CJE MED SURG 1 EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Fluid, Electrolyte, and Acid-Base Balance
Perioperative Nursing Care
Cardiovascular and Hematologic Disorders
Respiratory Disorders and Oxygen Therapy
Neurological and Sensory Disorders
Endocrine and Metabolic Disorders
Gastrointestinal and Nutritional Disorders
Renal and Urinary Disorders
Musculoskeletal and Integumentary Disorders
Infection Control, Safety, and Professional Standards
Introduction
The CJE Med Surg 1 Exam assesses foundational medical-surgical nursing knowledge required for safe,
effective care of adults with acute and chronic health conditions. This examination evaluates fluid and
electrolyte balance, perioperative care, cardiovascular, respiratory, neurological, endocrine,
gastrointestinal, renal, and musculoskeletal nursing management. Questions are structured in multiple-
choice and scenario-based formats emphasizing clinical judgment, prioritization, and evidence-based
decision-making. Candidates must demonstrate competency in assessment, intervention, monitoring,
and interdisciplinary collaboration across diverse healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client is admitted with fluid volume deficit. Which finding should the nurse expect?
A. Bounding pulse and hypertension
B. Tachycardia and decreased skin turgor
C. Peripheral edema and weight gain
D. Crackles and jugular venous distention
B. Tachycardia and decreased skin turgor
RATIONALE: Fluid volume deficit causes tachycardia as the heart compensates for decreased
circulating volume, and decreased skin turgor from loss of interstitial fluid. Bounding pulse,
hypertension, edema, crackles, and JVD indicate fluid volume excess.
,Question 2
A client with hypokalemia is at risk for which complication?
A. Cardiac dysrhythmias
B. Hypertension
C. Hyperactive bowel sounds
D. Increased deep tendon reflexes
A. Cardiac dysrhythmias
RATIONALE: Hypokalemia increases the risk of cardiac dysrhythmias, including premature ventricular
contractions and ventricular tachycardia. Other manifestations include muscle weakness, decreased
bowel sounds, and hyporeflexia.
Question 3
A client is scheduled for surgery and asks why they must be NPO before the procedure. Which response
by the nurse is most appropriate?
A. "It prevents aspiration during anesthesia."
B. "It reduces your risk of infection."
C. "It helps you heal faster after surgery."
D. "It prevents dehydration during surgery."
A. "It prevents aspiration during anesthesia."
RATIONALE: NPO status before surgery reduces the risk of aspiration of gastric contents during
anesthesia induction and emergence. This is a critical safety measure. Other options do not accurately
explain the rationale.
Question 4
A postoperative client reports incisional pain of 8 out of 10. Which action should the nurse take first?
A. Administer the prescribed analgesic
B. Reposition the client
C. Assess the surgical site
D. Encourage deep breathing
A. Administer the prescribed analgesic
RATIONALE: Severe pain requires prompt analgesic administration. While assessment is important,
pain of 8/10 indicates significant distress requiring immediate intervention. Repositioning and breathing
exercises are adjuncts, not primary interventions for severe pain.
Question 5
A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
,A. Heart rate of 58 beats per minute
B. Nausea and visual disturbances
C. Blood pressure of 110/70 mm Hg
D. Respiratory rate of 18 breaths per minute
B. Nausea and visual disturbances
RATIONALE: Digoxin toxicity presents with nausea, vomiting, visual disturbances such as yellow-
green halos, and cardiac dysrhythmias. A heart rate below 60 may require holding the dose but is not by
itself indicative of toxicity.
Question 6
A client with COPD has an oxygen saturation of 88%. Which oxygen delivery method is most
appropriate?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Venturi mask at 28%
D. Non-rebreather mask at 15 L/min
C. Venturi mask at 28%
RATIONALE: Clients with COPD require controlled oxygen therapy to prevent carbon dioxide
retention. Venturi mask delivers precise oxygen concentrations, typically 24% to 28%. High-flow oxygen
may suppress respiratory drive.
Question 7
A client with a new colostomy has a stoma that is dark purple and dry. What action should the nurse
take?
