ATI Capstone Comprehensive Predictor Examination
Advanced Practice Questions for Nursing Capstone & NCLEX-RN
Preparation
Fundamentals of Nursing (Questions 1–14)
1. A nurse is preparing to administer an enteral feeding through a nasogastric tube. Which action
should the nurse take first?
A. Flush the tube with 30 mL of sterile water
B. Verify tube placement by aspirating gastric contents and checking pH
C. Elevate the head of the bed to 30 degrees
D. Check the residual volume
Correct Answer: B
Rationale: Before administering any enteral feeding, the nurse must first verify proper tube placement.
Aspirating gastric contents and checking pH (expected pH ≤ 5) confirms gastric placement. While
elevating the head of the bed, checking residual, and flushing are all important steps, verification of
placement is the priority to prevent aspiration and ensure patient safety.
2. A client who is postoperative day 2 following abdominal surgery reports sudden shortness of
breath and chest pain. The nurse notes the client's oxygen saturation is 88% on room air. Which
action should the nurse take FIRST?
A. Administer oxygen via nasal cannula at 2 L/min
B. Notify the healthcare provider immediately
C. Position the client in high-Fowler's position
D. Assess the client's surgical incision site
Correct Answer: C
,Rationale: The priority action is to position the client in high-Fowler's position to maximize lung
expansion and facilitate breathing. This is followed by administering oxygen and notifying the
provider. The client's symptoms suggest a possible pulmonary embolism, a life-threatening
complication requiring immediate intervention.
3. A nurse is calculating the intake and output for a client over an 8-hour shift. The client received
1,000 mL of IV fluids, 240 mL of oral fluids, and voided 800 mL. What is the client's net fluid
balance?
A. +440 mL
B. +560 mL
C. -440 mL
D. -560 mL
Correct Answer: A
Rationale: Total intake = 1,000 mL + 240 mL = 1,240 mL. Total output = 800 mL. Net fluid balance =
1,240 mL - 800 mL = +440 mL (positive balance indicates fluid retention).
4. A nurse is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates a need for further teaching?
A. "I should avoid gas-forming foods like beans and broccoli."
B. "I can shower with my colostomy pouch in place."
C. "I should change my pouch immediately after meals."
D. "I need to monitor the skin around my stoma for irritation."
Correct Answer: C
Rationale: The client should NOT change the pouch immediately after meals, as the bowel is most
active during and shortly after eating. Pouches should be changed when the client's bowel is less
active, typically before meals or at bedtime.
,5. A client with diabetes mellitus is scheduled for surgery. The nurse notes that the client's morning
fasting blood glucose is 180 mg/dL. Which action should the nurse take?
A. Administer the client's usual dose of insulin as prescribed
B. Hold the insulin and notify the healthcare provider
C. Administer half the usual dose of insulin
D. Give the insulin and proceed with the surgery
Correct Answer: A
Rationale: The client should receive their usual insulin dose unless otherwise prescribed. Blood glucose
of 180 mg/dL is elevated but not critically so. Holding insulin could lead to hyperglycemia and
complications during surgery. The nurse should monitor blood glucose closely and notify the provider
of the value.
6. A nurse is caring for a client who has a prescription for a clear liquid diet. Which item is
appropriate to include on the client's meal tray?
A. Cream of chicken soup
B. Orange juice with pulp
C. Apple juice
D. Yogurt
Correct Answer: C
Rationale: Clear liquids include water, clear broth, clear juices without pulp (apple, cranberry, grape),
gelatin, and clear carbonated beverages. Apple juice is appropriate. Cream of chicken soup, orange
juice with pulp, and yogurt are not clear liquids.
7. A nurse is preparing to administer a blood transfusion to a client. Which action should the nurse
take FIRST?
A. Verify the client's identity using two identifiers
B. Obtain the client's vital signs
, C. Check the blood product expiration date
D. Ensure informed consent is on the chart
Correct Answer: A
Rationale: The first action is to verify the client's identity using two patient identifiers (e.g., name and
date of birth) to ensure the correct blood product is administered to the correct client. While all
options are important steps in the transfusion process, patient identification is the priority safety
measure.
8. A nurse is assessing a client who is 1 day postoperative and reports pain at the surgical site rated
8 on a scale of 0 to 10. Which action should the nurse take FIRST?
A. Administer the prescribed analgesic
B. Reposition the client to promote comfort
C. Assess the surgical incision for signs of complications
D. Document the client's pain rating
Correct Answer: C
Rationale: The nurse should first assess the surgical incision for signs of complications such as
infection, hematoma, or dehiscence before administering pain medication. This assessment helps
determine whether the pain is expected postoperative pain or indicative of a complication requiring
immediate intervention.
9. A client who is receiving continuous enteral feedings develops diarrhea. Which action should the
nurse take FIRST?
