NR324 CJE Exam – 2026/2027 Complete (150) Current Testing
Questions and Correct Answers Comprehensive Assessment
Year: 2026-2027
Verified Question Count: 150 Questions
100% VERIFIED
Introduction
This comprehensive assessment measures the knowledge, clinical judgment, and safe care
execution required in Adult Health I medical-surgical nursing. The Clinical Judgment
Measurement Model anchors every item, guiding the nurse through recognizing cues,
analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating
outcomes. Content spans the essential domains of Adult Health Nursing; Medical-Surgical
Concepts; Pharmacological Therapies; Safety and Infection Control; Physiological
Adaptation; Reduction of Risk Potential; and Management of Care. Each question
strengthens evidence-based decision-making, prioritization, delegation, and therapeutic
intervention skills for diverse adult client populations. Successful completion demonstrates
readiness for safe, high-quality patient care, supports academic progression within the
nursing curriculum, and builds the professional judgment and confidence required for
licensure success and lifelong clinical excellence.
Question 1. A nurse enters the room of a client who is two days postoperative and reports
sudden shortness of breath. Which action reflects the 'recognize cues' step of the Clinical
Judgment Measurement Model?
A. Review the client's vital signs, oxygen saturation, and breath sounds to gather
relevant data
B. Administer prescribed as-needed oxygen immediately
C. Determine that the client is likely experiencing a pulmonary embolism
D. Contact the provider to request a CT scan
Correct Answer: A
Rationale: Recognition of cues is the data-gathering step — identifying relevant
assessment findings before interpretation. Oxygen administration and provider notification
are actions, and forming a likely diagnosis is analyzing cues, which comes after data
collection.
Question 2. A client has jugular venous distention, bilateral crackles, 2+ pitting edema, and
a 3 kg weight gain in two days. Which interpretation reflects the 'analyze cues' step?
A. The client probably has a gastrointestinal virus
B. The findings cluster together to indicate fluid volume overload
C. The findings are expected for the second postoperative day and require no follow-up
, D. The weight gain is unrelated to the other findings and should be tracked separately
Correct Answer: B
Rationale: Analysis of cues means linking relevant findings to likely client conditions; this
cluster is classic for hypervolemia. Dismissing the findings as expected or fragmenting them
ignores the meaningful pattern.
Question 3. A nurse is reviewing findings for several clients. Which cue set should receive
the highest priority when determining hypotheses?
A. Chronic stable ankle pain rated 3 of 10
B. A healing stage 2 pressure injury with pink granulation tissue
C. A request for a routine medication refill appointment
D. New chest pressure with diaphoresis and pallor
Correct Answer: D
Rationale: Prioritizing hypotheses means determining which potential conditions are most
urgent; chest pressure with diaphoresis suggests acute cardiac ischemia, a life threat.
Chronic pain, a healing wound, and a refill request are lower acuity.
Question 4. Which expected outcome statement is most appropriate when generating
solutions for a postoperative client at risk for atelectasis?
A. Client will have improved lung sounds eventually
B. Client will use the incentive spirometer 10 times every hour while awake during the
first 24 hours
C. Client will not develop any complications
D. Client will understand the importance of breathing by discharge
Correct Answer: B
Rationale: Generating solutions requires measurable, time-specific, observable outcomes
tied to interventions. Vague statements such as improved lungs eventually or no
complications cannot be evaluated within a defined period.
Question 5. A postoperative client receiving opioid analgesia is found drowsy with an
oxygen saturation of 84% and slow respirations. Which action best reflects the 'take action'
step?
A. Stimulate the client, apply prescribed oxygen, raise the head of the bed, and reassess
respirations immediately
B. Let the client sleep and recheck the saturation at the next scheduled time
C. Dim the lights and decrease monitoring to promote rest
D. Document the saturation as normal for the postoperative period
Correct Answer: A
,Rationale: Acting on opioid-induced hypoventilation with stimulation, oxygen, positioning,
and immediate reassessment can avert respiratory arrest; delayed or reduced monitoring
risks fatal depression. Escalation follows if stimulation fails.
Question 6. A client's plan of care targeted a hemoglobin A1c below 7%; at follow-up the
value is 8.9%. Which response reflects the 'evaluate outcomes' step?
A. Document the plan as successful because the client attended every visit
B. Compare the result with the expected outcome and revise the plan of care with the
client
C. Discharge the client from follow-up since three months have passed
D. Repeat the A1c tomorrow before making any plan changes
Correct Answer: B
Rationale: Evaluation compares client findings with expected outcomes and revises the
plan when goals are unmet. Attendance does not equal goal attainment, and repeating a test
without revising strategies fails the evaluation step.
Question 7. A nurse is collecting data on a medical-surgical unit. Which finding requires the
most immediate notification of the provider?
A. A client reports mild incision soreness with walking
B. A client's dressing shows a small ring of serous drainage
C. A client who had a stroke becomes suddenly unresponsive
D. A client requests a different dinner selection
Correct Answer: C
Rationale: A sudden drop in responsiveness signals neurologic deterioration and requires
immediate provider notification. Mild soreness, small serous drainage, and dietary requests
are expected or routine.
