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RN ATI CAPSTONE COMPREHENSIVE ASSESSMENT A
2026/2027 | Practice Q&A + Rationales | Exam
A client with chronic kidney disease is scheduled for hemodialysis. Which of the following
medications should the nurse withhold on the morning of dialysis?
A) Epoetin alfa
B) Calcium acetate
C) Digoxin
D) Iron sucrose
Answer: C) Digoxin
Rationale: Digoxin is withheld prior to dialysis because the procedure can alter electrolyte
levels, particularly potassium, which increases the risk of digoxin toxicity. Hypotension during
dialysis also increases the risk of toxicity. Epoetin alfa (A) is often given after dialysis due to the
destruction of RBCs. Calcium acetate (B) and iron sucrose (D) are typically administered after
dialysis to replace losses.
A nurse is providing discharge teaching to a client who has a new prescription for warfarin.
Which of the following statements indicates an understanding of the teaching?
A) "I will take ibuprofen for my headaches."
B) "I will avoid eating large amounts of leafy green vegetables."
C) "I will use a straight razor to shave."
D) "I will check my INR levels weekly."
Answer: B) "I will avoid eating large amounts of leafy green vegetables."
Rationale: Warfarin is a vitamin K antagonist. Leafy green vegetables are high in vitamin K and
can decrease the effectiveness of the drug. Clients should maintain a consistent intake of
vitamin K. Ibuprofen (A) increases bleeding risk. An electric razor (C) should be used instead of a
straight razor to prevent cuts. INR is monitored regularly but not necessarily weekly at home
unless directed.
A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the
following findings is the priority for the nurse to report to the provider?
A) Hoarseness
B) Tingling around the mouth
C) Pain in the incision site
,2
D) Temperature of 99.2°F (37.3°C)
Answer: B) Tingling around the mouth
Rationale: Tingling around the mouth is a sign of hypocalcemia, which can occur if the
parathyroid glands are accidentally removed or damaged during surgery. This can lead to life-
threatening laryngeal stridor and seizures, making it the priority. Hoarseness (A) may indicate
laryngeal nerve damage but is less urgent. Incision pain (C) is expected. Low-grade fever (D) is
common postoperatively.
A nurse is preparing to administer a blood transfusion to a client. Which of the following actions
should the nurse take first?
A) Verify the client's identity using two identifiers.
B) Assess the client's vital signs.
C) Obtain the unit of blood from the blood bank.
D) Start an IV line with normal saline.
Answer: A) Verify the client's identity using two identifiers.
Rationale: The first priority is to verify the client's identity to ensure the correct blood is given
to the correct client, preventing a fatal hemolytic reaction. While vital signs (B), obtaining blood
(C), and starting an IV (D) are important steps, they occur after verification.
A client with heart failure is prescribed furosemide. Which of the following findings indicates a
therapeutic response to the medication?
A) Decreased blood pressure
B) Weight loss of 2 kg in 24 hours
C) Heart rate of 110/min
D) Crackles in the lung bases
Answer: B) Weight loss of 2 kg in 24 hours
Rationale: Furosemide is a loop diuretic used to reduce fluid volume overload. A weight loss of
2 kg (4.4 lbs) in 24 hours indicates effective diuresis and reduction of edema. Decreased blood
pressure (A) can be an adverse effect. Tachycardia (C) and crackles (D) indicate worsening heart
failure and fluid overload.
A nurse is caring for a client who has a nasogastric tube attached to low intermittent suction.
Which of the following findings indicates that the tube is correctly placed?
A) The client's abdomen is firm and distended.
B) The pH of the gastric aspirate is 4.
C) The nurse auscultates an air rush over the epigastrium.
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D) The client reports nausea.
Answer: B) The pH of the gastric aspirate is 4.
