ATI Proctored Capstone Comprehensive
Test 2025 - Final Exam Q&A
Comprehensive Nursing Study Guide for ATI
Capstone Assessment
Question 1
A nurse is caring for a client who has heart failure and is receiving furosemide.
Which of the following findings should the nurse report to the provider
immediately?
A) Urine output of 200 mL in 4 hours
B) Potassium level of 2.8 mEq/L
C) Blood pressure of 110/70 mmHg
D) Weight loss of 2 pounds in 24 hours
Answer: B
Rationale: A potassium level of 2.8 mEq/L indicates severe hypokalemia (normal
range 3.5-5.0 mEq/L), which is a serious complication of furosemide therapy.
Severe hypokalemia can cause life-threatening cardiac dysrhythmias and
requires immediate intervention. The other findings are expected with
furosemide therapy.
Question 2
A nurse is preparing to administer insulin to a client who has diabetes mellitus.
Which of the following actions should the nurse take first?
A) Check the client's blood glucose level
B) Verify the insulin type and dosage
,C) Identify the client using two identifiers
D) Select the appropriate injection site
Answer: C
Rationale: Patient identification using two identifiers is the first step in the
medication administration process according to the "Rights of Medication
Administration." This ensures patient safety by preventing medication errors.
After proper identification, the nurse can proceed with the other steps.
Question 3
A nurse is caring for a client who is postoperative following abdominal
surgery. The client reports severe incisional pain rated 8/10. Which action
should the nurse take first?
A) Administer the prescribed analgesic
B) Assess the surgical site
C) Encourage deep breathing exercises
D) Position the client for comfort
Answer: B
Rationale: When a postoperative client reports severe pain, the nurse should first
assess the surgical site to rule out complications such as bleeding, infection, or
wound dehiscence. While pain management is important, assessment must come
before intervention to ensure patient safety.
Question 4
A nurse is teaching a client who has a new prescription for warfarin. Which of
the following statements by the client indicates understanding of the
teaching?
A) "I will take aspirin for headaches while on this medication"
B) "I need to have my blood checked regularly while taking this medication"
,C) "I can eat as much green leafy vegetables as I want"
D) "I will take this medication with food to prevent stomach upset"
Answer: B
Rationale: Warfarin requires regular monitoring of INR/PT levels to ensure
therapeutic effectiveness and prevent bleeding complications. The client should
avoid aspirin (increases bleeding risk), maintain consistent vitamin K intake
(affects warfarin effectiveness), and food timing doesn't significantly affect
absorption.
Question 5
A nurse is assessing a client who has pneumonia. Which of the following
findings should the nurse expect?
A) Bradycardia and hypotension
B) Productive cough with yellow sputum
C) Decreased respiratory rate
D) Clear breath sounds bilaterally
Answer: B
Rationale: Pneumonia typically presents with productive cough containing
purulent (yellow, green, or rust-colored) sputum due to infection and
inflammation in the lungs. Other expected findings include tachycardia, fever,
increased respiratory rate, and abnormal breath sounds such as crackles or
diminished sounds.
Question 6
A nurse is caring for a client who is receiving mechanical ventilation. Which of
the following interventions should the nurse implement to prevent
ventilator-associated pneumonia (VAP)?
A) Change the ventilator circuit every 24 hours
B) Maintain the head of the bed at 30-45 degrees
, C) Suction the client every 2 hours
D) Keep the client sedated continuously
Answer: B
Rationale: Elevating the head of the bed 30-45 degrees helps prevent aspiration
and reduces the risk of VAP by promoting drainage of secretions away from the
lungs. Ventilator circuits are changed only when visibly soiled, suctioning should
be based on assessment, and continuous sedation increases VAP risk.
Question 7
A nurse is planning care for a client who has chronic kidney disease. Which of
the following dietary recommendations should the nurse include?
A) Increase protein intake to 2 g/kg/day
B) Restrict potassium to 2-3 g/day
C) Increase phosphorus-rich foods
D) Consume unlimited fluids
Answer: B
Rationale: Clients with chronic kidney disease should restrict potassium intake
to 2-3 g/day to prevent hyperkalemia, as damaged kidneys cannot effectively
excrete potassium. Protein should be moderate (0.8-1.0 g/kg/day), phosphorus
should be restricted, and fluid intake may need limitation based on stage.
Question 8
A nurse is caring for a client who has type 1 diabetes mellitus and is
experiencing diabetic ketoacidosis (DKA). Which of the following findings
should the nurse expect?
