CJE MED-SURG 1 EXAMINATION COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR JUST RELEASED
10-Point Exam Coverage
1. Medical-Surgical Nursing Foundations – Nursing process, patient-centered care, clinical
judgment, safety, and evidence-based practice.
2. Cardiovascular Disorders – Heart failure, hypertension, myocardial infarction, dysrhythmias,
vascular disorders, and medication management.
3. Respiratory Disorders – COPD, asthma, pneumonia, pulmonary embolism, respiratory
assessment, oxygen therapy, and mechanical ventilation basics.
4. Neurological Disorders – Stroke, seizures, increased intracranial pressure, spinal cord injuries,
and neurological assessments.
5. Gastrointestinal Disorders – Liver disease, pancreatitis, bowel disorders, GI bleeding, nutrition,
and ostomy care.
6. Renal and Urinary Disorders – Acute kidney injury, chronic kidney disease, dialysis, electrolyte
balance, and urinary tract disorders.
7. Endocrine Disorders – Diabetes mellitus, thyroid disorders, adrenal disorders, and endocrine
emergencies.
8. Musculoskeletal and Integumentary Disorders – Fractures, arthritis, wound care, burns,
pressure injuries, and postoperative recovery.
9. Fluid, Electrolyte, and Acid-Base Balance – IV therapy, dehydration, electrolyte imbalances, and
acid-base interpretation.
10. Pharmacology, Patient Safety, and Prioritization – Medication administration, adverse effects,
infection prevention, delegation, and clinical decision-making.
CJE Med-Surg 1 Examination
Question 1
A nurse is caring for an adult patient admitted with worsening shortness of
breath, bilateral ankle edema, and fatigue after several days of medication
noncompliance. Which nursing assessment finding most strongly supports
worsening left-sided heart failure?
,A. Jugular venous distention while sitting upright
B. Crackles heard over both lung bases during auscultation
C. Enlarged liver palpable below the right costal margin
D. Bilateral lower-leg pitting edema without respiratory symptoms
Answer: B
Rationale: Crackles indicate pulmonary congestion caused by left ventricular
failure. Jugular venous distention, hepatomegaly, and peripheral edema are more
commonly associated with right-sided heart failure.
Question 2
A nurse prepares to administer regular insulin before breakfast to a hospitalized
patient with type 1 diabetes mellitus. Which nursing intervention is the highest
priority before giving the medication?
A. Encourage increased oral fluid intake
B. Verify the patient's current blood glucose level
C. Assess bowel sounds in all four quadrants
D. Review the patient's cholesterol laboratory values
Answer: B
Rationale: Blood glucose verification ensures insulin administration is appropriate
and reduces the risk of hypoglycemia.
Question 3
A hospitalized patient suddenly develops severe chest pain, diaphoresis, nausea,
and pain radiating to the left shoulder while resting in bed. What should the nurse
do first?
A. Obtain a complete medication history
B. Assess vital signs and notify the rapid response team or provider immediately
,C. Encourage the patient to walk to improve circulation
D. Offer oral fluids while awaiting physician evaluation
Answer: B
Rationale: These findings suggest an acute myocardial infarction. Immediate
assessment and emergency response are priorities.
Question 4
A patient recovering from abdominal surgery reports increasing pain despite
prescribed analgesics. Which nursing action best reflects appropriate pain
management?
A. Explain that postoperative pain is expected and unavoidable
B. Reassess pain characteristics and evaluate for possible complications
C. Delay additional assessment until the next scheduled medication
D. Encourage the patient to avoid reporting pain frequently
Answer: B
Rationale: Increasing pain may indicate complications such as infection or
bleeding and requires further assessment.
Question 5
A nurse is caring for a patient diagnosed with bacterial pneumonia who is
receiving intravenous antibiotics. Which assessment finding best indicates that
treatment is effective?
A. Increasing white blood cell count
B. Oxygen saturation improving toward normal levels
C. Development of productive green sputum
D. Increasing respiratory rate during activity
, Answer: B
Rationale: Improved oxygenation demonstrates better lung function and
resolution of infection.
Question 6
A patient with chronic kidney disease has a serum potassium level of 6.3 mEq/L.
Which assessment finding requires the nurse's most immediate attention?
A. Dry skin
B. Muscle weakness with ECG changes
C. Mild peripheral edema
D. Decreased appetite
Answer: B
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias
requiring immediate intervention.
Question 7
A nurse teaches a patient recently diagnosed with hypertension about lifestyle
modifications. Which patient statement indicates correct understanding?
A. "I should stop taking medication once my blood pressure improves."
B. "Reducing sodium intake and exercising regularly can help control my blood
pressure."
