ATI Capstone Fundamentals: Comprehensive Examination
100 Multiple-Choice Questions with Rationales
Exam Title: ATI Capstone Fundamentals Comprehensive Assessment: Foundational Nursing Concepts,
Clinical Judgment, and Patient Care Priorities for Pre-Licensure Nursing Candidates
Target Audience: Nursing students preparing for ATI Capstone Fundamentals assessment and NCLEX-
RN examination
Difficulty Level: Advanced/Hard/Mixed (progressing from foundational knowledge to complex clinical
judgment)
Section 1: Nursing Process & Clinical Judgment (Questions 1–10)
1. A nurse is caring for a client who reports acute abdominal pain. Which of the following actions
should the nurse take first?
A) Administer prescribed analgesic medication
B) Position the client in a comfortable position
C) Perform a comprehensive pain assessment
D) Notify the provider of the client's report of pain
Correct Answer: C) Perform a comprehensive pain assessment
Rationale: The nursing process begins with assessment. Before implementing any intervention, the
nurse must gather data about the pain including location, intensity, quality, and associated factors.
Administering medication (A) or notifying the provider (D) would occur after assessment. Positioning
(B) may provide comfort but is not the priority first action.
2. A nurse is planning care for a client following the nursing process framework. Which of the
following represents the correct sequence of steps?
A) Planning, Assessment, Diagnosis, Implementation, Evaluation
B) Assessment, Diagnosis, Planning, Implementation, Evaluation
C) Diagnosis, Assessment, Planning, Evaluation, Implementation
D) Assessment, Planning, Diagnosis, Implementation, Evaluation
Correct Answer: B) Assessment, Diagnosis, Planning, Implementation, Evaluation
,Rationale: The nursing process follows the ADPIE framework: Assessment, Diagnosis, Planning,
Implementation, and Evaluation. This systematic approach ensures comprehensive client care through
sequential but overlapping steps.
3. A nurse is collecting data from a client who reports difficulty sleeping. Which of the following is a
subjective finding?
A) Client's heart rate is 88/min
B) Client reports waking up three times during the night
C) Client's blood pressure is 132/86 mmHg
D) Client appears fatigued with dark circles under eyes
Correct Answer: B) Client reports waking up three times during the night
Rationale: Subjective data are information reported by the client that cannot be independently verified
by the nurse. Client reports of sleep patterns are subjective. Heart rate, blood pressure, and physical
appearance are objective findings that can be observed or measured.
4. A nurse is developing a plan of care for a client with impaired mobility. Which of the following is
an appropriate expected outcome statement?
A) "Client will ambulate with assistance within 3 days"
B) "Client will be able to walk better"
C) "Client will improve mobility status"
D) "Client will receive physical therapy consultation"
Correct Answer: A) "Client will ambulate with assistance within 3 days"
Rationale: Expected outcomes must be specific, measurable, attainable, realistic, and time-bound
(SMART). "Client will ambulate with assistance within 3 days" includes a specific behavior, condition,
and time frame. Options B and C are vague and not measurable. Option D describes an intervention,
not an outcome.
5. After implementing a new pain management regimen, a nurse evaluates the client's response.
Which of the following indicates the evaluation phase of the nursing process?
A) The nurse documents the client's pain rating decreased from 8/10 to 3/10
B) The nurse administers the prescribed analgesic medication
C) The nurse identifies acute pain as the nursing diagnosis
D) The nurse establishes a goal for pain reduction
Correct Answer: A) The nurse documents the client's pain rating decreased from 8/10 to 3/10
,Rationale: Evaluation involves comparing client responses to expected outcomes to determine whether
interventions were effective. Documenting a decrease in pain rating represents evaluating the
effectiveness of the implemented interventions.
6. A nurse is using critical thinking to prioritize care for four clients. Which client should the nurse
assess first?
A) A client scheduled for discharge who requests pain medication
B) A client with new-onset confusion and oxygen saturation of 89%
C) A client requesting assistance with ambulation to the bathroom
D) A client who needs assistance with morning hygiene
Correct Answer: B) A client with new-onset confusion and oxygen saturation of 89%
Rationale: New-onset confusion with hypoxia indicates a potentially life-threatening condition
requiring immediate assessment. Prioritization follows Maslow's hierarchy and ABCs (Airway,
Breathing, Circulation)—oxygen saturation below 90% is a priority finding.
7. A nurse is documenting client care. Which of the following documentation entries is most
appropriate?
