RN ATI Capstone Practice Exam —
Original Questions (2025_2026)
1. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula at 2 L/min. The client reports shortness of breath
and a respiratory rate of 30/min. What is the nurse’s first action?
A. Increase oxygen to 4 L/min
B. Call the provider immediately
C. Assess respiratory status (breath sounds, O₂ saturation)
D. Place client in supine position
Answer: C
Rationale: Assessment is the priority to identify cause of increased dyspnea before adjusting
oxygen or notifying provider.
2. A postoperative client who received morphine 4 mg IV 30 minutes ago is
drowsy with a respiratory rate of 8/min. Which action is priority?
A. Stimulate client and prepare naloxone if needed
B. Administer oxygen via nasal cannula
C. Monitor vital signs every 15 minutes
D. Call provider after one hour
Answer: A
Rationale: Opioid-induced respiratory depression is life-threatening; immediate stimulation and
reversal if necessary is priority.
3. A client with heart failure is prescribed furosemide. Which lab should the
nurse monitor most closely?
A. Sodium
B. Potassium
,C. Creatinine
D. Hemoglobin
Answer: B
Rationale: Loop diuretics cause potassium loss; hypokalemia can cause arrhythmias and
muscle weakness.
4. A mother asks why her newborn appears yellow on day 3. Which
statement is correct?
A. This is a sign of infection
B. Bilirubin levels are dangerously high
C. Jaundice is abnormal after day 2
D. Physiologic jaundice is common and usually resolves in 1–2 weeks
Answer: D
Rationale: Physiologic jaundice is due to immature bilirubin metabolism and typically resolves
without intervention.
5. A client admitted with diabetic ketoacidosis (DKA) has potassium 3.1
mEq/L. What should the nurse anticipate?
A. Begin insulin infusion immediately
B. Replace potassium before giving insulin
C. Hold fluids until potassium normalizes
D. Administer sodium bicarbonate
Answer: B
Rationale: Insulin shifts potassium into cells, which could worsen hypokalemia; correct
potassium first.
6. Which action reduces the risk of central line–associated bloodstream
infection (CLABSI)?
A. Perform chlorhexidine scrub and sterile dressing changes per protocol
B. Flush line only when IV fluids are disconnected
C. Clean hands with alcohol-based rub before handling line
D. Use the same line for blood draws and medications
,Answer: A
Rationale: Proper sterile technique during line care is key in preventing CLABSI.
7. A client with schizophrenia is started on haloperidol. Which side effect
requires immediate intervention?
A. Mild tremor
B. Sedation
C. High fever, rigidity, altered mental status
D. Dry mouth
Answer: C
Rationale: Neuroleptic malignant syndrome is life-threatening and requires immediate action.
8. A nurse prepares to administer IV vancomycin. What should be
monitored during infusion?
A. Heart rate
B. Blood pressure only
C. Red man syndrome (flushing, hypotension)
D. Urine output
Answer: C
Rationale: Rapid infusion can cause histamine-mediated reactions; infusion should be slowed
if this occurs.
9. A child with acute asthma uses albuterol. Which symptom indicates
effective treatment?
A. Increased wheezing
B. Improved oxygen saturation and decreased wheezing
C. Dry cough
D. Tachycardia
Answer: B
Rationale: Bronchodilation improves air flow and oxygenation.
, 10. A pregnant client at 34 weeks reports decreased fetal movement. Best
initial action?
A. Perform nonstress test or fetal movement assessment
B. Advise client to rest at home
C. Schedule an ultrasound next week
D. Give magnesium sulfate
Answer: A
Rationale: Decreased fetal movement can indicate fetal compromise; immediate assessment
is warranted.
11. A client on warfarin has INR 5.0 and minor bleeding. What is the priority
action?
A. Continue warfarin and monitor
B. Hold warfarin and administer vitamin K per provider order
C. Increase dose of warfarin
D. Give protamine sulfate
Answer: B
Rationale: High INR increases bleeding risk; vitamin K reverses anticoagulation safely.
12. A nurse is teaching a client about metformin. Which instruction is
important?
A. Take on an empty stomach
B. Avoid alcohol due to lactic acidosis risk
C. Skip doses if nausea occurs
D. Take with grapefruit juice
Answer: B
Rationale: Alcohol increases the risk of lactic acidosis; metformin should be taken with meals.
13. A client with acute pancreatitis reports severe epigastric pain and
low-grade fever. Which lab confirms diagnosis?
