ATI RN Capstone Comprehensive Predictor Assessment 2026–2027 |
Ultimate Nursing Graduation Exam Study Guide Covering Adult
Medical-Surgical, Pharmacology, Fundamentals, Mental Health,
Maternal Newborn, Pediatrics, Community Health, Leadership, and
Critical Nursing Concepts
Question 1
A nurse in an emergency department is assessing four clients. Which client should
the nurse assess first?
A. A client with COPD and oxygen saturation of 88% on room air
B. A client with chest pain who reports pain 4/10 and is waiting for an ECG
C. A client with abdominal pain and a temperature of 38.3°C (100.9°F)
D. A client with a leg fracture who is asking for pain medication
Answer: A
Rationale: A client with SpO₂ of 88% is hypoxemic and requires immediate
intervention to prevent respiratory failure. The ABC (Airway, Breathing,
Circulation) framework guides prioritization; oxygenation is a breathing priority
before chest pain evaluation or other stable clients.
Question 2
A charge nurse is teaching newly licensed nurses about the correct use of
restraints. Which instruction should the nurse include?
A. Place a belt restraint on a school-age child who has seizures
B. Secure wrist restraints to the bed rails for an adolescent
C. Apply elbow immobilizers for an infant receiving cleft lip repair
D. Keep the side rails of a toddler's crib elevated
Answer: C
Rationale: Elbow immobilizers prevent infants from touching surgical sites (cleft
lip/palate repair). Restraints should never be secured to bed rails (risk of
entrapment); belt restraints are contraindicated for seizure clients.
Question 3
,A nurse is delegating client care to an assistive personnel (AP). Which of the
following tasks should the nurse delegate to the AP?
A. Administering enteral feedings via gastrostomy tube
B. Obtaining a sterile urine specimen from an indwelling catheter
C. Measuring a client's intake and output
D. Assessing a client's wound for signs of infection
Answer: C
Rationale: I&O measurement is within the scope of practice for APs and requires
no clinical judgment. Enteral feedings, sterile specimen collection, and wound
assessment require nursing judgment and licensure. APs can measure and record
but cannot interpret findings.
Question 4
A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. Which action should the nurse take?
A. Administer the blood transfusion without consent
B. Contact the provider to discuss alternative treatments
C. Notify the facility's ethics committee immediately
D. Ask the family to convince the client to accept the transfusion
Answer: B
Rationale: The client has the right to refuse treatment based on religious beliefs.
The nurse should respect this decision, document it, and collaborate with the
provider to explore alternatives (e.g., iron therapy, erythropoietin).
Question 5
A nurse on a psychiatric unit is caring for a client who is being discharged. Which
of the following actions demonstrates proper documentation?
A. Documenting that the client was "hostile and aggressive"
B. Using the client's exact words in quotation marks
C. Documenting only negative behaviors
D. Writing a note that the client "seems depressed"
Answer: B
,Rationale: Documentation should be objective, factual, and use the client's exact
words when quoting them. Terms like "hostile," "aggressive," and "seems
depressed" are subjective judgments and should be avoided.
Question 6
A nurse is assisting with mass casualty triage after an explosion at a local factory.
Which client should the nurse identify as the priority?
A. A client who has massive head trauma
B. A client with full-thickness burns to face and trunk
C. A client with indications of hypovolemic shock
D. A client with an open fracture of the lower extremity
Answer: C
Rationale: In mass casualty triage, clients with hypovolemic shock require
immediate life-saving interventions. Massive head trauma and full-thickness
burns to face/trunk are likely non-survivable (black tag), while open fractures can
wait (green/yellow tag).
Question 7
A nurse is receiving report on four clients. Which client should the nurse assess
first?
A. A client who has an ileal conduit and mucus in the pouch
B. A client with an arteriovenous fistula with vibration palpated
C. A client with chronic kidney disease who has cloudy dialysate outflow
D. A client post-transurethral resection of the prostate with red-tinged urine
Answer: C
Rationale: Cloudy dialysate outflow indicates possible peritonitis, a serious
complication of peritoneal dialysis that requires immediate assessment and
intervention. Mucus in an ileal conduit is normal, AV fistula thrill/vibration is
expected, and red-tinged urine post-TURP is expected.
Question 8
A nurse manager is updating protocols for the use of belt restraints. Which
guideline should the nurse include?
, A. Remove the client's restraint every 4 hours
B. Apply restraints only with a provider's order
C. Use belt restraints for clients who are at risk for falls
D. Secure restraints to the bed frame, not the side rails
Answer: D
Rationale: Restraints should be secured to the bed frame, not the side rails, to
prevent injury and entrapment. Restraints require a provider's order, must be
reassessed frequently, and should never be used as a fall prevention strategy.
Question 9
A charge nurse is assigning clients to a float nurse who is unfamiliar with the unit.
Which client should the charge nurse assign to this nurse?
A. A client receiving a continuous IV infusion of heparin
B. A client who is 1 day post-operative from a hip replacement
C. A client with a chest tube to water seal
D. A client requiring frequent neurological assessments
Answer: B
Rationale: The most stable client with predictable care needs should be assigned
to a float nurse unfamiliar with the unit. Clients receiving heparin, with chest
tubes, or requiring frequent neuro checks require more specialized knowledge
and assessment skills.
Question 10
A nurse is caring for a client who has a new prescription for a benzodiazepine.
Which of the following actions should the nurse take?
