MED SURG 1 CJE - LIPPINCOTT
CLINICAL JUDGMENT EXAM STUDY
GUIDE & NGN PRACTICE 2026 Update |
Complete Solutions| Jersey College
EXAM OVERVIEW & STRATEGY
Element Details
Course Med Surg 1 CJE – Medical-Surgical Nursing I
Institution Jersey College
Model NCSBN Clinical Judgment Measurement Model (6 layers)
Focus Areas Prioritization, delegation, clinical reasoning, red flags, critical lab values
Format NGN-style case studies, multiple choice, select all that apply
The 6 Layers of Clinical Judgment:
1. Recognize Cues – What data matters?
2. Analyze Cues – What's going wrong?
3. Prioritize Hypotheses – What's the most likely issue?
4. Generate Solutions – What can be done?
5. Take Action – Implement interventions
6. Evaluate Outcomes – Did it work?
,SECTION 1: CLINICAL JUDGMENT & NURSING PROCESS (Questions 1-20)
QUESTION 1
The nurse is caring for a patient using the nursing process. Which step should the
nurse take first?
A) Planning
B) Implementation
C) Assessment
D) Evaluation
Correct Answer: C) Assessment
Rationale: The nursing process begins with assessment, which involves collecting
data about the patient's condition. All subsequent steps (diagnosis, planning,
implementation, evaluation) depend on accurate assessment data.
QUESTION 2
The nurse hears the patient groan when getting out of bed and asks if there is pain,
using a pain scale. This describes which step of the clinical judgment process?
A) Generate solutions
B) Evaluate outcomes
,C) Recognize and analyze cues
D) Take action
Correct Answer: C) Recognize and analyze cues
Rationale: The nurse is identifying cues (groaning, difficulty moving) and analyzing
them by asking about pain using a standardized scale. This represents the first layer
of the CJMM.
QUESTION 3
The LPN/LVN enters the room of a patient who is angry and yells, "I asked 5
minutes ago for my pain medication. You're so worthless!" Which action by the
nurse demonstrates intellectual integrity?
A) Yelling back at the patient
B) Refusing to share details of the interaction with colleagues
C) Documenting the patient's behavior
D) Calling security immediately
Correct Answer: B) Refusing to share details of the interaction with colleagues
Rationale: Intellectual integrity involves maintaining professionalism and not
gossiping about patients or colleagues. The nurse should address the patient's
concerns directly rather than discussing the interaction with others.
QUESTION 4
The nurse is collecting data on a patient. Which data is considered a cue?
, A) The patient's age
B) Respiratory rate of 26 per minute
C) The patient's diagnosis
D) The patient's insurance information
Correct Answer: B) Respiratory rate of 26 per minute
Rationale: Cues are objective or subjective data that indicate a potential problem.
A respiratory rate of 26 is an abnormal finding that requires analysis. Demographic
information (A, D) and diagnoses (C) are not cues in the clinical judgment process.
QUESTION 5
Which items are a part of "generate solutions" when using the clinical judgment
process?
A) Reposition the patient
B) Assess vital signs
C) Document the findings
D) Notify the provider
Correct Answer: A) Reposition the patient
Rationale: Generating solutions involves identifying possible interventions.
Repositioning is an action that can be implemented. Assessing (B), documenting
(C), and notifying (D) are part of other phases of the process.
QUESTION 6
CLINICAL JUDGMENT EXAM STUDY
GUIDE & NGN PRACTICE 2026 Update |
Complete Solutions| Jersey College
EXAM OVERVIEW & STRATEGY
Element Details
Course Med Surg 1 CJE – Medical-Surgical Nursing I
Institution Jersey College
Model NCSBN Clinical Judgment Measurement Model (6 layers)
Focus Areas Prioritization, delegation, clinical reasoning, red flags, critical lab values
Format NGN-style case studies, multiple choice, select all that apply
The 6 Layers of Clinical Judgment:
1. Recognize Cues – What data matters?
2. Analyze Cues – What's going wrong?
3. Prioritize Hypotheses – What's the most likely issue?
4. Generate Solutions – What can be done?
5. Take Action – Implement interventions
6. Evaluate Outcomes – Did it work?
,SECTION 1: CLINICAL JUDGMENT & NURSING PROCESS (Questions 1-20)
QUESTION 1
The nurse is caring for a patient using the nursing process. Which step should the
nurse take first?
A) Planning
B) Implementation
C) Assessment
D) Evaluation
Correct Answer: C) Assessment
Rationale: The nursing process begins with assessment, which involves collecting
data about the patient's condition. All subsequent steps (diagnosis, planning,
implementation, evaluation) depend on accurate assessment data.
QUESTION 2
The nurse hears the patient groan when getting out of bed and asks if there is pain,
using a pain scale. This describes which step of the clinical judgment process?
A) Generate solutions
B) Evaluate outcomes
,C) Recognize and analyze cues
D) Take action
Correct Answer: C) Recognize and analyze cues
Rationale: The nurse is identifying cues (groaning, difficulty moving) and analyzing
them by asking about pain using a standardized scale. This represents the first layer
of the CJMM.
QUESTION 3
The LPN/LVN enters the room of a patient who is angry and yells, "I asked 5
minutes ago for my pain medication. You're so worthless!" Which action by the
nurse demonstrates intellectual integrity?
A) Yelling back at the patient
B) Refusing to share details of the interaction with colleagues
C) Documenting the patient's behavior
D) Calling security immediately
Correct Answer: B) Refusing to share details of the interaction with colleagues
Rationale: Intellectual integrity involves maintaining professionalism and not
gossiping about patients or colleagues. The nurse should address the patient's
concerns directly rather than discussing the interaction with others.
QUESTION 4
The nurse is collecting data on a patient. Which data is considered a cue?
, A) The patient's age
B) Respiratory rate of 26 per minute
C) The patient's diagnosis
D) The patient's insurance information
Correct Answer: B) Respiratory rate of 26 per minute
Rationale: Cues are objective or subjective data that indicate a potential problem.
A respiratory rate of 26 is an abnormal finding that requires analysis. Demographic
information (A, D) and diagnoses (C) are not cues in the clinical judgment process.
QUESTION 5
Which items are a part of "generate solutions" when using the clinical judgment
process?
A) Reposition the patient
B) Assess vital signs
C) Document the findings
D) Notify the provider
Correct Answer: A) Reposition the patient
Rationale: Generating solutions involves identifying possible interventions.
Repositioning is an action that can be implemented. Assessing (B), documenting
(C), and notifying (D) are part of other phases of the process.
QUESTION 6