A. Decrease the rate of the feeding
B. Check the client's serum electrolytes
C. Assess the client for abdominal distention and cramping
D. Notify the healthcare provider
Correct Answer: C
Advanced Practice Questions for Nursing Capstone & NCLEX-RN
Preparation
Fundamentals of Nursing (Questions 1–14)
1. A nurse is preparing to administer an enteral feeding through a nasogastric tube. Which action
should the nurse take first?
A. Flush the tube with 30 mL of sterile water
B. Verify tube placement by aspirating gastric contents and checking pH
C. Elevate the head of the bed to 30 degrees
D. Check the residual volume
Correct Answer: B
Rationale: Before administering any enteral feeding, the nurse must first verify proper tube placement.
Aspirating gastric contents and checking pH (expected pH ≤ 5) confirms gastric placement. While
elevating the head of the bed, checking residual, and flushing are all important steps, verification of
placement is the priority to prevent aspiration and ensure patient safety.
2. A client who is postoperative day 2 following abdominal surgery reports sudden shortness of
breath and chest pain. The nurse notes the client's oxygen saturation is 88% on room air. Which
action should the nurse take FIRST?
A. Administer oxygen via nasal cannula at 2 L/min
B. Notify the healthcare provider immediately
C. Position the client in high-Fowler's position
D. Assess the client's surgical incision site
Correct Answer: C
,Rationale: The priority action is to position the client in high-Fowler's position to maximize lung
expansion and facilitate breathing. This is followed by administering oxygen and notifying the
provider. The client's symptoms suggest a possible pulmonary embolism, a life-threatening
complication requiring immediate intervention.
3. A nurse is calculating the intake and output for a client over an 8-hour shift. The client received
1,000 mL of IV fluids, 240 mL of oral fluids, and voided 800 mL. What is the client's net fluid
balance?
A. +440 mL
B. +560 mL
C. -440 mL
D. -560 mL
Correct Answer: A
Rationale: Total intake = 1,000 mL + 240 mL = 1,240 mL. Total output = 800 mL. Net fluid balance =
1,240 mL - 800 mL = +440 mL (positive balance indicates fluid retention).
4. A nurse is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates a need for further teaching?
A. "I should avoid gas-forming foods like beans and broccoli."
B. "I can shower with my colostomy pouch in place."
C. "I should change my pouch immediately after meals."
D. "I need to monitor the skin around my stoma for irritation."
Correct Answer: C
Rationale: The client should NOT change the pouch immediately after meals, as the bowel is most
active during and shortly after eating. Pouches should be changed when the client's bowel is less
active, typically before meals or at bedtime.
,5. A client with diabetes mellitus is scheduled for surgery. The nurse notes that the client's morning
fasting blood glucose is 180 mg/dL. Which action should the nurse take?
A. Administer the client's usual dose of insulin as prescribed
B. Hold the insulin and notify the healthcare provider
C. Administer half the usual dose of insulin
D. Give the insulin and proceed with the surgery
Correct Answer: A
Rationale: The client should receive their usual insulin dose unless otherwise prescribed. Blood glucose
of 180 mg/dL is elevated but not critically so. Holding insulin could lead to hyperglycemia and
complications during surgery. The nurse should monitor blood glucose closely and notify the provider
of the value.
6. A nurse is caring for a client who has a prescription for a clear liquid diet. Which item is
appropriate to include on the client's meal tray?
A. Cream of chicken soup
B. Orange juice with pulp
C. Apple juice
D. Yogurt
Correct Answer: C
Rationale: Clear liquids include water, clear broth, clear juices without pulp (apple, cranberry, grape),
gelatin, and clear carbonated beverages. Apple juice is appropriate. Cream of chicken soup, orange
juice with pulp, and yogurt are not clear liquids.
7. A nurse is preparing to administer a blood transfusion to a client. Which action should the nurse
take FIRST?
A. Verify the client's identity using two identifiers
B. Obtain the client's vital signs
, C. Check the blood product expiration date
D. Ensure informed consent is on the chart
Correct Answer: A
Rationale: The first action is to verify the client's identity using two patient identifiers (e.g., name and
date of birth) to ensure the correct blood product is administered to the correct client. While all
options are important steps in the transfusion process, patient identification is the priority safety
measure.
8. A nurse is assessing a client who is 1 day postoperative and reports pain at the surgical site rated
8 on a scale of 0 to 10. Which action should the nurse take FIRST?
A. Administer the prescribed analgesic
B. Reposition the client to promote comfort
C. Assess the surgical incision for signs of complications
D. Document the client's pain rating
Correct Answer: C
Rationale: The nurse should first assess the surgical incision for signs of complications such as
infection, hematoma, or dehiscence before administering pain medication. This assessment helps
determine whether the pain is expected postoperative pain or indicative of a complication requiring
immediate intervention.
9. A client who is receiving continuous enteral feedings develops diarrhea. Which action should the
nurse take FIRST?
A. Decrease the rate of the feeding
B. Check the client's serum electrolytes
C. Assess the client for abdominal distention and cramping
D. Notify the healthcare provider
Correct Answer: C