A) Blood glucose less than 70 mg/dL
B) Fruity breath odor
C) Bradycardia
Test 2025 - Final Exam Q&A
Comprehensive Nursing Study Guide for ATI
Capstone Assessment
Question 1
A nurse is caring for a client who has heart failure and is receiving furosemide.
Which of the following findings should the nurse report to the provider
immediately?
A) Urine output of 200 mL in 4 hours
B) Potassium level of 2.8 mEq/L
C) Blood pressure of 110/70 mmHg
D) Weight loss of 2 pounds in 24 hours
Answer: B
Rationale: A potassium level of 2.8 mEq/L indicates severe hypokalemia (normal
range 3.5-5.0 mEq/L), which is a serious complication of furosemide therapy.
Severe hypokalemia can cause life-threatening cardiac dysrhythmias and
requires immediate intervention. The other findings are expected with
furosemide therapy.
Question 2
A nurse is preparing to administer insulin to a client who has diabetes mellitus.
Which of the following actions should the nurse take first?
A) Check the client's blood glucose level
B) Verify the insulin type and dosage
,C) Identify the client using two identifiers
D) Select the appropriate injection site
Answer: C
Rationale: Patient identification using two identifiers is the first step in the
medication administration process according to the "Rights of Medication
Administration." This ensures patient safety by preventing medication errors.
After proper identification, the nurse can proceed with the other steps.
Question 3
A nurse is caring for a client who is postoperative following abdominal
surgery. The client reports severe incisional pain rated 8/10. Which action
should the nurse take first?
A) Administer the prescribed analgesic
B) Assess the surgical site
C) Encourage deep breathing exercises
D) Position the client for comfort
Answer: B
Rationale: When a postoperative client reports severe pain, the nurse should first
assess the surgical site to rule out complications such as bleeding, infection, or
wound dehiscence. While pain management is important, assessment must come
before intervention to ensure patient safety.
Question 4
A nurse is teaching a client who has a new prescription for warfarin. Which of
the following statements by the client indicates understanding of the
teaching?
A) "I will take aspirin for headaches while on this medication"
B) "I need to have my blood checked regularly while taking this medication"
,C) "I can eat as much green leafy vegetables as I want"
D) "I will take this medication with food to prevent stomach upset"
Answer: B
Rationale: Warfarin requires regular monitoring of INR/PT levels to ensure
therapeutic effectiveness and prevent bleeding complications. The client should
avoid aspirin (increases bleeding risk), maintain consistent vitamin K intake
(affects warfarin effectiveness), and food timing doesn't significantly affect
absorption.
Question 5
A nurse is assessing a client who has pneumonia. Which of the following
findings should the nurse expect?
A) Bradycardia and hypotension
B) Productive cough with yellow sputum
C) Decreased respiratory rate
D) Clear breath sounds bilaterally
Answer: B
Rationale: Pneumonia typically presents with productive cough containing
purulent (yellow, green, or rust-colored) sputum due to infection and
inflammation in the lungs. Other expected findings include tachycardia, fever,
increased respiratory rate, and abnormal breath sounds such as crackles or
diminished sounds.
Question 6
A nurse is caring for a client who is receiving mechanical ventilation. Which of
the following interventions should the nurse implement to prevent
ventilator-associated pneumonia (VAP)?
A) Change the ventilator circuit every 24 hours
B) Maintain the head of the bed at 30-45 degrees
, C) Suction the client every 2 hours
D) Keep the client sedated continuously
Answer: B
Rationale: Elevating the head of the bed 30-45 degrees helps prevent aspiration
and reduces the risk of VAP by promoting drainage of secretions away from the
lungs. Ventilator circuits are changed only when visibly soiled, suctioning should
be based on assessment, and continuous sedation increases VAP risk.
Question 7
A nurse is planning care for a client who has chronic kidney disease. Which of
the following dietary recommendations should the nurse include?
A) Increase protein intake to 2 g/kg/day
B) Restrict potassium to 2-3 g/day
C) Increase phosphorus-rich foods
D) Consume unlimited fluids
Answer: B
Rationale: Clients with chronic kidney disease should restrict potassium intake
to 2-3 g/day to prevent hyperkalemia, as damaged kidneys cannot effectively
excrete potassium. Protein should be moderate (0.8-1.0 g/kg/day), phosphorus
should be restricted, and fluid intake may need limitation based on stage.
Question 8
A nurse is caring for a client who has type 1 diabetes mellitus and is
experiencing diabetic ketoacidosis (DKA). Which of the following findings
should the nurse expect?
A) Blood glucose less than 70 mg/dL
B) Fruity breath odor
C) Bradycardia
