ATI RN Capstone Final Comprehensive Review
2026/2027 | ATI Capstone Nursing Study Guide,
Practice Questions & Answers, Comprehensive
Exam Prep, NCLEX-RN Readiness & Final Review
Question 1: A nurse is caring for a client who is 2 hours postoperative
following a total hip arthroplasty. Which of the following actions should
the nurse take to prevent dislocation of the hip prosthesis?
A. Place a pillow between the client's legs when turning.
B. Keep the client's hip in a flexed position of 120 degrees.
C. Encourage the client to cross the affected leg over the unaffected leg.
D. Position the client in a side-lying position with the affected leg adducted.
CORRECT ANSWER: A. Place a pillow between the client's legs when
turning.
Rationale: Following total hip arthroplasty, the nurse should place a pillow
or abduction wedge between the client's legs to maintain the hip in
abduction and prevent dislocation. Hip flexion beyond 90 degrees,
adduction, and crossing the legs are all contraindicated after hip
arthroplasty because they increase the risk of prosthesis dislocation.
Question 2: A nurse is caring for a client who is receiving continuous
bladder irrigation following transurethral resection of the prostate. The
nurse notes the urinary output is dark red with clots. Which of the
following actions should the nurse take first?
A. Increase the irrigation flow rate.
B. Notify the provider immediately.
C. Manually irrigate the catheter with sterile saline.
D. Document the finding and reassess in 1 hour.
CORRECT ANSWER: A. Increase the irrigation flow rate.
Rationale: Dark red urine with clots following TURP indicates bleeding. The
first action is to increase the irrigation flow rate to prevent clot formation
and maintain catheter patency. If increasing the flow rate does not clear the
drainage, the nurse should then manually irrigate the catheter. Notifying the
provider may be necessary if bleeding persists, but the initial intervention is
to increase irrigation.
,Question 3: A nurse is preparing to administer digoxin to a client who
has heart failure. Which of the following findings should the nurse
identify as a contraindication to administering the medication?
A. Heart rate of 52 beats per minute.
B. Potassium level of 4.2 mEq/L.
C. Blood pressure of 118/72 mm Hg.
D. Serum digoxin level of 1.2 ng/mL.
CORRECT ANSWER: A. Heart rate of 52 beats per minute.
Rationale: Digoxin should be withheld if the apical pulse is below 60 beats
per minute in adults because the medication slows the heart rate and can
cause bradycardia. A potassium level of 4.2 mEq/L is within the normal
range. A blood pressure of 118/72 mm Hg is acceptable. A digoxin level of
1.2 ng/mL is within the therapeutic range of 0.5 to 2 ng/mL.
Question 4: A nurse is caring for a client who has a new prescription for
warfarin. Which of the following laboratory values should the nurse
monitor to evaluate the therapeutic effect of the medication?
A. Platelet count.
B. International normalized ratio (INR).
C. Activated partial thromboplastin time (aPTT).
D. Bleeding time.
CORRECT ANSWER: B. International normalized ratio (INR).
Rationale: Warfarin therapy is monitored using the INR, with a therapeutic
range typically between 2 and 3 for most conditions. The aPTT is used to
monitor heparin therapy. Platelet count and bleeding time are not used to
evaluate warfarin's therapeutic effect.
Question 5: A nurse is assessing a client who has been receiving
furosemide for heart failure. Which of the following findings should the
nurse report to the provider immediately?
A. Blood pressure of 102/68 mm Hg.
B. Serum potassium level of 2.8 mEq/L.
C. Urine output of 50 mL/hr.
D. Weight loss of 0.5 kg in 24 hours.
CORRECT ANSWER: B. Serum potassium level of 2.8 mEq/L.
,Rationale: Furosemide is a loop diuretic that causes potassium loss. A
serum potassium level of 2.8 mEq/L indicates hypokalemia, which can
cause cardiac dysrhythmias and requires immediate intervention. A blood
pressure of 102/68 mm Hg may be acceptable depending on baseline.
Urine output of 50 mL/hr is adequate. Weight loss of 0.5 kg in 24 hours is
within expected parameters for diuresis.
Question 6: A nurse is caring for a client who has a prescription for
morphine sulfate via patient-controlled analgesia (PCA) pump. Which
of the following findings should the nurse identify as an adverse effect
of the medication?
A. Respiratory rate of 8 breaths per minute.
B. Blood pressure of 128/76 mm Hg.
C. Pupils that are 4 mm and reactive.
D. Pain rating of 3 on a scale of 0 to 10.
CORRECT ANSWER: A. Respiratory rate of 8 breaths per minute.
