CJE MED SURG II EXAM NEWEST 2026 ACTUAL EXAM
COMPLETE 250 REAL EXAM QUESTIONS WITH CORRECT
VERIFIED ANSWERS AND DETAILED RATIONALES
(ALREADY GRADED A+)
SECTION A: CARDIOVASCULAR DISORDERS (Questions 1-45)
Q1. A nurse is assessing a client with suspected cardiac tamponade. Which
assessment finding would the nurse expect to observe?
A) Hypertension and bradycardia
B) Muffled heart sounds and jugular venous distension
C) Increased pulse pressure and bounding pulses
D) Crackles in the lung bases and peripheral edema
Correct Answer: B
Rationale: Cardiac tamponade compresses the heart due to fluid accumulation in
the pericardial sac, leading to muffled heart sounds, JVD, hypotension, and pulsus
paradoxus. Beck's triad includes muffled heart sounds, JVD, and hypotension.
Q2. A client with pericarditis is prescribed indomethacin. What is the primary
purpose of this medication?
A) To reduce pericardial fluid volume
B) To suppress inflammation and relieve pain
C) To increase cardiac contractility
D) To prevent bacterial superinfection
Correct Answer: B
Rationale: Indomethacin is an NSAID used to reduce inflammation and relieve the
chest pain associated with pericarditis. It does not directly affect fluid volume or
contractility.
Q3. Which ECG finding is classic for pericarditis?
A) ST-segment elevation in all leads
B) ST-segment depression with T-wave inversion
C) Wide QRS complexes
1
,D) Presence of U waves
Correct Answer: A
Rationale: Diffuse ST-segment elevation in all leads (concave upward) is a
hallmark ECG finding in acute pericarditis due to subepicardial myocardial
inflammation.
Q4. A client has an abdominal aortic aneurysm (AAA). Which assessment finding
indicates possible rupture?
A) Absent femoral pulses bilaterally
B) Sudden severe back pain and hypotension
C) Bruit over the umbilicus
D) Lower extremity edema
Correct Answer: B
Rationale: Sudden severe back or abdominal pain accompanied by hypotension is
the classic presentation of a rupturing AAA, a life-threatening emergency
requiring immediate surgical repair.
Q5. A patient with heart failure is prescribed furosemide. Which laboratory value
requires the most immediate nursing intervention?
A) Serum sodium of 135 mEq/L
B) Serum potassium of 3.0 mEq/L
C) Serum calcium of 9.5 mg/dL
D) Serum magnesium of 2.0 mEq/L
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A
potassium of 3.0 mEq/L is hypokalemia, which increases the risk of cardiac
arrhythmias, especially in patients on digoxin.
Q6. Which dietary instruction is most important for a client with heart failure?
A) Increase fluid intake to 3 L/day
B) Limit sodium intake to 2 grams per day
C) Increase saturated fat intake
D) Avoid all carbohydrates
2
,Correct Answer: B
Rationale: Sodium restriction (typically <2 g/day) reduces fluid retention and
decreases the workload on the failing heart. Fluid restriction may also be needed,
not increased intake.
Q7. A nurse is caring for a client with infective endocarditis. Which assessment
finding is consistent with this diagnosis?
A) Splinter hemorrhages and Janeway lesions
B) Pallor and cyanosis
C) Clubbing of fingers
D) Erythema marginatum
Correct Answer: A
Rationale: Splinter hemorrhages (linear red/brown streaks under nails) and
Janeway lesions (painless hemorrhagic lesions on palms/soles) are classic
peripheral manifestations of infective endocarditis.
Q8. A client is 2 hours post-cardiac catheterization via the femoral artery. The
nurse notes a large, expanding hematoma at the insertion site. What is the
priority action?
A) Apply warm compresses to the site
B) Administer prescribed anticoagulants
C) Apply manual pressure and notify the provider
D) Elevate the leg above heart level
Correct Answer: C
Rationale: An expanding hematoma indicates active bleeding. The nurse should
apply firm manual pressure just above the insertion site to occlude the vessel and
immediately notify the provider.
Q9. A patient with unstable angina is prescribed nitroglycerin sublingually. Which
instruction is correct?
A) Swallow the tablet with a full glass of water
B) Take one tablet every 5 minutes up to 3 tablets
C) Store the tablets in a clear glass bottle
3
, D) Replace tablets every 2 years
Correct Answer: B
Rationale: The standard protocol is to take one sublingual tablet every 5 minutes
up to a maximum of 3 tablets (15 minutes). If pain persists, emergency services
must be called.
Q10. The nurse is teaching a patient about lifestyle modifications after a
myocardial infarction. Which statement indicates understanding?
A) "I can resume smoking if I cut down to half a pack."
B) "I should avoid isometric exercises like heavy lifting."
C) "I should consume a high-fat diet to gain energy."
D) "I do not need to monitor my weight."
Correct Answer: B
Rationale: Isometric exercises increase cardiac workload and blood pressure,
which should be avoided post-MI. Smoking cessation, low-fat diet, and weight
monitoring are essential.
Q11. Which laboratory test is the most specific indicator of acute myocardial
infarction?
A) Creatine kinase-MB (CK-MB)
B) Myoglobin
C) Troponin I or T
D) Lactate dehydrogenase (LDH)
Correct Answer: C
Rationale: Cardiac troponins (I and T) are highly specific and sensitive to
myocardial injury. They rise within 3-4 hours and remain elevated for up to 14
days, making them the gold standard.
Q12. A patient is receiving IV heparin for a pulmonary embolism. Which
complication requires the nurse to monitor closely?
