ATI CAPSTONE PRE-ASSESSMENT 2026/2027 EXAM PRACTICE
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
INSTANT PDF
Core Domains
• Fundamentals of Nursing and Safety
• Pharmacology and Medication Administration
• Adult Medical-Surgical Nursing
• Maternal Newborn and Women's Health
• Nursing Care of Children
• Mental Health Nursing
• Leadership, Management, and Community Health
• Prioritization, Delegation, and Clinical Judgment
Introduction
This comprehensive practice examination is designed to prepare nursing students
for the ATI Capstone Pre-Assessment, which evaluates readiness for the NCLEX-
RN. The assessment encompasses the major content areas of nursing practice,
including fundamentals, pharmacology, medical-surgical, maternal-newborn,
pediatric, mental health, and leadership nursing. The multiple-choice format
integrates clinical scenarios requiring prioritization, delegation, and clinical
judgment consistent with the NCLEX-RN test plan. Candidates are expected to
demonstrate mastery of safe, effective nursing care across the lifespan and in
diverse healthcare settings. This examination serves as a rigorous evaluation of
readiness for entry-level professional nursing practice
,SECTION ONE: QUESTIONS 1–150
1. A nurse is assessing a client who has been taking furosemide for heart failure.
Which finding indicates a therapeutic response?
A. Weight gain of 2 kg
B. Urine output of 30 mL/hr
C. Decreased peripheral edema
D. Increased jugular venous distention
C. Decreased peripheral edema
RATIONALE: Decreased peripheral edema indicates effective diuresis and fluid
mobilization. Weight gain, decreased urine output, and increased JVD indicate
worsening fluid retention.
2. A nurse is caring for a client who is receiving a blood transfusion and develops
fever, chills, and low back pain. Which action should the nurse take first?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Obtain a urine specimen
C. Stop the transfusion immediately
RATIONALE: Fever, chills, and low back pain suggest an acute hemolytic
transfusion reaction. The first action is to stop the transfusion immediately to
prevent further hemolysis.
3. A nurse is preparing to administer digoxin to a client. Which assessment
finding should cause the nurse to withhold the medication?
A. Heart rate 58 bpm
B. Blood pressure 128/76 mmHg
C. Respiratory rate 18 breaths/min
D. Temperature 98.6°F
, A. Heart rate 58 bpm
RATIONALE: Digoxin should be withheld if the apical pulse is below 60 bpm in
adults. Digoxin slows conduction and can cause bradycardia.
4. A nurse is teaching a client about warfarin therapy. Which statement
indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will stop the medication if I feel better."
B. "I will use a soft toothbrush and electric razor."
RATIONALE: Warfarin increases bleeding risk. Using a soft toothbrush and
electric razor reduces injury risk. Consistent vitamin K intake is important; aspirin
increases bleeding risk.
5. A nurse is assessing a client with a suspected myocardial infarction. Which
laboratory value is most specific for cardiac damage?
A. CK-MB
B. Troponin I
C. Myoglobin
D. LDH
B. Troponin I
RATIONALE: Troponin I is highly specific for cardiac muscle damage. CK-MB is
less specific; myoglobin rises early but is not specific; LDH is nonspecific.
6. A nurse is caring for a client with COPD who has an oxygen saturation of 88%.
What is the appropriate oxygen delivery goal?
A. Maintain SpO2 at 95-100%
B. Maintain SpO2 at 88-92%
, C. Maintain SpO2 at 85-88%
D. Maintain SpO2 above 100%
B. Maintain SpO2 at 88-92%
RATIONALE: In COPD, target SpO2 is 88-92% to avoid suppressing hypoxic
drive and worsening hypercapnia.
7. A nurse is assessing a client with deep vein thrombosis. Which finding is most
concerning?
A. Calf pain
B. Unilateral leg swelling
C. Sudden shortness of breath
D. Warmth at the site
C. Sudden shortness of breath
RATIONALE: Sudden shortness of breath suggests pulmonary embolism, a life-
threatening complication of DVT requiring immediate intervention.
8. A nurse is preparing to administer heparin. Which laboratory value should be
monitored?
A. INR
B. aPTT
C. Platelet count
D. Bleeding time
B. aPTT
RATIONALE: aPTT monitors unfractionated heparin therapy. INR monitors
warfarin. Platelet count monitors for HIT.
