ATI Capstone Exam (2026–2027) | Complete 100-
Question NCLEX-RN Style Practice Exam with
Detailed Rationales, Comprehensive Review & Final
Nursing Prep Guide
Overview
This ATI Capstone Exam Practice Bundle is designed to help nursing students strengthen clinical
judgment, improve test-taking strategies, and prepare for the ATI Comprehensive Predictor and NCLEX-
RN® examination. The practice set includes 100 original NCLEX-style multiple-choice questions with
detailed rationales, focusing on high-yield nursing concepts commonly assessed during ATI Capstone
review courses and comprehensive exit examinations.
Questions emphasize patient safety, prioritization, delegation, evidence-based nursing interventions, and
integrated clinical reasoning across all major nursing specialties. Each item is designed to reinforce
foundational nursing knowledge, identify knowledge gaps, and improve confidence in managing complex
patient-care scenarios encountered on licensure examinations and in professional nursing practice.
Coverage
Fundamentals of Nursing and the Nursing Process
Management of Care and Nursing Leadership
Prioritization, Delegation, and Assignment Principles
Safety and Infection Prevention and Control
Medical-Surgical Nursing Across Major Body Systems
Cardiovascular Disorders and Emergency Interventions
Respiratory Disorders and Oxygenation Management
Neurological Conditions and Stroke Care
Endocrine Disorders and Diabetes Management
Renal and Urinary System Disorders
Gastrointestinal and Hepatic Disorders
Fluid, Electrolyte, and Acid-Base Imbalances
Pharmacology and Safe Medication Administration
Intravenous Therapy and Blood Product Administration
Critical Care and Emergency Nursing
Maternal-Newborn and Women's Health Nursing
Pediatric Nursing and Growth and Development
Mental Health and Therapeutic Communication
Health Promotion and Disease Prevention
Client Education and Discharge Planning
Laboratory Values and Diagnostic Interpretation
Next Generation NCLEX (NGN)-Style Clinical Judgment and Decision-Making
,1. A nurse is caring for a client who suddenly becomes short of breath and develops oxygen
saturation of 84% after receiving intravenous morphine. Which nursing action should the
nurse perform first?
A. Administer naloxone as prescribed.
B. Raise the head of the bed and assess respirations.
C. Notify the healthcare provider immediately.
D. Obtain an arterial blood gas sample.
Answer: B
Explanation: The priority is to support airway and breathing. Raising the head of the bed
and assessing respirations addresses the immediate life-threatening problem before
implementing additional interventions.
2. A nurse is assessing a client who has left-sided heart failure. Which finding should the
nurse expect to observe during assessment?
A. Jugular venous distention and ascites
B. Peripheral edema and hepatomegaly
C. Crackles in both lungs and dyspnea
D. Increased appetite and weight gain
Answer: C
Explanation: Left-sided heart failure commonly causes pulmonary congestion, resulting
in crackles, dyspnea, and orthopnea.
3. A nurse is preparing to administer insulin glargine to a client with type 1 diabetes mellitus.
Which statement accurately describes this medication?
A. It peaks approximately one hour after administration.
B. It may be mixed with regular insulin.
C. It provides rapid correction of hyperglycemia.
D. It has no pronounced peak and provides basal coverage.
,Answer: D
Explanation: Insulin glargine is a long-acting insulin with no significant peak and provides
steady basal insulin coverage.
4. A nurse is caring for a client receiving a blood transfusion who suddenly develops chills,
fever, and lower back pain. Which action should the nurse take first?
A. Stop the blood transfusion immediately.
B. Administer prescribed acetaminophen.
C. Continue the transfusion at a slower rate.
D. Obtain a complete blood count.
Answer: A
Explanation: These findings suggest an acute hemolytic transfusion reaction. The nurse
should immediately stop the transfusion.
5. A nurse is teaching a client newly diagnosed with deep vein thrombosis about prevention
of pulmonary embolism. Which instruction should the nurse include?
A. Massage the affected leg several times daily.
B. Apply warm compresses and elevate the extremity.
C. Ambulate without anticoagulant therapy.
D. Restrict fluid intake to prevent edema.
Answer: B
Explanation: Warm compresses, leg elevation, and anticoagulation therapy help reduce
symptoms and prevent complications.
6. A nurse is assessing a client experiencing hypoglycemia. Which finding should the nurse
expect to identify first?
A. Fruity breath odor
B. Warm, dry skin
C. Polyuria and polydipsia
D. Diaphoresis and tremors
, Answer: D
Explanation: Early manifestations of hypoglycemia include diaphoresis, shakiness,
tachycardia, and hunger.
7. A nurse is caring for a postoperative client who suddenly reports calf pain and swelling.
Which action is the nurse's priority?
A. Encourage ambulation immediately.
B. Massage the calf gently.
C. Keep the client on bed rest and notify the provider.
D. Apply sequential compression devices.
Answer: C
Explanation: The client may have developed a deep vein thrombosis. Bed rest and
provider notification are priorities to reduce embolization risk.
8. A nurse is teaching a client who has heart failure about reducing fluid overload. Which
statement by the client indicates understanding?
A. "I will weigh myself every morning at the same time."
B. "I should increase my sodium intake when fatigued."
C. "I will stop taking my diuretic if I feel better."
D. "I should drink as much water as possible."
Answer: A
Explanation: Daily weight measurements are important for monitoring fluid retention and
worsening heart failure.
9. A nurse is caring for a client with chronic obstructive pulmonary disease who suddenly
becomes restless and confused. Which action should the nurse take first?
