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NR324 CJE Exam Study Guide | Comprehensive
Exam Review with Practice Questions, Answers &
Detailed Rationales
1. A nurse is preparing to transfer a client from a chair to the bed. Which action should the nurse
take first?
A. Obtain a transfer belt
B. Call for additional staff assistance
C. Assess the client's ability to assist with the transfer
D. Position the chair close to the bed
C. Assess the client's ability to assist with the transfer
Rationale: The priority action before any transfer is to assess the client's functional ability, strength, and
comprehension to determine the appropriate level of assistance needed and ensure safety.
2. A nurse is caring for a client who has a latex allergy. Which product should the nurse use for this
client?
A. Natural rubber gloves
B. Silicon or Teflon products
C. Latex-based adhesive tape
D. Rubber tourniquets
B. Silicon or Teflon products
Rationale: Clients with latex allergies require avoidance of all latex-containing products. Silicon and
Teflon products are safe alternatives that do not contain latex proteins.
3. A nurse is teaching a client with hearing aids about proper care. Which instruction should the
nurse include?
A. Clean the hearing aid with alcohol wipes daily
B. Store the hearing aid with the battery in place at all times
C. Use the lowest setting that allows hearing without feedback
D. Remove the battery only when the hearing aid is not working properly
C. Use the lowest setting that allows hearing without feedback
Rationale: Using the lowest effective setting prevents feedback (whistling) and conserves battery life
while providing adequate amplification.
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4. A nurse is caring for a client who is NPO. Which statement best describes this order?
A. No food but clear liquids are allowed
B. No food or fluid at all by mouth
C. Only ice chips are permitted
D. Only water is permitted
B. No food or fluid at all by mouth
Rationale: NPO stands for "nil per os" and means nothing by mouth, including all foods, fluids, ice
chips, and water.
5. A nurse is planning non-pharmacological comfort measures for a client in pain. Which
intervention should the nurse include?
A. Administering PRN pain medication
B. Using guided imagery techniques
C. Increasing the room temperature
D. Restricting visitors
B. Using guided imagery techniques
Rationale: Guided imagery is a non-pharmacological comfort measure that helps distract the client from
pain and promotes relaxation through visualization.
6. A nurse is assessing a client's bowel sounds. In which order should the nurse auscultate?
A. RUQ, LUQ, LLQ, RLQ
B. RLQ, RUQ, LUQ, LLQ
C. LUQ, LLQ, RLQ, RUQ
D. LLQ, RLQ, RUQ, LUQ
B. RLQ, RUQ, LUQ, LLQ
Rationale: Auscultation begins in the right lower quadrant (RLQ) because bowel sounds are normally
audible there first, then proceeds to RUQ, LUQ, and LLQ.
7. A nurse is performing a breast self-exam teaching session. Which instruction should the nurse
include?
A. Palpate while standing only
B. Use the fingertips to feel for lumps
C. Palpate from the axilla to the sternum
D. Perform the exam once monthly during menstruation
B. Use the fingertips to feel for lumps
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Rationale: The finger pads are the most sensitive part of the hand for detecting breast lumps and should
be used for palpation.
8. A nurse is evaluating a client's intake over 8 hours. The client had 2 cups of coffee, 4 oz orange
juice, 8 oz iced tea, 1 cup ice chips, and 1 cup chicken broth. IV fluids are running at 20 ml/hr.
What is the total intake?
A. 480 mL
B. 520 mL
C. 560 mL
D. 600 mL
C. 560 mL
Rationale: 2 cups coffee (480 mL) + 4 oz OJ (120 mL) + 8 oz tea (240 mL) + 1 cup ice chips (120 mL,
counted as half volume) + 1 cup broth (240 mL) + IV (160 mL) = 560 mL total intake.
9. A nurse is reviewing ABG results: pH 7.20, PaCO2 60, HCO3 23. Which condition does this
indicate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
C. Respiratory acidosis
Rationale: The low pH (7.20) indicates acidosis, elevated PaCO2 (60) indicates respiratory cause, and
normal HCO3 (23) confirms the primary issue is respiratory.
10. A nurse is planning care for a client with hypernatremia. Which intervention should the nurse
include?
