ATI CAPSTONE COMPREHENSIVE
NCLEX PREP EXAM GUIDE 2026
EDITION Q&A
A nurse is caring for a client who has a sodium level of 128
mEq/L. Which of the following manifestations should the
nurse expect?
A. Hyperreflexia
B. Muscle weakness
C. Bradycardia
D. Hypertension
Correct Answer: B
Explanation: Hyponatremia (sodium <136 mEq/L) causes
cellular swelling and neurological/muscular manifestations
including muscle weakness, lethargy, and confusion.
Hyperreflexia is associated with hypocalcemia,
bradycardia with hyperkalemia or hypothyroidism, and
hypertension is not characteristic of hyponatremia which
typically causes hypotension.
A nurse is teaching a client about using a continuous positive
airway pressure (CPAP) machine for obstructive sleep apnea.
Which statement by the client indicates understanding?
A. "I will remove the mask when I fall asleep."
B. "The machine will deliver a constant pressure throughout
the breathing cycle."
C. "I only need to use this when I feel tired during the day."
D. "The pressure will increase when I inhale and decrease
when I exhale."
Correct Answer: B
, Explanation: CPAP delivers a constant, continuous pressure
throughout the entire breathing cycle (inhale and exhale),
keeping airways open. Option D describes BiPAP (bilevel
positive airway pressure), not CPAP. The mask should be
worn throughout sleep, and CPAP must be used consistently
every night, not just when feeling tired.
A nurse is assessing a client who has COPD and is experiencing
dyspnea. Which finding should the nurse expect?
A. Decreased respiratory rate
B. Flaring of the nostrils
C. Bounding pulse
D. Warm, flushed skin
Correct Answer: B
Explanation: Nasal flaring is a classic sign of respiratory
distress and increased work of breathing in clients with
COPD. Clients with COPD typically have increased (not
decreased) respiratory rate during dyspnea, tachycardia
(not bounding pulse), and may have cyanotic or pale (not
warm, flushed) skin due to hypoxemia.
A nurse is administering medication through a metered-dose
inhaler (MDI). What instruction should the nurse include
when teaching a client?
A. "Exhale forcefully immediately after inhaling the
medication."
B. "Inhale the medication deeply for 3-5 seconds."
C. "Hold your breath for 1-2 seconds after inhaling."
D. "Shake the inhaler only if it hasn't been used recently."
, Correct Answer: B
Explanation: Clients should inhale the medication deeply
for 3-5 seconds to ensure adequate deposition in the
airways. After inhaling, the client should hold their breath
for 10 seconds (not 1-2 seconds) to allow medication
absorption. The inhaler should be shaken before each use,
and the client should exhale fully BEFORE inhaling, not
after.
A nurse is caring for a client with dysphagia. Which
intervention should the nurse include in the plan of care?
A. Have the client lie flat for 30 minutes after meals
B. Thicken all liquids to honey consistency
C. Have the client sit upright for 1 hour following meals
D. Offer thin liquids first to ensure adequate hydration
Correct Answer: C
Explanation: The client should remain upright for at least
30-60 minutes after meals to prevent aspiration. Lying flat
increases aspiration risk. Liquid thickening should be based
on specific swallowing assessment results, not universally
applied. Thin liquids are most difficult for dysphagia clients
to control and pose the highest aspiration risk.
A nurse is assessing an IV infusion site and the client reports
pain. The site is red and warm to touch. What action should
the nurse take?
A. Apply warm compresses and continue the infusion
B. Discontinue the infusion immediately
C. Slow the infusion rate and monitor closely
, D. Massage the area to improve circulation
Correct Answer: B
Explanation: These are classic signs of phlebitis
(inflammation of the vein). The infusion should be
discontinued immediately to prevent complications. Warm
compresses may be applied AFTER discontinuation.
Continuing or slowing the infusion worsens phlebitis.
Massaging the area can dislodge clots and worsen
inflammation.
A nurse is teaching new nurses about immunity. Which
statement should the nurse include?
A. "Passive immunity occurs when the body produces
antibodies in response to an antigen."
B. "The body produces antibodies in response to an antigen
with active immunity."
C. "Natural immunity is acquired through vaccination."
D. "Artificial immunity occurs naturally through infection."
Correct Answer: B
Explanation: Active immunity occurs when the body
produces its own antibodies in response to an antigen
(either from infection or vaccination). Passive immunity
involves receiving pre-formed antibodies. Natural
immunity comes from infection; artificial immunity comes
from medical intervention like vaccination.
A nurse is identifying risk factors for infections in older adults.
Which factor increases infection risk?
