ATI Capstone Exam Questions and Answers 2026/2027 |
Complete Nursing NCLEX Preparation Study Guide
Question 1
A nurse receives report on four clients. Which client should the nurse assess first?
A client 1 day after cataract surgery with mild eye discomfort
A client with COPD whose oxygen saturation is 88% on the prescribed baseline
✓ A client 4 hr after thyroidectomy who reports a feeling of fullness in the throat
A client with diabetes whose premeal glucose is 186 mg/dL
Rationale: Airway compromise after thyroidectomy can progress rapidly and takes priority.
Human Heart — simplified educational diagram
SVC
Aorta
Right Left
atrium atrium
Pulmonary Pulmonary
artery veins
Right Left
ventricle ventricle
Question 2
Which task is appropriate for the nurse to delegate to an assistive personnel (AP)?
Assess a new admission for fall risk
Teach a client how to use an incentive spirometer
✓ Obtain the daily weight of a stable client with heart failure
Evaluate a client's response to IV morphine
Rationale: Routine measurement of weight for a stable client is within AP scope; assessment, teaching, and evaluation remain with
the nurse.
Question 3
A client is suspected of having Clostridioides difficile infection. Which action should the nurse take?
Use alcohol-based hand sanitizer after care
Place the client on airborne precautions
✓ Wash hands with soap and water after removing gloves
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 1
, Use a surgical mask for every room entry
Rationale: C. difficile spores require soap-and-water hand hygiene; contact precautions are used.
Question 4
A nurse is preparing to administer a medication. Which action is most important before giving the drug?
Ask another nurse to calculate every dose
✓ Verify the medication against the prescription and client identifiers
Document administration before giving the medication
Leave the medication at the bedside for later
Rationale: Medication verification and two client identifiers are core medication-safety checks.
Question 5
A client begins having a generalized tonic-clonic seizure. What should the nurse do first?
Restrain the client's extremities
Insert an oral airway
✓ Protect the client from injury and turn the client to the side
Offer oral fluids
Rationale: During a seizure, protect from injury and maintain airway positioning; do not restrain or place objects in the mouth.
Question 6
A nurse enters a room and finds a client on the floor. What is the priority action?
Complete an incident report
Move the client back to bed immediately
✓ Assess the client for injury before moving them
Call the family
Rationale: Assess for injury and physiologic instability before moving the client.
Question 7
Which finding requires immediate intervention for a client receiving a blood transfusion?
Temperature increases from 37.0°C to 37.2°C
Urine output is 45 mL/hr
✓ Client reports chills and low back pain
Blood pressure is 128/76 mm Hg
Rationale: Chills and low back pain can indicate an acute hemolytic transfusion reaction; stop the transfusion and follow protocol.
Question 8
Which position is best for a client experiencing acute pulmonary edema?
Supine
✓ High-Fowler
Trendelenburg
Prone
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 2
, Rationale: High-Fowler positioning promotes lung expansion and reduces venous return.
Question 9
Which intervention best reduces the risk for pressure injury in an immobile client?
Massage reddened bony prominences
✓ Reposition at regular intervals and offload pressure
Use a donut-shaped ring under the sacrum
Keep the head of bed elevated at 60° continuously
Rationale: Regular repositioning and pressure redistribution reduce tissue ischemia.
Question 10
A nurse is caring for a client with dysphagia after a stroke. Which action is appropriate?
Offer thin liquids first
Place food on the affected side of the mouth
✓ Keep the client upright during and after meals
Encourage use of a straw for all liquids
Rationale: Upright positioning reduces aspiration risk; texture and placement follow the swallowing evaluation.
Question 11
Which client is most appropriate for assignment to an LPN/LVN?
A client newly admitted with chest pain
A client requiring initial teaching about insulin
✓ A stable client receiving routine wound care
A client with rapidly changing neurologic status
Rationale: Stable, predictable clients with routine care are appropriate for LPN/LVN assignment.
Question 12
Which statement by a client demonstrates correct understanding of incentive spirometry?