Question 8. During the 'recognize cues' step, which data source is considered primary?
A. The previous nurse's shift note
B. The family member's description of events
C. The electronic record from a prior admission
D. The client's own verbal report of symptoms
Correct Answer: D
Rationale: The client is the primary source of subjective data. Chart notes, family
descriptions, and older records are secondary sources that supplement, not replace, direct
client report.
Question 9. A nurse notes a white blood cell count of 18,500/mm3, a temperature of 38.9 C,
and purulent drainage at a surgical site. Interpreting these together as wound infection
belongs to which Clinical Judgment Measurement Model step?
, A. Recognize cues
B. Generate solutions
C. Analyze cues
D. Evaluate outcomes
Correct Answer: C
Rationale: Linking laboratory data with clinical findings to identify a likely condition is the
analysis of cues step. Recognizing cues is collecting the individual data points, while
generating solutions and evaluating outcomes occur later.
Question 10. Which action best demonstrates use of the airway-breathing-circulation
framework when prioritizing hypotheses?
A. Address the laceration first because it is actively visible
B. Address a client's request for water before the stridor
C. Address audible stridor before a 2 cm forearm laceration
D. Address lower extremity edema before the stridor
Correct Answer: C
Rationale: Stridor indicates impending airway obstruction, the top priority in the airway-
breathing-circulation framework. A small visible laceration, thirst, and edema follow airway
threats in sequence.
Question 11. Using Maslow's hierarchy, which client need does the nurse address first?
A. Oxygen therapy for a client with saturations of 86%
B. Loneliness expressed by a long-term client
C. A request for help choosing television channels
D. Concerns about housing arrangements after discharge
Correct Answer: A
Rationale: Physiological oxygen needs rank first because they are immediately life-
sustaining. Psychosocial needs such as loneliness, recreation, and discharge housing are
important but secondary.
Question 12. When evaluation shows that expected outcomes have not been met, what is
the nurse's next step in the Clinical Judgment Measurement Model?
A. Document that goals failed and close the care plan
B. Repeat the same interventions without changes
C. Transfer responsibility for the plan to the next shift
D. Revise the plan of care based on reassessed findings
Correct Answer: D
Rationale: Unmet outcomes trigger reassessment and plan revision; evaluation is cyclical.
Closing the plan, repeating ineffective interventions, or shifting responsibility abandons the
judgment process.
Questions and Correct Answers Comprehensive Assessment
Year: 2026-2027
Verified Question Count: 150 Questions
100% VERIFIED
Introduction
This comprehensive assessment measures the knowledge, clinical judgment, and safe care
execution required in Adult Health I medical-surgical nursing. The Clinical Judgment
Measurement Model anchors every item, guiding the nurse through recognizing cues,
analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating
outcomes. Content spans the essential domains of Adult Health Nursing; Medical-Surgical
Concepts; Pharmacological Therapies; Safety and Infection Control; Physiological
Adaptation; Reduction of Risk Potential; and Management of Care. Each question
strengthens evidence-based decision-making, prioritization, delegation, and therapeutic
intervention skills for diverse adult client populations. Successful completion demonstrates
readiness for safe, high-quality patient care, supports academic progression within the
nursing curriculum, and builds the professional judgment and confidence required for
licensure success and lifelong clinical excellence.
Question 1. A nurse enters the room of a client who is two days postoperative and reports
sudden shortness of breath. Which action reflects the 'recognize cues' step of the Clinical
Judgment Measurement Model?
A. Review the client's vital signs, oxygen saturation, and breath sounds to gather
relevant data
B. Administer prescribed as-needed oxygen immediately
C. Determine that the client is likely experiencing a pulmonary embolism
D. Contact the provider to request a CT scan
Correct Answer: A
Rationale: Recognition of cues is the data-gathering step — identifying relevant
assessment findings before interpretation. Oxygen administration and provider notification
are actions, and forming a likely diagnosis is analyzing cues, which comes after data
collection.
Question 2. A client has jugular venous distention, bilateral crackles, 2+ pitting edema, and
a 3 kg weight gain in two days. Which interpretation reflects the 'analyze cues' step?
A. The client probably has a gastrointestinal virus
B. The findings cluster together to indicate fluid volume overload
C. The findings are expected for the second postoperative day and require no follow-up
, D. The weight gain is unrelated to the other findings and should be tracked separately
Correct Answer: B
Rationale: Analysis of cues means linking relevant findings to likely client conditions; this
cluster is classic for hypervolemia. Dismissing the findings as expected or fragmenting them
ignores the meaningful pattern.
Question 3. A nurse is reviewing findings for several clients. Which cue set should receive
the highest priority when determining hypotheses?
