Page 1 of 66
NR324 CJE EXAM – 2026/2027 COMPLETE (150) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NR324 CJE
Prepare effectively for the NR324 CJE Exam with this focused study resource. It
supports review of adult health and medical-surgical nursing concepts, patient
assessment, clinical judgment, disease management, nursing interventions, and
prioritization. Use the material to reinforce your knowledge, review key topics, and
identify areas that may require additional study. This resource is suited for NR324
nursing students, adult health learners, and candidates preparing for the NR324 CJE
examination.
MULTIPLE CHOICE.
SECTION 1: FLUID & ELECTROLYTE BALANCE (Questions 1–25)
1. A nurse is caring for a client who has a sodium level of 125 mEq/L.
Which of the following findings should the nurse expect?
A. Hyperreflexia
B. Muscle twitching
C. Confusion and lethargy
D. Hyperactive bowel sounds
Correct Answer: C
Rationale: Hyponatremia (serum sodium < 135 mEq/L) causes
neurological symptoms due to cellular swelling, including confusion,
lethargy, headache, and seizures. Hyperreflexia and muscle twitching are
associated with hypocalcemia or hypomagnesemia. Hyperactive bowel
sounds are not typical of hyponatremia.
2. A client with chronic kidney disease has a potassium level of 6.8 mEq/L.
What is the priority nursing action?
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A. Administer oral potassium supplements
B. Place the client on a cardiac monitor
C. Encourage high-potassium foods
D. Prepare for dialysis
Correct Answer: B
Rationale: Hyperkalemia (K⁺ > 5.0 mEq/L) can cause life-threatening
cardiac dysrhythmias. The priority action is to place the client on a
cardiac monitor to detect ECG changes (peaked T waves, widened QRS).
Oral potassium supplements and high-potassium foods would worsen
hyperkalemia. Dialysis may be indicated but is not the immediate priority.
3. A nurse is reviewing the laboratory results for a client who is at risk for
fluid volume deficit. Which of the following findings is consistent with this
condition?
A. BUN 22 mg/dL
B. Hct 55%
C. Sodium 136 mEq/L
D. Urine specific gravity 1.005
Correct Answer: B
Rationale: Fluid volume deficit (dehydration) causes hemoconcentration,
leading to an elevated hematocrit (> 52% for males, > 47% for females).
BUN and creatinine may also be elevated. Urine specific gravity is
typically elevated (> 1.030) in dehydration. A normal sodium level does not
rule out fluid volume deficit.
4. A client is receiving IV fluids at 125 mL/hr. Which of the following
assessment findings indicates fluid volume excess?
A. Decreased blood pressure
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B. Dyspnea and crackles in the lungs
C. Dry mucous membranes
D. Increased urine specific gravity
Correct Answer: B
Rationale: Fluid volume excess (hypervolemia) causes pulmonary
congestion, leading to dyspnea, crackles (rales), and peripheral edema.
Decreased blood pressure, dry mucous membranes, and increased urine
specific gravity are signs of fluid volume deficit.
5. A nurse is caring for a client who has a calcium level of 8.0 mg/dL.
Which of the following findings should the nurse expect?
A. Positive Chvostek's sign
B. Muscle weakness
C. Constipation
D. Bone pain
Correct Answer: A
Rationale: Hypocalcemia (serum calcium < 8.5 mg/dL) causes
neuromuscular irritability, including positive Chvostek's sign (facial
twitching) and Trousseau's sign (carpal spasm). Muscle weakness,
constipation, and bone pain are associated with hypercalcemia.
6. A client's arterial blood gas (ABG) results show: pH 7.32, PaCO₂ 50
mmHg, HCO₃⁻ 24 mEq/L. How should the nurse interpret this ABG?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
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Correct Answer: B
Rationale: The pH is low (acidemia) with an elevated PaCO₂ (50 mmHg),
indicating respiratory acidosis. The HCO₃⁻ is normal (24 mEq/L),
suggesting the acidosis is acute. Causes include hypoventilation, COPD
exacerbation, and respiratory depression.
7. A nurse is caring for a client who has a magnesium level of 1.0 mEq/L.
Which of the following is the priority nursing intervention?
A. Encourage high-magnesium foods
B. Monitor cardiac rhythm
C. Administer magnesium sulfate IV
D. Place the client on seizure precautions
Correct Answer: B
Rationale: Hypomagnesemia (< 1.5 mEq/L) can cause cardiac
dysrhythmias, including torsades de pointes. The priority is to monitor
cardiac rhythm. While magnesium replacement and seizure precautions
may be necessary, cardiac monitoring is the priority due to the risk of life-
threatening arrhythmias.
8. A nurse is reviewing the laboratory results for a client with fluid volume
excess. Which of the following electrolyte imbalances is most likely to be
present?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypokalemia
Correct Answer: B
Rationale: Fluid volume excess (hypervolemia) often results in dilutional
hyponatremia (low serum sodium) due to excess water retention.
