RN ATI CAPSTONE COMPREHENSIVE ASSESSMENT PRACTICE
TEST 2026 – 100 QUESTIONS WITH CORRECT ANSWERS AND
DETAILED RATIONALES
1. A nurse is caring for a client who suddenly develops shortness of breath,
restlessness, and an oxygen saturation of 84% on room air. Which action should
the nurse take first?
A. Obtain a prescription for a chest radiograph
B. Encourage the client to ambulate
C. Apply oxygen and assess the client's respiratory status
D. Administer the client's scheduled oral medication
C. Apply oxygen and assess the client's respiratory status
The oxygen saturation indicates significant hypoxemia. Airway and breathing take priority, so
oxygen should be applied while the nurse immediately reassesses respiratory status and seeks
further intervention as indicated.
2. A client receiving IV potassium chloride reports burning at the IV site. The nurse
notes swelling and coolness around the catheter. What is the nurse's priority
action?
A. Slow the infusion rate
B. Apply a warm compress
C. Flush the catheter with normal saline
D. Stop the infusion and assess the IV site
Pain, swelling, and coolness suggest IV infiltration. The infusion should be stopped promptly to
prevent further tissue exposure and injury.
3. A nurse is caring for a client with heart failure who reports difficulty breathing
when lying flat. Which position should the nurse use?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Sims'
High-Fowler's position promotes lung expansion and decreases venous return to the heart,
which can reduce pulmonary congestion and improve breathing.
4. A client with type 1 diabetes mellitus is awake, diaphoretic, and has a blood
glucose level of 54 mg/dL. Which intervention is appropriate?
,A. Administer the scheduled insulin
B. Give a high-protein meal
C. Provide 15 g of a rapid-acting carbohydrate
D. Restrict oral fluids
An alert client with symptomatic hypoglycemia should receive approximately 15 g of rapid-
acting carbohydrate, followed by reassessment of blood glucose.
5. A nurse is assessing a client receiving digoxin. Which finding requires the nurse
to withhold the medication and notify the provider?
A. Blood pressure 128/76 mm Hg
B. Apical pulse 88/min
C. Respiratory rate 18/min
D. Apical pulse 52/min
Digoxin can cause bradycardia. An adult apical pulse below the prescribed safety threshold,
commonly below 60/min, requires withholding the medication and further evaluation.
6. A client taking warfarin asks which food habit is most important to maintain.
Which response should the nurse give?
A. Eliminate all foods containing vitamin K
B. Increase grapefruit consumption
C. Maintain a consistent intake of vitamin K-containing foods
D. Avoid foods containing carbohydrates
Vitamin K can reduce the anticoagulant effect of warfarin. Clients do not usually need to
eliminate vitamin K; they should maintain a consistent intake so therapy can be appropriately
monitored.
7. A postoperative client suddenly reports sharp chest pain and difficulty breathing.
The nurse notes tachycardia and an oxygen saturation of 86%. Which
complication should the nurse suspect?
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Fluid overload
Sudden dyspnea, chest pain, tachycardia, and hypoxemia after surgery are concerning for
pulmonary embolism and require immediate intervention.
8. A nurse is caring for a client with increased intracranial pressure. Which
intervention is appropriate?
, A. Keep the neck flexed
B. Place the client flat
C. Encourage frequent coughing
D. Elevate the head of the bed and maintain neutral neck alignment
Head elevation and neutral neck alignment promote venous drainage from the brain and can
help reduce intracranial pressure.
9. A client receiving a blood transfusion develops chills, fever, and flank pain shortly
after the transfusion begins. What should the nurse do first?
A. Increase the transfusion rate
B. Administer prescribed acetaminophen
C. Stop the transfusion
D. Obtain a urine specimen
These findings can indicate an acute transfusion reaction. The transfusion must be stopped
immediately, and the IV line should be maintained with compatible solution according to facility
protocol.
10. A nurse is preparing to administer insulin lispro. When should the nurse
administer this medication?
A. One hour before eating
B. At bedtime only
C. Close to mealtime
D. Only when the client is fasting
Insulin lispro is rapid-acting insulin and should generally be administered shortly before a meal
so its action corresponds with the rise in blood glucose from food.
11. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which finding requires immediate attention?
A. Barrel-shaped chest
B. Chronic productive cough
C. Mild exertional dyspnea
D. Increasing respiratory distress with altered level of consciousness
Increasing respiratory distress accompanied by altered mental status can indicate severe
hypoxemia or respiratory failure and requires immediate intervention.
