ATI CAPSTONE MEDICAL-SURGICAL
ASSESSMENT 1 & 2 | 200 REAL QUESTIONS
WITH VERIFIED ANSWERS, DETAILED
RATIONALES & 2025/2026 UPDATED EXAM
PREP GUIDE
DOCUMENT OVERVIEW
• This comprehensive exam guide contains 200 questions covering all major
content areas of the ATI Capstone Medical-Surgical Assessment 1 & 2,
including cardiovascular, respiratory, renal, neurological, endocrine,
gastrointestinal, musculoskeletal, and perioperative nursing topics.
• Each question is presented with vertically spaced answer options, a clearly
highlighted correct answer in bold, and a detailed EXPERT RATIONALE
explaining the clinical reasoning behind the correct choice. Use this guide for
focused review, self-assessment, and identification of knowledge gaps as you
prepare for your exam.
ASSESSMENT 1
1. A nurse is teaching a client how to administer a medication using an inhaler
with a spacer. Which of the following instructions should the nurse include?
A. "Wait at least 5 minutes between puffs from the same inhaler."
B. "Breathe in rapidly when inhaling the medication."
C. "Clean the plastic inhaler cap weekly with cold water."
D. "Shake the inhaler vigorously prior to use."
Correct Answer: D. "Shake the inhaler vigorously prior to use."
EXPERT RATIONALE: The medication in a metered-dose inhaler can separate easily,
so the nurse should instruct the client to shake the inhaler vigorously to ensure
proper dispersion of the medication. Clients should also be instructed to wait 1-2
minutes between puffs, breathe in slowly and deeply, and clean the plastic cap with
warm water weekly .
,2. A nurse is planning care for a client who is receiving mechanical ventilation.
Which of the following actions should the nurse include in the plan?
A. Provide the client with a means of communication.
B. Maintain the head of the client's bed in a flat position.
C. Suction the client's endotracheal tube every 4 hours.
D. Perform oral hygiene for the client every 8 hours.
Correct Answer: A. Provide the client with a means of communication.
EXPERT RATIONALE: A client receiving mechanical ventilation is unable to speak
due to the endotracheal tube. The nurse should provide alternative communication
methods such as an electronic tablet, alphabet board, or pencil and paper. The
head of the bed should be elevated to 30-45 degrees to prevent ventilator-
associated pneumonia. Suctioning should be performed as needed, not on a fixed
schedule, and oral hygiene should be performed more frequently than every 8
hours .
3. A nurse is providing discharge teaching to a client who is postoperative
following glaucoma surgery. Which of the following instructions should the
nurse include to prevent increased intraocular pressure?
A. "Avoid straining to have a bowel movement."
B. "Avoid lying on your right side."
C. "Avoid lifting objects that weigh more than 5 pounds."
D. "Avoid sleeping with your head elevated."
Correct Answer: A. "Avoid straining to have a bowel movement."
EXPERT RATIONALE: Straining during a bowel movement increases intraocular
pressure (IOP) and can compromise the surgical site. The nurse should instruct the
client to consume a diet high in fiber and fluids to prevent constipation. Lying on
the operative side should be avoided, lifting more than 5 pounds is a general
,restriction but not specific to IOP prevention, and sleeping with the head elevated is
actually recommended to reduce IOP .
4. A nurse is providing teaching about health promotion activities to an older
adult client. Which of the following recommendations should the nurse
include in the teaching?
A. "Maintain your dietary fat intake at 45% of your daily caloric intake."
B. "Obtain 15 minutes of sunlight exposure 3 times per week."
C. "Exercise for 30 minutes twice per week."
D. "Decrease your fiber intake to less than 20 grams per day."
Correct Answer: B. "Obtain 15 minutes of sunlight exposure 3 times per
week."
EXPERT RATIONALE: Older adults are at risk for vitamin D deficiency. The nurse
should recommend 10-15 minutes of sunlight exposure 2-3 times per week to
promote adequate vitamin D production. Dietary fat intake should be limited to 20-
35% of daily calories, exercise should be at least 30 minutes most days of the week,
and fiber intake should be 25-35 grams per day .
