ATI Capstone Proctored Comprehensive Assessment exam 2,
PREP QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES.pdf
About This Exam Bank
This comprehensive 146-question exam bank is designed to prepare candidates for ATI Capstone Proctored
Comprehensive Assessment exam 2, PREP QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES.pdf.
Every question is aligned with the latest official content outline and includes a detailed, evidence-based rationale, an
explanation of why each remaining option is incorrect, and a supporting reference.
Keywords
ATI Capstone Proctored Comprehensive Assessment exam 2, PREP QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES.pdf, exam bank, practice questions, verified answers, detailed rationales, test prep, study guide,
review questions, certification exam, latest update, ATI Capstone Proctored Comprehensive Assessment exam 2,
PREP QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES.pdf, exam bank, practice questions, verified
answers, detailed rationales
PART 1: PRIORITIZE AND DELEGATE NURSING CARE USING CLINICAL JUDGMENT
MODELS (E
1. A patient with acute decompensated heart failure is receiving furosemide IV. Which laboratory trend, if noted over
the past 24 hours, most urgently requires provider notification?
A) Sodium 134 mEq/L
B) Potassium 3.1 mEq/L with new U waves on ECG
C) BUN 28 mg/dL
D) Hemoglobin 11.8 g/dL
' Correct Answer: B
Rationale: Loop diuretics cause hypokalemia, and a potassium of 3.1 with U waves indicates cardiac instability
and risk for dysrhythmias, requiring immediate intervention. Sodium 134 and BUN 28 are expected mild changes;
hemoglobin 11.8 is not life-threatening.
2. A patient with severe neutropenia from chemotherapy develops a fever of 38.3°C. Which action should the nurse
take first?
A) Administer acetaminophen and reassess in 2 hours
B) Obtain blood cultures from two sites and administer broad-spectrum IV antibiotics
C) Place the patient in a negative-pressure isolation room
D) Administer granulocyte colony-stimulating factor (G-CSF)
' Correct Answer: B
Rationale: Febrile neutropenia is a medical emergency requiring immediate blood cultures and empiric
broad-spectrum antibiotics within 1 hour. Acetaminophen masks fever; isolation and G-CSF are adjuncts but not
first-line. B is the priority.
3. Which statement by a patient prescribed lithium carbonate indicates a need for further teaching?
A) I will maintain a consistent sodium intake.
B) I should drink at least 2 liters of water daily.
Page 1
, C) I can take ibuprofen for headaches.
D) I will report excessive urination or thirst.
' Correct Answer: C
Rationale: NSAIDs like ibuprofen increase lithium levels by reducing renal clearance, risking toxicity. Consistent
sodium and hydration are correct; reporting polyuria/polydipsia monitors for nephrogenic diabetes insipidus. C
indicates need for teaching.
4. A community health nurse is planning a disaster response. Which principle should guide the nurse's initial triage
during a mass casualty incident?
A) Treat the most critically injured first
B) Provide care to those who can be saved with minimal resources
C) Prioritize pediatric and elderly populations
D) Follow standard first-come, first-served order
' Correct Answer: B
Rationale: Disaster triage (e.g., START) uses utilitarian principles to do the greatest good for the greatest number,
focusing on those with survivable injuries and minimal resource needs. Treating the most critical first (A) is for
conventional triage, not disasters. B is correct.
5. A child with acute epiglottitis is admitted. Which nursing action is contraindicated?
A) Maintaining the child in a position of comfort
B) Obtaining a throat culture with a swab
C) Administering IV corticosteroids as ordered
D) Preparing for possible intubation
' Correct Answer: B
Rationale: Throat culture or examination with a tongue blade can precipitate complete airway obstruction in
epiglottitis. Positioning, steroids, and intubation preparation are appropriate. B is contraindicated.
