Page |1
ATI CAPSTONE ADULT MEDICAL-SURGICAL
ASSESSMENT 2 – COMPREHENSIVE EXAM |
STUDY GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW
TABLE OF CONTENTS
1. Prioritization, Delegation, and Clinical Judgment
2. Cardiovascular and Hematologic Disorders
3. Respiratory Disorders and Mechanical Ventilation
4. Gastrointestinal and Hepatic Disorders
5. Renal and Urinary Disorders
6. Neurological Disorders and Musculoskeletal Care
7. Endocrine and Metabolic Disorders
8. Immunologic, Infectious, and Perioperative Care
9. Pharmacology and Safe Medication Administration
10. Patient Safety, Infection Control, and Quality Improvement
, Page |2
Question 1: A nurse is receiving change-of-shift report on four clients. Which client should
the nurse assess first?
A) A client with a dressing that needs reinforcement
B) A client reporting pain rated 6/10
C) A client whose urinary output was 100 mL in 12 hours
D) A client scheduled for discharge
Correct Answer: C) A client whose urinary output was 100 mL in 12 hours
Low urine output (100 mL in 12 hours = ~8 mL/hour) indicates possible acute kidney injury
or severe hypovolemia. Urine output should be at least 30 mL/hour (240 mL in 8 hours). This
is an urgent finding requiring immediate assessment.
Question 2: A charge nurse is assigning rooms for four clients. Which client should be placed
in a private room?
A) Client with pneumonia
B) Client with Clostridioides difficile
C) Client with cellulitis
D) Client with urinary tract infection
Correct Answer: B) Client with Clostridioides difficile
C. diff requires contact precautions and a private room to prevent spore transmission.
Pneumonia may need droplet precautions, while cellulitis and UTI require standard
precautions only.
Question 3: A nurse is delegating tasks to an LPN. Which task is appropriate?
, Page |3
A) Initial admission assessment
B) Insertion of a nasogastric tube for decompression
C) Teaching a diabetic patient about insulin injection
D) Evaluating the effectiveness of pain medication
Correct Answer: B) Insertion of a nasogastric tube for decompression
LPNs can perform stable, standard procedures like NG tube insertion (check facility policy).
Initial assessment, teaching, and evaluation of effectiveness require RN scope.
Question 4: A nurse is caring for a confused client attempting to pull out their IV line. The
provider orders restraints. Which action should the nurse take BEFORE applying restraints?
A) Obtain verbal consent from the client
B) Try less restrictive measures first
C) Restrain all four extremities for safety
D) Apply restraints without documentation
Correct Answer: B) Try less restrictive measures first
Restraints are a last resort. The nurse must attempt less restrictive measures first
(repositioning, sitters, diversions). Restraints require a provider order, client/family
notification, and frequent monitoring.
Question 5: A nurse is caring for a client who is 4 hours postoperative following a
transurethral resection of the prostate (TURP). Which finding is the priority to report to the
provider?
A) Thick, red-colored urine
B) Complaints of bladder spasms
C) Continuous bladder irrigation infusing at 40 mL/hr
D) Urine output of 100 mL in the past 4 hours
Correct Answer: A) Thick, red-colored urine
Thick, red-colored urine indicates active bleeding. Small amounts of pink-tinged urine are
expected. Bladder spasms are common post-TURP but are not the priority over hemorrhage.
, Page |4
Question 6: A nurse is caring for a client who has a temperature of 39.7°C (103.5°F) and has
a prescription for a hypothermia blanket. The nurse should monitor the client for which
adverse effect?
A) Hyperthermia
B) Shivering
C) Infection
D) Dehydration
Correct Answer: B) Shivering
Shivering is a common adverse effect of hypothermia blankets and can increase core
temperature, counteracting the treatment. The nurse should monitor for shivering and
provide warm blankets or medication as prescribed. Other complications include skin
damage and arrhythmias.
Question 7: A nurse is planning care for a client who has Meniere's disease and is
experiencing episodes of vertigo. Which intervention should the nurse include in the plan of
care?
A) Maintain strict bed rest
B) Restrict fluid intake to the morning hours
C) Administer aspirin
D) Provide a low-sodium diet
Correct Answer: D) Provide a low-sodium diet
A low-sodium diet helps reduce fluid retention in the inner ear, which can decrease the
frequency and severity of Meniere's disease attacks. Bed rest is not required, and aspirin can
worsen symptoms. Fluid restriction is not a standard intervention.
Question 8: A nurse is assessing a client for possible exposure to HIV. Which finding should
the nurse identify as an early manifestation of HIV infection?