C. "Only stress causes hypertension."
D. "Blood pressure medicines are needed only when symptoms occur."
Answer: B
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR JUST RELEASED
10-Point Exam Coverage
1. Medical-Surgical Nursing Foundations – Nursing process, patient-centered care, clinical
judgment, safety, and evidence-based practice.
2. Cardiovascular Disorders – Heart failure, hypertension, myocardial infarction, dysrhythmias,
vascular disorders, and medication management.
3. Respiratory Disorders – COPD, asthma, pneumonia, pulmonary embolism, respiratory
assessment, oxygen therapy, and mechanical ventilation basics.
4. Neurological Disorders – Stroke, seizures, increased intracranial pressure, spinal cord injuries,
and neurological assessments.
5. Gastrointestinal Disorders – Liver disease, pancreatitis, bowel disorders, GI bleeding, nutrition,
and ostomy care.
6. Renal and Urinary Disorders – Acute kidney injury, chronic kidney disease, dialysis, electrolyte
balance, and urinary tract disorders.
7. Endocrine Disorders – Diabetes mellitus, thyroid disorders, adrenal disorders, and endocrine
emergencies.
8. Musculoskeletal and Integumentary Disorders – Fractures, arthritis, wound care, burns,
pressure injuries, and postoperative recovery.
9. Fluid, Electrolyte, and Acid-Base Balance – IV therapy, dehydration, electrolyte imbalances, and
acid-base interpretation.
10. Pharmacology, Patient Safety, and Prioritization – Medication administration, adverse effects,
infection prevention, delegation, and clinical decision-making.
CJE Med-Surg 1 Examination
Question 1
A nurse is caring for an adult patient admitted with worsening shortness of
breath, bilateral ankle edema, and fatigue after several days of medication
noncompliance. Which nursing assessment finding most strongly supports
worsening left-sided heart failure?
,A. Jugular venous distention while sitting upright
B. Crackles heard over both lung bases during auscultation
C. Enlarged liver palpable below the right costal margin
D. Bilateral lower-leg pitting edema without respiratory symptoms
Answer: B
Rationale: Crackles indicate pulmonary congestion caused by left ventricular
failure. Jugular venous distention, hepatomegaly, and peripheral edema are more
commonly associated with right-sided heart failure.
Question 2
A nurse prepares to administer regular insulin before breakfast to a hospitalized
patient with type 1 diabetes mellitus. Which nursing intervention is the highest
priority before giving the medication?
A. Encourage increased oral fluid intake
B. Verify the patient's current blood glucose level
C. Assess bowel sounds in all four quadrants
D. Review the patient's cholesterol laboratory values
Answer: B
Rationale: Blood glucose verification ensures insulin administration is appropriate
and reduces the risk of hypoglycemia.
Question 3
A hospitalized patient suddenly develops severe chest pain, diaphoresis, nausea,
and pain radiating to the left shoulder while resting in bed. What should the nurse
do first?
A. Obtain a complete medication history
B. Assess vital signs and notify the rapid response team or provider immediately
,C. Encourage the patient to walk to improve circulation
D. Offer oral fluids while awaiting physician evaluation
Answer: B
Rationale: These findings suggest an acute myocardial infarction. Immediate
assessment and emergency response are priorities.
Question 4
A patient recovering from abdominal surgery reports increasing pain despite
prescribed analgesics. Which nursing action best reflects appropriate pain
management?
A. Explain that postoperative pain is expected and unavoidable
B. Reassess pain characteristics and evaluate for possible complications
C. Delay additional assessment until the next scheduled medication
D. Encourage the patient to avoid reporting pain frequently
Answer: B
Rationale: Increasing pain may indicate complications such as infection or
bleeding and requires further assessment.
Question 5
A nurse is caring for a patient diagnosed with bacterial pneumonia who is
receiving intravenous antibiotics. Which assessment finding best indicates that
treatment is effective?
A. Increasing white blood cell count
B. Oxygen saturation improving toward normal levels
C. Development of productive green sputum
D. Increasing respiratory rate during activity
, Answer: B
Rationale: Improved oxygenation demonstrates better lung function and
resolution of infection.
Question 6
A patient with chronic kidney disease has a serum potassium level of 6.3 mEq/L.
Which assessment finding requires the nurse's most immediate attention?
A. Dry skin
B. Muscle weakness with ECG changes
C. Mild peripheral edema
D. Decreased appetite
Answer: B
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias
requiring immediate intervention.
Question 7
A nurse teaches a patient recently diagnosed with hypertension about lifestyle
modifications. Which patient statement indicates correct understanding?
A. "I should stop taking medication once my blood pressure improves."
B. "Reducing sodium intake and exercising regularly can help control my blood
pressure."
C. "Only stress causes hypertension."
D. "Blood pressure medicines are needed only when symptoms occur."
Answer: B