6. Which assessment finding in a patient receiving a blood transfusion most suggests an acute hemolytic reaction?
A) Temperature increase of 1°C within 15 minutes
B) Urticaria and itching
C) Flank pain, dark urine, and hypotension
D) Circumoral paresthesia
' Correct Answer: C
Rationale: Acute hemolytic reaction presents with flank pain, hemoglobinuria (dark urine), hypotension, and fever
due to ABO incompatibility. Urticaria suggests allergic reaction; paresthesia suggests citrate toxicity. C is most
specific.
7. A nurse manager is evaluating staffing effectiveness. Which metric best reflects the quality of nursing care
delivery?
A) Nurse-to-patient ratio
B) Incidence of hospital-acquired pressure injuries
C) Overtime hours per nurse
D) Patient satisfaction with food services
' Correct Answer: B
Rationale: Hospital-acquired pressure injuries are a nurse-sensitive quality indicator reflecting nursing care quality.
Ratios and overtime are structural measures; food satisfaction is unrelated. B is the best indicator.
Page 2
,8. A patient with a new colostomy has stool output that is liquid and continuous. Which intervention should the
nurse anticipate?
A) Encouraging a low-fiber diet
B) Administering loperamide as prescribed
C) Increasing fluid intake to 3 L/day
D) Applying a tight ostomy belt
' Correct Answer: B
Rationale: High-output ileostomies or colostomies can cause dehydration and electrolyte loss; antimotility agents
like loperamide may be prescribed. Low-fiber diet and increased fluids are adjuncts but not primary. B is the
anticipated intervention.
9. Which action by a nurse preparing to administer IV potassium chloride is unsafe?
A) Diluting the dose in 100 mL of normal saline
B) Administering via IV push over 5 minutes
C) Using an infusion pump
D) Assessing urine output before administration
' Correct Answer: B
Rationale: IV potassium must never be given by IV push; it can cause fatal cardiac arrest. Dilution, pump use, and
urine output assessment are safe practices. B is unsafe.
10. A client with heart failure is prescribed furosemide 40 mg IV push. Which assessment finding most urgently
requires the nurse to withhold the dose and contact the provider?
A) Serum potassium 3.1 mEq/L
B) Blood pressure 98/60 mm Hg
C) Urine output 40 mL/hr
D) Serum sodium 134 mEq/L
' Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss; a serum potassium of 3.1 mEq/L is
dangerously low and increases the risk of lethal dysrhythmias, so the dose should be withheld and the provider
notified. Blood pressure 98/60 mm Hg may be acceptable if the client is asymptomatic, urine output 40 mL/hr is
adequate, and sodium 134 mEq/L is only mildly low.
11. A client receiving heparin infusion has an aPTT of 95 seconds (control 30 seconds). Which action should the
nurse anticipate?
A) Increase the heparin infusion rate
B) Administer vitamin K
C) Stop the infusion and prepare to administer protamine sulfate
D) Continue the infusion at the current rate
' Correct Answer: C
Rationale: The therapeutic aPTT range is typically 1.5 to 2.5 times the control (45–75 seconds); 95 seconds is
supratherapeutic, so the infusion should be stopped and protamine sulfate, the antidote for heparin, administered.
Increasing the rate would worsen bleeding risk, vitamin K reverses warfarin, and continuing the current rate ignores
the elevated aPTT.
12. A client with type 1 diabetes has a blood glucose of 560 mg/dL, pH 7.20, and deep rapid respirations. Which
prescription should the nurse question?
A) 0.9% sodium chloride IV bolus
B) Regular insulin IV infusion
Page 3
, C) Sodium bicarbonate IV push
D) Potassium chloride 20 mEq IV piggyback
' Correct Answer: C
Rationale: Sodium bicarbonate is not routinely recommended for diabetic ketoacidosis because it can cause
paradoxical CNS acidosis, hypokalemia, and rebound alkalosis; it is reserved for severe acidosis (pH < 6.9). IV
fluids, insulin infusion, and potassium replacement (once potassium is below 5.2 mEq/L) are standard treatments.
