CJE FUNDAMENTALS BENCHMARK EXAM 2 EXAM ACTUAL 2026/2027
TEST BANK HIGH YIELD PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. A nurse is caring for an older adult client who becomes dizzy when standing
after several days of limited oral intake. The client's blood pressure
decreases from 128/76 mmHg while lying down to 104/64 mmHg after
standing, and the client reports feeling faint. Which nursing action is the
priority?
A. Encourage the client to ambulate independently to improve tolerance
B. Assist the client back to a safe sitting or lying position and reassess vital
signs
C. Restrict oral fluids until the cause of the hypotension is identified
D. Document the finding as an expected age-related change
Answer: B
2. A hospitalized client who has been receiving opioid analgesics after
abdominal surgery is difficult to awaken and has a respiratory rate of 8/min
with shallow respirations. The oxygen saturation is 88% on room air. Which
action should the nurse take first?
A. Administer the prescribed opioid analgesic
B. Place the client flat and allow the client to sleep
C. Stimulate the client, support the airway, and immediately initiate
appropriate emergency assessment
D. Document the respiratory rate as an expected effect of pain medication
Answer: C
3. A nurse is preparing to administer medications to a client whose
identification bracelet is partially covered by a blanket. The client states a
name that is similar to the name on the medication administration record.
Which action is safest?
A. Use two approved identifiers before administering the medication
B. Ask the roommate to verify the client's identity
1
, C. Administer the medication because the room number matches the
record
D. Ask the client whether the medication looks familiar
Answer: A
4. A nurse is caring for a client who has been prescribed a medication with a
documented history of severe allergy to that medication. The electronic
medication record displays an allergy alert immediately before
administration. What should the nurse do?
A. Administer half the dose and monitor for a reaction
B. Ask another nurse to administer the medication
C. Give the medication with food to decrease the risk of allergy
D. Hold the medication and clarify the prescription with the appropriate
prescriber
Answer: D
5. A nurse is educating a client about preventing transmission of
microorganisms while hospitalized. The client asks why hand hygiene is
required even when the nurse plans to wear gloves. Which response is most
appropriate?
A. Gloves completely eliminate the need for hand hygiene
B. Hand hygiene is necessary before and after appropriate patient-care
activities because gloves can become contaminated
C. Hand hygiene is required only after removing visibly soiled gloves
D. Hand hygiene is necessary only when caring for clients with known
infections
Answer: B
6. A nurse enters the room of a client who is receiving contact precautions for
a multidrug-resistant organism. Before providing direct care that may
involve contact with the client or contaminated environmental surfaces,
which PPE is generally appropriate?
A. Gloves and gown
2
, B. N95 respirator only
C. Surgical mask only
D. Sterile gloves without a gown
Answer: A
7. A client with suspected pulmonary tuberculosis requires airborne
precautions. Which nursing intervention is most appropriate?
A. Place the client in a positive-pressure room
B. Use only a surgical mask for all staff entering the room
C. Place the client in an appropriate airborne infection isolation room and
use a fit-tested respirator as indicated
D. Keep the client's door open to improve room ventilation
Answer: C
8. A nurse is caring for a client with a draining wound who is on transmission-
based precautions. The nurse accidentally touches the contaminated
dressing with gloved hands and then needs to adjust the client's clean
intravenous tubing. What should the nurse do?
A. Continue because the gloves are still intact
B. Wipe the gloves with alcohol and continue
C. Change only the gown before touching the tubing
D. Perform appropriate hand hygiene and use clean gloves before handling
the clean equipment
Answer: D
9. A client who has limited mobility is at increased risk for pressure injury.
Which intervention is most appropriate for reducing the client's risk?
A. Reposition the client regularly and assess skin and pressure points
B. Massage reddened bony prominences vigorously
C. Keep the head of the bed elevated as high as possible continuously
D. Place a heating pad over areas of redness
Answer: A
3
, 10. A nurse assesses a bedridden client and finds intact skin over the sacrum
that is persistently red and does not blanch with pressure. Which
interpretation is most appropriate?
A. The finding represents normal skin pigmentation
B. The finding is consistent with a stage 1 pressure injury
C. The finding confirms a stage 3 pressure injury
D. The finding indicates a full-thickness wound with exposed bone
Answer: B
11. A nurse is assisting a client from bed to a wheelchair. The client has
weakness on the right side and requires substantial assistance. Which
action best promotes safety during the transfer?
A. Position the wheelchair several feet away so the client can walk toward it
B. Keep the wheelchair unlocked so it can move with the client
C. Lock the wheelchair, use appropriate transfer equipment, and support
the client's weaker side
D. Ask the client to pull on the nurse's neck during the transfer
Answer: C
12. A nurse is teaching a client how to use a cane after a lower-extremity injury.
Which instruction is generally appropriate for safe cane use?
A. Hold the cane on the stronger side unless specifically instructed
otherwise
B. Place the cane behind the body while stepping forward
C. Keep the cane several feet away from the body during ambulation
D. Advance the injured leg first while leaving the cane stationary
Answer: A
13. A nurse is caring for a client who has been prescribed bed rest and notices
that the client has been lying in the same position for several hours. Which
complication is the nurse most concerned about preventing through regular
repositioning and mobility as permitted?
