ATI Capstone Fundamentals: Comprehensive Examination V2.0
100 Multiple-Choice Questions with Rationales
Exam Title: ATI Capstone Fundamentals Advanced Practice Assessment: Clinical Reasoning,
Prioritization, and Evidence-Based Nursing Interventions for Pre-Licensure Nursing Candidates
Target Audience: Nursing students preparing for ATI Capstone Fundamentals assessment and NCLEX-
RN examination
Difficulty Level: Advanced/Hard/Mixed with emphasis on clinical judgment and prioritization
Section 1: Nursing Process & Clinical Judgment (Questions 1-10)
1. A nurse is caring for a client who has a new onset of confusion. Which of the following nursing
actions demonstrates the evaluation phase of the nursing process?
A) Determining that the client's confusion has improved following reorientation
B) Administering oxygen at 2 L/min via nasal cannula
C) Identifying the nursing diagnosis as acute confusion
D) Planning to reorient the client every 2 hours
Correct Answer: A) Determining that the client's confusion has improved following reorientation
Rationale: The evaluation phase involves determining whether the client's status has improved,
deteriorated, or remained unchanged following interventions. Administering oxygen is
implementation. Identifying the nursing diagnosis is diagnosis. Planning interventions is the planning
phase.
2. A nurse is using the SBAR communication tool to report a client's change in condition. Which
component of SBAR includes the client's history and current medications?
A) Situation
B) Background
C) Assessment
D) Recommendation
Correct Answer: B) Background
,Rationale: The Background component of SBAR includes relevant history, diagnoses, current
medications, allergies, and vital signs. Situation is what is happening now. Assessment is the nurse's
analysis. Recommendation is what the nurse suggests.
3. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A) A client with pneumonia who has a respiratory rate of 22/min
B) A client with diabetes who has a blood glucose of 180 mg/dL
C) A client with heart failure who has new-onset crackles in the lung bases
D) A client with hypertension whose blood pressure is 148/92 mmHg
Correct Answer: C) A client with heart failure who has new-onset crackles in the lung bases
Rationale: New-onset crackles in a client with heart failure indicate pulmonary edema, a life-
threatening complication requiring immediate intervention. The other findings, while abnormal, are
not immediately life-threatening.
4. A nurse is documenting care in the medical record. Which of the following statements is most
appropriate?
A) "Client is having a good day today"
B) "Client appears to be in pain"
C) "Client ambulated 50 feet with a walker, no complaints of dizziness"
D) "Client was uncooperative with care"
Correct Answer: C) "Client ambulated 50 feet with a walker, no complaints of dizziness"
Rationale: Documentation should be objective, specific, and measurable. "Having a good day,"
"appears to be in pain," and "uncooperative" are subjective judgments. Documenting specific
observations and client statements is appropriate.
5. A nurse is assigning tasks to nursing assistive personnel (NAP). Which of the following tasks is
within the scope of practice for NAP?
A) Administering tube feedings
B) Measuring and recording intake and output
C) Performing a sterile dressing change
D) Administering oral medications
Correct Answer: B) Measuring and recording intake and output
,Rationale: NAP can measure and record intake and output, including measuring urine output, counting
ice chips, and documenting oral intake. Tube feedings, sterile procedures, and medication
administration require licensed nursing skills.
6. A nurse is assessing a client who is experiencing chest pain. Which of the following findings is
most consistent with a myocardial infarction?
A) Pain that worsens with deep inspiration
B) Substernal pain radiating to the left arm
C) Pain that is relieved by leaning forward
D) Sharp pain that worsens with palpation
Correct Answer: B) Substernal pain radiating to the left arm
Rationale: Myocardial infarction typically presents with substernal chest pain that may radiate to the
left arm, jaw, or back. Pain worsening with inspiration suggests pericarditis. Pain relieved by leaning
forward suggests pericarditis. Sharp pain worsened by palpation suggests costochondritis.
7. A nurse is developing a plan of care for a client at risk for falls. Which of the following
interventions should the nurse include?