13. A client is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours. Which laboratory value should the
nurse monitor to evaluate the therapeutic effect?
A) aPTT
B) PT/INR
C) Anti-Xa level
D) Bleeding time
' Correct Answer: C
Rationale: Enoxaparin is a low-molecular-weight heparin; its therapeutic effect is best monitored by anti-Xa
activity, especially in renal impairment or obesity. aPTT is used for unfractionated heparin, PT/INR for warfarin, and
bleeding time is not a standard monitoring test for enoxaparin.
14. A client with a new colostomy has a stoma that is dark purple and dry. Which action should the nurse take first?
A) Apply a transparent dressing over the stoma
B) Notify the provider immediately
C) Document the finding as normal
D) Irrigate the stoma with sterile water
' Correct Answer: B
Rationale: A dark purple, dry stoma indicates ischemia or necrosis and requires immediate provider notification.
Applying a dressing, documenting as normal, or irrigating would delay necessary intervention and could worsen
tissue damage.
15. A client is receiving total parenteral nutrition (TPN). Which action is essential to prevent a complication?
A) Change the TPN tubing every 72 hours
B) Monitor blood glucose every 6 hours
C) Administer TPN via a peripheral IV line
D) Abruptly discontinue TPN if the client reports nausea
' Correct Answer: B
Rationale: TPN contains high dextrose concentrations, so blood glucose should be monitored regularly (often
every 6 hours) to detect hyperglycemia. TPN tubing is changed every 24 hours, TPN is administered via a central
line, and it must be tapered rather than abruptly discontinued to prevent hypoglycemia.
16. A client with a chest tube has continuous bubbling in the water seal chamber. Which action should the nurse
take?
A) Clamp the chest tube immediately
B) Assess for an air leak in the system
C) Increase the suction pressure
D) Milking the chest tube
' Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak; the nurse should assess the system
from the client to the drainage unit to locate the leak. Clamping the tube can cause tension pneumothorax, increasing
suction does not address the leak, and milking is not recommended as it can cause tissue damage.
Page 4
PREP QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES.pdf
About This Exam Bank
This comprehensive 146-question exam bank is designed to prepare candidates for ATI Capstone Proctored
Comprehensive Assessment exam 2, PREP QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES.pdf.
Every question is aligned with the latest official content outline and includes a detailed, evidence-based rationale, an
explanation of why each remaining option is incorrect, and a supporting reference.
Keywords
ATI Capstone Proctored Comprehensive Assessment exam 2, PREP QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES.pdf, exam bank, practice questions, verified answers, detailed rationales, test prep, study guide,
review questions, certification exam, latest update, ATI Capstone Proctored Comprehensive Assessment exam 2,
PREP QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES.pdf, exam bank, practice questions, verified
answers, detailed rationales
PART 1: PRIORITIZE AND DELEGATE NURSING CARE USING CLINICAL JUDGMENT
MODELS (E
1. A patient with acute decompensated heart failure is receiving furosemide IV. Which laboratory trend, if noted over
the past 24 hours, most urgently requires provider notification?
A) Sodium 134 mEq/L
B) Potassium 3.1 mEq/L with new U waves on ECG
C) BUN 28 mg/dL
D) Hemoglobin 11.8 g/dL
' Correct Answer: B
Rationale: Loop diuretics cause hypokalemia, and a potassium of 3.1 with U waves indicates cardiac instability
and risk for dysrhythmias, requiring immediate intervention. Sodium 134 and BUN 28 are expected mild changes;
hemoglobin 11.8 is not life-threatening.
2. A patient with severe neutropenia from chemotherapy develops a fever of 38.3°C. Which action should the nurse
take first?
A) Administer acetaminophen and reassess in 2 hours
B) Obtain blood cultures from two sites and administer broad-spectrum IV antibiotics
C) Place the patient in a negative-pressure isolation room
D) Administer granulocyte colony-stimulating factor (G-CSF)
' Correct Answer: B
Rationale: Febrile neutropenia is a medical emergency requiring immediate blood cultures and empiric
broad-spectrum antibiotics within 1 hour. Acetaminophen masks fever; isolation and G-CSF are adjuncts but not
first-line. B is the priority.
