ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
ATI RN CAPSTONE PROCTORED COMPREHENSIVE
ASSESSMENT
Version B | Complete Questions & Answers with Rationale
2026/2027 Updated - 100% Accurate Solutions
Examination Overview: This comprehensive assessment contains 150 multiple-choice questions aligned with the
2026-2027 ATI RN Capstone Comprehensive Assessment Version B blueprint, the ATI Comprehensive Predictor, and the
NGN Clinical Judgment Measurement Model (NCJMM). The exam covers nine content areas: Management of Care and
Leadership, Pharmacology, Medical-Surgical Nursing, Maternal-Newborn Nursing, Pediatric Nursing, Mental Health
Nursing, Safety and Infection Control, Health Promotion and Community Health, and NGN Integrated Clinical Scenarios.
Cognitive level distribution: 25% recall, 55% application, and 20% analysis. Each question includes four answer options with
one correct answer and a detailed rationale incorporating pathophysiology, pharmacology, priority frameworks (ABCs,
Maslow, Safety, Delegation), evidence-based practice, and ATI Capstone standards. Use this resource for NCLEX-RN
preparation and capstone review.
Section 1: Management of Care and Leadership
Q1: A nurse on a medical-surgical unit is caring for four clients. Using the ABC priority framework,
which client should the nurse assess first?
A. A client with a blood pressure of 160/90 mmHg complaining of a headache
B. A client with a respiratory rate of 8 breaths/min after receiving morphine **[CORRECT]**
C. A client with a blood glucose of 240 mg/dL and polyuria
D. A client with a temperature of 38.3°C (101°F) and diaphoresis
Correct Answer: B
Rationale: Using the ABC framework, Airway and Breathing take highest priority. A respiratory rate of 8
breaths/min indicates respiratory depression, likely from opioid administration, which is a life-threatening
emergency requiring immediate intervention such as naloxone (Narcan) and stimulation. The other clients are
stable or have less acute issues (hypertension, hyperglycemia, fever) that can be addressed after stabilizing the
client's breathing.
Q2: A charge nurse is making assignments for the oncoming shift. Which client should be
assigned to the most experienced RN?
A. A client 1 day postoperative from an appendectomy requiring ambulation
B. A client with chronic kidney disease receiving their first hemodialysis treatment **[CORRECT]**
C. A client with pneumonia requiring oral antibiotics and nebulizer treatments
D. A client with a stage 2 pressure ulcer needing a dressing change
Correct Answer: B
Rationale: The RN should care for unstable clients and those requiring complex assessments or IV medications.
A client receiving their first hemodialysis treatment is at high risk for complications such as hypotension,
disequilibrium syndrome, air embolism, and bleeding from the access site, requiring close monitoring by an
experienced RN. The other clients are stable and their care could be appropriately delegated to an LPN/LVN
with RN supervision.
ATI RN Capstone Comprehensive Assessment Version B Page 1
,ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
Q3: A registered nurse is delegating tasks to a UAP. Which of the following tasks is appropriate to
delegate to the UAP?
A. Teaching a client about a newly prescribed diabetic diet
B. Measuring vital signs on a client who is 2 hours post-angioplasty
C. Ambulating a stable client who is 3 days postoperative from a hernia repair **[CORRECT]**
D. Performing a sterile dressing change on a central line site
Correct Answer: C
Rationale: Ambulation of stable postoperative clients is within the UAP scope of practice because it involves
routine, non-complex care that does not require nursing judgment. Teaching requires RN-level knowledge and
cannot be delegated. Vital signs on a recently post-angioplasty client require RN assessment due to risk of
bleeding or complications. Sterile dressing changes, especially on central lines, are performed by the RN or LPN
with appropriate training. UAP may ambulate stable clients, perform ADLs, take routine vitals on stable clients,
and measure I&O.;
Q4: A client is scheduled for an elective cholecystectomy. The surgeon has explained the
procedure, risks, and alternatives. As the nurse witnesses the client signing the consent form, the
client says, 'I'm not really sure what the gallbladder does.' What is the nurse's best action?
A. Witness the signature and document the client's comment
B. Explain the function of the gallbladder in simple terms
C. Notify the surgeon that the client has questions about the procedure **[CORRECT]**
D. Ask the client to sign an additional consent for teaching
Correct Answer: C
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives.
If the client expresses uncertainty or lack of understanding, the nurse's role is to notify the surgeon so the
surgeon can provide additional information. The nurse may reinforce teaching but cannot substitute for the
provider's explanation. Witnessing the signature when the client lacks understanding violates the principle of
informed consent. The surgeon, not the nurse, is responsible for obtaining informed consent.
