ATI RN CAPSTONE PROCTORED COMPREHENSIVE
ASSESSMENT 2026/2027 | Newest Version | NCLEX-RN
Test Plan | NGN Format | Pass Guaranteed - A+ Graded
SECTION 1: MANAGEMENT OF CARE & ETHICAL/LEGAL
PRINCIPLES (Questions 1-32)
Q1. A charge nurse on a medical-surgical unit is assigning client care at the
beginning of the shift. Which client assignment is most appropriate for a licensed
practical nurse (LPN)?
A. A client admitted 2 hours ago with acute chest pain awaiting cardiac
catheterization results
B. A client with stable heart failure requiring routine furosemide and daily weights
[CORRECT]
C. A client with newly diagnosed type 1 diabetes requiring insulin dose titration and
carbohydrate counting education
D. A client with a new colostomy requiring complex wound care and psychosocial
support
Rationale: LPN scope includes stable clients with predictable outcomes; stable heart
failure with routine medications and weights falls within LPN scope. Option A
requires RN-level assessment and monitoring of unstable cardiac status. Option C
requires RN-level teaching and complex insulin management. Option D requires RN-
level psychosocial intervention and complex wound assessment.
Correct Answer: B
,Q2. A nurse manager is reviewing incident reports. Which situation requires filing a
formal incident report?
A. A client refuses prescribed physical therapy
B. A client falls while ambulating to the bathroom without assistance after the nurse
instructed the client to call for help [CORRECT]
C. A client requests a different meal selection than what was ordered
D. A family member arrives 30 minutes after visiting hours end
Rationale: Client falls, especially when safety instructions were given, constitute
adverse events requiring formal incident reporting for quality improvement and risk
management. Options A, C, and D are routine occurrences that do not meet incident
report criteria.
Correct Answer: B
Q3. A nurse is caring for a client who is Jehovah's Witness and requires emergency
surgery. The client refuses blood transfusions based on religious beliefs. The client's
spouse demands the transfusion be given. What is the nurse's priority action?
A. Administer the blood transfusion as the spouse is the next of kin
B. Honor the client's refusal and notify the surgeon and risk management
[CORRECT]
C. Obtain a court order to override the client's refusal
D. Ask the hospital chaplain to convince the client to accept the transfusion
Rationale: Competent adults have the right to refuse treatment based on religious
beliefs; the nurse must honor autonomous refusal while ensuring appropriate
notification. Option A violates client autonomy. Option C is premature and legally
unnecessary for a competent adult. Option D constitutes coercion.
Correct Answer: B
,Q4. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Measuring and recording intake and output for a client with a Foley catheter
[CORRECT]
C. Teaching a client how to use an incentive spirometer
D. Evaluating a client's response to pain medication
Rationale: UAP scope includes routine data collection such as measuring I&O;
assessment, teaching, and evaluation remain RN responsibilities. Options A, C, and D
all require nursing judgment and are outside UAP scope.
Correct Answer: B
Q5. A client with end-stage renal disease has an advance directive stating "do not
resuscitate" (DNR). The client's adult child, who is the healthcare proxy, demands full
resuscitation measures. What is the nurse's priority action?
A. Initiate resuscitation as requested by the healthcare proxy
B. Review the advance directive with the healthcare proxy and contact the ethics
committee if conflict persists [CORRECT]
C. Ignore the advance directive and follow the child's wishes
D. Call the attending physician to override the advance directive
Rationale: When a proxy's instructions conflict with the advance directive,
clarification and ethics consultation are needed; the documented advance directive
generally guides care unless revoked. Option A may violate the client's documented
wishes. Option C is illegal. Option D improperly delegates decision-making.
Correct Answer: B
, Q6. A nurse is using the ABC priority framework for a client who presents with
shortness of breath, chest pain, and anxiety. Which intervention is the priority?
A. Administering anxiolytic medication for anxiety
B. Assessing airway patency and oxygen saturation [CORRECT]
C. Obtaining a 12-lead ECG
D. Inserting an IV line
Rationale: ABC framework prioritizes airway and breathing first; oxygenation
assessment is the priority before other interventions. Options A, C, and D are
important but secondary to ensuring adequate oxygenation.
Correct Answer: B
Q7. A nurse is supervising a newly licensed nurse who is performing a sterile dressing
change. The new nurse contaminates the sterile field by touching it with ungloved
hands. What is the appropriate action by the supervising nurse?
A. Allow the new nurse to continue and document the incident
B. Stop the procedure, have the new nurse set up a new sterile field, and use it as a
teaching moment [CORRECT]
C. Complete the dressing change herself and counsel the new nurse later
D. Report the new nurse to the nurse manager for disciplinary action
Rationale: Patient safety requires immediate correction; stopping the procedure and
re-establishing sterility while teaching is the appropriate supervisory response.
Option A compromises patient safety. Option C misses the immediate teaching
opportunity. Option D is excessive for a learning error.
