ATI CARE OF CHILDREN & CAPSTONE ASSESSMENT 2026-2027 COMPREHENSIVE EXAM UPDATE
ATI CARE OF CHILDREN & CAPSTONE
ASSESSMENT
2026-2027 Comprehensive Exam Update
Exam Blueprint Overview: This comprehensive test bank is fully grounded in the official course materials and
proctored examination blueprints. It is designed to evaluate core competencies in pediatric and adult capstone
nursing. The questions cover pediatric growth and development, high-risk maternity triage, infection control, fluid and
electrolyte management, oncology, and psychiatric nursing interventions. Students should use this resource to
reinforce clinical reasoning, master nursing terminology, and identify key client safety protocols.
QUESTION 1
A nurse is teaching the parent of a school-age child who has asthma about a new prescription for montelukast.
Which of the following instructions should the nurse include in the teaching?
A. Administer the medication on a regular basis, once daily in the evening.
B. Give the medication as a PRN rescue therapy for acute wheezing.
C. Use the medication 30 minutes prior to exercise to prevent bronchospasm.
D. Discontinue the medication once the child's symptoms improve.
ANSWER : A — Administer the medication on a regular basis, once daily in the evening.
Explanation: Montelukast is a leukotriene modifier taken on a regular, daily basis, once a day in the evening. It is not
used as a PRN rescue medication for acute asthma attacks, nor is it indicated for acute exercise-induced asthma
when immediate bronchodilation is required. It is a long-term control medication that must be taken consistently even
when the child is asymptomatic.
QUESTION 2
A nurse is monitoring a client who is undergoing hemodialysis. Which of the following complications represents
the greatest acute risk to the client during this procedure?
A. Transient elevation in body temperature
B. Gradual weight loss over successive sessions
C. Disequilibrium syndrome due to rapid fluid and solute shifts
D. Mild decrease in systemic blood pressure
ANSWER : C — Disequilibrium syndrome due to rapid fluid and solute shifts
Explanation: The greatest acute risk to a client receiving hemodialysis is disequilibrium syndrome, which occurs as a
result of a rapid loss of fluids and a decrease in blood urea nitrogen (BUN) levels. This rapid shift can cause cerebral
edema and increased intracranial pressure. Transient elevated temperature, weight loss, and decreased blood
pressure are common expected findings during hemodialysis, making disequilibrium syndrome the highest priority
and greatest risk.
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,ATI CARE OF CHILDREN & CAPSTONE ASSESSMENT 2026-2027 COMPREHENSIVE EXAM UPDATE
QUESTION 3
A nurse is assessing a client undergoing hemodialysis. Which of the following clinical manifestations should the
nurse identify as an indication of disequilibrium syndrome?
A. Restlessness and a decreased level of consciousness
B. High-pitched, irregular bowel sounds in all quadrants
C. Bounding peripheral pulses and systemic hypertension
D. Severe lower back pain and severe chills
ANSWER : A — Restlessness and a decreased level of consciousness
Explanation: Disequilibrium syndrome manifests neurologically due to rapid solute removal from the blood, causing
fluid to shift into brain cells. Classic clinical manifestations include restlessness and a decreased level of
consciousness (LOC). High-pitched bowel sounds indicate hyperactive peristalsis. Bounding pulses/hypertension
indicate circulatory overload. Lower back pain indicates a hemolytic transfusion reaction, and chills indicate a febrile
transfusion reaction.
QUESTION 4
A nurse is discussing end-of-life care with a client who asks about advance directives. Which of the following
information should the nurse provide?
A. They are verbal agreements witnessed by two healthcare providers.
B. They contain written instructions regarding end-of-life care.
C. They are legally binding only if a patient is diagnosed with an acute illness.
D. They must be updated annually to remain valid in the medical record.
ANSWER : B — They contain written instructions regarding end-of-life care.
