Chamberlain University
EJC • 622 RN
TO E D U C AT E , E M P O W E R A N D E M B O L D E N D I V E R S E H E A LT H C A R E
P R O F E S S I O N A LS
CU
EST. 1889 College of Nursing • NR 226 Fundamentals: Patient Care
NR 226 — Fundamentals: Patient Care
CLINICAL JUDGMENT EXAM (CJE) PRACTICE GUIDE • 75 QUESTIONS
INSTITUTION Chamberlain University COURSE CODE NR 226
COURSE TITLE Fundamentals: Patient Care EXAM Clinical Judgment Exam (CJE)
FORMAT NCLEX-Style Questions with QUESTION COUNT 75 Practice Items
Clinical Rationales
E X A M I N AT I O N I N S T R U C T I O N S
▸ Select the single best answer unless the item states “Select all that apply.”
▸ For clinical judgment items, work through recognize cues → analyze cues → prioritize
hypotheses → generate solutions → take action → evaluate outcomes.
▸ For prioritization items, identify the most immediate threat (airway, breathing, circulation,
safety) before choosing the action.
▸ Use the answers and rationales immediately below each question for active-recall review.
You Already Know This
You already know the fundamentals foundations — that the nursing process organizes care, that
safety and infection control prevent harm, and that basic patient care requires assessment,
communication, and clinical reasoning.
NR 226 is about connecting the cue to the priority action and evaluating the response.
The difficulty comes from recognizing the urgent finding inside the routine presentation — the
oxygen saturation of 86%, the new confusion, the respiratory rate of 8 — while distinguishing it
from the stable need that can be managed on schedule.
The cue matters. But so does knowing what cannot wait.
, Where Is Your Preparation Breaking Down?
If you are missing NR 226 questions, do not automatically respond by memorizing more tasks.
Check where the reasoning chain breaks.
Recognize cuesCan you identify the most PrioritizeCan you identify the immediate
important finding before choosing an action? threat before the stable need?
AnalyzeCan you connect findings to the Generate solutionsCan you choose the
underlying problem? safest action within scope?
Take actionCan you implement the EvaluateCan you determine whether the
intervention correctly and timely? intervention produced the expected
response?
01 CLINICAL JUDGMENT & NURSING PROCESS Q1–Q10
1. A client reports new shortness of breath. The respiratory rate is 28/min and oxygen
saturation is 88% on room air. Which action should the nurse take first?
A) Assess airway patency and apply oxygen according to the care plan/protocol.
B) Document the finding and reassess in 1 hour.
C) Offer oral fluids.
D) Ask the client to ambulate to assess tolerance.
ANSWER A. Assess airway patency and apply oxygen according to the care plan/protocol.
RATIONALE The oxygen saturation and tachypnea indicate impaired oxygenation. Airway and
breathing take priority. The nurse should address the immediate threat and then
continue assessment. The other actions delay treatment or increase oxygen
demand.
,2. Which finding is objective data?
A) The client states, “I feel dizzy.”
B) The client reports nausea after breakfast.
C) Blood pressure is 88/54 mm Hg.
D) The client says the incision feels tight.
ANSWER C. Blood pressure is 88/54 mm Hg.
RATIONALE Objective data are measurable or observable findings. Blood pressure is directly
measured. The other statements are subjective reports from the client.
3. The nurse is evaluating a goal that states, “Client will maintain oxygen saturation at or
above 94% while resting.” Which finding indicates the goal has been met?
A) Oxygen saturation 90% on room air
B) Oxygen saturation 94% while resting
C) Respiratory rate 28/min with dyspnea
D) Client reports feeling tired
ANSWER B. Oxygen saturation 94% while resting
RATIONALE Evaluation compares actual outcomes with the expected measurable goal. A
resting saturation of 94% meets the stated target.
4. A nurse receives report on four clients. Which client should be assessed first?
A) A client with chronic arthritis reporting usual morning stiffness
B) A client requesting assistance with bathing
C) A client who became newly confused and has a respiratory rate of 30/min
D) A client waiting for routine discharge instructions
ANSWER C. A client who became newly confused and has a respiratory rate of 30/min
RATIONALE New confusion plus tachypnea may indicate acute deterioration or impaired
oxygenation. The change is unexpected and potentially life-threatening, so it
receives priority.
, 5. Which nursing action best demonstrates clinical judgment rather than simple task
completion?
A) Taking vital signs at the scheduled time
B) Recognizing a new drop in blood pressure and connecting it with recent bleeding
C) Changing a client’s linens
D) Recording the meal percentage eaten
ANSWER B. Recognizing a new drop in blood pressure and connecting it with recent bleeding
RATIONALE Clinical judgment requires recognizing relevant cues and connecting them to a
potential clinical problem. The other actions are important but do not
demonstrate the same level of analysis.
6. Which goal is written most appropriately for a client at risk for falls?
A) Client will understand fall prevention.
B) Client will be safe.
C) Client will remain free from falls during the 24-hour shift.
D) Nurse will keep the client safe.
ANSWER C. Client will remain free from falls during the 24-hour shift.
RATIONALE A useful outcome is client-centered, measurable, and time limited. The other
statements are vague or describe a nursing action rather than a measurable
client outcome.