A. Restrict fluid intake
B. Infuse hypotonic IV fluids
C. Administer sodium supplements
D. Increase dietary sodium
B. Infuse hypotonic IV fluids
Rationale: Hypernatremia indicates elevated sodium levels. Hypotonic IV fluids help dilute serum
sodium and correct the imbalance.
11. A nurse is caring for a client with a wrist restraint. Which observation indicates the restraint
was applied incorrectly?
, Page |4
A. A safety knot was used
B. The restraint is applied tightly around the wrist
C. The call light is within reach
D. The restraint is released every 2 hours
B. The restraint is applied tightly around the wrist
Rationale: Restraints should be applied with enough space to allow two fingers between the restraint and
the client's skin to prevent circulation impairment.
12. A nurse is reviewing the stages of grief according to Kubler-Ross. Place the stages in the correct
order.
A. Anger, Denial, Bargaining, Depression, Acceptance
B. Denial, Anger, Bargaining, Depression, Acceptance
C. Depression, Anger, Denial, Bargaining, Acceptance
D. Bargaining, Denial, Anger, Depression, Acceptance
B. Denial, Anger, Bargaining, Depression, Acceptance
Rationale: The correct sequence is Denial, Anger, Bargaining, Depression, Acceptance (DABDA).
13. A nurse is teaching a client about sleep promotion. Which recommendations should the nurse
include? Select all that apply.
A. Practice muscle relaxation techniques
B. Exercise each morning
C. Take an afternoon nap
D. Alter the sleep environment for comfort
E. Limit fluid intake 2 hours before bedtime
A, B, D, and E
Rationale: Exercise in the morning promotes sleep, relaxation techniques reduce anxiety, comfortable
environment enhances sleep, and limiting fluids reduces nocturia.
14. A nurse is caring for a client who has a seizure. Which action requires correction?
A. Placing the client on their side
B. Going to the nurses' station for assistance
C. Noting the time the seizure begins
D. Preparing to insert an airway
B. Going to the nurses' station for assistance
Rationale: The nurse should call for assistance immediately using the call light or emergency system, not
leave the client to go to the nurses' station.
NR324 CJE Exam Study Guide | Comprehensive
Exam Review with Practice Questions, Answers &
Detailed Rationales
1. A nurse is preparing to transfer a client from a chair to the bed. Which action should the nurse
take first?
A. Obtain a transfer belt
B. Call for additional staff assistance
C. Assess the client's ability to assist with the transfer
D. Position the chair close to the bed
C. Assess the client's ability to assist with the transfer
Rationale: The priority action before any transfer is to assess the client's functional ability, strength, and
comprehension to determine the appropriate level of assistance needed and ensure safety.
2. A nurse is caring for a client who has a latex allergy. Which product should the nurse use for this
client?
A. Natural rubber gloves
B. Silicon or Teflon products
C. Latex-based adhesive tape
D. Rubber tourniquets
B. Silicon or Teflon products
Rationale: Clients with latex allergies require avoidance of all latex-containing products. Silicon and
Teflon products are safe alternatives that do not contain latex proteins.
3. A nurse is teaching a client with hearing aids about proper care. Which instruction should the
nurse include?
A. Clean the hearing aid with alcohol wipes daily
B. Store the hearing aid with the battery in place at all times
C. Use the lowest setting that allows hearing without feedback
D. Remove the battery only when the hearing aid is not working properly
C. Use the lowest setting that allows hearing without feedback
Rationale: Using the lowest effective setting prevents feedback (whistling) and conserves battery life
while providing adequate amplification.
, Page |2
4. A nurse is caring for a client who is NPO. Which statement best describes this order?
A. No food but clear liquids are allowed
B. No food or fluid at all by mouth
C. Only ice chips are permitted
D. Only water is permitted
B. No food or fluid at all by mouth
Rationale: NPO stands for "nil per os" and means nothing by mouth, including all foods, fluids, ice
chips, and water.
5. A nurse is planning non-pharmacological comfort measures for a client in pain. Which
intervention should the nurse include?
A. Administering PRN pain medication
B. Using guided imagery techniques
C. Increasing the room temperature
D. Restricting visitors
B. Using guided imagery techniques
Rationale: Guided imagery is a non-pharmacological comfort measure that helps distract the client from
pain and promotes relaxation through visualization.
