NUR 2811 Nursing Capstone
Practice Exam with questions and
verified answers in bold and
rationale updated 2026 graded A+
SECTION 1: INFECTION CONTROL & SAFETY
1. A nurse is caring for multiple clients on a medical-surgical unit. Which client
is at the highest risk for developing a nosocomial infection?
A. Client with alcohol use disorder admitted for detoxification
B. Client with Type 1 diabetes mellitus and peripheral neuropathy
C. Client recovering from a laparoscopic cholecystectomy
D. Client with full-thickness burns, NG tube, and Foley catheter
Rationale: Patients with extensive burns have a severely compromised skin barrier,
making them highly susceptible to infection. The presence of invasive devices such as
an NG tube and Foley catheter further increases infection risk by providing entry
points for microorganisms -2-8 .
2. A client who had a cast applied to the right lower arm 48 hours ago presents
with severe burning pain, paresthesia, and a cool, pale extremity. What
complication should the nurse suspect?
A. Fat embolism syndrome
B. Compartment syndrome
C. Deep vein thrombosis
D. Cellulitis
Rationale: Compartment syndrome occurs when increased pressure within a closed
muscle compartment compromises circulation and nerve function. Classic signs
include severe pain unrelieved by medication, paresthesia, pallor, and coolness of the
extremity -5 .
,3. Which clients are at increased risk for falls? (Select all that apply)
A. 67-year-old with shuffling gait
B. 72-year-old fully oriented client
C. 48-year-old receiving opioids and sedatives
D. 58-year-old legally blind client
Rationale: Fall risk increases with gait disturbances, sedative use, and sensory
impairment. Orientation alone does not increase fall risk -5 .
4. A patient with COPD is short of breath and using accessory muscles. What is
the nurse's priority action?
A. Administer prescribed bronchodilator
B. Encourage ambulation
C. Provide high-fiber diet
D. Assess skin turgor
Rationale: Bronchodilators relieve airway constriction and improve oxygenation. This
is an airway priority -6 .
5. Which patient is at highest risk for falls?
A. 80-year-old patient on sedatives
B. 25-year-old outpatient
C. 40-year-old healthy adult
D. 30-year-old ambulatory patient
Rationale: Advanced age and sedative medications increase fall risk -6 .
SECTION 2: PRIORITIZATION & DELEGATION
,6. Which client should the nurse prioritize for transfer from ICU to a step-down
neurological unit?
A. Client with acute head injury and seizures
B. Client with ischemic stroke 4 days ago and mild confusion
C. Client 1-day post-transsphenoidal craniotomy with CSF leak
D. Client with bacterial meningitis and Glasgow Coma Scale of 7
Rationale: The most stable client is the one with an ischemic stroke who is several
days post-event and only mildly confused. The other clients are unstable due to CSF
leak, decreased level of consciousness, or active neurological compromise -2-8 .
7. After shift report, which client should the nurse assess first?
A. Ventilated client requiring sputum culture collection
B. COPD client with oxygen saturation of 90% from previous shift
C. Pneumonia client awaiting IV antibiotics
D. Asthma client reporting shortness of breath after bronchodilator use
Rationale: Shortness of breath after bronchodilator use suggests worsening
bronchospasm or treatment failure. This is an airway priority (ABCs) -2-8 .
8. Which postoperative client should the nurse assess first?
A. Client scheduled for laparoscopic cholecystectomy
B. Multiple trauma client from motor vehicle collision
C. Client scheduled for thyroidectomy
D. Client awaiting discharge after appendectomy
Rationale: Trauma patients are the most unstable and require immediate assessment
due to risk of internal injuries, hemorrhage, and airway compromise -2-8 .
9. Which post-report client requires immediate attention?
A. Femur fracture in cast
B. Mild headache
, C. 5-hour post-laryngectomy client
D. 1-day post-lobectomy client
Rationale: Airway obstruction risk is highest after laryngectomy; this is an ABC
priority -8-9 .
10. Which emergency department client is priority?
A. Nosebleed in elderly patient
B. Vomiting for 3 hours
C. Child with arm pain
D. Fever in toddler
Rationale: Uncontrolled bleeding poses immediate circulation risk -8-9 .
11. During disaster triage, which client can be safely discharged first?
A. 24-hour post-hysterectomy client
B. 5-day post-total hip replacement client
C. 12-hour pyelonephritis admission
D. 5-day stage III pressure ulcer patient
Rationale: This client is the most stable and least dependent on acute care services
compared to infection or surgical complications -2 .
12. Which oral cancer care task is appropriate for an LPN?
A. Assess oral hygiene
B. Teach brushing techniques
C. Administer sucralfate
D. Recommend saliva substitutes
Rationale: LPNs can administer medications but not teach or assess -9 .
