ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
ATI RN Capstone Proctored Comprehensive
Assessment Version B
150 Questions and Answers | 2026/2027 Updated | NGN Clinical Judgment Integrated
Total Questions 150 Questions (Q1-Q150)
Cognitive Levels 25% Recall | 55% Application | 20% Analysis
Standard Alignment ATI Comprehensive Predictor + NCJMM (2026/2027)
Question Style 75% scenario-based | 20% direct recall | 5% clinical analysis
Sections 9 content areas covering full ATI Capstone blueprint
SECTION 1: Management of Care and Leadership | Q1-Q25
Prioritization, Delegation, Assignment, Legal/Ethical Issues, and Interdisciplinary Collaboration. Tests ATI priority frameworks
(ABCs, Maslow, Safety, Least Restrictive, Acute vs. Chronic, Actual vs. Potential), delegation to RN/LPN/UAP, informed consent,
advance directives, HIPAA, mandatory reporting, Tarasoff duty, restraints, SBAR communication, and quality improvement
(PDSA).
Q1: A nurse on a medical-surgical unit is assigned four clients. Which client should the nurse assess first?
A. A client who is 2 days postoperative requesting pain medication for incisional pain rated 6/10
B. A client with heart failure whose weight has increased by 1 kg since yesterday
C. A client with chronic kidney disease who is refusing to take prescribed phosphate binders
D. A client who is 4 hours post-thoracentesis reporting new-onset shortness of breath [CORRECT]
Correct Answer: D
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework and the acute vs. chronic principle, the client
reporting new-onset shortness of breath 4 hours after a thoracentesis is at highest priority. This could indicate a pneumothorax,
a potentially life-threatening complication. New-onset respiratory distress after an invasive chest procedure is an acute, actual
problem requiring immediate assessment. Option B is an actual problem but chronic in nature. Option A requires pain
management but is not life-threatening. Option C is a chronic behavioral issue requiring teaching.
Q2: A charge nurse is planning assignments for the shift. Which client should be assigned to the most
experienced RN?
A. A client with a stage 3 pressure ulcer requiring a wet-to-dry dressing change
B. A client who is 6 hours postop from a total hip replacement needing assistance with repositioning
C. A client who was admitted 2 hours ago with acute gastrointestinal bleeding and is receiving a blood
transfusion [CORRECT]
D. A client with pneumonia who requires assistance with ambulation and incentive spirometry teaching
Correct Answer: C
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,ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
Rationale: According to the ATI delegation guidelines, the RN must care for unstable clients and clients receiving blood
products. A client with acute GI bleeding who is receiving a blood transfusion is hemodynamically unstable and requires close
monitoring for transfusion reactions and ongoing bleeding assessment. This exceeds the LPN/LVN scope (blood administration
is RN-only). Option A could be delegated to an LPN (stable client, sterile dressing). Option B can be delegated to UAP for
repositioning with RN supervision. Option D can be delegated to LPN with stable client.
Q3: A nurse is caring for a client who is scheduled for an elective cholecystectomy tomorrow. The client
signed the consent form 1 hour ago but now tells the nurse, "I really don't understand what they're going to
do." What is the nurse's priority action?
A. Explain the surgical procedure in detail to the client
B. Notify the surgeon that the client has questions about the procedure [CORRECT]
C. Reassure the client that the surgeon knows what is best
D. Ask the client to sign a new consent form after explaining the procedure
Correct Answer: B
Rationale: Informed consent requires that the provider (surgeon) explain the procedure, risks, benefits, and alternatives. The
nurse's role is to witness the signature and ensure understanding. If the client does not understand, the nurse must notify the
provider so they can return to discuss the procedure. The nurse should NOT explain the procedure (Option A) because this is
the provider's legal responsibility. Option C is false reassurance. Option D is incorrect because the nurse cannot obtain
informed consent; only the provider can.
Q4: A nurse is receiving a handoff report using SBAR communication. Which statement by the nurse giving
report represents the "Assessment" component?
A. "The client was admitted yesterday with pneumonia."
B. "I think the client is developing acute respiratory distress." [CORRECT]
C. "The client's respiratory rate is 28 and oxygen saturation is 88% on room air."
D. "I recommend you call the rapid response team immediately."
Correct Answer: B
Rationale: In SBAR (Situation, Background, Assessment, Recommendation), the Assessment component is the nurse's
professional judgment or interpretation of the client's condition. Option B ("I think the client is developing acute respiratory
distress") represents the nurse's assessment. Option A is Background (history). Option C is Situation (current vital signs/data).
