NSG 190 CAPSTONE FINAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Professional Nursing Standards & Legal/Ethical Principles
- Health Assessment & Clinical Reasoning
- Pharmacology & Safe Medication Administration
- Pathophysiology & Disease Management
- Evidence-Based Practice & Quality Improvement
- Leadership, Delegation, & Team Collaboration
- Patient Safety & Infection Control
- Psychosocial Integrity & Patient Education
- Emergency Response & Critical Care Fundamentals
- Transition to Professional Practice & NCLEX Readiness
Introduction
*This comprehensive assessment is designed to evaluate the culminating knowledge and clinical judgment
required for success on the NSG 190 Capstone Final Exam. The exam measures foundational nursing theory,
applied professional knowledge, regulatory compliance, ethical standards, and real-world clinical decision-
making. Each multiple-choice question presents a realistic patient scenario or direct knowledge check,
emphasizing critical thinking, prioritization, and safe, evidence-based practice. The following 200 questions are
divided into two sections. Correct answers are marked with the 🟢 symbol, followed by a 🔴 RATIONALE for
each. This document is formatted for immediate download and use in Word, Google Docs, or PDF.*
,SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a patient with heart failure who reports sudden weight gain of 3 pounds in 24 hours and
increased shortness of breath. Which action should the nurse take first?
A. Encourage the patient to ambulate more frequently
B. Restrict all oral fluids for the next 8 hours
C. Administer a PRN diuretic as ordered
D. Notify the healthcare provider of the findings
🟢D
🔴 RATIONALE: The nurse must notify the provider because rapid weight gain and worsening dyspnea suggest
acute decompensated heart failure requiring possible medication adjustment or escalation of care. Assessment
findings must be communicated first; administering a diuretic without an order is not permitted, and fluid
restriction or activity changes are not the priority.
2. A patient newly diagnosed with type 2 diabetes asks the nurse, “Why do I have to check my blood sugar if I
don’t take insulin?” What is the nurse’s best response?
A. “Monitoring helps you see how food and activity affect your glucose levels.”
B. “It is only necessary if you start taking oral diabetes medication.”
C. “You actually do not need to check it until you begin insulin therapy.”
D. “Checking blood sugar is required by hospital policy regardless of need.”
🟢A
,🔴 RATIONALE: Blood glucose monitoring provides feedback on lifestyle management even without insulin.
Options B, C, and D are incorrect because monitoring is not solely tied to insulin use, and it is clinically
indicated, not just a policy requirement.
3. A nurse delegates vital sign measurement to an unlicensed assistive personnel (UAP). The UAP reports a
blood pressure of 180/110 mm Hg for a postoperative patient. Which action by the nurse is most appropriate?
A. Ask the UAP to repeat the measurement in 15 minutes
B. Document the reading as reported and continue monitoring
C. Reassess the patient’s blood pressure personally
D. Instruct the UAP to use a different machine
🟢C
🔴 RATIONALE: The nurse must personally reassess any abnormal or unexpected finding delegated to a UAP
because the nurse retains accountability for assessment and clinical judgment. Repeating later, documenting
without verification, or changing equipment does not address potential patient risk.
4. A nurse is preparing to administer potassium chloride IV to a patient. Which action is essential for safe
administration?
A. Administer the potassium as a rapid IV push over 1–2 minutes
B. Ensure the solution is diluted and use an infusion pump
C. Mix the potassium into a primary IV bag of lactated Ringer’s solution
D. Decrease the infusion rate if the patient reports mild burning
🟢B
, 🔴 RATIONALE: IV potassium must always be diluted and given via infusion pump to prevent life-threatening
hyperkalemia and cardiac arrest. Rapid push is contraindicated; lactated Ringer’s contains potassium, increasing
risk; burning requires stopping the infusion, not just decreasing rate.
5. A patient with end-stage COPD is prescribed home oxygen at 2 L/min via nasal cannula. The patient’s spouse
asks what to do if the patient becomes drowsy and confused. Which response by the nurse is correct?
A. “Increase the oxygen to 4 L/min until confusion clears.”
B. “These are normal signs of COPD and do not require action.”
C. “Remove the oxygen and call 911 immediately.”
D. “Do not increase oxygen; notify the provider as this may indicate CO2 retention.”
🟢D
🔴 RATIONALE: Drowsiness and confusion in a COPD patient on oxygen may signal hypercapnia due to loss of
hypoxic drive. Increasing oxygen can worsen respiratory depression. The provider must be notified; removing
oxygen is dangerous without a prescription.
6. A nurse is teaching a patient about warfarin therapy. Which statement by the patient indicates a need for
further teaching?