A) Keep the bed in the highest position
B) Apply wrist restraints at night
C) Place the call light within reach
D) Dim the lights for comfort
Correct Answer: C) Place the call light within reach
Rationale: Placing the call light within reach allows the client to call for assistance, preventing falls. The
bed should be in the lowest position. Restraints are a last resort. Adequate lighting is important for
safety.
8. A nurse is using critical thinking to solve a problem. Which of the following describes the first
step in the critical thinking process?
A) Analyzing the situation
B) Identifying the problem
C) Implementing a solution
D) Evaluating the outcome
Correct Answer: B) Identifying the problem
, Rationale: The first step in the critical thinking process is identifying the problem. Without identifying
the problem, the nurse cannot analyze, implement, or evaluate solutions effectively.
9. A nurse is caring for a client who requires a transfer from bed to chair. Which of the following
actions is correct when using a mechanical lift?
A) Place the client's arms across the chest before lifting
B) Use a sling that fits loosely around the client
C) Position the lift over the client's center of gravity
D) Move the client quickly to minimize discomfort
Correct Answer: C) Position the lift over the client's center of gravity
Rationale: The lift should be positioned over the client's center of gravity for stability. Arms should be
crossed over the chest to prevent injury. The sling should fit snugly. The client should be moved slowly
and smoothly.
10. A nurse is evaluating a client's understanding of discharge instructions. Which of the following
indicates the need for further teaching?
A) "I will call my provider if I have fever or chills"
B) "I will take my medications as prescribed"
C) "I will follow up with my provider in 2 weeks"
D) "I will stop my medications when I feel better"
Correct Answer: D) "I will stop my medications when I feel better"
Rationale: Stopping medications when feeling better is unsafe, especially for antibiotics and chronic
disease management. Clients should complete prescribed medication courses and follow provider
instructions.
Section 2: Safety & Infection Control (Questions 11-20)
11. A nurse is caring for a client with tuberculosis (TB). Which of the following precautions should
the nurse implement?
A) Standard precautions only
B) Droplet precautions
C) Airborne precautions
D) Contact precautions
Correct Answer: C) Airborne precautions
100 Multiple-Choice Questions with Rationales
Exam Title: ATI Capstone Fundamentals Advanced Practice Assessment: Clinical Reasoning,
Prioritization, and Evidence-Based Nursing Interventions for Pre-Licensure Nursing Candidates
Target Audience: Nursing students preparing for ATI Capstone Fundamentals assessment and NCLEX-
RN examination
Difficulty Level: Advanced/Hard/Mixed with emphasis on clinical judgment and prioritization
Section 1: Nursing Process & Clinical Judgment (Questions 1-10)
1. A nurse is caring for a client who has a new onset of confusion. Which of the following nursing
actions demonstrates the evaluation phase of the nursing process?
A) Determining that the client's confusion has improved following reorientation
B) Administering oxygen at 2 L/min via nasal cannula
C) Identifying the nursing diagnosis as acute confusion
D) Planning to reorient the client every 2 hours
Correct Answer: A) Determining that the client's confusion has improved following reorientation
Rationale: The evaluation phase involves determining whether the client's status has improved,
deteriorated, or remained unchanged following interventions. Administering oxygen is
implementation. Identifying the nursing diagnosis is diagnosis. Planning interventions is the planning
phase.
2. A nurse is using the SBAR communication tool to report a client's change in condition. Which
component of SBAR includes the client's history and current medications?
A) Situation
B) Background
C) Assessment
D) Recommendation
Correct Answer: B) Background
,Rationale: The Background component of SBAR includes relevant history, diagnoses, current
medications, allergies, and vital signs. Situation is what is happening now. Assessment is the nurse's
analysis. Recommendation is what the nurse suggests.
3. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A) A client with pneumonia who has a respiratory rate of 22/min
B) A client with diabetes who has a blood glucose of 180 mg/dL
C) A client with heart failure who has new-onset crackles in the lung bases
D) A client with hypertension whose blood pressure is 148/92 mmHg
Correct Answer: C) A client with heart failure who has new-onset crackles in the lung bases
Rationale: New-onset crackles in a client with heart failure indicate pulmonary edema, a life-
threatening complication requiring immediate intervention. The other findings, while abnormal, are
not immediately life-threatening.
