COMPREHENSIVE ASSESSMENT B STUDY
GUIDE | LATEST 2026 EXAM QUESTIONS &
VERIFIED ANSWERS (INSTANT PDF
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ATI RN CAPSTONE PROCTORED COMPREHENSIVE ASSESSMENT B STUDY GUIDE
DOCUMENT OVERVIEW:
• This comprehensive study guide contains practice questions designed to mirror
the ATI RN Capstone Proctored Exam with verified correct answers and detailed
EXPERT RATIONALE to enhance your understanding of critical nursing concepts
• Use this material by reviewing one topic at a time, studying the EXPERT
RATIONALE thoroughly to understand the "why" behind correct answers, and
taking practice question sets to build endurance and improve time management
for the actual exam
1. A 45-year-old client with type 2 diabetes mellitus is admitted to the hospital
with a blood glucose level of 450 mg/dL. The client reports polyuria,
polydipsia, and fatigue for the past 3 days. Which of the following
complications is the client at greatest risk for developing?
A) Hypoglycemic coma
B) Diabetic ketoacidosis
C) Hyperglycemic hyperosmolar state
D) Dawn phenomenon
E) Somogyi effect
CORRECT ANSWER: C) Hyperglycemic hyperosmolar state ✓
EXPERT RATIONALE: A blood glucose level of 450 mg/dL in a type 2 diabetic client
with symptoms of polyuria, polydipsia, and fatigue for 3 days indicates
hyperglycemic hyperosmolar state (HHS). This condition is more common in type 2
diabetes and occurs when severe hyperglycemia causes osmotic diuresis leading to
,dehydration and increased serum osmolality. The client's symptoms and lab values
support this diagnosis rather than DKA, which is more common in type 1 diabetes.
Options A, D, and E are incorrect because they are either opposite conditions or
unrelated phenomena.
2. A client is receiving intravenous nitroglycerin for chest pain related to
acute coronary syndrome. Which of the following parameters should the
nurse monitor most closely?
A) Temperature
B) Blood pressure and heart rate
C) Respiratory rate
D) Oxygen saturation only
E) White blood cell count
CORRECT ANSWER: B) Blood pressure and heart rate ✓
EXPERT RATIONALE: Nitroglycerin is a vasodilator that causes peripheral and
coronary vasodilation, which can lead to significant decreases in blood pressure
and reflex tachycardia. Monitoring blood pressure and heart rate is critical to detect
hypotension and adjust the infusion rate accordingly. The medication is titrated to
maintain adequate blood pressure while relieving angina. Temperature, respiratory
rate alone, oxygen saturation alone, and WBC count are not the priority monitoring
parameters for IV nitroglycerin administration.
3. A 28-year-old primigravida at 38 weeks gestation presents to the labor and
delivery unit with spontaneous rupture of membranes. Which of the following
actions should the nurse take first?
A) Prepare for immediate cesarean delivery
B) Assess fetal heart rate and maternal vital signs
C) Ambulate the client to encourage labor progression
,D) Insert an indwelling urinary catheter
E) Administer oxytocin immediately
CORRECT ANSWER: B) Assess fetal heart rate and maternal vital signs ✓
EXPERT RATIONALE: The first action after SROM is to assess fetal heart rate to
determine fetal well-being and to obtain baseline maternal vital signs. This
assessment ensures there are no signs of fetal distress, cord prolapse, or maternal
infection. Only after this initial assessment should other interventions be
considered. Preparing for cesarean delivery, ambulation, catheter insertion, and
oxytocin administration may or may not be indicated depending on the assessment
findings.
4. A client with acute myocardial infarction is prescribed aspirin 325 mg.
Which of the following teaching points should the nurse emphasize?
A) Aspirin should be taken with food to prevent gastrointestinal upset
B) Aspirin should be chewed immediately for faster absorption
C) Aspirin can be discontinued after 1 week
D) Aspirin increases the risk of hemorrhage significantly
E) Aspirin is no longer recommended for cardiac patients
CORRECT ANSWER: B) Aspirin should be chewed immediately for faster
absorption ✓
EXPERT RATIONALE: In acute MI, aspirin is an antiplatelet medication that should
be chewed immediately to achieve faster absorption and therapeutic effect.
Chewing allows for more rapid onset of action in blocking platelet aggregation.
While aspirin can cause GI upset, taking it with food in an acute MI situation would
delay therapeutic action. Aspirin is a long-term therapy for post-MI prevention, not
discontinued after 1 week. While aspirin does increase bleeding risk, this must be
weighed against cardiac benefits, and this is not the primary teaching point for
immediate post-MI administration.
, 5. A 72-year-old client with COPD is experiencing an acute exacerbation. The
ABG results are: pH 7.30, PaCO2 55, HCO3- 24, PaO2 60. What does the nurse
interpret these findings as?
A) Metabolic acidosis with respiratory compensation
B) Respiratory acidosis with inadequate respiratory compensation
C) Respiratory alkalosis with metabolic compensation
D) Metabolic alkalosis with respiratory compensation
E) Mixed respiratory and metabolic alkalosis
CORRECT ANSWER: B) Respiratory acidosis with inadequate respiratory
compensation ✓
EXPERT RATIONALE: The pH of 7.30 is acidemic. The elevated PaCO2 of 55
indicates CO2 retention, which is the primary cause of the acidosis (respiratory
acidosis). In a client with COPD experiencing an acute exacerbation, the respiratory
system cannot compensate adequately. The HCO3- of 24 is normal but should be
elevated (>26) if metabolic compensation were adequate. This indicates respiratory
acidosis with inadequate metabolic compensation. The low PaO2 of 60 also
indicates inadequate oxygenation requiring intervention.
6. A client is scheduled for a coronary artery bypass graft (CABG). Which of the
following preoperative teaching points is most important?
A) The client will have no pain during the immediate postoperative period
B) The client should expect to be on a ventilator temporarily after surgery
C) The client can resume normal activities within 1 week
D) The client will not need medications after surgery
E) The client should fast for 48 hours before surgery