EJC • 622 RN
TO E D U C AT E , E M P O W E R A N D E M B O L D E N D I V E R S E H E A LT H C A R E
P R O F E S S I O N A LS
CU
EST. 1889 College of Nursing • NR 226 Fundamentals: Patient Care
NR 226 — Fundamentals: Patient Care
CLINICAL JUDGMENT EXAM (CJE) PRACTICE GUIDE • 75 QUESTIONS
INSTITUTION Chamberlain University COURSE CODE NR 226
COURSE TITLE Fundamentals: Patient Care EXAM Clinical Judgment Exam (CJE)
FORMAT NCLEX-Style Questions with QUESTION COUNT 75 Practice Items
Clinical Rationales
E X A M I N AT I O N I N S T R U C T I O N S
▸ Select the single best answer unless the item states “Select all that apply.”
▸ For clinical judgment items, work through recognize cues → analyze cues → prioritize
hypotheses → generate solutions → take action → evaluate outcomes.
▸ For prioritization items, identify the most immediate threat (airway, breathing, circulation,
safety) before choosing the action.
▸ Use the answers and rationales immediately below each question for active-recall review.
You Already Know This
You already know the fundamentals foundations — that the nursing process organizes care, that
safety and infection control prevent harm, and that basic patient care requires assessment,
communication, and clinical reasoning.
NR 226 is about connecting the cue to the priority action and evaluating the response.
The difficulty comes from recognizing the urgent finding inside the routine presentation — the
oxygen saturation of 86%, the new confusion, the respiratory rate of 8 — while distinguishing it
from the stable need that can be managed on schedule.
The cue matters. But so does knowing what cannot wait.
, Where Is Your Preparation Breaking Down?
If you are missing NR 226 questions, do not automatically respond by memorizing more tasks.
Check where the reasoning chain breaks.
Recognize cuesCan you identify the most PrioritizeCan you identify the immediate
important finding before choosing an action? threat before the stable need?
AnalyzeCan you connect findings to the Generate solutionsCan you choose the
underlying problem? safest action within scope?
Take actionCan you implement the EvaluateCan you determine whether the
intervention correctly and timely? intervention produced the expected
response?
01 CLINICAL JUDGMENT & NURSING PROCESS Q1–Q10
1. A client reports new shortness of breath. The respiratory rate is 28/min and oxygen
saturation is 88% on room air. Which action should the nurse take first?
A) Assess airway patency and apply oxygen according to the care plan/protocol.
B) Document the finding and reassess in 1 hour.
C) Offer oral fluids.
D) Ask the client to ambulate to assess tolerance.
ANSWER A. Assess airway patency and apply oxygen according to the care plan/protocol.
RATIONALE The oxygen saturation and tachypnea indicate impaired oxygenation. Airway and
breathing take priority. The nurse should address the immediate threat and then
continue assessment. The other actions delay treatment or increase oxygen
demand.
,2. Which finding is objective data?
A) The client states, “I feel dizzy.”
B) The client reports nausea after breakfast.
C) Blood pressure is 88/54 mm Hg.
D) The client says the incision feels tight.
ANSWER C. Blood pressure is 88/54 mm Hg.
RATIONALE Objective data are measurable or observable findings. Blood pressure is directly
measured. The other statements are subjective reports from the client.
3. The nurse is evaluating a goal that states, “Client will maintain oxygen saturation at or
above 94% while resting.” Which finding indicates the goal has been met?
A) Oxygen saturation 90% on room air
B) Oxygen saturation 94% while resting
C) Respiratory rate 28/min with dyspnea
D) Client reports feeling tired
ANSWER B. Oxygen saturation 94% while resting
RATIONALE Evaluation compares actual outcomes with the expected measurable goal. A
resting saturation of 94% meets the stated target.
4. A nurse receives report on four clients. Which client should be assessed first?
A) A client with chronic arthritis reporting usual morning stiffness
B) A client requesting assistance with bathing
C) A client who became newly confused and has a respiratory rate of 30/min
D) A client waiting for routine discharge instructions
ANSWER C. A client who became newly confused and has a respiratory rate of 30/min
RATIONALE New confusion plus tachypnea may indicate acute deterioration or impaired
oxygenation. The change is unexpected and potentially life-threatening, so it
receives priority.
, 5. Which nursing action best demonstrates clinical judgment rather than simple task
completion?
A) Taking vital signs at the scheduled time
B) Recognizing a new drop in blood pressure and connecting it with recent bleeding
C) Changing a client’s linens
D) Recording the meal percentage eaten
ANSWER B. Recognizing a new drop in blood pressure and connecting it with recent bleeding
RATIONALE Clinical judgment requires recognizing relevant cues and connecting them to a
potential clinical problem. The other actions are important but do not
demonstrate the same level of analysis.
6. Which goal is written most appropriately for a client at risk for falls?
A) Client will understand fall prevention.
B) Client will be safe.
C) Client will remain free from falls during the 24-hour shift.
D) Nurse will keep the client safe.
ANSWER C. Client will remain free from falls during the 24-hour shift.
RATIONALE A useful outcome is client-centered, measurable, and time limited. The other
statements are vague or describe a nursing action rather than a measurable
client outcome.
