RN ATI CAPSTONE COMPREHENSIVE
PREDICTOR 2026 FULL EXAMINATION
WITH QUESTIONS and ANSWERS
QUESTION 1
A client develops cor pulmonale (right-sided heart failure). The nurse would expect to observe which of
the following?
Increasing respiratory difficulty seen with exertion
Cough productive of a large amount of thick, yellow mucus
Peripheral edema and anorexia
Twitching of extremities
ANSWER: 3
Rationale:
Option 1: Incorrect. While respiratory difficulty may occur, it is not the primary manifestation of right-
sided heart failure. This symptom is more characteristic of left-sided heart failure or pulmonary
conditions.
,Option 2: Incorrect. Thick, yellow productive cough suggests an infectious process such as pneumonia or
bronchitis, not right-sided heart failure.
Option 3: Correct. Right-sided heart failure leads to systemic venous congestion, resulting in peripheral
edema, hepatomegaly, jugular venous distension, and anorexia due to liver congestion and GI venous
congestion.
Option 4: Incorrect. Twitching of extremities indicates neurological involvement or electrolyte
imbalances, not specifically cor pulmonale.
QUESTION 2
The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider
the assignments appropriate if the nursing assistant is assigned to care for which client?
A client with Alzheimer's requiring assistance with feeding
A client with osteoporosis complaining of burning on urination
A client with scleroderma receiving a tube feeding
A client with cancer who has Cheyne-Stokes respirations
ANSWER: 1
Rationale:
Option 1: Correct. Nursing assistants are trained to assist with activities of daily living including feeding
stable clients. Alzheimer's clients with stable conditions and no swallowing difficulties are appropriate
for nursing assistant assignment.
,Option 2: Incorrect. Burning on urination suggests a urinary tract infection requiring assessment and
evaluation by licensed nursing personnel. This client needs nursing assessment.
Option 3: Incorrect. Tube feedings require assessment of tube placement, residual checks, and
monitoring for complications. This is beyond the scope of a nursing assistant.
Option 4: Incorrect. Cheyne-Stokes respirations indicate neurological deterioration requiring complex
assessment and intervention by licensed nursing staff, not a nursing assistant.
QUESTION 3
A 23-year-old man is admitted with a subdural hematoma and cerebral edema after a motorcycle
accident. Which symptom should the nurse expect to see INITIALLY?
Unequal and dilated pupils
Decrebrate posturing
Grand mal seizures
Decreased level of consciousness
ANSWER: 4
Rationale:
Option 1: Incorrect. Unequal and dilated pupils indicate uncal herniation and occur later as intracranial
pressure significantly increases. This is a late sign of neurological deterioration.
Option 2: Incorrect. Decrebrate posturing indicates severe brain stem involvement and occurs in later
stages of increased intracranial pressure, not initially.
, Option 3: Incorrect. Grand mal seizures may occur but are not typically the initial finding in subdural
hematoma with cerebral edema.
Option 4: Correct. Decreased level of consciousness is the earliest and most sensitive indicator of
increased intracranial pressure and neurological deterioration following head trauma.
QUESTION 4
A 23-year-old woman at 32-weeks gestation is seen in the outpatient clinic. Which finding would
indicate a possible complication?
The client's urine test is positive for glucose and acetone
The client has 1+ pedal edema in both feet at the end of the day
The client complains of an increase in vaginal discharge
The client says she feels pressure against her diaphragm when the baby moves
ANSWER: 1
Rationale:
Option 1: Correct. Glucose and acetone in urine during pregnancy indicates possible gestational diabetes
or poor diabetic control, requiring further evaluation. This is an abnormal finding requiring intervention.
Option 2: Incorrect. Mild (1+) pedal edema at the end of the day is common in the third trimester due to
increased venous pressure and is not necessarily a complication.
PREDICTOR 2026 FULL EXAMINATION
WITH QUESTIONS and ANSWERS
QUESTION 1
A client develops cor pulmonale (right-sided heart failure). The nurse would expect to observe which of
the following?
Increasing respiratory difficulty seen with exertion
Cough productive of a large amount of thick, yellow mucus
Peripheral edema and anorexia
Twitching of extremities
ANSWER: 3
Rationale:
Option 1: Incorrect. While respiratory difficulty may occur, it is not the primary manifestation of right-
sided heart failure. This symptom is more characteristic of left-sided heart failure or pulmonary
conditions.
,Option 2: Incorrect. Thick, yellow productive cough suggests an infectious process such as pneumonia or
bronchitis, not right-sided heart failure.
Option 3: Correct. Right-sided heart failure leads to systemic venous congestion, resulting in peripheral
edema, hepatomegaly, jugular venous distension, and anorexia due to liver congestion and GI venous
congestion.
Option 4: Incorrect. Twitching of extremities indicates neurological involvement or electrolyte
imbalances, not specifically cor pulmonale.
QUESTION 2
The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider
the assignments appropriate if the nursing assistant is assigned to care for which client?
A client with Alzheimer's requiring assistance with feeding
A client with osteoporosis complaining of burning on urination
A client with scleroderma receiving a tube feeding
A client with cancer who has Cheyne-Stokes respirations
ANSWER: 1
Rationale:
Option 1: Correct. Nursing assistants are trained to assist with activities of daily living including feeding
stable clients. Alzheimer's clients with stable conditions and no swallowing difficulties are appropriate
for nursing assistant assignment.
,Option 2: Incorrect. Burning on urination suggests a urinary tract infection requiring assessment and
evaluation by licensed nursing personnel. This client needs nursing assessment.
Option 3: Incorrect. Tube feedings require assessment of tube placement, residual checks, and
monitoring for complications. This is beyond the scope of a nursing assistant.
Option 4: Incorrect. Cheyne-Stokes respirations indicate neurological deterioration requiring complex
assessment and intervention by licensed nursing staff, not a nursing assistant.
QUESTION 3
A 23-year-old man is admitted with a subdural hematoma and cerebral edema after a motorcycle
accident. Which symptom should the nurse expect to see INITIALLY?
Unequal and dilated pupils
Decrebrate posturing
Grand mal seizures
Decreased level of consciousness
ANSWER: 4
Rationale:
Option 1: Incorrect. Unequal and dilated pupils indicate uncal herniation and occur later as intracranial
pressure significantly increases. This is a late sign of neurological deterioration.
Option 2: Incorrect. Decrebrate posturing indicates severe brain stem involvement and occurs in later
stages of increased intracranial pressure, not initially.
, Option 3: Incorrect. Grand mal seizures may occur but are not typically the initial finding in subdural
hematoma with cerebral edema.
Option 4: Correct. Decreased level of consciousness is the earliest and most sensitive indicator of
increased intracranial pressure and neurological deterioration following head trauma.
QUESTION 4
A 23-year-old woman at 32-weeks gestation is seen in the outpatient clinic. Which finding would
indicate a possible complication?
The client's urine test is positive for glucose and acetone
The client has 1+ pedal edema in both feet at the end of the day
The client complains of an increase in vaginal discharge
The client says she feels pressure against her diaphragm when the baby moves
ANSWER: 1
Rationale:
Option 1: Correct. Glucose and acetone in urine during pregnancy indicates possible gestational diabetes
or poor diabetic control, requiring further evaluation. This is an abnormal finding requiring intervention.
Option 2: Incorrect. Mild (1+) pedal edema at the end of the day is common in the third trimester due to
increased venous pressure and is not necessarily a complication.
