NR 324 CJE EXAM-ADULT HEALTH 1 CLINICAL JUDGEMENT
EXAM 2026-2027 | ALL QUESTIONS AND ANSWERS (CORRECT
ANSWERS) PLUS DETAILED RATIONALES | COMPLETE
STUDYGUIDE| GUARANTEED PASS | DOWNLOAD INSTANT
PDF 2027-2028
1. A nurse is conducting an admission assessment on a client with a history of hypertension.
Which physiological mechanism primarily contributes to essential hypertension?
A. Hypersecretion of renin leading to systemic vasodilation
B. Increased peripheral vascular resistance and sodium retention
C. Decreased sympathetic nervous system activity
D. Excessive loss of intravascular fluid volume
Answer: B
Rationale: Essential hypertension is primarily driven by increased peripheral vascular
resistance and impaired renal sodium excretion. These mechanisms elevate systemic arterial
pressure over time, making understanding this etiology essential for nursing exam prep and
adult health clinical judgment.
2. A nurse is caring for a client who is 2 hours postoperative following an abdominal
hysterectomy. The nurse notes a heart rate of 120 beats/min, blood pressure of 88/52
mmHg, and urine output of 15 mL/hr over the past hour. Which action should the nurse
take first?
A. Administer the prescribed PRN oral analgesic for pain.
B. Place the client in a supine position with legs elevated and notify the provider.
C. Increase the room temperature to prevent hypothermia.
D. Reassess the surgical dressing in 2 hours.
Answer: B
Rationale: The client exhibits signs of hypovolemic shock (tachycardia, hypotension, oliguria).
Positioning the client with legs elevated improves venous return to vital organs while the
provider is immediately notified for IV fluid resuscitation.
3. A nurse reviews the laboratory results of a client receiving furosemide 40 mg PO daily.
Which serum laboratory value requires immediate clinical intervention?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
,C. Calcium 9.2 mg/dL
D. Fasting glucose 98 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion. A serum potassium
level of 2.9 mEq/L represents severe hypokalemia, placing the client at high risk for lethal
cardiac dysrhythmias. Verified answers on adult health practice tests emphasize immediate
potassium replacement for values below 3.5 mEq/L.
4. A client with chronic obstructive pulmonary disease (COPD) is admitted with acute
dyspnea. The arterial blood gas (ABG) results are: pH 7.31, PaCO2 58 mmHg, HCO3 26
mEq/L, PaO2 62 mmHg. How should the nurse interpret these findings?
A. Uncompensated metabolic acidosis
B. Fully compensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Combined metabolic and respiratory alkalosis
Answer: C
Rationale: The low pH (7.31) indicates acidosis, and the elevated PaCO2 (58 mmHg) indicates
a respiratory cause. The normal HCO3 (26 mEq/L) demonstrates that compensation has not
yet occurred, confirming uncompensated respiratory acidosis.
5. A nurse provides discharge teaching to a client newly diagnosed with type 1 diabetes
mellitus. Which instruction regarding hypoglycemia management should be included in the
complete study guide instructions?
A. Consume 15 grams of fast-acting carbohydrates if blood glucose drops below 70 mg/dL.
B. Administer 10 units of regular insulin immediately if shakiness occurs.
C. Drink 8 ounces of diet soda to rapidly restore normal blood glucose levels.
D. Wait 45 minutes before rechecking blood glucose after taking oral glucose.
Answer: A
Rationale: The "Rule of 15" dictates administering 15 grams of simple carbohydrates (e.g., 4
oz fruit juice, glucose tablets) for hypoglycemia (<70 mg/dL), followed by rechecking blood
glucose in 15 minutes.
6. An older adult client is admitted with community-acquired pneumonia. Which early
clinical manifestation should the nurse anticipate in this specific demographic?
A. High-grade fever and severe chest wall pain
B. Confusion and altered mental status
,C. Profuse diaphoresis and bradycardia
D. Productive cough with bright red blood
Answer: B
Rationale: Older adults often present with atypical signs of infection, such as acute confusion,
lethargy, or delirium, rather than the classic presentation of high fever and leukocytosis.
7. A nurse is caring for a client receiving total parenteral nutrition (TPN) through a central
venous catheter. The current TPN bag is empty, and the replacement bag has not arrived
from the pharmacy. Which IV solution should the nurse infuse until the new bag is
available?
A. 0.45% Sodium Chloride
B. 0.9% Sodium Chloride
C. 10% Dextrose in Water
D. Lactated Ringer's solution
Answer: C
Rationale: Abrupt cessation of TPN, which contains high concentrations of dextrose, can
precipitate severe rebound hypoglycemia. Infusing 10% Dextrose in Water at the same rate
maintains blood glucose levels until the next TPN container is obtained.
