College of Nursing
CJE Readiness II Examination 2026/2027
| Verified Questions
College of Nursing | University-Level Nursing Students
200 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
College of Nursing | CJE-R2 | Clinical Judgment Readiness Examination II
Readiness Assessment II Actual Exam | Academic Year 2026/2027
CJE Readiness II Examination 2026/2027 | Verified Questions
,INTRODUCTION
This examination document contains 200 original Verified Questions created for the College of
Nursing CJE-R2 Clinical Judgment Readiness Examination II Readiness Assessment II,
organized in an equal distribution across four core domains aligned with the clinical judgment
measurement model: Domain 1: Recognize and Analyze Cues (50 questions); Domain 2: Prioritize
Hypotheses and Generate Solutions (50 questions); Domain 3: Take Action and Clinical
Interventions (50 questions); and Domain 4: Evaluate Outcomes and Reflect on Practice (50
questions). Every question is an original work designed to reinforce the official CJE-R2 Clinical
Judgment Readiness Examination II Readiness Assessment II course objectives, drawing on
foundational clinical judgment methodology such as the NCSBN Clinical Judgment Measurement
Model and Ignatavicius Medical-Surgical Nursing. The content is aligned to the 2026/2027
academic year and is intended to build actual exam readiness and lasting clinical proficiency for
University-Level nursing students.
ACTUAL QUESTIONS
Domain 1: Recognize and Analyze Cues
Question 1. A nurse enters the room and finds the patient restless, using accessory
muscles, with an SpO2 of 88 percent. The nurse should assess which finding first?
A. The most recent laboratory panel
B. The current pain score
C. Urine output for the shift
D. Airway patency and breathing effort
Correct Answer: D
Rationale: Airway and breathing findings take priority over all other data when oxygenation is
threatened. Cue prioritization follows the NCSBN Clinical Judgment Measurement Model as
taught in the CJE-R2 curriculum.
Question 2. A postoperative patient's heart rate rises from 82 to 118 over two hours.
The nurse's best interpretation is:
A. An expected postoperative finding requiring no action
B. Evidence that pain control is adequate
C. Possible early hypovolemia requiring further assessment
D. Anxiety needing reassurance only
Correct Answer: C
Rationale: Unexplained tachycardia is an early cue to bleeding or volume loss and warrants
follow-up assessment. Trend analysis follows Ignatavicius Medical-Surgical Nursing principles.
Question 3. Crackles auscultated in both lung bases most likely indicate:
A. Bronchospasm
B. Fluid in the alveoli
C. Pleurisy
D. Pulmonary embolism
Correct Answer: B
Rationale: Fine crackles reflect fluid opening collapsed alveoli, as in heart failure or overload.
Breath sound interpretation follows the CJE-R2 curriculum.
Question 4. Persistent wheezing on auscultation suggests:
A. Airway narrowing
B. Consolidation
CJE Readiness II Examination 2026/2027 | Verified Questions
, C. Pleural effusion
D. Normal vesicular sounds
Correct Answer: A
Rationale: Wheezes arise from air moving through narrowed airways, as in asthma or COPD
exacerbation. Auscultation findings are covered in Ignatavicius Medical-Surgical Nursing.
Question 5. Continuous bubbling in the water-seal chamber of a chest drainage
system indicates:
A. Expected tidaling
B. Full lung re-expansion
C. Excessive wall suction
D. An air leak in the system
Correct Answer: D
Rationale: Continuous bubbling signals an air leak somewhere in the system and requires
troubleshooting. Chest system cues follow the CJE-R2 curriculum.
Question 6. A patient's urine output has been 20 mL per hour for the past two
hours. The nurse interprets this as:
A. Adequate output
B. Fluid overload
C. Inadequate renal perfusion requiring follow-up
D. Diabetes insipidus
Correct Answer: C
Rationale: Output below 30 mL per hour suggests reduced renal perfusion and possible
hypovolemia or shock. Urine output thresholds are taught in the CJE-R2 curriculum.
Question 7. Peaked T waves with a widened QRS complex on telemetry most likely
reflect:
A. Hypocalcemia
B. Hyperkalemia
C. Digoxin toxicity
D. Hypomagnesemia
Correct Answer: B
Rationale: Peaked T waves and conduction widening are classic electrocardiographic cues of
hyperkalemia. ECG recognition follows Ignatavicius Medical-Surgical Nursing.
Question 8. A patient with hypocalcemia develops facial twitching when the nurse
taps anterior to the ear. This finding is:
A. Chvostek sign
B. Trousseau sign
C. Homans sign
D. Brudzinski sign
Correct Answer: A
Rationale: Tapping the facial nerve producing twitching is Chvostek sign, indicating
neuromuscular irritability. Assessment signs follow the CJE-R2 curriculum.