Q5: A nurse is caring for a client who has a living will and a DNR order. The client's family
demands that the nurse perform CPR if the client arrests. What is the nurse's most appropriate
response?
A. Perform CPR because the family is requesting it
B. Contact the provider for a new order to perform CPR
C. Honor the DNR order and the client's living will **[CORRECT]**
D. Transfer the client to the ICU for closer monitoring
Correct Answer: C
Rationale: The client's advance directives (living will and DNR order) reflect the client's autonomous healthcare
decisions and must be honored even if family members disagree. Advance directives are legal documents that
take precedence over family wishes. Performing CPR against the client's documented wishes constitutes
battery. The nurse should acknowledge the family's concerns, explain the legal and ethical basis for honoring the
directive, and offer support such as a palliative care consult or social services referral.
Q6: A nurse overhears a colleague discussing a client's medical condition in the elevator. Which
action should the nurse take first?
A. Report the colleague to the nursing supervisor immediately
B. Remind the colleague that discussing clients in public areas violates HIPAA **[CORRECT]**
C. Document the incident in the colleague's personnel file
ATI RN Capstone Comprehensive Assessment Version B Page 2
,ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
D. File an incident report with the risk management department
Correct Answer: B
Rationale: The first action is to directly address the behavior by reminding the colleague that discussing client
information in public areas violates HIPAA's Privacy Rule, which protects Protected Health Information (PHI).
This immediate intervention stops the breach and prevents further disclosure. If the behavior continues or is part
of a pattern, escalation to a supervisor and formal documentation would follow. Direct professional
communication is the least restrictive first step and aligns with ethical practice.
Q7: A nurse suspects that a 4-year-old child admitted with a fractured femur is a victim of physical
abuse. The caregiver's explanation is inconsistent with the injury. What is the nurse's priority
action?
A. Confront the caregiver about the suspected abuse
B. Document the findings and wait for further evidence
C. Report the suspicion to child protective services immediately **[CORRECT]**
D. Discuss the concern with the charge nurse before taking action
Correct Answer: C
Rationale: Nurses are mandatory reporters of suspected child abuse and are legally required to report
suspicions immediately to child protective services or law enforcement. The nurse does not need to prove abuse
occurred - reasonable suspicion is sufficient. Confronting the caregiver may escalate the situation and endanger
the child. Waiting for additional evidence delays mandated reporting. While consulting the charge nurse is
appropriate, it does not replace the nurse's individual legal obligation to report.
Q8: A client with schizophrenia tells the nurse, 'When I get out of here, I'm going to kill my
neighbor who has been poisoning my food.' What is the nurse's priority action?
A. Document the statement in the client's medical record
B. Notify the provider and discuss medication adjustment
C. Warn the identified neighbor and notify law enforcement **[CORRECT]**
D. Place the client on one-to-one suicide precautions
Correct Answer: C
Rationale: Under the Tarasoff ruling (duty to warn), when a client makes a specific threat against an identifiable
victim, the nurse has a legal duty to protect the victim by warning them and notifying law enforcement. This duty
overrides client confidentiality. Documenting, notifying the provider, and adjusting medications are important
follow-up actions, but the priority is protecting the potential victim. The threat is homicidal, not suicidal, so suicide
precautions are not the priority intervention.
Q9: A client in restraints becomes increasingly agitated. The provider ordered restraints 2 hours
ago. What is the required action regarding the restraint order?
A. Renew the order now because it expires after 2 hours for adults
B. Continue the restraints; the order is valid for 24 hours
C. Renew the order in 2 more hours; adult orders last 4 hours **[CORRECT]**
D. Discontinue the restraints since the order has expired
Correct Answer: C
Rationale: For adults, a restraint order must be renewed every 4 hours (not 2 hours). The provider must conduct
a face-to-face evaluation within 1 hour of the restraint application, and the original order is valid for 4 hours for
adults, 2 hours for adolescents ages 9-17, and 1 hour for children under 9. The nurse should continue
monitoring, attempt to release the restraints, and notify the provider if renewal is needed. Maximum continuous
restraint time is 24 hours, after which a new face-to-face evaluation is required.
ATI RN Capstone Comprehensive Assessment Version B Page 3
, ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
Q10: A nurse is giving a change-of-shift report using SBAR format. Which statement represents
the 'Assessment' component?
