ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
ATI RN Capstone Proctored Post Assessment
Actual Exam | Complete 81 Questions with Verified Correct Answers and Detailed Rationales
Ultimate NCLEX-RN Review | 2026 Updated
8 Content Sections | 81 Questions | Aligned with 2026 ATI Capstone Curriculum Standards and the NCLEX-RN Test Plan
SECTION 1: MANAGEMENT OF CARE
Advocacy, Delegation, Prioritization, Case Management, and Continuity of Care | Questions 1-12
Q1. A nurse receives report on four assigned clients at the beginning of the shift. Which client should the
nurse assess first?
A. A client 2 days postoperative appendectomy reporting incision pain rated 5 on a 0 to 10 scale
B. A client scheduled for discharge later today who requests teaching review
C. A client with pneumonia whose oxygen saturation is 88% on 2 L/min nasal cannula
[CORRECT]
D. A client requesting a PRN sleep medication to help rest this evening
Correct Answer: C
Rationale: Using the ABC framework, breathing (oxygenation) takes priority over pain, discharge
teaching, and comfort requests. An oxygen saturation of 88% on supplemental oxygen indicates significant
hypoxemia that requires immediate assessment and intervention before it progresses to respiratory failure.
Incision pain rated 5/10 is important but is not immediately life-threatening, and discharge teaching and
PRN sleep requests are nonurgent and can be addressed after physiologic priorities are stable. On
NCLEX-style prioritization items, airway and breathing concerns always outrank comfort, teaching, and
psychosocial needs unless the airway problem is clearly managed and stable.
Q2. A nurse is working with an assistive personnel (AP). Which task is appropriate for the nurse to delegate
to the AP?
A. Evaluating a client's understanding of a low-sodium diet
B. Ambulating a stable postoperative client in the hallway [CORRECT]
C. Titration of an IV heparin infusion based on aPTT results
D. Performing the initial admission assessment on a new client
Correct Answer: B
Rationale: Ambulating a stable client is within the scope of assistive personnel because it is a routine,
noninvasive task with a predictable outcome and no independent assessment component. Evaluation,
assessment, and titration of IV medications require nursing judgment and fall exclusively within the RN
scope of practice, so options A, C, and D must be eliminated. Applying the Five Rights of Delegation, the
RN retains accountability for the task, must verify the AP is competent, and must provide clear directions
and follow-up supervision. A reliable testing strategy is to delegate what is routine and stable, and keep
anything involving assessment, teaching, evaluation, or unstable clients for licensed personnel.
1
,ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
Q3. A nurse is caring for a client who is scheduled for a cholecystectomy. Which action is the nurse's
responsibility related to informed consent?
A. Explaining the surgical risks, benefits, and alternatives to the client
B. Determining whether the surgical risks outweigh the benefits for this client
C. Signing the consent form on behalf of a client who is unable to write
D. Witnessing the client's signature after verifying that the provider explained the procedure
[CORRECT]
Correct Answer: D
Rationale: The provider performing the procedure is responsible for explaining the risks, benefits, and
alternatives; the nurse's role is to verify that the client understands the information and to witness the
voluntary signature. Determining whether benefits outweigh risks is a provider and client decision, not a
nursing function, so option B is incorrect. Signing a consent form for another person is falsification of a
legal document and is never acceptable nursing practice. When an informed consent item appears on the
ATI exam, first ask who is doing what: the provider explains and obtains, while the nurse verifies
understanding, witnesses, and documents.
Q4. A nurse is approached by a neighbor in the hospital lobby who asks whether the neighbor's coworker
was admitted overnight and what is wrong with her. Which response by the nurse is appropriate?
A. State that the nurse is unable to confirm or deny whether the person is a client in the facility
[CORRECT]
B. Share only the client's room number and general diagnosis without further detail
C. Look up the client in the electronic record to confirm the information before responding
D. Ask the neighbor to speak with the client's family to obtain an update
Correct Answer: A
Rationale: HIPAA prohibits the nurse from disclosing any client information, including whether an
individual is receiving care, to anyone without a valid need and authorization. Option B violates
confidentiality because even a room number and general diagnosis are protected health information, and
option C constitutes unauthorized access of the medical record, a frequent source of disciplinary action.