A) Hyperkalemia
B) Hemorrhage
C) Hypertension
4
COMPLETE 250 REAL EXAM QUESTIONS WITH CORRECT
VERIFIED ANSWERS AND DETAILED RATIONALES
(ALREADY GRADED A+)
SECTION A: CARDIOVASCULAR DISORDERS (Questions 1-45)
Q1. A nurse is assessing a client with suspected cardiac tamponade. Which
assessment finding would the nurse expect to observe?
A) Hypertension and bradycardia
B) Muffled heart sounds and jugular venous distension
C) Increased pulse pressure and bounding pulses
D) Crackles in the lung bases and peripheral edema
Correct Answer: B
Rationale: Cardiac tamponade compresses the heart due to fluid accumulation in
the pericardial sac, leading to muffled heart sounds, JVD, hypotension, and pulsus
paradoxus. Beck's triad includes muffled heart sounds, JVD, and hypotension.
Q2. A client with pericarditis is prescribed indomethacin. What is the primary
purpose of this medication?
A) To reduce pericardial fluid volume
B) To suppress inflammation and relieve pain
C) To increase cardiac contractility
D) To prevent bacterial superinfection
Correct Answer: B
Rationale: Indomethacin is an NSAID used to reduce inflammation and relieve the
chest pain associated with pericarditis. It does not directly affect fluid volume or
contractility.
Q3. Which ECG finding is classic for pericarditis?
A) ST-segment elevation in all leads
B) ST-segment depression with T-wave inversion
C) Wide QRS complexes
1
,D) Presence of U waves
Correct Answer: A
Rationale: Diffuse ST-segment elevation in all leads (concave upward) is a
hallmark ECG finding in acute pericarditis due to subepicardial myocardial
inflammation.
Q4. A client has an abdominal aortic aneurysm (AAA). Which assessment finding
indicates possible rupture?
A) Absent femoral pulses bilaterally
B) Sudden severe back pain and hypotension
C) Bruit over the umbilicus
D) Lower extremity edema
Correct Answer: B
Rationale: Sudden severe back or abdominal pain accompanied by hypotension is
the classic presentation of a rupturing AAA, a life-threatening emergency
requiring immediate surgical repair.
Q5. A patient with heart failure is prescribed furosemide. Which laboratory value
requires the most immediate nursing intervention?
A) Serum sodium of 135 mEq/L
B) Serum potassium of 3.0 mEq/L
C) Serum calcium of 9.5 mg/dL
D) Serum magnesium of 2.0 mEq/L
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A
potassium of 3.0 mEq/L is hypokalemia, which increases the risk of cardiac
arrhythmias, especially in patients on digoxin.
Q6. Which dietary instruction is most important for a client with heart failure?
A) Increase fluid intake to 3 L/day
B) Limit sodium intake to 2 grams per day
C) Increase saturated fat intake
D) Avoid all carbohydrates
2
,Correct Answer: B
Rationale: Sodium restriction (typically <2 g/day) reduces fluid retention and
decreases the workload on the failing heart. Fluid restriction may also be needed,
not increased intake.
Q7. A nurse is caring for a client with infective endocarditis. Which assessment
finding is consistent with this diagnosis?
A) Splinter hemorrhages and Janeway lesions
B) Pallor and cyanosis
C) Clubbing of fingers
D) Erythema marginatum
Correct Answer: A
Rationale: Splinter hemorrhages (linear red/brown streaks under nails) and
Janeway lesions (painless hemorrhagic lesions on palms/soles) are classic
peripheral manifestations of infective endocarditis.
Q8. A client is 2 hours post-cardiac catheterization via the femoral artery. The
nurse notes a large, expanding hematoma at the insertion site. What is the
priority action?
A) Apply warm compresses to the site
B) Administer prescribed anticoagulants
C) Apply manual pressure and notify the provider
D) Elevate the leg above heart level
Correct Answer: C
Rationale: An expanding hematoma indicates active bleeding. The nurse should
apply firm manual pressure just above the insertion site to occlude the vessel and
immediately notify the provider.
Q9. A patient with unstable angina is prescribed nitroglycerin sublingually. Which
instruction is correct?
A) Swallow the tablet with a full glass of water
B) Take one tablet every 5 minutes up to 3 tablets
C) Store the tablets in a clear glass bottle
3
, D) Replace tablets every 2 years
Correct Answer: B
Rationale: The standard protocol is to take one sublingual tablet every 5 minutes
up to a maximum of 3 tablets (15 minutes). If pain persists, emergency services
must be called.
Q10. The nurse is teaching a patient about lifestyle modifications after a
myocardial infarction. Which statement indicates understanding?
A) "I can resume smoking if I cut down to half a pack."
B) "I should avoid isometric exercises like heavy lifting."
C) "I should consume a high-fat diet to gain energy."
D) "I do not need to monitor my weight."
Correct Answer: B
Rationale: Isometric exercises increase cardiac workload and blood pressure,
which should be avoided post-MI. Smoking cessation, low-fat diet, and weight
monitoring are essential.
Q11. Which laboratory test is the most specific indicator of acute myocardial
infarction?
A) Creatine kinase-MB (CK-MB)
B) Myoglobin
C) Troponin I or T
D) Lactate dehydrogenase (LDH)
Correct Answer: C
Rationale: Cardiac troponins (I and T) are highly specific and sensitive to
myocardial injury. They rise within 3-4 hours and remain elevated for up to 14
days, making them the gold standard.
Q12. A patient is receiving IV heparin for a pulmonary embolism. Which
complication requires the nurse to monitor closely?
A) Hyperkalemia
B) Hemorrhage
C) Hypertension
4