A) "Client appears angry and uncooperative today"
B) "Client refused to take medications, stated 'I don't want them'"
C) "Client had a bad day and was difficult to manage"
D) "Client seems confused and disoriented to time"
Correct Answer: B) "Client refused to take medications, stated 'I don't want them'"
Rationale: Documentation should be objective, factual, and include direct client quotes when
appropriate. Option B provides objective documentation with the client's exact words. Options A, C,
and D contain subjective interpretations and judgments.
8. A nurse is receiving shift report on a client. Which of the following information should the nurse
prioritize for immediate follow-up?
A) The client's preferred breakfast food
B) The client's family visited yesterday
C) The client has a new prescription for insulin with an order to check blood glucose before meals
D) The client's room number changed
Correct Answer: C) The client has a new prescription for insulin with an order to check blood
glucose before meals
, Rationale: New medication orders requiring monitoring and potential intervention take priority. Insulin
administration requires blood glucose monitoring and carries significant safety implications.
9. A nurse is using the SBAR communication tool to report a change in a client's condition to the
provider. What does SBAR stand for?
A) Situation, Background, Assessment, Recommendation
B) Summary, Background, Action, Response
C) Situation, Brief, Action, Report
D) Summary, Brief, Assessment, Recommendation
Correct Answer: A) Situation, Background, Assessment, Recommendation
Rationale: SBAR is a standardized communication tool used to ensure effective handoff
communication. It stands for Situation, Background, Assessment, and Recommendation.
10. A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks is
appropriate to delegate to the AP?
A) Administering oral medications
B) Performing a sterile dressing change
C) Assisting a client with ambulation
D) Assessing a client's lung sounds
Correct Answer: C) Assisting a client with ambulation
Rationale: Delegation requires matching tasks to the appropriate scope of practice. AP can perform
basic care activities including ambulation assistance, hygiene, and vital signs. Medication
administration and sterile procedures require licensed nursing skills. Assessment requires nursing
judgment.
Section 2: Safety & Infection Control (Questions 11–20)
11. A nurse is caring for a client who has a central venous catheter. Which action is most important
to prevent catheter-related bloodstream infection?
A) Flush the catheter with heparin every shift
B) Change the dressing using sterile technique
C) Cap the catheter with a sterile cap after each use
D) Assess the insertion site for redness daily
Correct Answer: B) Change the dressing using sterile technique
100 Multiple-Choice Questions with Rationales
Exam Title: ATI Capstone Fundamentals Comprehensive Assessment: Foundational Nursing Concepts,
Clinical Judgment, and Patient Care Priorities for Pre-Licensure Nursing Candidates
Target Audience: Nursing students preparing for ATI Capstone Fundamentals assessment and NCLEX-
RN examination
Difficulty Level: Advanced/Hard/Mixed (progressing from foundational knowledge to complex clinical
judgment)
Section 1: Nursing Process & Clinical Judgment (Questions 1–10)
1. A nurse is caring for a client who reports acute abdominal pain. Which of the following actions
should the nurse take first?
A) Administer prescribed analgesic medication
B) Position the client in a comfortable position
C) Perform a comprehensive pain assessment
D) Notify the provider of the client's report of pain
Correct Answer: C) Perform a comprehensive pain assessment
Rationale: The nursing process begins with assessment. Before implementing any intervention, the
nurse must gather data about the pain including location, intensity, quality, and associated factors.
Administering medication (A) or notifying the provider (D) would occur after assessment. Positioning
(B) may provide comfort but is not the priority first action.
2. A nurse is planning care for a client following the nursing process framework. Which of the
following represents the correct sequence of steps?
A) Planning, Assessment, Diagnosis, Implementation, Evaluation
B) Assessment, Diagnosis, Planning, Implementation, Evaluation
C) Diagnosis, Assessment, Planning, Evaluation, Implementation
D) Assessment, Planning, Diagnosis, Implementation, Evaluation
Correct Answer: B) Assessment, Diagnosis, Planning, Implementation, Evaluation
,Rationale: The nursing process follows the ADPIE framework: Assessment, Diagnosis, Planning,
Implementation, and Evaluation. This systematic approach ensures comprehensive client care through
sequential but overlapping steps.
3. A nurse is collecting data from a client who reports difficulty sleeping. Which of the following is a
subjective finding?
A) Client's heart rate is 88/min
B) Client reports waking up three times during the night
C) Client's blood pressure is 132/86 mmHg
D) Client appears fatigued with dark circles under eyes
Correct Answer: B) Client reports waking up three times during the night
Rationale: Subjective data are information reported by the client that cannot be independently verified
by the nurse. Client reports of sleep patterns are subjective. Heart rate, blood pressure, and physical
appearance are objective findings that can be observed or measured.
