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CJE (Clinical Judgment Examination) Med Surg
II Exam WITH 300 QUESTIONS AND CORRECT
DETAILED SOLUTIONS JUST RELEASED THIS
YEAR
1. A patient with diabetes mellitus is prescribed an ACE inhibitor. The nurse understands this
medication helps prevent which complication?
A) Chronic obstructive pulmonary disease
B) Pancreatic cancer
C) Renal failure
D) Cerebrovascular accident
Answer: C
ACE inhibitors reduce intraglomerular pressure and decrease proteinuria, slowing the
progression of diabetic nephropathy toward renal failure.
2. A diabetic client reports feeling shaky and nervous. What is the nurse's priority action?
A) Administer insulin
B) Check blood glucose level
C) Give orange juice immediately
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D) Document the finding
Answer: B
Nervousness is a common symptom of hypoglycemia; the priority is to verify the blood glucose
level before intervening.
3. A client with type 1 diabetes has influenza. Which instruction should the nurse provide?
A) Discontinue insulin if unable to eat
B) Take half the normal insulin dose
C) Increase frequency of blood glucose monitoring
D) Reduce food intake to diminish nausea
Answer: C
Illness increases blood glucose levels; more frequent monitoring is essential to adjust insulin
needs and prevent DKA.
4. A client scheduled for a transsphenoidal hypophysectomy asks where the incision will be
made. The nurse responds:
A) Back of the mouth
B) Nose
C) Sinus channel below the right eye
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D) Upper gingival mucosa between the upper gums and lip
Answer: D
The transsphenoidal approach involves an incision in the upper gingival mucosa to access the
sphenoid sinus and pituitary gland.
5. A client with Addison's disease is most likely to exhibit which symptom?
A) Hypertension
B) Hyperglycemia
C) Bronze skin pigmentation
D) Weight gain
Answer: C
Addison's disease causes adrenal insufficiency with increased ACTH, leading to
hyperpigmentation of the skin.
6. A patient is in bradycardia and appears cool and clammy. What is the next expected
intervention?
A) Defibrillation
B) Atropine administration
C) Cardioversion
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D) Epinephrine
Answer: B
Symptomatic bradycardia with poor perfusion (cool, clammy skin) is treated with atropine to
increase heart rate.
7. An EKG shows tombstone-like rhythms and the patient has no pulse. What is the priority
intervention?
A) Cardioversion
B) Defibrillation
C) Amiodarone
D) CPR
Answer: B
Tombstone-like EKG indicates ventricular tachycardia without a pulse, requiring immediate
defibrillation.
8. Which heart rhythms are shockable?
A) Atrial fibrillation and atrial flutter
B) Ventricular fibrillation and pulseless ventricular tachycardia
C) Asystole and PEA
4
SUCCESS!
CJE (Clinical Judgment Examination) Med Surg
II Exam WITH 300 QUESTIONS AND CORRECT
DETAILED SOLUTIONS JUST RELEASED THIS
YEAR
1. A patient with diabetes mellitus is prescribed an ACE inhibitor. The nurse understands this
medication helps prevent which complication?
A) Chronic obstructive pulmonary disease
B) Pancreatic cancer
C) Renal failure
D) Cerebrovascular accident
Answer: C
ACE inhibitors reduce intraglomerular pressure and decrease proteinuria, slowing the
progression of diabetic nephropathy toward renal failure.
2. A diabetic client reports feeling shaky and nervous. What is the nurse's priority action?
A) Administer insulin
B) Check blood glucose level
C) Give orange juice immediately
1
SUCCESS!
,Page 2 of 149
D) Document the finding
Answer: B
Nervousness is a common symptom of hypoglycemia; the priority is to verify the blood glucose
level before intervening.
3. A client with type 1 diabetes has influenza. Which instruction should the nurse provide?
A) Discontinue insulin if unable to eat
B) Take half the normal insulin dose
C) Increase frequency of blood glucose monitoring
D) Reduce food intake to diminish nausea
Answer: C
Illness increases blood glucose levels; more frequent monitoring is essential to adjust insulin
needs and prevent DKA.
4. A client scheduled for a transsphenoidal hypophysectomy asks where the incision will be
made. The nurse responds:
A) Back of the mouth
B) Nose
C) Sinus channel below the right eye
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D) Upper gingival mucosa between the upper gums and lip
Answer: D
The transsphenoidal approach involves an incision in the upper gingival mucosa to access the
sphenoid sinus and pituitary gland.
5. A client with Addison's disease is most likely to exhibit which symptom?
A) Hypertension
B) Hyperglycemia
C) Bronze skin pigmentation
D) Weight gain
Answer: C
Addison's disease causes adrenal insufficiency with increased ACTH, leading to
hyperpigmentation of the skin.
6. A patient is in bradycardia and appears cool and clammy. What is the next expected
intervention?
A) Defibrillation
B) Atropine administration
C) Cardioversion
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D) Epinephrine
Answer: B
Symptomatic bradycardia with poor perfusion (cool, clammy skin) is treated with atropine to
increase heart rate.
7. An EKG shows tombstone-like rhythms and the patient has no pulse. What is the priority
intervention?
A) Cardioversion
B) Defibrillation
C) Amiodarone
D) CPR
Answer: B
Tombstone-like EKG indicates ventricular tachycardia without a pulse, requiring immediate
defibrillation.
8. Which heart rhythms are shockable?
A) Atrial fibrillation and atrial flutter
B) Ventricular fibrillation and pulseless ventricular tachycardia
C) Asystole and PEA
4
SUCCESS!