Option D indirectly confirms the admission and still breaches privacy. A reliable testing clue is that any
response that reveals, hints at, or verifies client information to an unauthorized person is a confidentiality
violation.
2
,ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
Q5. A competent adult client informs the nurse that he wants to leave the hospital against medical advice
before his diagnostic workup is complete. Which action should the nurse take?
A. Tell the client that he must stay until the provider returns in the morning
B. Ask security personnel to prevent the client from leaving the unit
C. Explain the risks of leaving in terms the client understands and ask him to sign an
against-medical-advice form [CORRECT]
D. Delay notifying the provider until the client has gathered his belongings
Correct Answer: C
Rationale: A competent client has the legal right to refuse treatment and to leave the facility at any time;
the nurse's obligation is to ensure the client makes an informed decision. Explaining the risks in
understandable terms, offering to notify the provider, and documenting the event with an AMA form
protects both the client's autonomy and the facility legally. Detaining a competent client or using security to
restrict exit constitutes false imprisonment. On client-rights items, remember the hierarchy: competent
clients may refuse anything, and the nurse responds with information, not coercion.
Q6. A nurse is reviewing four clients following report. Which client requires immediate nursing
intervention?
A. A client 1 day postoperative thyroidectomy who has a slightly hoarse voice
B. A client 4 hours after epidural analgesia whose respiratory rate is 10/min and who is
increasingly sedated [CORRECT]
C. A client with heart failure who has 1+ pitting edema of the ankles
D. A client with cellulitis whose temperature is 37.8 C (100.0 F)
Correct Answer: B
Rationale: A respiratory rate of 10/min with increasing sedation after epidural or opioid analgesia signals
life-threatening respiratory depression, which is an airway and breathing emergency requiring immediate
action. A mildly hoarse voice after thyroidectomy warrants monitoring for nerve irritation but does not
compromise the airway at this level, while 1+ ankle edema and a low-grade fever are findings to monitor
rather than emergencies. This is an analysis-level item: the nurse must compare physiologic stability across
multiple clients and rank them using ABCs plus Maslow. Acute problems that threaten airway, breathing, or
circulation always outrank mild or chronic changes.
3
, ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
Q7. A nurse manager is reviewing the principles of delegation with a group of new graduate nurses. Which
statement accurately reflects the Five Rights of Delegation?
A. Right dose, right route, right time, right client, and right documentation
B. Right assessment, right diagnosis, right planning, right implementation, and right evaluation
C. Right scope, right skill, right setting, right support, and right status
D. Right task, right circumstance, right person, right direction, and right supervision
[CORRECT]
Correct Answer: D
Rationale: The National Council of State Boards of Nursing defines the Five Rights of Delegation as right
task, right circumstance, right person, right direction or communication, and right supervision or evaluation.
Option A describes the rights of medication administration, option B describes the steps of the nursing
process, and option C is a fabricated list designed to attract test-takers who recognize individual words.
Memorizing which rights list belongs to which framework is a direct-recall item that ATI includes because
incorrect delegation is a frequent source of client harm and board discipline. When two lists look similar on
the exam, match the vocabulary set to the framework before choosing.
Q8. A nurse is assigning tasks to a licensed practical nurse (LPN) on a medical-surgical unit. Which client
is appropriate to assign to the LPN?
A. A client newly admitted with gastrointestinal bleeding who requires frequent assessments
B. A stable client who needs scheduled oral medications and a routine sterile dressing change
[CORRECT]
C. A client newly diagnosed with type 1 diabetes who needs teaching about insulin administration
D. A client experiencing chest pain who requires continuous interpretation of the cardiac rhythm
Correct Answer: B
Rationale: LPNs can safely care for stable clients with predictable outcomes and may administer most
scheduled medications and perform routine procedures such as dressing changes, depending on the state
practice act. Initial assessments, development of client teaching, and interpretation of unstable cardiac
rhythms require RN-level judgment, so options A, C, and D are inappropriate assignments. The delegation
rule tested here is stability plus predictability: the more a client's condition can change or the more
assessment and education are involved, the more the assignment belongs to the RN. Always verify LPN
scope against the state nurse practice act when answering these items.
