NGN) ATI RN | RN ATI CAPSTONE
PROCTORED COMPREHENSIVE
ASSESSMENT 2023 FORM B ALL
QUESTIONS AND WEL
Section 1: Management of Care (Q1–Q20)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days post-appendectomy requesting pain medication
B. A client with COPD reporting sudden shortness of breath
C. A client with a urinary tract infection requesting assistance to the bathroom
D. A client scheduled for discharge asking about wound care
Correct: B
Rationale: Sudden shortness of breath in a COPD client suggests possible
pneumothorax, PE, or acute exacerbation — a life-threatening emergency. Pain,
toileting, and discharge teaching are important but not immediately life-
threatening.
2. A nurse is reviewing informed consent. Which action is correct?
A. Have the nurse witness the client's signature after the surgeon explains the
procedure
B. Obtain the client's signature before the provider explains the procedure
C. Sign the consent form on behalf of a client who is confused
D. Delegate obtaining consent to the UAP
Correct: A
Rationale: The provider must explain the procedure; the nurse may witness
the signature and verify understanding. Consents cannot be delegated to UAP, and
a confused client cannot give informed consent.
,3. A nurse is prioritizing care after receiving shift report. Which client should the
nurse see first?
A. Client with a new onset of confusion
B. Client requesting a blanket
C. Client with a hemoglobin of 11 g/dL
D. Client awaiting discharge prescriptions
Correct: A
Rationale: New-onset confusion can indicate hypoxia, hypoglycemia, stroke,
or infection — a change in status requiring immediate assessment.
4. Which task can the nurse delegate to a UAP?
A. Administering a tube feeding
B. Measuring and recording intake and output
C. Assessing a client's incision
D. Teaching a client about a new medication
Correct: B
Rationale: I&O measurement is within UAP scope. Assessment, teaching, and
medication/tube-feeding administration require a licensed nurse.
5. A nurse is preparing to administer a blood transfusion. Which action should
the nurse take first?
A. Verify the client's identity with a second nurse
B. Obtain the client's vital signs
C. Prime the tubing with 0.9% sodium chloride
D. Assess for a history of transfusion reactions
Correct: D
Rationale: Assessing history and obtaining baseline vitals (B) are both
appropriate; of the options, assessing prior reaction history guides safe initiation.
,(Note: In a strict "first action" ATI-style item, baseline vitals are typically taken
before hanging blood; here D is the priority screening step.)
6. A nurse is caring for a client who speaks a different language. Which action
should the nurse take?
A. Ask a family member to interpret
B. Use a certified medical interpreter
C. Use gestures and pictures only
D. Speak loudly and slowly in English
Correct: B
Rationale: Certified interpreters protect confidentiality and accuracy. Family
members (especially minors) should not interpret.
7. A nurse is reviewing a client's advance directive. Which statement indicates
understanding?
A. "An advance directive can only be completed by the family."
B. "A living will documents the client's wishes for end-of-life care."
C. "A durable power of attorney for health care takes effect only after death."
D. "Advance directives cannot be changed once signed."
Correct: B
Rationale: A living will states the client's wishes for end-of-life treatment.
DPOA-HC is effective when the client loses capacity, and directives can be revised.
8. A nurse is preparing for a client's discharge. Which action best promotes
continuity of care?
A. Provide written instructions only
B. Arrange follow-up appointments and provide a written discharge summary
C. Delegate discharge teaching to the UAP
D. Delay discharge until the family arrives
, Correct: B
Rationale: Coordinated follow-up and written instructions improve adherence
and reduce readmission.
9. A nurse is caring for a client who is a Jehovah's Witness and refuses a blood
transfusion. Which action should the nurse take?
A. Administer the transfusion anyway
B. Respect the client's autonomy and document the refusal
C. Ask the family to convince the client
D. Obtain a court order
Correct: B
Rationale: Autonomy and informed refusal must be respected; document and
notify the provider.
10. A nurse is managing care for a client with an active DNR order. Which action
is appropriate?
A. Withhold all comfort measures
B. Continue all comfort-focused interventions and honor the DNR
C. Ignore the DNR during a cardiac arrest
D. Discontinue antibiotics without an order
Correct: B
Rationale: A DNR does not mean withholding comfort care; it applies to
resuscitation efforts.
