CJE Readiness II Exam Study Guide | Comprehensive
Practice Exam with Actual Questions, Verified Questions
and Detailed Rationales (100% Correct Solutions)|
Latest Update 2026/2027 - Graded A+
Question 1
A client presents to the emergency department with suspected placental abruption.
Which assessment finding is most concerning to the nurse?
A. Body shakiness and agitation
B. Hard, board-like abdomen
C. Tender uterus
D. Decrease in fundal height
Answer: B
Rationale: A hard, board-like abdomen is the classic sign of placental abruption
and indicates significant concealed hemorrhage. This finding is most concerning as
it suggests the uterus is filling with blood, which can lead to disseminated
intravascular coagulation (DIC) and maternal/fetal compromise. Body shakiness
(A) and agitation may occur but are less specific. A tender uterus (C) is expected
but not as concerning as a board-like abdomen. Decrease in fundal height (D) is
not typical of abruption.
Question 2
The nurse performs medication reconciliation for a newly admitted client and notes
a prescription for daily antacids. What other prescription in the client's electronic
health record causes the nurse to call the health care provider?
A. Quinidine
B. Neomycin
C. Levofloxacin
D. Streptomycin
Answer: A
Rationale: Antacids can decrease the absorption of quinidine, leading to
subtherapeutic levels and potentially life-threatening arrhythmias. The nurse
should call the healthcare provider to discuss this interaction. Neomycin (B),
pg. 1
,levofloxacin (C), and streptomycin (D) may have interactions but are less
concerning with antacids than quinidine.
Question 3
A client with HIV and AIDS is placed on reverse isolation for neutropenia. Which
comment made by the client requires further discussion with the nurse?
A. "I will ask visitors to wear a mask when they enter my room."
B. "I understand I need to wash my hands frequently."
C. "Everyone is wearing a mask to keep from spreading my germs to others."
D. "I know that my white blood cell count is very low right now."
Answer: C
Rationale: The client stating "everyone is wearing a mask to keep from spreading
my germs to others" indicates a misunderstanding that reverse isolation is to
protect the client from others' germs, not to prevent the client from spreading their
own germs. This requires further education. Options A, B, and D demonstrate
correct understanding.
Question 4
An infant has a bilateral cleft lip repair two days ago. Which nursing intervention
should the nurse include in the client's plan of care?
A. Place the infant on their stomach for sleep
B. Feed the infant using a standard bottle and nipple
C. Remove the restraints periodically to cuddle the infant
D. Encourage the infant to suck on a pacifier vigorously
Answer: C
Rationale: After cleft lip repair, the infant should have restraints removed
periodically for cuddling and comfort, but the restraints should be reapplied to
prevent the infant from touching the surgical site. The infant should be placed on
their back (not stomach, A) to prevent pressure on the suture line. A special feeder
(not standard bottle, B) should be used. Sucking on a pacifier (D) should be
avoided to prevent stress on the suture line.
Question 5
A client is being induced due to increasing symptoms of preeclampsia. The client
is also receiving magnesium sulfate. It appears that her labor has not become active
pg. 2
,despite several hours of oxytocin administration. The client asks the nurse, "Why is
it taking so long?" Which response by the nurse is most appropriate?
A. "The magnesium relaxes your uterus and competes with the oxytocin. It may
increase the duration of your labor."
B. "Your body is not responding to the medications as expected."
C. "We may need to increase the oxytocin dose."
D. "This is a normal response to the magnesium sulfate."
Answer: A
Rationale: Magnesium sulfate acts as a tocolytic and can relax the uterus,
potentially prolonging labor by competing with oxytocin. The nurse should provide
an honest, factual explanation that addresses the client's concern. Options B, C, and
D do not provide adequate education or explanation.
Question 6
The charge nurse delegates care of clients on the unit. In what order should the
assigned nurse plan to see these clients? Place the client in the order they should be
seen by the nurse from first to last:
• Client who is 2 days post-op with stable vital signs
• Client experiencing chest pain with diaphoresis
• Client requesting discharge teaching
• Client with a new onset of confusion
Answer:
1. Client experiencing chest pain with diaphoresis (highest priority - possible
MI)
2. Client with a new onset of confusion (potential neurological change)
3. Client who is 2 days post-op with stable vital signs (routine care)
4. Client requesting discharge teaching (lowest priority)
Rationale: The nurse should use the ABCs and Maslow's hierarchy to
prioritize care. Chest pain with diaphoresis could indicate a life-threatening
cardiac event. New onset confusion could indicate a neurological change.