12. A nurse is teaching a client who takes levothyroxine. Which instruction is
appropriate?
TEST 2026 – 100 QUESTIONS WITH CORRECT ANSWERS AND
DETAILED RATIONALES
1. A nurse is caring for a client who suddenly develops shortness of breath,
restlessness, and an oxygen saturation of 84% on room air. Which action should
the nurse take first?
A. Obtain a prescription for a chest radiograph
B. Encourage the client to ambulate
C. Apply oxygen and assess the client's respiratory status
D. Administer the client's scheduled oral medication
C. Apply oxygen and assess the client's respiratory status
The oxygen saturation indicates significant hypoxemia. Airway and breathing take priority, so
oxygen should be applied while the nurse immediately reassesses respiratory status and seeks
further intervention as indicated.
2. A client receiving IV potassium chloride reports burning at the IV site. The nurse
notes swelling and coolness around the catheter. What is the nurse's priority
action?
A. Slow the infusion rate
B. Apply a warm compress
C. Flush the catheter with normal saline
D. Stop the infusion and assess the IV site
Pain, swelling, and coolness suggest IV infiltration. The infusion should be stopped promptly to
prevent further tissue exposure and injury.
3. A nurse is caring for a client with heart failure who reports difficulty breathing
when lying flat. Which position should the nurse use?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Sims'
High-Fowler's position promotes lung expansion and decreases venous return to the heart,
which can reduce pulmonary congestion and improve breathing.
4. A client with type 1 diabetes mellitus is awake, diaphoretic, and has a blood
glucose level of 54 mg/dL. Which intervention is appropriate?
,A. Administer the scheduled insulin
B. Give a high-protein meal
C. Provide 15 g of a rapid-acting carbohydrate
D. Restrict oral fluids
An alert client with symptomatic hypoglycemia should receive approximately 15 g of rapid-
acting carbohydrate, followed by reassessment of blood glucose.
5. A nurse is assessing a client receiving digoxin. Which finding requires the nurse
to withhold the medication and notify the provider?
A. Blood pressure 128/76 mm Hg
B. Apical pulse 88/min
C. Respiratory rate 18/min
D. Apical pulse 52/min
Digoxin can cause bradycardia. An adult apical pulse below the prescribed safety threshold,
commonly below 60/min, requires withholding the medication and further evaluation.
6. A client taking warfarin asks which food habit is most important to maintain.
Which response should the nurse give?
A. Eliminate all foods containing vitamin K
B. Increase grapefruit consumption
C. Maintain a consistent intake of vitamin K-containing foods
D. Avoid foods containing carbohydrates
Vitamin K can reduce the anticoagulant effect of warfarin. Clients do not usually need to
eliminate vitamin K; they should maintain a consistent intake so therapy can be appropriately
monitored.
7. A postoperative client suddenly reports sharp chest pain and difficulty breathing.
The nurse notes tachycardia and an oxygen saturation of 86%. Which
complication should the nurse suspect?
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Fluid overload
Sudden dyspnea, chest pain, tachycardia, and hypoxemia after surgery are concerning for
pulmonary embolism and require immediate intervention.
8. A nurse is caring for a client with increased intracranial pressure. Which
intervention is appropriate?
, A. Keep the neck flexed
B. Place the client flat
C. Encourage frequent coughing
D. Elevate the head of the bed and maintain neutral neck alignment
Head elevation and neutral neck alignment promote venous drainage from the brain and can
help reduce intracranial pressure.
9. A client receiving a blood transfusion develops chills, fever, and flank pain shortly
after the transfusion begins. What should the nurse do first?
A. Increase the transfusion rate
B. Administer prescribed acetaminophen
C. Stop the transfusion
D. Obtain a urine specimen
These findings can indicate an acute transfusion reaction. The transfusion must be stopped
immediately, and the IV line should be maintained with compatible solution according to facility
protocol.
10. A nurse is preparing to administer insulin lispro. When should the nurse
administer this medication?
A. One hour before eating
B. At bedtime only
C. Close to mealtime
D. Only when the client is fasting
Insulin lispro is rapid-acting insulin and should generally be administered shortly before a meal
so its action corresponds with the rise in blood glucose from food.
11. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which finding requires immediate attention?
A. Barrel-shaped chest
B. Chronic productive cough
C. Mild exertional dyspnea
D. Increasing respiratory distress with altered level of consciousness
Increasing respiratory distress accompanied by altered mental status can indicate severe
hypoxemia or respiratory failure and requires immediate intervention.
12. A nurse is teaching a client who takes levothyroxine. Which instruction is
appropriate?
