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NR452 CAPSTONE COURSE PRACTICE EXAM
2026 QUESTIONS LATEST VERSION QUESTIONS
AND ANSWERS
NR452 CAPSTONE COURSE PRACTICE EXAM (250 Questions with Detailed
Rationales)
Category 1: Safe and Effective Care Environment (Questions 1-25)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client scheduled for discharge teaching after heart failure education.
B. A client with COPD reporting mild shortness of breath after walking.
C. A client with chest pain rated 8/10 and diaphoresis.
D. A client requesting pain medication for chronic back pain.
Answer: C. Prioritize Hypotheses: The priority is suspected acute coronary syndrome. Using
ABCs and acute instability, chest pain with diaphoresis indicates possible myocardial
infarction requiring immediate intervention.
2. A new graduate nurse is assigned a complex patient load. Which action by the charge
nurse is most appropriate?
A. Assign high-acuity clients immediately.
B. Provide assignments equal to experienced nurses.
C. Match client acuity with nurse competency level.
D. Allow the nurse to choose their own assignment.
Answer: C. Generate Solutions: Effective delegation and staffing require matching acuity
with skill level to ensure patient safety.
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3. A client refuses medication. What is the nurse's first action?
A. Document refusal.
B. Notify provider immediately.
C. Assess the reason for refusal.
D. Educate the client again.
Answer: C. Recognize Cues: The first step is assessment, identifying the reason before
further intervention or escalation.
4. Which intervention best reduces hospital-acquired infections?
A. Wearing gloves for all patient contact.
B. Hand hygiene before and after patient contact.
C. Administering prophylactic antibiotics.
D. Using sterile technique for all procedures.
Answer: B. Generate Solutions: Hand hygiene is the single most effective method to prevent
healthcare-associated infections (HAIs).
5. A client post-op is at highest risk for which complication?
A. Hypoglycemia.
B. Deep vein thrombosis.
C. Cataracts.
D. Hyperthyroidism.
Answer: B. Analyze Cues: Postoperative clients are at risk for venous stasis and immobility
complications such as DVT.
6. The nurse is delegating tasks to a UAP. Which task is appropriate?
A. Assess pain level.
B. Evaluate wound healing.
C. Obtain vital signs on a stable patient.
D. Administer oral medication.
Answer: C. Generate Solutions: Obtaining vital signs on a stable patient is within the scope
of UAP. Assessment, evaluation, and medication administration require nursing judgment.
7. A nurse should question which prescription?
A. Morphine for pain.
B. Furosemide for edema.
C. Potassium IV push.
D. Oxygen therapy.
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Answer: C. Analyze Cues: IV potassium can cause fatal cardiac dysrhythmias and must be
diluted and infused properly.
8. What is the priority in disaster triage?
A. Treat minor injuries first.
B. Treat most critically ill first regardless of survival.
C. Treat those with highest survival chance first.
D. Treat last arrived first.
Answer: C. Prioritize Hypotheses: Disaster triage prioritizes those with the highest chance of
survival to maximize use of limited resources.
9. A nurse finds a client on the floor. Which action should be performed first?
A. Move the client to bed.
B. Call the provider.
C. Assess for injury.
D. Notify the family.
Answer: C. Recognize Cues: The nurse's first priority after a fall is to assess for injury before
taking further action. Movement should not occur until injuries are identified.
10. Which finding requires immediate intervention in a post-operative client?
A. Urine output of 35 mL/hr.
B. Pain rated at 8/10.
C. Respiratory rate of 8 breaths/min.
D. Blood pressure of 138/84 mmHg.
Answer: C. Prioritize Hypotheses: A respiratory rate below 12 breaths/min can indicate
opioid-induced respiratory depression, which is life-threatening.
11. A nurse receives a client from the PACU who is difficult to arouse and has shallow
respirations. Which action is the priority?
