ATI Capstone Exit Exam Study Guide: 100
Comprehensive NCLEX-Style Practice
Questions, Answers, and Rationales |Instant
Download Pdf
This extensive, 100-question practice exam has been meticulously mapped directly to the
core client need categories of the ATI Capstone Blueprint. Across these two batches, you
will sharpen your critical thinking and pattern recognition skills across high-yield nursing
domains, including:
Coordinated Care & Management: Prioritization strategies using the ABCs (Airway,
Breathing, Circulation) framework, safe delegation parameters for Licensed Practical
Nurses (LPNs) and Unlicensed Assistive Personnel (UAPs), and ethical-legal advocacy
boundaries.
Pharmacology & Parenteral Therapies: Critical insulin mixing protocols, high-alert
medication toxicity limits (e.g., Digoxin, Lithium, Heparin, and Magnesium Sulfate), and
antidote selection.
Adult Medical-Surgical Nursing: Emergent post-operative tracking, systemic critical
interventions (such as autonomic dysreflexia and chest tube troubleshooting), and
electrolyte imbalance management.
Maternal-Newborn & Advanced Pediatrics: High-stakes labor complications, APGAR
breakdown metrics, developmental milestone recognition, and critical pediatric airway
syndromes.
Mental Health Nursing & Basic Safety: Therapeutic communication approaches for
actively hallucinating or manic clients, psychiatric defense mechanisms, and foundational
hospital safety measures (such as RACE protocols and isolation definitions).
Management of Care, Delegation & Prioritization
1. A nurse receives a shift report on four clients. Which client should the nurse assess
first?
o A) A client with chronic bronchitis and an oxygen saturation of 91%
, o B) A client who had an abdominal aortic aneurysm repair 4 hours ago
and has a blood pressure of 88/50 mmHg
o C) A client with a total hip arthroplasty reporting pain as 7 on a 1-10 scale
o D) A client diagnosed with deep vein thrombosis who is scheduled for
subcutaneous heparin
o Hemodynamic instability following a major vascular repair indicates potential
haemorrhage and must take immediate priority.
2. A registered nurse (RN) is planning care for a medical-surgical unit. Which task is
appropriate to delegate to an Unlicensed Assistive Personnel (UAP)?
o A) Adjusting the flow rate of an established continuous tube feeding
o B) Evaluating a client's understanding of how to use an incentive spirometer
o C) Assisting a stable client who is 3 days post-stroke to ambulate with a
walker
o D) Swabbing the oral cavity of an unconscious client with an active gag reflex
o Standard, routine ambulation of a stable, predictable client falls within the
task boundaries of trained assistive personnel.
3. A nurse is caring for a client who is scheduled for an elective emergency
appendectomy. The client states, "I don't really understand what the surgeon is
going to do to my stomach." Which action should the nurse take?
o A) Explain the surgical steps and potential complications to the client
o B) Notify the surgeon that the client requires further explanation of the
procedure
o C) Reassure the client that the procedure is routine and safe
o D) Document that the client gave verbal consent despite minimal
understanding
o The surgeon holds the legal obligation to explain procedures; the nurse's role
is to witness the signature and advocate if gaps exist.
4. A nurse on a telemetry unit notes a client's potassium level is 2.8 mEq/L. Which
action should the nurse take first?
, o A) Administer the scheduled oral potassium supplement
o B) Request a repeat serum potassium blood draw from the laboratory
o C) Place the client on continuous cardiac monitoring and obtain an ECG
o D) Review the client's intake and output records for the past 24 hours
o Severe hypokalemia places the client at immediate risk for lethal cardiac
arrhythmias, necessitating immediate electrical assessment.
5. A charge nurse is assigning clients to a licensed practical nurse (LPN). Which client
is most appropriate for the LPN's scope of practice?
o A) A client newly admitted with suspected diabetic ketoacidosis
o B) A client with a well-established colostomy who requires structural
stoma care teaching
o C) A client undergoing a blood transfusion who has a new spike in
temperature
o D) A client returning from a cardiac catheterization with an active groin
hematoma
o LPNs can care for stable clients with predictable outcomes and can reinforce
established teaching protocols.