Option D is Recommendation (suggested action). Understanding SBAR structure facilitates clear interdisciplinary
communication and patient safety.
Q5: A nurse is preparing to administer medications to four clients. Which medication should the nurse
administer first?
A. Furosemide 40 mg PO to a client with heart failure
B. Insulin lispro 10 units subcutaneous to a client with a blood glucose of 250 mg/dL [CORRECT]
C. Acetaminophen 650 mg PO to a client with a temperature of 38.3°C (101°F)
D. Pantoprazole 40 mg IV to a client with a GI bleed history
Correct Answer: B
Rationale: Using the ABCs and safety framework, insulin lispro (a rapid-acting insulin) must be administered immediately
before or within 15 minutes of meals to prevent hypoglycemia, and elevated blood glucose of 250 mg/dL requires timely
intervention. Insulin is also a high-alert medication requiring priority. Option A (furosemide) is important but not immediately
time-critical. Option C (acetaminophen) is for mild fever management, non-emergent. Option D (pantoprazole) is routine
prophylactic medication. Time-critical medications like rapid-acting insulin and antibiotics require priority administration.
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,ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
Q6: A nurse manager is implementing a quality improvement project to reduce falls on a medical-surgical
unit. Which framework should the nurse use to guide this project?
A. SBAR communication
B. PDSA (Plan-Do-Study-Act) [CORRECT]
C. Root cause analysis (RCA)
D. Failure mode and effects analysis (FMEA)
Correct Answer: B
Rationale: The PDSA (Plan-Do-Study-Act) cycle is the primary quality improvement framework used to test and implement
changes in practice. The nurse would plan the intervention (e.g., new fall risk protocol), do the intervention on a small scale,
study the results (data on fall rates), and act based on findings to refine or expand. Option A is communication, not QI. Option
C (RCA) is used after a sentinel event to find causes. Option D (FMEA) is proactive risk assessment. PDSA is the ongoing QI
framework.
Q7: A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's family requests that
everything be done if the client stops breathing. What is the nurse's best response?
A. Honor the family's request and initiate CPR if needed
B. Follow the DNR order as written by the provider [CORRECT]
C. Call the provider to clarify the order and request an ethics consult
D. Ask the family to leave if they cannot accept the DNR
Correct Answer: B
Rationale: A DNR order is a medical order written by the provider after discussion with the client or surrogate
decision-maker. Once written, the nurse must follow the order. The nurse's priority is to follow the provider's order while
facilitating communication between the family and provider. Option C is appropriate if there is conflict, but the immediate
action is to follow the DNR. Option A violates the order. Option D is non-therapeutic. The nurse should facilitate a care
conference with the provider and family.
Q8: A nurse is delegating tasks to a UAP. Which task is appropriate to delegate?
A. Measuring vital signs on a client who is 2 hours postoperative and hemodynamically unstable
B. Teaching a client about a low-sodium diet before discharge
C. Ambulating a stable client who is 1 day postoperative from an appendectomy [CORRECT]
D. Administering an oral medication to a client with swallowing difficulties
Correct Answer: C
Rationale: According to ATI delegation principles, the UAP can ambulate stable clients. Option A is incorrect because the
client is unstable (postoperative and hemodynamically unstable); vital signs on unstable clients must be done by the RN. Option
B is incorrect because client teaching is RN scope (LPN can reinforce teaching). Option D is incorrect because the client has
swallowing difficulties, which is a complex situation requiring nursing judgment (aspiration risk). The Five Rights of
Delegation ensure appropriate task assignment.
Q9: A nurse discovers that a colleague has been diverting narcotics from the medication dispensing system.
What is the nurse's priority action?
A. Confront the colleague directly and ask them to stop
B. Report the suspicion to the nurse manager and follow facility policy [CORRECT]
C. Ignore the situation since there is no proof
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, ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
D. Document the observations in the client's medical record
Correct Answer: B
Rationale: Impaired healthcare providers are a mandatory reporting issue and pose a safety risk to clients. The nurse must
report suspicions to the nurse manager and follow facility policy, which may include reporting to the Board of Nursing. Option
A is unsafe and may endanger the nurse. Option C violates the ethical duty to protect clients. Option D is incorrect because the
diversion should be documented through facility channels, not in client records. Reporting protects clients and supports the
impaired colleague.
