RN ATI CAPSTONE PROCTORED COMPREHENSIVE ASSESSMENT FORM
A ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES
Question 1
A nurse is assessing a client for Chvostek's sign. Which action should the nurse take?
A) Apply a blood pressure cuff to the client's arm and inflate it.
B) Tap lightly on the client's cheek just anterior to the ear.
C) Ask the client to touch their chin to their chest.
D) Auscultate the client's carotid artery.
Correct Answer: D) Tap lightly on the client's cheek
Rationale: Chvostek's sign is a clinical sign of hypocalcemia. It is elicited by tapping on the
facial nerve just below the temple. A positive sign is a twitching of the facial muscles on the
same side.
Question 2
A nurse is caring for a client with hypocalcemia. Which of the following findings are expected
manifestations? (Select all that apply.)
A) Tingling in fingers
B) Poor skin turgor
C) Abdominal pain and cramping
D) Elevated temperature
E) Muscle twitching
Correct Answer: A, C, E
Rationale: Hypocalcemia increases neuromuscular excitability, leading to symptoms like
paresthesia (tingling), muscle twitches, tetany, and abdominal cramping/diarrhea.
Question 3
Which of the following is an associated manifestation of hyperkalemia?
A) Positive Trousseau's sign
B) ECG with tall, peaked T-waves
C) Bounding pulse
D) Hypoactive bowel sounds
Correct Answer: B) ECG with tall, peaked t-waves
,Rationale: Hyperkalemia alters cardiac electrical stability. Tall, peaked T-waves on an ECG
are a classic, early sign of high potassium levels.
Question 4
A nurse is planning care for a client scheduled for a thoracentesis. What is the appropriate
position for the client during the procedure?
A) Lying flat in a supine position.
B) In a side-lying position with the affected side up.
C) Sitting upright and leaning over an overbed table.
D) In a prone position with arms at the sides.
Correct Answer: C) Position the client upright, leaning over the bedside table
Rationale: This position widens the intercostal spaces and allows for easier access to the
pleural space for the provider, while also promoting comfort and stability for the client.
Question 5
A nurse is reviewing information with a client scheduled for pulmonary function tests (PFTs).
Which statement should the nurse make?
A) "Do not use your inhaler medications for 6 hours after the test."
B) "Do not smoke tobacco for 6 to 8 hours prior to the test."
C) "You will be asked to hold your breath for as long as possible."
D) "This test will require an arterial blood draw."
Correct Answer: B) "Do not smoke tobacco for 6-8 hr prior to the test."
Rationale: Smoking can cause bronchospasm and affect the accuracy of the PFT results.
The client must refrain from smoking for a specified period before the test.
Question 6
A nurse is assessing a client following a thoracentesis. Which finding should the nurse report to
the provider immediately?
A) A small amount of serosanguineous drainage on the dressing.
B) A report of pain at the puncture site.
C) Dyspnea and an asymmetrical chest wall.
D) A respiratory rate of 20/min.
Correct Answer: C) dyspnea
, Rationale: Dyspnea, tachypnea, and asymmetrical chest movement are signs of a potential
pneumothorax, a serious complication of thoracentesis where the lung has been punctured.
Question 7
What is the purpose of the water seal chamber in a three-chamber chest tube drainage system?
A) To collect drainage from the pleural space.
B) To control the amount of suction applied.
C) To allow air to exit the pleural space but not to re-enter.
D) To regulate the temperature of the drainage.
Correct Answer: C) To allow air to exit the pleural space but not to re-enter.
Rationale: The water seal acts as a one-way valve, preventing atmospheric air from being
drawn back into the chest, which would collapse the lung.
Question 8
A nurse is caring for a client with a chest tube. The nurse observes continuous bubbling in the
water seal chamber. What does this indicate?
A) The system is working correctly.
B) The client's lung has re-expanded.
C) There is an air leak in the system.
D) The chest tube is clogged.
Correct Answer: C) There is an air leak in the system.
Rationale: While intermittent bubbling with exhalation is normal when the tube is first
placed for a pneumothorax, continuous bubbling indicates a persistent air leak, either from
the client's lung or from a loose connection in the tubing system.
Question 9
A nurse is assisting a provider with the removal of a chest tube. Which action should the nurse
take?
A) Instruct the client to take a deep breath and hold it (Valsalva maneuver) as the tube is
removed.
B) Place the client in a high Fowler's position for the removal.
C) Have a new drainage system ready at the bedside.
