1|Page
CJE MED SURG 1 EXAM NEWEST 2026/ 2027 ACTUAL
EXAM TEST BANK| CJE MED-SURG 1 EXAM REVIEW
WITH COMPLETE 350 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
Exam coverage:
The CJE Med-Surg 1 Exam includes foundational medical-surgical nursing
concepts, clinical assessment, pathophysiology, pharmacology, and evidence-
based nursing interventions for adult patients experiencing acute and chronic
health conditions. It focuses on the nursing process, clinical judgment,
prioritization, patient safety, and individualized care planning. The exam also
evaluates the ability to recognize changes in patient condition, interpret clinical
findings, implement appropriate interventions, and collaborate effectively with
the healthcare team.
A client admitted with an acute exacerbation of heart failure has received
IV furosemide. Two hours later, the client reports muscle weakness and
palpitations. Assessment shows HR 118/min with occasional PVCs.
Laboratory results show potassium 2.9 mEq/L. Which action should the
nurse take first?
A. Administer the prescribed potassium replacement
B. Place the client on continuous cardiac monitoring
C. Encourage foods high in potassium
D. Reassess the potassium level in 4 hours - Correct Answer - B.
Severe hypokalemia combined with PVCs places the client at risk for
potentially life-threatening dysrhythmias. Continuous monitoring is the
immediate priority while potassium replacement is
prepared/administered.
pg. 1
,2|Page
A client with COPD receiving oxygen at 2 L/min by nasal cannula
becomes increasingly drowsy. Respirations decrease from 20/min to
10/min, and the client is difficult to arouse. Which finding is most
concerning?
A. Oxygen saturation of 91%
B. Diminished breath sounds
C. Respiratory rate of 10/min
D. Productive morning cough – Correct Answer - C. Respiratory rate of
10/min
The marked decrease in respiratory rate with altered mental status
suggests worsening ventilatory failure and possible CO₂ retention.
Airway and ventilation take priority.
A client with suspected sepsis has a temperature of 39.2°C (102.6°F),
HR 126/min, BP 84/48 mm Hg, and lactate of 4.8 mmol/L. Which
prescribed intervention should the nurse prioritize?
A. Obtain a daily weight
B. Begin the ordered IV fluid bolus
C. Restrict oral fluids
D. Place the client in Trendelenburg position - Correct Answer - B.
Begin the ordered IV fluid bolus
Hypotension, elevated lactate, tachycardia, and infection indicate septic
shock with impaired tissue perfusion. Rapid administration of prescribed
IV fluids is a priority intervention.
A client with acute pancreatitis has received 2 L of IV crystalloid. Four
hours later, the client remains tachycardic at 128/min. BP is 86/50 mm
Hg, urine output is 15 mL/hr, and hematocrit has increased from 42% to
51%. Which interpretation is most appropriate?
pg. 2
,3|Page
A. Fluid resuscitation has caused hemodilution
B. The client is developing worsening third-spacing and hypovolemia
C. The findings indicate resolution of pancreatitis
D. The client has developed fluid volume excess - Correct Answer - B.
The client is developing worsening third-spacing and hypovolemia
Severe pancreatitis causes capillary leak and third-spacing. Persistent
hypotension, oliguria, tachycardia, and rising hematocrit suggest
inadequate circulating volume despite substantial fluid administration.
Further hemodynamic evaluation and aggressive treatment are required.
During a change-of-shift assessment, the nurse finds a patient with
pneumonia who was previously alert now difficult to arouse. Vital signs
are: BP 86/48 mm Hg, HR 128/min, RR 30/min, temperature 39.4°C
(102.9°F), and SpO₂ 89% on 4 L/min oxygen. Urine output during the
last 2 hours is 10 mL/hr.
Which finding requires the most immediate intervention?
A. Temperature of 39.4°C
B. Urine output of 10 mL/hr
C. Blood pressure of 86/48 mm Hg
D. Oxygen saturation of 89% - Correct Answer - C. Blood pressure of
86/48 mm Hg
The combination of hypotension, altered mental status, tachycardia, and
oliguria suggests severe systemic hypoperfusion and possible septic
shock. Although hypoxemia also requires treatment, the profound
hypotension indicates immediate circulatory compromise.
The morning assessment reveals increasing abdominal distention, severe
diffuse abdominal pain, HR 122/min, temperature 38.9°C (102°F), and a
rigid abdomen in a patient who underwent bowel surgery yesterday.
pg. 3
, 4|Page
Which complication is most concerning?
A. Paralytic ileus
B. Surgical-site infection
C. Peritonitis from possible perforation
D. Expected postoperative discomfort - Correct Answer - C. Peritonitis
from possible perforation
A rigid abdomen, severe worsening pain, fever, and tachycardia suggest
peritoneal irritation and possible perforation. This is a surgical
emergency.
At 0900, the nurse compares today's neurologic assessment with
yesterday's findings. The patient who had a stroke yesterday now has a
new left facial droop, worsening aphasia, and decreased strength in the
left arm. What is the priority?
A. Document the expected progression
B. Give the scheduled antihypertensive
C. Activate the acute stroke evaluation process
D. Reassess after the next meal - Correct Answer - C. Activate the acute
stroke evaluation process
New focal neurologic deficits represent possible recurrent stroke,
extension of the existing stroke, or hemorrhagic transformation.
Immediate evaluation is required.
A medication reconciliation reveals that a patient taking warfarin has
recently started trimethoprim-sulfamethoxazole. Today the INR is 6.2,
and the patient reports dark stools.
Which finding is the greatest concern?
