CJE MED SURG – COMPREHENSIVE QUESTIONS AND ANSWERS | VERIFIED AND
WELLDETAILED ANSWERS | DETAILED EXPLANATIONS AND RATIONALES | COMPLETE
EXAM PREPARATION STUDY GUIDE | PRACTICE QUESTIONS | LATEST EXAM UPDATE
•
CORE DOMAINS
1. Cardiovascular Disorders and Nursing Management
2. Respiratory Disorders and Nursing Management
3. Neurological Disorders and Nursing Management
4. Gastrointestinal and Hepatobiliary Disorders
5. Renal and Urinary Disorders
6. Endocrine and Metabolic Disorders
7. Musculoskeletal and Integumentary Disorders
8. Hematologic, Immune, and Infectious Disorders
9. Perioperative Care, Fluid/Electrolyte Balance, and Clinical Nursing Priorities
INTRODUCTION
This comprehensive CJE MED SURG assessment is designed to reinforce the knowledge,
clinical reasoning, assessment skills, prioritization, and nursing interventions required in
medical-surgical nursing. The multiple-choice questions progress from foundational concepts
to application, analysis, and clinical judgment. Emphasis is placed on recognizing
manifestations of disease, interpreting assessment findings, identifying complications,
selecting appropriate interventions, evaluating patient responses, and distinguishing closely
related clinical concepts. Effective preparation requires understanding why an intervention is
appropriate rather than relying solely on memorization. The questions therefore emphasize
practical application, patient safety, prioritization, and evidence-based nursing decision-
making across major medical-surgical domains.
SECTION ONE: QUESTIONS 1–100
Question 1. A nurse is assessing a client with suspected left-sided heart failure. Which
finding is most characteristic of left-sided heart failure?
A. Dependent peripheral edema
B. Jugular venous distention
C. Crackles in the lung bases
D. Enlarged liver
Correct Answer: C. Crackles in the lung bases
Explanation: Left-sided heart failure causes blood to back up into the pulmonary circulation,
resulting in pulmonary congestion and manifestations such as crackles, dyspnea, and
,orthopnea. Peripheral edema, jugular venous distention, and hepatomegaly are more
commonly associated with systemic venous congestion from right-sided heart failure.
Question 2. A client with chest pain is prescribed sublingual nitroglycerin. What is the
primary therapeutic effect of nitroglycerin?
A. Increased myocardial contractility
B. Coronary and systemic vasodilation
C. Increased blood volume
D. Prevention of platelet aggregation
Correct Answer: B. Coronary and systemic vasodilation
Explanation: Nitroglycerin produces vascular smooth-muscle relaxation, reducing venous
return and myocardial oxygen demand while also improving coronary blood flow. It is
commonly used to relieve anginal chest pain.
Question 3. A client reports crushing substernal chest pain radiating to the left arm with
diaphoresis and nausea. What should the nurse do first?
A. Encourage the client to ambulate
B. Obtain an immediate 12-lead ECG
C. Offer a high-fat snack
D. Place the client in Trendelenburg position
Correct Answer: B. Obtain an immediate 12-lead ECG
Explanation: Acute coronary syndrome is suspected. A 12-lead ECG should be obtained
promptly because it helps identify myocardial ischemia or infarction and guides urgent
treatment. The client should also be placed at rest and assessed rapidly.
Question 4. Which laboratory value is most specifically associated with myocardial injury?
A. Troponin
B. Sodium
C. Albumin
D. Amylase
Correct Answer: A. Troponin
Explanation: Cardiac troponins are highly sensitive and specific markers of myocardial injury.
They are central to evaluating suspected acute myocardial infarction.
,Question 5. A client taking warfarin should be monitored primarily using which laboratory
test?
A. aPTT
B. INR
C. Serum creatinine
D. Platelet count
Correct Answer: B. INR
Explanation: The international normalized ratio (INR) is used to monitor the therapeutic
effect of warfarin. The aPTT is commonly used to monitor unfractionated heparin therapy.
Question 6. Which assessment finding in a client receiving heparin requires immediate
attention?