3. Which statement by a patient prescribed lithium carbonate indicates a need for further teaching?
A) I will maintain a consistent sodium intake.
B) I should drink at least 2 liters of water daily.
Page 1
, C) I can take ibuprofen for headaches.
D) I will report excessive urination or thirst.
' Correct Answer: C
Rationale: NSAIDs like ibuprofen increase lithium levels by reducing renal clearance, risking toxicity. Consistent
sodium and hydration are correct; reporting polyuria/polydipsia monitors for nephrogenic diabetes insipidus. C
indicates need for teaching.
4. A community health nurse is planning a disaster response. Which principle should guide the nurse's initial triage
during a mass casualty incident?
A) Treat the most critically injured first
B) Provide care to those who can be saved with minimal resources
C) Prioritize pediatric and elderly populations
D) Follow standard first-come, first-served order
' Correct Answer: B
Rationale: Disaster triage (e.g., START) uses utilitarian principles to do the greatest good for the greatest number,
focusing on those with survivable injuries and minimal resource needs. Treating the most critical first (A) is for
conventional triage, not disasters. B is correct.
5. A child with acute epiglottitis is admitted. Which nursing action is contraindicated?
A) Maintaining the child in a position of comfort
B) Obtaining a throat culture with a swab
C) Administering IV corticosteroids as ordered
D) Preparing for possible intubation
' Correct Answer: B
Rationale: Throat culture or examination with a tongue blade can precipitate complete airway obstruction in
epiglottitis. Positioning, steroids, and intubation preparation are appropriate. B is contraindicated.
6. Which assessment finding in a patient receiving a blood transfusion most suggests an acute hemolytic reaction?
A) Temperature increase of 1°C within 15 minutes
B) Urticaria and itching
C) Flank pain, dark urine, and hypotension
D) Circumoral paresthesia
' Correct Answer: C
Rationale: Acute hemolytic reaction presents with flank pain, hemoglobinuria (dark urine), hypotension, and fever
due to ABO incompatibility. Urticaria suggests allergic reaction; paresthesia suggests citrate toxicity. C is most
specific.
7. A nurse manager is evaluating staffing effectiveness. Which metric best reflects the quality of nursing care
delivery?
A) Nurse-to-patient ratio
B) Incidence of hospital-acquired pressure injuries
C) Overtime hours per nurse
D) Patient satisfaction with food services
' Correct Answer: B
Rationale: Hospital-acquired pressure injuries are a nurse-sensitive quality indicator reflecting nursing care quality.
Ratios and overtime are structural measures; food satisfaction is unrelated. B is the best indicator.
Page 2
,8. A patient with a new colostomy has stool output that is liquid and continuous. Which intervention should the
nurse anticipate?
A) Encouraging a low-fiber diet
B) Administering loperamide as prescribed
C) Increasing fluid intake to 3 L/day
D) Applying a tight ostomy belt
' Correct Answer: B
Rationale: High-output ileostomies or colostomies can cause dehydration and electrolyte loss; antimotility agents
like loperamide may be prescribed. Low-fiber diet and increased fluids are adjuncts but not primary. B is the
anticipated intervention.
9. Which action by a nurse preparing to administer IV potassium chloride is unsafe?
A) Diluting the dose in 100 mL of normal saline
B) Administering via IV push over 5 minutes
C) Using an infusion pump
D) Assessing urine output before administration
' Correct Answer: B
Rationale: IV potassium must never be given by IV push; it can cause fatal cardiac arrest. Dilution, pump use, and
urine output assessment are safe practices. B is unsafe.
10. A client with heart failure is prescribed furosemide 40 mg IV push. Which assessment finding most urgently
requires the nurse to withhold the dose and contact the provider?