A. Increased visual acuity
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TEST BANK HIGH YIELD PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. A nurse is caring for an older adult client who becomes dizzy when standing
after several days of limited oral intake. The client's blood pressure
decreases from 128/76 mmHg while lying down to 104/64 mmHg after
standing, and the client reports feeling faint. Which nursing action is the
priority?
A. Encourage the client to ambulate independently to improve tolerance
B. Assist the client back to a safe sitting or lying position and reassess vital
signs
C. Restrict oral fluids until the cause of the hypotension is identified
D. Document the finding as an expected age-related change
Answer: B
2. A hospitalized client who has been receiving opioid analgesics after
abdominal surgery is difficult to awaken and has a respiratory rate of 8/min
with shallow respirations. The oxygen saturation is 88% on room air. Which
action should the nurse take first?
A. Administer the prescribed opioid analgesic
B. Place the client flat and allow the client to sleep
C. Stimulate the client, support the airway, and immediately initiate
appropriate emergency assessment
D. Document the respiratory rate as an expected effect of pain medication
Answer: C
3. A nurse is preparing to administer medications to a client whose
identification bracelet is partially covered by a blanket. The client states a
name that is similar to the name on the medication administration record.
Which action is safest?
A. Use two approved identifiers before administering the medication
B. Ask the roommate to verify the client's identity
1
, C. Administer the medication because the room number matches the
record
D. Ask the client whether the medication looks familiar
Answer: A
4. A nurse is caring for a client who has been prescribed a medication with a
documented history of severe allergy to that medication. The electronic
medication record displays an allergy alert immediately before
administration. What should the nurse do?
A. Administer half the dose and monitor for a reaction
B. Ask another nurse to administer the medication
C. Give the medication with food to decrease the risk of allergy
D. Hold the medication and clarify the prescription with the appropriate
prescriber
Answer: D
5. A nurse is educating a client about preventing transmission of
microorganisms while hospitalized. The client asks why hand hygiene is
required even when the nurse plans to wear gloves. Which response is most
appropriate?
A. Gloves completely eliminate the need for hand hygiene
B. Hand hygiene is necessary before and after appropriate patient-care
activities because gloves can become contaminated
C. Hand hygiene is required only after removing visibly soiled gloves
D. Hand hygiene is necessary only when caring for clients with known
infections
Answer: B
6. A nurse enters the room of a client who is receiving contact precautions for
a multidrug-resistant organism. Before providing direct care that may
involve contact with the client or contaminated environmental surfaces,
which PPE is generally appropriate?
A. Gloves and gown
2
, B. N95 respirator only
C. Surgical mask only
D. Sterile gloves without a gown
Answer: A
7. A client with suspected pulmonary tuberculosis requires airborne
precautions. Which nursing intervention is most appropriate?
A. Place the client in a positive-pressure room
B. Use only a surgical mask for all staff entering the room
C. Place the client in an appropriate airborne infection isolation room and
use a fit-tested respirator as indicated
D. Keep the client's door open to improve room ventilation
Answer: C
8. A nurse is caring for a client with a draining wound who is on transmission-
based precautions. The nurse accidentally touches the contaminated
dressing with gloved hands and then needs to adjust the client's clean
intravenous tubing. What should the nurse do?
A. Continue because the gloves are still intact
B. Wipe the gloves with alcohol and continue
C. Change only the gown before touching the tubing
D. Perform appropriate hand hygiene and use clean gloves before handling
the clean equipment
Answer: D
9. A client who has limited mobility is at increased risk for pressure injury.
Which intervention is most appropriate for reducing the client's risk?
A. Reposition the client regularly and assess skin and pressure points
B. Massage reddened bony prominences vigorously
C. Keep the head of the bed elevated as high as possible continuously
D. Place a heating pad over areas of redness
Answer: A
3
, 10. A nurse assesses a bedridden client and finds intact skin over the sacrum
that is persistently red and does not blanch with pressure. Which
interpretation is most appropriate?
A. The finding represents normal skin pigmentation
B. The finding is consistent with a stage 1 pressure injury
C. The finding confirms a stage 3 pressure injury
D. The finding indicates a full-thickness wound with exposed bone
Answer: B
11. A nurse is assisting a client from bed to a wheelchair. The client has
weakness on the right side and requires substantial assistance. Which
action best promotes safety during the transfer?
A. Position the wheelchair several feet away so the client can walk toward it
B. Keep the wheelchair unlocked so it can move with the client
C. Lock the wheelchair, use appropriate transfer equipment, and support
the client's weaker side
D. Ask the client to pull on the nurse's neck during the transfer
Answer: C
12. A nurse is teaching a client how to use a cane after a lower-extremity injury.
Which instruction is generally appropriate for safe cane use?
A. Hold the cane on the stronger side unless specifically instructed
otherwise
B. Place the cane behind the body while stepping forward
C. Keep the cane several feet away from the body during ambulation
D. Advance the injured leg first while leaving the cane stationary
Answer: A
13. A nurse is caring for a client who has been prescribed bed rest and notices
that the client has been lying in the same position for several hours. Which
complication is the nurse most concerned about preventing through regular
repositioning and mobility as permitted?
A. Increased visual acuity
4
