CJE Readiness II Exam 2026/2027 Study
Questions and Correct Verified Solutions
with Detailed Rationales (100% Correct
Verified Answers) Latest Updated Version
2026 Edit
Key Topics Covered
• Clinical Judgment & Prioritization – ABCs, Maslow, stable vs unstable, urgent vs non-urgent
• Delegation & Leadership – RN, LPN, UAP roles; charge nurse responsibilities; shared governance
• Medical-Surgical Nursing – Respiratory, cardiovascular, orthopedic, GI, renal, neuro, endocrine
• Pharmacology & Medication Safety – Drug interactions, adverse effects, medication reconciliation
• Safety & Infection Control – Fall precautions, restraints, child abuse, seizure precautions, isolation
• Emergency & Critical Care – Chest tubes, traumatic injuries, compartment syndrome, rapid response
• Pediatric & Newborn Nursing – Cleft lip repair, immunizations, developmental considerations
• Psychiatric & Mental Health – Depression, suicide risk, therapeutic communication
• Leadership & Professional Development – Shared governance, evidence-based practice, staff
empowerment
1. A nurse on the oncology unit who was known to be uninvolved in unit governance and not seen
as a leader is now energized and empowered. The nurse just shared an article at a staff meeting on
a new evidence-based practice for clients undergoing surgery. What specific occurrence is the
most likely contributor to this nurse’s increased leadership stance?
A) The nurse received a pay raise
B) The nurse was asked to work on the shared governance council and is actively participating
C) The nurse completed a mandatory online training
D) The nurse was assigned as charge nurse for the first time
Answer B: The nurse was asked to work on the shared governance council and is actively
participating
,Rationale: Active participation in shared governance empowers nurses, builds leadership skills, and
encourages evidence-based practice engagement.
2. A charge nurse on a medical unit noticed that nurses from other units are reluctant to float to
this unit. The hospital nurse leaders investigate the cause. Which observed behaviors would
indicate a toxic culture contributing to this problem?
A) Charge nurse goes to lunch with unit nurses but not with float nurses; charge nurse relieves unit
nurses for breaks but not float nurses; clients with the highest acuity are assigned to float nurses
B) All nurses receive equal breaks and assignments
C) The unit has a high staff retention rate
D) Float nurses are offered extra pay incentives
Answer A: Charge nurse goes to lunch with unit nurses but not with float nurses; charge nurse
relieves unit nurses for breaks but not float nurses; clients with the highest acuity are assigned to
float nurses
Rationale: Favoritism, exclusion, and unfair assignment of high-acuity clients to float staff create a toxic
environment and discourage floating .
3. The nurse performs medication reconciliation for a newly admitted client and notes a
prescription for daily antacids. What other prescription in the client’s electronic health record
causes the nurse to call the healthcare provider?
A) Lisinopril
B) Metformin
C) Levofloxacin
D) Acetaminophen
Answer C: Levofloxacin
Rationale: Fluoroquinolones like levofloxacin can bind with antacids containing calcium, magnesium, or
aluminum, significantly reducing antibiotic absorption. The provider should be consulted for timing
adjustment or alternative therapy .
,4. The nurse cares for a client with chronic obstructive pulmonary disease (COPD) who exhibits
shortness of breath, pursed-lip breathing, and neck vein distention. Which action should the nurse
take first?
A) Administer a bronchodilator
B) Check the client’s oxygen saturation
C) Position the client in high-Fowler’s position
D) Notify the healthcare provider
Answer B: Check the client’s oxygen saturation
Rationale: Assessment is the first step in the nursing process; checking oxygen saturation provides
objective data to guide interventions .
5. A client is admitted to the ED following a motor vehicle accident. The client has several broken
bones. Which assessment finding would suggest compartment syndrome?
A) Severe pain not relieved by analgesics, lack of sensation, tingling, and inability to move the extremity
B) Bounding pulses and increased warmth in the extremity
C) Mild swelling and erythema at the injury site
D) Pain that resolves with elevation
Answer A: Severe pain not relieved by analgesics, lack of sensation, tingling, and inability to move
the extremity
Rationale: The six Ps of compartment syndrome: pain out of proportion, paresthesia, pallor, paralysis,
pulselessness, and poikilothermia. Pain not relieved by analgesics is the earliest sign .
