NSG 190 CAPSTONE NURSING EXAM 2 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Nursing Leadership and Management*
*- Safety and Infection Control*
*- Ethical and Legal Standards in Nursing*
*- Health Promotion and Disease Prevention*
*- Physiological Adaptation and Acute Care*
*- Pharmacology and Medication Safety*
*- Communication and Therapeutic Relationships*
*- Quality Improvement and Evidence-Based Practice*
Introduction
This comprehensive capstone nursing exam assesses the knowledge, clinical judgment, and professional decision-making skills required of entry-
level registered nurses. The exam consists of 200 multiple-choice and scenario-based questions divided into two sections, with emphasis on real-
world application across diverse healthcare settings. Questions evaluate competence in nursing leadership, patient safety, ethical-legal
compliance, pharmacology, acute and chronic care management, and quality improvement. Success on this exam demonstrates readiness for
clinical practice and the NCLEX-RN examination by testing critical thinking, prioritization, delegation, and evidence-based intervention selection.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a client who has been diagnosed with major depressive disorder and is expressing suicidal ideation. The client states, "I won't be
a burden much longer." What is the nurse's priority action?
A. Document the statement and continue routine monitoring
B. Notify the healthcare provider immediately and initiate suicide precautions
C. Ask the client to sign a no-suicide contract
D. Assign the client to a private room for privacy
🟢 B. Notify the healthcare provider immediately and initiate suicide precautions
🔴 RATIONALE: Active suicidal ideation with a statement indicating intent ("won't be a burden much longer") requires immediate intervention.
Suicide precautions (constant observation, removal of hazardous items) and provider notification are priority actions to ensure client safety.
,Question 2
A nurse is preparing to administer 0.9% sodium chloride 1000 mL IV over 8 hours. The drop factor is 15 gtt/mL. What is the IV flow rate in drops per
minute?
A. 31 gtt/min
B. 32 gtt/min
C. 33 gtt/min
D. 34 gtt/min
🟡 A. 31 gtt/min
🔴 RATIONALE: Flow rate = (Volume × Drop factor) ÷ Time in minutes = (1000 mL × 15 gtt/mL) ÷ (8 hr × 60 min) = 15,000 ÷ 480 = 31.25 ≈ 31
gtt/min.
Question 3
A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate for the LPN?
A. Perform initial admission assessment on a new client
B. Administer IV push morphine to a postoperative client
C. Provide discharge teaching for a client with heart failure
D. Monitor a stable client with type 2 diabetes receiving oral hypoglycemics
🟢 D. Monitor a stable client with type 2 diabetes receiving oral hypoglycemics
🔴 RATIONALE: LPNs can monitor stable clients with predictable outcomes and administer oral medications. Initial assessments, IV push
medications, and discharge teaching require RN-level knowledge and judgment.
Question 4
A client with a nasogastric tube complains of nausea, and the tube has not drained for 4 hours. What is the nurse's first action?
A. Irrigate the tube with 30 mL normal saline
B. Check tube placement by aspirating gastric contents and checking pH
C. Advance the tube 2 inches
D. Replace the nasogastric tube
, 🟢 B. Check tube placement by aspirating gastric contents and checking pH
🔴 RATIONALE: Before irrigating or advancing, the nurse must verify tube placement to prevent aspiration. pH 0–4 confirms gastric placement.
Question 5
A nurse is caring for a client who refuses to take prescribed medication. Which legal principle supports the client's right to refuse?
A. Nonmaleficence
B. Autonomy
C. Beneficence
D. Justice
🟢 B. Autonomy
🔴 RATIONALE: Autonomy is the ethical principle that respects a competent client's right to make decisions about their own care, including
refusing treatment.
Question 6
A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L. Which intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Place the client on a cardiac monitor
C. Administer regular insulin with dextrose
D. Prepare for hemodialysis
🟢 B. Place the client on a cardiac monitor
🔴 RATIONALE: Hyperkalemia (K+ > 5.0) can cause life-threatening dysrhythmias. Cardiac monitoring is the priority to detect arrhythmias before
administering medications or dialysis.
Question 7
A nurse is caring for a client who has a DNR order. The client's family demands CPR if the client's heart stops. What should the nurse do?
