Preguntas de práctica NCLEX

Las 15 preguntas de un vistazo

¿Prefieres leer antes de jugar? Abajo están todas las preguntas de la muestra. Las respuestas y explicaciones quedan plegadas hasta que las abras.

1. 1. A nurse receives report on four clients at the start of the shift. Which client should the nurse assess first?

   • A. A client with a fractured femur who rates pain as 7 out of 10
   • B. A client with asthma who has new audible wheezing and is using neck muscles to breathe
   • C. A client being discharged today who has questions about a new medication
   • D. A client one day after surgery with a temperature of 100.8 degrees F
   Ver respuesta y explicación

   Respuesta: B. A client with asthma who has new audible wheezing and is using neck muscles to breathe

   Airway and breathing come before everything else, and accessory muscle use with new wheezing signals worsening airflow that can deteriorate quickly. Pain, discharge teaching and a low-grade fever on the first postoperative day all need attention, but none of them threatens the airway in the next few minutes.

2. 2. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?

   • A. Teaching a newly diagnosed client how to use an insulin pen
   • B. Assessing a surgical wound for signs of infection
   • C. Helping a stable client with a bed bath and recording intake and output
   • D. Writing the plan of care for a client admitted with heart failure
   Ver respuesta y explicación

   Respuesta: C. Helping a stable client with a bed bath and recording intake and output

   The delegation rule is that assessment, teaching, evaluation and care planning stay with the nurse and cannot be handed off. UAP take routine tasks with predictable outcomes for stable clients, such as hygiene, positioning and recording intake and output.

3. 3. A client is admitted with suspected active pulmonary tuberculosis. Which precautions should the nurse put in place?

   • A. Standard precautions in any available room
   • B. Contact precautions with gown and gloves in a private room
   • C. Droplet precautions with a surgical mask in a private room
   • D. Airborne precautions in a negative pressure room, with a fitted N95 respirator for anyone entering
   Ver respuesta y explicación

   Respuesta: D. Airborne precautions in a negative pressure room, with a fitted N95 respirator for anyone entering

   Tuberculosis spreads by droplet nuclei small enough to stay suspended in the air, so it requires airborne precautions: an airborne infection isolation room kept at negative pressure plus a fitted N95 respirator for staff. The surgical mask goes on the client, not on the nurse, and only when the client has to leave the room.

4. 4. A client with heart failure is receiving intravenous furosemide. Which findings require immediate follow-up? Select all that apply.

   Marca todas las que correspondan.

   • A. Serum potassium 2.9 mEq/L
   • B. Urine output of 60 mL per hour
   • C. New muscle weakness with an irregular pulse
   • D. Weight loss of 1 kg since yesterday
   • E. The client reports new ringing in the ears
   Ver respuesta y explicación

   Respuesta: A. Serum potassium 2.9 mEq/L, C. New muscle weakness with an irregular pulse, E. The client reports new ringing in the ears

   Furosemide wastes potassium, so a level of 2.9 mEq/L sits below the usual 3.5 to 5.0 mEq/L range, and new weakness with an irregular pulse suggests hypokalemia is already affecting the heart. New tinnitus points to ototoxicity, while good urine output and steady weight loss are exactly the response the drug is given to produce.

5. 5. A client who was just diagnosed with cancer says, "I do not see the point in starting treatment." Which response by the nurse is most therapeutic?

   • A. You should not give up. Many people do very well with treatment.
   • B. Tell me more about what you are thinking.
   • C. Your family would really want you to try.
   • D. I will ask the provider to come and explain your options.
   Ver respuesta y explicación

   Respuesta: B. Tell me more about what you are thinking.

   An open-ended invitation keeps the conversation open and lets the nurse assess what sits behind the statement, including hopelessness or thoughts of self-harm. False reassurance, appeals to guilt and handing the conversation to someone else all shut the client down before anything is assessed.

6. 6. Complete the sentence.

   A client receiving intravenous morphine has a respiratory rate of 7 breaths per minute and is difficult to arouse. The nurse stops the infusion and anticipates giving _____.