Q10: A client with a terminal illness tells the nurse, "I want my daughter to make decisions for me if I
cannot." Which document should the nurse recommend the client complete?
A. Living will
B. Durable power of attorney for health care [CORRECT]
C. Do-not-resuscitate order
D. Informed consent
Correct Answer: B
Rationale: A durable power of attorney for health care (DPOA-HC) designates a specific person (proxy) to make healthcare
decisions when the client cannot. This is what the client is requesting. Option A (living will) specifies treatment preferences but
does not designate a decision-maker. Option C (DNR) is a specific medical order. Option D (informed consent) is
procedure-specific. Advance care planning ensures client autonomy and is facilitated by nursing assessment and education.
Q11: A nurse is caring for a client who speaks a different language than the nurse. The client needs education
about a new diagnosis. Which action is most appropriate?
A. Ask the client's family member to translate
B. Use pictures and gestures to explain the diagnosis
C. Arrange for a trained medical interpreter [CORRECT]
D. Provide written materials in the client's language
Correct Answer: C
Rationale: A trained medical interpreter is required for accurate, unbiased communication. Family members (Option A) may
have conflicts of interest, lack medical terminology, or impose their own interpretation. Pictures and gestures (Option B) are
insufficient for complex medical information. Written materials alone (Option D) cannot replace interactive communication.
HIPAA and the Affordable Care Act require provision of language services. The nurse must document the interpreter's name in
the medical record.
Q12: A client is threatening to leave the hospital against medical advice (AMA). What is the nurse's priority
action?
A. Restrain the client to prevent them from leaving
B. Notify the provider and have the client sign AMA forms after explaining the risks [CORRECT]
C. Call security to escort the client off the property
D. Allow the client to leave without documentation
Correct Answer: B
Rationale: A competent adult client has the right to refuse treatment and leave AMA. The nurse's priority is to notify the
provider, explain the risks of leaving, and have the client sign AMA forms documenting informed refusal. Option A is false
imprisonment. Option C is unnecessary if the client is competent. Option D violates documentation requirements. The nurse
should also continue therapeutic communication to address concerns and offer alternatives.
NCJMM Integrated | 2026/2027 Updated Page 4
ATI RN Capstone Proctored Comprehensive
Assessment Version B
150 Questions and Answers | 2026/2027 Updated | NGN Clinical Judgment Integrated
Total Questions 150 Questions (Q1-Q150)
Cognitive Levels 25% Recall | 55% Application | 20% Analysis
Standard Alignment ATI Comprehensive Predictor + NCJMM (2026/2027)
Question Style 75% scenario-based | 20% direct recall | 5% clinical analysis
Sections 9 content areas covering full ATI Capstone blueprint
SECTION 1: Management of Care and Leadership | Q1-Q25
Prioritization, Delegation, Assignment, Legal/Ethical Issues, and Interdisciplinary Collaboration. Tests ATI priority frameworks
(ABCs, Maslow, Safety, Least Restrictive, Acute vs. Chronic, Actual vs. Potential), delegation to RN/LPN/UAP, informed consent,
advance directives, HIPAA, mandatory reporting, Tarasoff duty, restraints, SBAR communication, and quality improvement
(PDSA).
Q1: A nurse on a medical-surgical unit is assigned four clients. Which client should the nurse assess first?
A. A client who is 2 days postoperative requesting pain medication for incisional pain rated 6/10
B. A client with heart failure whose weight has increased by 1 kg since yesterday
C. A client with chronic kidney disease who is refusing to take prescribed phosphate binders
D. A client who is 4 hours post-thoracentesis reporting new-onset shortness of breath [CORRECT]
Correct Answer: D
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework and the acute vs. chronic principle, the client
reporting new-onset shortness of breath 4 hours after a thoracentesis is at highest priority. This could indicate a pneumothorax,
a potentially life-threatening complication. New-onset respiratory distress after an invasive chest procedure is an acute, actual
problem requiring immediate assessment. Option B is an actual problem but chronic in nature. Option A requires pain
management but is not life-threatening. Option C is a chronic behavioral issue requiring teaching.
Q2: A charge nurse is planning assignments for the shift. Which client should be assigned to the most
experienced RN?
