ATI Proctored Capstone Comprehensive Test B 2026 Exam Questions With
Complete Verified 100% Solutions
Question 1
A nurse is preparing to dispose of a newly opened fentanyl transdermal patch that a client has
refused. Which of the following actions should the nurse take?
A) Place the patch in a sharps container.
B) Return the patch to the automated medication dispensing system.
C) Ask another nurse to witness the disposal of the patch.
D) Flush the patch down the toilet immediately.
E) Place the patch back into its original packaging for later use.
Correct Answer: C) Ask another nurse to witness the disposal of the new patch.
Rationale: Fentanyl is a Schedule II opioid analgesic, and any wastage or disposal of
controlled substances must be witnessed by another licensed nurse to prevent diversion and
ensure proper facility protocol. The disposal should then be documented in the controlled
substance record with both nurses' signatures.
Question 2
A client is receiving a continuous heparin IV infusion and has been started on warfarin 5 mg PO
daily. The client’s latest lab values are aPTT 98 seconds and INR 1.8. Which of the following
actions should the nurse take?
A) Increase the heparin infusion rate.
B) Administer the scheduled dose of warfarin.
C) Withhold the heparin infusion.
D) Administer vitamin K intramuscularly.
E) Discontinue the warfarin and notify the provider.
Correct Answer: C) Withhold the heparin infusion.
Rationale: An aPTT of 98 seconds is significantly above the expected therapeutic range
(typically 1.5 to 2.5 times the normal reference value of 30-40 seconds, or roughly 60-80
seconds). A value this high puts the client at risk for spontaneous bleeding. While the INR is
1.8 (approaching the therapeutic range for warfarin of 2.0-3.0), the priority is to stop the
heparin to allow the aPTT to return to a safe range.
, 2
Question 3
A nurse at an urgent care clinic is assessing a client who reports a sudden onset of impaired
vision in one eye. Which of the following findings indicates the client has a detached retina?
A) Severe eye pain and pressure.
B) Halos around lights.
C) Floating dark spots and flashes of light.
D) Cloudy or milky appearance of the lens.
E) Loss of peripheral vision in both eyes.
Correct Answer: C) Floating dark spots.
Rationale: A detached retina is characterized by a sudden, painless onset of "floaters" (dark
spots), flashes of light (photopsia), or a "curtain" being pulled over the visual field. It is a
medical emergency. Pain and halos are more common with glaucoma, while cloudiness is
characteristic of cataracts.
Question 4
A nurse is assessing an infant with hydrocephalus 6 hours postoperatively following a
ventriculoperitoneal (VP) shunt placement. Which of the following findings should the nurse
report to the provider?
A) Heart rate of 120/min.
B) Symmetrical pupillary response to light.
C) Irritability when being held.
D) Respiratory rate of 30/min.
E) Hypoactive bowel sounds in all quadrants.
Correct Answer: C) Irritability when being held.
Rationale: Post-VP shunt placement, irritability is a sign of increased intracranial pressure
(ICP), which may indicate shunt malfunction or infection. In infants, high-pitched crying
and irritability when being moved or held (due to discomfort from pressure changes) are
critical signs to report immediately.
Question 5
A nurse is assessing a newborn's heart rate. Which of the following actions should the nurse
, 3
take?
A) Palpate the radial pulse for 30 seconds and multiply by 2.
B) Use a Doppler over the brachial artery.
C) Auscultate the apical pulse and count beats for at least 1 min.
D) Assess the heart rate while the newborn is crying to ensure maximum rate.
E) Palpate the femoral pulse and compare it to the carotid pulse.
Correct Answer: C) Auscultate the apical pulse and count beats for at least 1 min.
Rationale: Because of the potential for irregular rhythms (sinus arrhythmia) in newborns,
the apical pulse should always be auscultated for a full minute to ensure an accurate count.
This is the gold standard for pediatric assessment.
Question 6
A nurse is caring for a client who has a fecal impaction. Which of the following actions should
the nurse take when digitally evacuating the stool?
A) Place the client in a right-lateral position.
B) Use a dry gloved finger to facilitate grip.
C) Insert a lubricated gloved finger and advance along the rectal wall.
D) Perform the procedure quickly to minimize client discomfort.