Rationale: Gastric aspirate with a pH between 1 and 5 confirms placement in the stomach. A
firm, distended abdomen (A) or nausea (D) could indicate a blockage. Auscultating an air rush
(C) is no longer recommended as the primary method to confirm placement because it can be
inaccurate.
A nurse is providing teaching to a client who is starting on insulin therapy. Which of the
following instructions should the nurse include for managing hypoglycemia?
A) Administer glucagon subcutaneously.
B) Consume 15 grams of a fast-acting carbohydrate.
C) Eat a meal high in protein and fat.
D) Skip the next dose of insulin.
Answer: B) Consume 15 grams of a fast-acting carbohydrate.
Rationale: The treatment for hypoglycemia is to consume 15 grams of a fast-acting
carbohydrate (e.g., glucose tablets, juice, or soda) and recheck blood glucose in 15 minutes.
Glucagon (A) is for severe hypoglycemia when the client is unconscious. Protein and fat (C) do
not raise blood glucose quickly. Skipping insulin (D) is incorrect.
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of
the following findings should the nurse expect?
A) Clubbing of the fingers
B) Barrel-shaped chest
C) Pursed-lip breathing
D) All of the above
Answer: D) All of the above
Rationale: Chronic hypoxia leads to clubbing of the fingers (A). Hyperinflation of the lungs
causes a barrel-shaped chest (B). Pursed-lip breathing (C) is a compensatory mechanism to keep
airways open and improve gas exchange. All are classic findings in COPD.
A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. Which of the following
instructions should the nurse include in the teaching?
A) Take the medication with an antacid to prevent upset stomach.
B) Avoid taking the medication with dairy products.
C) Expect the urine to turn orange.
D) Take the medication only when symptoms are present.
Answer: B) Avoid taking the medication with dairy products.
Rationale: Ciprofloxacin binds with calcium in dairy products, reducing its absorption. It should
be taken 2 hours before or 6 hours after consuming dairy. Antacids (A) also interfere with
, 4
absorption. Orange urine (C) is a side effect of rifampin, not ciprofloxacin. The medication must
be taken as prescribed, not only when symptoms are present.
A nurse is caring for a client who is 2 hours postoperative following a femoral-popliteal bypass
graft. Which of the following assessments is the priority?
A) Pain level
B) Capillary refill time
C) Urine output
D) Incision site
Answer: B) Capillary refill time
Rationale: The priority assessment is to monitor perfusion of the affected extremity. Prolonged
capillary refill time indicates compromised blood flow to the graft and possible occlusion, which
is a surgical emergency. Pain (A), urine output (C), and incision site (D) are important but
secondary to evaluating immediate graft patency.
A nurse is planning care for a client with a new diagnosis of diabetes mellitus. Which of the
following interventions should the nurse include to prevent foot complications?
A) Soak feet in warm water daily.
B) Wear shoes that are 1 size larger than usual.
C) Trim toenails straight across.
D) Apply lotion between the toes.
Answer: C) Trim toenails straight across.
Rationale: Toenails should be trimmed straight across to prevent ingrown toenails and skin
breakdown. Soaking feet (A) can dry out skin. Shoes should fit properly, not larger (B). Lotion
should not be applied between the toes (D) as it can cause fungal infections.
A nurse is evaluating a client who is 1 day postoperative after a total hip arthroplasty. Which of
the following actions is correct to prevent hip dislocation?
A) Adduct the affected leg.
B) Flex the hip beyond 90 degrees.
C) Place a pillow between the legs when lying on the side.
D) Cross the legs at the ankles.
Answer: C) Place a pillow between the legs when lying on the side.
Rationale: A pillow between the legs maintains the hip in abduction, preventing dislocation.
Adduction (A), flexion beyond 90 degrees (B), and crossing the legs (D) are all contraindicated
and can cause dislocation.
A nurse is performing a focused assessment on a client who reports chest pain. Which of the
following findings should the nurse report to the provider immediately?
A) Pain that is relieved by rest.
B) Pain that radiates to the left arm.