Stable post-op and discharge teaching can wait.
Question 7
A client with diabetes presents to the clinic. Their glycosylated hemoglobin is
9.4%. The client has difficulty adhering to the prescribed diet and asks for
pg. 3
, suggestions. Which dietary choices would be most appropriate for the nurse to
recommend? (Select all that apply)
A. Spaghetti with meatballs and parmesan cheese, steamed broccoli, raw carrots,
and a glass of water
B. Ham sandwich with a slice of cheese, a banana, and iced tea with low-calorie
sweetener
C. Grilled chicken salad with vinaigrette dressing and a whole wheat roll
D. Fried fish, french fries, and a regular soda
Answer: A, C
Rationale: Spaghetti with meatballs can be part of a balanced diet if portion-
controlled, and steamed broccoli and raw carrots are healthy vegetable choices.
Water is a calorie-free beverage. A grilled chicken salad is also a healthy choice.
Option B includes high-sodium ham and processed cheese. Option D includes fried
foods and regular soda, which are not recommended for diabetes management.
Question 8
A nurse monitors a gravida 2 para 1 client who experiences a sudden onset of acute
abdominal pain and frank vaginal bleeding. Which additional assessment findings
are most concerning to the nurse? (Select all that apply)
A. Blood oozing from IV site
B. Late decelerations
C. Change in fundal height over 1 hour
D. Maternal tachycardia
Answer: A, B, C
Rationale: Blood oozing from IV site suggests coagulopathy (DIC). Late
decelerations indicate fetal distress. Change in fundal height suggests concealed
hemorrhage. Maternal tachycardia (D) is concerning but is a later sign of
hypovolemia and less specific than the other findings.
Question 9
The charge nurse has delegated care of five clients to the night shift nurse who
starts the shift at 1900. Which client should the nurse see first?
A. Client with a fractured arm who is watching television
B. Client with stable angina who is requesting a PRN pain medication
C. Client with a history of hypertension who is sleeping soundly
pg. 4
Practice Exam with Actual Questions, Verified Questions
and Detailed Rationales (100% Correct Solutions)|
Latest Update 2026/2027 - Graded A+
Question 1
A client presents to the emergency department with suspected placental abruption.
Which assessment finding is most concerning to the nurse?
A. Body shakiness and agitation
B. Hard, board-like abdomen
C. Tender uterus
D. Decrease in fundal height
Answer: B
Rationale: A hard, board-like abdomen is the classic sign of placental abruption
and indicates significant concealed hemorrhage. This finding is most concerning as
it suggests the uterus is filling with blood, which can lead to disseminated
intravascular coagulation (DIC) and maternal/fetal compromise. Body shakiness
(A) and agitation may occur but are less specific. A tender uterus (C) is expected
but not as concerning as a board-like abdomen. Decrease in fundal height (D) is
not typical of abruption.
Question 2
The nurse performs medication reconciliation for a newly admitted client and notes
a prescription for daily antacids. What other prescription in the client's electronic
health record causes the nurse to call the health care provider?
A. Quinidine
B. Neomycin
C. Levofloxacin
D. Streptomycin
Answer: A
Rationale: Antacids can decrease the absorption of quinidine, leading to
subtherapeutic levels and potentially life-threatening arrhythmias. The nurse
should call the healthcare provider to discuss this interaction. Neomycin (B),
pg. 1
,levofloxacin (C), and streptomycin (D) may have interactions but are less
concerning with antacids than quinidine.
Question 3
A client with HIV and AIDS is placed on reverse isolation for neutropenia. Which
comment made by the client requires further discussion with the nurse?
A. "I will ask visitors to wear a mask when they enter my room."
B. "I understand I need to wash my hands frequently."
C. "Everyone is wearing a mask to keep from spreading my germs to others."
D. "I know that my white blood cell count is very low right now."
Answer: C
Rationale: The client stating "everyone is wearing a mask to keep from spreading
my germs to others" indicates a misunderstanding that reverse isolation is to
protect the client from others' germs, not to prevent the client from spreading their
own germs. This requires further education. Options A, B, and D demonstrate
correct understanding.