D) Administer a sedative medication 30 minutes before the procedure.
A ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES
Question 1
A nurse is assessing a client for Chvostek's sign. Which action should the nurse take?
A) Apply a blood pressure cuff to the client's arm and inflate it.
B) Tap lightly on the client's cheek just anterior to the ear.
C) Ask the client to touch their chin to their chest.
D) Auscultate the client's carotid artery.
Correct Answer: D) Tap lightly on the client's cheek
Rationale: Chvostek's sign is a clinical sign of hypocalcemia. It is elicited by tapping on the
facial nerve just below the temple. A positive sign is a twitching of the facial muscles on the
same side.
Question 2
A nurse is caring for a client with hypocalcemia. Which of the following findings are expected
manifestations? (Select all that apply.)
A) Tingling in fingers
B) Poor skin turgor
C) Abdominal pain and cramping
D) Elevated temperature
E) Muscle twitching
Correct Answer: A, C, E
Rationale: Hypocalcemia increases neuromuscular excitability, leading to symptoms like
paresthesia (tingling), muscle twitches, tetany, and abdominal cramping/diarrhea.
Question 3
Which of the following is an associated manifestation of hyperkalemia?
A) Positive Trousseau's sign
B) ECG with tall, peaked T-waves
C) Bounding pulse
D) Hypoactive bowel sounds
Correct Answer: B) ECG with tall, peaked t-waves
,Rationale: Hyperkalemia alters cardiac electrical stability. Tall, peaked T-waves on an ECG
are a classic, early sign of high potassium levels.
Question 4
A nurse is planning care for a client scheduled for a thoracentesis. What is the appropriate
position for the client during the procedure?
A) Lying flat in a supine position.
B) In a side-lying position with the affected side up.
C) Sitting upright and leaning over an overbed table.
D) In a prone position with arms at the sides.
Correct Answer: C) Position the client upright, leaning over the bedside table
Rationale: This position widens the intercostal spaces and allows for easier access to the
pleural space for the provider, while also promoting comfort and stability for the client.
Question 5
A nurse is reviewing information with a client scheduled for pulmonary function tests (PFTs).
Which statement should the nurse make?
A) "Do not use your inhaler medications for 6 hours after the test."
B) "Do not smoke tobacco for 6 to 8 hours prior to the test."
C) "You will be asked to hold your breath for as long as possible."
D) "This test will require an arterial blood draw."
Correct Answer: B) "Do not smoke tobacco for 6-8 hr prior to the test."
Rationale: Smoking can cause bronchospasm and affect the accuracy of the PFT results.
The client must refrain from smoking for a specified period before the test.
Question 6
A nurse is assessing a client following a thoracentesis. Which finding should the nurse report to
the provider immediately?
A) A small amount of serosanguineous drainage on the dressing.
B) A report of pain at the puncture site.
C) Dyspnea and an asymmetrical chest wall.
D) A respiratory rate of 20/min.
Correct Answer: C) dyspnea
, Rationale: Dyspnea, tachypnea, and asymmetrical chest movement are signs of a potential
pneumothorax, a serious complication of thoracentesis where the lung has been punctured.
Question 7
What is the purpose of the water seal chamber in a three-chamber chest tube drainage system?
A) To collect drainage from the pleural space.
B) To control the amount of suction applied.
C) To allow air to exit the pleural space but not to re-enter.
D) To regulate the temperature of the drainage.
Correct Answer: C) To allow air to exit the pleural space but not to re-enter.
Rationale: The water seal acts as a one-way valve, preventing atmospheric air from being
drawn back into the chest, which would collapse the lung.
Question 8
A nurse is caring for a client with a chest tube. The nurse observes continuous bubbling in the
water seal chamber. What does this indicate?
A) The system is working correctly.
B) The client's lung has re-expanded.
C) There is an air leak in the system.
D) The chest tube is clogged.
Correct Answer: C) There is an air leak in the system.
Rationale: While intermittent bubbling with exhalation is normal when the tube is first
placed for a pneumothorax, continuous bubbling indicates a persistent air leak, either from
the client's lung or from a loose connection in the tubing system.
Question 9
A nurse is assisting a provider with the removal of a chest tube. Which action should the nurse
take?
A) Instruct the client to take a deep breath and hold it (Valsalva maneuver) as the tube is
removed.
B) Place the client in a high Fowler's position for the removal.
C) Have a new drainage system ready at the bedside.
D) Administer a sedative medication 30 minutes before the procedure.
