ATI RN CAPSTONE PROCTORED
COMPREHENSIVE ASSESSMENT B 2026–
2027 | COMPLETE STUDY GUIDE | VERIFIED
QUESTIONS & ANSWERS | NCLEX-RN EXAM
PREP PDF
ATI RN CAPSTONE PROCTORED COMPREHENSIVE ASSESSMENT B 2026–2027
• This comprehensive study guide contains verified practice questions designed to
assess mastery across all major nursing domains tested on the ATI RN Capstone
exam and NCLEX-RN preparation.
• Study this material by practicing questions under timed conditions, reviewing
detailed EXPERT RATIONALE for both correct and incorrect answers, and
identifying knowledge gaps for targeted review.
QUESTION 1
A nurse is caring for a client who has heart failure and reports dyspnea. The
nurse notes crackles in the lungs and elevated jugular venous pressure.
Which intervention should the nurse prioritize?
A) Encourage the client to ambulate to improve circulation
B) Administer diuretics as prescribed and monitor for electrolyte imbalances
C) Position the client flat to reduce respiratory strain
D) Decrease oral fluid intake and monitor daily weights
E) Administer oxygen and elevate the head of the bed
✓ CORRECT ANSWER: E) Administer oxygen and elevate the head of the bed
EXPERT RATIONALE: A client with heart failure presenting with dyspnea, crackles,
and elevated jugular venous pressure has fluid overload with pulmonary
congestion. The priority intervention is to improve oxygenation and reduce the
workload of breathing. Elevating the head of the bed promotes better chest
expansion and facilitates breathing, while oxygen therapy increases oxygen
saturation. Diuretics should also be given, but the immediate priority is addressing
,respiratory distress. Ambulation and positioning flat would worsen symptoms.
Decreasing fluid intake alone is insufficient for acute symptom management.
QUESTION 2
A nurse is assessing a client with chronic kidney disease. Which finding
indicates the client may be developing uremia?
A) Decreased serum potassium levels
B) Fruity-smelling breath and confusion
C) Increased hemoglobin and hematocrit levels
D) Hypertension with clear lung sounds
E) Elevated sodium levels with peripheral edema
✓ CORRECT ANSWER: B) Fruity-smelling breath and confusion
EXPERT RATIONALE: Uremia occurs when nitrogenous wastes accumulate in the
blood due to renal failure. Fruity-smelling breath (acetone breath) indicates
metabolic acidosis with ketone production, and confusion reflects uremic
encephalopathy from elevated blood urea nitrogen (BUN) and creatinine. These are
classic signs of advancing uremia. Decreased potassium and elevated hemoglobin
would not be typical uremic findings. Hypertension is common in CKD but is not
specific to uremia. Elevated sodium is not characteristic of uremia.
QUESTION 3
A nurse is administering morphine to a client with severe pain. The client's
respiratory rate is 10 breaths per minute. What is the most appropriate
nursing action?
A) Continue the infusion as scheduled and monitor closely
B) Hold the medication and notify the provider immediately
C) Reduce the dose by half and reassess in 15 minutes
,D) Administer naloxone to reverse the effects
E) Position the client in supine and apply oxygen
✓ CORRECT ANSWER: B) Hold the medication and notify the provider
immediately
EXPERT RATIONALE: A respiratory rate of 10 breaths per minute indicates
respiratory depression, which is a serious side effect of opioid analgesics. Morphine
depresses the respiratory center, and a rate below 12 is considered critical. The
nurse must hold further doses and immediately notify the provider to prevent
respiratory failure. Continuing the infusion could lead to respiratory arrest. While
naloxone may ultimately be needed, the provider must be notified first. Positioning
and oxygen are supportive measures but do not address the underlying opioid
overdose.
QUESTION 4
A nurse is educating a client on insulin administration. Which statement by
the client indicates a correct understanding?
