CJE MED SURG II BENCHMARK EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026/2027 Q&A | INSTANT
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Core Domains
Cardiovascular Disorders and Hemodynamic Monitoring
Respiratory Disorders and Mechanical Ventilation
Neurological Disorders and Sensory Impairments
Endocrine Disorders and Metabolic Emergencies
Renal and Genitourinary Disorders
Gastrointestinal and Hepatic Disorders
Musculoskeletal and Connective Tissue Disorders
Perioperative Care and Surgical Complications
Oncologic and Hematologic Disorders
Emergency and Critical Care Nursing
Introduction
The CJE Med Surg II Benchmark Exam assesses advanced medical-surgical nursing knowledge essential
for safe, effective care of adults with complex health conditions. This examination evaluates
cardiovascular, respiratory, neurological, endocrine, renal, gastrointestinal, musculoskeletal, and
oncologic 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 recognizing complications, implementing interventions, and coordinating
interdisciplinary care for acutely and chronically ill adults across diverse healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client with heart failure is prescribed furosemide. Which finding indicates the medication is effective?
A. Increased urine output and decreased edema
B. Decreased urine output and weight gain
C. Increased crackles and jugular venous distention
D. Bradycardia and hypertension
A. Increased urine output and decreased edema
, RATIONALE: Furosemide is a loop diuretic that reduces fluid volume by increasing urine output.
Effectiveness is indicated by decreased edema, weight loss, and improved respiratory status. Weight
gain and increased crackles indicate worsening fluid retention.
Question 2
A client with acute myocardial infarction is prescribed morphine. Which effect should the nurse expect?
A. Increased heart rate
B. Decreased pain and anxiety
C. Increased blood pressure
D. Increased respiratory rate
B. Decreased pain and anxiety
RATIONALE: Morphine relieves pain and anxiety while reducing preload and afterload through
venodilation. It decreases heart rate and blood pressure. Respiratory rate may decrease, requiring
monitoring for respiratory depression.
Question 3
A client with COPD has an oxygen saturation of 86%. 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 retain carbon dioxide and require controlled oxygen therapy. Venturi
mask delivers precise oxygen concentrations, typically 24% to 28%, preventing hypoventilation and
respiratory acidosis. High-flow oxygen may suppress respiratory drive.
Question 4
A client with increased intracranial pressure is prescribed mannitol. Which finding indicates therapeutic
effect?
A. Increased urine output and improved neurological status
B. Decreased urine output and worsening headache
C. Increased blood pressure and bradycardia
D. Decreased level of consciousness
A. Increased urine output and improved neurological status
RATIONALE: Mannitol is an osmotic diuretic that reduces cerebral edema by drawing fluid into the
vasculature for renal excretion. Effectiveness is indicated by increased urine output and improved
neurological status. Mannitol must be administered through a filter.
,Question 5
A client with diabetic ketoacidosis is prescribed an insulin infusion. Which laboratory value should the
nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium
RATIONALE: Insulin drives potassium into cells, potentially causing life-threatening hypokalemia.
Serum potassium must be monitored closely, and potassium replacement is often required before
insulin initiation if levels are low. Potassium levels below 3.3 mEq/L require replacement before insulin.
Question 6
A client with acute kidney injury has a serum potassium of 6.8 mEq/L. Which intervention is priority?
A. Administer sodium polystyrene sulfonate
B. Administer intravenous calcium gluconate
C. Restrict dietary potassium
D. Prepare for hemodialysis
B. Administer intravenous calcium gluconate
RATIONALE: Calcium gluconate stabilizes cardiac membranes and prevents dysrhythmias in
hyperkalemia. It does not lower potassium but protects the heart. Sodium polystyrene sulfonate and
dialysis lower potassium but take time. Calcium is the immediate priority.
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
AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026/2027 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
Cardiovascular Disorders and Hemodynamic Monitoring
Respiratory Disorders and Mechanical Ventilation
Neurological Disorders and Sensory Impairments
Endocrine Disorders and Metabolic Emergencies
Renal and Genitourinary Disorders
Gastrointestinal and Hepatic Disorders
Musculoskeletal and Connective Tissue Disorders
Perioperative Care and Surgical Complications
Oncologic and Hematologic Disorders
Emergency and Critical Care Nursing
Introduction
The CJE Med Surg II Benchmark Exam assesses advanced medical-surgical nursing knowledge essential
for safe, effective care of adults with complex health conditions. This examination evaluates
cardiovascular, respiratory, neurological, endocrine, renal, gastrointestinal, musculoskeletal, and
oncologic 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 recognizing complications, implementing interventions, and coordinating
interdisciplinary care for acutely and chronically ill adults across diverse healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client with heart failure is prescribed furosemide. Which finding indicates the medication is effective?
A. Increased urine output and decreased edema
B. Decreased urine output and weight gain
C. Increased crackles and jugular venous distention
D. Bradycardia and hypertension
A. Increased urine output and decreased edema
, RATIONALE: Furosemide is a loop diuretic that reduces fluid volume by increasing urine output.
Effectiveness is indicated by decreased edema, weight loss, and improved respiratory status. Weight
gain and increased crackles indicate worsening fluid retention.
Question 2
A client with acute myocardial infarction is prescribed morphine. Which effect should the nurse expect?
A. Increased heart rate
B. Decreased pain and anxiety
C. Increased blood pressure
D. Increased respiratory rate
B. Decreased pain and anxiety
RATIONALE: Morphine relieves pain and anxiety while reducing preload and afterload through
venodilation. It decreases heart rate and blood pressure. Respiratory rate may decrease, requiring
monitoring for respiratory depression.
Question 3
A client with COPD has an oxygen saturation of 86%. 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 retain carbon dioxide and require controlled oxygen therapy. Venturi
mask delivers precise oxygen concentrations, typically 24% to 28%, preventing hypoventilation and
respiratory acidosis. High-flow oxygen may suppress respiratory drive.
Question 4
A client with increased intracranial pressure is prescribed mannitol. Which finding indicates therapeutic
effect?
A. Increased urine output and improved neurological status
B. Decreased urine output and worsening headache
C. Increased blood pressure and bradycardia
D. Decreased level of consciousness
A. Increased urine output and improved neurological status
RATIONALE: Mannitol is an osmotic diuretic that reduces cerebral edema by drawing fluid into the
vasculature for renal excretion. Effectiveness is indicated by increased urine output and improved
neurological status. Mannitol must be administered through a filter.
,Question 5
A client with diabetic ketoacidosis is prescribed an insulin infusion. Which laboratory value should the
nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium
RATIONALE: Insulin drives potassium into cells, potentially causing life-threatening hypokalemia.
Serum potassium must be monitored closely, and potassium replacement is often required before
insulin initiation if levels are low. Potassium levels below 3.3 mEq/L require replacement before insulin.
Question 6
A client with acute kidney injury has a serum potassium of 6.8 mEq/L. Which intervention is priority?
A. Administer sodium polystyrene sulfonate
B. Administer intravenous calcium gluconate
C. Restrict dietary potassium
D. Prepare for hemodialysis
B. Administer intravenous calcium gluconate
RATIONALE: Calcium gluconate stabilizes cardiac membranes and prevents dysrhythmias in
hyperkalemia. It does not lower potassium but protects the heart. Sodium polystyrene sulfonate and
dialysis lower potassium but take time. Calcium is the immediate priority.
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
