ATI CAPSTONE COMPREHENSIVE PREDICTOR
PRACTICE EXAMINATION 2026–2027 — NGN &
CLINICAL JUDGMENT STUDY GUIDE | LATEST
UPDATE 2026/2027 | ACTUAL EXAM PRACTICE
QUESTIONS AND ANSWERS | EXAM REVIEW | 100%
CORRECT ANSWERS | VERIFIED SOLUTIONS
This advanced comprehensive predictor examination is designed for nursing
students preparing for the ATI Capstone Comprehensive Predictor, HESI Exit Exam,
and NCLEX-RN® licensure. The 100-question test integrates all major content
areas, including medical-surgical, pharmacology, maternal-newborn, pediatrics,
mental health, leadership, community health, and fundamentals. Each item
reflects the cognitive complexity of a high-stakes exit examination, using the Next
Generation NCLEX clinical judgment model to assess cue recognition, analysis,
prioritization, delegation, and evaluation. The 2026–2027 edition incorporates
current evidence-based practice, patient safety standards, and QSEN
competencies. Use this predictor to assess readiness, identify knowledge gaps, and
strengthen critical thinking for first-attempt success on the NCLEX-RN. Detailed
rationales clarify correct answers and distractors. This practice tool is for self-
assessment and review, not a substitute for official ATI or NCLEX resources.
Table of Contents
I. Fundamentals of Nursing and Safety
II. Medical-Surgical Nursing and Complex Care
III. Pharmacology and Medication Safety
IV. Maternal-Newborn and Women’s Health
V. Pediatric Nursing and Developmental Care
VI. Mental Health and Psychosocial Integrity
VII. Leadership, Delegation, and Management of Care
VIII. Community Health and Public Safety
IX. Next Generation NCLEX Clinical Judgment Scenarios
, 1. A nurse is planning care for a client with a new diagnosis of ulcerative
colitis. Which dietary instruction should the nurse include?
A) Increase intake of high-fiber whole grains
B) Follow a low-residue, low-fiber diet during exacerbations
C) Eat large meals to reduce bowel frequency
D) Avoid all dairy products permanently
Correct Answer: B
During acute exacerbations of ulcerative colitis, a low-residue, low-fiber diet
reduces bowel stimulation and inflammation. High-fiber diets (A) worsen diarrhea
and cramping. Small frequent meals are better than large meals (C). Dairy is not
universally restricted unless lactose intolerance exists (D).
2. A nurse is reviewing the laboratory results for a client with acute
pancreatitis. Which finding should the nurse report immediately?
A) Serum amylase 320 U/L
B) Serum calcium 6.8 mg/dL
C) Serum lipase 280 U/L
D) Blood glucose 160 mg/dL
Correct Answer: B
Hypocalcemia in acute pancreatitis indicates fat saponification and is a poor
prognostic sign; a calcium of 6.8 mg/dL requires urgent replacement. Elevated
amylase and lipase (A, C) are expected in pancreatitis. Mild hyperglycemia (D) is
common.
3. A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires the nurse to hold the dose and notify the
provider?
A) Serum potassium 3.2 mEq/L
B) Blood pressure 140/90 mm Hg
C) Heart rate 88 bpm
D) Respiratory rate 24 breaths per minute
,Correct Answer: A
Furosemide causes potassium loss; a potassium of 3.2 mEq/L is low and increases
the risk of digoxin toxicity and dysrhythmias. The provider should be notified
before giving the dose. Blood pressure, heart rate, and respiratory rate are
consistent with fluid overload and not contraindications.
4. A nurse is teaching a client with a new permanent colostomy about stoma
care. Which observation indicates a healthy stoma?
A) Dark purple and dry
B) Beefy red and moist
C) Pale pink and dry
D) Blue-tinged and cool
Correct Answer: B
A healthy stoma is moist and beefy red due to rich blood supply. Dark purple or
blue-tinged (A, D) indicates ischemia. Pale and dry (C) suggests poor perfusion.
5. A client is receiving a continuous heparin infusion. The aPTT is 105 seconds
(therapeutic 60–80 seconds). The client has no active bleeding. What is the
nurse’s best action?
