Adult Health CJE Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Question 1
A 68-year-old patient with heart failure is admitted with worsening dyspnea, orthopnea,
and bilateral crackles to the mid-lung fields. Vital signs: BP 162/94, HR 112, RR 28, SpO2
88% on room air. Which is the nurse's priority action?
A. Administer furosemide 40 mg IV as ordered
B. Apply supplemental oxygen and place the patient in high Fowler's position
C. Obtain a 12-lead ECG
D. Insert a Foley catheter to monitor output
Correct Answer: B
Rationale: Using the ABC framework, this patient has compromised oxygenation (SpO2
88%, RR 28, crackles). High Fowler's position reduces venous return and improves
ventilation; oxygen addresses hypoxemia. Distractor A is important but follows
airway/breathing stabilization. Distractor C is not the immediate priority. Distractor D is
not urgent.
Question 2
A 72-year-old patient with a history of atrial fibrillation is receiving warfarin. The INR is
5.2 (therapeutic range 2.0–3.0). The patient reports dark tarry stools and gum bleeding.
Which is the nurse's priority action?
,A. Hold the next warfarin dose and notify the provider immediately
B. Administer the scheduled warfarin dose because the patient needs anticoagulation
C. Encourage the patient to eat more green leafy vegetables
D. Apply pressure to the gums and reassess in 2 hours
Correct Answer: A
Rationale: INR >5.0 with bleeding manifestations indicates supratherapeutic
anticoagulation requiring immediate provider notification and dose hold. Distractor B
risks hemorrhage. Distractor C is inappropriate for acute bleeding. Distractor D delays
critical intervention.
Question 3
A patient with COPD presents with increased dyspnea, productive cough with thick
green sputum, and a temperature of 101.8°F (38.8°C). ABG results: pH 7.32, PaCO2 58
mmHg, PaO2 62 mmHg, HCO3 30 mEq/L. Which acid-base disorder is present?
A. Respiratory acidosis with metabolic compensation
B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: A
Rationale: pH <7.35 indicates acidosis; elevated PaCO2 (58) indicates respiratory cause;
elevated HCO3 (30) indicates metabolic compensation. Distractor B reverses the
primary and compensatory mechanisms. Distractors C and D describe alkalotic states.
,Question 4
A 55-year-old patient with type 2 diabetes mellitus is admitted with a blood glucose of
42 mg/dL. The patient is confused, diaphoretic, and tremulous. Which is the nurse's first
action?
A. Administer 1 mg glucagon IM
B. Give 15–20 g fast-acting carbohydrate (glucose tablets, juice) if the patient can
swallow safely
C. Start D10 IV infusion at 125 mL/hr
D. Recheck the blood glucose in 15 minutes
Correct Answer: B
Rationale: For conscious hypoglycemia, the 15-15 rule applies: 15 g fast-acting
carbohydrate, recheck in 15 minutes. Distractor A is for unconscious or NPO patients.
Distractor C is excessive for mild-moderate hypoglycemia. Distractor D delays
treatment.
Question 5
A patient with a history of peptic ulcer disease presents with sudden, severe upper
abdominal pain radiating to the shoulder, rigid abdomen, and absent bowel sounds. Vital
signs: BP 88/52, HR 128, RR 24. Which condition should the nurse suspect?
A. Gastric outlet obstruction
B. Perforated peptic ulcer with peritonitis and hypovolemic shock
C. Acute pancreatitis
, D. Gastroesophageal reflux disease exacerbation
Correct Answer: B
Rationale: Rigid abdomen, absent bowel sounds, hypotension, and tachycardia indicate
peritonitis and shock from perforation. Distractor A presents with vomiting and
distension, not rigidity. Distractor C typically presents with epigastric pain and elevated
amylase/lipase. Distractor D does not cause peritonitis or shock.
Question 6
A patient with chronic kidney disease stage 4 has a serum potassium of 6.8 mEq/L. The
ECG shows peaked T waves and widened QRS complexes. Which is the priority
intervention?
A. Administer oral kayexalate 15 g
B. Administer calcium gluconate 1 g IV to stabilize cardiac membranes
C. Prepare the patient for emergent hemodialysis immediately
D. Administer regular insulin 10 units subcutaneously
Correct Answer: B
Rationale: ECG changes indicate cardiotoxicity from hyperkalemia; calcium gluconate is
the immediate cardiac stabilizer. Distractor A is too slow for acute cardiotoxicity.
Distractor C is definitive but not the immediate priority. Distractor D (with glucose) shifts
potassium intracellularly but does not protect the heart immediately.
