CJE Readiness II Comprehensive Practice Examination 300 Original Questions with Correct Answers and Rationales

CJE Readiness II Comprehensive Practice Examination 300 Original Questions with Correct Answers and Rationales 1. A mass casualty event has occurred in a metropolitan area. Multiple hospitals are coordinating their disaster response efforts. In which order should the following actions occur? A. Hospitals begin receiving, triaging, and treating victims B. Emergency management office and first responders are notified C. Official disaster notification is made to area hospitals D. Initial 911 call is placed to emergency response center Correct Answer: D, B, C, A Rationale: The correct disaster response sequence begins with the initial 911 call, followed by notification of emergency management and first responders, then official disaster notification to hospitals, and finally hospitals receiving and treating victims. --- 2. A client has a chest tube in place for a hemothorax. The healthcare provider removes the chest tube. What is the nurse's priority action immediately following removal? A. Apply an occlusive dressing over the site B. Assess the client's breath sounds C. Monitor the client's vital signs D. Document the procedure Correct Answer: B. Assess the client's breath sounds Rationale: After chest tube removal, the priority is to assess breath sounds to ensure the lung remains expanded and to detect any complications such as pneumothorax. --- 3. The nurse is preparing to administer fentanyl 50 mcg via intravenous injection. The pharmacy provides fentanyl 100 mcg/mL. How many milliliters should the nurse administer? Round to the nearest tenth. A. 0.3 mL B. 0.5 mL C. 1.0 mL D. 2.0 mL Correct Answer: B. 0.5 mL Rationale: Using the formula: Desired dose / Available dose = 50 mcg / 100 mcg/mL = 0.5 mL. The nurse should administer 0.5 mL of fentanyl. --- 4. The nurse is assisting a client with moderate dementia with morning care. Which approach is most appropriate for the nurse to use? A. Provide multiple-step instructions to promote independence B. Keep instructions brief and simple C. Allow the client to perform all tasks without assistance D. Correct the client when they make errors Correct Answer: B. Keep instructions brief and simple Rationale: Clients with dementia benefit from simple, one-step instructions to reduce confusion and frustration. Complex instructions overwhelm their cognitive abilities. --- 5. The charge nurse is assigning client care priorities. The following clients need attention. In what order should the nurse see these clients from first to last? A. Client returning from physical therapy who is ready for discharge tomorrow B. Client with a new nasogastric tube and new-onset shortness of breath C. Client admitted from the emergency department with a COPD exacerbation D. Client requesting assistance with bathing who is becoming agitated E. Client who returned to the floor 4 hours ago with nausea and vomiting Correct Answer: B, C, E, D, A Rationale: Priority is given to the client with new-onset shortness of breath (ABCs), followed by the newly admitted COPD client requiring assessment, then the client with nausea/vomiting, the agitated client needing assistance, and finally the stable client ready for discharge. --- 6. A client scheduled for surgery will be using patient-controlled analgesia (PCA) postoperatively. Which statement by the client indicates a need for further education? A. "I can press the button when I start to feel pain." B. "The machine has a lockout feature to prevent overdosing." C. "I need to be careful because I could overdose myself." D. "My family should not press the button for me." Correct Answer: C. "I need to be careful because I could overdose myself." Rationale: PCA pumps have safety features including lockout intervals and dose limits that prevent overdose. This statement indicates the client misunderstands the safety mechanisms of PCA. --- 7. A nurse is communicating with a client who has a new cancer diagnosis. Which of the following statements is therapeutic? A. "Don't worry, treatment options have improved dramatically." B. "Tell me what is worrying you right now." C. "You should participate in cancer awareness events." D. "Everything happens for a reason." Correct Answer: B. "Tell me what is worrying you right now." Rationale: This statement uses therapeutic communication by encouraging the client to express feelings and concerns. It demonstrates active listening and validates the client's emotions. --- 8. A client who is deaf and uses American Sign Language (ASL) is being admitted to the unit. The nurse is proficient in ASL and plans to use a computer on wheels during the admission. What is most important for the nurse to consider? A. The computer screen should face the client B. The computer should be positioned so it is not between the client and nurse C. The nurse should type responses for the client to read D. The computer should be placed at the foot of the bed Correct Answer: B. The computer should be positioned so it is not between the client and nurse Rationale: Positioning the computer so it is not between the client and nurse ensures clear visibility for signing and maintains eye contact, which is essential for effective communication with deaf clients. --- 9. A client with COPD is receiving inhaled corticosteroids. Which goal should be included in the plan of care? A. Client will demonstrate proper inhaler technique by discharge B. Client will remain free of fungal oral infection throughout hospitalization C. Client will maintain oxygen saturation above 88% D. Client will verbalize understanding of medication side effects Correct Answer: B. Client will remain free of fungal oral infection throughout hospitalization Rationale: Inhaled corticosteroids increase the risk of oral fungal infections (thrush). Monitoring for and preventing this complication is an appropriate and specific goal. --- 10. A major disaster has occurred in a rural community. The local hospital is activating its emergency preparedness plan. Which action should occur immediately after the 911 call is placed? A. Hospitals begin receiving victims B. Emergency management office is notified C. Victims are triaged at the scene D. Mutual aid agreements are activated Correct Answer: B. Emergency management office is notified Rationale: Following the initial 911 call, the emergency management office and first responders must be notified to coordinate the disaster response. --- 11. A client has a chest tube for a pneumothorax. The nurse notices continuous bubbling in the water seal chamber. What is the most appropriate nursing action? A. Clamp the chest tube immediately B. Document the finding as normal C. Assess for an air leak D. Increase the suction pressure Correct Answer: C. Assess for an air leak Rationale: Continuous bubbling in the water seal chamber indicates an air leak that requires assessment and intervention. The nurse should assess the entire system to identify the source of the leak. --- 12. The nurse is calculating a medication dose. The provider orders hydromorphone 2 mg IV. The available concentration is 2 mg/mL. How many milliliters should the nurse administer? A. 0.5 mL B. 1 mL C. 1.5 mL D. 2 mL Correct Answer: B. 1 mL Rationale: Using the formula: Desired dose / Available dose = 2 mg / 2 mg/mL = 1 mL. The nurse should administer 1 mL. --- 13. The nurse is caring for a client with early-stage dementia. Which communication technique is most appropriate? A. Use complex sentences to challenge cognitive function B. Speak loudly to ensure the client hears C. Use simple, direct statements D. Ask open-ended questions about past events Correct Answer: C. Use simple, direct statements Rationale: Simple, direct statements reduce confusion and help clients with dementia understand and follow instructions.