A. Increased skin elasticity
NCLEX PREP EXAM GUIDE 2026
EDITION Q&A
A nurse is caring for a client who has a sodium level of 128
mEq/L. Which of the following manifestations should the
nurse expect?
A. Hyperreflexia
B. Muscle weakness
C. Bradycardia
D. Hypertension
Correct Answer: B
Explanation: Hyponatremia (sodium <136 mEq/L) causes
cellular swelling and neurological/muscular manifestations
including muscle weakness, lethargy, and confusion.
Hyperreflexia is associated with hypocalcemia,
bradycardia with hyperkalemia or hypothyroidism, and
hypertension is not characteristic of hyponatremia which
typically causes hypotension.
A nurse is teaching a client about using a continuous positive
airway pressure (CPAP) machine for obstructive sleep apnea.
Which statement by the client indicates understanding?
A. "I will remove the mask when I fall asleep."
B. "The machine will deliver a constant pressure throughout
the breathing cycle."
C. "I only need to use this when I feel tired during the day."
D. "The pressure will increase when I inhale and decrease
when I exhale."
Correct Answer: B
, Explanation: CPAP delivers a constant, continuous pressure
throughout the entire breathing cycle (inhale and exhale),
keeping airways open. Option D describes BiPAP (bilevel
positive airway pressure), not CPAP. The mask should be
worn throughout sleep, and CPAP must be used consistently
every night, not just when feeling tired.
A nurse is assessing a client who has COPD and is experiencing
dyspnea. Which finding should the nurse expect?
A. Decreased respiratory rate
B. Flaring of the nostrils
C. Bounding pulse
D. Warm, flushed skin
Correct Answer: B
Explanation: Nasal flaring is a classic sign of respiratory
distress and increased work of breathing in clients with
COPD. Clients with COPD typically have increased (not
decreased) respiratory rate during dyspnea, tachycardia
(not bounding pulse), and may have cyanotic or pale (not
warm, flushed) skin due to hypoxemia.
A nurse is administering medication through a metered-dose
inhaler (MDI). What instruction should the nurse include
when teaching a client?
A. "Exhale forcefully immediately after inhaling the
medication."
B. "Inhale the medication deeply for 3-5 seconds."
C. "Hold your breath for 1-2 seconds after inhaling."
D. "Shake the inhaler only if it hasn't been used recently."
, Correct Answer: B
Explanation: Clients should inhale the medication deeply
for 3-5 seconds to ensure adequate deposition in the
airways. After inhaling, the client should hold their breath
for 10 seconds (not 1-2 seconds) to allow medication
absorption. The inhaler should be shaken before each use,
and the client should exhale fully BEFORE inhaling, not
after.
A nurse is caring for a client with dysphagia. Which
intervention should the nurse include in the plan of care?
A. Have the client lie flat for 30 minutes after meals
B. Thicken all liquids to honey consistency
C. Have the client sit upright for 1 hour following meals
D. Offer thin liquids first to ensure adequate hydration
Correct Answer: C
Explanation: The client should remain upright for at least
30-60 minutes after meals to prevent aspiration. Lying flat
increases aspiration risk. Liquid thickening should be based
on specific swallowing assessment results, not universally
applied. Thin liquids are most difficult for dysphagia clients
to control and pose the highest aspiration risk.
A nurse is assessing an IV infusion site and the client reports
pain. The site is red and warm to touch. What action should
the nurse take?
A. Apply warm compresses and continue the infusion
B. Discontinue the infusion immediately
C. Slow the infusion rate and monitor closely
, D. Massage the area to improve circulation
Correct Answer: B
Explanation: These are classic signs of phlebitis
(inflammation of the vein). The infusion should be
discontinued immediately to prevent complications. Warm
compresses may be applied AFTER discontinuation.
Continuing or slowing the infusion worsens phlebitis.
Massaging the area can dislodge clots and worsen
inflammation.
A nurse is teaching new nurses about immunity. Which
statement should the nurse include?
A. "Passive immunity occurs when the body produces
antibodies in response to an antigen."
B. "The body produces antibodies in response to an antigen
with active immunity."
C. "Natural immunity is acquired through vaccination."
D. "Artificial immunity occurs naturally through infection."
Correct Answer: B
Explanation: Active immunity occurs when the body
produces its own antibodies in response to an antigen
(either from infection or vaccination). Passive immunity
involves receiving pre-formed antibodies. Natural
immunity comes from infection; artificial immunity comes
from medical intervention like vaccination.
A nurse is identifying risk factors for infections in older adults.
Which factor increases infection risk?
A. Increased skin elasticity
