Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 1 of 105 ustom: Capstone Exam 1 - 0126
A nurse is planning care for a client who has an absolute neutrophil count (ANC) less than
1,000/mm³. Which of the following interventions should the nurse include in the plan?
✓ A. Limit visitors to healthy adults.
B. Take the client's rectal temperature each day.
C. Instruct the client to floss his teeth daily.
D. Increase raw produce in the client's diet.
✓ Correct Answer: A
An ANC <1,000/mm³ indicates severe neutropenia (nadir) — the client is at extreme risk for life-threatening infection.
LIMITING VISITORS to healthy adults prevents transmission of pathogens. Rectal temperatures are CONTRAINDICATED
in neutropenic clients (mucosal trauma, infection risk). Flossing causes bleeding and introduces oral bacteria. Raw
produce (uncooked fruits/vegetables) harbors bacteria and fungi — a low-microbial diet (cooked foods only) is required.
, Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 9 of 105 Custom: Capstone Exam 1 - 0126
A public health nurse is assessing an older adult client who lives with a family member. The nurse
identifies several bruises in various stages of healing. The client and family member explain that the
bruises are a result of clumsiness. However, based on the distribution of the bruises, the nurse
suspects abuse. Which of the following actions should the nurse take first?
A. Discuss respite care with the client's family.
B. Provide the client with a crisis hotline number.
✓ C. Report the findings to a supervisor.
D. Document the bruises in the client's chart.
✓ Correct Answer: C
When elder abuse is suspected, the FIRST action is to REPORT to a supervisor — nurses are mandated reporters and
must follow the facility/agency chain of command and report suspected abuse to Adult Protective Services. Reporting to a
supervisor ensures proper protocols are activated. Documenting findings is essential but follows the reporting obligation.
Providing crisis hotline numbers and discussing respite care are secondary — safety must be addressed first through
proper reporting channels.
, Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 10 of 105 Custom: Capstone Exam 1 - 0126
A nurse is caring for a client who has emphysema. Which of the following findings should the nurse
expect to assess in this client? (Select all that apply.)
A. Bradycardia
✓ B. Barrel chest
C. Deep respirations
✓ D. Dyspnea
✓ E. Clubbing of the fingers
✓ Correct Answer: B, D, E
Emphysema is a COPD characterized by destruction of alveolar walls and air trapping. Expected findings include:
BARREL CHEST (increased AP diameter from air trapping and lung hyperinflation); DYSPNEA (progressively worsening,
especially on exertion); CLUBBING of the fingers (chronic hypoxia). Deep respirations are NOT typical — emphysema
causes SHALLOW, labored breathing with prolonged expiration. Bradycardia is NOT expected — tachycardia occurs as
compensation for hypoxemia.
, Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 25 of 105 Custom: Capstone Exam 1 - 0126
A nurse is caring for a client who has bipolar disorder. Which of the following actions by the client
should the nurse interpret as displaying manic behavior? (Select all that apply.)
✓ A. Spending large sums of money
B. Sleeping for long periods of time
✓ C. Talking in rapid, continuous speech
D. Dressing in black or grey clothing
✓ E. Interacting with others in a flirtatious way
✓ Correct Answer: A, C, E
MANIC EPISODE features (bipolar disorder): grandiosity, decreased need for sleep (not hypersomnia),
PRESSURED/RAPID SPEECH (flight of ideas), impulsive behaviors including EXCESSIVE SPENDING (poor judgment),
hypersexuality/FLIRTATIOUS behavior, increased goal-directed activity, and distractibility. Sleeping for long periods is a
feature of DEPRESSION, not mania. Wearing dark clothing may suggest depression — mania is associated with bright,
flamboyant dress.
2026 Exam · 105 Questions · With Rationales
Question: 1 of 105 ustom: Capstone Exam 1 - 0126
A nurse is planning care for a client who has an absolute neutrophil count (ANC) less than
1,000/mm³. Which of the following interventions should the nurse include in the plan?
✓ A. Limit visitors to healthy adults.
B. Take the client's rectal temperature each day.
C. Instruct the client to floss his teeth daily.
D. Increase raw produce in the client's diet.
✓ Correct Answer: A
An ANC <1,000/mm³ indicates severe neutropenia (nadir) — the client is at extreme risk for life-threatening infection.
LIMITING VISITORS to healthy adults prevents transmission of pathogens. Rectal temperatures are CONTRAINDICATED
in neutropenic clients (mucosal trauma, infection risk). Flossing causes bleeding and introduces oral bacteria. Raw
produce (uncooked fruits/vegetables) harbors bacteria and fungi — a low-microbial diet (cooked foods only) is required.
, Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 9 of 105 Custom: Capstone Exam 1 - 0126
A public health nurse is assessing an older adult client who lives with a family member. The nurse
identifies several bruises in various stages of healing. The client and family member explain that the
bruises are a result of clumsiness. However, based on the distribution of the bruises, the nurse
suspects abuse. Which of the following actions should the nurse take first?
A. Discuss respite care with the client's family.
B. Provide the client with a crisis hotline number.
✓ C. Report the findings to a supervisor.
D. Document the bruises in the client's chart.
✓ Correct Answer: C
When elder abuse is suspected, the FIRST action is to REPORT to a supervisor — nurses are mandated reporters and
must follow the facility/agency chain of command and report suspected abuse to Adult Protective Services. Reporting to a
supervisor ensures proper protocols are activated. Documenting findings is essential but follows the reporting obligation.
Providing crisis hotline numbers and discussing respite care are secondary — safety must be addressed first through
proper reporting channels.
, Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 10 of 105 Custom: Capstone Exam 1 - 0126
A nurse is caring for a client who has emphysema. Which of the following findings should the nurse
expect to assess in this client? (Select all that apply.)
A. Bradycardia
✓ B. Barrel chest
C. Deep respirations
✓ D. Dyspnea
✓ E. Clubbing of the fingers
✓ Correct Answer: B, D, E
Emphysema is a COPD characterized by destruction of alveolar walls and air trapping. Expected findings include:
BARREL CHEST (increased AP diameter from air trapping and lung hyperinflation); DYSPNEA (progressively worsening,
especially on exertion); CLUBBING of the fingers (chronic hypoxia). Deep respirations are NOT typical — emphysema
causes SHALLOW, labored breathing with prolonged expiration. Bradycardia is NOT expected — tachycardia occurs as
compensation for hypoxemia.
, Custom: Capstone Exam 1 - 0126
2026 Exam · 105 Questions · With Rationales
Question: 25 of 105 Custom: Capstone Exam 1 - 0126
A nurse is caring for a client who has bipolar disorder. Which of the following actions by the client
should the nurse interpret as displaying manic behavior? (Select all that apply.)
✓ A. Spending large sums of money
B. Sleeping for long periods of time
✓ C. Talking in rapid, continuous speech
D. Dressing in black or grey clothing
✓ E. Interacting with others in a flirtatious way
✓ Correct Answer: A, C, E
MANIC EPISODE features (bipolar disorder): grandiosity, decreased need for sleep (not hypersomnia),
PRESSURED/RAPID SPEECH (flight of ideas), impulsive behaviors including EXCESSIVE SPENDING (poor judgment),
hypersexuality/FLIRTATIOUS behavior, increased goal-directed activity, and distractibility. Sleeping for long periods is a
feature of DEPRESSION, not mania. Wearing dark clothing may suggest depression — mania is associated with bright,
flamboyant dress.