A. Mild fatigue
B. Small bruise at an old IV site
C. Black, tarry stool
D. Increased appetite
Correct Answer: C. Black, tarry stool
Explanation: Melena may indicate gastrointestinal bleeding, an important complication of
anticoagulant therapy. The nurse should promptly assess for additional bleeding and notify
the appropriate provider.
Question 7. A client with hypertension asks why lifestyle modification is recommended
even when antihypertensive medication is prescribed. Which response is most
appropriate?
A. “Lifestyle changes eliminate the need for medication in every client.”
B. “Lifestyle measures can improve blood pressure control and reduce cardiovascular risk.”
C. “Lifestyle modification only affects cholesterol.”
D. “Medication is ineffective unless you exercise daily.”
Correct Answer: B. “Lifestyle measures can improve blood pressure control and reduce
cardiovascular risk.”
Explanation: Dietary modification, appropriate physical activity, weight management,
smoking cessation, and moderation of sodium intake can improve blood pressure and
, reduce cardiovascular risk. These measures complement rather than universally replace
medication.
Question 8. A client with peripheral arterial disease reports intermittent calf pain when
walking that disappears with rest. How should the nurse interpret this finding?
A. Venous claudication
B. Intermittent claudication
C. Neuropathic pain
D. Acute compartment syndrome
Correct Answer: B. Intermittent claudication
Explanation: Intermittent claudication is ischemic muscle pain that occurs with activity
because arterial blood flow cannot meet increased oxygen demand. It typically improves
with rest.
Question 9. Which finding is more consistent with chronic venous insufficiency than
peripheral arterial disease?
A. Cool, pale extremity
B. Diminished pedal pulses
C. Dependent edema
D. Pain relieved by dangling the leg
Correct Answer: C. Dependent edema
Explanation: Venous insufficiency commonly causes dependent edema, skin changes, and
venous ulceration. Arterial disease is more strongly associated with coolness, pallor,
diminished pulses, and ischemic pain.
Question 10. A client suddenly develops facial drooping, unilateral arm weakness, and
difficulty speaking. What is the priority nursing action?
A. Give the client food
B. Determine the exact time symptoms began
C. Encourage the client to sleep
D. Place the client in a hot bath
Correct Answer: B. Determine the exact time symptoms began
WELLDETAILED ANSWERS | DETAILED EXPLANATIONS AND RATIONALES | COMPLETE
EXAM PREPARATION STUDY GUIDE | PRACTICE QUESTIONS | LATEST EXAM UPDATE
•
CORE DOMAINS
1. Cardiovascular Disorders and Nursing Management
2. Respiratory Disorders and Nursing Management
3. Neurological Disorders and Nursing Management
4. Gastrointestinal and Hepatobiliary Disorders
5. Renal and Urinary Disorders
6. Endocrine and Metabolic Disorders
7. Musculoskeletal and Integumentary Disorders
8. Hematologic, Immune, and Infectious Disorders
9. Perioperative Care, Fluid/Electrolyte Balance, and Clinical Nursing Priorities
INTRODUCTION
This comprehensive CJE MED SURG assessment is designed to reinforce the knowledge,
clinical reasoning, assessment skills, prioritization, and nursing interventions required in
medical-surgical nursing. The multiple-choice questions progress from foundational concepts
to application, analysis, and clinical judgment. Emphasis is placed on recognizing
manifestations of disease, interpreting assessment findings, identifying complications,
selecting appropriate interventions, evaluating patient responses, and distinguishing closely
related clinical concepts. Effective preparation requires understanding why an intervention is
appropriate rather than relying solely on memorization. The questions therefore emphasize
practical application, patient safety, prioritization, and evidence-based nursing decision-
making across major medical-surgical domains.
SECTION ONE: QUESTIONS 1–100
Question 1. A nurse is assessing a client with suspected left-sided heart failure. Which
finding is most characteristic of left-sided heart failure?
A. Dependent peripheral edema
B. Jugular venous distention
C. Crackles in the lung bases
D. Enlarged liver
Correct Answer: C. Crackles in the lung bases
Explanation: Left-sided heart failure causes blood to back up into the pulmonary circulation,
resulting in pulmonary congestion and manifestations such as crackles, dyspnea, and
,orthopnea. Peripheral edema, jugular venous distention, and hepatomegaly are more
commonly associated with systemic venous congestion from right-sided heart failure.