Question 7
Questions with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Question 1
A 68-year-old patient with heart failure is admitted with worsening dyspnea, orthopnea,
and bilateral crackles to the mid-lung fields. Vital signs: BP 162/94, HR 112, RR 28, SpO2
88% on room air. Which is the nurse's priority action?
A. Administer furosemide 40 mg IV as ordered
B. Apply supplemental oxygen and place the patient in high Fowler's position
C. Obtain a 12-lead ECG
D. Insert a Foley catheter to monitor output
Correct Answer: B
Rationale: Using the ABC framework, this patient has compromised oxygenation (SpO2
88%, RR 28, crackles). High Fowler's position reduces venous return and improves
ventilation; oxygen addresses hypoxemia. Distractor A is important but follows
airway/breathing stabilization. Distractor C is not the immediate priority. Distractor D is
not urgent.
Question 2
A 72-year-old patient with a history of atrial fibrillation is receiving warfarin. The INR is
5.2 (therapeutic range 2.0–3.0). The patient reports dark tarry stools and gum bleeding.
Which is the nurse's priority action?
,A. Hold the next warfarin dose and notify the provider immediately
B. Administer the scheduled warfarin dose because the patient needs anticoagulation
C. Encourage the patient to eat more green leafy vegetables
D. Apply pressure to the gums and reassess in 2 hours
Correct Answer: A
Rationale: INR >5.0 with bleeding manifestations indicates supratherapeutic
anticoagulation requiring immediate provider notification and dose hold. Distractor B
risks hemorrhage. Distractor C is inappropriate for acute bleeding. Distractor D delays
critical intervention.
Question 3
A patient with COPD presents with increased dyspnea, productive cough with thick
green sputum, and a temperature of 101.8°F (38.8°C). ABG results: pH 7.32, PaCO2 58
mmHg, PaO2 62 mmHg, HCO3 30 mEq/L. Which acid-base disorder is present?
A. Respiratory acidosis with metabolic compensation
B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: A
Rationale: pH <7.35 indicates acidosis; elevated PaCO2 (58) indicates respiratory cause;
elevated HCO3 (30) indicates metabolic compensation. Distractor B reverses the
primary and compensatory mechanisms. Distractors C and D describe alkalotic states.
,Question 4
A 55-year-old patient with type 2 diabetes mellitus is admitted with a blood glucose of
42 mg/dL. The patient is confused, diaphoretic, and tremulous. Which is the nurse's first
action?
A. Administer 1 mg glucagon IM
B. Give 15–20 g fast-acting carbohydrate (glucose tablets, juice) if the patient can
swallow safely
C. Start D10 IV infusion at 125 mL/hr
D. Recheck the blood glucose in 15 minutes
Correct Answer: B
Rationale: For conscious hypoglycemia, the 15-15 rule applies: 15 g fast-acting
carbohydrate, recheck in 15 minutes. Distractor A is for unconscious or NPO patients.
Distractor C is excessive for mild-moderate hypoglycemia. Distractor D delays
treatment.
Question 5
A patient with a history of peptic ulcer disease presents with sudden, severe upper
abdominal pain radiating to the shoulder, rigid abdomen, and absent bowel sounds. Vital
signs: BP 88/52, HR 128, RR 24. Which condition should the nurse suspect?
A. Gastric outlet obstruction
B. Perforated peptic ulcer with peritonitis and hypovolemic shock
C. Acute pancreatitis
, D. Gastroesophageal reflux disease exacerbation
Correct Answer: B
Rationale: Rigid abdomen, absent bowel sounds, hypotension, and tachycardia indicate
peritonitis and shock from perforation. Distractor A presents with vomiting and
distension, not rigidity. Distractor C typically presents with epigastric pain and elevated
amylase/lipase. Distractor D does not cause peritonitis or shock.
Question 6
A patient with chronic kidney disease stage 4 has a serum potassium of 6.8 mEq/L. The
ECG shows peaked T waves and widened QRS complexes. Which is the priority
intervention?
A. Administer oral kayexalate 15 g
B. Administer calcium gluconate 1 g IV to stabilize cardiac membranes
C. Prepare the patient for emergent hemodialysis immediately
D. Administer regular insulin 10 units subcutaneously
Correct Answer: B
Rationale: ECG changes indicate cardiotoxicity from hyperkalemia; calcium gluconate is
the immediate cardiac stabilizer. Distractor A is too slow for acute cardiotoxicity.
Distractor C is definitive but not the immediate priority. Distractor D (with glucose) shifts
potassium intracellularly but does not protect the heart immediately.
Question 7
