ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
ATI RN CAPSTONE
MEDICAL SURGICAL
ASSESSMENT
Proctored Exam
with Next Generation NCLEX (NGN) Integration
| Graded A+ |
150 Verified Questions with Comprehensive Clinical Rationales
Aligned to the 2026-2027 ATI RN Capstone Medical-Surgical
Assessment Blueprint
and the ATI Comprehensive Predictor Standards
NCJMM Clinical Judgment Measurement Model Integrated
ATI RN Capstone Med-Surg | NCJMM Integrated Page 1
,ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
EXAM BLUEPRINT OVERVIEW
Sectio
Content Domain Q Range #
n
Cardiovascular Disorders (CAD, MI, HF, Dysrhythmias, Valvular, HTN,
1 Q1-Q30 30
PVD)
2 Respiratory Disorders (COPD, Asthma, Pneumonia, PE, ARDS, TB) Q31-Q50 20
3 Gastrointestinal Disorders (GI Bleed, IBD, Liver, Pancreatitis, Biliary) Q51-Q65 15
4 Renal & Urinary Disorders (AKI, CKD, Dialysis, UTI, Glomerulonephritis) Q66-Q78 13
5 Endocrine Disorders (DM, Thyroid, Adrenal, SIADH/DI, Pituitary) Q79-Q95 17
6 Neurological Disorders (Stroke, Seizures, Parkinson's, TBI, MS) Q96-Q110 15
7 Musculoskeletal Disorders (Fractures, Arthritis, Osteoporosis) Q111-Q125 15
8 Hematological & Oncological Disorders (Anemia, Leukemia, Cancer Care) Q126-Q138 13
9 NGN Integrated Clinical Scenarios & Comprehensive Reasoning Q139-Q150 12
TOTAL 150
COGNITIVE LEVEL DISTRIBUTION (NCJMM)
Cognitive Level Target % Approx. # of Items
Recall / Knowledge 25% ~38 items
Application / Comprehension 55% ~82 items
Analysis / Clinical Judgment 20% ~30 items
EXAM INSTRUCTIONS
1. This examination consists of 150 multiple-choice items distributed across nine content domains aligned to the
2026-2027 ATI RN Capstone Medical-Surgical Assessment blueprint.
2. Each item presents four options (A-D). Select the single best answer. The correct response is marked
**[CORRECT]** and is followed by the rationale.
ATI RN Capstone Med-Surg | NCJMM Integrated Page 2
,ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
3. Rationales integrate pathophysiology, pharmacology, priority-setting frameworks (ABC, Maslow, Safety, Acute
vs. Chronic, Survival vs. Health), evidence-based practice, and ATI NCJMM clinical judgment standards.
4. Section 9 contains NGN Integrated Clinical Scenarios that require multi-step clinical reasoning across the six
NCJMM cognitive skills: Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action,
and Evaluate Outcomes.
5. Target completion time: 3 hours. Recommended pacing: approximately 1.2 minutes per item.
ATI RN Capstone Med-Surg | NCJMM Integrated Page 3
, ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
Section 1: Cardiovascular Disorders
CAD, Acute Coronary Syndrome, Heart Failure, Dysrhythmias, Valvular Disease, Hypertension,
and Peripheral Vascular Disease | Q1-Q30
Q1.
A 54-year-old male with a history of hyperlipidemia and tobacco use presents to the clinic reporting substernal
chest pain that occurs when walking uphill and is relieved by 5 minutes of rest. Which assessment finding
most strongly supports a diagnosis of stable angina rather than acute coronary syndrome (ACS)?
A. Chest pain that radiates to the left arm and jaw at rest
B. Pain that is predictable, occurs with the same level of exertion, and is relieved by rest or nitroglycerin
**[CORRECT]**
C. ST-segment elevation on a 12-lead ECG obtained during the episode
D. Elevated serum troponin I drawn 4 hours after the pain began
Correct Answer: B
Rationale: Stable angina is characterized by predictable chest discomfort that occurs at a consistent level of exertion
and is relieved by rest or nitroglycerin, reflecting fixed atherosclerotic obstruction without plaque rupture. Radiation
at rest, ST elevation, and troponin elevation all indicate ACS (unstable angina or MI) and would require emergent
reperfusion pathways rather than routine outpatient management.
Q2.
The nurse is teaching a patient with coronary artery disease (CAD) about modifiable risk factors. Which
patient statement indicates that further teaching is needed?
A. I will work with my dietitian to keep my LDL cholesterol below 70 mg/dL.
B. I have set a quit date to stop smoking and enrolled in a nicotine replacement program.
C. Since my father had a heart attack at age 50, there is nothing I can do to lower my risk. **[CORRECT]**
D. I will walk 30 minutes most days of the week to improve my exercise tolerance.
Correct Answer: C
Rationale: Family history and age are non-modifiable risk factors, but the patient's belief that nothing can be done
reflects a misunderstanding; modifiable risks (smoking, hyperlipidemia, hypertension, obesity, sedentary lifestyle,
diabetes control) can be optimized to dramatically lower CAD progression and event rates. Statements about LDL
targets, smoking cessation, and exercise all reflect correct understanding of modifiable risk reduction per ATI and
AHA/ACC secondary prevention guidance.