Correct Answer: B
ASSESSMENT 2026/2027 | Newest Version | NCLEX-RN
Test Plan | NGN Format | Pass Guaranteed - A+ Graded
SECTION 1: MANAGEMENT OF CARE & ETHICAL/LEGAL
PRINCIPLES (Questions 1-32)
Q1. A charge nurse on a medical-surgical unit is assigning client care at the
beginning of the shift. Which client assignment is most appropriate for a licensed
practical nurse (LPN)?
A. A client admitted 2 hours ago with acute chest pain awaiting cardiac
catheterization results
B. A client with stable heart failure requiring routine furosemide and daily weights
[CORRECT]
C. A client with newly diagnosed type 1 diabetes requiring insulin dose titration and
carbohydrate counting education
D. A client with a new colostomy requiring complex wound care and psychosocial
support
Rationale: LPN scope includes stable clients with predictable outcomes; stable heart
failure with routine medications and weights falls within LPN scope. Option A
requires RN-level assessment and monitoring of unstable cardiac status. Option C
requires RN-level teaching and complex insulin management. Option D requires RN-
level psychosocial intervention and complex wound assessment.
Correct Answer: B
,Q2. A nurse manager is reviewing incident reports. Which situation requires filing a
formal incident report?
A. A client refuses prescribed physical therapy
B. A client falls while ambulating to the bathroom without assistance after the nurse
instructed the client to call for help [CORRECT]
C. A client requests a different meal selection than what was ordered
D. A family member arrives 30 minutes after visiting hours end
Rationale: Client falls, especially when safety instructions were given, constitute
adverse events requiring formal incident reporting for quality improvement and risk
management. Options A, C, and D are routine occurrences that do not meet incident
report criteria.
Correct Answer: B
Q3. A nurse is caring for a client who is Jehovah's Witness and requires emergency
surgery. The client refuses blood transfusions based on religious beliefs. The client's
spouse demands the transfusion be given. What is the nurse's priority action?
A. Administer the blood transfusion as the spouse is the next of kin
B. Honor the client's refusal and notify the surgeon and risk management
[CORRECT]
C. Obtain a court order to override the client's refusal
D. Ask the hospital chaplain to convince the client to accept the transfusion
Rationale: Competent adults have the right to refuse treatment based on religious
beliefs; the nurse must honor autonomous refusal while ensuring appropriate
notification. Option A violates client autonomy. Option C is premature and legally
unnecessary for a competent adult. Option D constitutes coercion.
Correct Answer: B
,Q4. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Measuring and recording intake and output for a client with a Foley catheter
[CORRECT]
C. Teaching a client how to use an incentive spirometer
D. Evaluating a client's response to pain medication
Rationale: UAP scope includes routine data collection such as measuring I&O;
assessment, teaching, and evaluation remain RN responsibilities. Options A, C, and D
all require nursing judgment and are outside UAP scope.
Correct Answer: B
Q5. A client with end-stage renal disease has an advance directive stating "do not
resuscitate" (DNR). The client's adult child, who is the healthcare proxy, demands full
resuscitation measures. What is the nurse's priority action?
A. Initiate resuscitation as requested by the healthcare proxy
B. Review the advance directive with the healthcare proxy and contact the ethics
committee if conflict persists [CORRECT]
C. Ignore the advance directive and follow the child's wishes
D. Call the attending physician to override the advance directive
Rationale: When a proxy's instructions conflict with the advance directive,
clarification and ethics consultation are needed; the documented advance directive
generally guides care unless revoked. Option A may violate the client's documented
wishes. Option C is illegal. Option D improperly delegates decision-making.
Correct Answer: B
, Q6. A nurse is using the ABC priority framework for a client who presents with
shortness of breath, chest pain, and anxiety. Which intervention is the priority?
A. Administering anxiolytic medication for anxiety
B. Assessing airway patency and oxygen saturation [CORRECT]
C. Obtaining a 12-lead ECG
D. Inserting an IV line
Rationale: ABC framework prioritizes airway and breathing first; oxygenation
assessment is the priority before other interventions. Options A, C, and D are
important but secondary to ensuring adequate oxygenation.
Correct Answer: B
Q7. A nurse is supervising a newly licensed nurse who is performing a sterile dressing
change. The new nurse contaminates the sterile field by touching it with ungloved
hands. What is the appropriate action by the supervising nurse?
A. Allow the new nurse to continue and document the incident
B. Stop the procedure, have the new nurse set up a new sterile field, and use it as a
teaching moment [CORRECT]
C. Complete the dressing change herself and counsel the new nurse later
D. Report the new nurse to the nurse manager for disciplinary action
Rationale: Patient safety requires immediate correction; stopping the procedure and
re-establishing sterility while teaching is the appropriate supervisory response.
Option A compromises patient safety. Option C misses the immediate teaching
opportunity. Option D is excessive for a learning error.
Correct Answer: B