Rationale: Respiratory depression is a life-threatening adverse effect of
opioid analgesics such as morphine. A respiratory rate below 12 breaths
per minute requires immediate intervention, including stopping the PCA
pump and administering naloxone if prescribed. A blood pressure of 128/76
mm Hg is within normal limits. Reactive pupils are expected. A pain rating
of 3 indicates the medication is effective.
Question 7: A nurse is caring for a client who is receiving a blood
transfusion and develops chills, fever, and low back pain. Which of the
following actions should the nurse take first?
A. Stop the transfusion.
B. Administer acetaminophen.
C. Obtain a urine specimen.
D. Notify the provider.
CORRECT ANSWER: A. Stop the transfusion.
Rationale: Chills, fever, and low back pain during a blood transfusion
indicate a possible acute hemolytic reaction, which is a life-threatening
emergency. The first action is to stop the transfusion immediately to
prevent further administration of incompatible blood. The nurse should
, then maintain IV access with normal saline, notify the provider, and obtain
blood and urine specimens.
Question 8: A nurse is teaching a client who has a new prescription for
levothyroxine. Which of the following statements by the client
indicates an understanding of the teaching?
A. "I should take this medication at bedtime."
B. "I should take this medication with food."
C. "I should take this medication on an empty stomach."
D. "I should take this medication with an antacid."
CORRECT ANSWER: C. "I should take this medication on an empty
stomach."
Rationale: Levothyroxine should be taken on an empty stomach, 30 to 60
minutes before breakfast, to enhance absorption. Taking it at bedtime is
not recommended because it can cause insomnia. Food and antacids
decrease the absorption of levothyroxine and should be avoided within 4
hours of administration.
Question 9: A nurse is caring for a client who has been prescribed
lithium carbonate. Which of the following findings should the nurse
report to the provider?
A. Fine hand tremors.
B. Serum lithium level of 2.0 mEq/L.
C. Mild thirst.
D. Urine output of 40 mL/hr.
CORRECT ANSWER: B. Serum lithium level of 2.0 mEq/L.
Rationale: The therapeutic range for lithium is 0.5 to 1.2 mEq/L. A serum
lithium level of 2.0 mEq/L indicates lithium toxicity, which can cause severe
neurological and cardiac effects and requires immediate intervention. Fine
hand tremors, mild thirst, and urine output of 40 mL/hr are expected
findings in clients taking lithium.
Question 10: A nurse is preparing to administer phenytoin to a client
who has a seizure disorder. Which of the following actions should the
nurse take?
2026/2027 | ATI Capstone Nursing Study Guide,
Practice Questions & Answers, Comprehensive
Exam Prep, NCLEX-RN Readiness & Final Review
Question 1: A nurse is caring for a client who is 2 hours postoperative
following a total hip arthroplasty. Which of the following actions should
the nurse take to prevent dislocation of the hip prosthesis?
A. Place a pillow between the client's legs when turning.
B. Keep the client's hip in a flexed position of 120 degrees.
C. Encourage the client to cross the affected leg over the unaffected leg.
D. Position the client in a side-lying position with the affected leg adducted.
CORRECT ANSWER: A. Place a pillow between the client's legs when
turning.
Rationale: Following total hip arthroplasty, the nurse should place a pillow
or abduction wedge between the client's legs to maintain the hip in
abduction and prevent dislocation. Hip flexion beyond 90 degrees,
adduction, and crossing the legs are all contraindicated after hip
arthroplasty because they increase the risk of prosthesis dislocation.
Question 2: A nurse is caring for a client who is receiving continuous
bladder irrigation following transurethral resection of the prostate. The
nurse notes the urinary output is dark red with clots. Which of the
following actions should the nurse take first?
A. Increase the irrigation flow rate.
B. Notify the provider immediately.
C. Manually irrigate the catheter with sterile saline.
D. Document the finding and reassess in 1 hour.
CORRECT ANSWER: A. Increase the irrigation flow rate.
Rationale: Dark red urine with clots following TURP indicates bleeding. The
first action is to increase the irrigation flow rate to prevent clot formation
and maintain catheter patency. If increasing the flow rate does not clear the
drainage, the nurse should then manually irrigate the catheter. Notifying the
provider may be necessary if bleeding persists, but the initial intervention is
to increase irrigation.
,Question 3: A nurse is preparing to administer digoxin to a client who
has heart failure. Which of the following findings should the nurse
identify as a contraindication to administering the medication?
A. Heart rate of 52 beats per minute.
B. Potassium level of 4.2 mEq/L.
C. Blood pressure of 118/72 mm Hg.
D. Serum digoxin level of 1.2 ng/mL.
CORRECT ANSWER: A. Heart rate of 52 beats per minute.