   Opciones para el hueco 1: flumazenil, naloxone, protamine sulfate, vitamin K

   Ver respuesta y explicación

   Respuesta: naloxone

   Naloxone is the opioid antagonist that reverses respiratory depression, and under the ABCs breathing is treated before anything else on the list. Flumazenil reverses benzodiazepines, protamine sulfate reverses heparin and vitamin K reverses warfarin.

7. 7. Which nursing actions reduce an older adult client's risk of falling in the hospital? Select all that apply.

   Marca todas las que correspondan.

   • A. Keep the bed in the lowest position with the wheels locked
   • B. Place the call light and personal items within the client's reach
   • C. Apply a vest restraint at night so the client stays in bed
   • D. Make sure the client wears nonskid footwear when walking
   • E. Turn off all lighting at night so the room stays completely dark
   Ver respuesta y explicación

   Respuesta: A. Keep the bed in the lowest position with the wheels locked, B. Place the call light and personal items within the client's reach, D. Make sure the client wears nonskid footwear when walking

   A low locked bed, items within reach and nonskid footwear are standard fall precautions because they remove the reasons a client climbs out unassisted. Restraints are a last resort and raise the risk of injury rather than lowering it, and a fully dark room makes an unassisted trip to the bathroom more dangerous, so a night light is the safer choice.

8. 8. A nurse teaches a postmenopausal client about lowering the risk of osteoporosis. Which statement shows the teaching was effective?

   • A. I will add walking or other weight-bearing exercise on most days of the week.
   • B. I should cut dairy out of my diet.
   • C. Swimming laps is the best exercise for my bones.
   • D. I only need to worry about calcium after I break a bone.
   Ver respuesta y explicación

   Respuesta: A. I will add walking or other weight-bearing exercise on most days of the week.

   Bone rebuilds in response to load, so weight-bearing exercise such as walking, together with adequate calcium and vitamin D, is the core of prevention. Swimming is good for the heart but does not load the skeleton, and dairy is a useful calcium source rather than something to avoid.

9. 9. A client has a chest tube connected to a water seal drainage system. Which finding requires immediate follow-up?

   • A. Continuous bubbling in the water seal chamber
   • B. Fluid in the water seal chamber that rises and falls with breathing
   • C. 50 mL of serosanguineous drainage over the past 8 hours
   • D. A dressing around the insertion site that is dry and intact
   Ver respuesta y explicación

   Respuesta: A. Continuous bubbling in the water seal chamber

   Continuous bubbling in the water seal chamber means air is entering the system, so the nurse checks the tubing connections and the insertion site right away. Tidaling with respiration, modest serosanguineous drainage and a dry intact dressing are all expected findings.

10. 10. A client is going home on warfarin. Which client statements show that the teaching was effective? Select all that apply.

    Marca todas las que correspondan.

    • A. I will keep the amount of green leafy vegetables I eat about the same each week.
    • B. I will use a soft toothbrush and an electric razor.
    • C. I will take ibuprofen whenever I get a headache.
    • D. I will call the clinic if my stools look black or tarry.
    • E. I can stop taking it once my INR reaches the target range.
    Ver respuesta y explicación

    Respuesta: A. I will keep the amount of green leafy vegetables I eat about the same each week., B. I will use a soft toothbrush and an electric razor., D. I will call the clinic if my stools look black or tarry.

    Warfarin blocks vitamin K dependent clotting factors, so a steady weekly vitamin K intake keeps the INR stable, gentle grooming limits bleeding, and black tarry stools are reported because they suggest gastrointestinal bleeding. Ibuprofen adds to the bleeding risk, and the drug is never stopped just because the INR has reached target.

11. 11. Complete the sentence.

    Before giving digoxin to an adult client, the nurse counts the apical pulse for one full minute and holds the dose if the rate is below _____ beats per minute.