Question 9. A patient with diabetes is diaphoretic, tremulous, and confused with a
glucose of 52 mg per dL. These cues indicate:
A. Hyperglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
CJE Readiness II Examination 2026/2027 | Verified Questions
, D. Hypoglycemia
Correct Answer: D
Rationale: Autonomic cues such as sweating and tremor with low glucose define hypoglycemia.
Glucose pattern recognition is taught in the CJE-R2 curriculum.
Question 10. Fruity breath odor with deep, rapid respirations in a patient with type
1 diabetes suggests:
A. Hypoglycemia
B. Respiratory alkalosis
C. Diabetic ketoacidosis
D. Opioid toxicity
Correct Answer: C
Rationale: Kussmaul respirations and acetone breath reflect acidosis from ketone
accumulation. DKA cues follow Ignatavicius Medical-Surgical Nursing.
Question 11. A serum sodium of 118 mEq per L with confusion most strongly
suggests:
A. Diabetes insipidus
B. Severe hyponatremia
C. Dehydration
D. Hypercalcemia
Correct Answer: B
Rationale: Profound hyponatremia causes cerebral edema and altered mentation. Electrolyte
cue analysis follows the CJE-R2 curriculum.
Question 12. Jugular venous distention, bilateral crackles, and 2+ pitting edema
indicate:
A. Fluid volume excess
B. Hypovolemia
C. Septic shock
D. Pulmonary embolism
Correct Answer: A
Rationale: The triad reflects venous congestion and overload, as in heart failure. Volume status
cues are taught in the CJE-R2 curriculum.
Question 13. Skin tenting, dry mucous membranes, and a BUN-to-creatinine ratio of
25 to 1 indicate:
A. Fluid overload
B. Renal failure
C. Heart failure
D. Dehydration
Correct Answer: D
Rationale: Poor turgor, dry membranes, and elevated ratio reflect volume depletion.
Dehydration cues follow Ignatavicius Medical-Surgical Nursing.
Question 14. Dyspnea, orthopnea, and pink frothy sputum point to:
A. Right-sided heart failure
B. Chronic obstructive pulmonary disease
C. Left-sided heart failure
D. Asthma
Correct Answer: C
CJE Readiness II Examination 2026/2027 | Verified Questions
CJE Readiness II Examination 2026/2027
| Verified Questions
College of Nursing | University-Level Nursing Students
200 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
College of Nursing | CJE-R2 | Clinical Judgment Readiness Examination II
Readiness Assessment II Actual Exam | Academic Year 2026/2027
CJE Readiness II Examination 2026/2027 | Verified Questions
,INTRODUCTION
This examination document contains 200 original Verified Questions created for the College of
Nursing CJE-R2 Clinical Judgment Readiness Examination II Readiness Assessment II,
organized in an equal distribution across four core domains aligned with the clinical judgment
measurement model: Domain 1: Recognize and Analyze Cues (50 questions); Domain 2: Prioritize
Hypotheses and Generate Solutions (50 questions); Domain 3: Take Action and Clinical
Interventions (50 questions); and Domain 4: Evaluate Outcomes and Reflect on Practice (50
questions). Every question is an original work designed to reinforce the official CJE-R2 Clinical
Judgment Readiness Examination II Readiness Assessment II course objectives, drawing on
foundational clinical judgment methodology such as the NCSBN Clinical Judgment Measurement
Model and Ignatavicius Medical-Surgical Nursing. The content is aligned to the 2026/2027
academic year and is intended to build actual exam readiness and lasting clinical proficiency for
University-Level nursing students.
ACTUAL QUESTIONS
Domain 1: Recognize and Analyze Cues
Question 1. A nurse enters the room and finds the patient restless, using accessory
muscles, with an SpO2 of 88 percent. The nurse should assess which finding first?
A. The most recent laboratory panel
B. The current pain score
C. Urine output for the shift
D. Airway patency and breathing effort
Correct Answer: D
Rationale: Airway and breathing findings take priority over all other data when oxygenation is
threatened. Cue prioritization follows the NCSBN Clinical Judgment Measurement Model as
taught in the CJE-R2 curriculum.
Question 2. A postoperative patient's heart rate rises from 82 to 118 over two hours.
The nurse's best interpretation is:
A. An expected postoperative finding requiring no action
B. Evidence that pain control is adequate
C. Possible early hypovolemia requiring further assessment
D. Anxiety needing reassurance only
Correct Answer: C
Rationale: Unexplained tachycardia is an early cue to bleeding or volume loss and warrants
follow-up assessment. Trend analysis follows Ignatavicius Medical-Surgical Nursing principles.