Practice Exam with questions and
verified answers in bold and
rationale updated 2026 graded A+
SECTION 1: INFECTION CONTROL & SAFETY
1. A nurse is caring for multiple clients on a medical-surgical unit. Which client
is at the highest risk for developing a nosocomial infection?
A. Client with alcohol use disorder admitted for detoxification
B. Client with Type 1 diabetes mellitus and peripheral neuropathy
C. Client recovering from a laparoscopic cholecystectomy
D. Client with full-thickness burns, NG tube, and Foley catheter
Rationale: Patients with extensive burns have a severely compromised skin barrier,
making them highly susceptible to infection. The presence of invasive devices such as
an NG tube and Foley catheter further increases infection risk by providing entry
points for microorganisms -2-8 .
2. A client who had a cast applied to the right lower arm 48 hours ago presents
with severe burning pain, paresthesia, and a cool, pale extremity. What
complication should the nurse suspect?
A. Fat embolism syndrome
B. Compartment syndrome
C. Deep vein thrombosis
D. Cellulitis
Rationale: Compartment syndrome occurs when increased pressure within a closed
muscle compartment compromises circulation and nerve function. Classic signs
include severe pain unrelieved by medication, paresthesia, pallor, and coolness of the
extremity -5 .
,3. Which clients are at increased risk for falls? (Select all that apply)
A. 67-year-old with shuffling gait
B. 72-year-old fully oriented client
C. 48-year-old receiving opioids and sedatives
D. 58-year-old legally blind client
Rationale: Fall risk increases with gait disturbances, sedative use, and sensory
impairment. Orientation alone does not increase fall risk -5 .
4. A patient with COPD is short of breath and using accessory muscles. What is
the nurse's priority action?
A. Administer prescribed bronchodilator
B. Encourage ambulation
C. Provide high-fiber diet
D. Assess skin turgor
Rationale: Bronchodilators relieve airway constriction and improve oxygenation. This
is an airway priority -6 .
5. Which patient is at highest risk for falls?
A. 80-year-old patient on sedatives
B. 25-year-old outpatient
C. 40-year-old healthy adult
D. 30-year-old ambulatory patient
Rationale: Advanced age and sedative medications increase fall risk -6 .
SECTION 2: PRIORITIZATION & DELEGATION
,6. Which client should the nurse prioritize for transfer from ICU to a step-down
neurological unit?
A. Client with acute head injury and seizures
B. Client with ischemic stroke 4 days ago and mild confusion
C. Client 1-day post-transsphenoidal craniotomy with CSF leak
D. Client with bacterial meningitis and Glasgow Coma Scale of 7
Rationale: The most stable client is the one with an ischemic stroke who is several
days post-event and only mildly confused. The other clients are unstable due to CSF
leak, decreased level of consciousness, or active neurological compromise -2-8 .
7. After shift report, which client should the nurse assess first?
A. Ventilated client requiring sputum culture collection
B. COPD client with oxygen saturation of 90% from previous shift
C. Pneumonia client awaiting IV antibiotics
D. Asthma client reporting shortness of breath after bronchodilator use
Rationale: Shortness of breath after bronchodilator use suggests worsening
bronchospasm or treatment failure. This is an airway priority (ABCs) -2-8 .
8. Which postoperative client should the nurse assess first?
A. Client scheduled for laparoscopic cholecystectomy
B. Multiple trauma client from motor vehicle collision
C. Client scheduled for thyroidectomy
D. Client awaiting discharge after appendectomy
Rationale: Trauma patients are the most unstable and require immediate assessment
due to risk of internal injuries, hemorrhage, and airway compromise -2-8 .
9. Which post-report client requires immediate attention?
A. Femur fracture in cast
B. Mild headache
, C. 5-hour post-laryngectomy client
D. 1-day post-lobectomy client
Rationale: Airway obstruction risk is highest after laryngectomy; this is an ABC
priority -8-9 .
10. Which emergency department client is priority?
A. Nosebleed in elderly patient
B. Vomiting for 3 hours
C. Child with arm pain
D. Fever in toddler
Rationale: Uncontrolled bleeding poses immediate circulation risk -8-9 .
11. During disaster triage, which client can be safely discharged first?
A. 24-hour post-hysterectomy client
B. 5-day post-total hip replacement client
C. 12-hour pyelonephritis admission
D. 5-day stage III pressure ulcer patient
Rationale: This client is the most stable and least dependent on acute care services
compared to infection or surgical complications -2 .
12. Which oral cancer care task is appropriate for an LPN?
A. Assess oral hygiene
B. Teach brushing techniques
C. Administer sucralfate
D. Recommend saliva substitutes
Rationale: LPNs can administer medications but not teach or assess -9 .
