RN ATI Capstone Proctored Comprehensive
Assessment Test Exam Study Guide & Practice
Questions with Rationales (2025–2026) |
NCLEX-Style Review
Section 1: Fundamentals & Basic Nursing Care (Q1–Q18)
1. The nurse is caring for a client with dysphagia. Which intervention should the nurse
implement to reduce the risk of aspiration?
A. Offer thin liquids with meals
B. Position the client supine during feeding
C. Place food on the unaffected side of the mouth
D. Encourage large bites to stimulate swallowing
Correct Answer: C
Rationale: Placing food on the unaffected side of the mouth improves bolus control and
swallowing safety in clients with dysphagia. Thin liquids (A) increase aspiration risk; supine
positioning (B) is unsafe; large bites (D) increase choking risk.
2. Which action by the nurse best demonstrates proper hand hygiene technique?
A. Rubbing hands together for 5 seconds with soap
B. Using alcohol-based rub when hands are visibly soiled
C. Washing hands for at least 20 seconds with friction
D. Wearing gloves in place of handwashing for all care
Correct Answer: C
Rationale: Handwashing requires at least 20 seconds of friction to remove transient flora.
Alcohol rub (B) is ineffective on visibly soiled hands; gloves (D) do not replace hand hygiene.
3. A nurse is preparing to insert an indwelling urinary catheter. Which action maintains sterile
technique?
A. Reusing the same sterile glove after touching the bed rail
B. Cleansing the meatus from front to back with the dominant hand
C. Allowing the catheter tip to touch the labia before insertion
D. Using the nondominant hand to separate the labia and maintain exposure
, Correct Answer: D
Rationale: The nondominant hand is used to separate the labia and is considered
contaminated; the dominant hand remains sterile for cleansing and insertion. Options A, B, and
C break sterile technique.
4. The nurse observes a colleague not performing hand hygiene between clients. Which action
should the nurse take first?
A. Report the colleague to the state board of nursing
B. Ignore the behavior to avoid conflict
C. Remind the colleague privately about hand hygiene
D. Document the incident in the client’s chart
Correct Answer: C
Rationale: The first step is a respectful, private reminder to promote client safety and a
culture of safety. Reporting to the board (A) is premature; ignoring (B) jeopardizes safety;
documenting in the client’s chart (D) is inappropriate.
5. A client is on fall precautions. Which finding requires immediate intervention?
A. The client uses the call light to ask for help
B. The bed is in the lowest position with the brake locked
C. The client’s IV pump alarm is sounding
D. The client is attempting to climb over the side rails
Correct Answer: D
Rationale: Climbing over side rails is an imminent fall risk requiring immediate intervention.
The other options reflect safe practices or routine alarms.
6. Which statement by the nurse indicates correct understanding of pressure injury
prevention?
A. “I will reposition the client every 4 hours.”
B. “I will massage reddened bony prominences.”
C. “I will keep the head of the bed elevated at 45 degrees at all times.”
D. “I will use a pressure-redistribution mattress and reposition every 2 hours.”
Correct Answer: D
Rationale: Repositioning every 2 hours and using pressure-redistribution surfaces prevent
pressure injuries. Massaging reddened areas (B) can worsen tissue damage; 4-hour intervals (A)
are too infrequent; 45-degree elevation (C) increases shear.
7. A nurse is teaching a client about a low-sodium diet. Which food should the client avoid?
A. Fresh apples
,B. Canned soup
C. Brown rice
D. Grilled chicken breast
Correct Answer: B
Rationale: Canned soups are high in sodium due to processing. Fresh fruits, unprocessed
grains, and fresh meats are low in sodium.
8. The nurse is caring for a client with a new colostomy. Which stoma appearance should the
nurse report immediately?
A. Pink, moist stoma
B. Dusky, dark red stoma
C. Slight edema 24 hours post-op
D. Small amount of serosanguineous drainage
Correct Answer: B
Rationale: A dusky or dark red stoma indicates ischemia and must be reported. Pink/moist
(A) and mild edema (C) are expected; small serosanguineous drainage (D) is normal.
9. Which action should the nurse take when a client refuses a prescribed medication?
A. Crush the medication and hide it in food
B. Document the refusal and notify the provider
C. Threaten the client with discharge
D. Administer the medication intramuscularly instead
Correct Answer: B
Rationale: The client has the right to refuse. The nurse documents the refusal and notifies
the provider. Hiding medication (A) and threatening (C) violate client rights; changing the route
(D) requires a new order.
