ATI Capstone Comprehensive Exam V2 |
2026 Q&A with Rationale (ATI Capstone
Comprehensive Exam 2026)
1. A nurse is caring for a client who has developed a pulmonary embolism. Complete the
following sentence by choosing from the list of options: The nurse should first [Column 1],
then [Column 2], to achieve the outcome of [Column 3].
A. Apply oxygen; Start Heparin; Improved oxygenation
B. Place in Trendelenburg; Administer Alteplase; Increased blood pressure
C. Start an IV line; Notify the provider; Stable heart rate
D. Perform a chest X-ray; Administer Morphine; Reduced pain
Correct Answer: A
Rationale: The primary goal for a client with a pulmonary embolism is to maintain
respiratory function and prevent further clot formation. Oxygen therapy is the priority to
treat hypoxemia, followed by anticoagulation with Heparin to prevent clot propagation.
Improved oxygenation is the measurable clinical outcome indicating successful
intervention.
2. A nurse is assessing a client with fluid volume excess. Which of the following findings
should the nurse expect? (Select all that apply)
A. Distended neck veins
,B. Flattened neck veins
C. Dependent edema
D. Bounding pulse
E. Hypotension
F. Crackles on auscultation
Correct Answer: A,C,D,F
Rationale: Fluid volume excess commonly manifests as distended neck veins due to
increased central venous pressure. Bounding pulses and peripheral edema are also classic
signs of fluid overload in the vascular and interstitial spaces. Crackles occur when fluid
shifts into the alveoli, requiring immediate respiratory assessment.
3. A nurse is planning care for a client who is post-operative following a total hip arthroplasty.
Which of the following actions should the nurse include in the plan of care?
A. Place an abduction wedge between the client’s legs.
B. Instruct the client to lean forward when sitting in a chair.
C. Maintain the affected leg in an adducted position.
D. Keep the head of the bed at a 90-degree angle.
Correct Answer: A
Rationale: An abduction wedge is used to prevent the hip from adducting, which reduces
the risk of dislocation. Clients should be taught to avoid flexing the hip more than 90
,degrees and to avoid crossing their legs. These precautions are critical during the initial
post-operative recovery phase to ensure prosthetic stability.
4. A nurse is reviewing the laboratory results for a client taking lithium carbonate for bipolar
disorder. The lithium level is 2.1 mEq/L. Which of the following actions should the nurse
take?
A. Hold the medication and notify the provider.
B. Increase the client’s sodium intake.
C. Prepare the client for immediate hemodialysis.
D. Administer the next dose as scheduled.
Correct Answer: A
Rationale: A lithium level of 2.1 mEq/L is well above the therapeutic range of 0.6 to 1.2
mEq/L and indicates severe toxicity. Toxicity at this level can lead to seizures, coma, or
even death, necessitating immediate cessation of the drug. The nurse must notify the
provider and monitor the client for worsening neurological symptoms.
5. A nurse is preparing to administer a blood transfusion to a client. Which of the following
actions is the priority?
A. Obtain the client’s vital signs.
B. Check the blood type with another nurse at the bedside.
C. Ensure the IV catheter is 22-gauge or smaller.
, D. Warm the blood in a microwave before administration.
Correct Answer: B
Rationale: Verification of the blood product and the client’s identity by two qualified
healthcare professionals is the most critical step to prevent hemolytic reactions. While
baseline vital signs are important, they do not prevent an incompatible transfusion. Using
an appropriately sized catheter is necessary, but 22-gauge is often too small for rapid
infusion; 18 or 20-gauge is preferred.
6. A nurse is assessing a client who has preeclampsia. Which of the following findings should
the nurse report to the provider as a sign of worsening condition?
A. 1+ pedal edema
B. Epigastric pain
C. Blood pressure 142/92 mmHg
D. Urinary output of 40 mL/hr
Correct Answer: B
Rationale: Epigastric pain in a client with preeclampsia often indicates hepatic
involvement or liver swelling, which is a sign of HELLP syndrome or impending eclampsia.
This is a medical emergency that requires immediate intervention to prevent maternal and
fetal complications. Other signs of worsening preeclampsia include severe headaches and
visual disturbances.