A) Stop the heparin and administer protamine sulfate
B) Continue the current rate and monitor for petechiae
C) Reduce the infusion rate per protocol and recheck aPTT in 6 hours
D) Administer vitamin K subcutaneously
Correct Answer: C
A supratherapeutic aPTT without bleeding requires a rate reduction per titration
nomogram. Protamine (A) is for severe hemorrhage. Continuing the rate (B)
increases bleeding risk. Vitamin K (D) reverses warfarin, not heparin.
6. A nurse is assessing a client 24 hours after a femoral-popliteal bypass graft.
The client reports severe pain in the affected leg, and the foot is pale, cool,
and mottled with absent pedal pulses. What should the nurse do first?
A) Elevate the leg on two pillows
B) Notify the surgeon immediately of suspected graft occlusion
, C) Document the findings and reassess in 30 minutes
D) Apply warm compresses to the foot
Correct Answer: B
Sudden severe pain, pallor, pulselessness, and coolness indicate acute arterial
occlusion, a surgical emergency. Elevation (A) reduces arterial flow. Delay (C) risks
limb loss. Warm compresses (D) do not restore perfusion.
7. A client with major depressive disorder suddenly becomes more energetic,
gives away personal belongings, and states, “I finally have a plan to stop the
pain.” What is the priority nursing intervention?
A) Encourage the client to attend group therapy
B) Ask the client to sign a no-suicide contract
C) Place the client on continuous one-to-one observation
D) Administer an as-needed anxiolytic
Correct Answer: C
Sudden mood elevation and giving away possessions are warning signs of
imminent suicide; continuous observation is the immediate priority. A no-suicide
contract (B) does not replace supervision. Group therapy (A) and anxiolytics (D) do
not address acute risk.
8. A nurse is supervising a student nurse inserting an indwelling urinary
catheter in a female client. Which action by the student requires immediate
intervention?
A) Lubricating the catheter tip with water-soluble gel
B) Advancing the catheter 2 to 3 inches after urine return before inflating
the balloon
C) Inflating the balloon prior to verifying urine return
D) Using the dominant hand to maintain labial separation after cleansing
Correct Answer: C
Inflating the balloon before seeing urine risks urethral trauma if the catheter is not
in the bladder. Options A, B, and D are correct steps.
PRACTICE EXAMINATION 2026–2027 — NGN &
CLINICAL JUDGMENT STUDY GUIDE | LATEST
UPDATE 2026/2027 | ACTUAL EXAM PRACTICE
QUESTIONS AND ANSWERS | EXAM REVIEW | 100%
CORRECT ANSWERS | VERIFIED SOLUTIONS
This advanced comprehensive predictor examination is designed for nursing
students preparing for the ATI Capstone Comprehensive Predictor, HESI Exit Exam,
and NCLEX-RN® licensure. The 100-question test integrates all major content
areas, including medical-surgical, pharmacology, maternal-newborn, pediatrics,
mental health, leadership, community health, and fundamentals. Each item
reflects the cognitive complexity of a high-stakes exit examination, using the Next
Generation NCLEX clinical judgment model to assess cue recognition, analysis,
prioritization, delegation, and evaluation. The 2026–2027 edition incorporates
current evidence-based practice, patient safety standards, and QSEN
competencies. Use this predictor to assess readiness, identify knowledge gaps, and
strengthen critical thinking for first-attempt success on the NCLEX-RN. Detailed
rationales clarify correct answers and distractors. This practice tool is for self-
assessment and review, not a substitute for official ATI or NCLEX resources.
Table of Contents
I. Fundamentals of Nursing and Safety
II. Medical-Surgical Nursing and Complex Care
III. Pharmacology and Medication Safety
IV. Maternal-Newborn and Women’s Health
V. Pediatric Nursing and Developmental Care
VI. Mental Health and Psychosocial Integrity
VII. Leadership, Delegation, and Management of Care
VIII. Community Health and Public Safety
IX. Next Generation NCLEX Clinical Judgment Scenarios
, 1. A nurse is planning care for a client with a new diagnosis of ulcerative
colitis. Which dietary instruction should the nurse include?
