ATI Capstone Comprehensive Assessment: 100 Multiple-Choice
Questions for Advanced Nursing Practice and NCLEX-RN
Preparation
Exam Title: ATI Capstone Comprehensive Assessment: Advanced Clinical Judgment, Prioritization, and
Evidence-Based Nursing Practice for Pre-Licensure RN Candidates
Difficulty Level: Advanced / Hard / Mixed
Target Audience: Senior nursing students, pre-licensure RN candidates preparing for the ATI
Comprehensive Predictor, ATI Capstone Proctored Assessment, and NCLEX-RN examination
Exam Format: 100 multiple-choice questions with one correct answer per question
Content Areas: Fundamentals, Pharmacology, Medical-Surgical Nursing, Maternal-Newborn Nursing,
Pediatrics, Mental Health Nursing, Leadership and Management, Community Health
Instructions:
Select the single best answer for each question. Base your responses on current evidence-based
nursing practice, the NCLEX-RN Test Plan, and ATI Nursing Education standards. Prioritize client safety,
the nursing process, and clinical judgment in all responses.
Section 1: Fundamentals of Nursing (Questions 1–15)
Question 1
A nurse is preparing to insert a nasogastric tube for gastric decompression. Which of the following
actions should the nurse take to verify proper tube placement after insertion?
A) Auscultate for a whooshing sound over the epigastric area while injecting air
B) Measure the pH of aspirated gastric contents
C) Observe for bubbling at the tube's end when submerged in water
D) Obtain a chest x-ray to confirm placement
,Correct Answer: D
Rationale: Radiographic confirmation (chest x-ray) is the gold standard for verifying NG tube
placement and is the most reliable method. While pH testing of aspirate (B) and auscultation (A) are
used, they are less reliable and can lead to misinterpretation. The "whoosh" test (A) is no longer
recommended as a sole verification method. Observing for bubbling (C) is used for chest tube
assessment, not NG tube placement.
Question 2
A nurse is caring for a client who has a new diagnosis of diabetes mellitus and requires insulin
administration teaching. Which of the following actions demonstrates the nurse's understanding of
effective client education?
A) Providing a detailed written handout and asking the client to read it independently
B) Demonstrating the injection technique and then asking the client to return the demonstration
C) Showing the client a video about insulin administration and answering questions afterward
D) Giving the client a list of websites for additional information about diabetes management
Correct Answer: B
Rationale: The "teach-back" or return demonstration method is the most effective strategy for
evaluating client understanding of psychomotor skills. It allows the nurse to assess comprehension and
correct any errors in real-time. Passive methods like providing handouts (A), videos (C), or website lists
(D) do not verify that the client has acquired the necessary skill.
Question 3
A nurse is preparing to administer a blood transfusion to a client. Which of the following actions
should the nurse take first?
A) Obtain the client's vital signs
B) Verify the client's identity using two identifiers
C) Check the blood product expiration date
D) Assess the client's IV site for patency
,Correct Answer: B
Rationale: Client identification using two unique identifiers (e.g., name and date of birth) is the priority
action before any blood transfusion to prevent transfusion-related errors. While obtaining vital signs
(A), checking the expiration date (C), and assessing IV patency (D) are important steps, they occur after
confirming the correct client and blood product match.
Question 4
A nurse is caring for a client who has a new colostomy. Which of the following findings should the
nurse report to the healthcare provider immediately?
A) Stoma appears dark purple in color
B) Stoma is slightly edematous and moist
C) Minimal serosanguineous drainage from the stoma
D) The client reports mild discomfort around the stoma site
Correct Answer: A
Rationale: A dark purple or black stoma indicates compromised blood supply and potential necrosis,
requiring immediate intervention. Slight edema and moisture (B) are normal findings in a new stoma.
Minimal serosanguineous drainage (C) and mild discomfort (D) are expected during the postoperative
period.
Question 5
A nurse is planning care for a client who has a latex allergy. Which of the following items should the
nurse avoid using in the client's room?
A) Vinyl gloves
B) Non-latex blood pressure cuff
C) Rubber tourniquet
D) Silicone catheter
Correct Answer: C
, Rationale: Rubber tourniquets contain natural rubber latex and must be avoided in clients with latex
allergy. Vinyl gloves (A), non-latex blood pressure cuffs (B), and silicone catheters (D) are latex-safe
alternatives and should be used instead.
Question 6
A nurse is providing postoperative care to a client who has undergone abdominal surgery. Which of
the following actions should the nurse take to prevent deep vein thrombosis (DVT)?
A) Apply sequential compression devices (SCDs) bilaterally
B) Massage the client's lower extremities
C) Place pillows under the client's knees
D) Restrict oral fluid intake to minimize edema
Correct Answer: A
Rationale: Sequential compression devices promote venous return and reduce the risk of DVT in
postoperative clients. Massaging the lower extremities (B) can dislodge existing thrombi. Placing
pillows under the knees (C) can impair venous return. Restricting fluids (D) is contraindicated and can
lead to dehydration and increased viscosity.
Question 7
A nurse is assessing a client who has a wound infection. Which of the following laboratory values
should the nurse monitor to evaluate the client's response to antibiotic therapy?