A. Increase oxygen to 10 liters per minute.
B. Assess oxygen saturation and respiratory status.
C. Administer prescribed sedatives.
D. Place the client in the supine position.
Question NCLEX-RN Style Practice Exam with
Detailed Rationales, Comprehensive Review & Final
Nursing Prep Guide
Overview
This ATI Capstone Exam Practice Bundle is designed to help nursing students strengthen clinical
judgment, improve test-taking strategies, and prepare for the ATI Comprehensive Predictor and NCLEX-
RN® examination. The practice set includes 100 original NCLEX-style multiple-choice questions with
detailed rationales, focusing on high-yield nursing concepts commonly assessed during ATI Capstone
review courses and comprehensive exit examinations.
Questions emphasize patient safety, prioritization, delegation, evidence-based nursing interventions, and
integrated clinical reasoning across all major nursing specialties. Each item is designed to reinforce
foundational nursing knowledge, identify knowledge gaps, and improve confidence in managing complex
patient-care scenarios encountered on licensure examinations and in professional nursing practice.
Coverage
Fundamentals of Nursing and the Nursing Process
Management of Care and Nursing Leadership
Prioritization, Delegation, and Assignment Principles
Safety and Infection Prevention and Control
Medical-Surgical Nursing Across Major Body Systems
Cardiovascular Disorders and Emergency Interventions
Respiratory Disorders and Oxygenation Management
Neurological Conditions and Stroke Care
Endocrine Disorders and Diabetes Management
Renal and Urinary System Disorders
Gastrointestinal and Hepatic Disorders
Fluid, Electrolyte, and Acid-Base Imbalances
Pharmacology and Safe Medication Administration
Intravenous Therapy and Blood Product Administration
Critical Care and Emergency Nursing
Maternal-Newborn and Women's Health Nursing
Pediatric Nursing and Growth and Development
Mental Health and Therapeutic Communication
Health Promotion and Disease Prevention
Client Education and Discharge Planning
Laboratory Values and Diagnostic Interpretation
Next Generation NCLEX (NGN)-Style Clinical Judgment and Decision-Making
,1. A nurse is caring for a client who suddenly becomes short of breath and develops oxygen
saturation of 84% after receiving intravenous morphine. Which nursing action should the
nurse perform first?
A. Administer naloxone as prescribed.
B. Raise the head of the bed and assess respirations.
C. Notify the healthcare provider immediately.
D. Obtain an arterial blood gas sample.
Answer: B
Explanation: The priority is to support airway and breathing. Raising the head of the bed
and assessing respirations addresses the immediate life-threatening problem before
implementing additional interventions.
2. A nurse is assessing a client who has left-sided heart failure. Which finding should the
nurse expect to observe during assessment?
A. Jugular venous distention and ascites
B. Peripheral edema and hepatomegaly
C. Crackles in both lungs and dyspnea
D. Increased appetite and weight gain
Answer: C
Explanation: Left-sided heart failure commonly causes pulmonary congestion, resulting
in crackles, dyspnea, and orthopnea.
3. A nurse is preparing to administer insulin glargine to a client with type 1 diabetes mellitus.
Which statement accurately describes this medication?
A. It peaks approximately one hour after administration.
B. It may be mixed with regular insulin.
C. It provides rapid correction of hyperglycemia.
D. It has no pronounced peak and provides basal coverage.
,Answer: D
Explanation: Insulin glargine is a long-acting insulin with no significant peak and provides
steady basal insulin coverage.
4. A nurse is caring for a client receiving a blood transfusion who suddenly develops chills,
fever, and lower back pain. Which action should the nurse take first?
A. Stop the blood transfusion immediately.
B. Administer prescribed acetaminophen.
C. Continue the transfusion at a slower rate.
D. Obtain a complete blood count.
Answer: A
Explanation: These findings suggest an acute hemolytic transfusion reaction. The nurse
should immediately stop the transfusion.
5. A nurse is teaching a client newly diagnosed with deep vein thrombosis about prevention
of pulmonary embolism. Which instruction should the nurse include?
A. Massage the affected leg several times daily.
B. Apply warm compresses and elevate the extremity.
C. Ambulate without anticoagulant therapy.
D. Restrict fluid intake to prevent edema.
Answer: B
Explanation: Warm compresses, leg elevation, and anticoagulation therapy help reduce
symptoms and prevent complications.
6. A nurse is assessing a client experiencing hypoglycemia. Which finding should the nurse
expect to identify first?
A. Fruity breath odor
B. Warm, dry skin
C. Polyuria and polydipsia
D. Diaphoresis and tremors
, Answer: D
Explanation: Early manifestations of hypoglycemia include diaphoresis, shakiness,
tachycardia, and hunger.
7. A nurse is caring for a postoperative client who suddenly reports calf pain and swelling.
Which action is the nurse's priority?
A. Encourage ambulation immediately.
B. Massage the calf gently.
C. Keep the client on bed rest and notify the provider.
D. Apply sequential compression devices.
Answer: C
Explanation: The client may have developed a deep vein thrombosis. Bed rest and
provider notification are priorities to reduce embolization risk.
8. A nurse is teaching a client who has heart failure about reducing fluid overload. Which
statement by the client indicates understanding?
A. "I will weigh myself every morning at the same time."
B. "I should increase my sodium intake when fatigued."
C. "I will stop taking my diuretic if I feel better."
D. "I should drink as much water as possible."
Answer: A
Explanation: Daily weight measurements are important for monitoring fluid retention and
worsening heart failure.
9. A nurse is caring for a client with chronic obstructive pulmonary disease who suddenly
becomes restless and confused. Which action should the nurse take first?
A. Increase oxygen to 10 liters per minute.
B. Assess oxygen saturation and respiratory status.
C. Administer prescribed sedatives.
D. Place the client in the supine position.