Explanation: Advance directives contain written instructions regarding end-of-life care, allowing clients to specify
their medical preferences in advance of losing the capacity to make decisions. They are not verbal agreements, do
not require an active acute illness to be legally binding, and do not expire or require annual updates to remain valid.
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, ATI CARE OF CHILDREN & CAPSTONE ASSESSMENT 2026-2027 COMPREHENSIVE EXAM UPDATE
QUESTION 5
A client who is ambulatory reports feeling lightheaded and begins to fall while walking with the nurse. Which of
the following actions should the nurse take immediately?
A. Place both arms around the client's waist and pull them backward.
B. Encourage the client to stand straight and hold on to the nearest wall.
C. Spread feet apart and extend one leg for the client to slide down while lowering them to the floor.
D. Call for assistance and hold the client in an upright position until help arrives.
ANSWER : C — Spread feet apart and extend one leg for the client to slide down while lowering them to the
floor.
Explanation: When an ambulatory client begins to fall, the nurse should spread their feet apart to establish a wide
base of support and extend one leg, allowing the client to slide down the nurse's leg while lowering them slowly to the
floor. This technique minimizes the risk of injury to both the client and the nurse. Pulling the client backward or
attempting to hold them upright can lead to loss of balance and muscle strain for the nurse.
QUESTION 6
A nurse is assessing a client who has dependent personality disorder. Which of the following characteristics
should the nurse expect?
A. Splitting behavior, placing others in strictly 'good' or 'bad' categories.
B. Problems making everyday decisions without input from others.
C. Persistent obsessive behaviors and ritualistic physical habits.
D. Frequent outbursts of physical violence and verbal aggression.
ANSWER : B — Problems making everyday decisions without input from others.
Explanation: Clients with dependent personality disorder exhibit a pervasive and excessive need to be taken care of,
leading to submissive and clinging behaviors. They typically have significant problems making everyday decisions
without an excessive amount of advice and reassurance from others. Splitting behavior is associated with borderline
personality disorder. Obsessive behaviors indicate anxiety disorders, and a history of violence is a separate
behavioral concern.
Page 3
ATI CARE OF CHILDREN & CAPSTONE
ASSESSMENT
2026-2027 Comprehensive Exam Update
Exam Blueprint Overview: This comprehensive test bank is fully grounded in the official course materials and
proctored examination blueprints. It is designed to evaluate core competencies in pediatric and adult capstone
nursing. The questions cover pediatric growth and development, high-risk maternity triage, infection control, fluid and
electrolyte management, oncology, and psychiatric nursing interventions. Students should use this resource to
reinforce clinical reasoning, master nursing terminology, and identify key client safety protocols.
QUESTION 1
A nurse is teaching the parent of a school-age child who has asthma about a new prescription for montelukast.
Which of the following instructions should the nurse include in the teaching?
A. Administer the medication on a regular basis, once daily in the evening.
B. Give the medication as a PRN rescue therapy for acute wheezing.
C. Use the medication 30 minutes prior to exercise to prevent bronchospasm.
D. Discontinue the medication once the child's symptoms improve.
ANSWER : A — Administer the medication on a regular basis, once daily in the evening.
Explanation: Montelukast is a leukotriene modifier taken on a regular, daily basis, once a day in the evening. It is not
used as a PRN rescue medication for acute asthma attacks, nor is it indicated for acute exercise-induced asthma
when immediate bronchodilation is required. It is a long-term control medication that must be taken consistently even
when the child is asymptomatic.
QUESTION 2
A nurse is monitoring a client who is undergoing hemodialysis. Which of the following complications represents
the greatest acute risk to the client during this procedure?