A) Serum albumin level
B) White blood cell (WBC) count
C) Serum creatinine level
D) Hemoglobin level
Correct Answer: B
Rationale: White blood cell count is a key indicator of infection and response to antibiotic therapy. A
decreasing WBC count suggests improvement. Serum albumin (A) reflects nutritional status. Serum
Questions for Advanced Nursing Practice and NCLEX-RN
Preparation
Exam Title: ATI Capstone Comprehensive Assessment: Advanced Clinical Judgment, Prioritization, and
Evidence-Based Nursing Practice for Pre-Licensure RN Candidates
Difficulty Level: Advanced / Hard / Mixed
Target Audience: Senior nursing students, pre-licensure RN candidates preparing for the ATI
Comprehensive Predictor, ATI Capstone Proctored Assessment, and NCLEX-RN examination
Exam Format: 100 multiple-choice questions with one correct answer per question
Content Areas: Fundamentals, Pharmacology, Medical-Surgical Nursing, Maternal-Newborn Nursing,
Pediatrics, Mental Health Nursing, Leadership and Management, Community Health
Instructions:
Select the single best answer for each question. Base your responses on current evidence-based
nursing practice, the NCLEX-RN Test Plan, and ATI Nursing Education standards. Prioritize client safety,
the nursing process, and clinical judgment in all responses.
Section 1: Fundamentals of Nursing (Questions 1–15)
Question 1
A nurse is preparing to insert a nasogastric tube for gastric decompression. Which of the following
actions should the nurse take to verify proper tube placement after insertion?
A) Auscultate for a whooshing sound over the epigastric area while injecting air
B) Measure the pH of aspirated gastric contents
C) Observe for bubbling at the tube's end when submerged in water
D) Obtain a chest x-ray to confirm placement
,Correct Answer: D
Rationale: Radiographic confirmation (chest x-ray) is the gold standard for verifying NG tube
placement and is the most reliable method. While pH testing of aspirate (B) and auscultation (A) are
used, they are less reliable and can lead to misinterpretation. The "whoosh" test (A) is no longer
recommended as a sole verification method. Observing for bubbling (C) is used for chest tube
assessment, not NG tube placement.
Question 2
A nurse is caring for a client who has a new diagnosis of diabetes mellitus and requires insulin
administration teaching. Which of the following actions demonstrates the nurse's understanding of
effective client education?
A) Providing a detailed written handout and asking the client to read it independently
B) Demonstrating the injection technique and then asking the client to return the demonstration
C) Showing the client a video about insulin administration and answering questions afterward
D) Giving the client a list of websites for additional information about diabetes management
Correct Answer: B
Rationale: The "teach-back" or return demonstration method is the most effective strategy for
evaluating client understanding of psychomotor skills. It allows the nurse to assess comprehension and
correct any errors in real-time. Passive methods like providing handouts (A), videos (C), or website lists
(D) do not verify that the client has acquired the necessary skill.
Question 3
A nurse is preparing to administer a blood transfusion to a client. Which of the following actions
should the nurse take first?
A) Obtain the client's vital signs
B) Verify the client's identity using two identifiers
C) Check the blood product expiration date
D) Assess the client's IV site for patency
,Correct Answer: B
Rationale: Client identification using two unique identifiers (e.g., name and date of birth) is the priority
action before any blood transfusion to prevent transfusion-related errors. While obtaining vital signs
(A), checking the expiration date (C), and assessing IV patency (D) are important steps, they occur after
confirming the correct client and blood product match.
Question 4
A nurse is caring for a client who has a new colostomy. Which of the following findings should the
nurse report to the healthcare provider immediately?
A) Stoma appears dark purple in color
B) Stoma is slightly edematous and moist
C) Minimal serosanguineous drainage from the stoma
D) The client reports mild discomfort around the stoma site
Correct Answer: A
Rationale: A dark purple or black stoma indicates compromised blood supply and potential necrosis,
requiring immediate intervention. Slight edema and moisture (B) are normal findings in a new stoma.
Minimal serosanguineous drainage (C) and mild discomfort (D) are expected during the postoperative
period.
Question 5
A nurse is planning care for a client who has a latex allergy. Which of the following items should the
nurse avoid using in the client's room?
A) Vinyl gloves
B) Non-latex blood pressure cuff
C) Rubber tourniquet
D) Silicone catheter
Correct Answer: C
, Rationale: Rubber tourniquets contain natural rubber latex and must be avoided in clients with latex
allergy. Vinyl gloves (A), non-latex blood pressure cuffs (B), and silicone catheters (D) are latex-safe
alternatives and should be used instead.
Question 6
A nurse is providing postoperative care to a client who has undergone abdominal surgery. Which of
the following actions should the nurse take to prevent deep vein thrombosis (DVT)?
A) Apply sequential compression devices (SCDs) bilaterally
B) Massage the client's lower extremities
C) Place pillows under the client's knees
D) Restrict oral fluid intake to minimize edema
Correct Answer: A
Rationale: Sequential compression devices promote venous return and reduce the risk of DVT in
postoperative clients. Massaging the lower extremities (B) can dislodge existing thrombi. Placing
pillows under the knees (C) can impair venous return. Restricting fluids (D) is contraindicated and can
lead to dehydration and increased viscosity.
Question 7
A nurse is assessing a client who has a wound infection. Which of the following laboratory values
should the nurse monitor to evaluate the client's response to antibiotic therapy?
A) Serum albumin level
B) White blood cell (WBC) count
C) Serum creatinine level
D) Hemoglobin level
Correct Answer: B
Rationale: White blood cell count is a key indicator of infection and response to antibiotic therapy. A
decreasing WBC count suggests improvement. Serum albumin (A) reflects nutritional status. Serum