A. Document the finding as normal
B. Apply petroleum jelly to the stoma
C. Notify the provider immediately
D. Increase fluid intake
C. Notify the provider immediately
RATIONALE: A dark purple, dry stoma indicates ischemia or necrosis, requiring immediate provider
notification. A healthy stoma is pink to red, moist, and shiny. Ischemia may require surgical intervention.
Question 8
A client with a chest tube has continuous bubbling in the water-seal chamber. What does this indicate?
A. Normal functioning
B. Air leak in the system
C. Improved lung expansion
D. Excessive suction
, B. Air leak in the system
RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak. Intermittent
bubbling is normal with coughing. The nurse should assess the tubing, connections, and insertion site for
leaks and notify the provider.
Question 9
A client with a new below-the-knee amputation reports phantom limb pain. Which intervention is most
appropriate?
A. Tell the client the pain is not real
B. Administer prescribed gabapentin
C. Apply ice to the residual limb
D. Restrict all pain medication
B. Administer prescribed gabapentin
RATIONALE: Phantom limb pain is real and often treated with gabapentin, pregabalin, or tricyclic
antidepressants. Telling the client the pain is not real is dismissive. Ice is not appropriate for phantom
pain.
Question 10
A client with a head injury is exhibiting clear drainage from the nose. Which action should the nurse
take?
A. Test the drainage for glucose
B. Pack the nose with gauze
C. Suction the nose gently
D. Encourage the client to blow the nose
A. Test the drainage for glucose
RATIONALE: Clear drainage from the nose after head injury may indicate cerebrospinal fluid leak.
Testing for glucose (halo sign) helps confirm CSF. Packing, suctioning, or blowing the nose can introduce
infection and increase intracranial pressure.
Question 11
A client with sepsis is receiving norepinephrine. Which finding indicates adequate tissue perfusion?
A. Urine output of 0.5 mL/kg/hr
B. Mean arterial pressure of 65 mm Hg
C. Warm, flushed extremities
D. Capillary refill of 4 seconds
B. Mean arterial pressure of 65 mm Hg
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Fluid, Electrolyte, and Acid-Base Balance
Perioperative Nursing Care
Cardiovascular and Hematologic Disorders
Respiratory Disorders and Oxygen Therapy
Neurological and Sensory Disorders
Endocrine and Metabolic Disorders
Gastrointestinal and Nutritional Disorders
Renal and Urinary Disorders
Musculoskeletal and Integumentary Disorders
Infection Control, Safety, and Professional Standards
Introduction
The CJE Med Surg 1 Exam assesses foundational medical-surgical nursing knowledge required for safe,
effective care of adults with acute and chronic health conditions. This examination evaluates fluid and
electrolyte balance, perioperative care, cardiovascular, respiratory, neurological, endocrine,
gastrointestinal, renal, and musculoskeletal nursing management. Questions are structured in multiple-
choice and scenario-based formats emphasizing clinical judgment, prioritization, and evidence-based
decision-making. Candidates must demonstrate competency in assessment, intervention, monitoring,
and interdisciplinary collaboration across diverse healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client is admitted with fluid volume deficit. Which finding should the nurse expect?
A. Bounding pulse and hypertension
B. Tachycardia and decreased skin turgor
C. Peripheral edema and weight gain
D. Crackles and jugular venous distention
B. Tachycardia and decreased skin turgor
RATIONALE: Fluid volume deficit causes tachycardia as the heart compensates for decreased
circulating volume, and decreased skin turgor from loss of interstitial fluid. Bounding pulse,
hypertension, edema, crackles, and JVD indicate fluid volume excess.
,Question 2
A client with hypokalemia is at risk for which complication?
A. Cardiac dysrhythmias
B. Hypertension
C. Hyperactive bowel sounds
D. Increased deep tendon reflexes
A. Cardiac dysrhythmias
RATIONALE: Hypokalemia increases the risk of cardiac dysrhythmias, including premature ventricular
contractions and ventricular tachycardia. Other manifestations include muscle weakness, decreased
bowel sounds, and hyporeflexia.
