CJE Readiness II Exam Study Questions and
Answers with Rationales
Question 1
The nurse performs medication reconciliation for a newly admitted client and notes a
prescription for daily antacids. What other prescription in the client's electronic health
record causes the nurse to call the healthcare provider?
A) Metformin
B) Lisinopril
C) Levofloxacin
D) Acetaminophen
Answer: C) Levofloxacin
*Rationale: * Levofloxacin absorption is significantly reduced by antacids containing
calcium, magnesium, or aluminum. The nurse should call the healthcare provider to
discuss spacing the medications or consider an alternative antibiotic to ensure therapeutic
effectiveness .
Question 2
An infant has a bilateral cleft lip repair two days ago. Which nursing intervention should
the nurse include in the client's plan of care?
,A) Keep restraints on at all times
B) Remove the restraints periodically to cuddle the infant
C) Feed the infant with a regular bottle
D) Position the infant prone
Answer: B) Remove the restraints periodically to cuddle the infant
*Rationale: * Infants with bilateral cleft lip repairs require elbow restraints to prevent
them from touching the surgical site. However, restraints should be removed periodically
for comfort and cuddling, which supports developmental needs and bonding. The infant
should be positioned on the side or back to prevent rubbing the repair site .
Question 3
The nurse instructs the unlicensed assistive personnel (UAP) assigned to a client with
major depression to remove all items from the client's meal tray that can be used as a
weapon. What assessment finding prompted the nurse to implement this intervention?
A) The client stated life is hopeless and empty
B) The client refused to eat the meal
C) The client was sleeping most of the day
D) The client requested to see a chaplain
Answer: A) The client stated life is hopeless and empty
*Rationale: * Statements of hopelessness and emptiness are indicators of suicidal ideation
requiring immediate intervention. Removing potential weapons from the client's
environment is a safety measure when a client has expressed suicidal thoughts. This
reflects the priority of patient safety in mental health nursing .
Question 4
A nurse on the oncology unit who was known to be uninvolved in any aspect of the unit
governance and not seen as a leader is noted to be energized and empowered lately.
The nurse just shared an article in the staff meeting on a new evidence-based practice
,for clients undergoing a surgical procedure. What specific occurrence is the most likely
contributor to the nurse's increased leadership stance?
A) Was asked to work on the shared governance council and is actively participating
B) Received a pay raise
C) Completed a continuing education course
D) Was assigned as charge nurse for the shift
Answer: A) Was asked to work on the shared governance council and is actively
participating
*Rationale: * Shared governance empowers nurses by giving them a voice in practice
decisions, which can increase engagement and leadership behaviors. Participation in
shared governance councils has been shown to increase nurses' sense of ownership,
professional growth, and willingness to share evidence-based practice .
Question 5
A medical unit is always short-staffed, but nurses from other units are not eager to float
to that unit or to take a shift. Since this is the only unit in the facility where nurses do
not want to work, the hospital nurse leaders take time to investigate the cause. Which
finding is most concerning?
A) Charge nurse goes to lunch with nurses on the unit but not with float nurses
B) Charge nurses relieve unit nurses for breaks but not the nurses floated to the unit
C) Clients with the highest acuity are assigned to staff who float to the unit
D) All of the above
Answer: C) Clients with the highest acuity are assigned to staff who float to the
unit
*Rationale: * Assigning the highest acuity patients to float nurses is unsafe and represents
a significant patient safety concern. Float nurses are unfamiliar with the unit and its
patients, and assigning them the most complex patients increases the risk of adverse
events. While the other issues reflect poor inclusion, the acuity assignment directly impacts
patient safety .
, Question 6
A 46-year-old client presents to the ED following a motor vehicle accident. The client's
blood alcohol level is several times over the normal limit, and the client admitted to
leaving a bar just before the accident occurred. The client is transferred to the
orthopedic unit at 2245. What assessment related to the alcohol intake is most
important over the next few hours as the nurse cares for the client?
A) Blood pressure changes
B) Body shakiness and agitation
C) Respiratory rate
D) Level of consciousness
Answer: B) Body shakiness and agitation
*Rationale: * The client is at risk for alcohol withdrawal, which typically begins 6-12 hours
after the last drink. Signs of early withdrawal include shakiness, agitation, anxiety, and
tachycardia. Monitoring for withdrawal symptoms is the priority assessment to allow for
early intervention and prevent progression to more severe symptoms such as delirium
tremens .
Question 7
The nurse cares for a client with chronic obstructive pulmonary disease (COPD). The
client exhibits symptoms of shortness of breath, pursed-lip breathing, and neck vein
distention. Which action should the nurse take first?
A) Administer prescribed bronchodilator
B) Check the client's O₂ saturation
C) Position the client in high-Fowler's position
D) Notify the healthcare provider
Answer: B) Check the client's O₂ saturation
*Rationale: * Assessment is the priority nursing action. The nurse should first check the O₂
saturation to determine the severity of hypoxemia and guide subsequent interventions.
Neck vein distention in a COPD patient may indicate cor pulmonale or right-sided heart
failure, making assessment of oxygenation critical .
