ATI Capstone Exam 2 Summer 2026 High-Yield
Practice Test Bank | Original Multiple-Choice
Questions & Detailed Clinical Rationales
Ace your summer nursing benchmarks and secure your graduation sign-off with this
high-yield ATI Capstone Exam 2 Summer 2026 practice test bank. Master complex,
multi-system nursing domains including advanced maternal-newborn emergencies,
high-risk adult medical-surgical alterations, critical psychopharmacology safety
protocols, and Next Generation NCLEX (NGN) clinical judgment models. Every
original multiple-choice question features a comprehensive clinical rationale designed to
sharpen your diagnostic reasoning and guarantee a top predictor score.
1. A nurse is caring for a client who has COPD and is receiving oxygen at 2 L/min
via nasal cannula. The client becomes drowsy and the respiratory rate drops to
8/min. Which action should the nurse take first?
A) Increase the oxygen flow rate to 4 L/min
B) Decrease the oxygen flow rate and reassess the client
C) Place the client in Trendelenburg position
D) Prepare for immediate intubation
Rationale: Clients with COPD and chronic hypercapnia may rely on hypoxic drive to
stimulate breathing. Excessive oxygen can suppress this drive and cause respiratory
depression. The priority is to reduce the oxygen and reassess, aiming for SpO₂ of 88–92%.
,2. A nurse is assessing a client who has increased intracranial pressure (ICP). Which
finding is the earliest indicator of deterioration?
A) Pupil dilation
B) Change in level of consciousness
C) Bradycardia
D) Hypertension
Rationale: A change in level of consciousness is the earliest and most sensitive sign of
increased ICP. Pupil changes, bradycardia, and hypertension (Cushing's triad) are late
signs.
3. A nurse is caring for a client who has a chest tube connected to a closed-chest
drainage system. Which action should the nurse take?
A) Strip the chest tube to maintain patency
B) Keep the drainage system below the level of the client's chest
C) Clamp the chest tube when ambulating the client
D) Ignore continuous bubbling in the water seal chamber
Rationale: The drainage system must remain below chest level to promote gravity
drainage and prevent fluid from flowing back into the pleural space. Stripping is not
recommended. Continuous bubbling indicates an air leak and should be reported.
4. A nurse is providing teaching to a client who has a new prescription for
warfarin. Which instruction should the nurse include?
A) "Take the medication with aspirin to prevent clots."
B) "Avoid all green leafy vegetables."
C) "Report any unusual bleeding to your provider."
,D) "Stop the medication if you experience side effects."
Rationale: Clients on warfarin should report signs of bleeding (bruising, gum bleeding,
dark urine). Aspirin should be avoided. Green leafy vegetables should be eaten in
consistent amounts, not avoided entirely.
5. A nurse is caring for a client who has hyperthyroidism. Which manifestations
should the nurse expect?
A) Weight gain and cold intolerance
B) Bradycardia and fatigue
C) Weight loss and heat intolerance
D) Constipation and dry skin
Rationale: Hyperthyroidism increases metabolic rate, causing weight loss, heat
intolerance, tachycardia, and anxiety. Weight gain, cold intolerance, bradycardia, and
constipation are associated with hypothyroidism.
6. A charge nurse is making assignments for a float nurse from postpartum to the
medical-surgical unit. Which client is most appropriate to assign to this float
nurse?
A) Client in diabetic ketoacidosis
B) Client who is postoperative day 2 following an appendectomy, stable
C) Client with a chest tube for a pneumothorax
D) Client receiving IV heparin for deep vein thrombosis
Rationale: A stable postoperative client requires routine care within the float nurse's
general nursing competence. Clients with DKA, chest tubes, and complex anticoagulation
require specialized assessment and monitoring.
, 7. A nurse is caring for a client who is receiving IV antibiotics every 6 hours. Which
client response is the priority for the nurse to evaluate?
A) "I don't understand why I am getting this antibiotic."
B) "My arm burns each time the medication is running."
C) "My throat feels tight."
D) "This medication bag is still full."
Rationale: A tight throat may indicate anaphylaxis, a life-threatening allergic reaction.
This is the priority finding and requires immediate intervention.
8. A nurse is positioning a client who has a stage II pressure ulcer on the coccyx.
Which intervention should the nurse implement?
A) Reposition the client every 3 hours
B) Use two staff members to slide the client up in bed
C) Position the client laterally at 30 degrees
D) Apply lotion to the skin every 4 hours
Rationale: Lateral positioning at 30 degrees relieves pressure on the coccyx. Clients
should be repositioned every 2 hours. Sliding causes shearing injury.
9. A nurse is assessing a client who has a head injury and a Glasgow Coma Scale
score of 8. Which action is the priority?
