CJE MedSurg 1 Exam Review | Latest Update 2026/2027 | 200
Practice Questions & Detailed Answers | Guaranteed Pass
MedicalSurgical Mastery Edition
1. A patient with leftsided heart failure is admitted with acute dyspnea and orthopnea. Which
assessment finding should the nurse anticipate?
A. Peripheral edema and jugular venous distention (JVD)
B. Crackles in the lung bases and pink, frothy sputum
C. Hepatomegaly and ascites
D. Bradycardia and hypotension
Answer: B. Crackles in the lung bases and pink, frothy sputum.
Explanation: Leftsided heart failure leads to pulmonary congestion. Fluid backs up into the lungs, causing
crackles (rales) and potentially pulmonary edema, evidenced by pink, frothy sputum. Peripheral edema,
JVD, and hepatomegaly are signs of rightsided failure. Bradycardia is not typical in acute exacerbations;
tachycardia is.
2. The nurse is caring for a patient on a continuous insulin drip for diabetic ketoacidosis (DKA). The blood
glucose is now 180 mg/dL. The provider orders to add dextrose to the IV fluids. The nurse understands
this is primarily to prevent which complication?
A. Hyperglycemia
B. Hypokalemia
C. Cerebral edema
D. Hypoglycemia
,Answer: B. Hypokalemia.
Explanation: Insulin drives potassium into cells, causing serum potassium levels to drop. Adding dextrose
allows the insulin infusion to continue so that ketosis resolves while preventing the blood glucose from
dropping too low and causing hypoglycemia. The primary reason is to prevent hypokalemia as insulin
continues to drive potassium intracellularly.
3. A patient has a nursing diagnosis of ineffective airway clearance related to retained secretions,
excessive mucus, and ineffective cough as evidenced by adventitious breath sounds. Which NOC
outcome and NIC intervention should the nurse include in the care plan?
A. Aspiration Prevention (NOC) and Aspiration Precautions (NIC)
B. Respiratory Status: Gas Exchange (NOC) and Oxygen Therapy (NIC)
C. Respiratory Status: Ventilation (NOC) and Respiratory Monitoring (NIC)
D. Respiratory Status: Airway Patency (NOC) and Airway Management (NIC)
Answer: D. Respiratory Status: Airway Patency (NOC) and Airway Management (NIC).
Explanation: For a patient with ineffective airway clearance, the appropriate NOC outcome is
Respiratory Status: Airway Patency, and the corresponding NIC intervention is Airway Management to
maintain a clear airway.
4. A nurse teaches a student nurse about evidencebased nursing practice guidelines. Which statement
by the student nurse indicates understanding?
A. "Patient care is based on research findings instead of the expertise of the nurse."
B. "Patient preferences should not be considered if guidelines are supported by evidence."
C. "Nursing care provided is based on the best evidence for quality care and desired outcomes."
,D. "Practice guidelines are used so that professional decisions about patient care are unnecessary."
Answer: C. "Nursing care provided is based on the best evidence for quality care and desired outcomes."
Explanation: Evidencebased practice integrates the best available research evidence, clinical expertise,
and patient preferences to provide quality care and achieve desired outcomes.
5. A nurse is caring for an older adult with a new diagnosis of type 2 diabetes who reports difficulty
following the diet plan and taking medication. Which actions should the nurse take? (Select All That
Apply)
A. Ask the dietitian to assist with meal planning
B. Contact the client's support system
C. Assess for agerelated cognitive awareness
D. Encourage use of a daily medication dispenser
Answer: A, B, C, D. All are appropriate actions.
Explanation: All these interventions support medication adherence and dietary compliance in an older
adult with newonset diabetes. Involving the dietitian, engaging support systems, assessing cognitive
status, and using medication organizers are all evidencebased strategies.
6. A nurse in a health care clinic is evaluating the level of wellness for clients using the illnesswellness
continuum. Which client should the nurse identify as being at the center of the continuum?
A. College student with influenza
B. Older adult with new diagnosis of type 2 diabetes
, C. New mother with a UTI
D. Young male with a long history of controlled arthritis
Answer: D. Young male with a long history of controlled arthritis.
Explanation: The center of the illnesswellness continuum represents a neutral point where an individual
is not experiencing acute illness but has a chronic condition that is wellmanaged. A young male with
controlled arthritis fits this description.
7. A nurse is evaluating clients at a health fair for modifiable variables affecting health and wellness.
Which variables can the nurse identify as modifiable? (Select All That Apply)
A. Smoking on occasion
B. BMI of 28
C. Alopecia
D. Trisomy 21
E. History of reflux
Answer: A, B, E. Smoking, BMI, and history of reflux.
Explanation: Modifiable risk factors are those that can be changed through lifestyle modifications or
treatment. Smoking, obesity (BMI ≥25), and reflux are modifiable. Alopecia (hair loss) and Trisomy 21
(genetic condition) are nonmodifiable.
8. A nurse preparing a sterile field drops a sterile gauze pad onto the edge of the field, which is 1 inch
from the border. What is the correct action?
