NUR 2811 Nursing Capstone Exam
Comprehensive Study Guide,
Practice Questions, Test Bank
Review and Final Exam Prep
2026/2027
QUESTION 1
A nurse is caring for multiple clients on a medical-surgical unit. Which client is at the
highest risk for developing a nosocomial infection?
A. Client with alcohol use disorder admitted for detoxification
B. Client with Type 1 diabetes mellitus and peripheral neuropathy
C. Client recovering from a laparoscopic cholecystectomy
D. Client with full-thickness burns, NG tube, and Foley catheter
Correct Answer: D. Client with full-thickness burns, NG tube, and Foley
catheter
Rationale:
Patients with extensive burns have a severely compromised skin barrier, making them
highly susceptible to infection. The presence of invasive devices such as an NG tube
and Foley catheter further increases infection risk by providing entry points for
microorganisms. Although diabetes and surgery also increase risk, the combination of
broken skin integrity and multiple invasive devices places the burn patient at the
greatest risk.
QUESTION 2
Which client should the nurse prioritize for transfer from ICU to a step-down
neurological unit?
A. Client with acute head injury and seizures
B. Client with ischemic stroke 4 days ago and mild confusion
C. Client 1-day post-transsphenoidal craniotomy with CSF leak
D. Client with bacterial meningitis and Glasgow Coma Scale of 7
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Correct Answer: B. Client with ischemic stroke 4 days ago and mild confusion
Rationale:
The most stable client is the one with an ischemic stroke who is several days post-
event and only mildly confused. The other clients are unstable due to CSF leak,
decreased level of consciousness, or active neurological compromise.
QUESTION 3
After shift report, which client should the nurse assess first?
A. Ventilated client requiring sputum culture collection
B. COPD client with oxygen saturation of 90% from previous shift
C. Pneumonia client awaiting IV antibiotics
D. Asthma client reporting shortness of breath after bronchodilator use
Correct Answer: D. Asthma client reporting shortness of breath after
bronchodilator use
Rationale:
Shortness of breath after bronchodilator use suggests worsening bronchospasm or
treatment failure. This is an airway priority (ABCs). The other clients are either stable
or receiving routine care.
QUESTION 4
Which postoperative client should the nurse assess first?
A. Client scheduled for laparoscopic cholecystectomy
B. Multiple trauma client from motor vehicle collision
C. Client scheduled for thyroidectomy
D. Client awaiting discharge after appendectomy
Correct Answer: B. Multiple trauma client from motor vehicle collision
Rationale:
Trauma patients are the most unstable and require immediate assessment due to risk
of internal injuries, hemorrhage, and airway compromise.
QUESTION 5
During disaster triage, which client can be safely discharged first?
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A. 24-hour post-hysterectomy client
B. 5-day post-total hip replacement client
C. 12-hour pyelonephritis admission
D. 5-day stage III pressure ulcer patient
Correct Answer: B. 5-day post-total hip replacement client
Rationale:
This client is the most stable and least dependent on acute care services compared to
infection or surgical complications.
QUESTION 6
Which client requires immediate assessment after shift change?
A. BP 90/60 with hot, dry skin
B. Sleeping client with stable vital signs
C. Fruity breath, polydipsia, and polyphagia
D. Irritable client with tremors
Correct Answer: C. Fruity breath, polydipsia, and polyphagia
Rationale:
These are classic signs of diabetic ketoacidosis (DKA), a life-threatening metabolic
emergency.
QUESTION 7
Which client should the nurse assess first?
A. Headache rated 3/10
B. Watery diarrhea with abdominal pain
C. Oxygen saturation 94%
D. Nausea after contrast dye
Correct Answer: B. Watery diarrhea with abdominal pain
Rationale:
Frequent diarrhea increases risk for dehydration and electrolyte imbalance, which can
quickly become life-threatening.
QUESTION 8
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Which finding should be immediately reported in a COPD patient without
pneumococcal vaccination?
A. BP 152/84
B. RR 27/min
C. HR 92 bpm
D. Temperature 38.4°C
Correct Answer: D. Temperature 38.4°C
Rationale:
Fever suggests infection, which is particularly dangerous in COPD patients at risk for
respiratory complications.
QUESTION 9
A postoperative patient has RR 38/min and oxygen saturation 90% on 6 L/min
oxygen. What is the priority action?
A. Increase nasal cannula to 10 L/min
B. Encourage incentive spirometry
C. Administer morphine
D. Switch to non-rebreather mask and notify provider
Correct Answer: D. Switch to non-rebreather mask and notify provider
Rationale:
Severe hypoxia requires high-concentration oxygen delivery and immediate escalation
of care.
QUESTION 10
Which obstetric message should the nurse prioritize?
A. Headache and blurred vision at 34 weeks
B. Supine dizziness at 22 weeks
C. No fetal movement at 15 weeks
D. Vaginal discharge at 12 weeks
Correct Answer: A. Headache and blurred vision at 34 weeks
Rationale:
These are signs of preeclampsia, a life-threatening pregnancy complication.