NR324 CJE Exam Questions and Verified Answers
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Pass your specialized clinical assessment with this premium study guide
optimized for the 2026 Chamberlain University NR324 Adult Health I
Clinical Junior Evaluation (CJE) Exam. This comprehensive document
delivers realistic practice questions, verified answer keys, and deep
evidentiary rationales covering advanced medical-surgical nursing
concepts, acute disease processes, and client care management. Tailored
specifically for nursing students, it highlights essential diagnostic
algorithms, pharmacological profiles, and prioritization frameworks to
ensure level 3 proficiency.
SECTION 1: FUNDAMENTALS & PATIENT SAFETY (Questions 1-50)
Question 1
A nurse is caring for a client who is sitting in a chair and asks to return to bed.
Which action is the nurse's priority?
A) Obtain a walker for the client to use to transfer back to bed.
B) Call for additional staff to assist with the transfer.
C) Use a transfer belt and assist the client back into bed.
D) Determine the client's ability to help with the transfer.
Rationale: The priority action before any transfer is to assess the client's capability to
participate, ensuring safe mobilization and preventing falls.
Question 2
A nurse is preparing to instill an enteral feeding for a client with an NG tube. What
is the highest assessment priority?
,A) Check how long the feeding container has been open.
B) Verify the placement of the NG tube.
C) Confirm that the client does not have diarrhea.
D) Make sure the client is alert and oriented.
Rationale: Verifying NG tube placement is critical to prevent aspiration pneumonia
before any enteral feeding is administered.
Question 3
A nurse is teaching a client about ways to promote sleep and rest. Which
recommendations should the nurse include? (Select all that apply.)
A) Practice muscle relaxation techniques.
B) Exercise each morning.
C) Take an afternoon nap.
D) Alter the sleep environment for comfort.
E) Limit fluid intake at least 2 hours before bedtime.
Rationale: Muscle relaxation, morning exercise (which promotes sleep), a comfortable
environment, and limiting fluids before bed are all effective sleep hygiene practices.
Question 4
A nurse is evaluating a patient's intake for the last 8 hours. The patient consumed
two cups of coffee and 4 oz of orange juice for breakfast, and 8 oz of iced tea, a
cup of ice chips, and 1 cup of chicken broth for lunch. The patient also has IV fluids
running at 20 ml/hr of normal saline. Urine output was 800 ml. What is the net
intake?
A) 480 ml
B) 520 ml
C) 560 ml
D) 640 ml
Rationale: Total intake (oral fluids and IV fluids) minus urine output gives the net intake.
Oral intake includes 16oz coffee (480ml), 4oz juice (120ml), 8oz tea (240ml), ice chips
(120ml, measured as half of volume), and 8oz broth (240ml) for a total of 1200ml. IV
,fluids provide 160ml (20ml/hr × 8hr). Total intake is 1360ml. Net intake is 1360ml -
800ml = 560ml.
Question 5
A patient with an occluded chest tube requires which priority nursing action?
A) Milking the tubing to remove clots.
B) Checking for kinks in the tubing and ensuring no dependent loops.
C) Clamping the chest tube immediately.
D) Notifying the provider.
Rationale: The priority is to check for kinks or dependent loops that could impede
drainage. Clamping is dangerous and could cause a tension pneumothorax.
Question 6
Continuous bubbling in the water seal chamber of a chest tube indicates what?
A) Normal tidaling with respirations.
B) An air leak in the system.
C) The patient is ready for tube removal.
D) Fluid overload.
Rationale: Continuous bubbling indicates an air leak that must be located and corrected
to maintain proper negative pressure.
Question 7
What is the best way to prevent atelectasis post-operatively?
A) Frequent position changes.
B) Use of the Incentive Spirometer (10 times per hour).
C) Early ambulation.
D) Coughing and deep breathing exercises.
, Rationale: Incentive spirometry encourages sustained alveolar inflation, preventing lung
collapse and pneumonia.
Question 8
When assessing a client with a wrist restraint, which observation indicates the
nurse failed to follow safety guidelines?
A) A safety knot was used to secure the restraint.
B) The call light was placed within reach of the client.
C) The restraint was applied tightly around the client's wrist.
D) The client's record indicates the restraint was released every 2 hours.
Rationale: A tight restraint can cause skin breakdown, nerve damage, or circulatory
impairment. A safety knot and the call light are correct practices.
Question 9
A nurse is planning a teaching session for an older adult about a prescribed
medication regimen. Which concern should the nurse consider?
A) They experience an increase in drug absorption.
B) They are less motivated to follow a prescribed drug regimen.
C) They are less likely to learn due to a decline in intelligence.
D) They have a decreased risk for adverse reactions to drugs.
Rationale: Older adults may have complex medication regimens, side effects, or cognitive
concerns that affect motivation and adherence.
Question 10
A client requests pain medication for severe pain. What should the nurse do first?
A) Use distraction to minimize the client's perception of pain.