4
ATI RN Capstone Proctored Post Assessment
Actual Exam | Complete 81 Questions with Verified Correct Answers and Detailed Rationales
Ultimate NCLEX-RN Review | 2026 Updated
8 Content Sections | 81 Questions | Aligned with 2026 ATI Capstone Curriculum Standards and the NCLEX-RN Test Plan
SECTION 1: MANAGEMENT OF CARE
Advocacy, Delegation, Prioritization, Case Management, and Continuity of Care | Questions 1-12
Q1. A nurse receives report on four assigned clients at the beginning of the shift. Which client should the
nurse assess first?
A. A client 2 days postoperative appendectomy reporting incision pain rated 5 on a 0 to 10 scale
B. A client scheduled for discharge later today who requests teaching review
C. A client with pneumonia whose oxygen saturation is 88% on 2 L/min nasal cannula
[CORRECT]
D. A client requesting a PRN sleep medication to help rest this evening
Correct Answer: C
Rationale: Using the ABC framework, breathing (oxygenation) takes priority over pain, discharge
teaching, and comfort requests. An oxygen saturation of 88% on supplemental oxygen indicates significant
hypoxemia that requires immediate assessment and intervention before it progresses to respiratory failure.
Incision pain rated 5/10 is important but is not immediately life-threatening, and discharge teaching and
PRN sleep requests are nonurgent and can be addressed after physiologic priorities are stable. On
NCLEX-style prioritization items, airway and breathing concerns always outrank comfort, teaching, and
psychosocial needs unless the airway problem is clearly managed and stable.
Q2. A nurse is working with an assistive personnel (AP). Which task is appropriate for the nurse to delegate
to the AP?
A. Evaluating a client's understanding of a low-sodium diet
B. Ambulating a stable postoperative client in the hallway [CORRECT]
C. Titration of an IV heparin infusion based on aPTT results
D. Performing the initial admission assessment on a new client
Correct Answer: B
Rationale: Ambulating a stable client is within the scope of assistive personnel because it is a routine,
noninvasive task with a predictable outcome and no independent assessment component. Evaluation,
assessment, and titration of IV medications require nursing judgment and fall exclusively within the RN
scope of practice, so options A, C, and D must be eliminated. Applying the Five Rights of Delegation, the
RN retains accountability for the task, must verify the AP is competent, and must provide clear directions
and follow-up supervision. A reliable testing strategy is to delegate what is routine and stable, and keep
anything involving assessment, teaching, evaluation, or unstable clients for licensed personnel.
1
,ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
Q3. A nurse is caring for a client who is scheduled for a cholecystectomy. Which action is the nurse's
responsibility related to informed consent?
A. Explaining the surgical risks, benefits, and alternatives to the client
B. Determining whether the surgical risks outweigh the benefits for this client
C. Signing the consent form on behalf of a client who is unable to write
D. Witnessing the client's signature after verifying that the provider explained the procedure
[CORRECT]
Correct Answer: D
Rationale: The provider performing the procedure is responsible for explaining the risks, benefits, and
alternatives; the nurse's role is to verify that the client understands the information and to witness the
voluntary signature. Determining whether benefits outweigh risks is a provider and client decision, not a
nursing function, so option B is incorrect. Signing a consent form for another person is falsification of a
legal document and is never acceptable nursing practice. When an informed consent item appears on the
ATI exam, first ask who is doing what: the provider explains and obtains, while the nurse verifies
understanding, witnesses, and documents.
Q4. A nurse is approached by a neighbor in the hospital lobby who asks whether the neighbor's coworker
was admitted overnight and what is wrong with her. Which response by the nurse is appropriate?
A. State that the nurse is unable to confirm or deny whether the person is a client in the facility
[CORRECT]
B. Share only the client's room number and general diagnosis without further detail
C. Look up the client in the electronic record to confirm the information before responding
D. Ask the neighbor to speak with the client's family to obtain an update
Correct Answer: A
Rationale: HIPAA prohibits the nurse from disclosing any client information, including whether an
individual is receiving care, to anyone without a valid need and authorization. Option B violates
confidentiality because even a room number and general diagnosis are protected health information, and
option C constitutes unauthorized access of the medical record, a frequent source of disciplinary action.
