NR 324 CJE EXAM PREMIUM CLINICAL JUDGEMENT – QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS |EXAM TESTBANK | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains:
• Medical-Surgical Nursing (Cardiovascular, Respiratory, Renal, Neurological,
Endocrine)
• Pharmacology and Medication Administration
• Fluid and Electrolyte Balance
• Acid-Base Balance and Interpretation
• Perioperative and Postoperative Care
• Pain Management and Palliative Care
• Infection Control and Wound Management
• Legal, Ethical, and Professional Nursing Standards
• Clinical Judgment and Prioritization (Maslow, ABCs, Safety)
• Patient Education and Health Promotion
Introduction
This comprehensive examination is designed to assess the clinical judgment and
foundational knowledge essential for success in the NR 324 CJE. It evaluates your
ability to synthesize complex patient data, apply evidence-based practice, and
prioritize care in diverse, real-world scenarios. The exam includes a rigorous mix of
multiple-choice and scenario-based questions that challenge critical thinking,
decision-making under pressure, and the application of nursing theory to clinical
practice. Emphasis is placed on safety, pharmacology, and the holistic management of
adult health conditions. This testbank serves as a premium resource for self-
assessment, remediation, and mastery of core concepts required for the 2026/2027
examination cycle.
,════════════════════════════════════
SECTION ONE: QUESTIONS 1 – 50
════════════════════════════════════
1. A patient with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) result showing pH 7.31, PaCO2 58 mm Hg, HCO3- 30 mEq/L. How
should the nurse interpret these findings?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Compensated metabolic alkalosis
D. Uncompensated metabolic acidosis
🟢 Correct Answer: B. Partially compensated respiratory acidosis
🔴 Explanation: The pH is below normal (acidosis), PaCO2 is elevated (respiratory
cause), and HCO3- is elevated (metabolic compensation). Since the pH is still
abnormal, compensation is partial (the kidneys have begun to retain bicarbonate,
but not enough to normalize pH).
2. A nurse is preparing to administer 40 mEq of potassium chloride (KCl) IV. Which
action is most important?
A. Administer via IV push over 5 minutes
B. Mix in a 50 mL minibag and infuse over 1 hour
C. Assess urine output before administration
D. Use an IV filter during administration
🟢 Correct Answer: C. Assess urine output before administration
🔴 Explanation: Potassium should NEVER be given IV push. It must be diluted and
infused at a rate no greater than 10 mEq/hr. Assessing urine output is crucial
,because administering potassium to a patient with renal failure can cause life-
threatening hyperkalemia.
3. A patient is admitted with heart failure and is receiving furosemide (Lasix). The
nurse notes a serum potassium level of 3.1 mEq/L. Which of the following is the
priority nursing action?
A. Hold the furosemide and notify the healthcare provider
B. Administer the furosemide as ordered and monitor output
C. Encourage consumption of potassium-rich foods
D. Check the patient’s blood pressure
🟢 Correct Answer: A. Hold the furosemide and notify the healthcare provider
🔴 Explanation: Furosemide is a loop diuretic that causes potassium wasting. A
potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to cardiac
arrhythmias. The nurse should hold the medication and notify the provider to obtain
an order for potassium replacement.
4. A patient is scheduled for a colonoscopy. The nurse is providing patient
education regarding the bowel preparation. Which statement by the patient
indicates a need for further teaching?
A. "I will drink clear liquids the day before the procedure."
B. "I can eat a light breakfast the morning of the procedure."
C. "I will take the laxative as prescribed to clean my bowel."
D. "I should avoid red or purple liquids during the prep."
🟢 Correct Answer: B. "I can eat a light breakfast the morning of the procedure."
🔴 Explanation: For a colonoscopy, the patient must be NPO after midnight or
adhere to a strict clear liquid diet for a specific duration. Eating a light breakfast on
, the morning of the procedure would violate the NPO status and could lead to
complications and procedure cancellation.
5. The nurse is caring for a patient with a chest tube to water-seal drainage for a
pneumothorax. The nurse observes continuous bubbling in the water-seal
chamber. What is the most appropriate initial action?
A. Clamp the chest tube immediately
B. Assess the patient for respiratory distress
C. Document the finding as normal
D. Increase the suction pressure
🟢 Correct Answer: B. Assess the patient for respiratory distress
🔴 Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak. The nurse should first assess the patient for respiratory distress and ensure the
patient is stable, then assess the system and notify the provider if needed. Clamping
the tube is done only in emergencies and with a provider order.
6. A nurse is calculating the intake and output for a shift. The patient has an IV
infusing at 125 mL/hr, drank 240 mL of water, and had 120 mL of ice chips. Which
value represents the total intake for the shift?