A. Apply warm blankets.
B. Increase IV fluids.
C. Stimulate and support airway.
D. Notify the surgeon.
Answer: C. Take Actions: Airway is life-or-death. If you don't fix breathing first, nothing
else matters.
12. A nurse finds a UAP transferring a high-fall-risk client without assistance. What is
the best initial action?
A. Document the event.
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B. Reassign the task.
C. Stop the transfer immediately.
D. Notify the charge nurse.
Answer: C. Take Actions: Safety first. Fix the dangerous situation before dealing with the
personnel issue.
13. A nurse is preparing to care for a client diagnosed with pulmonary tuberculosis
(TB). Which PPE must the nurse don before entering the room?
A. Surgical mask and gloves.
B. N95 respirator mask and gloves.
C. Gown, gloves, and face shield.
D. Gown and surgical mask.
Answer: B. Generate Solutions: TB is transmitted via airborne droplet nuclei, requiring an
N95 respirator.
14. A client is on a mechanical ventilator. The high-pressure alarm sounds. What is the
nurse's priority action?
A. Silence the alarm.
B. Increase the oxygen flow rate.
C. Assess the client and suction if needed.
D. Check the ventilator settings.
Answer: C. Take Actions: A high-pressure alarm typically indicates increased airway
resistance. The nurse must assess the client first.
15. The charge nurse is making assignments for the day shift. Which task is appropriate
to delegate to UAP?
A. Evaluating the client's response to pain medication.
B. Reinforcing teaching about a low-sodium diet.
C. Assisting a client with a continuous tube feeding to ambulate.
D. Assessing a client's surgical wound.
Answer: C. Generate Solutions: Assisting with ambulation is within UAP scope. Evaluation,
teaching, and assessment require nursing judgment.
16. A nurse is caring for a client with a new tracheostomy. Which piece of equipment
should be kept at the bedside at all times?
A. An Ambu bag and a suction catheter.
B. An obturator and a spare tracheostomy tube.
C. A sterile tracheostomy dressing.
NR452 CAPSTONE COURSE PRACTICE EXAM
2026 QUESTIONS LATEST VERSION QUESTIONS
AND ANSWERS
NR452 CAPSTONE COURSE PRACTICE EXAM (250 Questions with Detailed
Rationales)
Category 1: Safe and Effective Care Environment (Questions 1-25)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client scheduled for discharge teaching after heart failure education.
B. A client with COPD reporting mild shortness of breath after walking.
C. A client with chest pain rated 8/10 and diaphoresis.
D. A client requesting pain medication for chronic back pain.
Answer: C. Prioritize Hypotheses: The priority is suspected acute coronary syndrome. Using
ABCs and acute instability, chest pain with diaphoresis indicates possible myocardial
infarction requiring immediate intervention.
2. A new graduate nurse is assigned a complex patient load. Which action by the charge
nurse is most appropriate?
A. Assign high-acuity clients immediately.
B. Provide assignments equal to experienced nurses.
C. Match client acuity with nurse competency level.
D. Allow the nurse to choose their own assignment.
Answer: C. Generate Solutions: Effective delegation and staffing require matching acuity
with skill level to ensure patient safety.
, Page 2 of 56
3. A client refuses medication. What is the nurse's first action?
A. Document refusal.
B. Notify provider immediately.
C. Assess the reason for refusal.
D. Educate the client again.
Answer: C. Recognize Cues: The first step is assessment, identifying the reason before
further intervention or escalation.
4. Which intervention best reduces hospital-acquired infections?
A. Wearing gloves for all patient contact.
B. Hand hygiene before and after patient contact.
C. Administering prophylactic antibiotics.
D. Using sterile technique for all procedures.
Answer: B. Generate Solutions: Hand hygiene is the single most effective method to prevent
healthcare-associated infections (HAIs).
5. A client post-op is at highest risk for which complication?
A. Hypoglycemia.
B. Deep vein thrombosis.
C. Cataracts.
D. Hyperthyroidism.
Answer: B. Analyze Cues: Postoperative clients are at risk for venous stasis and immobility
complications such as DVT.