10. A client with an NG tube is receiving intermittent feedings. Which action should the nurse
take before administering the feeding?
A. Verify tube placement by auscultating air
B. Check gastric residual volume
C. Flush the tube with 100 mL of water
D. Position the client supine
Correct Answer: B
Rationale: Checking residual volume helps assess tolerance and prevents overfeeding.
Auscultating air (A) is unreliable; 100 mL flush (C) is excessive; supine position (D) increases
aspiration risk.
, 11. Which client is at greatest risk for developing a deep vein thrombosis (DVT)?
A. A client who ambulates three times daily
B. A client who had abdominal surgery and is on bed rest
C. A client with a hemoglobin of 14 g/dL
D. A client who drinks 2 L of water daily
Correct Answer: B
Rationale: Immobility after surgery is a major DVT risk. Ambulation, normal hemoglobin,
and hydration reduce risk.
12. The nurse is assessing a client’s pain. Which tool is most appropriate for a 4-year-old
child?
A. Numeric rating scale (0–10)
B. Wong-Baker FACES scale
C. Visual analog scale
D. Verbal descriptor scale
Correct Answer: B
Rationale: The Wong-Baker FACES scale is validated for young children. Numeric and visual
analog scales require abstract thinking; verbal descriptors may be limited in preschoolers.
13. A nurse is caring for a client receiving a blood transfusion. Which finding indicates a
transfusion reaction?
A. Temperature increase of 1.8°F (1°C) and chills
B. Blood pressure 118/76 mm Hg
C. Heart rate 78 beats/min
D. Urine output 50 mL/hr
Correct Answer: A
Rationale: Fever and chills are classic signs of a febrile transfusion reaction. The other
values are within normal limits.
14. Which intervention best prevents catheter-associated urinary tract infection (CAUTI)?
A. Irrigating the catheter daily
B. Keeping the drainage bag below the bladder
C. Changing the catheter every 48 hours
D. Disconnecting the tubing for specimen collection
Correct Answer: B
Rationale: Keeping the bag below the bladder prevents backflow of urine. Routine irrigation
Assessment Test Exam Study Guide & Practice
Questions with Rationales (2025–2026) |
NCLEX-Style Review
Section 1: Fundamentals & Basic Nursing Care (Q1–Q18)
1. The nurse is caring for a client with dysphagia. Which intervention should the nurse
implement to reduce the risk of aspiration?
A. Offer thin liquids with meals
B. Position the client supine during feeding
C. Place food on the unaffected side of the mouth
D. Encourage large bites to stimulate swallowing
Correct Answer: C
Rationale: Placing food on the unaffected side of the mouth improves bolus control and
swallowing safety in clients with dysphagia. Thin liquids (A) increase aspiration risk; supine
positioning (B) is unsafe; large bites (D) increase choking risk.
2. Which action by the nurse best demonstrates proper hand hygiene technique?
A. Rubbing hands together for 5 seconds with soap
B. Using alcohol-based rub when hands are visibly soiled
C. Washing hands for at least 20 seconds with friction
D. Wearing gloves in place of handwashing for all care
Correct Answer: C
Rationale: Handwashing requires at least 20 seconds of friction to remove transient flora.
Alcohol rub (B) is ineffective on visibly soiled hands; gloves (D) do not replace hand hygiene.
3. A nurse is preparing to insert an indwelling urinary catheter. Which action maintains sterile
technique?
A. Reusing the same sterile glove after touching the bed rail
B. Cleansing the meatus from front to back with the dominant hand
C. Allowing the catheter tip to touch the labia before insertion
D. Using the nondominant hand to separate the labia and maintain exposure
, Correct Answer: D
Rationale: The nondominant hand is used to separate the labia and is considered
contaminated; the dominant hand remains sterile for cleansing and insertion. Options A, B, and
C break sterile technique.
4. The nurse observes a colleague not performing hand hygiene between clients. Which action
should the nurse take first?
A. Report the colleague to the state board of nursing
B. Ignore the behavior to avoid conflict
C. Remind the colleague privately about hand hygiene
D. Document the incident in the client’s chart
Correct Answer: C
Rationale: The first step is a respectful, private reminder to promote client safety and a
culture of safety. Reporting to the board (A) is premature; ignoring (B) jeopardizes safety;
documenting in the client’s chart (D) is inappropriate.
