CJE MED SURG I EXAM 2026 | 200 VERIFIED
PRACTICE QUESTIONS & DETAILED
ANSWERS | COMPLETE MEDICAL-SURGICAL
NURSING STUDY GUIDE
OVERVIEW: CJE MED SURG I EXAM 2026 | 200 VERIFIED PRACTICE QUESTIONS &
DETAILED ANSWERS
• Comprehensive study resource with 200 practice questions designed to prepare
you for medical-surgical nursing exams, covering all major body systems, common
conditions, and clinical scenarios
• Use this guide to assess knowledge gaps, practice test-taking strategies, and build
confidence by studying one section at a time or taking full 50-question blocks
Question 1
A 65-year-old male patient presents to the emergency department with acute
chest pain radiating to his left arm, diaphoresis, and shortness of breath. His
ECG shows ST-segment elevation in leads II, III, and aVF. What is the priority
nursing intervention at this moment?
A) Administer aspirin and obtain a 12-lead ECG
B) Establish large-bore IV access and prepare for emergency cardiac catheterization
C) Place the patient on oxygen therapy and continuous cardiac monitoring
D) Administer morphine for pain control and anxiety reduction
E) Perform a comprehensive physical examination and obtain detailed history
CORRECT ANSWER: B) Establish large-bore IV access and prepare for
emergency cardiac catheterization
Rationale: The patient is experiencing an acute STEMI (ST-elevation myocardial
infarction) as evidenced by ST-segment elevation on ECG and classic symptoms of
acute MI. The priority intervention is to establish vascular access and prepare for
,emergency reperfusion therapy via cardiac catheterization (percutaneous coronary
intervention or PCI). While options A, C, and D are important supportive measures,
they are secondary to achieving reperfusion, which is time-sensitive. The window
for optimal intervention is typically within 90 minutes of symptom onset.
Establishing IV access and preparing for catheterization directly addresses the life-
threatening cardiac crisis.
Question 2
Which clinical finding would the nurse expect to assess in a patient with
advanced heart failure and pulmonary edema?
A) Dry, non-productive cough with clear lung sounds
B) Pink-tinged, frothy sputum with crackles throughout lung fields
C) Unilateral wheezing with reduced air movement on one side
D) Stridor with a barky, seal-like cough
E) Absence of breath sounds bilaterally with hyperresonance on percussion
CORRECT ANSWER: B) Pink-tinged, frothy sputum with crackles throughout
lung fields
Rationale: Pulmonary edema in heart failure results from increased hydrostatic
pressure backing up into the pulmonary vasculature, causing fluid to leak into the
alveolar spaces. This produces characteristic findings: pink-tinged sputum (mixture
of air, fluid, and red blood cells) that is frothy in appearance, along with crackles
(rales) heard throughout both lung fields on auscultation. This classic presentation
indicates severe pulmonary edema requiring immediate intervention. The other
options represent different respiratory conditions not associated with heart failure-
induced pulmonary edema.
Question 3
,A patient with a history of hypertension and diabetes mellitus is admitted
with a blood pressure of 185/110 mmHg and complaining of a sudden severe
headache with vision changes. What is the nurse's priority assessment?
A) Obtain a 12-lead ECG and cardiac enzymes
B) Assess neurological status and evaluate for signs of hypertensive crisis
C) Administer antihypertensive medications immediately
D) Place patient in Trendelenburg position to increase cerebral perfusion
E) Document blood pressure readings and reassess in 30 minutes
CORRECT ANSWER: B) Assess neurological status and evaluate for signs of
hypertensive crisis
Rationale: The clinical presentation of severe hypertension, severe headache, and
vision changes suggests a hypertensive emergency or hypertensive
encephalopathy. A comprehensive neurological assessment is essential to
determine if end-organ damage is occurring. Findings such as confusion, altered
consciousness, seizures, or focal neurological deficits indicate severe hypertensive
crisis requiring immediate intervention. This takes priority over ECG or medication
administration, as the neurological status determines the urgency and type of
treatment. Trendelenburg position is contraindicated in hypertensive crisis, and
waiting 30 minutes delays critical assessment.