6. The nurse is delegating tasks to a UAP. Which task is appropriate?
A. Assess pain level.
B. Evaluate wound healing.
C. Obtain vital signs on a stable patient.
D. Administer oral medication.
Answer: C. Generate Solutions: Obtaining vital signs on a stable patient is within the scope
of UAP. Assessment, evaluation, and medication administration require nursing judgment.
7. A nurse should question which prescription?
A. Morphine for pain.
B. Furosemide for edema.
C. Potassium IV push.
D. Oxygen therapy.
, Page 3 of 56
Answer: C. Analyze Cues: IV potassium can cause fatal cardiac dysrhythmias and must be
diluted and infused properly.
8. What is the priority in disaster triage?
A. Treat minor injuries first.
B. Treat most critically ill first regardless of survival.
C. Treat those with highest survival chance first.
D. Treat last arrived first.
Answer: C. Prioritize Hypotheses: Disaster triage prioritizes those with the highest chance of
survival to maximize use of limited resources.
9. A nurse finds a client on the floor. Which action should be performed first?
A. Move the client to bed.
B. Call the provider.
C. Assess for injury.
D. Notify the family.
Answer: C. Recognize Cues: The nurse's first priority after a fall is to assess for injury before
taking further action. Movement should not occur until injuries are identified.
10. Which finding requires immediate intervention in a post-operative client?
A. Urine output of 35 mL/hr.
B. Pain rated at 8/10.
C. Respiratory rate of 8 breaths/min.
D. Blood pressure of 138/84 mmHg.
Answer: C. Prioritize Hypotheses: A respiratory rate below 12 breaths/min can indicate
opioid-induced respiratory depression, which is life-threatening.
11. A nurse receives a client from the PACU who is difficult to arouse and has shallow
respirations. Which action is the priority?
A. Apply warm blankets.
B. Increase IV fluids.
C. Stimulate and support airway.
D. Notify the surgeon.
Answer: C. Take Actions: Airway is life-or-death. If you don't fix breathing first, nothing
else matters.
12. A nurse finds a UAP transferring a high-fall-risk client without assistance. What is
the best initial action?
A. Document the event.
, Page 4 of 56
B. Reassign the task.
C. Stop the transfer immediately.
D. Notify the charge nurse.
Answer: C. Take Actions: Safety first. Fix the dangerous situation before dealing with the
personnel issue.
13. A nurse is preparing to care for a client diagnosed with pulmonary tuberculosis
(TB). Which PPE must the nurse don before entering the room?
A. Surgical mask and gloves.
B. N95 respirator mask and gloves.
C. Gown, gloves, and face shield.
D. Gown and surgical mask.
Answer: B. Generate Solutions: TB is transmitted via airborne droplet nuclei, requiring an
N95 respirator.
14. A client is on a mechanical ventilator. The high-pressure alarm sounds. What is the
nurse's priority action?
A. Silence the alarm.
B. Increase the oxygen flow rate.
C. Assess the client and suction if needed.
D. Check the ventilator settings.
Answer: C. Take Actions: A high-pressure alarm typically indicates increased airway
resistance. The nurse must assess the client first.
15. The charge nurse is making assignments for the day shift. Which task is appropriate
to delegate to UAP?
A. Evaluating the client's response to pain medication.
B. Reinforcing teaching about a low-sodium diet.
C. Assisting a client with a continuous tube feeding to ambulate.
D. Assessing a client's surgical wound.
Answer: C. Generate Solutions: Assisting with ambulation is within UAP scope. Evaluation,
teaching, and assessment require nursing judgment.
16. A nurse is caring for a client with a new tracheostomy. Which piece of equipment
should be kept at the bedside at all times?
A. An Ambu bag and a suction catheter.
B. An obturator and a spare tracheostomy tube.
C. A sterile tracheostomy dressing.