RN ATI CAPSTONE COMPREHENSIVE ASSESSMENT A
2026/2027 | Practice Q&A + Rationales | Exam
A client with chronic kidney disease is scheduled for hemodialysis. Which of the following
medications should the nurse withhold on the morning of dialysis?
A) Epoetin alfa
B) Calcium acetate
C) Digoxin
D) Iron sucrose
Answer: C) Digoxin
Rationale: Digoxin is withheld prior to dialysis because the procedure can alter electrolyte
levels, particularly potassium, which increases the risk of digoxin toxicity. Hypotension during
dialysis also increases the risk of toxicity. Epoetin alfa (A) is often given after dialysis due to the
destruction of RBCs. Calcium acetate (B) and iron sucrose (D) are typically administered after
dialysis to replace losses.
A nurse is providing discharge teaching to a client who has a new prescription for warfarin.
Which of the following statements indicates an understanding of the teaching?
A) "I will take ibuprofen for my headaches."
B) "I will avoid eating large amounts of leafy green vegetables."
C) "I will use a straight razor to shave."
D) "I will check my INR levels weekly."
Answer: B) "I will avoid eating large amounts of leafy green vegetables."
Rationale: Warfarin is a vitamin K antagonist. Leafy green vegetables are high in vitamin K and
can decrease the effectiveness of the drug. Clients should maintain a consistent intake of
vitamin K. Ibuprofen (A) increases bleeding risk. An electric razor (C) should be used instead of a
straight razor to prevent cuts. INR is monitored regularly but not necessarily weekly at home
unless directed.
A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the
following findings is the priority for the nurse to report to the provider?
A) Hoarseness
B) Tingling around the mouth
C) Pain in the incision site
,2
D) Temperature of 99.2°F (37.3°C)
Answer: B) Tingling around the mouth
Rationale: Tingling around the mouth is a sign of hypocalcemia, which can occur if the
parathyroid glands are accidentally removed or damaged during surgery. This can lead to life-
threatening laryngeal stridor and seizures, making it the priority. Hoarseness (A) may indicate
laryngeal nerve damage but is less urgent. Incision pain (C) is expected. Low-grade fever (D) is
common postoperatively.
A nurse is preparing to administer a blood transfusion to a client. Which of the following actions
should the nurse take first?
A) Verify the client's identity using two identifiers.
B) Assess the client's vital signs.
C) Obtain the unit of blood from the blood bank.
D) Start an IV line with normal saline.
Answer: A) Verify the client's identity using two identifiers.
Rationale: The first priority is to verify the client's identity to ensure the correct blood is given
to the correct client, preventing a fatal hemolytic reaction. While vital signs (B), obtaining blood
(C), and starting an IV (D) are important steps, they occur after verification.
A client with heart failure is prescribed furosemide. Which of the following findings indicates a
therapeutic response to the medication?
A) Decreased blood pressure
B) Weight loss of 2 kg in 24 hours
C) Heart rate of 110/min
D) Crackles in the lung bases
Answer: B) Weight loss of 2 kg in 24 hours
Rationale: Furosemide is a loop diuretic used to reduce fluid volume overload. A weight loss of
2 kg (4.4 lbs) in 24 hours indicates effective diuresis and reduction of edema. Decreased blood
pressure (A) can be an adverse effect. Tachycardia (C) and crackles (D) indicate worsening heart
failure and fluid overload.
A nurse is caring for a client who has a nasogastric tube attached to low intermittent suction.
Which of the following findings indicates that the tube is correctly placed?
A) The client's abdomen is firm and distended.
B) The pH of the gastric aspirate is 4.
C) The nurse auscultates an air rush over the epigastrium.
,3
D) The client reports nausea.
Answer: B) The pH of the gastric aspirate is 4.
