CJE Readiness II Exam Study Questions and Answers 300 Original Multiple-Choice Questions with Answers and Rationales

CJE Readiness II Exam Study Questions and Answers 300 Original Multiple-Choice Questions with Answers and Rationales Section Topic Questions 1 Clinical Judgment 1-60 2 Prioritization 61-120 3 Delegation 121-180 4 Safety and Infection Control 181-240 5 Patient Assessment 241-300 SECTION 1: CLINICAL JUDGMENT (Questions 1-60) 1. A nurse notices a patient's respiratory rate has increased from 18 to 26 breaths per minute over the past hour. Which action best demonstrates clinical judgment? A. Document the finding and continue monitoring B. Ask the patient if they are feeling anxious C. Assess lung sounds and check oxygen saturation D. Notify the healthcare provider immediately Answer: C Rationale: Clinical judgment requires gathering additional assessment data before determining the appropriate intervention. --- 2. Which action best represents the application of clinical judgment in nursing practice? A. Following standing orders without question B. Analyzing assessment data to identify patient problems C. Documenting all findings in the electronic health record D. Completing tasks in the order they are assigned Answer: B Rationale: Clinical judgment involves analyzing and synthesizing patient data to identify problems and determine appropriate care. --- 3. A nurse observes that a post-surgical patient's wound drainage has changed from serosanguineous to purulent. What is the most appropriate action? A. Apply a fresh dressing and document the change B. Notify the healthcare provider of the change C. Increase the frequency of dressing changes D. Wait until the next shift to report the finding Answer: B Rationale: A change from serosanguineous to purulent drainage may indicate infection and requires immediate provider notification. --- 4. Which patient assessment finding should be prioritized based on the ABC framework? A. Blood pressure 148/92 mmHg B. Heart rate 102 beats per minute C. Stridor on inspiration D. Temperature 38.2°C (100.8°F) Answer: C Rationale: Stridor indicates an upper airway obstruction, which is a threat to airway patency and the highest priority. --- 5. A nurse is caring for four patients. Which patient should be assessed first? A. Patient with pneumonia who has an oxygen saturation of 91% on room air B. Patient with diabetes who has a blood glucose of 180 mg/dL C. Patient with hypertension who has a blood pressure of 150/90 mmHg D. Patient with a wound who reports pain rated 4 on a scale of 0-10 Answer: A Rationale: An oxygen saturation of 91% indicates hypoxemia and requires immediate attention to prevent respiratory compromise. --- 6. A patient's heart rate drops from 88 to 52 beats per minute. Which action demonstrates the best clinical judgment? A. Document the change and reassess in 30 minutes B. Assess the patient's blood pressure and level of consciousness C. Notify the rapid response team immediately D. Administer atropine per standing order Answer: B Rationale: Assessment of blood pressure and level of consciousness helps determine if the bradycardia is clinically significant. --- 7. A nurse uses critical thinking to evaluate a patient's lab results. Which finding requires immediate intervention? A. Hemoglobin 11.2 g/dL B. Potassium 6.8 mEq/L C. Sodium 135 mEq/L D. Glucose 140 mg/dL Answer: B Rationale: A potassium level of 6.8 mEq/L indicates hyperkalemia, which can cause fatal cardiac arrhythmias. --- 8. Which action demonstrates the nurse is using clinical judgment when caring for a patient with chest pain? A. Administering nitroglycerin without assessing blood pressure B. Reassessing the patient's pain level after interventions C. Documenting chest pain as stable and unchanged D. Waiting for the healthcare provider to assess the patient Answer: B Rationale: Clinical judgment includes evaluating the effectiveness of interventions and reassessing patient response. --- 9. A patient with a history of falls attempts to get out of bed unassisted. Which action demonstrates sound clinical judgment? A. Ask the patient to wait until the next shift B. Place a bed alarm and remind the patient to call for help C. Apply soft restraints to prevent the patient from falling D. Document the patient's noncompliance with safety measures Answer: B Rationale: A bed alarm combined with patient education promotes safety while preserving patient autonomy. --- 10. Which assessment