MEDICAL-SURGICAL II CJE BENCHMARK –
COMPREHENSIVE QUESTIONS
AND ANSWERS | VERIFIED AND WELLDETAILED
ANSWERS | DETAILED EXPLANATIONS AND
RATIONALES | COMPLETE EXAM PREPARATION
STUDY GUIDE | PRACTICE QUESTIONS |
LATEST EXAM UPDATE
* CORE DOMAINS *
• Cardiovascular Disorders and Hemodynamic Management
• Respiratory Disorders and Gas Exchange
• Neurological Disorders and Neurologic Emergencies
• Endocrine and Metabolic Disorders
• Gastrointestinal, Hepatic, and Pancreatic Disorders
• Renal, Urinary, Fluid, Electrolyte, and Acid-Base Disorders
• Hematologic, Immunologic, and Oncologic Disorders
• Musculoskeletal, Integumentary, and Perioperative Care
• Emergency, Critical Care, Infection Prevention, and Sepsis
• Pharmacology, Patient Safety, Ethics, and Clinical Judgment
* INTRODUCTION *
This comprehensive Medical-Surgical II CJE Benchmark preparation assessment is designed
to evaluate advanced nursing knowledge, clinical reasoning, prioritization, patient safety,
and application of medical-surgical principles. The 100 multiple-choice questions integrate
foundational concepts with realistic clinical situations requiring assessment, interpretation,
intervention, evaluation, and professional judgment. Emphasis is placed on recognizing
deterioration, identifying priorities, understanding pathophysiology, applying pharmacologic
principles, interpreting clinical findings, and selecting safe nursing interventions. Effective
preparation requires more than memorizing isolated facts; learners should understand
relationships among disease processes, assessment findings, treatments, complications, and
nursing responsibilities. The questions therefore progress across basic, intermediate, and
advanced levels to support examination-style practice and deeper clinical understanding.
SECTION ONE: QUESTIONS 1–100
,Question 1. A patient with acute heart failure develops severe dyspnea, bilateral crackles,
and pink, frothy sputum. Which action should the nurse take first?
A. Place the patient in high-Fowler position
B. Encourage oral fluid intake
C. Obtain the patient's daily weight
D. Place the patient flat with the legs elevated
Correct Answer: A. Place the patient in high-Fowler position
Explanation: High-Fowler positioning improves lung expansion and decreases venous return
to the heart, helping reduce pulmonary congestion and improve oxygenation. The patient's
findings suggest acute pulmonary edema, which is an emergency requiring immediate
support of airway and breathing.
Question 2. A patient reports crushing substernal chest pain radiating to the left arm and
diaphoresis. Which diagnostic test is the priority?
A. Echocardiogram
B. 12-lead electrocardiogram
C. Exercise stress test
D. Chest radiograph
Correct Answer: B. 12-lead electrocardiogram
Explanation: A 12-lead ECG should be obtained rapidly in a patient with suspected acute
coronary syndrome because it can identify myocardial ischemia or infarction and guide
urgent treatment. Stress testing is inappropriate during an acute suspected infarction.
Question 3. The nurse is caring for a patient receiving IV unfractionated heparin. Which
laboratory value is most important for monitoring therapeutic effect?
A. INR
B. Platelet count only
C. aPTT
D. Serum creatinine
Correct Answer: C. aPTT
Explanation: Activated partial thromboplastin time is commonly used to monitor the
therapeutic effect of IV unfractionated heparin. INR is primarily used for monitoring warfarin
therapy.
Question 4. A patient with atrial fibrillation is prescribed warfarin. Which finding requires the
nurse's greatest concern?
A. INR of 2.4
B. Mild bruising at an IV site
, C. Black, tarry stool
D. Heart rate of 88/min
Correct Answer: C. Black, tarry stool
Explanation: Black, tarry stool may indicate gastrointestinal bleeding. A therapeutic INR for
many patients with atrial fibrillation is approximately 2.0–3.0, whereas melena requires
prompt evaluation for significant bleeding.
Question 5. A patient with heart failure takes furosemide daily. Which laboratory result is
most important for the nurse to monitor?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Amylase
Correct Answer: A. Potassium
Explanation: Loop diuretics such as furosemide can cause potassium loss. Hypokalemia can
produce weakness and dangerous cardiac dysrhythmias, particularly in patients with
underlying cardiac disease.
Question 6. A patient suddenly develops hypotension, jugular venous distention, muffled
heart sounds, and tachycardia after a cardiac procedure. Which condition should the nurse
suspect?
A. Pulmonary embolism
B. Cardiac tamponade
C. Left-sided heart failure
D. Aortic stenosis
Correct Answer: B. Cardiac tamponade
Explanation: Hypotension, jugular venous distention, and muffled heart sounds are classic
findings associated with cardiac tamponade. Accumulated pericardial fluid compresses the
heart and prevents adequate ventricular filling.
Question 7. A patient with peripheral arterial disease reports severe calf pain while walking
that resolves with rest. How should the nurse interpret this finding?
