Capstone ATI NCLEX Medical Surgical
Assessment 1 2025 Questions and
Answers|100% Solved
A nurse is teaching a client how to administer a medication using an inhaler with a
spacer. Which of the following instructions should the nurse include
A. "Wait at least 5 minutes between puffs from the same inhaler"
B. "Breathe in rapidly when inhaling the medication"
C. "Clean the plastic inhaler cap weekly with cold water"
D. "Shake the inhaler vigorously prior to use" - ....ANSWER ...-D .) "Shake
the inhaler vigorously prior to use"
Thoroughly shake the inhaler to disperse the medication because the medication in
the inhaler can separate easily
A nurse is planning care for a client who is receiving mechanical ventilation. Which
of the following actions should the nurse include in the plan
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,A. Provide the client with a means of communication
B. Maintain the head of the client's bed in a flat position
C. Suction the client's endotracheal tube every 4 hr
D. Perform oral hygiene for the client every 8 hr - ....ANSWER ...-A.)
Provide the client with a means of communication
Use electronic tablet computer, programmable speech generating device, alphabet
board, pencil and paper, etc
A nurse is caring for a client who is receiving IV fluid replacement therapy for
dehydration. Which of the following laboratory results indicates effectiveness of
the treatment
A. Sodium 165 mEq/L
B. Potassium 5.2 mEq/L
C. Urine specific gravity 1.020
D. Hct 62% - ....ANSWER ...-C Urine specific gravity 1.020
Within the expected range of 1.005-1.030
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,A nurse is monitoring the laboratory findings for a client who is postoperative
following a total hip arthroplasty 6 hr ago. Which of the following values indicates
that the client has an increased risk for bleeding
A. PT 11.5 seconds
B. aPTT 35 seconds
C. Platelets 80,000
D. RBC 4.0 million - ....ANSWER ...-C Platelets 80,000
platelet range is 150,000-400,000
A nurse is admitting a client who has a cervical spinal cord injury following a
motor vehicle crash. Which of the following interventions is the nurse's priority
while caring for this client
A. Change the client's position every 2 hours
B. Pad pressure points at the edges of the client's cervical collar
C. Palpate the client's abdomen for bladder distention
D. Assist the client with quad coughing - ....ANSWER ...-D Assist the client
with quad coughing
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, The greatest risk to a client who has a cervical spinal cord injury is an obstructed
airway; the priority is to ensure the client can clear their airway. Apply abdominal
pressure as the client coughs (quad coughing)
A nurse is caring for a client who is receiving a blood transfusion. Which of the
following findings indicates that the client is experiencing transfusion-associated
circulatory overload
A. Nasuea
B. Hypothermia
C. Dyspnea
D. Bradycardia - ....ANSWER ...-C Dyspnea
Dyspnea is an indication of possible transfusion associated circulatory overload,
leading to hypertension, bounding pulses, and confusion. Dyspnea can also
indicate transfusion related acute lung injury to an anaphylactic response, which
also causes wheezing, chest tightness, cyanosis, and low BP
A nurse is assessing a client who has lung cancer and is undergoing radiation
therapy to the chest. Which of the following indicates an adverse effect of the
therapy
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
Assessment 1 2025 Questions and
Answers|100% Solved
A nurse is teaching a client how to administer a medication using an inhaler with a
spacer. Which of the following instructions should the nurse include
A. "Wait at least 5 minutes between puffs from the same inhaler"
B. "Breathe in rapidly when inhaling the medication"
C. "Clean the plastic inhaler cap weekly with cold water"
D. "Shake the inhaler vigorously prior to use" - ....ANSWER ...-D .) "Shake
the inhaler vigorously prior to use"
Thoroughly shake the inhaler to disperse the medication because the medication in
the inhaler can separate easily
A nurse is planning care for a client who is receiving mechanical ventilation. Which
of the following actions should the nurse include in the plan
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,A. Provide the client with a means of communication
B. Maintain the head of the client's bed in a flat position
C. Suction the client's endotracheal tube every 4 hr
D. Perform oral hygiene for the client every 8 hr - ....ANSWER ...-A.)
Provide the client with a means of communication
Use electronic tablet computer, programmable speech generating device, alphabet
board, pencil and paper, etc
A nurse is caring for a client who is receiving IV fluid replacement therapy for
dehydration. Which of the following laboratory results indicates effectiveness of
the treatment
A. Sodium 165 mEq/L
B. Potassium 5.2 mEq/L
C. Urine specific gravity 1.020
D. Hct 62% - ....ANSWER ...-C Urine specific gravity 1.020
Within the expected range of 1.005-1.030
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,A nurse is monitoring the laboratory findings for a client who is postoperative
following a total hip arthroplasty 6 hr ago. Which of the following values indicates
that the client has an increased risk for bleeding
A. PT 11.5 seconds
B. aPTT 35 seconds
C. Platelets 80,000
D. RBC 4.0 million - ....ANSWER ...-C Platelets 80,000
platelet range is 150,000-400,000
A nurse is admitting a client who has a cervical spinal cord injury following a
motor vehicle crash. Which of the following interventions is the nurse's priority
while caring for this client
A. Change the client's position every 2 hours
B. Pad pressure points at the edges of the client's cervical collar
C. Palpate the client's abdomen for bladder distention
D. Assist the client with quad coughing - ....ANSWER ...-D Assist the client
with quad coughing
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, The greatest risk to a client who has a cervical spinal cord injury is an obstructed
airway; the priority is to ensure the client can clear their airway. Apply abdominal
pressure as the client coughs (quad coughing)
A nurse is caring for a client who is receiving a blood transfusion. Which of the
following findings indicates that the client is experiencing transfusion-associated
circulatory overload
A. Nasuea
B. Hypothermia
C. Dyspnea
D. Bradycardia - ....ANSWER ...-C Dyspnea
Dyspnea is an indication of possible transfusion associated circulatory overload,
leading to hypertension, bounding pulses, and confusion. Dyspnea can also
indicate transfusion related acute lung injury to an anaphylactic response, which
also causes wheezing, chest tightness, cyanosis, and low BP
A nurse is assessing a client who has lung cancer and is undergoing radiation
therapy to the chest. Which of the following indicates an adverse effect of the
therapy
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
