ATI Capstone Pre-Assessment Exam Master Practice Test
Bank | 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 caring for a client who has been prescribed a 2-gram sodium diet. Which food
selection by the client indicates understanding of the teaching?
A. Ham sandwich with pickles
B. Fresh fruit salad with grilled chicken
C. Canned tomato soup with crackers
D. Frozen pizza with pepperoni
Rationale: Fresh fruits and grilled chicken are low in sodium. Processed meats, canned
soups, pickles, and frozen pizzas are high in sodium.
Question 2
A nurse is assessing a client who has been receiving IV fluids for 24 hours. Which finding
indicates the client is experiencing fluid overload?
A. Flat neck veins
B. Bounding pulse and hypertension
C. Poor skin turgor
D. Dry mucous membranes
,Rationale: Fluid overload presents with bounding pulse, hypertension, crackles, edema,
and weight gain. Poor skin turgor and dry mucous membranes indicate dehydration.
Question 3
A nurse is preparing to administer acetaminophen to a client who has liver disease.
Which action should the nurse take?
A. Administer the maximum dose
B. Hold the medication and notify the provider
C. Administer with food
D. Crush the medication
Rationale: Acetaminophen is metabolized by the liver. Clients with liver disease are at risk
for hepatotoxicity and the medication should be withheld pending provider notification.
Question 4
A nurse is teaching a client about crutch walking. Which instruction should the nurse
include?
A. "Lean forward while walking."
B. "Keep elbows bent at 30 degrees."
C. "Place crutches 12 inches ahead."
D. "Bear weight on the axillae."
Rationale: Elbows should be bent at 15-30 degrees when using crutches. Weight should be
borne on the hands, not the axillae, to prevent nerve damage.
Question 5
A nurse is assessing a client who has a new prescription for haloperidol. Which finding
should the nurse report immediately?
,A. Mild drowsiness
B. Torticollis and difficulty swallowing
C. Dry mouth
D. Constipation
Rationale: Torticollis and difficulty swallowing indicate acute dystonia, an extrapyramidal
side effect requiring immediate treatment with an anticholinergic medication.
Question 6
A nurse is caring for a client who has a chest tube connected to water seal drainage.
Which finding indicates the system is functioning properly?
A. Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber
C. No drainage output
D. Bubbling in the suction control chamber only
Rationale: Tidaling (fluctuation with respiration) in the water seal chamber indicates the
system is patent and functioning. Continuous bubbling indicates an air leak.
Question 7
A nurse is teaching a client about a new prescription for levothyroxine. Which statement
by the client indicates a need for further teaching?
A. "I will take it before breakfast."
B. "I will take it with my calcium supplement."
C. "I will report chest pain to my provider."
D. "I will not stop taking it abruptly."
Rationale: Calcium interferes with levothyroxine absorption. The client should separate
these medications by at least 4 hours.
, Question 8
A nurse is assessing a client who has a stage 2 pressure injury. Which finding should the
nurse expect?
A. Intact skin with redness
B. Partial-thickness skin loss with a blister
C. Full-thickness skin loss with visible fat
D. Full-thickness loss with exposed bone
Rationale: Stage 2 pressure injury involves partial-thickness skin loss presenting as a
shallow ulcer or blister. Stage 1 is intact skin with redness, stage 3 involves subcutaneous
tissue, and stage 4 involves bone, tendon, or muscle.
Question 9
A nurse is preparing to administer a blood transfusion. Which action should the nurse
take if the client develops fever and chills during the transfusion?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Continue the transfusion and monitor
Rationale: Fever and chills indicate a febrile transfusion reaction. The transfusion must be
stopped immediately, and the provider notified.
Question 10
A nurse is assessing a client who has been prescribed lithium. Which finding indicates
toxicity?