5. A client is on fall precautions. Which finding requires immediate intervention?
A. The client uses the call light to ask for help
B. The bed is in the lowest position with the brake locked
C. The client’s IV pump alarm is sounding
D. The client is attempting to climb over the side rails
Correct Answer: D
Rationale: Climbing over side rails is an imminent fall risk requiring immediate intervention.
The other options reflect safe practices or routine alarms.
6. Which statement by the nurse indicates correct understanding of pressure injury
prevention?
A. “I will reposition the client every 4 hours.”
B. “I will massage reddened bony prominences.”
C. “I will keep the head of the bed elevated at 45 degrees at all times.”
D. “I will use a pressure-redistribution mattress and reposition every 2 hours.”
Correct Answer: D
Rationale: Repositioning every 2 hours and using pressure-redistribution surfaces prevent
pressure injuries. Massaging reddened areas (B) can worsen tissue damage; 4-hour intervals (A)
are too infrequent; 45-degree elevation (C) increases shear.
7. A nurse is teaching a client about a low-sodium diet. Which food should the client avoid?
A. Fresh apples
,B. Canned soup
C. Brown rice
D. Grilled chicken breast
Correct Answer: B
Rationale: Canned soups are high in sodium due to processing. Fresh fruits, unprocessed
grains, and fresh meats are low in sodium.
8. The nurse is caring for a client with a new colostomy. Which stoma appearance should the
nurse report immediately?
A. Pink, moist stoma
B. Dusky, dark red stoma
C. Slight edema 24 hours post-op
D. Small amount of serosanguineous drainage
Correct Answer: B
Rationale: A dusky or dark red stoma indicates ischemia and must be reported. Pink/moist
(A) and mild edema (C) are expected; small serosanguineous drainage (D) is normal.
9. Which action should the nurse take when a client refuses a prescribed medication?
A. Crush the medication and hide it in food
B. Document the refusal and notify the provider
C. Threaten the client with discharge
D. Administer the medication intramuscularly instead
Correct Answer: B
Rationale: The client has the right to refuse. The nurse documents the refusal and notifies
the provider. Hiding medication (A) and threatening (C) violate client rights; changing the route
(D) requires a new order.
10. A client with an NG tube is receiving intermittent feedings. Which action should the nurse
take before administering the feeding?
A. Verify tube placement by auscultating air
B. Check gastric residual volume
C. Flush the tube with 100 mL of water
D. Position the client supine
Correct Answer: B
Rationale: Checking residual volume helps assess tolerance and prevents overfeeding.
Auscultating air (A) is unreliable; 100 mL flush (C) is excessive; supine position (D) increases
aspiration risk.
, 11. Which client is at greatest risk for developing a deep vein thrombosis (DVT)?
A. A client who ambulates three times daily
B. A client who had abdominal surgery and is on bed rest
C. A client with a hemoglobin of 14 g/dL
D. A client who drinks 2 L of water daily
Correct Answer: B
Rationale: Immobility after surgery is a major DVT risk. Ambulation, normal hemoglobin,
and hydration reduce risk.
12. The nurse is assessing a client’s pain. Which tool is most appropriate for a 4-year-old
child?
A. Numeric rating scale (0–10)
B. Wong-Baker FACES scale
C. Visual analog scale
D. Verbal descriptor scale
Correct Answer: B
Rationale: The Wong-Baker FACES scale is validated for young children. Numeric and visual
analog scales require abstract thinking; verbal descriptors may be limited in preschoolers.
13. A nurse is caring for a client receiving a blood transfusion. Which finding indicates a
transfusion reaction?
A. Temperature increase of 1.8°F (1°C) and chills
B. Blood pressure 118/76 mm Hg
C. Heart rate 78 beats/min
D. Urine output 50 mL/hr
Correct Answer: A
Rationale: Fever and chills are classic signs of a febrile transfusion reaction. The other
values are within normal limits.
14. Which intervention best prevents catheter-associated urinary tract infection (CAUTI)?
A. Irrigating the catheter daily
B. Keeping the drainage bag below the bladder
C. Changing the catheter every 48 hours
D. Disconnecting the tubing for specimen collection
Correct Answer: B
Rationale: Keeping the bag below the bladder prevents backflow of urine. Routine irrigation