ATI RN Capstone Med-Surg | NCJMM Integrated Page 4
ATI RN CAPSTONE
MEDICAL SURGICAL
ASSESSMENT
Proctored Exam
with Next Generation NCLEX (NGN) Integration
| Graded A+ |
150 Verified Questions with Comprehensive Clinical Rationales
Aligned to the 2026-2027 ATI RN Capstone Medical-Surgical
Assessment Blueprint
and the ATI Comprehensive Predictor Standards
NCJMM Clinical Judgment Measurement Model Integrated
ATI RN Capstone Med-Surg | NCJMM Integrated Page 1
,ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
EXAM BLUEPRINT OVERVIEW
Sectio
Content Domain Q Range #
n
Cardiovascular Disorders (CAD, MI, HF, Dysrhythmias, Valvular, HTN,
1 Q1-Q30 30
PVD)
2 Respiratory Disorders (COPD, Asthma, Pneumonia, PE, ARDS, TB) Q31-Q50 20
3 Gastrointestinal Disorders (GI Bleed, IBD, Liver, Pancreatitis, Biliary) Q51-Q65 15
4 Renal & Urinary Disorders (AKI, CKD, Dialysis, UTI, Glomerulonephritis) Q66-Q78 13
5 Endocrine Disorders (DM, Thyroid, Adrenal, SIADH/DI, Pituitary) Q79-Q95 17
6 Neurological Disorders (Stroke, Seizures, Parkinson's, TBI, MS) Q96-Q110 15
7 Musculoskeletal Disorders (Fractures, Arthritis, Osteoporosis) Q111-Q125 15
8 Hematological & Oncological Disorders (Anemia, Leukemia, Cancer Care) Q126-Q138 13
9 NGN Integrated Clinical Scenarios & Comprehensive Reasoning Q139-Q150 12
TOTAL 150
COGNITIVE LEVEL DISTRIBUTION (NCJMM)
Cognitive Level Target % Approx. # of Items
Recall / Knowledge 25% ~38 items
Application / Comprehension 55% ~82 items
Analysis / Clinical Judgment 20% ~30 items
EXAM INSTRUCTIONS
1. This examination consists of 150 multiple-choice items distributed across nine content domains aligned to the
2026-2027 ATI RN Capstone Medical-Surgical Assessment blueprint.
2. Each item presents four options (A-D). Select the single best answer. The correct response is marked
**[CORRECT]** and is followed by the rationale.
ATI RN Capstone Med-Surg | NCJMM Integrated Page 2
,ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
3. Rationales integrate pathophysiology, pharmacology, priority-setting frameworks (ABC, Maslow, Safety, Acute
vs. Chronic, Survival vs. Health), evidence-based practice, and ATI NCJMM clinical judgment standards.
4. Section 9 contains NGN Integrated Clinical Scenarios that require multi-step clinical reasoning across the six
NCJMM cognitive skills: Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action,
and Evaluate Outcomes.
5. Target completion time: 3 hours. Recommended pacing: approximately 1.2 minutes per item.
ATI RN Capstone Med-Surg | NCJMM Integrated Page 3
, ATI RN Capstone Medical-Surgical Assessment | 2026/2027 Proctored Exam (NGN) Graded A+ | 150 Questions
Section 1: Cardiovascular Disorders
CAD, Acute Coronary Syndrome, Heart Failure, Dysrhythmias, Valvular Disease, Hypertension,
and Peripheral Vascular Disease | Q1-Q30
Q1.
A 54-year-old male with a history of hyperlipidemia and tobacco use presents to the clinic reporting substernal
chest pain that occurs when walking uphill and is relieved by 5 minutes of rest. Which assessment finding
most strongly supports a diagnosis of stable angina rather than acute coronary syndrome (ACS)?
A. Chest pain that radiates to the left arm and jaw at rest
B. Pain that is predictable, occurs with the same level of exertion, and is relieved by rest or nitroglycerin
**[CORRECT]**
C. ST-segment elevation on a 12-lead ECG obtained during the episode
D. Elevated serum troponin I drawn 4 hours after the pain began
Correct Answer: B
Rationale: Stable angina is characterized by predictable chest discomfort that occurs at a consistent level of exertion
and is relieved by rest or nitroglycerin, reflecting fixed atherosclerotic obstruction without plaque rupture. Radiation
at rest, ST elevation, and troponin elevation all indicate ACS (unstable angina or MI) and would require emergent
reperfusion pathways rather than routine outpatient management.
Q2.
The nurse is teaching a patient with coronary artery disease (CAD) about modifiable risk factors. Which
patient statement indicates that further teaching is needed?
A. I will work with my dietitian to keep my LDL cholesterol below 70 mg/dL.
B. I have set a quit date to stop smoking and enrolled in a nicotine replacement program.
C. Since my father had a heart attack at age 50, there is nothing I can do to lower my risk. **[CORRECT]**
D. I will walk 30 minutes most days of the week to improve my exercise tolerance.
Correct Answer: C
Rationale: Family history and age are non-modifiable risk factors, but the patient's belief that nothing can be done
reflects a misunderstanding; modifiable risks (smoking, hyperlipidemia, hypertension, obesity, sedentary lifestyle,
diabetes control) can be optimized to dramatically lower CAD progression and event rates. Statements about LDL
targets, smoking cessation, and exercise all reflect correct understanding of modifiable risk reduction per ATI and
AHA/ACC secondary prevention guidance.
ATI RN Capstone Med-Surg | NCJMM Integrated Page 4