Question 4
Which medication should be available at the bedside for a patient
experiencing angina pectoris?
A) Metoprolol (beta-blocker)
B) Sublingual nitroglycerin
C) Atorvastatin (statin)
D) Lisinopril (ACE inhibitor)
E) Warfarin (anticoagulant)
, CORRECT ANSWER: B) Sublingual nitroglycerin
Rationale: Sublingual nitroglycerin is the first-line acute treatment for angina
pectoris. It works rapidly (within 1-3 minutes) to relieve anginal chest pain by
causing vasodilation and reducing myocardial oxygen demand. Nitroglycerin should
be kept at the patient's bedside for immediate use during an anginal episode. While
the other medications are important in the long-term management of coronary
artery disease and angina, they do not provide acute relief. Nitroglycerin's rapid
onset of action makes it essential for emergency symptom management.
Question 5
A 72-year-old patient with COPD is receiving supplemental oxygen therapy.
The nurse notes the patient's respiratory rate has decreased from 24 to 12
breaths per minute and the patient appears drowsy. What should the nurse
do first?
A) Increase the oxygen flow rate to improve oxygenation
B) Check the patient's oxygen saturation and arterial blood gas values
C) Administer an amphetamine-based stimulant to increase respirations
D) Reduce the oxygen flow rate or discontinue supplemental oxygen
E) Place the patient in high Fowler's position and monitor closely
CORRECT ANSWER: D) Reduce the oxygen flow rate or discontinue
supplemental oxygen
Rationale: In COPD patients, the primary drive to breathe may be hypoxemia rather
than hypercapnia (elevated CO2). High-flow oxygen can suppress the hypoxic drive,
leading to hypoventilation, increased CO2 retention (hypercapnia), and respiratory
depression. This results in decreased respiratory rate and drowsiness—classic signs
of CO2 narcosis. The solution is to reduce oxygen delivery, typically to 1-2 L/min via
nasal cannula, to maintain mild hypoxemia and preserve respiratory drive. The
nurse should monitor blood gases afterward, but the immediate intervention is to
reduce oxygen flow to prevent further respiratory depression.
PRACTICE QUESTIONS & DETAILED
ANSWERS | COMPLETE MEDICAL-SURGICAL
NURSING STUDY GUIDE
OVERVIEW: CJE MED SURG I EXAM 2026 | 200 VERIFIED PRACTICE QUESTIONS &
DETAILED ANSWERS
• Comprehensive study resource with 200 practice questions designed to prepare
you for medical-surgical nursing exams, covering all major body systems, common
conditions, and clinical scenarios
• Use this guide to assess knowledge gaps, practice test-taking strategies, and build
confidence by studying one section at a time or taking full 50-question blocks
Question 1
A 65-year-old male patient presents to the emergency department with acute
chest pain radiating to his left arm, diaphoresis, and shortness of breath. His
ECG shows ST-segment elevation in leads II, III, and aVF. What is the priority
nursing intervention at this moment?
A) Administer aspirin and obtain a 12-lead ECG
B) Establish large-bore IV access and prepare for emergency cardiac catheterization
C) Place the patient on oxygen therapy and continuous cardiac monitoring
D) Administer morphine for pain control and anxiety reduction
E) Perform a comprehensive physical examination and obtain detailed history
CORRECT ANSWER: B) Establish large-bore IV access and prepare for
emergency cardiac catheterization
Rationale: The patient is experiencing an acute STEMI (ST-elevation myocardial
infarction) as evidenced by ST-segment elevation on ECG and classic symptoms of
acute MI. The priority intervention is to establish vascular access and prepare for
,emergency reperfusion therapy via cardiac catheterization (percutaneous coronary
intervention or PCI). While options A, C, and D are important supportive measures,
they are secondary to achieving reperfusion, which is time-sensitive. The window
for optimal intervention is typically within 90 minutes of symptom onset.
Establishing IV access and preparing for catheterization directly addresses the life-
threatening cardiac crisis.
Question 2
Which clinical finding would the nurse expect to assess in a patient with
advanced heart failure and pulmonary edema?