A. Lithium level of 0.8 mEq/L
B. Lithium level of 2.0 mEq/L
C. Blood pressure of 120/80 mm Hg
D. Heart rate of 76/min
Bank | 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 caring for a client who has been prescribed a 2-gram sodium diet. Which food
selection by the client indicates understanding of the teaching?
A. Ham sandwich with pickles
B. Fresh fruit salad with grilled chicken
C. Canned tomato soup with crackers
D. Frozen pizza with pepperoni
Rationale: Fresh fruits and grilled chicken are low in sodium. Processed meats, canned
soups, pickles, and frozen pizzas are high in sodium.
Question 2
A nurse is assessing a client who has been receiving IV fluids for 24 hours. Which finding
indicates the client is experiencing fluid overload?
A. Flat neck veins
B. Bounding pulse and hypertension
C. Poor skin turgor
D. Dry mucous membranes
,Rationale: Fluid overload presents with bounding pulse, hypertension, crackles, edema,
and weight gain. Poor skin turgor and dry mucous membranes indicate dehydration.
Question 3
A nurse is preparing to administer acetaminophen to a client who has liver disease.
Which action should the nurse take?
A. Administer the maximum dose
B. Hold the medication and notify the provider
C. Administer with food
D. Crush the medication
Rationale: Acetaminophen is metabolized by the liver. Clients with liver disease are at risk
for hepatotoxicity and the medication should be withheld pending provider notification.
Question 4
A nurse is teaching a client about crutch walking. Which instruction should the nurse
include?
A. "Lean forward while walking."
B. "Keep elbows bent at 30 degrees."
C. "Place crutches 12 inches ahead."
D. "Bear weight on the axillae."
Rationale: Elbows should be bent at 15-30 degrees when using crutches. Weight should be
borne on the hands, not the axillae, to prevent nerve damage.
Question 5
A nurse is assessing a client who has a new prescription for haloperidol. Which finding
should the nurse report immediately?
,A. Mild drowsiness
B. Torticollis and difficulty swallowing
C. Dry mouth
D. Constipation
Rationale: Torticollis and difficulty swallowing indicate acute dystonia, an extrapyramidal
side effect requiring immediate treatment with an anticholinergic medication.
Question 6
A nurse is caring for a client who has a chest tube connected to water seal drainage.
Which finding indicates the system is functioning properly?
A. Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber
C. No drainage output
D. Bubbling in the suction control chamber only
Rationale: Tidaling (fluctuation with respiration) in the water seal chamber indicates the
system is patent and functioning. Continuous bubbling indicates an air leak.
Question 7
A nurse is teaching a client about a new prescription for levothyroxine. Which statement
by the client indicates a need for further teaching?
A. "I will take it before breakfast."
B. "I will take it with my calcium supplement."
C. "I will report chest pain to my provider."
D. "I will not stop taking it abruptly."
Rationale: Calcium interferes with levothyroxine absorption. The client should separate
these medications by at least 4 hours.
, Question 8
A nurse is assessing a client who has a stage 2 pressure injury. Which finding should the
nurse expect?
A. Intact skin with redness
B. Partial-thickness skin loss with a blister
C. Full-thickness skin loss with visible fat
D. Full-thickness loss with exposed bone
Rationale: Stage 2 pressure injury involves partial-thickness skin loss presenting as a
shallow ulcer or blister. Stage 1 is intact skin with redness, stage 3 involves subcutaneous
tissue, and stage 4 involves bone, tendon, or muscle.
Question 9
A nurse is preparing to administer a blood transfusion. Which action should the nurse
take if the client develops fever and chills during the transfusion?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Continue the transfusion and monitor
Rationale: Fever and chills indicate a febrile transfusion reaction. The transfusion must be
stopped immediately, and the provider notified.
Question 10
A nurse is assessing a client who has been prescribed lithium. Which finding indicates
toxicity?
A. Lithium level of 0.8 mEq/L
B. Lithium level of 2.0 mEq/L
C. Blood pressure of 120/80 mm Hg
D. Heart rate of 76/min