A) "I will inject insulin into the same site each time to develop familiarity with the
procedure"
B) "I should refrigerate my insulin at all times, even the bottle I am currently using"
C) "I will rotate injection sites to prevent lipohypertrophy and ensure consistent
absorption"
D) "I can reuse needles if I clean them with alcohol between injections"
E) "I should inject insulin into muscle tissue for faster absorption"
✓ CORRECT ANSWER: C) I will rotate injection sites to prevent lipohypertrophy
and ensure consistent absorption
EXPERT RATIONALE: Rotating insulin injection sites is essential to prevent
lipohypertrophy (fatty tissue buildup), which can develop with repeated injections
to the same site and cause unpredictable insulin absorption. Rotating sites ensures
, consistent medication effect. Injecting into the same site repeatedly compromises
absorption. Insulin in use can be kept at room temperature; refrigeration is only for
unopened vials. Needles should never be reused as this increases infection risk and
needle dulling. Insulin must be injected subcutaneously, not intramuscularly, as
muscle injection causes too-rapid absorption.
QUESTION 5
A nurse is caring for a client receiving chemotherapy. The client reports
nausea and decreased appetite. Which intervention should the nurse
implement first?
A) Administer antiemetic medication 30 minutes before meals
B) Offer small, frequent meals with preferred foods and encourage nutritional
supplements
C) Restrict fluid intake to decrease nausea
D) Provide large meals when the client feels hungry
E) Avoid discussing food with the client to prevent nausea triggers
✓ CORRECT ANSWER: A) Administer antiemetic medication 30 minutes before
meals
EXPERT RATIONALE: Preventing nausea through medication administration before
meals allows the client to eat without nausea, improving nutritional intake during a
critical period of treatment. Antiemetics should be given prophylactically. While
small, frequent meals are beneficial, they are ineffective if the client cannot control
nausea. Restricting fluids can lead to dehydration. Large meals are not tolerated
during chemotherapy. Food is not a "trigger" to avoid discussing; addressing
nausea medically is the priority.
QUESTION 6
COMPREHENSIVE ASSESSMENT B 2026–
2027 | COMPLETE STUDY GUIDE | VERIFIED
QUESTIONS & ANSWERS | NCLEX-RN EXAM
PREP PDF
ATI RN CAPSTONE PROCTORED COMPREHENSIVE ASSESSMENT B 2026–2027
• This comprehensive study guide contains verified practice questions designed to
assess mastery across all major nursing domains tested on the ATI RN Capstone
exam and NCLEX-RN preparation.
• Study this material by practicing questions under timed conditions, reviewing
detailed EXPERT RATIONALE for both correct and incorrect answers, and
identifying knowledge gaps for targeted review.
QUESTION 1
A nurse is caring for a client who has heart failure and reports dyspnea. The
nurse notes crackles in the lungs and elevated jugular venous pressure.
Which intervention should the nurse prioritize?
A) Encourage the client to ambulate to improve circulation
B) Administer diuretics as prescribed and monitor for electrolyte imbalances
C) Position the client flat to reduce respiratory strain
D) Decrease oral fluid intake and monitor daily weights
E) Administer oxygen and elevate the head of the bed
✓ CORRECT ANSWER: E) Administer oxygen and elevate the head of the bed
EXPERT RATIONALE: A client with heart failure presenting with dyspnea, crackles,
and elevated jugular venous pressure has fluid overload with pulmonary
congestion. The priority intervention is to improve oxygenation and reduce the
workload of breathing. Elevating the head of the bed promotes better chest
expansion and facilitates breathing, while oxygen therapy increases oxygen
saturation. Diuretics should also be given, but the immediate priority is addressing
,respiratory distress. Ambulation and positioning flat would worsen symptoms.
Decreasing fluid intake alone is insufficient for acute symptom management.
QUESTION 2
A nurse is assessing a client with chronic kidney disease. Which finding
indicates the client may be developing uremia?