A) Dry, non-productive cough with clear lung sounds
B) Pink-tinged, frothy sputum with crackles throughout lung fields
C) Unilateral wheezing with reduced air movement on one side
D) Stridor with a barky, seal-like cough
E) Absence of breath sounds bilaterally with hyperresonance on percussion
CORRECT ANSWER: B) Pink-tinged, frothy sputum with crackles throughout
lung fields
Rationale: Pulmonary edema in heart failure results from increased hydrostatic
pressure backing up into the pulmonary vasculature, causing fluid to leak into the
alveolar spaces. This produces characteristic findings: pink-tinged sputum (mixture
of air, fluid, and red blood cells) that is frothy in appearance, along with crackles
(rales) heard throughout both lung fields on auscultation. This classic presentation
indicates severe pulmonary edema requiring immediate intervention. The other
options represent different respiratory conditions not associated with heart failure-
induced pulmonary edema.
Question 3
,A patient with a history of hypertension and diabetes mellitus is admitted
with a blood pressure of 185/110 mmHg and complaining of a sudden severe
headache with vision changes. What is the nurse's priority assessment?
A) Obtain a 12-lead ECG and cardiac enzymes
B) Assess neurological status and evaluate for signs of hypertensive crisis
C) Administer antihypertensive medications immediately
D) Place patient in Trendelenburg position to increase cerebral perfusion
E) Document blood pressure readings and reassess in 30 minutes
CORRECT ANSWER: B) Assess neurological status and evaluate for signs of
hypertensive crisis
Rationale: The clinical presentation of severe hypertension, severe headache, and
vision changes suggests a hypertensive emergency or hypertensive
encephalopathy. A comprehensive neurological assessment is essential to
determine if end-organ damage is occurring. Findings such as confusion, altered
consciousness, seizures, or focal neurological deficits indicate severe hypertensive
crisis requiring immediate intervention. This takes priority over ECG or medication
administration, as the neurological status determines the urgency and type of
treatment. Trendelenburg position is contraindicated in hypertensive crisis, and
waiting 30 minutes delays critical assessment.
Question 4
Which medication should be available at the bedside for a patient
experiencing angina pectoris?
A) Metoprolol (beta-blocker)
B) Sublingual nitroglycerin
C) Atorvastatin (statin)
D) Lisinopril (ACE inhibitor)
E) Warfarin (anticoagulant)
, CORRECT ANSWER: B) Sublingual nitroglycerin
Rationale: Sublingual nitroglycerin is the first-line acute treatment for angina
pectoris. It works rapidly (within 1-3 minutes) to relieve anginal chest pain by
causing vasodilation and reducing myocardial oxygen demand. Nitroglycerin should
be kept at the patient's bedside for immediate use during an anginal episode. While
the other medications are important in the long-term management of coronary
artery disease and angina, they do not provide acute relief. Nitroglycerin's rapid
onset of action makes it essential for emergency symptom management.
Question 5
A 72-year-old patient with COPD is receiving supplemental oxygen therapy.
The nurse notes the patient's respiratory rate has decreased from 24 to 12
breaths per minute and the patient appears drowsy. What should the nurse
do first?
A) Increase the oxygen flow rate to improve oxygenation
B) Check the patient's oxygen saturation and arterial blood gas values
C) Administer an amphetamine-based stimulant to increase respirations
D) Reduce the oxygen flow rate or discontinue supplemental oxygen
E) Place the patient in high Fowler's position and monitor closely
CORRECT ANSWER: D) Reduce the oxygen flow rate or discontinue
supplemental oxygen
Rationale: In COPD patients, the primary drive to breathe may be hypoxemia rather
than hypercapnia (elevated CO2). High-flow oxygen can suppress the hypoxic drive,
leading to hypoventilation, increased CO2 retention (hypercapnia), and respiratory
depression. This results in decreased respiratory rate and drowsiness—classic signs
of CO2 narcosis. The solution is to reduce oxygen delivery, typically to 1-2 L/min via
nasal cannula, to maintain mild hypoxemia and preserve respiratory drive. The
nurse should monitor blood gases afterward, but the immediate intervention is to
reduce oxygen flow to prevent further respiratory depression.