11. Which client should the nurse assign to an LPN?
A. A client requiring complex assessment of a new stroke
B. A stable client with a healing surgical wound needing a dressing change
C. A client receiving a first chemotherapy infusion
D. A client in the ICU on a ventilator
PROCTORED COMPREHENSIVE
ASSESSMENT 2023 FORM B ALL
QUESTIONS AND WEL
Section 1: Management of Care (Q1–Q20)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days post-appendectomy requesting pain medication
B. A client with COPD reporting sudden shortness of breath
C. A client with a urinary tract infection requesting assistance to the bathroom
D. A client scheduled for discharge asking about wound care
Correct: B
Rationale: Sudden shortness of breath in a COPD client suggests possible
pneumothorax, PE, or acute exacerbation — a life-threatening emergency. Pain,
toileting, and discharge teaching are important but not immediately life-
threatening.
2. A nurse is reviewing informed consent. Which action is correct?
A. Have the nurse witness the client's signature after the surgeon explains the
procedure
B. Obtain the client's signature before the provider explains the procedure
C. Sign the consent form on behalf of a client who is confused
D. Delegate obtaining consent to the UAP
Correct: A
Rationale: The provider must explain the procedure; the nurse may witness
the signature and verify understanding. Consents cannot be delegated to UAP, and
a confused client cannot give informed consent.
,3. A nurse is prioritizing care after receiving shift report. Which client should the
nurse see first?
A. Client with a new onset of confusion
B. Client requesting a blanket
C. Client with a hemoglobin of 11 g/dL
D. Client awaiting discharge prescriptions
Correct: A
Rationale: New-onset confusion can indicate hypoxia, hypoglycemia, stroke,
or infection — a change in status requiring immediate assessment.
4. Which task can the nurse delegate to a UAP?
A. Administering a tube feeding
B. Measuring and recording intake and output
C. Assessing a client's incision
D. Teaching a client about a new medication
Correct: B
Rationale: I&O measurement is within UAP scope. Assessment, teaching, and
medication/tube-feeding administration require a licensed nurse.
5. A nurse is preparing to administer a blood transfusion. Which action should
the nurse take first?
A. Verify the client's identity with a second nurse
B. Obtain the client's vital signs
C. Prime the tubing with 0.9% sodium chloride
D. Assess for a history of transfusion reactions
Correct: D
Rationale: Assessing history and obtaining baseline vitals (B) are both
appropriate; of the options, assessing prior reaction history guides safe initiation.
,(Note: In a strict "first action" ATI-style item, baseline vitals are typically taken
before hanging blood; here D is the priority screening step.)
6. A nurse is caring for a client who speaks a different language. Which action
should the nurse take?
A. Ask a family member to interpret
B. Use a certified medical interpreter
C. Use gestures and pictures only
D. Speak loudly and slowly in English
Correct: B
Rationale: Certified interpreters protect confidentiality and accuracy. Family
members (especially minors) should not interpret.
7. A nurse is reviewing a client's advance directive. Which statement indicates
understanding?
A. "An advance directive can only be completed by the family."
B. "A living will documents the client's wishes for end-of-life care."
C. "A durable power of attorney for health care takes effect only after death."
D. "Advance directives cannot be changed once signed."
Correct: B
Rationale: A living will states the client's wishes for end-of-life treatment.
DPOA-HC is effective when the client loses capacity, and directives can be revised.
8. A nurse is preparing for a client's discharge. Which action best promotes
continuity of care?
A. Provide written instructions only
B. Arrange follow-up appointments and provide a written discharge summary
C. Delegate discharge teaching to the UAP
D. Delay discharge until the family arrives
, Correct: B
Rationale: Coordinated follow-up and written instructions improve adherence
and reduce readmission.
9. A nurse is caring for a client who is a Jehovah's Witness and refuses a blood
transfusion. Which action should the nurse take?
A. Administer the transfusion anyway
B. Respect the client's autonomy and document the refusal
C. Ask the family to convince the client
D. Obtain a court order
Correct: B
Rationale: Autonomy and informed refusal must be respected; document and
notify the provider.
10. A nurse is managing care for a client with an active DNR order. Which action
is appropriate?
A. Withhold all comfort measures
B. Continue all comfort-focused interventions and honor the DNR
C. Ignore the DNR during a cardiac arrest
D. Discontinue antibiotics without an order
Correct: B
Rationale: A DNR does not mean withholding comfort care; it applies to
resuscitation efforts.
11. Which client should the nurse assign to an LPN?
A. A client requiring complex assessment of a new stroke
B. A stable client with a healing surgical wound needing a dressing change
C. A client receiving a first chemotherapy infusion
D. A client in the ICU on a ventilator