A. Transient elevation in body temperature
B. Gradual weight loss over successive sessions
C. Disequilibrium syndrome due to rapid fluid and solute shifts
D. Mild decrease in systemic blood pressure
ANSWER : C — Disequilibrium syndrome due to rapid fluid and solute shifts
Explanation: The greatest acute risk to a client receiving hemodialysis is disequilibrium syndrome, which occurs as a
result of a rapid loss of fluids and a decrease in blood urea nitrogen (BUN) levels. This rapid shift can cause cerebral
edema and increased intracranial pressure. Transient elevated temperature, weight loss, and decreased blood
pressure are common expected findings during hemodialysis, making disequilibrium syndrome the highest priority
and greatest risk.
Page 1
,ATI CARE OF CHILDREN & CAPSTONE ASSESSMENT 2026-2027 COMPREHENSIVE EXAM UPDATE
QUESTION 3
A nurse is assessing a client undergoing hemodialysis. Which of the following clinical manifestations should the
nurse identify as an indication of disequilibrium syndrome?
A. Restlessness and a decreased level of consciousness
B. High-pitched, irregular bowel sounds in all quadrants
C. Bounding peripheral pulses and systemic hypertension
D. Severe lower back pain and severe chills
ANSWER : A — Restlessness and a decreased level of consciousness
Explanation: Disequilibrium syndrome manifests neurologically due to rapid solute removal from the blood, causing
fluid to shift into brain cells. Classic clinical manifestations include restlessness and a decreased level of
consciousness (LOC). High-pitched bowel sounds indicate hyperactive peristalsis. Bounding pulses/hypertension
indicate circulatory overload. Lower back pain indicates a hemolytic transfusion reaction, and chills indicate a febrile
transfusion reaction.
QUESTION 4
A nurse is discussing end-of-life care with a client who asks about advance directives. Which of the following
information should the nurse provide?
A. They are verbal agreements witnessed by two healthcare providers.
B. They contain written instructions regarding end-of-life care.
C. They are legally binding only if a patient is diagnosed with an acute illness.
D. They must be updated annually to remain valid in the medical record.
ANSWER : B — They contain written instructions regarding end-of-life care.
Explanation: Advance directives contain written instructions regarding end-of-life care, allowing clients to specify
their medical preferences in advance of losing the capacity to make decisions. They are not verbal agreements, do
not require an active acute illness to be legally binding, and do not expire or require annual updates to remain valid.
Page 2
, ATI CARE OF CHILDREN & CAPSTONE ASSESSMENT 2026-2027 COMPREHENSIVE EXAM UPDATE
QUESTION 5
A client who is ambulatory reports feeling lightheaded and begins to fall while walking with the nurse. Which of
the following actions should the nurse take immediately?
A. Place both arms around the client's waist and pull them backward.
B. Encourage the client to stand straight and hold on to the nearest wall.
C. Spread feet apart and extend one leg for the client to slide down while lowering them to the floor.
D. Call for assistance and hold the client in an upright position until help arrives.
ANSWER : C — Spread feet apart and extend one leg for the client to slide down while lowering them to the
floor.
Explanation: When an ambulatory client begins to fall, the nurse should spread their feet apart to establish a wide
base of support and extend one leg, allowing the client to slide down the nurse's leg while lowering them slowly to the
floor. This technique minimizes the risk of injury to both the client and the nurse. Pulling the client backward or
attempting to hold them upright can lead to loss of balance and muscle strain for the nurse.
QUESTION 6
A nurse is assessing a client who has dependent personality disorder. Which of the following characteristics
should the nurse expect?
A. Splitting behavior, placing others in strictly 'good' or 'bad' categories.
B. Problems making everyday decisions without input from others.
C. Persistent obsessive behaviors and ritualistic physical habits.
D. Frequent outbursts of physical violence and verbal aggression.
ANSWER : B — Problems making everyday decisions without input from others.
Explanation: Clients with dependent personality disorder exhibit a pervasive and excessive need to be taken care of,
leading to submissive and clinging behaviors. They typically have significant problems making everyday decisions
without an excessive amount of advice and reassurance from others. Splitting behavior is associated with borderline
personality disorder. Obsessive behaviors indicate anxiety disorders, and a history of violence is a separate
behavioral concern.
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