CJE READINESS II EXAM STUDY QUESTIONS AND
COMPLETE VERIFIED ANSWERS
Table of Contents
Section Domain Approx. Page
Questions Reference
1 Prioritization & Clinical Judgment 45 3
2 Patient Safety & Infection Control 35 15
3 Cardiovascular & Respiratory 40 25
Conditions
4 Neurological & Endocrine 30 40
Emergencies
5 Pharmacology & Medication Safety 40 52
6 Leadership, Delegation & Staff 30 68
Management
7 Maternal-Newborn & Pediatric 30 80
Nursing
8 Mental Health & Psychosocial 20 95
Integrity
9 Gastrointestinal & Renal Disorders 20 105
10 Emergency & Critical Care 10 115
,SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT (Questions 1–45)
Question 1
A nurse receives handoff for four clients. Which client should the nurse
assess first?
A. A client with chronic heart failure who has gained 1 kg (2.2 lb) over
the past week
B. A client 12 hours after thyroidectomy who reports tingling around
the mouth and has new muscle twitching
C. A client with pneumonia whose temperature is 38.1°C (100.6°F) after
receiving acetaminophen
D. A client with type 2 diabetes whose premeal glucose is 214 mg/dL
(11.9 mmol/L)
Rationale: Perioral paresthesia and muscle twitching after thyroid
surgery suggest acute hypocalcemia caused by parathyroid injury or
dysfunction. Progression to laryngospasm, seizures, or cardiac
dysrhythmias can occur, making this the highest-priority assessment.
The other clients have chronic or less acute issues.
Question 2
A client with septic shock has received a crystalloid bolus and broad-
spectrum antibiotics. The client's blood pressure remains 82/48 mm Hg,
and the mean arterial pressure is 59 mm Hg. Which intervention should
the nurse anticipate next?
A. Administer an isotonic fluid bolus indefinitely until blood pressure
normalizes
B. Initiate a prescribed vasopressor infusion
C. Administer a loop diuretic to prevent pulmonary edema
D. Place the client in a high-Fowler position and reassess in 30 minutes
,Rationale: Persistent hypotension despite appropriate initial fluid
resuscitation in septic shock indicates the need for vasopressor support
to restore adequate tissue perfusion. Delaying vasopressors can worsen
organ hypoperfusion.
Question 3
A client receiving a heparin infusion has a platelet count that decreases
from 238,000/mm³ to 108,000/mm³ on day 6 of therapy. The client also
develops a new painful swelling in the calf. Which action is the nurse's
priority?
A. Increase the heparin infusion because thrombosis is suspected
B. Administer prescribed vitamin K
C. Stop the heparin infusion and notify the provider immediately
D. Apply a warm compress to the affected calf
Rationale: A substantial platelet decline 5–10 days after heparin
exposure accompanied by new thrombosis is characteristic of heparin-
induced thrombocytopenia (HIT). The priority is to stop heparin
immediately and notify the provider.
Question 4
A nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with COPD who has an oxygen saturation of 88% on room air
B. A client with pneumonia who has a temperature of 101.2°F and is
diaphoretic
C. A client with heart failure who has 2+ pitting edema and is short of
breath
D. A client post-operative day 2 who is requesting pain medication
, Correct Answer: A
Rationale: The patient with an oxygen saturation of 88% is hypoxic and
requires immediate assessment and intervention. Airway and breathing
are always the first priority in the ABC framework.
Question 5
A 7-year-old child having an asthma attack is administered a prescribed
inhaler. The nurse notices cigarette burn marks on the child's arm.
Which action should the nurse take?
A. Document the findings and continue monitoring
B. Ask the child how the burns occurred
C. Place a call to child protective services
D. Notify the healthcare provider
Rationale: Suspicious injuries such as cigarette burn marks in a pattern
inconsistent with accidental injury warrant a report to child protective
services. The nurse has a legal and ethical obligation to report
suspected child abuse.
Question 6
What is the first priority during a mass casualty incident?
A. Establishing incident command and scene safety
B. Transporting all victims to the hospital immediately
C. Starting IV fluids on all patients
D. Performing surgery on critical patients
Rationale: Establishing incident command and ensuring scene safety is
the first priority in any mass casualty incident. This allows for organized
triage, resource allocation, and safe victim transport.