Practice Questions & Detailed Answers | Guaranteed Pass
MedicalSurgical Mastery Edition
1. A patient with leftsided heart failure is admitted with acute dyspnea and orthopnea. Which
assessment finding should the nurse anticipate?
A. Peripheral edema and jugular venous distention (JVD)
B. Crackles in the lung bases and pink, frothy sputum
C. Hepatomegaly and ascites
D. Bradycardia and hypotension
Answer: B. Crackles in the lung bases and pink, frothy sputum.
Explanation: Leftsided heart failure leads to pulmonary congestion. Fluid backs up into the lungs, causing
crackles (rales) and potentially pulmonary edema, evidenced by pink, frothy sputum. Peripheral edema,
JVD, and hepatomegaly are signs of rightsided failure. Bradycardia is not typical in acute exacerbations;
tachycardia is.
2. The nurse is caring for a patient on a continuous insulin drip for diabetic ketoacidosis (DKA). The blood
glucose is now 180 mg/dL. The provider orders to add dextrose to the IV fluids. The nurse understands
this is primarily to prevent which complication?
A. Hyperglycemia
B. Hypokalemia
C. Cerebral edema
D. Hypoglycemia
,Answer: B. Hypokalemia.
Explanation: Insulin drives potassium into cells, causing serum potassium levels to drop. Adding dextrose
allows the insulin infusion to continue so that ketosis resolves while preventing the blood glucose from
dropping too low and causing hypoglycemia. The primary reason is to prevent hypokalemia as insulin
continues to drive potassium intracellularly.
3. A patient has a nursing diagnosis of ineffective airway clearance related to retained secretions,
excessive mucus, and ineffective cough as evidenced by adventitious breath sounds. Which NOC
outcome and NIC intervention should the nurse include in the care plan?
A. Aspiration Prevention (NOC) and Aspiration Precautions (NIC)
B. Respiratory Status: Gas Exchange (NOC) and Oxygen Therapy (NIC)
C. Respiratory Status: Ventilation (NOC) and Respiratory Monitoring (NIC)
D. Respiratory Status: Airway Patency (NOC) and Airway Management (NIC)
Answer: D. Respiratory Status: Airway Patency (NOC) and Airway Management (NIC).
Explanation: For a patient with ineffective airway clearance, the appropriate NOC outcome is
Respiratory Status: Airway Patency, and the corresponding NIC intervention is Airway Management to
maintain a clear airway.
4. A nurse teaches a student nurse about evidencebased nursing practice guidelines. Which statement
by the student nurse indicates understanding?
A. "Patient care is based on research findings instead of the expertise of the nurse."
B. "Patient preferences should not be considered if guidelines are supported by evidence."
C. "Nursing care provided is based on the best evidence for quality care and desired outcomes."
,D. "Practice guidelines are used so that professional decisions about patient care are unnecessary."
Answer: C. "Nursing care provided is based on the best evidence for quality care and desired outcomes."
Explanation: Evidencebased practice integrates the best available research evidence, clinical expertise,
and patient preferences to provide quality care and achieve desired outcomes.
5. A nurse is caring for an older adult with a new diagnosis of type 2 diabetes who reports difficulty
following the diet plan and taking medication. Which actions should the nurse take? (Select All That
Apply)
A. Ask the dietitian to assist with meal planning
B. Contact the client's support system
C. Assess for agerelated cognitive awareness
D. Encourage use of a daily medication dispenser
Answer: A, B, C, D. All are appropriate actions.
Explanation: All these interventions support medication adherence and dietary compliance in an older
adult with newonset diabetes. Involving the dietitian, engaging support systems, assessing cognitive
status, and using medication organizers are all evidencebased strategies.
6. A nurse in a health care clinic is evaluating the level of wellness for clients using the illnesswellness
continuum. Which client should the nurse identify as being at the center of the continuum?
A. College student with influenza
B. Older adult with new diagnosis of type 2 diabetes
, C. New mother with a UTI
D. Young male with a long history of controlled arthritis
Answer: D. Young male with a long history of controlled arthritis.
Explanation: The center of the illnesswellness continuum represents a neutral point where an individual
is not experiencing acute illness but has a chronic condition that is wellmanaged. A young male with
controlled arthritis fits this description.
7. A nurse is evaluating clients at a health fair for modifiable variables affecting health and wellness.
Which variables can the nurse identify as modifiable? (Select All That Apply)
A. Smoking on occasion
B. BMI of 28
C. Alopecia
D. Trisomy 21
E. History of reflux
Answer: A, B, E. Smoking, BMI, and history of reflux.
Explanation: Modifiable risk factors are those that can be changed through lifestyle modifications or
treatment. Smoking, obesity (BMI ≥25), and reflux are modifiable. Alopecia (hair loss) and Trisomy 21
(genetic condition) are nonmodifiable.
8. A nurse preparing a sterile field drops a sterile gauze pad onto the edge of the field, which is 1 inch
from the border. What is the correct action?