6. The charge nurse has delegated care of five clients to the night shift nurse who starts at 1900.
Which client should the nurse see first?
A) Client with diabetes needing a fingerstick glucose check
B) Confused client with an intestinal obstruction who just pulled out the NG tube
C) Client with a fractured femur requesting pain medication
D) Client with a urinary catheter needing output recorded
, Answer B: Confused client with an intestinal obstruction who just pulled out the NG tube
Rationale: A confused client who just pulled out an NG tube is at risk for aspiration, airway obstruction,
and further gastrointestinal complications. This is an unstable situation requiring immediate assessment .
7. A client presents to the ED at 2200 with broken bones sustained in a motor vehicle accident. The
client’s blood alcohol level is several times over the normal limit, and the client admitted to
leaving a bar just before the accident. The client is transferred to the orthopedic unit at 2245.
What assessment related to alcohol intake is most important over the next few hours as the nurse
cares for the client?
A) Body shakiness and agitation
B) Decreased appetite and nausea
C) Excessive thirst and dry mouth
D) Drowsiness and sleepiness
Answer A: Body shakiness and agitation
Rationale: Alcohol withdrawal symptoms typically begin 6–12 hours after the last drink. The client is at
high risk for withdrawal, which initially presents with tremors, anxiety, and agitation .
8. The nurse cares for a client who reports vomiting and diarrhea over the last 48 hours. The
client’s blood pressure is 90/56, heart rate is 120, skin is cool and clammy. Which interventions
should the nurse implement?
A) Establish IV access, administer ondansetron, and place client on fall precautions
B) Apply oxygen and notify rapid response
C) Restrict oral fluids and monitor intake
D) Administer antidiarrheal and discharge home
Answer A: Establish IV access, administer ondansetron, and place client on fall precautions
Rationale: Hypovolemia causes tachycardia and hypotension; IV access allows fluid resuscitation.
Ondansetron treats nausea/vomiting. Fall precautions are necessary due to orthostatic hypotension .
Questions and Correct Verified Solutions
with Detailed Rationales (100% Correct
Verified Answers) Latest Updated Version
2026 Edit
Key Topics Covered
• Clinical Judgment & Prioritization – ABCs, Maslow, stable vs unstable, urgent vs non-urgent
• Delegation & Leadership – RN, LPN, UAP roles; charge nurse responsibilities; shared governance
• Medical-Surgical Nursing – Respiratory, cardiovascular, orthopedic, GI, renal, neuro, endocrine
• Pharmacology & Medication Safety – Drug interactions, adverse effects, medication reconciliation
• Safety & Infection Control – Fall precautions, restraints, child abuse, seizure precautions, isolation
• Emergency & Critical Care – Chest tubes, traumatic injuries, compartment syndrome, rapid response
• Pediatric & Newborn Nursing – Cleft lip repair, immunizations, developmental considerations
• Psychiatric & Mental Health – Depression, suicide risk, therapeutic communication
• Leadership & Professional Development – Shared governance, evidence-based practice, staff
empowerment
1. A nurse on the oncology unit who was known to be uninvolved in unit governance and not seen
as a leader is now energized and empowered. The nurse just shared an article at a staff meeting on
a new evidence-based practice for clients undergoing surgery. What specific occurrence is the
most likely contributor to this nurse’s increased leadership stance?
A) The nurse received a pay raise
B) The nurse was asked to work on the shared governance council and is actively participating
C) The nurse completed a mandatory online training
D) The nurse was assigned as charge nurse for the first time
Answer B: The nurse was asked to work on the shared governance council and is actively
participating
,Rationale: Active participation in shared governance empowers nurses, builds leadership skills, and
encourages evidence-based practice engagement.
2. A charge nurse on a medical unit noticed that nurses from other units are reluctant to float to
this unit. The hospital nurse leaders investigate the cause. Which observed behaviors would
indicate a toxic culture contributing to this problem?