A. Administer the medication with food
B. Monitor the client for signs of respiratory depression
C. Instruct the client to avoid drinking grapefruit juice
D. Administer the medication intramuscularly
Answer: B
Ultimate Nursing Graduation Exam Study Guide Covering Adult
Medical-Surgical, Pharmacology, Fundamentals, Mental Health,
Maternal Newborn, Pediatrics, Community Health, Leadership, and
Critical Nursing Concepts
Question 1
A nurse in an emergency department is assessing four clients. Which client should
the nurse assess first?
A. A client with COPD and oxygen saturation of 88% on room air
B. A client with chest pain who reports pain 4/10 and is waiting for an ECG
C. A client with abdominal pain and a temperature of 38.3°C (100.9°F)
D. A client with a leg fracture who is asking for pain medication
Answer: A
Rationale: A client with SpO₂ of 88% is hypoxemic and requires immediate
intervention to prevent respiratory failure. The ABC (Airway, Breathing,
Circulation) framework guides prioritization; oxygenation is a breathing priority
before chest pain evaluation or other stable clients.
Question 2
A charge nurse is teaching newly licensed nurses about the correct use of
restraints. Which instruction should the nurse include?
A. Place a belt restraint on a school-age child who has seizures
B. Secure wrist restraints to the bed rails for an adolescent
C. Apply elbow immobilizers for an infant receiving cleft lip repair
D. Keep the side rails of a toddler's crib elevated
Answer: C
Rationale: Elbow immobilizers prevent infants from touching surgical sites (cleft
lip/palate repair). Restraints should never be secured to bed rails (risk of
entrapment); belt restraints are contraindicated for seizure clients.
Question 3
,A nurse is delegating client care to an assistive personnel (AP). Which of the
following tasks should the nurse delegate to the AP?
A. Administering enteral feedings via gastrostomy tube
B. Obtaining a sterile urine specimen from an indwelling catheter
C. Measuring a client's intake and output
D. Assessing a client's wound for signs of infection
Answer: C
Rationale: I&O measurement is within the scope of practice for APs and requires
no clinical judgment. Enteral feedings, sterile specimen collection, and wound
assessment require nursing judgment and licensure. APs can measure and record
but cannot interpret findings.
Question 4
A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. Which action should the nurse take?
A. Administer the blood transfusion without consent
B. Contact the provider to discuss alternative treatments
C. Notify the facility's ethics committee immediately
D. Ask the family to convince the client to accept the transfusion
Answer: B
Rationale: The client has the right to refuse treatment based on religious beliefs.
The nurse should respect this decision, document it, and collaborate with the
provider to explore alternatives (e.g., iron therapy, erythropoietin).
Question 5
A nurse on a psychiatric unit is caring for a client who is being discharged. Which
of the following actions demonstrates proper documentation?
A. Documenting that the client was "hostile and aggressive"
B. Using the client's exact words in quotation marks
C. Documenting only negative behaviors
D. Writing a note that the client "seems depressed"
Answer: B
,Rationale: Documentation should be objective, factual, and use the client's exact
words when quoting them. Terms like "hostile," "aggressive," and "seems
depressed" are subjective judgments and should be avoided.
Question 6
A nurse is assisting with mass casualty triage after an explosion at a local factory.
Which client should the nurse identify as the priority?
A. A client who has massive head trauma
B. A client with full-thickness burns to face and trunk
C. A client with indications of hypovolemic shock
D. A client with an open fracture of the lower extremity
Answer: C
Rationale: In mass casualty triage, clients with hypovolemic shock require
immediate life-saving interventions. Massive head trauma and full-thickness
burns to face/trunk are likely non-survivable (black tag), while open fractures can
wait (green/yellow tag).
Question 7
A nurse is receiving report on four clients. Which client should the nurse assess
first?
A. A client who has an ileal conduit and mucus in the pouch
B. A client with an arteriovenous fistula with vibration palpated
C. A client with chronic kidney disease who has cloudy dialysate outflow
D. A client post-transurethral resection of the prostate with red-tinged urine
Answer: C
Rationale: Cloudy dialysate outflow indicates possible peritonitis, a serious
complication of peritoneal dialysis that requires immediate assessment and
intervention. Mucus in an ileal conduit is normal, AV fistula thrill/vibration is
expected, and red-tinged urine post-TURP is expected.
Question 8
A nurse manager is updating protocols for the use of belt restraints. Which
guideline should the nurse include?
, A. Remove the client's restraint every 4 hours
B. Apply restraints only with a provider's order
C. Use belt restraints for clients who are at risk for falls
D. Secure restraints to the bed frame, not the side rails
Answer: D
Rationale: Restraints should be secured to the bed frame, not the side rails, to
prevent injury and entrapment. Restraints require a provider's order, must be
reassessed frequently, and should never be used as a fall prevention strategy.
Question 9
A charge nurse is assigning clients to a float nurse who is unfamiliar with the unit.
Which client should the charge nurse assign to this nurse?
A. A client receiving a continuous IV infusion of heparin
B. A client who is 1 day post-operative from a hip replacement
C. A client with a chest tube to water seal
D. A client requiring frequent neurological assessments
Answer: B
Rationale: The most stable client with predictable care needs should be assigned
to a float nurse unfamiliar with the unit. Clients receiving heparin, with chest
tubes, or requiring frequent neuro checks require more specialized knowledge
and assessment skills.
Question 10
A nurse is caring for a client who has a new prescription for a benzodiazepine.
Which of the following actions should the nurse take?
A. Administer the medication with food
B. Monitor the client for signs of respiratory depression
C. Instruct the client to avoid drinking grapefruit juice
D. Administer the medication intramuscularly
Answer: B