4. A nurse is developing a plan of care for a client with impaired mobility. Which of the following is
an appropriate expected outcome statement?
A) "Client will ambulate with assistance within 3 days"
B) "Client will be able to walk better"
C) "Client will improve mobility status"
D) "Client will receive physical therapy consultation"
Correct Answer: A) "Client will ambulate with assistance within 3 days"
Rationale: Expected outcomes must be specific, measurable, attainable, realistic, and time-bound
(SMART). "Client will ambulate with assistance within 3 days" includes a specific behavior, condition,
and time frame. Options B and C are vague and not measurable. Option D describes an intervention,
not an outcome.
5. After implementing a new pain management regimen, a nurse evaluates the client's response.
Which of the following indicates the evaluation phase of the nursing process?
A) The nurse documents the client's pain rating decreased from 8/10 to 3/10
B) The nurse administers the prescribed analgesic medication
C) The nurse identifies acute pain as the nursing diagnosis
D) The nurse establishes a goal for pain reduction
Correct Answer: A) The nurse documents the client's pain rating decreased from 8/10 to 3/10
,Rationale: Evaluation involves comparing client responses to expected outcomes to determine whether
interventions were effective. Documenting a decrease in pain rating represents evaluating the
effectiveness of the implemented interventions.
6. A nurse is using critical thinking to prioritize care for four clients. Which client should the nurse
assess first?
A) A client scheduled for discharge who requests pain medication
B) A client with new-onset confusion and oxygen saturation of 89%
C) A client requesting assistance with ambulation to the bathroom
D) A client who needs assistance with morning hygiene
Correct Answer: B) A client with new-onset confusion and oxygen saturation of 89%
Rationale: New-onset confusion with hypoxia indicates a potentially life-threatening condition
requiring immediate assessment. Prioritization follows Maslow's hierarchy and ABCs (Airway,
Breathing, Circulation)—oxygen saturation below 90% is a priority finding.
7. A nurse is documenting client care. Which of the following documentation entries is most
appropriate?
A) "Client appears angry and uncooperative today"
B) "Client refused to take medications, stated 'I don't want them'"
C) "Client had a bad day and was difficult to manage"
D) "Client seems confused and disoriented to time"
Correct Answer: B) "Client refused to take medications, stated 'I don't want them'"
Rationale: Documentation should be objective, factual, and include direct client quotes when
appropriate. Option B provides objective documentation with the client's exact words. Options A, C,
and D contain subjective interpretations and judgments.
8. A nurse is receiving shift report on a client. Which of the following information should the nurse
prioritize for immediate follow-up?
A) The client's preferred breakfast food
B) The client's family visited yesterday
C) The client has a new prescription for insulin with an order to check blood glucose before meals
D) The client's room number changed
Correct Answer: C) The client has a new prescription for insulin with an order to check blood
glucose before meals
, Rationale: New medication orders requiring monitoring and potential intervention take priority. Insulin
administration requires blood glucose monitoring and carries significant safety implications.
9. A nurse is using the SBAR communication tool to report a change in a client's condition to the
provider. What does SBAR stand for?
A) Situation, Background, Assessment, Recommendation
B) Summary, Background, Action, Response
C) Situation, Brief, Action, Report
D) Summary, Brief, Assessment, Recommendation
Correct Answer: A) Situation, Background, Assessment, Recommendation
Rationale: SBAR is a standardized communication tool used to ensure effective handoff
communication. It stands for Situation, Background, Assessment, and Recommendation.
10. A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks is
appropriate to delegate to the AP?
A) Administering oral medications
B) Performing a sterile dressing change
C) Assisting a client with ambulation
D) Assessing a client's lung sounds
Correct Answer: C) Assisting a client with ambulation
Rationale: Delegation requires matching tasks to the appropriate scope of practice. AP can perform
basic care activities including ambulation assistance, hygiene, and vital signs. Medication
administration and sterile procedures require licensed nursing skills. Assessment requires nursing
judgment.
Section 2: Safety & Infection Control (Questions 11–20)
11. A nurse is caring for a client who has a central venous catheter. Which action is most important
to prevent catheter-related bloodstream infection?
A) Flush the catheter with heparin every shift
B) Change the dressing using sterile technique
C) Cap the catheter with a sterile cap after each use
D) Assess the insertion site for redness daily
Correct Answer: B) Change the dressing using sterile technique