A) Serum potassium 3.1 mEq/L
B) Blood pressure 98/60 mm Hg
C) Urine output 40 mL/hr
D) Serum sodium 134 mEq/L
' Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss; a serum potassium of 3.1 mEq/L is
dangerously low and increases the risk of lethal dysrhythmias, so the dose should be withheld and the provider
notified. Blood pressure 98/60 mm Hg may be acceptable if the client is asymptomatic, urine output 40 mL/hr is
adequate, and sodium 134 mEq/L is only mildly low.
11. A client receiving heparin infusion has an aPTT of 95 seconds (control 30 seconds). Which action should the
nurse anticipate?
A) Increase the heparin infusion rate
B) Administer vitamin K
C) Stop the infusion and prepare to administer protamine sulfate
D) Continue the infusion at the current rate
' Correct Answer: C
Rationale: The therapeutic aPTT range is typically 1.5 to 2.5 times the control (45–75 seconds); 95 seconds is
supratherapeutic, so the infusion should be stopped and protamine sulfate, the antidote for heparin, administered.
Increasing the rate would worsen bleeding risk, vitamin K reverses warfarin, and continuing the current rate ignores
the elevated aPTT.
12. A client with type 1 diabetes has a blood glucose of 560 mg/dL, pH 7.20, and deep rapid respirations. Which
prescription should the nurse question?
A) 0.9% sodium chloride IV bolus
B) Regular insulin IV infusion
Page 3
, C) Sodium bicarbonate IV push
D) Potassium chloride 20 mEq IV piggyback
' Correct Answer: C
Rationale: Sodium bicarbonate is not routinely recommended for diabetic ketoacidosis because it can cause
paradoxical CNS acidosis, hypokalemia, and rebound alkalosis; it is reserved for severe acidosis (pH < 6.9). IV
fluids, insulin infusion, and potassium replacement (once potassium is below 5.2 mEq/L) are standard treatments.
13. A client is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours. Which laboratory value should the
nurse monitor to evaluate the therapeutic effect?
A) aPTT
B) PT/INR
C) Anti-Xa level
D) Bleeding time
' Correct Answer: C
Rationale: Enoxaparin is a low-molecular-weight heparin; its therapeutic effect is best monitored by anti-Xa
activity, especially in renal impairment or obesity. aPTT is used for unfractionated heparin, PT/INR for warfarin, and
bleeding time is not a standard monitoring test for enoxaparin.
14. A client with a new colostomy has a stoma that is dark purple and dry. Which action should the nurse take first?
A) Apply a transparent dressing over the stoma
B) Notify the provider immediately
C) Document the finding as normal
D) Irrigate the stoma with sterile water
' Correct Answer: B
Rationale: A dark purple, dry stoma indicates ischemia or necrosis and requires immediate provider notification.
Applying a dressing, documenting as normal, or irrigating would delay necessary intervention and could worsen
tissue damage.
15. A client is receiving total parenteral nutrition (TPN). Which action is essential to prevent a complication?
A) Change the TPN tubing every 72 hours
B) Monitor blood glucose every 6 hours
C) Administer TPN via a peripheral IV line
D) Abruptly discontinue TPN if the client reports nausea
' Correct Answer: B
Rationale: TPN contains high dextrose concentrations, so blood glucose should be monitored regularly (often
every 6 hours) to detect hyperglycemia. TPN tubing is changed every 24 hours, TPN is administered via a central
line, and it must be tapered rather than abruptly discontinued to prevent hypoglycemia.
16. A client with a chest tube has continuous bubbling in the water seal chamber. Which action should the nurse
take?
A) Clamp the chest tube immediately
B) Assess for an air leak in the system
C) Increase the suction pressure
D) Milking the chest tube
' Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak; the nurse should assess the system
from the client to the drainage unit to locate the leak. Clamping the tube can cause tension pneumothorax, increasing
suction does not address the leak, and milking is not recommended as it can cause tissue damage.
Page 4