A. The client in room 412 is post-op day 2 from a hip replacement
B. I think the client may be developing a deep vein thrombosis **[CORRECT]**
C. The client's left calf is swollen, red, and warm to the touch
D. I recommend you assess the client and consider a Doppler study
Correct Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, Recommendation. The Assessment
component is the nurse's professional interpretation or judgment about the client's condition. 'I think the client
may be developing a DVT' is the nurse's assessment. The Situation is the current issue, Background is the
relevant history, and Recommendation is the suggested action. Option C is part of the Situation/Background
(objective data), while option D is the Recommendation.
Q11: Following a mass casualty incident, a nurse is triaging clients. Which client should be
categorized as 'Expectant' (Black tag)?
A. A client with a partially amputated leg and absent distal pulses
B. A client with second-degree burns over 40% of the body surface area
C. A client with massive head trauma, fixed and dilated pupils, and agonal breathing
**[CORRECT]**
D. A client with a sucking chest wound and severe respiratory distress
Correct Answer: C
Rationale: The Expectant (Black) category is for clients with unsurvivable injuries who receive comfort care only,
allowing resources to be directed to those with survivable injuries. Massive head trauma with fixed and dilated
pupils and agonal breathing indicates brain death is imminent and resuscitation is futile. The other clients have
potentially survivable injuries: the amputated leg (Emergent/Red), severe burns (Emergent or Urgent depending
on resources), and sucking chest wound (Emergent/Red) all require immediate intervention.
Q12: A fire starts in a client's room. The client is on oxygen and cannot self-evacuate. Using the
RACE acronym, what is the nurse's first action?
A. Pull the fire alarm in the hallway
B. Rescue the client from the room **[CORRECT]**
C. Close the door to contain the fire
D. Extinguish the fire using a fire extinguisher
Correct Answer: B
Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish. The first action is to Rescue the client by
moving them from the room to safety, especially critical because the client is on oxygen which accelerates
combustion. After rescuing the client, the nurse activates the Alarm, then Contain the fire by closing doors and
windows, and finally Extinguish if trained and the fire is small. Client safety always takes priority over property
preservation.
Q13: A nurse manager is implementing a quality improvement project to reduce falls. Which
framework should the manager use to structure the project?
A. SBAR communication tool
B. PDSA (Plan-Do-Study-Act) cycle **[CORRECT]**
C. Maslow's hierarchy of needs
D. Nursing process (ADPIE)
Correct Answer: B
ATI RN Capstone Comprehensive Assessment Version B Page 4
ATI RN CAPSTONE PROCTORED COMPREHENSIVE
ASSESSMENT
Version B | Complete Questions & Answers with Rationale
2026/2027 Updated - 100% Accurate Solutions
Examination Overview: This comprehensive assessment contains 150 multiple-choice questions aligned with the
2026-2027 ATI RN Capstone Comprehensive Assessment Version B blueprint, the ATI Comprehensive Predictor, and the
NGN Clinical Judgment Measurement Model (NCJMM). The exam covers nine content areas: Management of Care and
Leadership, Pharmacology, Medical-Surgical Nursing, Maternal-Newborn Nursing, Pediatric Nursing, Mental Health
Nursing, Safety and Infection Control, Health Promotion and Community Health, and NGN Integrated Clinical Scenarios.
Cognitive level distribution: 25% recall, 55% application, and 20% analysis. Each question includes four answer options with
one correct answer and a detailed rationale incorporating pathophysiology, pharmacology, priority frameworks (ABCs,
Maslow, Safety, Delegation), evidence-based practice, and ATI Capstone standards. Use this resource for NCLEX-RN
preparation and capstone review.
Section 1: Management of Care and Leadership
Q1: A nurse on a medical-surgical unit is caring for four clients. Using the ABC priority framework,
which client should the nurse assess first?
A. A client with a blood pressure of 160/90 mmHg complaining of a headache
B. A client with a respiratory rate of 8 breaths/min after receiving morphine **[CORRECT]**
C. A client with a blood glucose of 240 mg/dL and polyuria
D. A client with a temperature of 38.3°C (101°F) and diaphoresis
Correct Answer: B
Rationale: Using the ABC framework, Airway and Breathing take highest priority. A respiratory rate of 8
breaths/min indicates respiratory depression, likely from opioid administration, which is a life-threatening
emergency requiring immediate intervention such as naloxone (Narcan) and stimulation. The other clients are
stable or have less acute issues (hypertension, hyperglycemia, fever) that can be addressed after stabilizing the
client's breathing.
Q2: A charge nurse is making assignments for the oncoming shift. Which client should be
assigned to the most experienced RN?
A. A client 1 day postoperative from an appendectomy requiring ambulation
B. A client with chronic kidney disease receiving their first hemodialysis treatment **[CORRECT]**
C. A client with pneumonia requiring oral antibiotics and nebulizer treatments
D. A client with a stage 2 pressure ulcer needing a dressing change
Correct Answer: B
Rationale: The RN should care for unstable clients and those requiring complex assessments or IV medications.