A. INR 6.2 with possible GI bleeding
pg. 4
CJE MED SURG 1 EXAM NEWEST 2026/ 2027 ACTUAL
EXAM TEST BANK| CJE MED-SURG 1 EXAM REVIEW
WITH COMPLETE 350 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
Exam coverage:
The CJE Med-Surg 1 Exam includes foundational medical-surgical nursing
concepts, clinical assessment, pathophysiology, pharmacology, and evidence-
based nursing interventions for adult patients experiencing acute and chronic
health conditions. It focuses on the nursing process, clinical judgment,
prioritization, patient safety, and individualized care planning. The exam also
evaluates the ability to recognize changes in patient condition, interpret clinical
findings, implement appropriate interventions, and collaborate effectively with
the healthcare team.
A client admitted with an acute exacerbation of heart failure has received
IV furosemide. Two hours later, the client reports muscle weakness and
palpitations. Assessment shows HR 118/min with occasional PVCs.
Laboratory results show potassium 2.9 mEq/L. Which action should the
nurse take first?
A. Administer the prescribed potassium replacement
B. Place the client on continuous cardiac monitoring
C. Encourage foods high in potassium
D. Reassess the potassium level in 4 hours - Correct Answer - B.
Severe hypokalemia combined with PVCs places the client at risk for
potentially life-threatening dysrhythmias. Continuous monitoring is the
immediate priority while potassium replacement is
prepared/administered.
pg. 1
,2|Page
A client with COPD receiving oxygen at 2 L/min by nasal cannula
becomes increasingly drowsy. Respirations decrease from 20/min to
10/min, and the client is difficult to arouse. Which finding is most
concerning?
A. Oxygen saturation of 91%
B. Diminished breath sounds
C. Respiratory rate of 10/min
D. Productive morning cough – Correct Answer - C. Respiratory rate of
10/min
The marked decrease in respiratory rate with altered mental status
suggests worsening ventilatory failure and possible CO₂ retention.
Airway and ventilation take priority.
A client with suspected sepsis has a temperature of 39.2°C (102.6°F),
HR 126/min, BP 84/48 mm Hg, and lactate of 4.8 mmol/L. Which
prescribed intervention should the nurse prioritize?
A. Obtain a daily weight
B. Begin the ordered IV fluid bolus
C. Restrict oral fluids
D. Place the client in Trendelenburg position - Correct Answer - B.
Begin the ordered IV fluid bolus
Hypotension, elevated lactate, tachycardia, and infection indicate septic
shock with impaired tissue perfusion. Rapid administration of prescribed
IV fluids is a priority intervention.
A client with acute pancreatitis has received 2 L of IV crystalloid. Four
hours later, the client remains tachycardic at 128/min. BP is 86/50 mm
Hg, urine output is 15 mL/hr, and hematocrit has increased from 42% to
51%. Which interpretation is most appropriate?
pg. 2
,3|Page
A. Fluid resuscitation has caused hemodilution
B. The client is developing worsening third-spacing and hypovolemia
C. The findings indicate resolution of pancreatitis
D. The client has developed fluid volume excess - Correct Answer - B.
The client is developing worsening third-spacing and hypovolemia
Severe pancreatitis causes capillary leak and third-spacing. Persistent
hypotension, oliguria, tachycardia, and rising hematocrit suggest
inadequate circulating volume despite substantial fluid administration.
Further hemodynamic evaluation and aggressive treatment are required.
During a change-of-shift assessment, the nurse finds a patient with
pneumonia who was previously alert now difficult to arouse. Vital signs
are: BP 86/48 mm Hg, HR 128/min, RR 30/min, temperature 39.4°C
(102.9°F), and SpO₂ 89% on 4 L/min oxygen. Urine output during the
last 2 hours is 10 mL/hr.
Which finding requires the most immediate intervention?
A. Temperature of 39.4°C
B. Urine output of 10 mL/hr
C. Blood pressure of 86/48 mm Hg
D. Oxygen saturation of 89% - Correct Answer - C. Blood pressure of
86/48 mm Hg
The combination of hypotension, altered mental status, tachycardia, and
oliguria suggests severe systemic hypoperfusion and possible septic
shock. Although hypoxemia also requires treatment, the profound
hypotension indicates immediate circulatory compromise.
The morning assessment reveals increasing abdominal distention, severe
diffuse abdominal pain, HR 122/min, temperature 38.9°C (102°F), and a
rigid abdomen in a patient who underwent bowel surgery yesterday.
pg. 3
, 4|Page
Which complication is most concerning?
A. Paralytic ileus
B. Surgical-site infection
C. Peritonitis from possible perforation
D. Expected postoperative discomfort - Correct Answer - C. Peritonitis
from possible perforation
A rigid abdomen, severe worsening pain, fever, and tachycardia suggest
peritoneal irritation and possible perforation. This is a surgical
emergency.
At 0900, the nurse compares today's neurologic assessment with
yesterday's findings. The patient who had a stroke yesterday now has a
new left facial droop, worsening aphasia, and decreased strength in the
left arm. What is the priority?
A. Document the expected progression
B. Give the scheduled antihypertensive
C. Activate the acute stroke evaluation process
D. Reassess after the next meal - Correct Answer - C. Activate the acute
stroke evaluation process
New focal neurologic deficits represent possible recurrent stroke,
extension of the existing stroke, or hemorrhagic transformation.
Immediate evaluation is required.
A medication reconciliation reveals that a patient taking warfarin has
recently started trimethoprim-sulfamethoxazole. Today the INR is 6.2,
and the patient reports dark stools.
Which finding is the greatest concern?
A. INR 6.2 with possible GI bleeding
pg. 4