5. A nurse is caring for a client who has an above-the-knee amputation
related to trauma and is experiencing phantom limb pain. Which of the
following medications should the nurse administer to treat the client's pain?
A. Meloxicam
B. Cyclobenzaprine
C. Gabapentin
D. Lidocaine
Correct Answer: C. Gabapentin
, EXPERT RATIONALE: Phantom limb pain is a type of neuropathic pain resulting
from damage to peripheral and central nervous system pathways. Gabapentin is an
anticonvulsant medication that is effective in treating neuropathic pain. Meloxicam
is an NSAID for inflammatory pain, cyclobenzaprine is a muscle relaxant, and
lidocaine is a local anesthetic .
6. A nurse is reviewing the laboratory findings for a client who has a urinary
tract infection. Which of the following laboratory findings should the nurse
identify as an indication the client is in the initial stages of systemic
inflammatory response syndrome (SIRS)?
A. WBC count 14,000/mm³
B. Platelets 110,000/mm³
C. Lactic acid 19 mg/dL
D. C-reactive protein 2.8 mg/L
Correct Answer: A. WBC count 14,000/mm³
EXPERT RATIONALE: SIRS criteria include two or more of the following:
temperature >38°C or <36°C, heart rate >90/min, respiratory rate >20/min or
PaCO2 <32 mmHg, and WBC count >12,000/mm³ or <4,000/mm³ or >10% bands. A
WBC count of 14,000/mm³ meets the criteria for SIRS. Platelets below 100,000/mm³
indicate thrombocytopenia, lactic acid >2 mmol/L indicates tissue hypoperfusion,
and elevated CRP indicates inflammation but is not a specific SIRS criterion .
7. A nurse in the ICU is caring for a client who is reporting heart palpitations.
The nurse notes ventricular tachycardia on the ECG monitor. Which of the
following actions should the nurse take?
A. Defibrillate the client
B. Prepare the client for cardioversion
C. Initiate CPR
ASSESSMENT 1 & 2 | 200 REAL QUESTIONS
WITH VERIFIED ANSWERS, DETAILED
RATIONALES & 2025/2026 UPDATED EXAM
PREP GUIDE
DOCUMENT OVERVIEW
• This comprehensive exam guide contains 200 questions covering all major
content areas of the ATI Capstone Medical-Surgical Assessment 1 & 2,
including cardiovascular, respiratory, renal, neurological, endocrine,
gastrointestinal, musculoskeletal, and perioperative nursing topics.
• Each question is presented with vertically spaced answer options, a clearly
highlighted correct answer in bold, and a detailed EXPERT RATIONALE
explaining the clinical reasoning behind the correct choice. Use this guide for
focused review, self-assessment, and identification of knowledge gaps as you
prepare for your exam.
ASSESSMENT 1
1. A nurse is teaching a client how to administer a medication using an inhaler
with a spacer. Which of the following instructions should the nurse include?
A. "Wait at least 5 minutes between puffs from the same inhaler."
B. "Breathe in rapidly when inhaling the medication."
C. "Clean the plastic inhaler cap weekly with cold water."
D. "Shake the inhaler vigorously prior to use."
Correct Answer: D. "Shake the inhaler vigorously prior to use."
EXPERT RATIONALE: The medication in a metered-dose inhaler can separate easily,
so the nurse should instruct the client to shake the inhaler vigorously to ensure
proper dispersion of the medication. Clients should also be instructed to wait 1-2
minutes between puffs, breathe in slowly and deeply, and clean the plastic cap with
warm water weekly .
,2. A nurse is planning care for a client who is receiving mechanical ventilation.
Which of the following actions should the nurse include in the plan?
A. Provide the client with a means of communication.
B. Maintain the head of the client's bed in a flat position.
C. Suction the client's endotracheal tube every 4 hours.
D. Perform oral hygiene for the client every 8 hours.
Correct Answer: A. Provide the client with a means of communication.