9. A nurse is teaching a client about insulin administration. Which statement
indicates correct understanding?
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
INSTANT PDF
Core Domains
• Fundamentals of Nursing and Safety
• Pharmacology and Medication Administration
• Adult Medical-Surgical Nursing
• Maternal Newborn and Women's Health
• Nursing Care of Children
• Mental Health Nursing
• Leadership, Management, and Community Health
• Prioritization, Delegation, and Clinical Judgment
Introduction
This comprehensive practice examination is designed to prepare nursing students
for the ATI Capstone Pre-Assessment, which evaluates readiness for the NCLEX-
RN. The assessment encompasses the major content areas of nursing practice,
including fundamentals, pharmacology, medical-surgical, maternal-newborn,
pediatric, mental health, and leadership nursing. The multiple-choice format
integrates clinical scenarios requiring prioritization, delegation, and clinical
judgment consistent with the NCLEX-RN test plan. Candidates are expected to
demonstrate mastery of safe, effective nursing care across the lifespan and in
diverse healthcare settings. This examination serves as a rigorous evaluation of
readiness for entry-level professional nursing practice
,SECTION ONE: QUESTIONS 1–150
1. A nurse is assessing a client who has been taking furosemide for heart failure.
Which finding indicates a therapeutic response?
A. Weight gain of 2 kg
B. Urine output of 30 mL/hr
C. Decreased peripheral edema
D. Increased jugular venous distention
C. Decreased peripheral edema
RATIONALE: Decreased peripheral edema indicates effective diuresis and fluid
mobilization. Weight gain, decreased urine output, and increased JVD indicate
worsening fluid retention.
2. A nurse is caring for a client who is receiving a blood transfusion and develops
fever, chills, and low back pain. Which action should the nurse take first?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Obtain a urine specimen
C. Stop the transfusion immediately
RATIONALE: Fever, chills, and low back pain suggest an acute hemolytic
transfusion reaction. The first action is to stop the transfusion immediately to
prevent further hemolysis.
3. A nurse is preparing to administer digoxin to a client. Which assessment
finding should cause the nurse to withhold the medication?
A. Heart rate 58 bpm
B. Blood pressure 128/76 mmHg
C. Respiratory rate 18 breaths/min
D. Temperature 98.6°F
, A. Heart rate 58 bpm
RATIONALE: Digoxin should be withheld if the apical pulse is below 60 bpm in
adults. Digoxin slows conduction and can cause bradycardia.
4. A nurse is teaching a client about warfarin therapy. Which statement
indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will stop the medication if I feel better."
B. "I will use a soft toothbrush and electric razor."
RATIONALE: Warfarin increases bleeding risk. Using a soft toothbrush and
electric razor reduces injury risk. Consistent vitamin K intake is important; aspirin
increases bleeding risk.
5. A nurse is assessing a client with a suspected myocardial infarction. Which
laboratory value is most specific for cardiac damage?
A. CK-MB
B. Troponin I
C. Myoglobin
D. LDH
B. Troponin I
RATIONALE: Troponin I is highly specific for cardiac muscle damage. CK-MB is
less specific; myoglobin rises early but is not specific; LDH is nonspecific.
6. A nurse is caring for a client with COPD who has an oxygen saturation of 88%.
What is the appropriate oxygen delivery goal?
A. Maintain SpO2 at 95-100%
B. Maintain SpO2 at 88-92%
, C. Maintain SpO2 at 85-88%
D. Maintain SpO2 above 100%
B. Maintain SpO2 at 88-92%
RATIONALE: In COPD, target SpO2 is 88-92% to avoid suppressing hypoxic
drive and worsening hypercapnia.
7. A nurse is assessing a client with deep vein thrombosis. Which finding is most
concerning?
A. Calf pain
B. Unilateral leg swelling
C. Sudden shortness of breath
D. Warmth at the site
C. Sudden shortness of breath
RATIONALE: Sudden shortness of breath suggests pulmonary embolism, a life-
threatening complication of DVT requiring immediate intervention.
8. A nurse is preparing to administer heparin. Which laboratory value should be
monitored?
A. INR
B. aPTT
C. Platelet count
D. Bleeding time
B. aPTT
RATIONALE: aPTT monitors unfractionated heparin therapy. INR monitors
warfarin. Platelet count monitors for HIT.
9. A nurse is teaching a client about insulin administration. Which statement
indicates correct understanding?