Rationale: Gastric aspirate with a pH between 1 and 5 confirms placement in the stomach. A
firm, distended abdomen (A) or nausea (D) could indicate a blockage. Auscultating an air rush
(C) is no longer recommended as the primary method to confirm placement because it can be
inaccurate.
A nurse is providing teaching to a client who is starting on insulin therapy. Which of the
following instructions should the nurse include for managing hypoglycemia?
A) Administer glucagon subcutaneously.
B) Consume 15 grams of a fast-acting carbohydrate.
C) Eat a meal high in protein and fat.
D) Skip the next dose of insulin.
Answer: B) Consume 15 grams of a fast-acting carbohydrate.
Rationale: The treatment for hypoglycemia is to consume 15 grams of a fast-acting
carbohydrate (e.g., glucose tablets, juice, or soda) and recheck blood glucose in 15 minutes.
Glucagon (A) is for severe hypoglycemia when the client is unconscious. Protein and fat (C) do
not raise blood glucose quickly. Skipping insulin (D) is incorrect.
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of
the following findings should the nurse expect?
A) Clubbing of the fingers
B) Barrel-shaped chest
C) Pursed-lip breathing
D) All of the above
Answer: D) All of the above
Rationale: Chronic hypoxia leads to clubbing of the fingers (A). Hyperinflation of the lungs
causes a barrel-shaped chest (B). Pursed-lip breathing (C) is a compensatory mechanism to keep
airways open and improve gas exchange. All are classic findings in COPD.
A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. Which of the following
instructions should the nurse include in the teaching?
A) Take the medication with an antacid to prevent upset stomach.
B) Avoid taking the medication with dairy products.
C) Expect the urine to turn orange.
D) Take the medication only when symptoms are present.
Answer: B) Avoid taking the medication with dairy products.
Rationale: Ciprofloxacin binds with calcium in dairy products, reducing its absorption. It should
be taken 2 hours before or 6 hours after consuming dairy. Antacids (A) also interfere with
, 4
absorption. Orange urine (C) is a side effect of rifampin, not ciprofloxacin. The medication must
be taken as prescribed, not only when symptoms are present.
A nurse is caring for a client who is 2 hours postoperative following a femoral-popliteal bypass
graft. Which of the following assessments is the priority?
A) Pain level
B) Capillary refill time
C) Urine output
D) Incision site
Answer: B) Capillary refill time
Rationale: The priority assessment is to monitor perfusion of the affected extremity. Prolonged
capillary refill time indicates compromised blood flow to the graft and possible occlusion, which
is a surgical emergency. Pain (A), urine output (C), and incision site (D) are important but
secondary to evaluating immediate graft patency.
A nurse is planning care for a client with a new diagnosis of diabetes mellitus. Which of the
following interventions should the nurse include to prevent foot complications?
A) Soak feet in warm water daily.
B) Wear shoes that are 1 size larger than usual.
C) Trim toenails straight across.
D) Apply lotion between the toes.
Answer: C) Trim toenails straight across.
Rationale: Toenails should be trimmed straight across to prevent ingrown toenails and skin
breakdown. Soaking feet (A) can dry out skin. Shoes should fit properly, not larger (B). Lotion
should not be applied between the toes (D) as it can cause fungal infections.
A nurse is evaluating a client who is 1 day postoperative after a total hip arthroplasty. Which of
the following actions is correct to prevent hip dislocation?
A) Adduct the affected leg.
B) Flex the hip beyond 90 degrees.
C) Place a pillow between the legs when lying on the side.
D) Cross the legs at the ankles.
Answer: C) Place a pillow between the legs when lying on the side.
Rationale: A pillow between the legs maintains the hip in abduction, preventing dislocation.
Adduction (A), flexion beyond 90 degrees (B), and crossing the legs (D) are all contraindicated
and can cause dislocation.
A nurse is performing a focused assessment on a client who reports chest pain. Which of the
following findings should the nurse report to the provider immediately?
A) Pain that is relieved by rest.
B) Pain that radiates to the left arm.
