ATI Capstone Pre-Assessment Exam Master Practice Test
Bank |2026 Multiple Choice Questions & Detailed Clinical
Rationales
Maximize your chances of secure program sign-off and passing the boards with this
massive, high-yield ATI Capstone Pre-Assessment Exam master practice test bank
containing comprehensive multiple-choice questions. Master high-yield, across-the-
board nursing domains including advanced pharmacology, complex adult medical-
surgical alterations, maternal-newborn emergencies, pediatric developmental
milestones, and leadership management. Every verified question features a highly
thorough clinical rationale aligned with Next Generation NCLEX (NGN) evaluation
criteria to sharpen your nursing judgment and guarantee a top predictor score.
Question 1
A nurse is admitting a client who has Clostridioides difficile. Which type of precautions
should the nurse initiate?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions
D. Protective environment
Rationale: C. difficile is transmitted via direct and indirect contact with spores. Contact
precautions, including gown and gloves, are required. Hand hygiene with soap and water
is preferred over alcohol-based sanitizer because alcohol does not kill C. difficile spores.
Question 2
A nurse is assessing a client who has been receiving IV gentamicin for 7 days. Which
finding should the nurse report to the provider?
A. Blood pressure of 128/76 mm Hg
B. Serum creatinine of 2.4 mg/dL
C. Temperature of 37.2°C (99.0°F)
D. Heart rate of 82/min
,Rationale: Gentamicin is an aminoglycoside antibiotic that is nephrotoxic and ototoxic. An
elevated serum creatinine indicates renal impairment and should be reported
immediately.
Question 3
A nurse is caring for a client who is 1 day postoperative following a total knee
arthroplasty. Which intervention should the nurse implement to prevent venous
thromboembolism?
A. Massage the affected leg every 4 hours
B. Apply intermittent pneumatic compression devices
C. Keep the client on strict bed rest
D. Place pillows under the knee
Rationale: Intermittent pneumatic compression devices promote venous return and
prevent DVT. Massaging the leg is contraindicated due to DVT risk. Early ambulation, not
bed rest, is encouraged. Pillows under the knee impair venous return.
Question 4
A nurse is reviewing laboratory results for a client who has cirrhosis. Which finding
should the nurse expect?
A. Decreased bilirubin
B. Increased ammonia level
C. Increased albumin level
D. Decreased prothrombin time
Rationale: Cirrhosis impairs the liver's ability to convert ammonia to urea, leading to
elevated ammonia levels. Bilirubin increases, albumin decreases, and prothrombin time
lengthens due to impaired clotting factor synthesis.
,Question 5
A nurse is teaching a client who has gout about dietary modifications. Which food
should the nurse instruct the client to avoid?
A. Fresh cherries
B. Organ meats such as liver
C. Whole grain bread
D. Low-fat dairy products
Rationale: Organ meats are high in purines, which break down into uric acid and worsen
gout. Cherries, whole grains, and low-fat dairy may actually help lower uric acid levels.
Question 6
A nurse is assessing a client who has a new prescription for haloperidol. Which finding
indicates the client is experiencing akathisia?
A. Inability to sit still and continuous pacing
B. Muscle rigidity and high fever
C. Torticollis and difficulty swallowing
D. Tremors at rest
Rationale: Akathisia is an extrapyramidal side effect characterized by an intense urge to
move and continuous pacing. Muscle rigidity with fever indicates neuroleptic malignant
syndrome. Torticollis indicates acute dystonia. Resting tremors suggest parkinsonism.
Question 7
A nurse is preparing to administer a nasogastric feeding to a client. Which action should
the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement by aspirating gastric contents and checking pH
C. Administer the feeding over 30 minutes
D. Position the client supine
, Rationale: Verifying tube placement is the priority before any feeding to prevent
aspiration. The pH of gastric aspirate should be 5.5 or lower. The client should be
positioned with the head of the bed elevated at least 30 degrees.
Question 8
A nurse is caring for a client who has a new prescription for digoxin and furosemide.
Which finding indicates the client may be experiencing digoxin toxicity?
A. Heart rate of 88/min
B. Nausea, vomiting, and visual changes
C. Blood pressure of 130/80 mm Hg
D. Increased urine output
Rationale: Furosemide causes potassium loss, which increases the risk of digoxin toxicity.
Early signs include nausea, vomiting, anorexia, and visual disturbances such as yellow-
green halos.
Question 9
A nurse is assessing a client who has a new onset of atrial fibrillation. Which medication
should the nurse anticipate administering to control the heart rate?
A. Atropine
B. Diltiazem
C. Adenosine
D. Epinephrine
Rationale: Diltiazem, a calcium channel blocker, is used to control heart rate in atrial
fibrillation. Adenosine is used for supraventricular tachycardia. Atropine treats
bradycardia. Epinephrine treats cardiac arrest.