    Opciones para el hueco 1: 50, 60, 70, 80

    Ver respuesta y explicación

    Respuesta: 60

    The standard rule is to hold digoxin and notify the prescriber when an adult's apical pulse is under 60, because the drug already slows conduction through the heart. Nausea, vomiting and visual changes such as yellow or green halos suggest toxicity, and a low potassium level makes toxicity more likely.

12. 12. A client returns to the unit after a bronchoscopy with moderate sedation. Which action must the nurse take before giving the client anything to drink?

    • A. Check the client's temperature
    • B. Confirm that the gag reflex has returned
    • C. Listen for bowel sounds in all four quadrants
    • D. Have the client sit up for 30 minutes
    Ver respuesta y explicación

    Respuesta: B. Confirm that the gag reflex has returned

    The throat is anesthetized for a bronchoscopy, so fluids can pass into the airway until sensation comes back. The client stays NPO until the nurse confirms the gag reflex, which is airway protection taking priority over comfort.

13. 13. A client is having a panic attack and is pacing, breathing rapidly and unable to follow directions. Which action should the nurse take first?

    • A. Explore what may have triggered the attack
    • B. Stay with the client and speak calmly in short, simple sentences
    • C. Leave the client alone in a quiet room until the anxiety passes
    • D. Give detailed instructions on diaphragmatic breathing technique
    Ver respuesta y explicación

    Respuesta: B. Stay with the client and speak calmly in short, simple sentences

    At panic level anxiety the ability to take in information collapses, so the nurse stays present, lowers stimulation and gives short direct sentences. Exploring triggers and teaching breathing techniques only work once the anxiety has come down, and leaving the client alone is unsafe.

14. 14. A charge nurse is making assignments on a medical unit. Which clients are appropriate to assign to a licensed practical nurse (LPN/LVN)? Select all that apply.

    Marca todas las que correspondan.

    • A. A stable client with a healing surgical wound who needs a routine dressing change
    • B. A newly admitted client who needs the initial admission assessment
    • C. A client with pneumonia on oral antibiotics who needs vital signs monitored
    • D. A client whose first unit of packed red blood cells needs to be started
    • E. A client with a long-term indwelling urinary catheter who needs routine catheter care
    Ver respuesta y explicación

    Respuesta: A. A stable client with a healing surgical wound who needs a routine dressing change, C. A client with pneumonia on oral antibiotics who needs vital signs monitored, E. A client with a long-term indwelling urinary catheter who needs routine catheter care

    LPNs care for stable clients with predictable outcomes, which covers routine dressing changes, ongoing monitoring and routine catheter care. The initial admission assessment and starting a blood transfusion stay with the RN, since both require nursing judgment on a client whose status is not yet established.

15. 15. Complete the sentence.

    To lower the risk of aspiration, the nurse feeds a client who has dysphagia after a stroke while the client is _____.

    Opciones para el hueco 1: lying flat on the back, sitting fully upright at 90 degrees, side-lying with the head of the bed flat, in a semi-prone position

    Ver respuesta y explicación

    Respuesta: sitting fully upright at 90 degrees

    Sitting fully upright with a slight chin tuck lets gravity carry food toward the esophagus rather than the airway, and the client stays upright for about 30 minutes after eating. Any reclined position raises the aspiration risk, and aspiration is an airway problem, which makes positioning a top priority rather than a comfort measure.

Qué es en realidad el NCLEX-RN

El NCLEX-RN es el examen de licencia que haces al terminar la carrera de enfermería, y aprobarlo es lo que convierte el título en una licencia de RN. Lo escribe el National Council of State Boards of Nursing y se hace en centros de examen. A diferencia de un examen final de asignatura, no está hecho para comprobar si memorizaste un libro. Comprueba si puedes ejercer con seguridad desde el primer día, y por eso tantas preguntas te piden qué harías primero en vez de cómo se llama algo.