Question 2. A client with chest pain is prescribed sublingual nitroglycerin. What is the
primary therapeutic effect of nitroglycerin?
A. Increased myocardial contractility
B. Coronary and systemic vasodilation
C. Increased blood volume
D. Prevention of platelet aggregation
Correct Answer: B. Coronary and systemic vasodilation
Explanation: Nitroglycerin produces vascular smooth-muscle relaxation, reducing venous
return and myocardial oxygen demand while also improving coronary blood flow. It is
commonly used to relieve anginal chest pain.
Question 3. A client reports crushing substernal chest pain radiating to the left arm with
diaphoresis and nausea. What should the nurse do first?
A. Encourage the client to ambulate
B. Obtain an immediate 12-lead ECG
C. Offer a high-fat snack
D. Place the client in Trendelenburg position
Correct Answer: B. Obtain an immediate 12-lead ECG
Explanation: Acute coronary syndrome is suspected. A 12-lead ECG should be obtained
promptly because it helps identify myocardial ischemia or infarction and guides urgent
treatment. The client should also be placed at rest and assessed rapidly.
Question 4. Which laboratory value is most specifically associated with myocardial injury?
A. Troponin
B. Sodium
C. Albumin
D. Amylase
Correct Answer: A. Troponin
Explanation: Cardiac troponins are highly sensitive and specific markers of myocardial injury.
They are central to evaluating suspected acute myocardial infarction.
,Question 5. A client taking warfarin should be monitored primarily using which laboratory
test?
A. aPTT
B. INR
C. Serum creatinine
D. Platelet count
Correct Answer: B. INR
Explanation: The international normalized ratio (INR) is used to monitor the therapeutic
effect of warfarin. The aPTT is commonly used to monitor unfractionated heparin therapy.
Question 6. Which assessment finding in a client receiving heparin requires immediate
attention?
A. Mild fatigue
B. Small bruise at an old IV site
C. Black, tarry stool
D. Increased appetite
Correct Answer: C. Black, tarry stool
Explanation: Melena may indicate gastrointestinal bleeding, an important complication of
anticoagulant therapy. The nurse should promptly assess for additional bleeding and notify
the appropriate provider.
Question 7. A client with hypertension asks why lifestyle modification is recommended
even when antihypertensive medication is prescribed. Which response is most
appropriate?
A. “Lifestyle changes eliminate the need for medication in every client.”
B. “Lifestyle measures can improve blood pressure control and reduce cardiovascular risk.”
C. “Lifestyle modification only affects cholesterol.”
D. “Medication is ineffective unless you exercise daily.”
Correct Answer: B. “Lifestyle measures can improve blood pressure control and reduce
cardiovascular risk.”
Explanation: Dietary modification, appropriate physical activity, weight management,
smoking cessation, and moderation of sodium intake can improve blood pressure and
, reduce cardiovascular risk. These measures complement rather than universally replace
medication.
Question 8. A client with peripheral arterial disease reports intermittent calf pain when
walking that disappears with rest. How should the nurse interpret this finding?
A. Venous claudication
B. Intermittent claudication
C. Neuropathic pain
D. Acute compartment syndrome
Correct Answer: B. Intermittent claudication
Explanation: Intermittent claudication is ischemic muscle pain that occurs with activity
because arterial blood flow cannot meet increased oxygen demand. It typically improves
with rest.
Question 9. Which finding is more consistent with chronic venous insufficiency than
peripheral arterial disease?
A. Cool, pale extremity
B. Diminished pedal pulses
C. Dependent edema
D. Pain relieved by dangling the leg
Correct Answer: C. Dependent edema
Explanation: Venous insufficiency commonly causes dependent edema, skin changes, and
venous ulceration. Arterial disease is more strongly associated with coolness, pallor,
diminished pulses, and ischemic pain.
Question 10. A client suddenly develops facial drooping, unilateral arm weakness, and
difficulty speaking. What is the priority nursing action?
A. Give the client food
B. Determine the exact time symptoms began
C. Encourage the client to sleep
D. Place the client in a hot bath
Correct Answer: B. Determine the exact time symptoms began