Question 10
Bank |2026 Multiple Choice Questions & Detailed Clinical
Rationales
Maximize your chances of secure program sign-off and passing the boards with this
massive, high-yield ATI Capstone Pre-Assessment Exam master practice test bank
containing comprehensive multiple-choice questions. Master high-yield, across-the-
board nursing domains including advanced pharmacology, complex adult medical-
surgical alterations, maternal-newborn emergencies, pediatric developmental
milestones, and leadership management. Every verified question features a highly
thorough clinical rationale aligned with Next Generation NCLEX (NGN) evaluation
criteria to sharpen your nursing judgment and guarantee a top predictor score.
Question 1
A nurse is admitting a client who has Clostridioides difficile. Which type of precautions
should the nurse initiate?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions
D. Protective environment
Rationale: C. difficile is transmitted via direct and indirect contact with spores. Contact
precautions, including gown and gloves, are required. Hand hygiene with soap and water
is preferred over alcohol-based sanitizer because alcohol does not kill C. difficile spores.
Question 2
A nurse is assessing a client who has been receiving IV gentamicin for 7 days. Which
finding should the nurse report to the provider?
A. Blood pressure of 128/76 mm Hg
B. Serum creatinine of 2.4 mg/dL
C. Temperature of 37.2°C (99.0°F)
D. Heart rate of 82/min
,Rationale: Gentamicin is an aminoglycoside antibiotic that is nephrotoxic and ototoxic. An
elevated serum creatinine indicates renal impairment and should be reported
immediately.
Question 3
A nurse is caring for a client who is 1 day postoperative following a total knee
arthroplasty. Which intervention should the nurse implement to prevent venous
thromboembolism?
A. Massage the affected leg every 4 hours
B. Apply intermittent pneumatic compression devices
C. Keep the client on strict bed rest
D. Place pillows under the knee
Rationale: Intermittent pneumatic compression devices promote venous return and
prevent DVT. Massaging the leg is contraindicated due to DVT risk. Early ambulation, not
bed rest, is encouraged. Pillows under the knee impair venous return.
Question 4
A nurse is reviewing laboratory results for a client who has cirrhosis. Which finding
should the nurse expect?
A. Decreased bilirubin
B. Increased ammonia level
C. Increased albumin level
D. Decreased prothrombin time
Rationale: Cirrhosis impairs the liver's ability to convert ammonia to urea, leading to
elevated ammonia levels. Bilirubin increases, albumin decreases, and prothrombin time
lengthens due to impaired clotting factor synthesis.
,Question 5
A nurse is teaching a client who has gout about dietary modifications. Which food
should the nurse instruct the client to avoid?
A. Fresh cherries
B. Organ meats such as liver
C. Whole grain bread
D. Low-fat dairy products
Rationale: Organ meats are high in purines, which break down into uric acid and worsen
gout. Cherries, whole grains, and low-fat dairy may actually help lower uric acid levels.
Question 6
A nurse is assessing a client who has a new prescription for haloperidol. Which finding
indicates the client is experiencing akathisia?
A. Inability to sit still and continuous pacing
B. Muscle rigidity and high fever
C. Torticollis and difficulty swallowing
D. Tremors at rest
Rationale: Akathisia is an extrapyramidal side effect characterized by an intense urge to
move and continuous pacing. Muscle rigidity with fever indicates neuroleptic malignant
syndrome. Torticollis indicates acute dystonia. Resting tremors suggest parkinsonism.
Question 7
A nurse is preparing to administer a nasogastric feeding to a client. Which action should
the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement by aspirating gastric contents and checking pH
C. Administer the feeding over 30 minutes
D. Position the client supine
, Rationale: Verifying tube placement is the priority before any feeding to prevent
aspiration. The pH of gastric aspirate should be 5.5 or lower. The client should be
positioned with the head of the bed elevated at least 30 degrees.
Question 8
A nurse is caring for a client who has a new prescription for digoxin and furosemide.
Which finding indicates the client may be experiencing digoxin toxicity?
A. Heart rate of 88/min
B. Nausea, vomiting, and visual changes
C. Blood pressure of 130/80 mm Hg
D. Increased urine output
Rationale: Furosemide causes potassium loss, which increases the risk of digoxin toxicity.
Early signs include nausea, vomiting, anorexia, and visual disturbances such as yellow-
green halos.
Question 9
A nurse is assessing a client who has a new onset of atrial fibrillation. Which medication
should the nurse anticipate administering to control the heart rate?
A. Atropine
B. Diltiazem
C. Adenosine
D. Epinephrine
Rationale: Diltiazem, a calcium channel blocker, is used to control heart rate in atrial
fibrillation. Adenosine is used for supraventricular tachycardia. Atropine treats
bradycardia. Epinephrine treats cardiac arrest.
Question 10
