CJE Med-Surg 1 Exam Review
2025–2026 Practice Questions &
Rationales
This comprehensive review guide is designed for nursing students
preparing for the Clinical Judgment Exam (CJE) in Medical-Surgical
Nursing I. The material follows the NCSBN Clinical Judgment Measurement
Model (CJMM) and includes high-yield content frequently tested.
EXAM OVERVIEW
Detail Information
Course Med-Surg 1 CJE –
Medical-Surgical
Nursing I
Model NCSBN Clinical
Judgment
Measurement Model
(6 cognitive skills)
Focus Prioritization,
Areas delegation, clinical
reasoning, red flags,
critical lab values
,Format NGN-style case
studies, multiple
choice, select all that
apply
NCSBN Clinical Judgment Measurement Model (CJMM) Cognitive
Skills
1. Recognize Cues – Identify relevant clinical findings
2. Analyze Cues – Connect findings to probable conditions
3. Prioritize Hypotheses – Rank problems by urgency and likelihood
4. Generate Solutions – Develop possible interventions
5. Take Actions – Implement nursing interventions
6. Evaluate Outcomes – Reassess to determine if interventions were
effective
SECTION 1: CLINICAL JUDGMENT & PRIORITIZATION
(Questions 1-25)
Question 1
A nurse is caring for a client with pneumonia. Which assessment finding is
the most important cue for potential sepsis?
A. Temperature 38.3°C (100.9°F)
B. Respiratory rate 22/min
C. Heart rate 110/min and blood pressure 98/62 mm Hg
D. Oxygen saturation 91% on room air
Answer: C. Heart rate 110/min and blood pressure 98/62 mm Hg
,Rationale: Tachycardia with borderline hypotension are early signs of
sepsis (warm shock). While fever and tachypnea are also important, the
combination of heart rate and blood pressure indicates hemodynamic
compromise, which is a higher priority cue.
Question 2
The nurse is using the NCSBN Clinical Judgment Measurement Model
(CJMM). Place the six cognitive skills in the correct order.
A. Take Actions, Evaluate Outcomes, Generate Solutions, Prioritize
Hypotheses, Recognize Cues, Analyze Cues
B. Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate
Solutions, Take Actions, Evaluate Outcomes
C. Recognize Cues, Prioritize Hypotheses, Analyze Cues, Generate
Solutions, Take Actions, Evaluate Outcomes
Answer: B. Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate
Solutions, Take Actions, Evaluate Outcomes
Rationale: This sequence reflects the logical progression of clinical
judgment. The nurse must first identify relevant data (Recognize Cues),
then interpret it (Analyze Cues), rank problems by urgency (Prioritize
Hypotheses), develop interventions (Generate Solutions), implement them
(Take Actions), and finally reassess to determine effectiveness (Evaluate
Outcomes).
Question 3
The nurse is assigned to care for the following clients. Which client should
the nurse see FIRST?
, A. A client with diabetes requesting pain medication for a headache rated
4/10
B. A client with a new onset of slurred speech and facial droop
C. A client needing assistance with ambulation to the bathroom
D. A client scheduled for discharge teaching
Answer: B. A client with a new onset of slurred speech and facial droop
Rationale: New onset of slurred speech and facial droop are signs of a
stroke (CVA). This is a time-sensitive emergency requiring immediate
assessment and intervention. "Time is brain."
Question 4
A nurse completes preoperative teaching for a client scheduled for a
cholecystectomy. The client states, "If I lie still and avoid turning, I will avoid
pain. Do you think this is a good idea?" What is the nurse's best response?
A. "Yes, that is an excellent way to manage post-operative pain."
B. "Lying still will increase your risk of complications like pneumonia and
blood clots. Let's talk about how to turn and use your pain medication
effectively."
C. "You should not be experiencing pain after surgery."
D. "It's fine to lie still for the first 24 hours."
Answer: B. "Lying still will increase your risk of complications like
pneumonia and blood clots. Let's talk about how to turn and use your pain
medication effectively."
Rationale: This response provides education about the risks of immobility
(atelectasis, thromboembolism) and offers a solution. It addresses the
patient's concern and promotes safe postoperative care.
