CAPSTONE COMPREHENSIVE STUDY
GUIDE HIGH-YIELD QUESTIONS (PASS
VERIFIED)
Master your nursing school finals with this ultra-comprehensive bank
of high-yield, premium practice questions meticulously modeled after
the ATI NUR2811 Capstone Exam. Every question features clear,
italicised correct answers alongside deeply detailed rationales in bold italics
to ensure rapid retention and concept mastery. It covers critical clinical
segments—including advanced medical-surgical nursing, maternal-
newborn health, pharmacology antidotes, isolation tiers, and critical lab
values—making it the ultimate high-traffic study guide to guarantee a
passing grade
1. Adult Medical-Surgical Care
A nurse is assessing a client who underwent a subtotal
thyroidectomy 24 hours ago. The client reports numbness
and tingling around the mouth and fingertips. Which action
should the nurse take first?
A) Check the client's serum potassium level.
B) Assess for a positive Chvostek's sign.
C) Administer an oral calcium supplement.
D) Assess the surgical dressing for hemorrhage.
Correct Answer: B) Assess for a positive Chvostek's
sign.
Rationale: Numbness and tingling around the
mouth and fingertips are classic early signs of
, hypocalcemia, which can occur post-
thyroidectomy due to accidental damage or
removal of the parathyroid glands. Assessing for
Chvostek's sign (facial twitching when tapping the
facial nerve) or Trousseau's sign confirms acute
neuromuscular irritability before administering
corrective medications.
2. Adult Medical-Surgical Care
A nurse is caring for a client with a chest tube attached to
a water-seal drainage system. The nurse notes
continuous, vigorous bubbling in the water-seal chamber.
How should the nurse interpret this finding?
A) The client's pneumothorax is resolving as
expected.
B) The suction control chamber pressure is set too
low.
C) There is an air leak present in the system or
insertion site.
D) The chest tube is obstructed by a blood clot.
Correct Answer: C) There is an air leak present in the
system or insertion site.
Rationale: Continuous bubbling in the water-seal
chamber indicates that air is entering the system
from an unintended leak, either within the
drainage system connections or at the chest wall
insertion site. Intermittent bubbling is expected
, with expiration or coughing in a client with a
pneumothorax, but continuous bubbling requires
systematic troubleshooting to locate the leak.
3. Pharmacology & Antidotes
A client with deep vein thrombosis is receiving a
continuous intravenous infusion of heparin. The morning
laboratory results reveal an activated partial
thromboplastin time (aPTT) of 140 seconds, and the client
reports new onset hematuria. Which medication should
the nurse prepare to administer?
A) Vitamin K
B) Protamine sulfate
C) Flumazenil
D) Aminocaproic acid
Correct Answer: B) Protamine sulfate
Rationale: Protamine sulfate is the specific
antidote used to reverse the anticoagulant effects
of heparin in cases of severe overdose or active
hemorrhage. Vitamin K is the reversal agent for
warfarin. An aPTT of 140 seconds is significantly
above the therapeutic range (typically 60–80
seconds), and active bleeding requires rapid
neutralization.
4. Pharmacology & Antidotes
, A nurse in the emergency department is caring for a client
brought in with an intentional overdose of acetaminophen
that occurred approximately 5 hours ago. Which
pharmacological agent should the nurse expect to
administer?
A) Activated charcoal
B) Deferoxamine
C) Acetylcysteine
D) Calcium gluconate
Correct Answer: C) Acetylcysteine
Rationale: Acetylcysteine is the specific antidote
for acetaminophen toxicity. It acts by restoring
hepatic glutathione stores, which prevents the
toxic metabolite of acetaminophen from causing
irreversible liver necrosis. It is most effective
when administered within 8 hours of ingestion.
5. Isolation & Transmission-Based Precautions
A nurse is preparing to admit a client with a suspected
diagnosis of pulmonary tuberculosis. Which of the
following isolation precautions must the nurse implement?
A) Droplet precautions with a standard surgical mask.
B) Airborne precautions with an N95 respirator and a
negative-pressure room.
C) Contact precautions with a protective gown and
gloves.