Question 3
A client is scheduled for surgery and asks why they must be NPO before the procedure. Which response
by the nurse is most appropriate?
A. "It prevents aspiration during anesthesia."
B. "It reduces your risk of infection."
C. "It helps you heal faster after surgery."
D. "It prevents dehydration during surgery."
A. "It prevents aspiration during anesthesia."
RATIONALE: NPO status before surgery reduces the risk of aspiration of gastric contents during
anesthesia induction and emergence. This is a critical safety measure. Other options do not accurately
explain the rationale.
Question 4
A postoperative client reports incisional pain of 8 out of 10. Which action should the nurse take first?
A. Administer the prescribed analgesic
B. Reposition the client
C. Assess the surgical site
D. Encourage deep breathing
A. Administer the prescribed analgesic
RATIONALE: Severe pain requires prompt analgesic administration. While assessment is important,
pain of 8/10 indicates significant distress requiring immediate intervention. Repositioning and breathing
exercises are adjuncts, not primary interventions for severe pain.
Question 5
A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
,A. Heart rate of 58 beats per minute
B. Nausea and visual disturbances
C. Blood pressure of 110/70 mm Hg
D. Respiratory rate of 18 breaths per minute
B. Nausea and visual disturbances
RATIONALE: Digoxin toxicity presents with nausea, vomiting, visual disturbances such as yellow-
green halos, and cardiac dysrhythmias. A heart rate below 60 may require holding the dose but is not by
itself indicative of toxicity.
Question 6
A client with COPD has an oxygen saturation of 88%. Which oxygen delivery method is most
appropriate?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Venturi mask at 28%
D. Non-rebreather mask at 15 L/min
C. Venturi mask at 28%
RATIONALE: Clients with COPD require controlled oxygen therapy to prevent carbon dioxide
retention. Venturi mask delivers precise oxygen concentrations, typically 24% to 28%. High-flow oxygen
may suppress respiratory drive.
Question 7
A client with a new colostomy has a stoma that is dark purple and dry. What action should the nurse
take?
A. Document the finding as normal
B. Apply petroleum jelly to the stoma
C. Notify the provider immediately
D. Increase fluid intake
C. Notify the provider immediately
RATIONALE: A dark purple, dry stoma indicates ischemia or necrosis, requiring immediate provider
notification. A healthy stoma is pink to red, moist, and shiny. Ischemia may require surgical intervention.
Question 8
A client with a chest tube has continuous bubbling in the water-seal chamber. What does this indicate?
A. Normal functioning
B. Air leak in the system
C. Improved lung expansion
D. Excessive suction
, B. Air leak in the system
RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak. Intermittent
bubbling is normal with coughing. The nurse should assess the tubing, connections, and insertion site for
leaks and notify the provider.
Question 9
A client with a new below-the-knee amputation reports phantom limb pain. Which intervention is most
appropriate?
A. Tell the client the pain is not real
B. Administer prescribed gabapentin
C. Apply ice to the residual limb
D. Restrict all pain medication
B. Administer prescribed gabapentin
RATIONALE: Phantom limb pain is real and often treated with gabapentin, pregabalin, or tricyclic
antidepressants. Telling the client the pain is not real is dismissive. Ice is not appropriate for phantom
pain.
Question 10
A client with a head injury is exhibiting clear drainage from the nose. Which action should the nurse
take?
A. Test the drainage for glucose
B. Pack the nose with gauze
C. Suction the nose gently
D. Encourage the client to blow the nose
A. Test the drainage for glucose
RATIONALE: Clear drainage from the nose after head injury may indicate cerebrospinal fluid leak.
Testing for glucose (halo sign) helps confirm CSF. Packing, suctioning, or blowing the nose can introduce
infection and increase intracranial pressure.
Question 11
A client with sepsis is receiving norepinephrine. Which finding indicates adequate tissue perfusion?
A. Urine output of 0.5 mL/kg/hr
B. Mean arterial pressure of 65 mm Hg
C. Warm, flushed extremities
D. Capillary refill of 4 seconds
B. Mean arterial pressure of 65 mm Hg