A client receiving their first hemodialysis treatment is at high risk for complications such as hypotension,
disequilibrium syndrome, air embolism, and bleeding from the access site, requiring close monitoring by an
experienced RN. The other clients are stable and their care could be appropriately delegated to an LPN/LVN
with RN supervision.
ATI RN Capstone Comprehensive Assessment Version B Page 1
,ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
Q3: A registered nurse is delegating tasks to a UAP. Which of the following tasks is appropriate to
delegate to the UAP?
A. Teaching a client about a newly prescribed diabetic diet
B. Measuring vital signs on a client who is 2 hours post-angioplasty
C. Ambulating a stable client who is 3 days postoperative from a hernia repair **[CORRECT]**
D. Performing a sterile dressing change on a central line site
Correct Answer: C
Rationale: Ambulation of stable postoperative clients is within the UAP scope of practice because it involves
routine, non-complex care that does not require nursing judgment. Teaching requires RN-level knowledge and
cannot be delegated. Vital signs on a recently post-angioplasty client require RN assessment due to risk of
bleeding or complications. Sterile dressing changes, especially on central lines, are performed by the RN or LPN
with appropriate training. UAP may ambulate stable clients, perform ADLs, take routine vitals on stable clients,
and measure I&O.;
Q4: A client is scheduled for an elective cholecystectomy. The surgeon has explained the
procedure, risks, and alternatives. As the nurse witnesses the client signing the consent form, the
client says, 'I'm not really sure what the gallbladder does.' What is the nurse's best action?
A. Witness the signature and document the client's comment
B. Explain the function of the gallbladder in simple terms
C. Notify the surgeon that the client has questions about the procedure **[CORRECT]**
D. Ask the client to sign an additional consent for teaching
Correct Answer: C
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives.
If the client expresses uncertainty or lack of understanding, the nurse's role is to notify the surgeon so the
surgeon can provide additional information. The nurse may reinforce teaching but cannot substitute for the
provider's explanation. Witnessing the signature when the client lacks understanding violates the principle of
informed consent. The surgeon, not the nurse, is responsible for obtaining informed consent.
Q5: A nurse is caring for a client who has a living will and a DNR order. The client's family
demands that the nurse perform CPR if the client arrests. What is the nurse's most appropriate
response?
A. Perform CPR because the family is requesting it
B. Contact the provider for a new order to perform CPR
C. Honor the DNR order and the client's living will **[CORRECT]**
D. Transfer the client to the ICU for closer monitoring
Correct Answer: C
Rationale: The client's advance directives (living will and DNR order) reflect the client's autonomous healthcare
decisions and must be honored even if family members disagree. Advance directives are legal documents that
take precedence over family wishes. Performing CPR against the client's documented wishes constitutes
battery. The nurse should acknowledge the family's concerns, explain the legal and ethical basis for honoring the
directive, and offer support such as a palliative care consult or social services referral.
Q6: A nurse overhears a colleague discussing a client's medical condition in the elevator. Which
action should the nurse take first?
A. Report the colleague to the nursing supervisor immediately
B. Remind the colleague that discussing clients in public areas violates HIPAA **[CORRECT]**
C. Document the incident in the colleague's personnel file
ATI RN Capstone Comprehensive Assessment Version B Page 2
,ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
D. File an incident report with the risk management department
Correct Answer: B
Rationale: The first action is to directly address the behavior by reminding the colleague that discussing client
information in public areas violates HIPAA's Privacy Rule, which protects Protected Health Information (PHI).
This immediate intervention stops the breach and prevents further disclosure. If the behavior continues or is part
of a pattern, escalation to a supervisor and formal documentation would follow. Direct professional
communication is the least restrictive first step and aligns with ethical practice.
Q7: A nurse suspects that a 4-year-old child admitted with a fractured femur is a victim of physical
abuse. The caregiver's explanation is inconsistent with the injury. What is the nurse's priority
action?
A. Confront the caregiver about the suspected abuse
B. Document the findings and wait for further evidence
C. Report the suspicion to child protective services immediately **[CORRECT]**
D. Discuss the concern with the charge nurse before taking action
Correct Answer: C
Rationale: Nurses are mandatory reporters of suspected child abuse and are legally required to report
suspicions immediately to child protective services or law enforcement. The nurse does not need to prove abuse
occurred - reasonable suspicion is sufficient. Confronting the caregiver may escalate the situation and endanger
the child. Waiting for additional evidence delays mandated reporting. While consulting the charge nurse is
appropriate, it does not replace the nurse's individual legal obligation to report.