6. A nurse is completing an incident report after a client fell out of bed. Which detail
should the nurse exclude from the progress notes in the client's medical record?
o A) The physical location and position the client was found in
o B) The vital signs obtained immediately following the event
o C) A statement that an official facility incident report was filled out and
submitted
o D) The name of the healthcare provider notified of the occurrence
o Incident reports are internal quality tools and should never be mentioned or
referenced within the official medical record.
7. A nurse enters a client's room and finds the client gasping for air with a respiratory
rate of 38/min and pink, frothy sputum. Which action should the nurse take first?
o A) Check the client's peripheral capillary refill time
, o B) Position the client upright in high-Fowler's with legs dangling
o C) Obtain a portable chest X-ray from radiology
o D) Prepare to administer a loading dose of IV digoxin
o High-Fowler's position immediately reduces venous return (preload),
alleviating pulmonary congestion in acute pulmonary oedema.
8. A client with terminal cancer states, "I want to stop all chemotherapy treatments and
go home under hospice care." The family objects strongly. The nurse advocates for
the client's right to choose. Which ethical principle is the nurse upholding?
o A) Beneficence
o B) Veracity
o C) Autonomy
o D) Non-maleficence
o Autonomy emphasizes the right of a competent client to make self-
determined decisions regarding their own healthcare.
9. A nurse is receiving a telephone prescription from a healthcare provider. Which
action is required to ensure client safety?
o A) Transcribe the prescription onto a scrap paper before entering it into the
chart
o B) Write the prescription down completely and read it back to the
provider
o C) Request that another nurse listen to the phone conversation silently
o D) Implement the medication order immediately and wait 24 hours for
documentation
o The "write down and read back" protocol is mandatory to verify accuracy and
prevent communication errors.
10. A nurse is preparing a discharge plan for an older adult client who lives alone. Which
assessment is the priority to ensure safety at home?
o A) The client's financial ability to purchase organic groceries
Comprehensive NCLEX-Style Practice
Questions, Answers, and Rationales |Instant
Download Pdf
This extensive, 100-question practice exam has been meticulously mapped directly to the
core client need categories of the ATI Capstone Blueprint. Across these two batches, you
will sharpen your critical thinking and pattern recognition skills across high-yield nursing
domains, including:
Coordinated Care & Management: Prioritization strategies using the ABCs (Airway,
Breathing, Circulation) framework, safe delegation parameters for Licensed Practical
Nurses (LPNs) and Unlicensed Assistive Personnel (UAPs), and ethical-legal advocacy
boundaries.
Pharmacology & Parenteral Therapies: Critical insulin mixing protocols, high-alert
medication toxicity limits (e.g., Digoxin, Lithium, Heparin, and Magnesium Sulfate), and
antidote selection.
Adult Medical-Surgical Nursing: Emergent post-operative tracking, systemic critical
interventions (such as autonomic dysreflexia and chest tube troubleshooting), and
electrolyte imbalance management.
Maternal-Newborn & Advanced Pediatrics: High-stakes labor complications, APGAR
breakdown metrics, developmental milestone recognition, and critical pediatric airway
syndromes.
Mental Health Nursing & Basic Safety: Therapeutic communication approaches for
actively hallucinating or manic clients, psychiatric defense mechanisms, and foundational
hospital safety measures (such as RACE protocols and isolation definitions).
Management of Care, Delegation & Prioritization
1. A nurse receives a shift report on four clients. Which client should the nurse assess
first?
o A) A client with chronic bronchitis and an oxygen saturation of 91%
, o B) A client who had an abdominal aortic aneurysm repair 4 hours ago
and has a blood pressure of 88/50 mmHg
o C) A client with a total hip arthroplasty reporting pain as 7 on a 1-10 scale
o D) A client diagnosed with deep vein thrombosis who is scheduled for
subcutaneous heparin
o Hemodynamic instability following a major vascular repair indicates potential
haemorrhage and must take immediate priority.