E) Ask the client to take deep breaths to stimulate the Valsalva maneuver.
Correct Answer: C) Insert a lubricated gloved finger and advance along the rectal wall.
Rationale: Lubrication is essential to prevent mucosal trauma. Advancing along the rectal
wall allows the nurse to gently break up the stool and remove it in segments. The nurse
must monitor for bradycardia during this procedure due to vagal nerve stimulation.
Question 7
A nurse is providing dietary teaching to a client with a new prescription for phenelzine. Which of
the following foods should the nurse instruct the client to consume?
A) Pepperoni and aged cheddar cheese.
B) Smoked salmon and avocados.
C) Broccoli, yogurt, and cream cheese.
, 4
D) Red wine and soy sauce.
E) Fava beans and overripe bananas.
Correct Answer: C) Broccoli, Yogurt, Cream Cheese.
Rationale: Phenelzine is an MAOI. Clients taking MAOIs must avoid tyramine-rich foods to
prevent a hypertensive crisis. Aged cheeses, cured meats, smoked fish, and fermented
products are high in tyramine. Broccoli, yogurt, and cream cheese are considered low-
tyramine options and are safe to consume.
Question 8
A nurse administers an incorrect dose of medication to a client. Which of the following facts
related to the incident report should the nurse document in the client's medical record?
A) The fact that an incident report was completed.
B) The nurse’s personal opinion on why the error occurred.
C) The time the medication was given.
D) The name of the pharmacy technician who filled the prescription.
E) A copy of the incident report should be attached to the chart.
Correct Answer: C) Time the medication was given.
Rationale: Documentation in the medical record should be factual and objective, focusing
on what happened to the client (medication, dose, time, and client response). The nurse
should NOT mention that an incident report was filed in the medical record, as that is an
internal quality improvement document intended for the facility's legal protection and risk
management.
Question 9
A nurse on a pediatric unit has received shift report on four children. Which of the following
children should the nurse assess first?
A) A 5-year-old child with a temperature of 101.2°F following an ear infection.
B) A 2-year-old child with a barking cough and mild stridor.
C) A 10-year-old child who is awaiting surgery for an appendectomy and experienced sudden
relief of pain.
Complete Verified 100% Solutions
Question 1
A nurse is preparing to dispose of a newly opened fentanyl transdermal patch that a client has
refused. Which of the following actions should the nurse take?
A) Place the patch in a sharps container.
B) Return the patch to the automated medication dispensing system.
C) Ask another nurse to witness the disposal of the patch.
D) Flush the patch down the toilet immediately.
E) Place the patch back into its original packaging for later use.
Correct Answer: C) Ask another nurse to witness the disposal of the new patch.
Rationale: Fentanyl is a Schedule II opioid analgesic, and any wastage or disposal of
controlled substances must be witnessed by another licensed nurse to prevent diversion and
ensure proper facility protocol. The disposal should then be documented in the controlled
substance record with both nurses' signatures.
Question 2
A client is receiving a continuous heparin IV infusion and has been started on warfarin 5 mg PO
daily. The client’s latest lab values are aPTT 98 seconds and INR 1.8. Which of the following
actions should the nurse take?
A) Increase the heparin infusion rate.
B) Administer the scheduled dose of warfarin.
C) Withhold the heparin infusion.
D) Administer vitamin K intramuscularly.
E) Discontinue the warfarin and notify the provider.
Correct Answer: C) Withhold the heparin infusion.
Rationale: An aPTT of 98 seconds is significantly above the expected therapeutic range
(typically 1.5 to 2.5 times the normal reference value of 30-40 seconds, or roughly 60-80
seconds). A value this high puts the client at risk for spontaneous bleeding. While the INR is
1.8 (approaching the therapeutic range for warfarin of 2.0-3.0), the priority is to stop the
heparin to allow the aPTT to return to a safe range.
, 2
Question 3
A nurse at an urgent care clinic is assessing a client who reports a sudden onset of impaired
vision in one eye. Which of the following findings indicates the client has a detached retina?
A) Severe eye pain and pressure.
B) Halos around lights.
C) Floating dark spots and flashes of light.
D) Cloudy or milky appearance of the lens.
E) Loss of peripheral vision in both eyes.
Correct Answer: C) Floating dark spots.
