Capstone Comprehensive Exit Exam

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Sample questions from Capstone Comprehensive Exit Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a client with crushing chest pain becomes pale and diaphoretic. Which action should the nurse take first?

   • A.Administer prescribed morphine
   • B.Prepare the client for cardiac rehabilitation
   • C.Obtain a 12-lead electrocardiogram
   • D.Ask about the client's family history

   Rationale: A 12-lead electrocardiogram rapidly identifies acute ischemia and guides time-sensitive reperfusion care. Morphine may be prescribed but does not replace immediate assessment; family history and rehabilitation are not first priorities during active chest pain. Rapid ECG acquisition is a key priority in suspected acute coronary syndrome.

2. 2.Refer to the client's chart. Which action should the nurse take first in response to the change in status?

   • A.Administer the scheduled oral antihypertensive
   • B.Apply oxygen and activate the rapid response team
   • C.Assist the client to ambulate to improve circulation
   • D.Offer oral fluids and reassess in 1 hour

   Rationale: The falling oxygen saturation, increasing respiratory rate, and new confusion indicate acute deterioration requiring immediate escalation and oxygen support. Oral fluids and ambulation are unsafe before evaluating respiratory compromise, and the scheduled antihypertensive does not address the urgent problem. A rapid response supports prompt assessment and stabilization.

3. 3.A client with a new colostomy is preparing for discharge. Which instructions should the nurse include? Select all that apply.

   • A.Scrub the stoma firmly with alcohol during each change
   • B.Empty the pouch when it is one-third to one-half full
   • C.Expect the stoma to appear moist and pink to red
   • D.Notify the provider if the stoma becomes dusky or black
   • E.Cut the skin barrier opening slightly larger than the stoma

   Rationale: Emptying a partly full pouch reduces pulling and leakage, and a close-fitting barrier protects peristomal skin. A healthy stoma is moist and pink to red; a dusky or black stoma may signal impaired perfusion and needs prompt evaluation. Alcohol can irritate tissue, so gentle cleansing with water is preferred.

4. 4.Which finding in a client with suspected appendicitis requires immediate follow-up?

   • A.Pain that suddenly decreases followed by a rigid abdomen
   • B.Nausea after eating a small meal
   • C.Tenderness localized to the right lower quadrant
   • D.Temperature of 37.8 C (100 F)

   Answer and rationale are in the full material.

5. 5.A client with heart failure has gained 2.3 kg (5 lb) in 3 days and reports increased orthopnea. Which action is most appropriate?

   • A.Encourage increased oral fluids
   • B.Place the client flat to reduce cardiac workload
   • C.Document the findings as an expected variation
   • D.Assess lung sounds and oxygenation, then notify the provider

   Answer and rationale are in the full material.