Q8: A client with schizophrenia tells the nurse, 'When I get out of here, I'm going to kill my
neighbor who has been poisoning my food.' What is the nurse's priority action?
A. Document the statement in the client's medical record
B. Notify the provider and discuss medication adjustment
C. Warn the identified neighbor and notify law enforcement **[CORRECT]**
D. Place the client on one-to-one suicide precautions
Correct Answer: C
Rationale: Under the Tarasoff ruling (duty to warn), when a client makes a specific threat against an identifiable
victim, the nurse has a legal duty to protect the victim by warning them and notifying law enforcement. This duty
overrides client confidentiality. Documenting, notifying the provider, and adjusting medications are important
follow-up actions, but the priority is protecting the potential victim. The threat is homicidal, not suicidal, so suicide
precautions are not the priority intervention.
Q9: A client in restraints becomes increasingly agitated. The provider ordered restraints 2 hours
ago. What is the required action regarding the restraint order?
A. Renew the order now because it expires after 2 hours for adults
B. Continue the restraints; the order is valid for 24 hours
C. Renew the order in 2 more hours; adult orders last 4 hours **[CORRECT]**
D. Discontinue the restraints since the order has expired
Correct Answer: C
Rationale: For adults, a restraint order must be renewed every 4 hours (not 2 hours). The provider must conduct
a face-to-face evaluation within 1 hour of the restraint application, and the original order is valid for 4 hours for
adults, 2 hours for adolescents ages 9-17, and 1 hour for children under 9. The nurse should continue
monitoring, attempt to release the restraints, and notify the provider if renewal is needed. Maximum continuous
restraint time is 24 hours, after which a new face-to-face evaluation is required.
ATI RN Capstone Comprehensive Assessment Version B Page 3
, ATI RN Capstone Proctored Comprehensive Assessment - Version B 2026/2027 Updated - 100% Accurate Solutions
Q10: A nurse is giving a change-of-shift report using SBAR format. Which statement represents
the 'Assessment' component?
A. The client in room 412 is post-op day 2 from a hip replacement
B. I think the client may be developing a deep vein thrombosis **[CORRECT]**
C. The client's left calf is swollen, red, and warm to the touch
D. I recommend you assess the client and consider a Doppler study
Correct Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, Recommendation. The Assessment
component is the nurse's professional interpretation or judgment about the client's condition. 'I think the client
may be developing a DVT' is the nurse's assessment. The Situation is the current issue, Background is the
relevant history, and Recommendation is the suggested action. Option C is part of the Situation/Background
(objective data), while option D is the Recommendation.
Q11: Following a mass casualty incident, a nurse is triaging clients. Which client should be
categorized as 'Expectant' (Black tag)?
A. A client with a partially amputated leg and absent distal pulses
B. A client with second-degree burns over 40% of the body surface area
C. A client with massive head trauma, fixed and dilated pupils, and agonal breathing
**[CORRECT]**
D. A client with a sucking chest wound and severe respiratory distress
Correct Answer: C
Rationale: The Expectant (Black) category is for clients with unsurvivable injuries who receive comfort care only,
allowing resources to be directed to those with survivable injuries. Massive head trauma with fixed and dilated
pupils and agonal breathing indicates brain death is imminent and resuscitation is futile. The other clients have
potentially survivable injuries: the amputated leg (Emergent/Red), severe burns (Emergent or Urgent depending
on resources), and sucking chest wound (Emergent/Red) all require immediate intervention.
Q12: A fire starts in a client's room. The client is on oxygen and cannot self-evacuate. Using the
RACE acronym, what is the nurse's first action?
A. Pull the fire alarm in the hallway
B. Rescue the client from the room **[CORRECT]**
C. Close the door to contain the fire
D. Extinguish the fire using a fire extinguisher
Correct Answer: B
Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish. The first action is to Rescue the client by
moving them from the room to safety, especially critical because the client is on oxygen which accelerates
combustion. After rescuing the client, the nurse activates the Alarm, then Contain the fire by closing doors and
windows, and finally Extinguish if trained and the fire is small. Client safety always takes priority over property
preservation.
Q13: A nurse manager is implementing a quality improvement project to reduce falls. Which
framework should the manager use to structure the project?
A. SBAR communication tool
B. PDSA (Plan-Do-Study-Act) cycle **[CORRECT]**
C. Maslow's hierarchy of needs
D. Nursing process (ADPIE)
Correct Answer: B
ATI RN Capstone Comprehensive Assessment Version B Page 4