El examen es adaptativo por ordenador. Cada respuesta cambia lo que viene después: si aciertas una pregunta la siguiente es más difícil, si fallas la siguiente es más fácil, así que el test se va ajustando a tu nivel. Eso tiene dos efectos prácticos. No puedes saltarte una pregunta ni volver atrás para cambiar una respuesta, y dos candidatos sentados uno al lado del otro casi nunca ven el mismo examen. El número de preguntas también varía. Todo el mundo responde al menos un mínimo, el examen puede llegar hasta un máximo, y se detiene en cuanto puede decidir con seguridad si estás por encima o por debajo del nivel de aprobado, o cuando se acaba el tiempo. Algunas preguntas son de prueba, no puntúan y no puedes identificarlas. El mínimo, el máximo y el tiempo límite actuales los fija la NCSBN y han cambiado con los años, así que consulta el boletín del candidato de la versión vigente cuando te examines. El resultado es apto o no apto, no una puntuación.

El Next Generation NCLEX añadió casos clínicos y varios tipos de pregunta nuevos por encima de la opción múltiple clásica. Un caso clínico te da una situación del paciente que se va desarrollando, con datos nuevos en cada paso, y entre los tipos de pregunta están la respuesta múltiple ampliada, las preguntas de matriz y de rejilla, el cloze desplegable, el resaltado, las preguntas tipo bowtie y las de tendencia. Muchas dan puntuación parcial en vez de todo o nada. El objetivo del rediseño era el juicio clínico: reconocer indicios, analizarlos, fijar una prioridad, actuar y luego evaluar el resultado.

Cómo usar esta muestra

Las 15 preguntas de abajo muestrean en pequeño las cuatro categorías de necesidades del paciente: delegación, priorización y control de infecciones del entorno de cuidados seguro y eficaz, una pregunta de promoción de la salud, una psicosocial, y el resto de integridad fisiológica, incluidos cuidados básicos y confort, terapias farmacológicas, reducción del riesgo potencial y adaptación fisiológica. Son preguntas de aplicación, así que saberse la definición casi nunca basta. Esta muestra no es adaptativa y no se puntúa como el examen real, así que tómala como un diagnóstico y no como una predicción.

Las preguntas de priorización merecen su propio método, porque son las que parecen injustas. Cuando una pregunta te pide a qué paciente valora primero la enfermera, o qué hallazgo exige actuar de inmediato, da por hecho que todas las opciones describen un problema real. No buscas lo único que importa: buscas lo que va a hacer daño antes. Aplica primero el ABC: vía aérea, luego respiración, luego circulación. Si nada es un problema de ABC, pregúntate qué hallazgo es nuevo, inesperado o inestable, porque un hallazgo esperable en ese diagnóstico puede esperar. Maslow resuelve el resto, con las necesidades físicas antes que la seguridad y la seguridad antes que las psicosociales. Las preguntas de delegación van de competencias, no de quién está más ocupado: la valoración, la enseñanza, la evaluación y cualquier paciente inestable se quedan con la RN, la LPN se encarga de pacientes estables con evolución previsible, y el personal auxiliar sin licencia asume tareas rutinarias como la higiene, la colocación y el registro de entradas y salidas.

Haz las 15 de una sentada y sin apuntes, después lee todas las explicaciones, también las de las que acertaste. Un fallo suele señalar una categoría, no un dato. Dos fallos en preguntas de farmacología significan que el hueco está en la vigilancia de los fármacos, no en esos dos fármacos.

Cómo StudyPDF crea tests completos con tu propio material

Quince preguntas te enseñan dónde flojeas. No te preparan para un examen de licencia, y los bancos de preguntas genéricos se alejan del contenido que subrayó tu propio programa.

StudyPDF parte de lo que ya tienes. Sube tu libro de repaso del NCLEX, las diapositivas de clase, los planes de cuidados o los apuntes, y Bo, el agente de estudio, crea tests de práctica completos con ese material exacto. Cada pregunta sale de tus páginas y cada explicación cita de dónde viene la respuesta, así que puedes ir directo a la fuente cuando el razonamiento no te encaje. Puedes generar tests nuevos tantas veces como quieras, acotarlos a un área como farmacología o materno infantil, y seguir qué conceptos sigues fallando entre intentos. Empezar es gratis.