ATI CAPSTONE FINAL EXAM
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A nurse is caring for a client who is in the first stage of labor and has a fetal heart rate (FHR)
tracing showing late decelerations. Which of the following actions should the nurse take first?
A. Assist the client into a left-lateral position
B. Increase the rate of the IV fluid infusion
C. Administer oxygen at 8 to 10 L/min via nonrebreather mask
D. Notify the healthcare provider immediately
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority action is to improve placental perfusion by repositioning the client, followed by
oxygen and IV fluids.
2. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should the nurse identify as a manifestation of digoxin toxicity?
A. Yellow-tinged vision
B. Increased appetite
,C. Increased urinary output
D. Tachycardia
Answer: A
Conceptual Explanation: Visual disturbances, such as yellow or green halos and blurred
vision, are classic signs of digoxin toxicity, alongside nausea and bradycardia.
3. A nurse is assigned to a group of clients. Which of the following clients should the nurse
assess first?
A. A client with a hip fracture reporting pain of 8 on a scale of 0 to 10
B. A client with type 1 diabetes whose pre-meal glucose is 150 mg/dL
C. A client with a casted leg who reports a ‘pins and needles’ sensation
D. A client who is 2 days postoperative and has not yet had a bowel movement
Answer: C
Conceptual Explanation: Paresthesia (pins and needles) in a casted extremity can indicate
compartment syndrome, which is a neurovascular emergency requiring immediate
intervention.
4. A nurse is caring for a client with a serum potassium level of 6.2 mEq/L. Which of the
following ECG changes should the nurse expect to see?
A. Prominent U waves
B. ST-segment depression
, C. Tall, peaked T waves
D. Prolonged PR interval
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves, widened QRS complexes, and potentially flat P waves.
5. A nurse in a mental health facility is caring for a client with schizophrenia who is
experiencing auditory hallucinations. Which of the following responses is appropriate?
A. ‘I can hear them too; what are they saying to you?’
B. ‘Why do you think the voices are talking to you right now?’
C. ‘Tell the voices to go away and leave you alone.’
D. ‘I don’t hear the voices, but I can see that they are upsetting you.’
Answer: D
Conceptual Explanation: The nurse should acknowledge the client’s feelings while
presenting reality without validating the hallucination.
6. A nurse is caring for a child who has epiglottitis. Which of the following actions should the
nurse avoid?
A. Monitoring oxygen saturation
B. Examining the throat with a tongue depressor
C. Placing the child in an upright position
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A nurse is caring for a client who is in the first stage of labor and has a fetal heart rate (FHR)
tracing showing late decelerations. Which of the following actions should the nurse take first?
A. Assist the client into a left-lateral position
B. Increase the rate of the IV fluid infusion
C. Administer oxygen at 8 to 10 L/min via nonrebreather mask
D. Notify the healthcare provider immediately
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority action is to improve placental perfusion by repositioning the client, followed by
oxygen and IV fluids.
2. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should the nurse identify as a manifestation of digoxin toxicity?
A. Yellow-tinged vision
B. Increased appetite
,C. Increased urinary output
D. Tachycardia
Answer: A
Conceptual Explanation: Visual disturbances, such as yellow or green halos and blurred
vision, are classic signs of digoxin toxicity, alongside nausea and bradycardia.
3. A nurse is assigned to a group of clients. Which of the following clients should the nurse
assess first?
A. A client with a hip fracture reporting pain of 8 on a scale of 0 to 10
B. A client with type 1 diabetes whose pre-meal glucose is 150 mg/dL
C. A client with a casted leg who reports a ‘pins and needles’ sensation
D. A client who is 2 days postoperative and has not yet had a bowel movement
Answer: C
Conceptual Explanation: Paresthesia (pins and needles) in a casted extremity can indicate
compartment syndrome, which is a neurovascular emergency requiring immediate
intervention.
4. A nurse is caring for a client with a serum potassium level of 6.2 mEq/L. Which of the
following ECG changes should the nurse expect to see?
A. Prominent U waves
B. ST-segment depression
, C. Tall, peaked T waves
D. Prolonged PR interval
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves, widened QRS complexes, and potentially flat P waves.
5. A nurse in a mental health facility is caring for a client with schizophrenia who is
experiencing auditory hallucinations. Which of the following responses is appropriate?
A. ‘I can hear them too; what are they saying to you?’
B. ‘Why do you think the voices are talking to you right now?’
C. ‘Tell the voices to go away and leave you alone.’
D. ‘I don’t hear the voices, but I can see that they are upsetting you.’
Answer: D
Conceptual Explanation: The nurse should acknowledge the client’s feelings while
presenting reality without validating the hallucination.
6. A nurse is caring for a child who has epiglottitis. Which of the following actions should the
nurse avoid?
A. Monitoring oxygen saturation
B. Examining the throat with a tongue depressor
C. Placing the child in an upright position