A) Decreased serum potassium levels
B) Fruity-smelling breath and confusion
C) Increased hemoglobin and hematocrit levels
D) Hypertension with clear lung sounds
E) Elevated sodium levels with peripheral edema
✓ CORRECT ANSWER: B) Fruity-smelling breath and confusion
EXPERT RATIONALE: Uremia occurs when nitrogenous wastes accumulate in the
blood due to renal failure. Fruity-smelling breath (acetone breath) indicates
metabolic acidosis with ketone production, and confusion reflects uremic
encephalopathy from elevated blood urea nitrogen (BUN) and creatinine. These are
classic signs of advancing uremia. Decreased potassium and elevated hemoglobin
would not be typical uremic findings. Hypertension is common in CKD but is not
specific to uremia. Elevated sodium is not characteristic of uremia.
QUESTION 3
A nurse is administering morphine to a client with severe pain. The client's
respiratory rate is 10 breaths per minute. What is the most appropriate
nursing action?
A) Continue the infusion as scheduled and monitor closely
B) Hold the medication and notify the provider immediately
C) Reduce the dose by half and reassess in 15 minutes
,D) Administer naloxone to reverse the effects
E) Position the client in supine and apply oxygen
✓ CORRECT ANSWER: B) Hold the medication and notify the provider
immediately
EXPERT RATIONALE: A respiratory rate of 10 breaths per minute indicates
respiratory depression, which is a serious side effect of opioid analgesics. Morphine
depresses the respiratory center, and a rate below 12 is considered critical. The
nurse must hold further doses and immediately notify the provider to prevent
respiratory failure. Continuing the infusion could lead to respiratory arrest. While
naloxone may ultimately be needed, the provider must be notified first. Positioning
and oxygen are supportive measures but do not address the underlying opioid
overdose.
QUESTION 4
A nurse is educating a client on insulin administration. Which statement by
the client indicates a correct understanding?
A) "I will inject insulin into the same site each time to develop familiarity with the
procedure"
B) "I should refrigerate my insulin at all times, even the bottle I am currently using"
C) "I will rotate injection sites to prevent lipohypertrophy and ensure consistent
absorption"
D) "I can reuse needles if I clean them with alcohol between injections"
E) "I should inject insulin into muscle tissue for faster absorption"
✓ CORRECT ANSWER: C) I will rotate injection sites to prevent lipohypertrophy
and ensure consistent absorption
EXPERT RATIONALE: Rotating insulin injection sites is essential to prevent
lipohypertrophy (fatty tissue buildup), which can develop with repeated injections
to the same site and cause unpredictable insulin absorption. Rotating sites ensures
, consistent medication effect. Injecting into the same site repeatedly compromises
absorption. Insulin in use can be kept at room temperature; refrigeration is only for
unopened vials. Needles should never be reused as this increases infection risk and
needle dulling. Insulin must be injected subcutaneously, not intramuscularly, as
muscle injection causes too-rapid absorption.
QUESTION 5
A nurse is caring for a client receiving chemotherapy. The client reports
nausea and decreased appetite. Which intervention should the nurse
implement first?
A) Administer antiemetic medication 30 minutes before meals
B) Offer small, frequent meals with preferred foods and encourage nutritional
supplements
C) Restrict fluid intake to decrease nausea
D) Provide large meals when the client feels hungry
E) Avoid discussing food with the client to prevent nausea triggers
✓ CORRECT ANSWER: A) Administer antiemetic medication 30 minutes before
meals
EXPERT RATIONALE: Preventing nausea through medication administration before
meals allows the client to eat without nausea, improving nutritional intake during a
critical period of treatment. Antiemetics should be given prophylactically. While
small, frequent meals are beneficial, they are ineffective if the client cannot control
nausea. Restricting fluids can lead to dehydration. Large meals are not tolerated
during chemotherapy. Food is not a "trigger" to avoid discussing; addressing
nausea medically is the priority.
QUESTION 6
