Nursing Capstone Comprehensive Exam – 200 Complete
Questions and Answers with Rationales 2026/2027
Latest Update
This comprehensive examination is designed to help nursing students review the major
competencies expected near the end of a prelicensure nursing program. The questions
emphasize clinical judgment, prioritization, safety, assessment, pharmacology, medical-
surgical nursing, maternal-newborn care, pediatrics, mental health, leadership, delegation,
infection prevention, and patient education.
1. A nurse is caring for a client who reports sudden shortness of
breath and chest pain. Which action should the nurse take first?
A. Obtain a complete health history
B. Assess oxygen saturation and respiratory status
C. Ask the client to rate the pain
D. Notify the health care provider
Answer: B
Rationale: Airway and breathing are immediate priorities. Assessing
respiratory status and oxygenation helps determine the severity of the
client's condition before additional interventions.
2. Which finding requires the nurse's immediate attention?
A. Temperature of 37.4°C (99.3°F)
B. Heart rate of 88/min
C. Respiratory rate of 8/min
D. Blood pressure of 128/76 mm Hg
Answer: C
,Rationale: A respiratory rate of 8/min indicates significant respiratory
depression and threatens adequate ventilation. This requires
immediate assessment and intervention.
3. A client receiving IV potassium chloride reports burning at the IV
site. What should the nurse do first?
A. Increase the infusion rate
B. Apply a warm compress
C. Stop the infusion and assess the IV site
D. Flush the catheter rapidly
Answer: C
Rationale: IV potassium is irritating and can cause tissue injury if
extravasation occurs. The infusion should be stopped while the IV site is
assessed.
4. Which client should the nurse assess first?
A. Client with chronic arthritis reporting pain of 6/10
B. Client with pneumonia and new confusion
C. Client requesting assistance with bathing
D. Client awaiting discharge instructions
Answer: B
Rationale: New confusion in a client with pneumonia may indicate
hypoxemia, sepsis, or worsening respiratory status. Acute changes in
neurologic status require prompt assessment.
,5. A nurse is teaching a client about incentive spirometry. Which
instruction is correct?
A. "Blow forcefully into the device."
B. "Use the device once every 4 hours."
C. "Inhale slowly and deeply through the mouthpiece."
D. "Use the device only when you feel short of breath."
Answer: C
Rationale: Incentive spirometry promotes alveolar expansion through
slow, sustained inhalation and helps prevent postoperative atelectasis.
6. Which intervention best reduces the risk of pressure injury in an
immobile client?
A. Massage reddened areas
B. Reposition the client regularly
C. Restrict fluid intake
D. Keep the head of bed elevated continuously
Answer: B
Rationale: Regular repositioning relieves prolonged pressure and
promotes tissue perfusion. Reddened areas should not be massaged
because tissue damage may worsen.
7. A nurse enters a client's room and finds the client on the floor.
What is the nurse's priority?
A. Complete an incident report
B. Move the client back into bed
, C. Assess the client for injury
D. Notify the client's family
Answer: C
Rationale: The nurse must first determine whether the client sustained
injury. The client should not be moved unnecessarily until injury is
assessed.
8. Which assessment finding is most concerning in a client with heart
failure?
A. Mild ankle edema
B. Weight gain of 0.5 kg over one week
C. Crackles and increasing dyspnea
D. Fatigue after activity
Answer: C
Rationale: Crackles and increasing dyspnea may indicate pulmonary
congestion and worsening heart failure.
9. A client taking furosemide is at greatest risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion and can cause hypokalemia.
Questions and Answers with Rationales 2026/2027
Latest Update
This comprehensive examination is designed to help nursing students review the major
competencies expected near the end of a prelicensure nursing program. The questions
emphasize clinical judgment, prioritization, safety, assessment, pharmacology, medical-
surgical nursing, maternal-newborn care, pediatrics, mental health, leadership, delegation,
infection prevention, and patient education.
1. A nurse is caring for a client who reports sudden shortness of
breath and chest pain. Which action should the nurse take first?
A. Obtain a complete health history
B. Assess oxygen saturation and respiratory status
C. Ask the client to rate the pain
D. Notify the health care provider
Answer: B
Rationale: Airway and breathing are immediate priorities. Assessing
respiratory status and oxygenation helps determine the severity of the
client's condition before additional interventions.
2. Which finding requires the nurse's immediate attention?
A. Temperature of 37.4°C (99.3°F)
B. Heart rate of 88/min
C. Respiratory rate of 8/min
D. Blood pressure of 128/76 mm Hg
Answer: C
,Rationale: A respiratory rate of 8/min indicates significant respiratory
depression and threatens adequate ventilation. This requires
immediate assessment and intervention.
3. A client receiving IV potassium chloride reports burning at the IV
site. What should the nurse do first?
A. Increase the infusion rate
B. Apply a warm compress
C. Stop the infusion and assess the IV site
D. Flush the catheter rapidly
Answer: C
Rationale: IV potassium is irritating and can cause tissue injury if
extravasation occurs. The infusion should be stopped while the IV site is
assessed.
4. Which client should the nurse assess first?
A. Client with chronic arthritis reporting pain of 6/10
B. Client with pneumonia and new confusion
C. Client requesting assistance with bathing
D. Client awaiting discharge instructions
Answer: B
Rationale: New confusion in a client with pneumonia may indicate
hypoxemia, sepsis, or worsening respiratory status. Acute changes in
neurologic status require prompt assessment.
,5. A nurse is teaching a client about incentive spirometry. Which
instruction is correct?
A. "Blow forcefully into the device."
B. "Use the device once every 4 hours."
C. "Inhale slowly and deeply through the mouthpiece."
D. "Use the device only when you feel short of breath."
Answer: C
Rationale: Incentive spirometry promotes alveolar expansion through
slow, sustained inhalation and helps prevent postoperative atelectasis.
6. Which intervention best reduces the risk of pressure injury in an
immobile client?
A. Massage reddened areas
B. Reposition the client regularly
C. Restrict fluid intake
D. Keep the head of bed elevated continuously
Answer: B
Rationale: Regular repositioning relieves prolonged pressure and
promotes tissue perfusion. Reddened areas should not be massaged
because tissue damage may worsen.
7. A nurse enters a client's room and finds the client on the floor.
What is the nurse's priority?
A. Complete an incident report
B. Move the client back into bed
, C. Assess the client for injury
D. Notify the client's family
Answer: C
Rationale: The nurse must first determine whether the client sustained
injury. The client should not be moved unnecessarily until injury is
assessed.
8. Which assessment finding is most concerning in a client with heart
failure?
A. Mild ankle edema
B. Weight gain of 0.5 kg over one week
C. Crackles and increasing dyspnea
D. Fatigue after activity
Answer: C
Rationale: Crackles and increasing dyspnea may indicate pulmonary
congestion and worsening heart failure.
9. A client taking furosemide is at greatest risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion and can cause hypokalemia.