EXPERT RATIONALE: A client receiving mechanical ventilation is unable to speak
due to the endotracheal tube. The nurse should provide alternative communication
methods such as an electronic tablet, alphabet board, or pencil and paper. The
head of the bed should be elevated to 30-45 degrees to prevent ventilator-
associated pneumonia. Suctioning should be performed as needed, not on a fixed
schedule, and oral hygiene should be performed more frequently than every 8
hours .
3. A nurse is providing discharge teaching to a client who is postoperative
following glaucoma surgery. Which of the following instructions should the
nurse include to prevent increased intraocular pressure?
A. "Avoid straining to have a bowel movement."
B. "Avoid lying on your right side."
C. "Avoid lifting objects that weigh more than 5 pounds."
D. "Avoid sleeping with your head elevated."
Correct Answer: A. "Avoid straining to have a bowel movement."
EXPERT RATIONALE: Straining during a bowel movement increases intraocular
pressure (IOP) and can compromise the surgical site. The nurse should instruct the
client to consume a diet high in fiber and fluids to prevent constipation. Lying on
the operative side should be avoided, lifting more than 5 pounds is a general
,restriction but not specific to IOP prevention, and sleeping with the head elevated is
actually recommended to reduce IOP .
4. A nurse is providing teaching about health promotion activities to an older
adult client. Which of the following recommendations should the nurse
include in the teaching?
A. "Maintain your dietary fat intake at 45% of your daily caloric intake."
B. "Obtain 15 minutes of sunlight exposure 3 times per week."
C. "Exercise for 30 minutes twice per week."
D. "Decrease your fiber intake to less than 20 grams per day."
Correct Answer: B. "Obtain 15 minutes of sunlight exposure 3 times per
week."
EXPERT RATIONALE: Older adults are at risk for vitamin D deficiency. The nurse
should recommend 10-15 minutes of sunlight exposure 2-3 times per week to
promote adequate vitamin D production. Dietary fat intake should be limited to 20-
35% of daily calories, exercise should be at least 30 minutes most days of the week,
and fiber intake should be 25-35 grams per day .
5. A nurse is caring for a client who has an above-the-knee amputation
related to trauma and is experiencing phantom limb pain. Which of the
following medications should the nurse administer to treat the client's pain?
A. Meloxicam
B. Cyclobenzaprine
C. Gabapentin
D. Lidocaine
Correct Answer: C. Gabapentin
, EXPERT RATIONALE: Phantom limb pain is a type of neuropathic pain resulting
from damage to peripheral and central nervous system pathways. Gabapentin is an
anticonvulsant medication that is effective in treating neuropathic pain. Meloxicam
is an NSAID for inflammatory pain, cyclobenzaprine is a muscle relaxant, and
lidocaine is a local anesthetic .
6. A nurse is reviewing the laboratory findings for a client who has a urinary
tract infection. Which of the following laboratory findings should the nurse
identify as an indication the client is in the initial stages of systemic
inflammatory response syndrome (SIRS)?
A. WBC count 14,000/mm³
B. Platelets 110,000/mm³
C. Lactic acid 19 mg/dL
D. C-reactive protein 2.8 mg/L
Correct Answer: A. WBC count 14,000/mm³
EXPERT RATIONALE: SIRS criteria include two or more of the following:
temperature >38°C or <36°C, heart rate >90/min, respiratory rate >20/min or
PaCO2 <32 mmHg, and WBC count >12,000/mm³ or <4,000/mm³ or >10% bands. A
WBC count of 14,000/mm³ meets the criteria for SIRS. Platelets below 100,000/mm³
indicate thrombocytopenia, lactic acid >2 mmol/L indicates tissue hypoperfusion,
and elevated CRP indicates inflammation but is not a specific SIRS criterion .
7. A nurse in the ICU is caring for a client who is reporting heart palpitations.
The nurse notes ventricular tachycardia on the ECG monitor. Which of the
following actions should the nurse take?
A. Defibrillate the client
B. Prepare the client for cardioversion
C. Initiate CPR