A) Charge nurse goes to lunch with unit nurses but not with float nurses; charge nurse relieves unit
nurses for breaks but not float nurses; clients with the highest acuity are assigned to float nurses
B) All nurses receive equal breaks and assignments
C) The unit has a high staff retention rate
D) Float nurses are offered extra pay incentives
Answer A: Charge nurse goes to lunch with unit nurses but not with float nurses; charge nurse
relieves unit nurses for breaks but not float nurses; clients with the highest acuity are assigned to
float nurses
Rationale: Favoritism, exclusion, and unfair assignment of high-acuity clients to float staff create a toxic
environment and discourage floating .
3. The nurse performs medication reconciliation for a newly admitted client and notes a
prescription for daily antacids. What other prescription in the client’s electronic health record
causes the nurse to call the healthcare provider?
A) Lisinopril
B) Metformin
C) Levofloxacin
D) Acetaminophen
Answer C: Levofloxacin
Rationale: Fluoroquinolones like levofloxacin can bind with antacids containing calcium, magnesium, or
aluminum, significantly reducing antibiotic absorption. The provider should be consulted for timing
adjustment or alternative therapy .
,4. The nurse cares for a client with chronic obstructive pulmonary disease (COPD) who exhibits
shortness of breath, pursed-lip breathing, and neck vein distention. Which action should the nurse
take first?
A) Administer a bronchodilator
B) Check the client’s oxygen saturation
C) Position the client in high-Fowler’s position
D) Notify the healthcare provider
Answer B: Check the client’s oxygen saturation
Rationale: Assessment is the first step in the nursing process; checking oxygen saturation provides
objective data to guide interventions .
5. A client is admitted to the ED following a motor vehicle accident. The client has several broken
bones. Which assessment finding would suggest compartment syndrome?
A) Severe pain not relieved by analgesics, lack of sensation, tingling, and inability to move the extremity
B) Bounding pulses and increased warmth in the extremity
C) Mild swelling and erythema at the injury site
D) Pain that resolves with elevation
Answer A: Severe pain not relieved by analgesics, lack of sensation, tingling, and inability to move
the extremity
Rationale: The six Ps of compartment syndrome: pain out of proportion, paresthesia, pallor, paralysis,
pulselessness, and poikilothermia. Pain not relieved by analgesics is the earliest sign .
6. The charge nurse has delegated care of five clients to the night shift nurse who starts at 1900.
Which client should the nurse see first?
A) Client with diabetes needing a fingerstick glucose check
B) Confused client with an intestinal obstruction who just pulled out the NG tube
C) Client with a fractured femur requesting pain medication
D) Client with a urinary catheter needing output recorded
, Answer B: Confused client with an intestinal obstruction who just pulled out the NG tube
Rationale: A confused client who just pulled out an NG tube is at risk for aspiration, airway obstruction,
and further gastrointestinal complications. This is an unstable situation requiring immediate assessment .
7. A client presents to the ED at 2200 with broken bones sustained in a motor vehicle accident. The
client’s blood alcohol level is several times over the normal limit, and the client admitted to
leaving a bar just before the accident. The client is transferred to the orthopedic unit at 2245.
What assessment related to alcohol intake is most important over the next few hours as the nurse
cares for the client?
A) Body shakiness and agitation
B) Decreased appetite and nausea
C) Excessive thirst and dry mouth
D) Drowsiness and sleepiness
Answer A: Body shakiness and agitation
Rationale: Alcohol withdrawal symptoms typically begin 6–12 hours after the last drink. The client is at
high risk for withdrawal, which initially presents with tremors, anxiety, and agitation .
8. The nurse cares for a client who reports vomiting and diarrhea over the last 48 hours. The
client’s blood pressure is 90/56, heart rate is 120, skin is cool and clammy. Which interventions
should the nurse implement?
A) Establish IV access, administer ondansetron, and place client on fall precautions
B) Apply oxygen and notify rapid response
C) Restrict oral fluids and monitor intake
D) Administer antidiarrheal and discharge home
Answer A: Establish IV access, administer ondansetron, and place client on fall precautions
Rationale: Hypovolemia causes tachycardia and hypotension; IV access allows fluid resuscitation.
Ondansetron treats nausea/vomiting. Fall precautions are necessary due to orthostatic hypotension .