A. A client with a stage 3 pressure ulcer requiring a wet-to-dry dressing change
B. A client who is 6 hours postop from a total hip replacement needing assistance with repositioning
C. A client who was admitted 2 hours ago with acute gastrointestinal bleeding and is receiving a blood
transfusion [CORRECT]
D. A client with pneumonia who requires assistance with ambulation and incentive spirometry teaching
Correct Answer: C
NCJMM Integrated | 2026/2027 Updated Page 1
,ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
Rationale: According to the ATI delegation guidelines, the RN must care for unstable clients and clients receiving blood
products. A client with acute GI bleeding who is receiving a blood transfusion is hemodynamically unstable and requires close
monitoring for transfusion reactions and ongoing bleeding assessment. This exceeds the LPN/LVN scope (blood administration
is RN-only). Option A could be delegated to an LPN (stable client, sterile dressing). Option B can be delegated to UAP for
repositioning with RN supervision. Option D can be delegated to LPN with stable client.
Q3: A nurse is caring for a client who is scheduled for an elective cholecystectomy tomorrow. The client
signed the consent form 1 hour ago but now tells the nurse, "I really don't understand what they're going to
do." What is the nurse's priority action?
A. Explain the surgical procedure in detail to the client
B. Notify the surgeon that the client has questions about the procedure [CORRECT]
C. Reassure the client that the surgeon knows what is best
D. Ask the client to sign a new consent form after explaining the procedure
Correct Answer: B
Rationale: Informed consent requires that the provider (surgeon) explain the procedure, risks, benefits, and alternatives. The
nurse's role is to witness the signature and ensure understanding. If the client does not understand, the nurse must notify the
provider so they can return to discuss the procedure. The nurse should NOT explain the procedure (Option A) because this is
the provider's legal responsibility. Option C is false reassurance. Option D is incorrect because the nurse cannot obtain
informed consent; only the provider can.
Q4: A nurse is receiving a handoff report using SBAR communication. Which statement by the nurse giving
report represents the "Assessment" component?
A. "The client was admitted yesterday with pneumonia."
B. "I think the client is developing acute respiratory distress." [CORRECT]
C. "The client's respiratory rate is 28 and oxygen saturation is 88% on room air."
D. "I recommend you call the rapid response team immediately."
Correct Answer: B
Rationale: In SBAR (Situation, Background, Assessment, Recommendation), the Assessment component is the nurse's
professional judgment or interpretation of the client's condition. Option B ("I think the client is developing acute respiratory
distress") represents the nurse's assessment. Option A is Background (history). Option C is Situation (current vital signs/data).
Option D is Recommendation (suggested action). Understanding SBAR structure facilitates clear interdisciplinary
communication and patient safety.
Q5: A nurse is preparing to administer medications to four clients. Which medication should the nurse
administer first?
A. Furosemide 40 mg PO to a client with heart failure
B. Insulin lispro 10 units subcutaneous to a client with a blood glucose of 250 mg/dL [CORRECT]
C. Acetaminophen 650 mg PO to a client with a temperature of 38.3°C (101°F)
D. Pantoprazole 40 mg IV to a client with a GI bleed history
Correct Answer: B
Rationale: Using the ABCs and safety framework, insulin lispro (a rapid-acting insulin) must be administered immediately
before or within 15 minutes of meals to prevent hypoglycemia, and elevated blood glucose of 250 mg/dL requires timely
intervention. Insulin is also a high-alert medication requiring priority. Option A (furosemide) is important but not immediately
time-critical. Option C (acetaminophen) is for mild fever management, non-emergent. Option D (pantoprazole) is routine
prophylactic medication. Time-critical medications like rapid-acting insulin and antibiotics require priority administration.
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,ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
Q6: A nurse manager is implementing a quality improvement project to reduce falls on a medical-surgical
unit. Which framework should the nurse use to guide this project?
A. SBAR communication
B. PDSA (Plan-Do-Study-Act) [CORRECT]
C. Root cause analysis (RCA)
D. Failure mode and effects analysis (FMEA)
Correct Answer: B
Rationale: The PDSA (Plan-Do-Study-Act) cycle is the primary quality improvement framework used to test and implement
changes in practice. The nurse would plan the intervention (e.g., new fall risk protocol), do the intervention on a small scale,
study the results (data on fall rates), and act based on findings to refine or expand. Option A is communication, not QI. Option
C (RCA) is used after a sentinel event to find causes. Option D (FMEA) is proactive risk assessment. PDSA is the ongoing QI
framework.
Q7: A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's family requests that
everything be done if the client stops breathing. What is the nurse's best response?