2025–2026 Practice Questions &
Rationales
This comprehensive review guide is designed for nursing students
preparing for the Clinical Judgment Exam (CJE) in Medical-Surgical
Nursing I. The material follows the NCSBN Clinical Judgment Measurement
Model (CJMM) and includes high-yield content frequently tested.
EXAM OVERVIEW
Detail Information
Course Med-Surg 1 CJE –
Medical-Surgical
Nursing I
Model NCSBN Clinical
Judgment
Measurement Model
(6 cognitive skills)
Focus Prioritization,
Areas delegation, clinical
reasoning, red flags,
critical lab values
,Format NGN-style case
studies, multiple
choice, select all that
apply
NCSBN Clinical Judgment Measurement Model (CJMM) Cognitive
Skills
1. Recognize Cues – Identify relevant clinical findings
2. Analyze Cues – Connect findings to probable conditions
3. Prioritize Hypotheses – Rank problems by urgency and likelihood
4. Generate Solutions – Develop possible interventions
5. Take Actions – Implement nursing interventions
6. Evaluate Outcomes – Reassess to determine if interventions were
effective
SECTION 1: CLINICAL JUDGMENT & PRIORITIZATION
(Questions 1-25)
Question 1
A nurse is caring for a client with pneumonia. Which assessment finding is
the most important cue for potential sepsis?
A. Temperature 38.3°C (100.9°F)
B. Respiratory rate 22/min
C. Heart rate 110/min and blood pressure 98/62 mm Hg
D. Oxygen saturation 91% on room air
Answer: C. Heart rate 110/min and blood pressure 98/62 mm Hg
,Rationale: Tachycardia with borderline hypotension are early signs of
sepsis (warm shock). While fever and tachypnea are also important, the
combination of heart rate and blood pressure indicates hemodynamic
compromise, which is a higher priority cue.
Question 2
The nurse is using the NCSBN Clinical Judgment Measurement Model
(CJMM). Place the six cognitive skills in the correct order.
A. Take Actions, Evaluate Outcomes, Generate Solutions, Prioritize
Hypotheses, Recognize Cues, Analyze Cues
B. Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate
Solutions, Take Actions, Evaluate Outcomes
C. Recognize Cues, Prioritize Hypotheses, Analyze Cues, Generate
Solutions, Take Actions, Evaluate Outcomes
Answer: B. Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate
Solutions, Take Actions, Evaluate Outcomes
Rationale: This sequence reflects the logical progression of clinical
judgment. The nurse must first identify relevant data (Recognize Cues),
then interpret it (Analyze Cues), rank problems by urgency (Prioritize
Hypotheses), develop interventions (Generate Solutions), implement them
(Take Actions), and finally reassess to determine effectiveness (Evaluate
Outcomes).
Question 3
The nurse is assigned to care for the following clients. Which client should
the nurse see FIRST?
, A. A client with diabetes requesting pain medication for a headache rated
4/10
B. A client with a new onset of slurred speech and facial droop
C. A client needing assistance with ambulation to the bathroom
D. A client scheduled for discharge teaching
Answer: B. A client with a new onset of slurred speech and facial droop
Rationale: New onset of slurred speech and facial droop are signs of a
stroke (CVA). This is a time-sensitive emergency requiring immediate
assessment and intervention. "Time is brain."
Question 4
A nurse completes preoperative teaching for a client scheduled for a
cholecystectomy. The client states, "If I lie still and avoid turning, I will avoid
pain. Do you think this is a good idea?" What is the nurse's best response?
A. "Yes, that is an excellent way to manage post-operative pain."
B. "Lying still will increase your risk of complications like pneumonia and
blood clots. Let's talk about how to turn and use your pain medication
effectively."
C. "You should not be experiencing pain after surgery."
D. "It's fine to lie still for the first 24 hours."
Answer: B. "Lying still will increase your risk of complications like
pneumonia and blood clots. Let's talk about how to turn and use your pain
medication effectively."
Rationale: This response provides education about the risks of immobility
(atelectasis, thromboembolism) and offers a solution. It addresses the
patient's concern and promotes safe postoperative care.