2. A registered nurse (RN) is planning care for a medical-surgical unit. Which task is
appropriate to delegate to an Unlicensed Assistive Personnel (UAP)?
o A) Adjusting the flow rate of an established continuous tube feeding
o B) Evaluating a client's understanding of how to use an incentive spirometer
o C) Assisting a stable client who is 3 days post-stroke to ambulate with a
walker
o D) Swabbing the oral cavity of an unconscious client with an active gag reflex
o Standard, routine ambulation of a stable, predictable client falls within the
task boundaries of trained assistive personnel.
3. A nurse is caring for a client who is scheduled for an elective emergency
appendectomy. The client states, "I don't really understand what the surgeon is
going to do to my stomach." Which action should the nurse take?
o A) Explain the surgical steps and potential complications to the client
o B) Notify the surgeon that the client requires further explanation of the
procedure
o C) Reassure the client that the procedure is routine and safe
o D) Document that the client gave verbal consent despite minimal
understanding
o The surgeon holds the legal obligation to explain procedures; the nurse's role
is to witness the signature and advocate if gaps exist.
4. A nurse on a telemetry unit notes a client's potassium level is 2.8 mEq/L. Which
action should the nurse take first?
, o A) Administer the scheduled oral potassium supplement
o B) Request a repeat serum potassium blood draw from the laboratory
o C) Place the client on continuous cardiac monitoring and obtain an ECG
o D) Review the client's intake and output records for the past 24 hours
o Severe hypokalemia places the client at immediate risk for lethal cardiac
arrhythmias, necessitating immediate electrical assessment.
5. A charge nurse is assigning clients to a licensed practical nurse (LPN). Which client
is most appropriate for the LPN's scope of practice?
o A) A client newly admitted with suspected diabetic ketoacidosis
o B) A client with a well-established colostomy who requires structural
stoma care teaching
o C) A client undergoing a blood transfusion who has a new spike in
temperature
o D) A client returning from a cardiac catheterization with an active groin
hematoma
o LPNs can care for stable clients with predictable outcomes and can reinforce
established teaching protocols.
6. A nurse is completing an incident report after a client fell out of bed. Which detail
should the nurse exclude from the progress notes in the client's medical record?
o A) The physical location and position the client was found in
o B) The vital signs obtained immediately following the event
o C) A statement that an official facility incident report was filled out and
submitted
o D) The name of the healthcare provider notified of the occurrence
o Incident reports are internal quality tools and should never be mentioned or
referenced within the official medical record.
7. A nurse enters a client's room and finds the client gasping for air with a respiratory
rate of 38/min and pink, frothy sputum. Which action should the nurse take first?
o A) Check the client's peripheral capillary refill time
, o B) Position the client upright in high-Fowler's with legs dangling
o C) Obtain a portable chest X-ray from radiology
o D) Prepare to administer a loading dose of IV digoxin
o High-Fowler's position immediately reduces venous return (preload),
alleviating pulmonary congestion in acute pulmonary oedema.
8. A client with terminal cancer states, "I want to stop all chemotherapy treatments and
go home under hospice care." The family objects strongly. The nurse advocates for
the client's right to choose. Which ethical principle is the nurse upholding?
o A) Beneficence
o B) Veracity
o C) Autonomy
o D) Non-maleficence
o Autonomy emphasizes the right of a competent client to make self-
determined decisions regarding their own healthcare.
9. A nurse is receiving a telephone prescription from a healthcare provider. Which
action is required to ensure client safety?
o A) Transcribe the prescription onto a scrap paper before entering it into the
chart
o B) Write the prescription down completely and read it back to the
provider
o C) Request that another nurse listen to the phone conversation silently
o D) Implement the medication order immediately and wait 24 hours for
documentation
o The "write down and read back" protocol is mandatory to verify accuracy and
prevent communication errors.
10. A nurse is preparing a discharge plan for an older adult client who lives alone. Which
assessment is the priority to ensure safety at home?
o A) The client's financial ability to purchase organic groceries
