ANSWERS | 300 VERIFIED QUESTIONS WITH
COMPLETE SOLUTIONS | NCLEX-STYLE
NURSING PRACTICE | UPDATED 2026
CJE BENCHMARK EXAM #2 — 300 Question
QUESTION 1 Topic: Tuberculosis — Signs & Symptoms | Difficulty: Moderate
A nurse is assessing a patient admitted with suspected pulmonary tuberculosis. Which of the
following is the MOST classic cluster of symptoms the nurse should expect?
• A. Sudden high fever, productive cough with green sputum, and pleuritic chest pain
• B. Night sweats, chronic productive cough, hemoptysis, and unintentional weight loss
• C. Dry cough, wheezing, shortness of breath, and bilateral leg edema
• D. Low-grade fever, rhinorrhea, sore throat, and myalgia
• E. Night sweats, fatigue, chronic cough lasting more than 3 weeks, and anorexia
CORRECT ANSWER: E RATIONALE: Classic TB symptoms include persistent
cough (>3 weeks), night sweats, fatigue, anorexia, and weight loss. Hemoptysis may also occur
in advanced disease. Option B includes hemoptysis which is possible but Option E better reflects
the early and classic presentation. Options A and C describe bacterial pneumonia and heart
failure respectively. Option D describes a viral URI.
QUESTION 2 Topic: Tuberculosis — Pharmacologic Treatment | Difficulty: Hard
A patient with active pulmonary TB is started on the standard four-drug regimen. Which
combination represents the correct initial phase of treatment?
• A. Amoxicillin, Clarithromycin, Ethambutol, Pyrazinamide
• B. Ciprofloxacin, Rifampin, Isoniazid, Streptomycin
• C. Isoniazid, Rifampin, Pyrazinamide, Ethambutol (RIPE)
• D. Rifampin, Dapsone, Ethambutol, Levofloxacin
• E. Isoniazid, Azithromycin, Pyrazinamide, Metronidazole
CORRECT ANSWER: C RATIONALE: The standard initial 2-month intensive phase
for active TB is RIPE — Rifampin, Isoniazid, Pyrazinamide, Ethambutol. This combination is
,supported by WHO and CDC guidelines. All other options include antibiotics not part of first-
line TB therapy.
QUESTION 3 Topic: Rifampin — Medication Side Effects | Difficulty: Easy
A nurse is educating a patient newly started on Rifampin for tuberculosis. Which statement by
the patient indicates understanding of the medication's side effects?
• A. "I should report any yellow discoloration of my skin immediately as this is
dangerous."
• B. "I must avoid all dairy products while taking this medication."
• C. "My urine, sweat, and tears may turn orange-red in color — this is normal."
• D. "I should take this medication with antacids to prevent stomach upset."
• E. "I will need weekly blood transfusions to monitor for anemia."
CORRECT ANSWER: C RATIONALE: Rifampin causes harmless orange-red
discoloration of body fluids including urine, sweat, saliva, and tears. Patients should be educated
about this expected side effect to prevent unnecessary alarm. Option A is incorrect — jaundice
should be reported but is not the expected normal side effect being asked. Option D is wrong;
antacids reduce Rifampin absorption.
QUESTION 4 Topic: TB — Patient Education | Difficulty: Easy
A patient with active TB asks why they must continue taking medications even though they feel
better after 2 weeks. What is the nurse's BEST response?
• A. "You can stop once your sputum culture is negative."
• B. "The medications help boost your immune system long-term."
• C. "Stopping early can cause drug-resistant TB, which is much harder to treat."
• D. "You only need to continue if you still have a cough."
• E. "Two more weeks is all that is needed for full treatment."
CORRECT ANSWER: C RATIONALE: Non-adherence and early discontinuation of
TB treatment is the primary cause of drug-resistant TB (MDR-TB and XDR-TB). Patients must
complete the full 6–9 month course regardless of symptom resolution. Patient education on
adherence is a critical nursing responsibility.
,QUESTION 5 Topic: Infection Control — Respiratory Precautions | Difficulty: Moderate
A patient with confirmed active pulmonary tuberculosis is admitted to the medical floor. Which
infection control measures should the nurse implement? Select all that apply.
• A. Contact precautions with gown and gloves only
• B. Airborne precautions — negative pressure room
• C. N95 respirator for all healthcare workers entering the room
• D. Surgical mask for the nurse is sufficient
• E. Patient to wear a surgical mask when being transported outside the room
CORRECT ANSWER: B, C, E RATIONALE: TB is transmitted via airborne droplet
nuclei (<5 microns). Airborne precautions require a negative pressure isolation room and N95
respirators (not surgical masks) for HCWs. When a TB patient must leave the room, they should
wear a surgical mask to protect others. Contact precautions alone are insufficient.
QUESTION 6 Topic: Pneumonia — Assessment | Difficulty: Moderate
A nurse assesses a 68-year-old patient with community-acquired pneumonia. Which finding is
MOST concerning and requires immediate intervention?
• A. Temperature of 38.2°C and productive cough
• B. Respiratory rate of 18 breaths/min with mild crackles
• C. SpO2 of 88% on room air with use of accessory muscles
• D. White blood cell count of 11,500/mm³
• E. Dullness to percussion over the right lower lobe
CORRECT ANSWER: C RATIONALE: An SpO2 of 88% indicates significant
hypoxia requiring immediate supplemental oxygen. The use of accessory muscles signals
increased work of breathing and impending respiratory failure. Options A, D, and E are expected
findings in pneumonia but do not require immediate intervention. Option B shows normal
respiratory rate.
QUESTION 7 Topic: Hypoxia — Recognition | Difficulty: Easy
, Which of the following is an EARLY sign of hypoxia that the nurse should recognize?
• A. Restlessness and anxiety
• B. Cyanosis of the lips and fingertips
• C. Bradycardia and hypotension
• D. Loss of consciousness
• E. Cheyne-Stokes respirations
CORRECT ANSWER: A RATIONALE: Restlessness and anxiety are early signs of
hypoxia as the brain is highly sensitive to decreased oxygen. Cyanosis (B) is a late sign.
Bradycardia, hypotension, and altered consciousness (C, D) indicate severe, late-stage hypoxia.
Cheyne-Stokes breathing indicates severe neurological or cardiac compromise.
QUESTION 8 Topic: Hypoxia — Clinical Interventions | Difficulty: Moderate
A patient with pneumonia has an SpO2 of 90% on room air. The nurse applies 2L/min oxygen
via nasal cannula. After 15 minutes, SpO2 is 91%. What is the nurse's priority next action?
• A. Document the findings and continue monitoring
• B. Reposition the patient to the supine position
• C. Increase oxygen flow rate and notify the physician
• D. Encourage the patient to cough and deep breathe
• E. Prepare for immediate intubation
CORRECT ANSWER: C RATIONALE: A target SpO2 of ≥94% is generally accepted
for most patients. An SpO2 of 91% after oxygen therapy is inadequate improvement and
warrants increasing the oxygen delivery and notifying the physician for further orders.
Immediate intubation (E) is premature. Supine positioning (B) worsens oxygenation.
QUESTION 9 Topic: H5N1 Influenza — Viral Respiratory Infections | Difficulty: Hard
A nurse is caring for a patient with suspected H5N1 avian influenza. Which precaution level is
MOST appropriate?
• A. Standard precautions only
• B. Droplet precautions with a surgical mask