ATI Capstone Adult Medical-Surgical
Comprehensive Examination
Advanced-Level Practice Questions with
Rationales
Cardiovascular Disorders (Questions 1-15)
1. A nurse is providing discharge teaching to a client following a
heart transplant. Which of the following information should the
nurse include?
A. Immunosuppressant medications need to be taken for up to 1
year.
B. Shortness of breath might be an indication of organ rejection.
C. The surgical site will heal completely in 3 to 4 weeks.
D. Begin 45 minutes of moderate aerobic exercise per day following
discharge.
Correct Answer: B
Rationale: After a heart transplant, clients must take
immunosuppressant medications for LIFE — not just 1 year — to
prevent organ rejection. Shortness of breath, fatigue, decreased
exercise tolerance, and flu-like symptoms are warning signs of
rejection and must be reported immediately. Returning to full
,household activities immediately is premature — activity is
gradually increased per cardiac rehab protocol. Forty-five minutes
of aerobic exercise immediately post-discharge is excessive and
requires a structured, progressive rehabilitation program.
2. A nurse is admitting a client who reports chest pain and has
been placed on a telemetry monitor. Which of the following
should the nurse analyze to determine whether the client is
experiencing a myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
Correct Answer: D
Rationale: ST elevation indicates myocardial infarction, while ST
depression indicates ischemia. The PR interval, QRS duration, and T
wave changes provide additional information but are not the
primary indicators for diagnosing an MI. ST-segment analysis is the
most critical ECG finding for identifying acute myocardial injury.
3. A nurse is caring for a client who has a permanent pacemaker
with a ventricular demand setting of 70. Which of the following
findings should alert the nurse to a pacemaker malfunction?
,A. Apical pulse rate of 72/min
B. Apical pulse rate of 70/min
C. Apical pulse rate of 64/min
D. Apical pulse rate of 68/min
Correct Answer: C
Rationale: A ventricular demand pacemaker set at 70 should
maintain a heart rate of at least 70 beats per minute. An apical
pulse rate of 64/min is below the set rate and indicates that the
pacemaker is not capturing appropriately. This finding requires
immediate assessment and provider notification. Rates at or above
the set rate (70, 72, 68) suggest appropriate pacemaker function.
4. A nurse is assessing a client who has a history of peripheral
vascular disease. Which of the following factors should alert the
nurse to an increased risk of deep vein thrombosis?
A. Regular exercise and adequate hydration
B. Dehydration, combination oral contraceptives, immobility, and
hypercalcemia
C. Low-calcium diet and mobility
D. Use of antiplatelet medications
Correct Answer: B
Rationale: Risk factors for DVT include dehydration, combination
oral contraceptives, immobility, and hypercalcemia. Other risk
factors include surgery, trauma, malignancy, obesity, smoking, and
inherited hypercoagulable states. Regular exercise, adequate
, hydration, and antiplatelet medications reduce DVT risk rather than
increase it.
5. A nurse is teaching a client who has angina pectoris about
nitroglycerin sublingual tablets. Which of the following
statements indicates to the nurse that the client understands the
teaching?
A. "I will keep the tablets in the original container."
B. "I will replace the tablets every 12 months."
C. "I will take one tablet every 10 minutes for up to three doses."
D. "I will chew the tablet for faster absorption."
Correct Answer: A
Rationale: Nitroglycerin sublingual tablets should be kept in the
original container to protect them from light and moisture, which
can degrade the medication. Tablets should be replaced every 6
months, not 12 months. The correct dosing is one tablet every 5
minutes for up to three doses (not 10 minutes). Sublingual tablets
should be placed under the tongue and allowed to dissolve — they
should never be chewed or swallowed.
6. A nurse is assessing a client who is 12 hours postoperative
following a colon resection. Which of the following findings
should the nurse report to the surgeon?
Comprehensive Examination
Advanced-Level Practice Questions with
Rationales
Cardiovascular Disorders (Questions 1-15)
1. A nurse is providing discharge teaching to a client following a
heart transplant. Which of the following information should the
nurse include?
A. Immunosuppressant medications need to be taken for up to 1
year.
B. Shortness of breath might be an indication of organ rejection.
C. The surgical site will heal completely in 3 to 4 weeks.
D. Begin 45 minutes of moderate aerobic exercise per day following
discharge.
Correct Answer: B
Rationale: After a heart transplant, clients must take
immunosuppressant medications for LIFE — not just 1 year — to
prevent organ rejection. Shortness of breath, fatigue, decreased
exercise tolerance, and flu-like symptoms are warning signs of
rejection and must be reported immediately. Returning to full
,household activities immediately is premature — activity is
gradually increased per cardiac rehab protocol. Forty-five minutes
of aerobic exercise immediately post-discharge is excessive and
requires a structured, progressive rehabilitation program.
2. A nurse is admitting a client who reports chest pain and has
been placed on a telemetry monitor. Which of the following
should the nurse analyze to determine whether the client is
experiencing a myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
Correct Answer: D
Rationale: ST elevation indicates myocardial infarction, while ST
depression indicates ischemia. The PR interval, QRS duration, and T
wave changes provide additional information but are not the
primary indicators for diagnosing an MI. ST-segment analysis is the
most critical ECG finding for identifying acute myocardial injury.
3. A nurse is caring for a client who has a permanent pacemaker
with a ventricular demand setting of 70. Which of the following
findings should alert the nurse to a pacemaker malfunction?
,A. Apical pulse rate of 72/min
B. Apical pulse rate of 70/min
C. Apical pulse rate of 64/min
D. Apical pulse rate of 68/min
Correct Answer: C
Rationale: A ventricular demand pacemaker set at 70 should
maintain a heart rate of at least 70 beats per minute. An apical
pulse rate of 64/min is below the set rate and indicates that the
pacemaker is not capturing appropriately. This finding requires
immediate assessment and provider notification. Rates at or above
the set rate (70, 72, 68) suggest appropriate pacemaker function.
4. A nurse is assessing a client who has a history of peripheral
vascular disease. Which of the following factors should alert the
nurse to an increased risk of deep vein thrombosis?
A. Regular exercise and adequate hydration
B. Dehydration, combination oral contraceptives, immobility, and
hypercalcemia
C. Low-calcium diet and mobility
D. Use of antiplatelet medications
Correct Answer: B
Rationale: Risk factors for DVT include dehydration, combination
oral contraceptives, immobility, and hypercalcemia. Other risk
factors include surgery, trauma, malignancy, obesity, smoking, and
inherited hypercoagulable states. Regular exercise, adequate
, hydration, and antiplatelet medications reduce DVT risk rather than
increase it.
5. A nurse is teaching a client who has angina pectoris about
nitroglycerin sublingual tablets. Which of the following
statements indicates to the nurse that the client understands the
teaching?
A. "I will keep the tablets in the original container."
B. "I will replace the tablets every 12 months."
C. "I will take one tablet every 10 minutes for up to three doses."
D. "I will chew the tablet for faster absorption."
Correct Answer: A
Rationale: Nitroglycerin sublingual tablets should be kept in the
original container to protect them from light and moisture, which
can degrade the medication. Tablets should be replaced every 6
months, not 12 months. The correct dosing is one tablet every 5
minutes for up to three doses (not 10 minutes). Sublingual tablets
should be placed under the tongue and allowed to dissolve — they
should never be chewed or swallowed.
6. A nurse is assessing a client who is 12 hours postoperative
following a colon resection. Which of the following findings
should the nurse report to the surgeon?
