
prevent seizures. Fine tremors are considered a common side effect rather than a sign of
acute toxicity.
2. A nurse is assessing a client who is 4 hours post-thyroidectomy. Which of the following
findings is the priority for the nurse to report?
A. Small amount of serosanguineous drainage on the dressing
B. Sore throat and painful swallowing
,C. Laryngeal stridor and respiratory distress
D. Client reports thirst and dry mouth
Correct Answer: C
Rationale: Laryngeal stridor indicates an airway obstruction, often due to edema or
hypocalcemia-related tetany. This is a life-threatening emergency that requires immediate
intervention and notification of the surgical team. Sore throat and minor drainage are
expected findings following this procedure.
3. A nurse is initiating a blood transfusion for a client. Which of the following actions should
the nurse take within the first 15 minutes?
A. Instruct the client to remain in a supine position
B. Increase the flow rate to the prescribed hourly amount
C. Administer diphenhydramine to prevent a reaction
D. Monitor the client for fever, chills, and lower back pain
Correct Answer: D
Rationale: The first 15 minutes are critical for detecting hemolytic or allergic transfusion
reactions. Symptoms like fever, chills, and back pain indicate a potential incompatibility or
acute reaction. The nurse must stay with the client and maintain a slow rate initially to
ensure safety.
,4. [SATA] A nurse is caring for a client with pre-eclampsia. Which of the following clinical
manifestations should the nurse identify as signs of worsening condition? (Select all that
apply)
A. Epigastric pain
B. Blurred vision
C. Hyperreflexia
D. Polyuria
E. Severe headache
F. Hypotension
Correct Answer: A,B,C,E
Rationale: Epigastric pain, blurred vision, hyperreflexia, and severe headaches are
hallmark signs of pre-eclampsia progression toward eclampsia. These symptoms indicate
neurological involvement and hepatic swelling. Polyuria and hypotension are not typical
findings of worsening pre-eclampsia.
5. A nurse is reviewing the plan of care for a client who is receiving total parenteral nutrition
(TPN). Which of the following laboratory values should the nurse prioritize?
A. Serum sodium level
B. Hemoglobin level
C. Serum creatinine level
, D. Blood glucose level
Correct Answer: D
Rationale: TPN has a very high dextrose concentration, making hyperglycemia a common
and significant complication. Blood glucose should be monitored every 4 to 6 hours to
guide insulin therapy and adjust the TPN formula. Sodium and creatinine are important but
less critical for acute TPN management than glucose.
6. A nurse is evaluating an 18-month-old toddler during a well-child visit. Which of the
following developmental milestones should the nurse expect?
A. The toddler can jump in place with both feet
B. The toddler can build a tower of six blocks
C. The toddler can state their full name and age
D. The toddler uses a spoon without rotation
Correct Answer: D
Rationale: By 18 months, a toddler is expected to use a spoon independently without
spilling most of the contents. Building a six-block tower is usually achieved by 24 months.
Jumping in place is typically a 30-month milestone.
7. A nurse is assessing a client with a chest tube connected to a water-seal drainage system.
Which of the following findings indicates a potential air leak?
A. Fluctuation of fluid levels with the client’s respirations