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Nursing Leadership and Management*
*- Safety and Infection Control*
*- Ethical and Legal Standards in Nursing*
*- Health Promotion and Disease Prevention*
*- Physiological Adaptation and Acute Care*
*- Pharmacology and Medication Safety*
*- Communication and Therapeutic Relationships*
*- Quality Improvement and Evidence-Based Practice*
Introduction
This comprehensive capstone nursing exam assesses the knowledge, clinical judgment, and professional decision-making skills required of entry-
level registered nurses. The exam consists of 200 multiple-choice and scenario-based questions divided into two sections, with emphasis on real-
world application across diverse healthcare settings. Questions evaluate competence in nursing leadership, patient safety, ethical-legal
compliance, pharmacology, acute and chronic care management, and quality improvement. Success on this exam demonstrates readiness for
clinical practice and the NCLEX-RN examination by testing critical thinking, prioritization, delegation, and evidence-based intervention selection.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a client who has been diagnosed with major depressive disorder and is expressing suicidal ideation. The client states, "I won't be
a burden much longer." What is the nurse's priority action?
A. Document the statement and continue routine monitoring
B. Notify the healthcare provider immediately and initiate suicide precautions
C. Ask the client to sign a no-suicide contract
D. Assign the client to a private room for privacy
🟢 B. Notify the healthcare provider immediately and initiate suicide precautions
🔴 RATIONALE: Active suicidal ideation with a statement indicating intent ("won't be a burden much longer") requires immediate intervention.
Suicide precautions (constant observation, removal of hazardous items) and provider notification are priority actions to ensure client safety.
,Question 2
A nurse is preparing to administer 0.9% sodium chloride 1000 mL IV over 8 hours. The drop factor is 15 gtt/mL. What is the IV flow rate in drops per
minute?
A. 31 gtt/min
B. 32 gtt/min
C. 33 gtt/min
D. 34 gtt/min
🟡 A. 31 gtt/min
🔴 RATIONALE: Flow rate = (Volume × Drop factor) ÷ Time in minutes = (1000 mL × 15 gtt/mL) ÷ (8 hr × 60 min) = 15,000 ÷ 480 = 31.25 ≈ 31
gtt/min.
Question 3
A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate for the LPN?
A. Perform initial admission assessment on a new client
B. Administer IV push morphine to a postoperative client
C. Provide discharge teaching for a client with heart failure
D. Monitor a stable client with type 2 diabetes receiving oral hypoglycemics
🟢 D. Monitor a stable client with type 2 diabetes receiving oral hypoglycemics
🔴 RATIONALE: LPNs can monitor stable clients with predictable outcomes and administer oral medications. Initial assessments, IV push
medications, and discharge teaching require RN-level knowledge and judgment.
Question 4
A client with a nasogastric tube complains of nausea, and the tube has not drained for 4 hours. What is the nurse's first action?
A. Irrigate the tube with 30 mL normal saline
B. Check tube placement by aspirating gastric contents and checking pH
C. Advance the tube 2 inches
D. Replace the nasogastric tube
, 🟢 B. Check tube placement by aspirating gastric contents and checking pH
🔴 RATIONALE: Before irrigating or advancing, the nurse must verify tube placement to prevent aspiration. pH 0–4 confirms gastric placement.
Question 5
A nurse is caring for a client who refuses to take prescribed medication. Which legal principle supports the client's right to refuse?
A. Nonmaleficence
B. Autonomy
C. Beneficence
D. Justice
🟢 B. Autonomy
🔴 RATIONALE: Autonomy is the ethical principle that respects a competent client's right to make decisions about their own care, including
refusing treatment.
Question 6
A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L. Which intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Place the client on a cardiac monitor
C. Administer regular insulin with dextrose
D. Prepare for hemodialysis
🟢 B. Place the client on a cardiac monitor
🔴 RATIONALE: Hyperkalemia (K+ > 5.0) can cause life-threatening dysrhythmias. Cardiac monitoring is the priority to detect arrhythmias before
administering medications or dialysis.
Question 7
A nurse is caring for a client who has a DNR order. The client's family demands CPR if the client's heart stops. What should the nurse do?