NR324 CJE EXAM – 2026/2027 COMPLETE (150) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NR324 CJE
Prepare effectively for the NR324 CJE Exam with this focused study resource. It
supports review of adult health and medical-surgical nursing concepts, patient
assessment, clinical judgment, disease management, nursing interventions, and
prioritization. Use the material to reinforce your knowledge, review key topics, and
identify areas that may require additional study. This resource is suited for NR324
nursing students, adult health learners, and candidates preparing for the NR324 CJE
examination.
MULTIPLE CHOICE.
SECTION 1: FLUID & ELECTROLYTE BALANCE (Questions 1–25)
1. A nurse is caring for a client who has a sodium level of 125 mEq/L.
Which of the following findings should the nurse expect?
A. Hyperreflexia
B. Muscle twitching
C. Confusion and lethargy
D. Hyperactive bowel sounds
Correct Answer: C
Rationale: Hyponatremia (serum sodium < 135 mEq/L) causes
neurological symptoms due to cellular swelling, including confusion,
lethargy, headache, and seizures. Hyperreflexia and muscle twitching are
associated with hypocalcemia or hypomagnesemia. Hyperactive bowel
sounds are not typical of hyponatremia.
2. A client with chronic kidney disease has a potassium level of 6.8 mEq/L.
What is the priority nursing action?
, Page 2 of 66
A. Administer oral potassium supplements
B. Place the client on a cardiac monitor
C. Encourage high-potassium foods
D. Prepare for dialysis
Correct Answer: B
Rationale: Hyperkalemia (K⁺ > 5.0 mEq/L) can cause life-threatening
cardiac dysrhythmias. The priority action is to place the client on a
cardiac monitor to detect ECG changes (peaked T waves, widened QRS).
Oral potassium supplements and high-potassium foods would worsen
hyperkalemia. Dialysis may be indicated but is not the immediate priority.
3. A nurse is reviewing the laboratory results for a client who is at risk for
fluid volume deficit. Which of the following findings is consistent with this
condition?
A. BUN 22 mg/dL
B. Hct 55%
C. Sodium 136 mEq/L
D. Urine specific gravity 1.005
Correct Answer: B
Rationale: Fluid volume deficit (dehydration) causes hemoconcentration,
leading to an elevated hematocrit (> 52% for males, > 47% for females).
BUN and creatinine may also be elevated. Urine specific gravity is
typically elevated (> 1.030) in dehydration. A normal sodium level does not
rule out fluid volume deficit.
4. A client is receiving IV fluids at 125 mL/hr. Which of the following
assessment findings indicates fluid volume excess?
A. Decreased blood pressure
, Page 3 of 66
B. Dyspnea and crackles in the lungs
C. Dry mucous membranes
D. Increased urine specific gravity
Correct Answer: B
Rationale: Fluid volume excess (hypervolemia) causes pulmonary
congestion, leading to dyspnea, crackles (rales), and peripheral edema.
Decreased blood pressure, dry mucous membranes, and increased urine
specific gravity are signs of fluid volume deficit.
5. A nurse is caring for a client who has a calcium level of 8.0 mg/dL.
Which of the following findings should the nurse expect?
A. Positive Chvostek's sign
B. Muscle weakness
C. Constipation
D. Bone pain
Correct Answer: A
Rationale: Hypocalcemia (serum calcium < 8.5 mg/dL) causes
neuromuscular irritability, including positive Chvostek's sign (facial
twitching) and Trousseau's sign (carpal spasm). Muscle weakness,
constipation, and bone pain are associated with hypercalcemia.
6. A client's arterial blood gas (ABG) results show: pH 7.32, PaCO₂ 50
mmHg, HCO₃⁻ 24 mEq/L. How should the nurse interpret this ABG?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
, Page 4 of 66
Correct Answer: B
Rationale: The pH is low (acidemia) with an elevated PaCO₂ (50 mmHg),
indicating respiratory acidosis. The HCO₃⁻ is normal (24 mEq/L),
suggesting the acidosis is acute. Causes include hypoventilation, COPD
exacerbation, and respiratory depression.
7. A nurse is caring for a client who has a magnesium level of 1.0 mEq/L.
Which of the following is the priority nursing intervention?
A. Encourage high-magnesium foods
B. Monitor cardiac rhythm
C. Administer magnesium sulfate IV
D. Place the client on seizure precautions
Correct Answer: B
Rationale: Hypomagnesemia (< 1.5 mEq/L) can cause cardiac
dysrhythmias, including torsades de pointes. The priority is to monitor
cardiac rhythm. While magnesium replacement and seizure precautions
may be necessary, cardiac monitoring is the priority due to the risk of life-
threatening arrhythmias.
8. A nurse is reviewing the laboratory results for a client with fluid volume
excess. Which of the following electrolyte imbalances is most likely to be
present?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypokalemia
Correct Answer: B
Rationale: Fluid volume excess (hypervolemia) often results in dilutional
hyponatremia (low serum sodium) due to excess water retention.