A. 485 mL
B. 605 mL
C. 725 mL
D. 845 mL
🟢 Correct Answer: C. 725 mL
🔴 Explanation: IV intake: 125 mL/hr × 8 hrs = 1000 mL. Water: 240 mL. Ice chips:
120 mL (measured as half the volume, so 60 mL). Total = 1000 + 240 + 60 = 1300
mL. CORRECTION: The question lacks the shift length. Assuming 8 hours, intake is
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS |EXAM TESTBANK | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains:
• Medical-Surgical Nursing (Cardiovascular, Respiratory, Renal, Neurological,
Endocrine)
• Pharmacology and Medication Administration
• Fluid and Electrolyte Balance
• Acid-Base Balance and Interpretation
• Perioperative and Postoperative Care
• Pain Management and Palliative Care
• Infection Control and Wound Management
• Legal, Ethical, and Professional Nursing Standards
• Clinical Judgment and Prioritization (Maslow, ABCs, Safety)
• Patient Education and Health Promotion
Introduction
This comprehensive examination is designed to assess the clinical judgment and
foundational knowledge essential for success in the NR 324 CJE. It evaluates your
ability to synthesize complex patient data, apply evidence-based practice, and
prioritize care in diverse, real-world scenarios. The exam includes a rigorous mix of
multiple-choice and scenario-based questions that challenge critical thinking,
decision-making under pressure, and the application of nursing theory to clinical
practice. Emphasis is placed on safety, pharmacology, and the holistic management of
adult health conditions. This testbank serves as a premium resource for self-
assessment, remediation, and mastery of core concepts required for the 2026/2027
examination cycle.
,════════════════════════════════════
SECTION ONE: QUESTIONS 1 – 50
════════════════════════════════════
1. A patient with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) result showing pH 7.31, PaCO2 58 mm Hg, HCO3- 30 mEq/L. How
should the nurse interpret these findings?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Compensated metabolic alkalosis
D. Uncompensated metabolic acidosis
🟢 Correct Answer: B. Partially compensated respiratory acidosis
🔴 Explanation: The pH is below normal (acidosis), PaCO2 is elevated (respiratory
cause), and HCO3- is elevated (metabolic compensation). Since the pH is still
abnormal, compensation is partial (the kidneys have begun to retain bicarbonate,
but not enough to normalize pH).
2. A nurse is preparing to administer 40 mEq of potassium chloride (KCl) IV. Which
action is most important?
A. Administer via IV push over 5 minutes
B. Mix in a 50 mL minibag and infuse over 1 hour
C. Assess urine output before administration
D. Use an IV filter during administration
🟢 Correct Answer: C. Assess urine output before administration
🔴 Explanation: Potassium should NEVER be given IV push. It must be diluted and
infused at a rate no greater than 10 mEq/hr. Assessing urine output is crucial
,because administering potassium to a patient with renal failure can cause life-
threatening hyperkalemia.
3. A patient is admitted with heart failure and is receiving furosemide (Lasix). The
nurse notes a serum potassium level of 3.1 mEq/L. Which of the following is the
priority nursing action?
A. Hold the furosemide and notify the healthcare provider
B. Administer the furosemide as ordered and monitor output
C. Encourage consumption of potassium-rich foods
D. Check the patient’s blood pressure
🟢 Correct Answer: A. Hold the furosemide and notify the healthcare provider
🔴 Explanation: Furosemide is a loop diuretic that causes potassium wasting. A
potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to cardiac
arrhythmias. The nurse should hold the medication and notify the provider to obtain
an order for potassium replacement.
4. A patient is scheduled for a colonoscopy. The nurse is providing patient
education regarding the bowel preparation. Which statement by the patient
indicates a need for further teaching?
A. "I will drink clear liquids the day before the procedure."
B. "I can eat a light breakfast the morning of the procedure."
C. "I will take the laxative as prescribed to clean my bowel."
D. "I should avoid red or purple liquids during the prep."
🟢 Correct Answer: B. "I can eat a light breakfast the morning of the procedure."
🔴 Explanation: For a colonoscopy, the patient must be NPO after midnight or
adhere to a strict clear liquid diet for a specific duration. Eating a light breakfast on
, the morning of the procedure would violate the NPO status and could lead to
complications and procedure cancellation.
5. The nurse is caring for a patient with a chest tube to water-seal drainage for a
pneumothorax. The nurse observes continuous bubbling in the water-seal
chamber. What is the most appropriate initial action?
A. Clamp the chest tube immediately
B. Assess the patient for respiratory distress
C. Document the finding as normal
D. Increase the suction pressure
🟢 Correct Answer: B. Assess the patient for respiratory distress
🔴 Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak. The nurse should first assess the patient for respiratory distress and ensure the
patient is stable, then assess the system and notify the provider if needed. Clamping
the tube is done only in emergencies and with a provider order.
6. A nurse is calculating the intake and output for a shift. The patient has an IV
infusing at 125 mL/hr, drank 240 mL of water, and had 120 mL of ice chips. Which
value represents the total intake for the shift?
A. 485 mL
B. 605 mL
C. 725 mL
D. 845 mL
🟢 Correct Answer: C. 725 mL
🔴 Explanation: IV intake: 125 mL/hr × 8 hrs = 1000 mL. Water: 240 mL. Ice chips:
120 mL (measured as half the volume, so 60 mL). Total = 1000 + 240 + 60 = 1300
mL. CORRECTION: The question lacks the shift length. Assuming 8 hours, intake is
