ATI Capstone Comprehensive Assessment v2.0: Advanced
Clinical Judgment, Prioritization, and Evidence-Based Nursing
Practice for Pre-Licensure RN Candidates
Exam Version: 2.0
Difficulty Level: Advanced / Hard / Mixed
Target Audience: Senior nursing students, pre-licensure RN candidates preparing for the ATI
Comprehensive Predictor, ATI Capstone Proctored Assessment, and NCLEX-RN examination
Exam Format: 100 multiple-choice questions with one correct answer per question
Content Areas: Fundamentals, Pharmacology, Medical-Surgical Nursing, Maternal-Newborn Nursing,
Pediatrics, Mental Health Nursing, Leadership and Management, Community Health
Instructions:
Select the single best answer for each question. Base your responses on current evidence-based
nursing practice, the NCLEX-RN Test Plan, and ATI Nursing Education standards. Prioritize client safety,
the nursing process, and clinical judgment in all responses.
Section 1: Fundamentals of Nursing (Questions 1–15)
Question 1
A nurse is caring for a client who has a nasogastric (NG) tube set to continuous suction. Which of the
following findings should the nurse report to the healthcare provider immediately?
A) Gastric output of 300 mL in the past 8 hours
B) Intermittent bubbling in the suction control chamber
C) Greenish-yellow drainage in the collection canister
D) The client reports nausea and abdominal cramping
,Correct Answer: D
Rationale: Nausea and abdominal cramping with continuous NG suction may indicate tube
obstruction or displacement, requiring immediate assessment. Gastric output of 300 mL in 8 hours (A)
is within expected range. Intermittent bubbling (B) is normal suction function. Greenish-yellow
drainage (C) is expected gastric contents.
Question 2
A nurse is preparing to perform a sterile dressing change for a client with a surgical wound. Which of
the following actions demonstrates proper sterile technique?
A) Opening the sterile package away from the body
B) Setting up the sterile field while wearing clean gloves
C) Placing the sterile field at waist level
D) Reaching over the sterile field to retrieve additional supplies
Correct Answer: C
Rationale: A sterile field should be placed at waist level, which is considered the sterile boundary. The
sterile package should be opened away from the body (A) but this is only one aspect. Clean gloves (B)
are not appropriate for establishing a sterile field. Reaching over the sterile field (D) contaminates the
field.
Question 3
A nurse is assessing a client who has a pressure injury. Which of the following findings indicates the
wound is healing?
A) Wound edges are rolled under (epibole)
B) Granulation tissue is present in the wound bed
C) Surrounding skin is erythematous and warm
D) Exudate is purulent and malodorous
Correct Answer: B
,Rationale: Granulation tissue (pink/red moist tissue) indicates wound healing. Rolled wound edges
(epibole, A) indicate stalled healing. Erythema and warmth (C) suggest infection. Purulent, malodorous
exudate (D) indicates infection, not healing.
Question 4
A nurse is providing instructions to a client who is prescribed a 24-hour urine collection. Which of the
following statements by the client indicates understanding?
A) "I will collect all urine starting with my first morning void."
B) "I will discard the first void and start the collection after that."
C) "I will store the urine at room temperature during collection."
D) "I will collect urine only during daytime hours."
Correct Answer: B
Rationale: The first void of the day is discarded, and the collection begins with the second void. All
urine is collected for 24 hours, including nighttime (not D). The collection container should be
refrigerated or kept on ice (not C). The first morning void is discarded (not A).
Question 5
A nurse is preparing to insert a Foley catheter in a female client. Which of the following actions should
the nurse take?
A) Use sterile water to inflate the balloon
B) Advance the catheter until resistance is met
C) Lubricate the catheter with sterile water-soluble lubricant
D) Clean the meatus from the rectum toward the urethra
Correct Answer: C
Rationale: Sterile water-soluble lubricant is used for catheter insertion. Sterile water is used to inflate
the balloon, but not as lubricant (A). The catheter should be advanced until urine flows, not until
resistance (B). Cleaning should be from the urethra toward the rectum, not the reverse (D).
, Question 6
A nurse is assessing a client who has a tracheostomy. Which of the following findings requires
immediate intervention?
A) Serosanguineous drainage around the stoma
B) Difficulty passing a suction catheter through the tracheostomy tube
C) Small amount of dried secretions around the tracheostomy site
D) The client is able to speak using a speaking valve
Correct Answer: B
Rationale: Difficulty passing a suction catheter may indicate tracheostomy tube obstruction or
displacement, requiring immediate intervention. Serosanguineous drainage (A) is expected. Dried
secretions (C) can be cleaned. Speaking valves (D) are appropriate for some clients.
Question 7
A nurse is preparing to administer a medication via a nasogastric tube. Which of the following actions
should the nurse take?
A) Crush all medications, including enteric-coated tablets
B) Verify tube placement by aspirating gastric contents
C) Administer each medication separately without flushing
D) Dilute medications in 60 mL of normal saline
Correct Answer: B
Rationale: Verifying tube placement by aspirating gastric contents and checking pH is essential before
administering medications. Enteric-coated tablets (A) should not be crushed. Medications should be
administered separately with flushing between each (not C). Dilution amount varies (not fixed at 60
mL, D).