A) Assess vital signs
B) Prepare for intubation
Practice Test Bank | Original Multiple-Choice
Questions & Detailed Clinical Rationales
Ace your summer nursing benchmarks and secure your graduation sign-off with this
high-yield ATI Capstone Exam 2 Summer 2026 practice test bank. Master complex,
multi-system nursing domains including advanced maternal-newborn emergencies,
high-risk adult medical-surgical alterations, critical psychopharmacology safety
protocols, and Next Generation NCLEX (NGN) clinical judgment models. Every
original multiple-choice question features a comprehensive clinical rationale designed to
sharpen your diagnostic reasoning and guarantee a top predictor score.
1. A nurse is caring for a client who has COPD and is receiving oxygen at 2 L/min
via nasal cannula. The client becomes drowsy and the respiratory rate drops to
8/min. Which action should the nurse take first?
A) Increase the oxygen flow rate to 4 L/min
B) Decrease the oxygen flow rate and reassess the client
C) Place the client in Trendelenburg position
D) Prepare for immediate intubation
Rationale: Clients with COPD and chronic hypercapnia may rely on hypoxic drive to
stimulate breathing. Excessive oxygen can suppress this drive and cause respiratory
depression. The priority is to reduce the oxygen and reassess, aiming for SpO₂ of 88–92%.
,2. A nurse is assessing a client who has increased intracranial pressure (ICP). Which
finding is the earliest indicator of deterioration?
A) Pupil dilation
B) Change in level of consciousness
C) Bradycardia
D) Hypertension
Rationale: A change in level of consciousness is the earliest and most sensitive sign of
increased ICP. Pupil changes, bradycardia, and hypertension (Cushing's triad) are late
signs.
3. A nurse is caring for a client who has a chest tube connected to a closed-chest
drainage system. Which action should the nurse take?
A) Strip the chest tube to maintain patency
B) Keep the drainage system below the level of the client's chest
C) Clamp the chest tube when ambulating the client
D) Ignore continuous bubbling in the water seal chamber
Rationale: The drainage system must remain below chest level to promote gravity
drainage and prevent fluid from flowing back into the pleural space. Stripping is not
recommended. Continuous bubbling indicates an air leak and should be reported.
4. A nurse is providing teaching to a client who has a new prescription for
warfarin. Which instruction should the nurse include?
A) "Take the medication with aspirin to prevent clots."
B) "Avoid all green leafy vegetables."
C) "Report any unusual bleeding to your provider."
,D) "Stop the medication if you experience side effects."
Rationale: Clients on warfarin should report signs of bleeding (bruising, gum bleeding,
dark urine). Aspirin should be avoided. Green leafy vegetables should be eaten in
consistent amounts, not avoided entirely.
5. A nurse is caring for a client who has hyperthyroidism. Which manifestations
should the nurse expect?
A) Weight gain and cold intolerance
B) Bradycardia and fatigue
C) Weight loss and heat intolerance
D) Constipation and dry skin
Rationale: Hyperthyroidism increases metabolic rate, causing weight loss, heat
intolerance, tachycardia, and anxiety. Weight gain, cold intolerance, bradycardia, and
constipation are associated with hypothyroidism.
6. A charge nurse is making assignments for a float nurse from postpartum to the
medical-surgical unit. Which client is most appropriate to assign to this float
nurse?
A) Client in diabetic ketoacidosis
B) Client who is postoperative day 2 following an appendectomy, stable
C) Client with a chest tube for a pneumothorax
D) Client receiving IV heparin for deep vein thrombosis
Rationale: A stable postoperative client requires routine care within the float nurse's
general nursing competence. Clients with DKA, chest tubes, and complex anticoagulation
require specialized assessment and monitoring.
, 7. A nurse is caring for a client who is receiving IV antibiotics every 6 hours. Which
client response is the priority for the nurse to evaluate?
A) "I don't understand why I am getting this antibiotic."
B) "My arm burns each time the medication is running."
C) "My throat feels tight."
D) "This medication bag is still full."
Rationale: A tight throat may indicate anaphylaxis, a life-threatening allergic reaction.
This is the priority finding and requires immediate intervention.
8. A nurse is positioning a client who has a stage II pressure ulcer on the coccyx.
Which intervention should the nurse implement?
A) Reposition the client every 3 hours
B) Use two staff members to slide the client up in bed
C) Position the client laterally at 30 degrees
D) Apply lotion to the skin every 4 hours
Rationale: Lateral positioning at 30 degrees relieves pressure on the coccyx. Clients
should be repositioned every 2 hours. Sliding causes shearing injury.
9. A nurse is assessing a client who has a head injury and a Glasgow Coma Scale
score of 8. Which action is the priority?
A) Assess vital signs
B) Prepare for intubation