finding in a postoperative patient requires the most immediate intervention? A. Pain rated 6 on a scale of 0-10 B. Urinary output of 40 mL in the past 2 hours C. Incision site with mild erythema D. Oxygen saturation of 89% on 2 L nasal cannula Answer: D Rationale: An oxygen saturation of 89% indicates hypoxemia that requires immediate intervention. --- 11. A nurse notices a patient's mental status has declined from alert to confused. What is the priority action? A. Reorient the patient and continue monitoring B. Assess for physiological causes of the change C. Document the change in the patient's chart D. Ask family members about the patient's baseline Answer: B Rationale: A change in mental status requires immediate assessment for physiological causes such as hypoxia or infection. --- 12. Which action best demonstrates clinical judgment when a patient reports chest discomfort? A. Administering oxygen without assessing oxygen saturation B. Obtaining a 12-lead ECG and assessing vital signs C. Documenting the complaint and continuing rounds D. Reassuring the patient that discomfort is expected Answer: B Rationale: Clinical judgment requires comprehensive assessment including ECG and vital signs when chest discomfort is reported. --- 13. A nurse is evaluating a patient's response to pain medication. Which finding indicates the need for reassessment? A. Pain decreased from 8 to 4 on a scale of 0-10 B. Respiratory rate decreased from 16 to 10 breaths per minute C. Patient reports being comfortable and relaxed D. Heart rate decreased from 110 to 80 beats per minute Answer: B Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a serious adverse effect of pain medication. --- 14. Which patient situation requires the nurse to use clinical judgment to modify the plan of care? A. Patient's blood pressure is within expected range B. Patient's temperature returns to normal after antipyretic C. Patient develops new-onset confusion D. Patient's pain score decreases by 2 points Answer: C Rationale: New-onset confusion represents a change in condition that requires modification of the plan of care. --- 15. A nurse is assessing a patient with shortness of breath. Which finding is most significant? A. Cough producing clear sputum B. Use of accessory muscles to breathe C. Respiratory rate of 22 breaths per minute D. Oxygen saturation of 94% on room air Answer: B Rationale: Use of accessory muscles indicates respiratory distress and increased work of breathing. --- 16. Which action demonstrates clinical judgment in managing a patient's postoperative pain? A. Administering pain medication on a fixed schedule B. Assessing pain using a standardized pain scale C. Documenting pain level as moderate without reassessment D. Waiting for the patient to request pain medication Answer: B Rationale: Clinical judgment involves using appropriate assessment tools to evaluate pain and guide interventions. --- 17. A patient's blood pressure drops from 140/90 to 100/60 mmHg. What is the priority nursing action? A. Notify the healthcare provider immediately B. Assess for signs of hypovolemia C. Increase the IV fluid rate D. Document the finding and continue monitoring Answer: B Rationale: Assessment for hypovolemia signs helps determine the cause of hypotension and appropriate interventions. --- 18. Which finding in a patient with a head injury requires immediate intervention? A. Headache rated 5 on a scale of 0-10 B. Pupils equal and reactive to light C. Glasgow Coma Scale score of 12 D. Nausea without vomiting Answer: C Rationale: A GCS score of 12 indicates decreased level of consciousness and requires immediate intervention. --- 19. A nurse is caring for a patient with new-onset atrial fibrillation. Which assessment finding is most concerning? A. Heart rate of 110 beats per minute B. Blood pressure of 140/85 mmHg C. Respiratory rate of 18 breaths per minute D. Sudden onset of slurred speech Answer: D Rationale: Sudden onset of slurred speech may indicate a stroke related to atrial fibrillation. --- 20. Which action demonstrates the nurse is using clinical judgment when prioritizing patient care? A. Caring for patients in the order they were admitted B. Addressing the patient with the most unstable condition first C. Completing all tasks for one patient before moving to the next D. Following the same routine for all patients Answer: B Rationale: Clinical judgment involves prioritizing care based on patient acuity and stability.