Question 8
Clinical Judgment, Prioritization, and Evidence-Based Nursing
Practice for Pre-Licensure RN Candidates
Exam Version: 2.0
Difficulty Level: Advanced / Hard / Mixed
Target Audience: Senior nursing students, pre-licensure RN candidates preparing for the ATI
Comprehensive Predictor, ATI Capstone Proctored Assessment, and NCLEX-RN examination
Exam Format: 100 multiple-choice questions with one correct answer per question
Content Areas: Fundamentals, Pharmacology, Medical-Surgical Nursing, Maternal-Newborn Nursing,
Pediatrics, Mental Health Nursing, Leadership and Management, Community Health
Instructions:
Select the single best answer for each question. Base your responses on current evidence-based
nursing practice, the NCLEX-RN Test Plan, and ATI Nursing Education standards. Prioritize client safety,
the nursing process, and clinical judgment in all responses.
Section 1: Fundamentals of Nursing (Questions 1–15)
Question 1
A nurse is caring for a client who has a nasogastric (NG) tube set to continuous suction. Which of the
following findings should the nurse report to the healthcare provider immediately?
A) Gastric output of 300 mL in the past 8 hours
B) Intermittent bubbling in the suction control chamber
C) Greenish-yellow drainage in the collection canister
D) The client reports nausea and abdominal cramping
,Correct Answer: D
Rationale: Nausea and abdominal cramping with continuous NG suction may indicate tube
obstruction or displacement, requiring immediate assessment. Gastric output of 300 mL in 8 hours (A)
is within expected range. Intermittent bubbling (B) is normal suction function. Greenish-yellow
drainage (C) is expected gastric contents.
Question 2
A nurse is preparing to perform a sterile dressing change for a client with a surgical wound. Which of
the following actions demonstrates proper sterile technique?
A) Opening the sterile package away from the body
B) Setting up the sterile field while wearing clean gloves
C) Placing the sterile field at waist level
D) Reaching over the sterile field to retrieve additional supplies
Correct Answer: C
Rationale: A sterile field should be placed at waist level, which is considered the sterile boundary. The
sterile package should be opened away from the body (A) but this is only one aspect. Clean gloves (B)
are not appropriate for establishing a sterile field. Reaching over the sterile field (D) contaminates the
field.
Question 3
A nurse is assessing a client who has a pressure injury. Which of the following findings indicates the
wound is healing?
A) Wound edges are rolled under (epibole)
B) Granulation tissue is present in the wound bed
C) Surrounding skin is erythematous and warm
D) Exudate is purulent and malodorous
Correct Answer: B
,Rationale: Granulation tissue (pink/red moist tissue) indicates wound healing. Rolled wound edges
(epibole, A) indicate stalled healing. Erythema and warmth (C) suggest infection. Purulent, malodorous
exudate (D) indicates infection, not healing.
Question 4
A nurse is providing instructions to a client who is prescribed a 24-hour urine collection. Which of the
following statements by the client indicates understanding?
A) "I will collect all urine starting with my first morning void."
B) "I will discard the first void and start the collection after that."
C) "I will store the urine at room temperature during collection."
D) "I will collect urine only during daytime hours."
Correct Answer: B
Rationale: The first void of the day is discarded, and the collection begins with the second void. All
urine is collected for 24 hours, including nighttime (not D). The collection container should be
refrigerated or kept on ice (not C). The first morning void is discarded (not A).
Question 5
A nurse is preparing to insert a Foley catheter in a female client. Which of the following actions should
the nurse take?
A) Use sterile water to inflate the balloon
B) Advance the catheter until resistance is met
C) Lubricate the catheter with sterile water-soluble lubricant
D) Clean the meatus from the rectum toward the urethra
Correct Answer: C
Rationale: Sterile water-soluble lubricant is used for catheter insertion. Sterile water is used to inflate
the balloon, but not as lubricant (A). The catheter should be advanced until urine flows, not until
resistance (B). Cleaning should be from the urethra toward the rectum, not the reverse (D).
, Question 6
A nurse is assessing a client who has a tracheostomy. Which of the following findings requires
immediate intervention?
A) Serosanguineous drainage around the stoma
B) Difficulty passing a suction catheter through the tracheostomy tube
C) Small amount of dried secretions around the tracheostomy site
D) The client is able to speak using a speaking valve
Correct Answer: B
Rationale: Difficulty passing a suction catheter may indicate tracheostomy tube obstruction or
displacement, requiring immediate intervention. Serosanguineous drainage (A) is expected. Dried
secretions (C) can be cleaned. Speaking valves (D) are appropriate for some clients.
Question 7
A nurse is preparing to administer a medication via a nasogastric tube. Which of the following actions
should the nurse take?
A) Crush all medications, including enteric-coated tablets
B) Verify tube placement by aspirating gastric contents
C) Administer each medication separately without flushing
D) Dilute medications in 60 mL of normal saline
Correct Answer: B
Rationale: Verifying tube placement by aspirating gastric contents and checking pH is essential before
administering medications. Enteric-coated tablets (A) should not be crushed. Medications should be
administered separately with flushing between each (not C). Dilution amount varies (not fixed at 60
mL, D).
Question 8