I will blow forcefully into the device
✓ I will inhale slowly and deeply through the mouthpiece
I will use it only when I feel short of breath
I will lie flat while using it
Rationale: The client should inhale slowly and deeply to expand alveoli.
Question 13
A client with neutropenia asks how to reduce infection risk. Which instruction is best?
Avoid all cooked vegetables
✓ Perform frequent hand hygiene and avoid people who are ill
Use fresh flowers in the room
Share personal grooming items only with family
Rationale: Hand hygiene and avoiding exposure to infection are key neutropenia precautions.
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 3
, Question 14
A nurse is caring for a client with a central venous catheter. Which finding should be reported immediately?
Transparent dressing is intact
✓ Insertion site is warm, red, and tender
Catheter flushes without resistance
Client asks when the dressing will be changed
Rationale: Redness, warmth, and tenderness suggest catheter-related infection.
Question 15
Which action is appropriate when applying a restraint?
Tie the restraint to the side rail
✓ Use the least restrictive method and reassess frequently
Apply restraints whenever a client is confused
Remove restraints only once per shift
Rationale: Restraints require least-restrictive use, monitoring, and frequent reassessment.
Question 16
A nurse is caring for a client with suspected tuberculosis. Which PPE is required?
Surgical mask
✓ N95 or equivalent respirator
Sterile gloves only
Face shield only
Rationale: Tuberculosis requires airborne precautions and a fit-tested respirator.
Question 17
Which action is correct when removing PPE after contact precautions?
✓ Remove the gown and gloves before leaving the room according to facility sequence
Remove the respirator first
Touch the outside of the gloves with bare hands
Reuse disposable gloves
Rationale: Gown and gloves are removed carefully to prevent contamination, following facility sequence.
Question 18
A client has orthostatic hypotension. Which instruction should the nurse provide?
Stand up quickly to improve circulation
✓ Dangle the legs before standing
Restrict all fluids
Avoid using assistive devices
Rationale: Slow position changes and dangling reduce orthostatic symptoms and falls.
Question 19
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 4
Complete Nursing NCLEX Preparation Study Guide
Question 1
A nurse receives report on four clients. Which client should the nurse assess first?
A client 1 day after cataract surgery with mild eye discomfort
A client with COPD whose oxygen saturation is 88% on the prescribed baseline
✓ A client 4 hr after thyroidectomy who reports a feeling of fullness in the throat
A client with diabetes whose premeal glucose is 186 mg/dL
Rationale: Airway compromise after thyroidectomy can progress rapidly and takes priority.
Human Heart — simplified educational diagram
SVC
Aorta
Right Left
atrium atrium
Pulmonary Pulmonary
artery veins
Right Left
ventricle ventricle
Question 2
Which task is appropriate for the nurse to delegate to an assistive personnel (AP)?
Assess a new admission for fall risk
Teach a client how to use an incentive spirometer
✓ Obtain the daily weight of a stable client with heart failure
Evaluate a client's response to IV morphine
Rationale: Routine measurement of weight for a stable client is within AP scope; assessment, teaching, and evaluation remain with
the nurse.
Question 3
A client is suspected of having Clostridioides difficile infection. Which action should the nurse take?
Use alcohol-based hand sanitizer after care
Place the client on airborne precautions
✓ Wash hands with soap and water after removing gloves
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 1
, Use a surgical mask for every room entry
Rationale: C. difficile spores require soap-and-water hand hygiene; contact precautions are used.
Question 4
A nurse is preparing to administer a medication. Which action is most important before giving the drug?
Ask another nurse to calculate every dose
✓ Verify the medication against the prescription and client identifiers
Document administration before giving the medication
Leave the medication at the bedside for later
Rationale: Medication verification and two client identifiers are core medication-safety checks.
Question 5
A client begins having a generalized tonic-clonic seizure. What should the nurse do first?
Restrain the client's extremities
Insert an oral airway
✓ Protect the client from injury and turn the client to the side
Offer oral fluids
Rationale: During a seizure, protect from injury and maintain airway positioning; do not restrain or place objects in the mouth.