COMPLETE VERIFIED ANSWERS
Table of Contents
Section Domain Approx. Page
Questions Reference
1 Prioritization & Clinical Judgment 45 3
2 Patient Safety & Infection Control 35 15
3 Cardiovascular & Respiratory 40 25
Conditions
4 Neurological & Endocrine 30 40
Emergencies
5 Pharmacology & Medication Safety 40 52
6 Leadership, Delegation & Staff 30 68
Management
7 Maternal-Newborn & Pediatric 30 80
Nursing
8 Mental Health & Psychosocial 20 95
Integrity
9 Gastrointestinal & Renal Disorders 20 105
10 Emergency & Critical Care 10 115
,SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT (Questions 1–45)
Question 1
A nurse receives handoff for four clients. Which client should the nurse
assess first?
A. A client with chronic heart failure who has gained 1 kg (2.2 lb) over
the past week
B. A client 12 hours after thyroidectomy who reports tingling around
the mouth and has new muscle twitching
C. A client with pneumonia whose temperature is 38.1°C (100.6°F) after
receiving acetaminophen
D. A client with type 2 diabetes whose premeal glucose is 214 mg/dL
(11.9 mmol/L)
Rationale: Perioral paresthesia and muscle twitching after thyroid
surgery suggest acute hypocalcemia caused by parathyroid injury or
dysfunction. Progression to laryngospasm, seizures, or cardiac
dysrhythmias can occur, making this the highest-priority assessment.
The other clients have chronic or less acute issues.
Question 2
A client with septic shock has received a crystalloid bolus and broad-
spectrum antibiotics. The client's blood pressure remains 82/48 mm Hg,
and the mean arterial pressure is 59 mm Hg. Which intervention should
the nurse anticipate next?
A. Administer an isotonic fluid bolus indefinitely until blood pressure
normalizes
B. Initiate a prescribed vasopressor infusion
C. Administer a loop diuretic to prevent pulmonary edema
D. Place the client in a high-Fowler position and reassess in 30 minutes
,Rationale: Persistent hypotension despite appropriate initial fluid
resuscitation in septic shock indicates the need for vasopressor support
to restore adequate tissue perfusion. Delaying vasopressors can worsen
organ hypoperfusion.
Question 3
A client receiving a heparin infusion has a platelet count that decreases
from 238,000/mm³ to 108,000/mm³ on day 6 of therapy. The client also
develops a new painful swelling in the calf. Which action is the nurse's
priority?
A. Increase the heparin infusion because thrombosis is suspected
B. Administer prescribed vitamin K
C. Stop the heparin infusion and notify the provider immediately
D. Apply a warm compress to the affected calf
Rationale: A substantial platelet decline 5–10 days after heparin
exposure accompanied by new thrombosis is characteristic of heparin-
induced thrombocytopenia (HIT). The priority is to stop heparin
immediately and notify the provider.
Question 4
A nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with COPD who has an oxygen saturation of 88% on room air
B. A client with pneumonia who has a temperature of 101.2°F and is
diaphoretic
C. A client with heart failure who has 2+ pitting edema and is short of
breath
D. A client post-operative day 2 who is requesting pain medication
, Correct Answer: A
Rationale: The patient with an oxygen saturation of 88% is hypoxic and
requires immediate assessment and intervention. Airway and breathing
are always the first priority in the ABC framework.
Question 5
A 7-year-old child having an asthma attack is administered a prescribed
inhaler. The nurse notices cigarette burn marks on the child's arm.
Which action should the nurse take?
A. Document the findings and continue monitoring
B. Ask the child how the burns occurred
C. Place a call to child protective services
D. Notify the healthcare provider
Rationale: Suspicious injuries such as cigarette burn marks in a pattern
inconsistent with accidental injury warrant a report to child protective
services. The nurse has a legal and ethical obligation to report
suspected child abuse.
Question 6
What is the first priority during a mass casualty incident?
A. Establishing incident command and scene safety
B. Transporting all victims to the hospital immediately
C. Starting IV fluids on all patients
D. Performing surgery on critical patients
Rationale: Establishing incident command and ensuring scene safety is
the first priority in any mass casualty incident. This allows for organized
triage, resource allocation, and safe victim transport.