Rationale: A detached retina is characterized by a sudden, painless onset of "floaters" (dark
spots), flashes of light (photopsia), or a "curtain" being pulled over the visual field. It is a
medical emergency. Pain and halos are more common with glaucoma, while cloudiness is
characteristic of cataracts.
Question 4
A nurse is assessing an infant with hydrocephalus 6 hours postoperatively following a
ventriculoperitoneal (VP) shunt placement. Which of the following findings should the nurse
report to the provider?
A) Heart rate of 120/min.
B) Symmetrical pupillary response to light.
C) Irritability when being held.
D) Respiratory rate of 30/min.
E) Hypoactive bowel sounds in all quadrants.
Correct Answer: C) Irritability when being held.
Rationale: Post-VP shunt placement, irritability is a sign of increased intracranial pressure
(ICP), which may indicate shunt malfunction or infection. In infants, high-pitched crying
and irritability when being moved or held (due to discomfort from pressure changes) are
critical signs to report immediately.
Question 5
A nurse is assessing a newborn's heart rate. Which of the following actions should the nurse
, 3
take?
A) Palpate the radial pulse for 30 seconds and multiply by 2.
B) Use a Doppler over the brachial artery.
C) Auscultate the apical pulse and count beats for at least 1 min.
D) Assess the heart rate while the newborn is crying to ensure maximum rate.
E) Palpate the femoral pulse and compare it to the carotid pulse.
Correct Answer: C) Auscultate the apical pulse and count beats for at least 1 min.
Rationale: Because of the potential for irregular rhythms (sinus arrhythmia) in newborns,
the apical pulse should always be auscultated for a full minute to ensure an accurate count.
This is the gold standard for pediatric assessment.
Question 6
A nurse is caring for a client who has a fecal impaction. Which of the following actions should
the nurse take when digitally evacuating the stool?
A) Place the client in a right-lateral position.
B) Use a dry gloved finger to facilitate grip.
C) Insert a lubricated gloved finger and advance along the rectal wall.
D) Perform the procedure quickly to minimize client discomfort.
E) Ask the client to take deep breaths to stimulate the Valsalva maneuver.
Correct Answer: C) Insert a lubricated gloved finger and advance along the rectal wall.
Rationale: Lubrication is essential to prevent mucosal trauma. Advancing along the rectal
wall allows the nurse to gently break up the stool and remove it in segments. The nurse
must monitor for bradycardia during this procedure due to vagal nerve stimulation.
Question 7
A nurse is providing dietary teaching to a client with a new prescription for phenelzine. Which of
the following foods should the nurse instruct the client to consume?
A) Pepperoni and aged cheddar cheese.
B) Smoked salmon and avocados.
C) Broccoli, yogurt, and cream cheese.
, 4
D) Red wine and soy sauce.
E) Fava beans and overripe bananas.
Correct Answer: C) Broccoli, Yogurt, Cream Cheese.
Rationale: Phenelzine is an MAOI. Clients taking MAOIs must avoid tyramine-rich foods to
prevent a hypertensive crisis. Aged cheeses, cured meats, smoked fish, and fermented
products are high in tyramine. Broccoli, yogurt, and cream cheese are considered low-
tyramine options and are safe to consume.
Question 8
A nurse administers an incorrect dose of medication to a client. Which of the following facts
related to the incident report should the nurse document in the client's medical record?
A) The fact that an incident report was completed.
B) The nurse’s personal opinion on why the error occurred.
C) The time the medication was given.
D) The name of the pharmacy technician who filled the prescription.
E) A copy of the incident report should be attached to the chart.
Correct Answer: C) Time the medication was given.
Rationale: Documentation in the medical record should be factual and objective, focusing
on what happened to the client (medication, dose, time, and client response). The nurse
should NOT mention that an incident report was filed in the medical record, as that is an
internal quality improvement document intended for the facility's legal protection and risk
management.
Question 9
A nurse on a pediatric unit has received shift report on four children. Which of the following
children should the nurse assess first?
A) A 5-year-old child with a temperature of 101.2°F following an ear infection.
B) A 2-year-old child with a barking cough and mild stridor.
C) A 10-year-old child who is awaiting surgery for an appendectomy and experienced sudden
relief of pain.