Option D indirectly confirms the admission and still breaches privacy. A reliable testing clue is that any
response that reveals, hints at, or verifies client information to an unauthorized person is a confidentiality
violation.
2
,ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
Q5. A competent adult client informs the nurse that he wants to leave the hospital against medical advice
before his diagnostic workup is complete. Which action should the nurse take?
A. Tell the client that he must stay until the provider returns in the morning
B. Ask security personnel to prevent the client from leaving the unit
C. Explain the risks of leaving in terms the client understands and ask him to sign an
against-medical-advice form [CORRECT]
D. Delay notifying the provider until the client has gathered his belongings
Correct Answer: C
Rationale: A competent client has the legal right to refuse treatment and to leave the facility at any time;
the nurse's obligation is to ensure the client makes an informed decision. Explaining the risks in
understandable terms, offering to notify the provider, and documenting the event with an AMA form
protects both the client's autonomy and the facility legally. Detaining a competent client or using security to
restrict exit constitutes false imprisonment. On client-rights items, remember the hierarchy: competent
clients may refuse anything, and the nurse responds with information, not coercion.
Q6. A nurse is reviewing four clients following report. Which client requires immediate nursing
intervention?
A. A client 1 day postoperative thyroidectomy who has a slightly hoarse voice
B. A client 4 hours after epidural analgesia whose respiratory rate is 10/min and who is
increasingly sedated [CORRECT]
C. A client with heart failure who has 1+ pitting edema of the ankles
D. A client with cellulitis whose temperature is 37.8 C (100.0 F)
Correct Answer: B
Rationale: A respiratory rate of 10/min with increasing sedation after epidural or opioid analgesia signals
life-threatening respiratory depression, which is an airway and breathing emergency requiring immediate
action. A mildly hoarse voice after thyroidectomy warrants monitoring for nerve irritation but does not
compromise the airway at this level, while 1+ ankle edema and a low-grade fever are findings to monitor
rather than emergencies. This is an analysis-level item: the nurse must compare physiologic stability across
multiple clients and rank them using ABCs plus Maslow. Acute problems that threaten airway, breathing, or
circulation always outrank mild or chronic changes.
3
, ATI RN Capstone Proctored Post Assessment - Ultimate NCLEX-RN Review 2026
Q7. A nurse manager is reviewing the principles of delegation with a group of new graduate nurses. Which
statement accurately reflects the Five Rights of Delegation?
A. Right dose, right route, right time, right client, and right documentation
B. Right assessment, right diagnosis, right planning, right implementation, and right evaluation
C. Right scope, right skill, right setting, right support, and right status
D. Right task, right circumstance, right person, right direction, and right supervision
[CORRECT]
Correct Answer: D
Rationale: The National Council of State Boards of Nursing defines the Five Rights of Delegation as right
task, right circumstance, right person, right direction or communication, and right supervision or evaluation.
Option A describes the rights of medication administration, option B describes the steps of the nursing
process, and option C is a fabricated list designed to attract test-takers who recognize individual words.
Memorizing which rights list belongs to which framework is a direct-recall item that ATI includes because
incorrect delegation is a frequent source of client harm and board discipline. When two lists look similar on
the exam, match the vocabulary set to the framework before choosing.
Q8. A nurse is assigning tasks to a licensed practical nurse (LPN) on a medical-surgical unit. Which client
is appropriate to assign to the LPN?
A. A client newly admitted with gastrointestinal bleeding who requires frequent assessments
B. A stable client who needs scheduled oral medications and a routine sterile dressing change
[CORRECT]
C. A client newly diagnosed with type 1 diabetes who needs teaching about insulin administration
D. A client experiencing chest pain who requires continuous interpretation of the cardiac rhythm
Correct Answer: B
Rationale: LPNs can safely care for stable clients with predictable outcomes and may administer most
scheduled medications and perform routine procedures such as dressing changes, depending on the state
practice act. Initial assessments, development of client teaching, and interpretation of unstable cardiac
rhythms require RN-level judgment, so options A, C, and D are inappropriate assignments. The delegation
rule tested here is stability plus predictability: the more a client's condition can change or the more
assessment and education are involved, the more the assignment belongs to the RN. Always verify LPN
scope against the state nurse practice act when answering these items.
4