Rationale: Digoxin should be withheld if the apical pulse is below 60 beats
per minute in adults because the medication slows the heart rate and can
cause bradycardia. A potassium level of 4.2 mEq/L is within the normal
range. A blood pressure of 118/72 mm Hg is acceptable. A digoxin level of
1.2 ng/mL is within the therapeutic range of 0.5 to 2 ng/mL.
Question 4: A nurse is caring for a client who has a new prescription for
warfarin. Which of the following laboratory values should the nurse
monitor to evaluate the therapeutic effect of the medication?
A. Platelet count.
B. International normalized ratio (INR).
C. Activated partial thromboplastin time (aPTT).
D. Bleeding time.
CORRECT ANSWER: B. International normalized ratio (INR).
Rationale: Warfarin therapy is monitored using the INR, with a therapeutic
range typically between 2 and 3 for most conditions. The aPTT is used to
monitor heparin therapy. Platelet count and bleeding time are not used to
evaluate warfarin's therapeutic effect.
Question 5: A nurse is assessing a client who has been receiving
furosemide for heart failure. Which of the following findings should the
nurse report to the provider immediately?
A. Blood pressure of 102/68 mm Hg.
B. Serum potassium level of 2.8 mEq/L.
C. Urine output of 50 mL/hr.
D. Weight loss of 0.5 kg in 24 hours.
CORRECT ANSWER: B. Serum potassium level of 2.8 mEq/L.
,Rationale: Furosemide is a loop diuretic that causes potassium loss. A
serum potassium level of 2.8 mEq/L indicates hypokalemia, which can
cause cardiac dysrhythmias and requires immediate intervention. A blood
pressure of 102/68 mm Hg may be acceptable depending on baseline.
Urine output of 50 mL/hr is adequate. Weight loss of 0.5 kg in 24 hours is
within expected parameters for diuresis.
Question 6: A nurse is caring for a client who has a prescription for
morphine sulfate via patient-controlled analgesia (PCA) pump. Which
of the following findings should the nurse identify as an adverse effect
of the medication?
A. Respiratory rate of 8 breaths per minute.
B. Blood pressure of 128/76 mm Hg.
C. Pupils that are 4 mm and reactive.
D. Pain rating of 3 on a scale of 0 to 10.
CORRECT ANSWER: A. Respiratory rate of 8 breaths per minute.
Rationale: Respiratory depression is a life-threatening adverse effect of
opioid analgesics such as morphine. A respiratory rate below 12 breaths
per minute requires immediate intervention, including stopping the PCA
pump and administering naloxone if prescribed. A blood pressure of 128/76
mm Hg is within normal limits. Reactive pupils are expected. A pain rating
of 3 indicates the medication is effective.
Question 7: A nurse is caring for a client who is receiving a blood
transfusion and develops chills, fever, and low back pain. Which of the
following actions should the nurse take first?
A. Stop the transfusion.
B. Administer acetaminophen.
C. Obtain a urine specimen.
D. Notify the provider.
CORRECT ANSWER: A. Stop the transfusion.
Rationale: Chills, fever, and low back pain during a blood transfusion
indicate a possible acute hemolytic reaction, which is a life-threatening
emergency. The first action is to stop the transfusion immediately to
prevent further administration of incompatible blood. The nurse should
, then maintain IV access with normal saline, notify the provider, and obtain
blood and urine specimens.
Question 8: A nurse is teaching a client who has a new prescription for
levothyroxine. Which of the following statements by the client
indicates an understanding of the teaching?
A. "I should take this medication at bedtime."
B. "I should take this medication with food."
C. "I should take this medication on an empty stomach."
D. "I should take this medication with an antacid."
CORRECT ANSWER: C. "I should take this medication on an empty
stomach."
Rationale: Levothyroxine should be taken on an empty stomach, 30 to 60
minutes before breakfast, to enhance absorption. Taking it at bedtime is
not recommended because it can cause insomnia. Food and antacids
decrease the absorption of levothyroxine and should be avoided within 4
hours of administration.
Question 9: A nurse is caring for a client who has been prescribed
lithium carbonate. Which of the following findings should the nurse
report to the provider?
A. Fine hand tremors.
B. Serum lithium level of 2.0 mEq/L.
C. Mild thirst.
D. Urine output of 40 mL/hr.
CORRECT ANSWER: B. Serum lithium level of 2.0 mEq/L.
Rationale: The therapeutic range for lithium is 0.5 to 1.2 mEq/L. A serum
lithium level of 2.0 mEq/L indicates lithium toxicity, which can cause severe
neurological and cardiac effects and requires immediate intervention. Fine
hand tremors, mild thirst, and urine output of 40 mL/hr are expected
findings in clients taking lithium.
Question 10: A nurse is preparing to administer phenytoin to a client
who has a seizure disorder. Which of the following actions should the
nurse take?