Question 6
A nurse enters a room and finds a client on the floor. What is the priority action?
Complete an incident report
Move the client back to bed immediately
✓ Assess the client for injury before moving them
Call the family
Rationale: Assess for injury and physiologic instability before moving the client.
Question 7
Which finding requires immediate intervention for a client receiving a blood transfusion?
Temperature increases from 37.0°C to 37.2°C
Urine output is 45 mL/hr
✓ Client reports chills and low back pain
Blood pressure is 128/76 mm Hg
Rationale: Chills and low back pain can indicate an acute hemolytic transfusion reaction; stop the transfusion and follow protocol.
Question 8
Which position is best for a client experiencing acute pulmonary edema?
Supine
✓ High-Fowler
Trendelenburg
Prone
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 2
, Rationale: High-Fowler positioning promotes lung expansion and reduces venous return.
Question 9
Which intervention best reduces the risk for pressure injury in an immobile client?
Massage reddened bony prominences
✓ Reposition at regular intervals and offload pressure
Use a donut-shaped ring under the sacrum
Keep the head of bed elevated at 60° continuously
Rationale: Regular repositioning and pressure redistribution reduce tissue ischemia.
Question 10
A nurse is caring for a client with dysphagia after a stroke. Which action is appropriate?
Offer thin liquids first
Place food on the affected side of the mouth
✓ Keep the client upright during and after meals
Encourage use of a straw for all liquids
Rationale: Upright positioning reduces aspiration risk; texture and placement follow the swallowing evaluation.
Question 11
Which client is most appropriate for assignment to an LPN/LVN?
A client newly admitted with chest pain
A client requiring initial teaching about insulin
✓ A stable client receiving routine wound care
A client with rapidly changing neurologic status
Rationale: Stable, predictable clients with routine care are appropriate for LPN/LVN assignment.
Question 12
Which statement by a client demonstrates correct understanding of incentive spirometry?
I will blow forcefully into the device
✓ I will inhale slowly and deeply through the mouthpiece
I will use it only when I feel short of breath
I will lie flat while using it
Rationale: The client should inhale slowly and deeply to expand alveoli.
Question 13
A client with neutropenia asks how to reduce infection risk. Which instruction is best?
Avoid all cooked vegetables
✓ Perform frequent hand hygiene and avoid people who are ill
Use fresh flowers in the room
Share personal grooming items only with family
Rationale: Hand hygiene and avoiding exposure to infection are key neutropenia precautions.
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 3
, Question 14
A nurse is caring for a client with a central venous catheter. Which finding should be reported immediately?
Transparent dressing is intact
✓ Insertion site is warm, red, and tender
Catheter flushes without resistance
Client asks when the dressing will be changed
Rationale: Redness, warmth, and tenderness suggest catheter-related infection.
Question 15
Which action is appropriate when applying a restraint?
Tie the restraint to the side rail
✓ Use the least restrictive method and reassess frequently
Apply restraints whenever a client is confused
Remove restraints only once per shift
Rationale: Restraints require least-restrictive use, monitoring, and frequent reassessment.
Question 16
A nurse is caring for a client with suspected tuberculosis. Which PPE is required?
Surgical mask
✓ N95 or equivalent respirator
Sterile gloves only
Face shield only
Rationale: Tuberculosis requires airborne precautions and a fit-tested respirator.
Question 17
Which action is correct when removing PPE after contact precautions?
✓ Remove the gown and gloves before leaving the room according to facility sequence
Remove the respirator first
Touch the outside of the gloves with bare hands
Reuse disposable gloves
Rationale: Gown and gloves are removed carefully to prevent contamination, following facility sequence.
Question 18
A client has orthostatic hypotension. Which instruction should the nurse provide?
Stand up quickly to improve circulation
✓ Dangle the legs before standing
Restrict all fluids
Avoid using assistive devices
Rationale: Slow position changes and dangling reduce orthostatic symptoms and falls.
Question 19
Original ATI/NCLEX-style practice content — not confidential ATI exam items. Page 4
