5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Fundamental CJE Benchmark Review & Adult Health CJE
Benchmark Review Handouts 2025/2026 | Nursing Clinical
Judgment Study Guide | ABGs, Chest Tubes, Seizure
Precautions, Blood Transfusions & Electrolytes.
Blood Transfusion Step Before During & After
1. 2 nurses should verify blood with client ID
2. Gain Informed Consent
3. Baseline vital signs
4. 20-Gauge (or larger) IV catheter
5. Administer with .9% Sodium Chloride only
6. Stay with client for
first 15 min.
7. Compare next set
of vital signs to
baseline.
8. Begin infusion slowly.
9. Stop blood
immediately if any
signs of transfusion
reaction.
10.Complete infusion
within 4 hr
hypocalcemia (<9.0 mg/dL) Causes
Hypoparathyroidism
Renal failure
Malabsorption
Hypocalcemia: <9.0 mg/dL
Signs and Symptoms
•Changes in HR, prolonged QT interval
•Tetany
•Change in LOC leading to seizures
1/59
,5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Hypocalcemia: <9.0 mg/dL interventions
•Replace Ca
•Vit D (essential for calcium absorption in the intestines.)
2/59
,5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Hypercalcemia (>10.5 mg/dL) causes
Hyperparathyroidism
•Excessive intake of Ca
or Vit. D
Hypercalcemia: >10.5 mg/dL
Signs and Symptoms
Dysrhythmias → cardiac
arrest Blood clots
Confusion → coma
Hypercalcemia (>10.5 mg/dL)
-Interventions
Increase mobility
Dialysis
A client develops syndrome of inappropriate antidiuretic hormone following a head
injury. The serum sodium is 116 mEq/L. What is the most important action for the
nurse to implement?
1. Record daily weight.
2. Administer furosemide.
3. Obtain a urine osmolality.
4. Initiate seizure precautions.
4. Initiate seizure precautions.
Acid-Base Imbalances Evaluation Steps
1. Evaluate oxygenation.
2. Evaluate acid-base status.
3. Determine primary acid-base imbalance
Respiratory Acidosis ABG patterns
Decreased pH (7.35<)
Increased PaCo2 (<45)
Within range HCO3 (22-
26)
ex: pH 7.24 PaCO2 83 HCO3 24
3/59
, 5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Respiratory Acidosis Cause
Hypoventilation (COPD, overdose)
Respiratory Alkolosis ABG patterns
Increased pH (7.45>)
Decreased PaCo2 (35<)
Within range HCO3 (22-
26)
ex: pH 7.62 PaCO2 18 HCO3 26
Respiratory Alkolosis cause
Hyperventilation (anxiety, PE)
Metabolic Acidosis ABG patterns
Decreased pH (7.35<)
Decreased HCO3 (22<)
Within range PaCO2 (35 - 45
mmHg) ex: pH 7.18 PaCO2 37
HCO3 16
Metabolic Acidosis cause
DKA, diarrhea, kidney failure
Metabolic Alkalosis ABG patterns
Increased pH (7.45>)
Increased HCO3 (26>)
Within range PaCO2 (35 - 45
mmHg) pH 7.52 PaCO2 43 HCO3
34
Metabolic Alkalosis cause
Vomiting, diuretics
3 Rules of Compensation: Uncompensated
pH and 1 other not within expected
4/59
AM
Fundamental CJE Benchmark Review & Adult Health CJE
Benchmark Review Handouts 2025/2026 | Nursing Clinical
Judgment Study Guide | ABGs, Chest Tubes, Seizure
Precautions, Blood Transfusions & Electrolytes.
Blood Transfusion Step Before During & After
1. 2 nurses should verify blood with client ID
2. Gain Informed Consent
3. Baseline vital signs
4. 20-Gauge (or larger) IV catheter
5. Administer with .9% Sodium Chloride only
6. Stay with client for
first 15 min.
7. Compare next set
of vital signs to
baseline.
8. Begin infusion slowly.
9. Stop blood
immediately if any
signs of transfusion
reaction.
10.Complete infusion
within 4 hr
hypocalcemia (<9.0 mg/dL) Causes
Hypoparathyroidism
Renal failure
Malabsorption
Hypocalcemia: <9.0 mg/dL
Signs and Symptoms
•Changes in HR, prolonged QT interval
•Tetany
•Change in LOC leading to seizures
1/59
,5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Hypocalcemia: <9.0 mg/dL interventions
•Replace Ca
•Vit D (essential for calcium absorption in the intestines.)
2/59
,5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Hypercalcemia (>10.5 mg/dL) causes
Hyperparathyroidism
•Excessive intake of Ca
or Vit. D
Hypercalcemia: >10.5 mg/dL
Signs and Symptoms
Dysrhythmias → cardiac
arrest Blood clots
Confusion → coma
Hypercalcemia (>10.5 mg/dL)
-Interventions
Increase mobility
Dialysis
A client develops syndrome of inappropriate antidiuretic hormone following a head
injury. The serum sodium is 116 mEq/L. What is the most important action for the
nurse to implement?
1. Record daily weight.
2. Administer furosemide.
3. Obtain a urine osmolality.
4. Initiate seizure precautions.
4. Initiate seizure precautions.
Acid-Base Imbalances Evaluation Steps
1. Evaluate oxygenation.
2. Evaluate acid-base status.
3. Determine primary acid-base imbalance
Respiratory Acidosis ABG patterns
Decreased pH (7.35<)
Increased PaCo2 (<45)
Within range HCO3 (22-
26)
ex: pH 7.24 PaCO2 83 HCO3 24
3/59
, 5/16/26, 12:27 CJE Fundamentals Benchmar
AM
Respiratory Acidosis Cause
Hypoventilation (COPD, overdose)
Respiratory Alkolosis ABG patterns
Increased pH (7.45>)
Decreased PaCo2 (35<)
Within range HCO3 (22-
26)
ex: pH 7.62 PaCO2 18 HCO3 26
Respiratory Alkolosis cause
Hyperventilation (anxiety, PE)
Metabolic Acidosis ABG patterns
Decreased pH (7.35<)
Decreased HCO3 (22<)
Within range PaCO2 (35 - 45
mmHg) ex: pH 7.18 PaCO2 37
HCO3 16
Metabolic Acidosis cause
DKA, diarrhea, kidney failure
Metabolic Alkalosis ABG patterns
Increased pH (7.45>)
Increased HCO3 (26>)
Within range PaCO2 (35 - 45
mmHg) pH 7.52 PaCO2 43 HCO3
34
Metabolic Alkalosis cause
Vomiting, diuretics
3 Rules of Compensation: Uncompensated
pH and 1 other not within expected
4/59