ATI CAPSTONE ADULT MEDICAL-SURGICAL
ASSESSMENT 2 – COMPREHENSIVE EXAM |
STUDY GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW
TABLE OF CONTENTS
1. Prioritization, Delegation, and Clinical Judgment
2. Cardiovascular and Hematologic Disorders
3. Respiratory Disorders and Mechanical Ventilation
4. Gastrointestinal and Hepatic Disorders
5. Renal and Urinary Disorders
6. Neurological Disorders and Musculoskeletal Care
7. Endocrine and Metabolic Disorders
8. Immunologic, Infectious, and Perioperative Care
9. Pharmacology and Safe Medication Administration
10. Patient Safety, Infection Control, and Quality Improvement
, Page |2
Question 1: A nurse is receiving change-of-shift report on four clients. Which client should
the nurse assess first?
A) A client with a dressing that needs reinforcement
B) A client reporting pain rated 6/10
C) A client whose urinary output was 100 mL in 12 hours
D) A client scheduled for discharge
Correct Answer: C) A client whose urinary output was 100 mL in 12 hours
Low urine output (100 mL in 12 hours = ~8 mL/hour) indicates possible acute kidney injury
or severe hypovolemia. Urine output should be at least 30 mL/hour (240 mL in 8 hours). This
is an urgent finding requiring immediate assessment.
Question 2: A charge nurse is assigning rooms for four clients. Which client should be placed
in a private room?
A) Client with pneumonia
B) Client with Clostridioides difficile
C) Client with cellulitis
D) Client with urinary tract infection
Correct Answer: B) Client with Clostridioides difficile
C. diff requires contact precautions and a private room to prevent spore transmission.
Pneumonia may need droplet precautions, while cellulitis and UTI require standard
precautions only.
Question 3: A nurse is delegating tasks to an LPN. Which task is appropriate?
, Page |3
A) Initial admission assessment
B) Insertion of a nasogastric tube for decompression
C) Teaching a diabetic patient about insulin injection
D) Evaluating the effectiveness of pain medication
Correct Answer: B) Insertion of a nasogastric tube for decompression
LPNs can perform stable, standard procedures like NG tube insertion (check facility policy).
Initial assessment, teaching, and evaluation of effectiveness require RN scope.
Question 4: A nurse is caring for a confused client attempting to pull out their IV line. The
provider orders restraints. Which action should the nurse take BEFORE applying restraints?
A) Obtain verbal consent from the client
B) Try less restrictive measures first
C) Restrain all four extremities for safety
D) Apply restraints without documentation
Correct Answer: B) Try less restrictive measures first
Restraints are a last resort. The nurse must attempt less restrictive measures first
(repositioning, sitters, diversions). Restraints require a provider order, client/family
notification, and frequent monitoring.
Question 5: A nurse is caring for a client who is 4 hours postoperative following a
transurethral resection of the prostate (TURP). Which finding is the priority to report to the
provider?
A) Thick, red-colored urine
B) Complaints of bladder spasms
C) Continuous bladder irrigation infusing at 40 mL/hr
D) Urine output of 100 mL in the past 4 hours
Correct Answer: A) Thick, red-colored urine
Thick, red-colored urine indicates active bleeding. Small amounts of pink-tinged urine are
expected. Bladder spasms are common post-TURP but are not the priority over hemorrhage.
, Page |4
Question 6: A nurse is caring for a client who has a temperature of 39.7°C (103.5°F) and has
a prescription for a hypothermia blanket. The nurse should monitor the client for which
adverse effect?
A) Hyperthermia
B) Shivering
C) Infection
D) Dehydration
Correct Answer: B) Shivering
Shivering is a common adverse effect of hypothermia blankets and can increase core
temperature, counteracting the treatment. The nurse should monitor for shivering and
provide warm blankets or medication as prescribed. Other complications include skin
damage and arrhythmias.
Question 7: A nurse is planning care for a client who has Meniere's disease and is
experiencing episodes of vertigo. Which intervention should the nurse include in the plan of
care?
A) Maintain strict bed rest
B) Restrict fluid intake to the morning hours
C) Administer aspirin
D) Provide a low-sodium diet
Correct Answer: D) Provide a low-sodium diet
A low-sodium diet helps reduce fluid retention in the inner ear, which can decrease the
frequency and severity of Meniere's disease attacks. Bed rest is not required, and aspirin can
worsen symptoms. Fluid restriction is not a standard intervention.
Question 8: A nurse is assessing a client for possible exposure to HIV. Which finding should
the nurse identify as an early manifestation of HIV infection?