A. “I will avoid eating large amounts of spinach and kale.”
B. “I can take ibuprofen for my occasional headaches.”
C. “I will get my blood tested regularly as scheduled.”
D. “I should watch for bruising or bleeding in my gums.”
🟢B
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Professional Nursing Standards & Legal/Ethical Principles
- Health Assessment & Clinical Reasoning
- Pharmacology & Safe Medication Administration
- Pathophysiology & Disease Management
- Evidence-Based Practice & Quality Improvement
- Leadership, Delegation, & Team Collaboration
- Patient Safety & Infection Control
- Psychosocial Integrity & Patient Education
- Emergency Response & Critical Care Fundamentals
- Transition to Professional Practice & NCLEX Readiness
Introduction
*This comprehensive assessment is designed to evaluate the culminating knowledge and clinical judgment
required for success on the NSG 190 Capstone Final Exam. The exam measures foundational nursing theory,
applied professional knowledge, regulatory compliance, ethical standards, and real-world clinical decision-
making. Each multiple-choice question presents a realistic patient scenario or direct knowledge check,
emphasizing critical thinking, prioritization, and safe, evidence-based practice. The following 200 questions are
divided into two sections. Correct answers are marked with the 🟢 symbol, followed by a 🔴 RATIONALE for
each. This document is formatted for immediate download and use in Word, Google Docs, or PDF.*
,SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a patient with heart failure who reports sudden weight gain of 3 pounds in 24 hours and
increased shortness of breath. Which action should the nurse take first?
A. Encourage the patient to ambulate more frequently
B. Restrict all oral fluids for the next 8 hours
C. Administer a PRN diuretic as ordered
D. Notify the healthcare provider of the findings
🟢D
🔴 RATIONALE: The nurse must notify the provider because rapid weight gain and worsening dyspnea suggest
acute decompensated heart failure requiring possible medication adjustment or escalation of care. Assessment
findings must be communicated first; administering a diuretic without an order is not permitted, and fluid
restriction or activity changes are not the priority.
2. A patient newly diagnosed with type 2 diabetes asks the nurse, “Why do I have to check my blood sugar if I
don’t take insulin?” What is the nurse’s best response?
A. “Monitoring helps you see how food and activity affect your glucose levels.”
B. “It is only necessary if you start taking oral diabetes medication.”
C. “You actually do not need to check it until you begin insulin therapy.”
D. “Checking blood sugar is required by hospital policy regardless of need.”
🟢A
,🔴 RATIONALE: Blood glucose monitoring provides feedback on lifestyle management even without insulin.
Options B, C, and D are incorrect because monitoring is not solely tied to insulin use, and it is clinically
indicated, not just a policy requirement.
3. A nurse delegates vital sign measurement to an unlicensed assistive personnel (UAP). The UAP reports a
blood pressure of 180/110 mm Hg for a postoperative patient. Which action by the nurse is most appropriate?
A. Ask the UAP to repeat the measurement in 15 minutes
B. Document the reading as reported and continue monitoring
C. Reassess the patient’s blood pressure personally
D. Instruct the UAP to use a different machine
🟢C
🔴 RATIONALE: The nurse must personally reassess any abnormal or unexpected finding delegated to a UAP
because the nurse retains accountability for assessment and clinical judgment. Repeating later, documenting
without verification, or changing equipment does not address potential patient risk.
4. A nurse is preparing to administer potassium chloride IV to a patient. Which action is essential for safe
administration?
A. Administer the potassium as a rapid IV push over 1–2 minutes
B. Ensure the solution is diluted and use an infusion pump
C. Mix the potassium into a primary IV bag of lactated Ringer’s solution
D. Decrease the infusion rate if the patient reports mild burning
🟢B
, 🔴 RATIONALE: IV potassium must always be diluted and given via infusion pump to prevent life-threatening
hyperkalemia and cardiac arrest. Rapid push is contraindicated; lactated Ringer’s contains potassium, increasing
risk; burning requires stopping the infusion, not just decreasing rate.
5. A patient with end-stage COPD is prescribed home oxygen at 2 L/min via nasal cannula. The patient’s spouse
asks what to do if the patient becomes drowsy and confused. Which response by the nurse is correct?
A. “Increase the oxygen to 4 L/min until confusion clears.”
B. “These are normal signs of COPD and do not require action.”
C. “Remove the oxygen and call 911 immediately.”
D. “Do not increase oxygen; notify the provider as this may indicate CO2 retention.”
🟢D
🔴 RATIONALE: Drowsiness and confusion in a COPD patient on oxygen may signal hypercapnia due to loss of
hypoxic drive. Increasing oxygen can worsen respiratory depression. The provider must be notified; removing
oxygen is dangerous without a prescription.
6. A nurse is teaching a patient about warfarin therapy. Which statement by the patient indicates a need for
further teaching?
A. “I will avoid eating large amounts of spinach and kale.”
B. “I can take ibuprofen for my occasional headaches.”
C. “I will get my blood tested regularly as scheduled.”
D. “I should watch for bruising or bleeding in my gums.”
🟢B