B) Place the client in the most comfortable position possible.
.
Pass your specialized clinical assessment with this premium study guide
optimized for the 2026 Chamberlain University NR324 Adult Health I
Clinical Junior Evaluation (CJE) Exam. This comprehensive document
delivers realistic practice questions, verified answer keys, and deep
evidentiary rationales covering advanced medical-surgical nursing
concepts, acute disease processes, and client care management. Tailored
specifically for nursing students, it highlights essential diagnostic
algorithms, pharmacological profiles, and prioritization frameworks to
ensure level 3 proficiency.
SECTION 1: FUNDAMENTALS & PATIENT SAFETY (Questions 1-50)
Question 1
A nurse is caring for a client who is sitting in a chair and asks to return to bed.
Which action is the nurse's priority?
A) Obtain a walker for the client to use to transfer back to bed.
B) Call for additional staff to assist with the transfer.
C) Use a transfer belt and assist the client back into bed.
D) Determine the client's ability to help with the transfer.
Rationale: The priority action before any transfer is to assess the client's capability to
participate, ensuring safe mobilization and preventing falls.
Question 2
A nurse is preparing to instill an enteral feeding for a client with an NG tube. What
is the highest assessment priority?
,A) Check how long the feeding container has been open.
B) Verify the placement of the NG tube.
C) Confirm that the client does not have diarrhea.
D) Make sure the client is alert and oriented.
Rationale: Verifying NG tube placement is critical to prevent aspiration pneumonia
before any enteral feeding is administered.
Question 3
A nurse is teaching a client about ways to promote sleep and rest. Which
recommendations should the nurse include? (Select all that apply.)
A) Practice muscle relaxation techniques.
B) Exercise each morning.
C) Take an afternoon nap.
D) Alter the sleep environment for comfort.
E) Limit fluid intake at least 2 hours before bedtime.
Rationale: Muscle relaxation, morning exercise (which promotes sleep), a comfortable
environment, and limiting fluids before bed are all effective sleep hygiene practices.
Question 4
A nurse is evaluating a patient's intake for the last 8 hours. The patient consumed
two cups of coffee and 4 oz of orange juice for breakfast, and 8 oz of iced tea, a
cup of ice chips, and 1 cup of chicken broth for lunch. The patient also has IV fluids
running at 20 ml/hr of normal saline. Urine output was 800 ml. What is the net
intake?
A) 480 ml
B) 520 ml
C) 560 ml
D) 640 ml
Rationale: Total intake (oral fluids and IV fluids) minus urine output gives the net intake.
Oral intake includes 16oz coffee (480ml), 4oz juice (120ml), 8oz tea (240ml), ice chips
(120ml, measured as half of volume), and 8oz broth (240ml) for a total of 1200ml. IV
,fluids provide 160ml (20ml/hr × 8hr). Total intake is 1360ml. Net intake is 1360ml -
800ml = 560ml.
Question 5
A patient with an occluded chest tube requires which priority nursing action?
A) Milking the tubing to remove clots.
B) Checking for kinks in the tubing and ensuring no dependent loops.
C) Clamping the chest tube immediately.
D) Notifying the provider.
Rationale: The priority is to check for kinks or dependent loops that could impede
drainage. Clamping is dangerous and could cause a tension pneumothorax.
Question 6
Continuous bubbling in the water seal chamber of a chest tube indicates what?
A) Normal tidaling with respirations.
B) An air leak in the system.
C) The patient is ready for tube removal.
D) Fluid overload.
Rationale: Continuous bubbling indicates an air leak that must be located and corrected
to maintain proper negative pressure.
Question 7
What is the best way to prevent atelectasis post-operatively?
A) Frequent position changes.
B) Use of the Incentive Spirometer (10 times per hour).
C) Early ambulation.
D) Coughing and deep breathing exercises.
, Rationale: Incentive spirometry encourages sustained alveolar inflation, preventing lung
collapse and pneumonia.
Question 8
When assessing a client with a wrist restraint, which observation indicates the
nurse failed to follow safety guidelines?
A) A safety knot was used to secure the restraint.
B) The call light was placed within reach of the client.
C) The restraint was applied tightly around the client's wrist.
D) The client's record indicates the restraint was released every 2 hours.
Rationale: A tight restraint can cause skin breakdown, nerve damage, or circulatory
impairment. A safety knot and the call light are correct practices.
Question 9
A nurse is planning a teaching session for an older adult about a prescribed
medication regimen. Which concern should the nurse consider?
A) They experience an increase in drug absorption.
B) They are less motivated to follow a prescribed drug regimen.
C) They are less likely to learn due to a decline in intelligence.
D) They have a decreased risk for adverse reactions to drugs.
Rationale: Older adults may have complex medication regimens, side effects, or cognitive
concerns that affect motivation and adherence.
Question 10
A client requests pain medication for severe pain. What should the nurse do first?
A) Use distraction to minimize the client's perception of pain.
B) Place the client in the most comfortable position possible.