6. A nurse is assessing a client's bowel sounds. In which order should the nurse auscultate?
A. RUQ, LUQ, LLQ, RLQ
B. RLQ, RUQ, LUQ, LLQ
C. LUQ, LLQ, RLQ, RUQ
D. LLQ, RLQ, RUQ, LUQ
B. RLQ, RUQ, LUQ, LLQ
Rationale: Auscultation begins in the right lower quadrant (RLQ) because bowel sounds are normally
audible there first, then proceeds to RUQ, LUQ, and LLQ.
7. A nurse is performing a breast self-exam teaching session. Which instruction should the nurse
include?
A. Palpate while standing only
B. Use the fingertips to feel for lumps
C. Palpate from the axilla to the sternum
D. Perform the exam once monthly during menstruation
B. Use the fingertips to feel for lumps
, Page |3
Rationale: The finger pads are the most sensitive part of the hand for detecting breast lumps and should
be used for palpation.
8. A nurse is evaluating a client's intake over 8 hours. The client had 2 cups of coffee, 4 oz orange
juice, 8 oz iced tea, 1 cup ice chips, and 1 cup chicken broth. IV fluids are running at 20 ml/hr.
What is the total intake?
A. 480 mL
B. 520 mL
C. 560 mL
D. 600 mL
C. 560 mL
Rationale: 2 cups coffee (480 mL) + 4 oz OJ (120 mL) + 8 oz tea (240 mL) + 1 cup ice chips (120 mL,
counted as half volume) + 1 cup broth (240 mL) + IV (160 mL) = 560 mL total intake.
9. A nurse is reviewing ABG results: pH 7.20, PaCO2 60, HCO3 23. Which condition does this
indicate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
C. Respiratory acidosis
Rationale: The low pH (7.20) indicates acidosis, elevated PaCO2 (60) indicates respiratory cause, and
normal HCO3 (23) confirms the primary issue is respiratory.
10. A nurse is planning care for a client with hypernatremia. Which intervention should the nurse
include?
A. Restrict fluid intake
B. Infuse hypotonic IV fluids
C. Administer sodium supplements
D. Increase dietary sodium
B. Infuse hypotonic IV fluids
Rationale: Hypernatremia indicates elevated sodium levels. Hypotonic IV fluids help dilute serum
sodium and correct the imbalance.
11. A nurse is caring for a client with a wrist restraint. Which observation indicates the restraint
was applied incorrectly?
, Page |4
A. A safety knot was used
B. The restraint is applied tightly around the wrist
C. The call light is within reach
D. The restraint is released every 2 hours
B. The restraint is applied tightly around the wrist
Rationale: Restraints should be applied with enough space to allow two fingers between the restraint and
the client's skin to prevent circulation impairment.
12. A nurse is reviewing the stages of grief according to Kubler-Ross. Place the stages in the correct
order.
A. Anger, Denial, Bargaining, Depression, Acceptance
B. Denial, Anger, Bargaining, Depression, Acceptance
C. Depression, Anger, Denial, Bargaining, Acceptance
D. Bargaining, Denial, Anger, Depression, Acceptance
B. Denial, Anger, Bargaining, Depression, Acceptance
Rationale: The correct sequence is Denial, Anger, Bargaining, Depression, Acceptance (DABDA).
13. A nurse is teaching a client about sleep promotion. Which recommendations should the nurse
include? Select all that apply.
A. Practice muscle relaxation techniques
B. Exercise each morning
C. Take an afternoon nap
D. Alter the sleep environment for comfort
E. Limit fluid intake 2 hours before bedtime
A, B, D, and E
Rationale: Exercise in the morning promotes sleep, relaxation techniques reduce anxiety, comfortable
environment enhances sleep, and limiting fluids reduces nocturia.
14. A nurse is caring for a client who has a seizure. Which action requires correction?
A. Placing the client on their side
B. Going to the nurses' station for assistance
C. Noting the time the seizure begins
D. Preparing to insert an airway
B. Going to the nurses' station for assistance
Rationale: The nurse should call for assistance immediately using the call light or emergency system, not
leave the client to go to the nurses' station.