A. Venous stasis
B. Intermittent claudication
C. Acute compartment syndrome
D. Neuropathic pain
Correct Answer: B. Intermittent claudication
COMPREHENSIVE QUESTIONS
AND ANSWERS | VERIFIED AND WELLDETAILED
ANSWERS | DETAILED EXPLANATIONS AND
RATIONALES | COMPLETE EXAM PREPARATION
STUDY GUIDE | PRACTICE QUESTIONS |
LATEST EXAM UPDATE
* CORE DOMAINS *
• Cardiovascular Disorders and Hemodynamic Management
• Respiratory Disorders and Gas Exchange
• Neurological Disorders and Neurologic Emergencies
• Endocrine and Metabolic Disorders
• Gastrointestinal, Hepatic, and Pancreatic Disorders
• Renal, Urinary, Fluid, Electrolyte, and Acid-Base Disorders
• Hematologic, Immunologic, and Oncologic Disorders
• Musculoskeletal, Integumentary, and Perioperative Care
• Emergency, Critical Care, Infection Prevention, and Sepsis
• Pharmacology, Patient Safety, Ethics, and Clinical Judgment
* INTRODUCTION *
This comprehensive Medical-Surgical II CJE Benchmark preparation assessment is designed
to evaluate advanced nursing knowledge, clinical reasoning, prioritization, patient safety,
and application of medical-surgical principles. The 100 multiple-choice questions integrate
foundational concepts with realistic clinical situations requiring assessment, interpretation,
intervention, evaluation, and professional judgment. Emphasis is placed on recognizing
deterioration, identifying priorities, understanding pathophysiology, applying pharmacologic
principles, interpreting clinical findings, and selecting safe nursing interventions. Effective
preparation requires more than memorizing isolated facts; learners should understand
relationships among disease processes, assessment findings, treatments, complications, and
nursing responsibilities. The questions therefore progress across basic, intermediate, and
advanced levels to support examination-style practice and deeper clinical understanding.
SECTION ONE: QUESTIONS 1–100
,Question 1. A patient with acute heart failure develops severe dyspnea, bilateral crackles,
and pink, frothy sputum. Which action should the nurse take first?
A. Place the patient in high-Fowler position
B. Encourage oral fluid intake
C. Obtain the patient's daily weight
D. Place the patient flat with the legs elevated
Correct Answer: A. Place the patient in high-Fowler position
Explanation: High-Fowler positioning improves lung expansion and decreases venous return
to the heart, helping reduce pulmonary congestion and improve oxygenation. The patient's
findings suggest acute pulmonary edema, which is an emergency requiring immediate
support of airway and breathing.
Question 2. A patient reports crushing substernal chest pain radiating to the left arm and
diaphoresis. Which diagnostic test is the priority?
A. Echocardiogram
B. 12-lead electrocardiogram
C. Exercise stress test
D. Chest radiograph
Correct Answer: B. 12-lead electrocardiogram
Explanation: A 12-lead ECG should be obtained rapidly in a patient with suspected acute
coronary syndrome because it can identify myocardial ischemia or infarction and guide
urgent treatment. Stress testing is inappropriate during an acute suspected infarction.
Question 3. The nurse is caring for a patient receiving IV unfractionated heparin. Which
laboratory value is most important for monitoring therapeutic effect?
A. INR
B. Platelet count only
C. aPTT
D. Serum creatinine
Correct Answer: C. aPTT
Explanation: Activated partial thromboplastin time is commonly used to monitor the
therapeutic effect of IV unfractionated heparin. INR is primarily used for monitoring warfarin
therapy.
Question 4. A patient with atrial fibrillation is prescribed warfarin. Which finding requires the
nurse's greatest concern?
A. INR of 2.4
B. Mild bruising at an IV site
, C. Black, tarry stool
D. Heart rate of 88/min
Correct Answer: C. Black, tarry stool
Explanation: Black, tarry stool may indicate gastrointestinal bleeding. A therapeutic INR for
many patients with atrial fibrillation is approximately 2.0–3.0, whereas melena requires
prompt evaluation for significant bleeding.
Question 5. A patient with heart failure takes furosemide daily. Which laboratory result is
most important for the nurse to monitor?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Amylase
Correct Answer: A. Potassium
Explanation: Loop diuretics such as furosemide can cause potassium loss. Hypokalemia can
produce weakness and dangerous cardiac dysrhythmias, particularly in patients with
underlying cardiac disease.
Question 6. A patient suddenly develops hypotension, jugular venous distention, muffled
heart sounds, and tachycardia after a cardiac procedure. Which condition should the nurse
suspect?
A. Pulmonary embolism
B. Cardiac tamponade
C. Left-sided heart failure
D. Aortic stenosis
Correct Answer: B. Cardiac tamponade
Explanation: Hypotension, jugular venous distention, and muffled heart sounds are classic
findings associated with cardiac tamponade. Accumulated pericardial fluid compresses the
heart and prevents adequate ventricular filling.
Question 7. A patient with peripheral arterial disease reports severe calf pain while walking
that resolves with rest. How should the nurse interpret this finding?
A. Venous stasis
B. Intermittent claudication
C. Acute compartment syndrome
D. Neuropathic pain
Correct Answer: B. Intermittent claudication