Question 3. Crackles auscultated in both lung bases most likely indicate:
A. Bronchospasm
B. Fluid in the alveoli
C. Pleurisy
D. Pulmonary embolism
Correct Answer: B
Rationale: Fine crackles reflect fluid opening collapsed alveoli, as in heart failure or overload.
Breath sound interpretation follows the CJE-R2 curriculum.
Question 4. Persistent wheezing on auscultation suggests:
A. Airway narrowing
B. Consolidation
CJE Readiness II Examination 2026/2027 | Verified Questions
, C. Pleural effusion
D. Normal vesicular sounds
Correct Answer: A
Rationale: Wheezes arise from air moving through narrowed airways, as in asthma or COPD
exacerbation. Auscultation findings are covered in Ignatavicius Medical-Surgical Nursing.
Question 5. Continuous bubbling in the water-seal chamber of a chest drainage
system indicates:
A. Expected tidaling
B. Full lung re-expansion
C. Excessive wall suction
D. An air leak in the system
Correct Answer: D
Rationale: Continuous bubbling signals an air leak somewhere in the system and requires
troubleshooting. Chest system cues follow the CJE-R2 curriculum.
Question 6. A patient's urine output has been 20 mL per hour for the past two
hours. The nurse interprets this as:
A. Adequate output
B. Fluid overload
C. Inadequate renal perfusion requiring follow-up
D. Diabetes insipidus
Correct Answer: C
Rationale: Output below 30 mL per hour suggests reduced renal perfusion and possible
hypovolemia or shock. Urine output thresholds are taught in the CJE-R2 curriculum.
Question 7. Peaked T waves with a widened QRS complex on telemetry most likely
reflect:
A. Hypocalcemia
B. Hyperkalemia
C. Digoxin toxicity
D. Hypomagnesemia
Correct Answer: B
Rationale: Peaked T waves and conduction widening are classic electrocardiographic cues of
hyperkalemia. ECG recognition follows Ignatavicius Medical-Surgical Nursing.
Question 8. A patient with hypocalcemia develops facial twitching when the nurse
taps anterior to the ear. This finding is:
A. Chvostek sign
B. Trousseau sign
C. Homans sign
D. Brudzinski sign
Correct Answer: A
Rationale: Tapping the facial nerve producing twitching is Chvostek sign, indicating
neuromuscular irritability. Assessment signs follow the CJE-R2 curriculum.
Question 9. A patient with diabetes is diaphoretic, tremulous, and confused with a
glucose of 52 mg per dL. These cues indicate:
A. Hyperglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
CJE Readiness II Examination 2026/2027 | Verified Questions
, D. Hypoglycemia
Correct Answer: D
Rationale: Autonomic cues such as sweating and tremor with low glucose define hypoglycemia.
Glucose pattern recognition is taught in the CJE-R2 curriculum.
Question 10. Fruity breath odor with deep, rapid respirations in a patient with type
1 diabetes suggests:
A. Hypoglycemia
B. Respiratory alkalosis
C. Diabetic ketoacidosis
D. Opioid toxicity
Correct Answer: C
Rationale: Kussmaul respirations and acetone breath reflect acidosis from ketone
accumulation. DKA cues follow Ignatavicius Medical-Surgical Nursing.
Question 11. A serum sodium of 118 mEq per L with confusion most strongly
suggests:
A. Diabetes insipidus
B. Severe hyponatremia
C. Dehydration
D. Hypercalcemia
Correct Answer: B
Rationale: Profound hyponatremia causes cerebral edema and altered mentation. Electrolyte
cue analysis follows the CJE-R2 curriculum.
Question 12. Jugular venous distention, bilateral crackles, and 2+ pitting edema
indicate:
A. Fluid volume excess
B. Hypovolemia
C. Septic shock
D. Pulmonary embolism
Correct Answer: A
Rationale: The triad reflects venous congestion and overload, as in heart failure. Volume status
cues are taught in the CJE-R2 curriculum.
Question 13. Skin tenting, dry mucous membranes, and a BUN-to-creatinine ratio of
25 to 1 indicate:
A. Fluid overload
B. Renal failure
C. Heart failure
D. Dehydration
Correct Answer: D
Rationale: Poor turgor, dry membranes, and elevated ratio reflect volume depletion.
Dehydration cues follow Ignatavicius Medical-Surgical Nursing.
Question 14. Dyspnea, orthopnea, and pink frothy sputum point to:
A. Right-sided heart failure
B. Chronic obstructive pulmonary disease
C. Left-sided heart failure
D. Asthma
Correct Answer: C
CJE Readiness II Examination 2026/2027 | Verified Questions