4. A nurse is documenting care in the medical record. Which of the following statements is most
appropriate?
A) "Client is having a good day today"
B) "Client appears to be in pain"
C) "Client ambulated 50 feet with a walker, no complaints of dizziness"
D) "Client was uncooperative with care"
Correct Answer: C) "Client ambulated 50 feet with a walker, no complaints of dizziness"
Rationale: Documentation should be objective, specific, and measurable. "Having a good day,"
"appears to be in pain," and "uncooperative" are subjective judgments. Documenting specific
observations and client statements is appropriate.
5. A nurse is assigning tasks to nursing assistive personnel (NAP). Which of the following tasks is
within the scope of practice for NAP?
A) Administering tube feedings
B) Measuring and recording intake and output
C) Performing a sterile dressing change
D) Administering oral medications
Correct Answer: B) Measuring and recording intake and output
,Rationale: NAP can measure and record intake and output, including measuring urine output, counting
ice chips, and documenting oral intake. Tube feedings, sterile procedures, and medication
administration require licensed nursing skills.
6. A nurse is assessing a client who is experiencing chest pain. Which of the following findings is
most consistent with a myocardial infarction?
A) Pain that worsens with deep inspiration
B) Substernal pain radiating to the left arm
C) Pain that is relieved by leaning forward
D) Sharp pain that worsens with palpation
Correct Answer: B) Substernal pain radiating to the left arm
Rationale: Myocardial infarction typically presents with substernal chest pain that may radiate to the
left arm, jaw, or back. Pain worsening with inspiration suggests pericarditis. Pain relieved by leaning
forward suggests pericarditis. Sharp pain worsened by palpation suggests costochondritis.
7. A nurse is developing a plan of care for a client at risk for falls. Which of the following
interventions should the nurse include?
A) Keep the bed in the highest position
B) Apply wrist restraints at night
C) Place the call light within reach
D) Dim the lights for comfort
Correct Answer: C) Place the call light within reach
Rationale: Placing the call light within reach allows the client to call for assistance, preventing falls. The
bed should be in the lowest position. Restraints are a last resort. Adequate lighting is important for
safety.
8. A nurse is using critical thinking to solve a problem. Which of the following describes the first
step in the critical thinking process?
A) Analyzing the situation
B) Identifying the problem
C) Implementing a solution
D) Evaluating the outcome
Correct Answer: B) Identifying the problem
, Rationale: The first step in the critical thinking process is identifying the problem. Without identifying
the problem, the nurse cannot analyze, implement, or evaluate solutions effectively.
9. A nurse is caring for a client who requires a transfer from bed to chair. Which of the following
actions is correct when using a mechanical lift?
A) Place the client's arms across the chest before lifting
B) Use a sling that fits loosely around the client
C) Position the lift over the client's center of gravity
D) Move the client quickly to minimize discomfort
Correct Answer: C) Position the lift over the client's center of gravity
Rationale: The lift should be positioned over the client's center of gravity for stability. Arms should be
crossed over the chest to prevent injury. The sling should fit snugly. The client should be moved slowly
and smoothly.
10. A nurse is evaluating a client's understanding of discharge instructions. Which of the following
indicates the need for further teaching?
A) "I will call my provider if I have fever or chills"
B) "I will take my medications as prescribed"
C) "I will follow up with my provider in 2 weeks"
D) "I will stop my medications when I feel better"
Correct Answer: D) "I will stop my medications when I feel better"
Rationale: Stopping medications when feeling better is unsafe, especially for antibiotics and chronic
disease management. Clients should complete prescribed medication courses and follow provider
instructions.
Section 2: Safety & Infection Control (Questions 11-20)
11. A nurse is caring for a client with tuberculosis (TB). Which of the following precautions should
the nurse implement?
A) Standard precautions only
B) Droplet precautions
C) Airborne precautions
D) Contact precautions
Correct Answer: C) Airborne precautions