Question 4
An infant has a bilateral cleft lip repair two days ago. Which nursing intervention
should the nurse include in the client's plan of care?
A. Place the infant on their stomach for sleep
B. Feed the infant using a standard bottle and nipple
C. Remove the restraints periodically to cuddle the infant
D. Encourage the infant to suck on a pacifier vigorously
Answer: C
Rationale: After cleft lip repair, the infant should have restraints removed
periodically for cuddling and comfort, but the restraints should be reapplied to
prevent the infant from touching the surgical site. The infant should be placed on
their back (not stomach, A) to prevent pressure on the suture line. A special feeder
(not standard bottle, B) should be used. Sucking on a pacifier (D) should be
avoided to prevent stress on the suture line.
Question 5
A client is being induced due to increasing symptoms of preeclampsia. The client
is also receiving magnesium sulfate. It appears that her labor has not become active
pg. 2
,despite several hours of oxytocin administration. The client asks the nurse, "Why is
it taking so long?" Which response by the nurse is most appropriate?
A. "The magnesium relaxes your uterus and competes with the oxytocin. It may
increase the duration of your labor."
B. "Your body is not responding to the medications as expected."
C. "We may need to increase the oxytocin dose."
D. "This is a normal response to the magnesium sulfate."
Answer: A
Rationale: Magnesium sulfate acts as a tocolytic and can relax the uterus,
potentially prolonging labor by competing with oxytocin. The nurse should provide
an honest, factual explanation that addresses the client's concern. Options B, C, and
D do not provide adequate education or explanation.
Question 6
The charge nurse delegates care of clients on the unit. In what order should the
assigned nurse plan to see these clients? Place the client in the order they should be
seen by the nurse from first to last:
• Client who is 2 days post-op with stable vital signs
• Client experiencing chest pain with diaphoresis
• Client requesting discharge teaching
• Client with a new onset of confusion
Answer:
1. Client experiencing chest pain with diaphoresis (highest priority - possible
MI)
2. Client with a new onset of confusion (potential neurological change)
3. Client who is 2 days post-op with stable vital signs (routine care)
4. Client requesting discharge teaching (lowest priority)
Rationale: The nurse should use the ABCs and Maslow's hierarchy to
prioritize care. Chest pain with diaphoresis could indicate a life-threatening
cardiac event. New onset confusion could indicate a neurological change.
Stable post-op and discharge teaching can wait.
Question 7
A client with diabetes presents to the clinic. Their glycosylated hemoglobin is
9.4%. The client has difficulty adhering to the prescribed diet and asks for
pg. 3
, suggestions. Which dietary choices would be most appropriate for the nurse to
recommend? (Select all that apply)
A. Spaghetti with meatballs and parmesan cheese, steamed broccoli, raw carrots,
and a glass of water
B. Ham sandwich with a slice of cheese, a banana, and iced tea with low-calorie
sweetener
C. Grilled chicken salad with vinaigrette dressing and a whole wheat roll
D. Fried fish, french fries, and a regular soda
Answer: A, C
Rationale: Spaghetti with meatballs can be part of a balanced diet if portion-
controlled, and steamed broccoli and raw carrots are healthy vegetable choices.
Water is a calorie-free beverage. A grilled chicken salad is also a healthy choice.
Option B includes high-sodium ham and processed cheese. Option D includes fried
foods and regular soda, which are not recommended for diabetes management.
Question 8
A nurse monitors a gravida 2 para 1 client who experiences a sudden onset of acute
abdominal pain and frank vaginal bleeding. Which additional assessment findings
are most concerning to the nurse? (Select all that apply)
A. Blood oozing from IV site
B. Late decelerations
C. Change in fundal height over 1 hour
D. Maternal tachycardia
Answer: A, B, C
Rationale: Blood oozing from IV site suggests coagulopathy (DIC). Late
decelerations indicate fetal distress. Change in fundal height suggests concealed
hemorrhage. Maternal tachycardia (D) is concerning but is a later sign of
hypovolemia and less specific than the other findings.
Question 9
The charge nurse has delegated care of five clients to the night shift nurse who
starts the shift at 1900. Which client should the nurse see first?
A. Client with a fractured arm who is watching television
B. Client with stable angina who is requesting a PRN pain medication
C. Client with a history of hypertension who is sleeping soundly
pg. 4