A. Honor the family's request and initiate CPR if needed
B. Follow the DNR order as written by the provider [CORRECT]
C. Call the provider to clarify the order and request an ethics consult
D. Ask the family to leave if they cannot accept the DNR
Correct Answer: B
Rationale: A DNR order is a medical order written by the provider after discussion with the client or surrogate
decision-maker. Once written, the nurse must follow the order. The nurse's priority is to follow the provider's order while
facilitating communication between the family and provider. Option C is appropriate if there is conflict, but the immediate
action is to follow the DNR. Option A violates the order. Option D is non-therapeutic. The nurse should facilitate a care
conference with the provider and family.
Q8: A nurse is delegating tasks to a UAP. Which task is appropriate to delegate?
A. Measuring vital signs on a client who is 2 hours postoperative and hemodynamically unstable
B. Teaching a client about a low-sodium diet before discharge
C. Ambulating a stable client who is 1 day postoperative from an appendectomy [CORRECT]
D. Administering an oral medication to a client with swallowing difficulties
Correct Answer: C
Rationale: According to ATI delegation principles, the UAP can ambulate stable clients. Option A is incorrect because the
client is unstable (postoperative and hemodynamically unstable); vital signs on unstable clients must be done by the RN. Option
B is incorrect because client teaching is RN scope (LPN can reinforce teaching). Option D is incorrect because the client has
swallowing difficulties, which is a complex situation requiring nursing judgment (aspiration risk). The Five Rights of
Delegation ensure appropriate task assignment.
Q9: A nurse discovers that a colleague has been diverting narcotics from the medication dispensing system.
What is the nurse's priority action?
A. Confront the colleague directly and ask them to stop
B. Report the suspicion to the nurse manager and follow facility policy [CORRECT]
C. Ignore the situation since there is no proof
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, ATI RN Capstone Proctored Comprehensive Assessment Version B 150 Questions | A+ Verified
D. Document the observations in the client's medical record
Correct Answer: B
Rationale: Impaired healthcare providers are a mandatory reporting issue and pose a safety risk to clients. The nurse must
report suspicions to the nurse manager and follow facility policy, which may include reporting to the Board of Nursing. Option
A is unsafe and may endanger the nurse. Option C violates the ethical duty to protect clients. Option D is incorrect because the
diversion should be documented through facility channels, not in client records. Reporting protects clients and supports the
impaired colleague.
Q10: A client with a terminal illness tells the nurse, "I want my daughter to make decisions for me if I
cannot." Which document should the nurse recommend the client complete?
A. Living will
B. Durable power of attorney for health care [CORRECT]
C. Do-not-resuscitate order
D. Informed consent
Correct Answer: B
Rationale: A durable power of attorney for health care (DPOA-HC) designates a specific person (proxy) to make healthcare
decisions when the client cannot. This is what the client is requesting. Option A (living will) specifies treatment preferences but
does not designate a decision-maker. Option C (DNR) is a specific medical order. Option D (informed consent) is
procedure-specific. Advance care planning ensures client autonomy and is facilitated by nursing assessment and education.
Q11: A nurse is caring for a client who speaks a different language than the nurse. The client needs education
about a new diagnosis. Which action is most appropriate?
A. Ask the client's family member to translate
B. Use pictures and gestures to explain the diagnosis
C. Arrange for a trained medical interpreter [CORRECT]
D. Provide written materials in the client's language
Correct Answer: C
Rationale: A trained medical interpreter is required for accurate, unbiased communication. Family members (Option A) may
have conflicts of interest, lack medical terminology, or impose their own interpretation. Pictures and gestures (Option B) are
insufficient for complex medical information. Written materials alone (Option D) cannot replace interactive communication.
HIPAA and the Affordable Care Act require provision of language services. The nurse must document the interpreter's name in
the medical record.
Q12: A client is threatening to leave the hospital against medical advice (AMA). What is the nurse's priority
action?
A. Restrain the client to prevent them from leaving
B. Notify the provider and have the client sign AMA forms after explaining the risks [CORRECT]
C. Call security to escort the client off the property
D. Allow the client to leave without documentation
Correct Answer: B
Rationale: A competent adult client has the right to refuse treatment and leave AMA. The nurse's priority is to notify the
provider, explain the risks of leaving, and have the client sign AMA forms documenting informed refusal. Option A is false
imprisonment. Option C is unnecessary if the client is competent. Option D violates documentation requirements. The nurse
should also continue therapeutic communication to address concerns and offer alternatives.
NCJMM Integrated | 2026/2027 Updated Page 4