2026 Q&A with Rationale (ATI Capstone
Comprehensive Exam 2026)
1. A nurse is caring for a client who has developed a pulmonary embolism. Complete the
following sentence by choosing from the list of options: The nurse should first [Column 1],
then [Column 2], to achieve the outcome of [Column 3].
A. Apply oxygen; Start Heparin; Improved oxygenation
B. Place in Trendelenburg; Administer Alteplase; Increased blood pressure
C. Start an IV line; Notify the provider; Stable heart rate
D. Perform a chest X-ray; Administer Morphine; Reduced pain
Correct Answer: A
Rationale: The primary goal for a client with a pulmonary embolism is to maintain
respiratory function and prevent further clot formation. Oxygen therapy is the priority to
treat hypoxemia, followed by anticoagulation with Heparin to prevent clot propagation.
Improved oxygenation is the measurable clinical outcome indicating successful
intervention.
2. A nurse is assessing a client with fluid volume excess. Which of the following findings
should the nurse expect? (Select all that apply)
A. Distended neck veins
,B. Flattened neck veins
C. Dependent edema
D. Bounding pulse
E. Hypotension
F. Crackles on auscultation
Correct Answer: A,C,D,F
Rationale: Fluid volume excess commonly manifests as distended neck veins due to
increased central venous pressure. Bounding pulses and peripheral edema are also classic
signs of fluid overload in the vascular and interstitial spaces. Crackles occur when fluid
shifts into the alveoli, requiring immediate respiratory assessment.
3. A nurse is planning care for a client who is post-operative following a total hip arthroplasty.
Which of the following actions should the nurse include in the plan of care?
A. Place an abduction wedge between the client’s legs.
B. Instruct the client to lean forward when sitting in a chair.
C. Maintain the affected leg in an adducted position.
D. Keep the head of the bed at a 90-degree angle.
Correct Answer: A
Rationale: An abduction wedge is used to prevent the hip from adducting, which reduces
the risk of dislocation. Clients should be taught to avoid flexing the hip more than 90
,degrees and to avoid crossing their legs. These precautions are critical during the initial
post-operative recovery phase to ensure prosthetic stability.
4. A nurse is reviewing the laboratory results for a client taking lithium carbonate for bipolar
disorder. The lithium level is 2.1 mEq/L. Which of the following actions should the nurse
take?
A. Hold the medication and notify the provider.
B. Increase the client’s sodium intake.
C. Prepare the client for immediate hemodialysis.
D. Administer the next dose as scheduled.
Correct Answer: A
Rationale: A lithium level of 2.1 mEq/L is well above the therapeutic range of 0.6 to 1.2
mEq/L and indicates severe toxicity. Toxicity at this level can lead to seizures, coma, or
even death, necessitating immediate cessation of the drug. The nurse must notify the
provider and monitor the client for worsening neurological symptoms.
5. A nurse is preparing to administer a blood transfusion to a client. Which of the following
actions is the priority?
A. Obtain the client’s vital signs.
B. Check the blood type with another nurse at the bedside.
C. Ensure the IV catheter is 22-gauge or smaller.
, D. Warm the blood in a microwave before administration.
Correct Answer: B
Rationale: Verification of the blood product and the client’s identity by two qualified
healthcare professionals is the most critical step to prevent hemolytic reactions. While
baseline vital signs are important, they do not prevent an incompatible transfusion. Using
an appropriately sized catheter is necessary, but 22-gauge is often too small for rapid
infusion; 18 or 20-gauge is preferred.
6. A nurse is assessing a client who has preeclampsia. Which of the following findings should
the nurse report to the provider as a sign of worsening condition?
A. 1+ pedal edema
B. Epigastric pain
C. Blood pressure 142/92 mmHg
D. Urinary output of 40 mL/hr
Correct Answer: B
Rationale: Epigastric pain in a client with preeclampsia often indicates hepatic
involvement or liver swelling, which is a sign of HELLP syndrome or impending eclampsia.
This is a medical emergency that requires immediate intervention to prevent maternal and
fetal complications. Other signs of worsening preeclampsia include severe headaches and
visual disturbances.