A) Increase intake of high-fiber whole grains
B) Follow a low-residue, low-fiber diet during exacerbations
C) Eat large meals to reduce bowel frequency
D) Avoid all dairy products permanently
Correct Answer: B
During acute exacerbations of ulcerative colitis, a low-residue, low-fiber diet
reduces bowel stimulation and inflammation. High-fiber diets (A) worsen diarrhea
and cramping. Small frequent meals are better than large meals (C). Dairy is not
universally restricted unless lactose intolerance exists (D).
2. A nurse is reviewing the laboratory results for a client with acute
pancreatitis. Which finding should the nurse report immediately?
A) Serum amylase 320 U/L
B) Serum calcium 6.8 mg/dL
C) Serum lipase 280 U/L
D) Blood glucose 160 mg/dL
Correct Answer: B
Hypocalcemia in acute pancreatitis indicates fat saponification and is a poor
prognostic sign; a calcium of 6.8 mg/dL requires urgent replacement. Elevated
amylase and lipase (A, C) are expected in pancreatitis. Mild hyperglycemia (D) is
common.
3. A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires the nurse to hold the dose and notify the
provider?
A) Serum potassium 3.2 mEq/L
B) Blood pressure 140/90 mm Hg
C) Heart rate 88 bpm
D) Respiratory rate 24 breaths per minute
,Correct Answer: A
Furosemide causes potassium loss; a potassium of 3.2 mEq/L is low and increases
the risk of digoxin toxicity and dysrhythmias. The provider should be notified
before giving the dose. Blood pressure, heart rate, and respiratory rate are
consistent with fluid overload and not contraindications.
4. A nurse is teaching a client with a new permanent colostomy about stoma
care. Which observation indicates a healthy stoma?
A) Dark purple and dry
B) Beefy red and moist
C) Pale pink and dry
D) Blue-tinged and cool
Correct Answer: B
A healthy stoma is moist and beefy red due to rich blood supply. Dark purple or
blue-tinged (A, D) indicates ischemia. Pale and dry (C) suggests poor perfusion.
5. A client is receiving a continuous heparin infusion. The aPTT is 105 seconds
(therapeutic 60–80 seconds). The client has no active bleeding. What is the
nurse’s best action?
A) Stop the heparin and administer protamine sulfate
B) Continue the current rate and monitor for petechiae
C) Reduce the infusion rate per protocol and recheck aPTT in 6 hours
D) Administer vitamin K subcutaneously
Correct Answer: C
A supratherapeutic aPTT without bleeding requires a rate reduction per titration
nomogram. Protamine (A) is for severe hemorrhage. Continuing the rate (B)
increases bleeding risk. Vitamin K (D) reverses warfarin, not heparin.
6. A nurse is assessing a client 24 hours after a femoral-popliteal bypass graft.
The client reports severe pain in the affected leg, and the foot is pale, cool,
and mottled with absent pedal pulses. What should the nurse do first?
A) Elevate the leg on two pillows
B) Notify the surgeon immediately of suspected graft occlusion
, C) Document the findings and reassess in 30 minutes
D) Apply warm compresses to the foot
Correct Answer: B
Sudden severe pain, pallor, pulselessness, and coolness indicate acute arterial
occlusion, a surgical emergency. Elevation (A) reduces arterial flow. Delay (C) risks
limb loss. Warm compresses (D) do not restore perfusion.
7. A client with major depressive disorder suddenly becomes more energetic,
gives away personal belongings, and states, “I finally have a plan to stop the
pain.” What is the priority nursing intervention?
A) Encourage the client to attend group therapy
B) Ask the client to sign a no-suicide contract
C) Place the client on continuous one-to-one observation
D) Administer an as-needed anxiolytic
Correct Answer: C
Sudden mood elevation and giving away possessions are warning signs of
imminent suicide; continuous observation is the immediate priority. A no-suicide
contract (B) does not replace supervision. Group therapy (A) and anxiolytics (D) do
not address acute risk.
8. A nurse is supervising a student nurse inserting an indwelling urinary
catheter in a female client. Which action by the student requires immediate
intervention?
A) Lubricating the catheter tip with water-soluble gel
B) Advancing the catheter 2 to 3 inches after urine return before inflating
the balloon
C) Inflating the balloon prior to verifying urine return
D) Using the dominant hand to maintain labial separation after cleansing
Correct Answer: C
Inflating the balloon before seeing urine risks urethral trauma if the catheter is not
in the bladder. Options A, B, and D are correct steps.