Answers with Rationales
Question 1
The nurse performs medication reconciliation for a newly admitted client and notes a
prescription for daily antacids. What other prescription in the client's electronic health
record causes the nurse to call the healthcare provider?
A) Metformin
B) Lisinopril
C) Levofloxacin
D) Acetaminophen
Answer: C) Levofloxacin
*Rationale: * Levofloxacin absorption is significantly reduced by antacids containing
calcium, magnesium, or aluminum. The nurse should call the healthcare provider to
discuss spacing the medications or consider an alternative antibiotic to ensure therapeutic
effectiveness .
Question 2
An infant has a bilateral cleft lip repair two days ago. Which nursing intervention should
the nurse include in the client's plan of care?
,A) Keep restraints on at all times
B) Remove the restraints periodically to cuddle the infant
C) Feed the infant with a regular bottle
D) Position the infant prone
Answer: B) Remove the restraints periodically to cuddle the infant
*Rationale: * Infants with bilateral cleft lip repairs require elbow restraints to prevent
them from touching the surgical site. However, restraints should be removed periodically
for comfort and cuddling, which supports developmental needs and bonding. The infant
should be positioned on the side or back to prevent rubbing the repair site .
Question 3
The nurse instructs the unlicensed assistive personnel (UAP) assigned to a client with
major depression to remove all items from the client's meal tray that can be used as a
weapon. What assessment finding prompted the nurse to implement this intervention?
A) The client stated life is hopeless and empty
B) The client refused to eat the meal
C) The client was sleeping most of the day
D) The client requested to see a chaplain
Answer: A) The client stated life is hopeless and empty
*Rationale: * Statements of hopelessness and emptiness are indicators of suicidal ideation
requiring immediate intervention. Removing potential weapons from the client's
environment is a safety measure when a client has expressed suicidal thoughts. This
reflects the priority of patient safety in mental health nursing .
Question 4
A nurse on the oncology unit who was known to be uninvolved in any aspect of the unit
governance and not seen as a leader is noted to be energized and empowered lately.
The nurse just shared an article in the staff meeting on a new evidence-based practice
,for clients undergoing a surgical procedure. What specific occurrence is the most likely
contributor to the nurse's increased leadership stance?
A) Was asked to work on the shared governance council and is actively participating
B) Received a pay raise
C) Completed a continuing education course
D) Was assigned as charge nurse for the shift
Answer: A) Was asked to work on the shared governance council and is actively
participating
*Rationale: * Shared governance empowers nurses by giving them a voice in practice
decisions, which can increase engagement and leadership behaviors. Participation in
shared governance councils has been shown to increase nurses' sense of ownership,
professional growth, and willingness to share evidence-based practice .
Question 5
A medical unit is always short-staffed, but nurses from other units are not eager to float
to that unit or to take a shift. Since this is the only unit in the facility where nurses do
not want to work, the hospital nurse leaders take time to investigate the cause. Which
finding is most concerning?
A) Charge nurse goes to lunch with nurses on the unit but not with float nurses
B) Charge nurses relieve unit nurses for breaks but not the nurses floated to the unit
C) Clients with the highest acuity are assigned to staff who float to the unit
D) All of the above
Answer: C) Clients with the highest acuity are assigned to staff who float to the
unit
*Rationale: * Assigning the highest acuity patients to float nurses is unsafe and represents
a significant patient safety concern. Float nurses are unfamiliar with the unit and its
patients, and assigning them the most complex patients increases the risk of adverse
events. While the other issues reflect poor inclusion, the acuity assignment directly impacts
patient safety .
, Question 6
A 46-year-old client presents to the ED following a motor vehicle accident. The client's
blood alcohol level is several times over the normal limit, and the client admitted to
leaving a bar just before the accident occurred. The client is transferred to the
orthopedic unit at 2245. What assessment related to the alcohol intake is most
important over the next few hours as the nurse cares for the client?
A) Blood pressure changes
B) Body shakiness and agitation
C) Respiratory rate
D) Level of consciousness
Answer: B) Body shakiness and agitation
*Rationale: * The client is at risk for alcohol withdrawal, which typically begins 6-12 hours
after the last drink. Signs of early withdrawal include shakiness, agitation, anxiety, and
tachycardia. Monitoring for withdrawal symptoms is the priority assessment to allow for
early intervention and prevent progression to more severe symptoms such as delirium
tremens .
Question 7
The nurse cares for a client with chronic obstructive pulmonary disease (COPD). The
client exhibits symptoms of shortness of breath, pursed-lip breathing, and neck vein
distention. Which action should the nurse take first?
A) Administer prescribed bronchodilator
B) Check the client's O₂ saturation
C) Position the client in high-Fowler's position
D) Notify the healthcare provider
Answer: B) Check the client's O₂ saturation
*Rationale: * Assessment is the priority nursing action. The nurse should first check the O₂
saturation to determine the severity of hypoxemia and guide subsequent interventions.
Neck vein distention in a COPD patient may indicate cor pulmonale or right-sided heart
failure, making assessment of oxygenation critical .