A. Chronic stable ankle pain rated 3 of 10
B. A healing stage 2 pressure injury with pink granulation tissue
C. A request for a routine medication refill appointment
D. New chest pressure with diaphoresis and pallor
Correct Answer: D
Rationale: Prioritizing hypotheses means determining which potential conditions are most
urgent; chest pressure with diaphoresis suggests acute cardiac ischemia, a life threat.
Chronic pain, a healing wound, and a refill request are lower acuity.
Question 4. Which expected outcome statement is most appropriate when generating
solutions for a postoperative client at risk for atelectasis?
A. Client will have improved lung sounds eventually
B. Client will use the incentive spirometer 10 times every hour while awake during the
first 24 hours
C. Client will not develop any complications
D. Client will understand the importance of breathing by discharge
Correct Answer: B
Rationale: Generating solutions requires measurable, time-specific, observable outcomes
tied to interventions. Vague statements such as improved lungs eventually or no
complications cannot be evaluated within a defined period.
Question 5. A postoperative client receiving opioid analgesia is found drowsy with an
oxygen saturation of 84% and slow respirations. Which action best reflects the 'take action'
step?
A. Stimulate the client, apply prescribed oxygen, raise the head of the bed, and reassess
respirations immediately
B. Let the client sleep and recheck the saturation at the next scheduled time
C. Dim the lights and decrease monitoring to promote rest
D. Document the saturation as normal for the postoperative period
Correct Answer: A
,Rationale: Acting on opioid-induced hypoventilation with stimulation, oxygen, positioning,
and immediate reassessment can avert respiratory arrest; delayed or reduced monitoring
risks fatal depression. Escalation follows if stimulation fails.
Question 6. A client's plan of care targeted a hemoglobin A1c below 7%; at follow-up the
value is 8.9%. Which response reflects the 'evaluate outcomes' step?
A. Document the plan as successful because the client attended every visit
B. Compare the result with the expected outcome and revise the plan of care with the
client
C. Discharge the client from follow-up since three months have passed
D. Repeat the A1c tomorrow before making any plan changes
Correct Answer: B
Rationale: Evaluation compares client findings with expected outcomes and revises the
plan when goals are unmet. Attendance does not equal goal attainment, and repeating a test
without revising strategies fails the evaluation step.
Question 7. A nurse is collecting data on a medical-surgical unit. Which finding requires the
most immediate notification of the provider?
A. A client reports mild incision soreness with walking
B. A client's dressing shows a small ring of serous drainage
C. A client who had a stroke becomes suddenly unresponsive
D. A client requests a different dinner selection
Correct Answer: C
Rationale: A sudden drop in responsiveness signals neurologic deterioration and requires
immediate provider notification. Mild soreness, small serous drainage, and dietary requests
are expected or routine.
Question 8. During the 'recognize cues' step, which data source is considered primary?
A. The previous nurse's shift note
B. The family member's description of events
C. The electronic record from a prior admission
D. The client's own verbal report of symptoms
Correct Answer: D
Rationale: The client is the primary source of subjective data. Chart notes, family
descriptions, and older records are secondary sources that supplement, not replace, direct
client report.
Question 9. A nurse notes a white blood cell count of 18,500/mm3, a temperature of 38.9 C,
and purulent drainage at a surgical site. Interpreting these together as wound infection
belongs to which Clinical Judgment Measurement Model step?
, A. Recognize cues
B. Generate solutions
C. Analyze cues
D. Evaluate outcomes
Correct Answer: C
Rationale: Linking laboratory data with clinical findings to identify a likely condition is the
analysis of cues step. Recognizing cues is collecting the individual data points, while
generating solutions and evaluating outcomes occur later.
Question 10. Which action best demonstrates use of the airway-breathing-circulation
framework when prioritizing hypotheses?
A. Address the laceration first because it is actively visible
B. Address a client's request for water before the stridor
C. Address audible stridor before a 2 cm forearm laceration
D. Address lower extremity edema before the stridor
Correct Answer: C
Rationale: Stridor indicates impending airway obstruction, the top priority in the airway-
breathing-circulation framework. A small visible laceration, thirst, and edema follow airway
threats in sequence.
Question 11. Using Maslow's hierarchy, which client need does the nurse address first?
A. Oxygen therapy for a client with saturations of 86%
B. Loneliness expressed by a long-term client
C. A request for help choosing television channels
D. Concerns about housing arrangements after discharge
Correct Answer: A
Rationale: Physiological oxygen needs rank first because they are immediately life-
sustaining. Psychosocial needs such as loneliness, recreation, and discharge housing are
important but secondary.
Question 12. When evaluation shows that expected outcomes have not been met, what is
the nurse's next step in the Clinical Judgment Measurement Model?
A. Document that goals failed and close the care plan
B. Repeat the same interventions without changes
C. Transfer responsibility for the plan to the next shift
D. Revise the plan of care based on reassessed findings
Correct Answer: D
Rationale: Unmet outcomes trigger reassessment and plan revision; evaluation is cyclical.
Closing the plan, repeating ineffective interventions, or shifting responsibility abandons the
judgment process.