8. A client with dark skin tone is being assessed for cyanosis. Which anatomical area should
the nurse inspect to accurately detect cyanosis?
A. Dorsal surface of the hands
B. Sacral region and elbows
C. Conjunctivae and oral mucosa
D. Sclera and lower extremities
Answer: C
Rationale: In clients with dark skin pigmentation, cyanosis is best assessed in areas with
minimal pigmentation and rich capillary beds, such as the conjunctivae, oral mucous
membranes, and nail beds.
9. A nurse prepares to administer digoxin 0.25 mg PO to a client with heart failure. Prior to
administration, the nurse measures the apical pulse for 1 full minute and notes a rate of 54
beats/min. Which action is most appropriate?
A. Administer the medication as prescribed and document the rate.
B. Hold the medication and notify the healthcare provider.
C. Administer half the dose and recheck the pulse in 30 minutes.
, D. Instruct the client to perform a Valsalva maneuver before taking the pill.
Answer: B
Rationale: Digoxin decreases heart rate (negative chronotropic effect). It should be held and
the provider notified if the adult apical pulse is less than 60 beats/min to avoid severe
bradycardia and digoxin toxicity.
10. A nurse is assigned to four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client with osteoarthritis reporting right knee pain rated 6/10
B. A client with asthma who has audible wheezing and an oxygen saturation of 89%
C. A client who underwent an appendectomy 24 hours ago with moderate incisional drainage
D. A client with diabetes mellitus requesting assistance with morning hygiene
Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with
asthma experiencing wheezing and hypoxia (SpO2 89%) requires immediate airway and
breathing intervention.
11. A nurse is reviewing cardiac rhythm strips and identifies a rhythm with no identifiable
P waves, irregular ventricular response, and a heart rate of 118 beats/min. Which rhythm
is present?
A. Sinus bradycardia
B. Atrial fibrillation with rapid ventricular response
C. First-degree atrioventricular block
D. Ventricular tachycardia
Answer: B
Rationale: Atrial fibrillation is characterized by an absence of distinct P waves, chaotic
fibrillatory baseline waves, and an irregularly irregular QRS complex response. When the rate
exceeds 100 beats/min, it is classified with rapid ventricular response.
12. A client with deep vein thrombosis (DVT) in the right lower extremity is receiving a
continuous intravenous heparin infusion. Which laboratory test must the nurse monitor to
adjust the infusion rate?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count alone
EXAM 2026-2027 | ALL QUESTIONS AND ANSWERS (CORRECT
ANSWERS) PLUS DETAILED RATIONALES | COMPLETE
STUDYGUIDE| GUARANTEED PASS | DOWNLOAD INSTANT
PDF 2027-2028
1. A nurse is conducting an admission assessment on a client with a history of hypertension.
Which physiological mechanism primarily contributes to essential hypertension?
A. Hypersecretion of renin leading to systemic vasodilation
B. Increased peripheral vascular resistance and sodium retention
C. Decreased sympathetic nervous system activity
D. Excessive loss of intravascular fluid volume
Answer: B
Rationale: Essential hypertension is primarily driven by increased peripheral vascular
resistance and impaired renal sodium excretion. These mechanisms elevate systemic arterial
pressure over time, making understanding this etiology essential for nursing exam prep and
adult health clinical judgment.
2. A nurse is caring for a client who is 2 hours postoperative following an abdominal
hysterectomy. The nurse notes a heart rate of 120 beats/min, blood pressure of 88/52
mmHg, and urine output of 15 mL/hr over the past hour. Which action should the nurse
take first?
A. Administer the prescribed PRN oral analgesic for pain.
B. Place the client in a supine position with legs elevated and notify the provider.
C. Increase the room temperature to prevent hypothermia.
D. Reassess the surgical dressing in 2 hours.
Answer: B
Rationale: The client exhibits signs of hypovolemic shock (tachycardia, hypotension, oliguria).
Positioning the client with legs elevated improves venous return to vital organs while the
provider is immediately notified for IV fluid resuscitation.
3. A nurse reviews the laboratory results of a client receiving furosemide 40 mg PO daily.
Which serum laboratory value requires immediate clinical intervention?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
,C. Calcium 9.2 mg/dL
D. Fasting glucose 98 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion. A serum potassium
level of 2.9 mEq/L represents severe hypokalemia, placing the client at high risk for lethal
cardiac dysrhythmias. Verified answers on adult health practice tests emphasize immediate
potassium replacement for values below 3.5 mEq/L.
4. A client with chronic obstructive pulmonary disease (COPD) is admitted with acute
dyspnea. The arterial blood gas (ABG) results are: pH 7.31, PaCO2 58 mmHg, HCO3 26
mEq/L, PaO2 62 mmHg. How should the nurse interpret these findings?