A. Elevated amylase and lipase
B. Elevated AST only
Original Questions (2025_2026)
1. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula at 2 L/min. The client reports shortness of breath
and a respiratory rate of 30/min. What is the nurse’s first action?
A. Increase oxygen to 4 L/min
B. Call the provider immediately
C. Assess respiratory status (breath sounds, O₂ saturation)
D. Place client in supine position
Answer: C
Rationale: Assessment is the priority to identify cause of increased dyspnea before adjusting
oxygen or notifying provider.
2. A postoperative client who received morphine 4 mg IV 30 minutes ago is
drowsy with a respiratory rate of 8/min. Which action is priority?
A. Stimulate client and prepare naloxone if needed
B. Administer oxygen via nasal cannula
C. Monitor vital signs every 15 minutes
D. Call provider after one hour
Answer: A
Rationale: Opioid-induced respiratory depression is life-threatening; immediate stimulation and
reversal if necessary is priority.
3. A client with heart failure is prescribed furosemide. Which lab should the
nurse monitor most closely?
A. Sodium
B. Potassium
,C. Creatinine
D. Hemoglobin
Answer: B
Rationale: Loop diuretics cause potassium loss; hypokalemia can cause arrhythmias and
muscle weakness.
4. A mother asks why her newborn appears yellow on day 3. Which
statement is correct?
A. This is a sign of infection
B. Bilirubin levels are dangerously high
C. Jaundice is abnormal after day 2
D. Physiologic jaundice is common and usually resolves in 1–2 weeks
Answer: D
Rationale: Physiologic jaundice is due to immature bilirubin metabolism and typically resolves
without intervention.
5. A client admitted with diabetic ketoacidosis (DKA) has potassium 3.1
mEq/L. What should the nurse anticipate?
A. Begin insulin infusion immediately
B. Replace potassium before giving insulin
C. Hold fluids until potassium normalizes
D. Administer sodium bicarbonate
Answer: B
Rationale: Insulin shifts potassium into cells, which could worsen hypokalemia; correct
potassium first.
6. Which action reduces the risk of central line–associated bloodstream
infection (CLABSI)?
A. Perform chlorhexidine scrub and sterile dressing changes per protocol
B. Flush line only when IV fluids are disconnected
C. Clean hands with alcohol-based rub before handling line
D. Use the same line for blood draws and medications
,Answer: A
Rationale: Proper sterile technique during line care is key in preventing CLABSI.
7. A client with schizophrenia is started on haloperidol. Which side effect
requires immediate intervention?
A. Mild tremor
B. Sedation
C. High fever, rigidity, altered mental status
D. Dry mouth
Answer: C
Rationale: Neuroleptic malignant syndrome is life-threatening and requires immediate action.
8. A nurse prepares to administer IV vancomycin. What should be
monitored during infusion?
A. Heart rate
B. Blood pressure only
C. Red man syndrome (flushing, hypotension)
D. Urine output
Answer: C
Rationale: Rapid infusion can cause histamine-mediated reactions; infusion should be slowed
if this occurs.
9. A child with acute asthma uses albuterol. Which symptom indicates
effective treatment?
A. Increased wheezing
B. Improved oxygen saturation and decreased wheezing
C. Dry cough
D. Tachycardia
Answer: B
Rationale: Bronchodilation improves air flow and oxygenation.
, 10. A pregnant client at 34 weeks reports decreased fetal movement. Best
initial action?
A. Perform nonstress test or fetal movement assessment
B. Advise client to rest at home
C. Schedule an ultrasound next week
D. Give magnesium sulfate
Answer: A
Rationale: Decreased fetal movement can indicate fetal compromise; immediate assessment
is warranted.
11. A client on warfarin has INR 5.0 and minor bleeding. What is the priority
action?
A. Continue warfarin and monitor
B. Hold warfarin and administer vitamin K per provider order
C. Increase dose of warfarin
D. Give protamine sulfate
Answer: B
Rationale: High INR increases bleeding risk; vitamin K reverses anticoagulation safely.
12. A nurse is teaching a client about metformin. Which instruction is
important?
A. Take on an empty stomach
B. Avoid alcohol due to lactic acidosis risk
C. Skip doses if nausea occurs
D. Take with grapefruit juice
Answer: B
Rationale: Alcohol increases the risk of lactic acidosis; metformin should be taken with meals.
13. A client with acute pancreatitis reports severe epigastric pain and
low-grade fever. Which lab confirms diagnosis?
A. Elevated amylase and lipase
B. Elevated AST only