A. Uncompensated metabolic acidosis
B. Fully compensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Combined metabolic and respiratory alkalosis
Answer: C
Rationale: The low pH (7.31) indicates acidosis, and the elevated PaCO2 (58 mmHg) indicates
a respiratory cause. The normal HCO3 (26 mEq/L) demonstrates that compensation has not
yet occurred, confirming uncompensated respiratory acidosis.
5. A nurse provides discharge teaching to a client newly diagnosed with type 1 diabetes
mellitus. Which instruction regarding hypoglycemia management should be included in the
complete study guide instructions?
A. Consume 15 grams of fast-acting carbohydrates if blood glucose drops below 70 mg/dL.
B. Administer 10 units of regular insulin immediately if shakiness occurs.
C. Drink 8 ounces of diet soda to rapidly restore normal blood glucose levels.
D. Wait 45 minutes before rechecking blood glucose after taking oral glucose.
Answer: A
Rationale: The "Rule of 15" dictates administering 15 grams of simple carbohydrates (e.g., 4
oz fruit juice, glucose tablets) for hypoglycemia (<70 mg/dL), followed by rechecking blood
glucose in 15 minutes.
6. An older adult client is admitted with community-acquired pneumonia. Which early
clinical manifestation should the nurse anticipate in this specific demographic?
A. High-grade fever and severe chest wall pain
B. Confusion and altered mental status
,C. Profuse diaphoresis and bradycardia
D. Productive cough with bright red blood
Answer: B
Rationale: Older adults often present with atypical signs of infection, such as acute confusion,
lethargy, or delirium, rather than the classic presentation of high fever and leukocytosis.
7. A nurse is caring for a client receiving total parenteral nutrition (TPN) through a central
venous catheter. The current TPN bag is empty, and the replacement bag has not arrived
from the pharmacy. Which IV solution should the nurse infuse until the new bag is
available?
A. 0.45% Sodium Chloride
B. 0.9% Sodium Chloride
C. 10% Dextrose in Water
D. Lactated Ringer's solution
Answer: C
Rationale: Abrupt cessation of TPN, which contains high concentrations of dextrose, can
precipitate severe rebound hypoglycemia. Infusing 10% Dextrose in Water at the same rate
maintains blood glucose levels until the next TPN container is obtained.
8. A client with dark skin tone is being assessed for cyanosis. Which anatomical area should
the nurse inspect to accurately detect cyanosis?
A. Dorsal surface of the hands
B. Sacral region and elbows
C. Conjunctivae and oral mucosa
D. Sclera and lower extremities
Answer: C
Rationale: In clients with dark skin pigmentation, cyanosis is best assessed in areas with
minimal pigmentation and rich capillary beds, such as the conjunctivae, oral mucous
membranes, and nail beds.
9. A nurse prepares to administer digoxin 0.25 mg PO to a client with heart failure. Prior to
administration, the nurse measures the apical pulse for 1 full minute and notes a rate of 54
beats/min. Which action is most appropriate?
A. Administer the medication as prescribed and document the rate.
B. Hold the medication and notify the healthcare provider.
C. Administer half the dose and recheck the pulse in 30 minutes.
, D. Instruct the client to perform a Valsalva maneuver before taking the pill.
Answer: B
Rationale: Digoxin decreases heart rate (negative chronotropic effect). It should be held and
the provider notified if the adult apical pulse is less than 60 beats/min to avoid severe
bradycardia and digoxin toxicity.
10. A nurse is assigned to four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client with osteoarthritis reporting right knee pain rated 6/10
B. A client with asthma who has audible wheezing and an oxygen saturation of 89%
C. A client who underwent an appendectomy 24 hours ago with moderate incisional drainage
D. A client with diabetes mellitus requesting assistance with morning hygiene
Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with
asthma experiencing wheezing and hypoxia (SpO2 89%) requires immediate airway and
breathing intervention.
11. A nurse is reviewing cardiac rhythm strips and identifies a rhythm with no identifiable
P waves, irregular ventricular response, and a heart rate of 118 beats/min. Which rhythm
is present?
A. Sinus bradycardia
B. Atrial fibrillation with rapid ventricular response
C. First-degree atrioventricular block
D. Ventricular tachycardia
Answer: B
Rationale: Atrial fibrillation is characterized by an absence of distinct P waves, chaotic
fibrillatory baseline waves, and an irregularly irregular QRS complex response. When the rate
exceeds 100 beats/min, it is classified with rapid ventricular response.
12. A client with deep vein thrombosis (DVT) in the right lower extremity is receiving a
continuous intravenous heparin infusion. Which laboratory test must the nurse monitor to
adjust the infusion rate?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count alone
