Download 2025-2026 CNL (CLINICAL NURSE LEADER)CERTIFICATION REVIEW|200Qs&As WITH RATIONALES|A+GRADE and more Exams Nursing in PDF only on Docsity!
2025 - 2026 CNL (CLINICAL NURSE LEADER)
CERTIFICATION REVIEW QUESTIONS AND
ANSWERS|ACTUAL 200Qs&As WITH
RATIONALES|NEW UPDATE|ALREADY GRADED A+
Patient satisfaction scores in emergency department have shown a downward trend over the past three quarters. As a clinical nurse leader in ED focus is to: A) Create a script for triage nurse in welcoming the patient B) Assign a volunteer to welcome patients to the hospital C) Compare desired outcomes with national & state standards D) Write a letter of apology to each dissatisfied patient C) Compare desired outcomes with national & State standards Rationale: Client care outcomes are a measure of quality practice. CNLs must know how to compare desired outcomes that will improve safety, effectiveness, timeliness, efficiency, quality, and the degree to which they are client centered. Which of the following actions illustrates the CNL professional value of altruism? A) Leading an interdisciplinary team looking at the remote cardiac monitoring process B) Sponsoring a meeting with the monitor technicians to understand their barriers in the cardiac monitoring process C) Flow mapping the admission process of the remote cardiac-monitored patient D) Editing the policy for the remote cardiac monitoring process.
B) Sponsoring a meeting with the monitor technicians to understand their barriers in the cardiac monitoring process Rationale: Altruism is a concern for the welfare & well-being of others. In professional practice, altruism is reflected by the CNL's concern for the welfare of clients, other nurses, and other health care providers. You are a CNL on the tele unit & orienting a newly graduated nurse. Critical thinking is best demonstrated when: A) The CNL discusses with the physician the rationale for discontinuing cardiac monitoring in the hospice patient B) Drawing the scheduled cardiac enzymes q8h Reviewing the patient care guidelines & protocols related to hourly rounding D) The CNL balances both the charge role & the preceptor role simultaneously A) The CNL discusses with the physician the rationale for discontinuing cardiac monitoring in the hospice patient Rationale: Critical thinking underlies independent & interdependent decision making. Critical thinking includes questioning, analysis, synthesis, interpretation, inference, inductive & deductive reasoning, intuition, application, & creativity. You are a CNL selected to lead a team focused on implementing a multidisciplinary clinical pathway for acute ischemic stroke & transient ischemic attack. The risk assessment tool that you have adopted identifies all of the following as independent stroke risk factors except: A) Age B) Systolic BP
You are working on improving the patient discharge process. Which of these targets would best reflect clinical microsystem outcomes? A) Hospital length of stay B) Time of discharge order for all medical patients to the actual time the patient left C) Number of discharge orders on your unit entered before 11am D) Total number of discharged patients leaving by llam C) Number of discharge orders on your unit entered before 11am Rationale: A CNL as an outcomes manager uses data to change practice & to improve outcomes. Selecting the most appropriate goals & targets will provide meaningful information. Electronic nursing documentation has recently been instituted in organization. Select a response that best defines a clinical decision support: A) A reminder to save & sign your admission assessment B) A visual red-alert when a patient's potassium is 6..8 mEq/L C) A pop-up to initiate the discharge instruction sheet with every physician discharge order D) An electronic nursing care plan C) A pop-up to initiate the discharge instruction sheet with every physician discharge order. Rationale: CDS is a computer-based program designed to assist clinicians in making clinical decisions by filtering & integrating vast amounts of information & providing suggestions for clinical intervention.
CNL focus on projects within a clinical microsystem. A clinical microsystem can be best described as: A) A department-wide program focused on improving continuity of care & patient satisfaction B) Trending the post-op care on all surgical units C) The clinical & business processes of a single unit within an organization D) All medical & surgical units guided by a chief nursing officer C) The clinical & business processes of a single unit within an organization Rationale: The microsystem is described by the AACN White Paper as the practice level of the CNL. All are part of the data necessary for a CNL to fully understand & assess his or her clinical unit except: A) The organization financial statement B) The target population & age distribution C) The percentage of FTEs D) Rate of nosocomial infections E) Fall rates A) The organization financial statement Rationale: A comprehensive assessment of the clinical unit is a foundation for the work of the CNL but does not include the financial statement of the organization. In comprehending the "big picture" of the organization, the CNL should have an understanding of the financial health of the institution.
strong correlation between patient falls & delirium. Exercise programs focused on strength, functional performance, & balance training are effective steps in reducing inpatient falls. As a CNL in the ICU, you have observed several prolonged & fragmented processes of starting an IV line in a critically ill patient. All of the following considerations are necessary in identifying a THEME for your improvement process except: A) A thorough review of the clinical unit B) The manager's mandate for change C) The alignment with the organization's strategic priorities D) Input from the patient's family B) The manager's mandate for change Rationale: Specific mandates for change would be considered as the team "drills down" for further information. The hospital is looking to utilize cardiac monitor watchers. Your analysis includes all of the following except: A) A review of an online ECG monitoring education program B) Identifying a clinical issue with a focus on a specific population C) Conducting a trend analysis of outcome data D) Analyzing barriers & facilitators with the organization A) A review of an online ECG monitoring education program Rationale: Systems analysis & risk anticipation are the competencies of the CNL.
Several near misses were identified by ICU nurses who had mistaken invasive lines for IV ports for medication administration. You have completed an analysis for the issue. Your recommendations include: A) A visual signal on all ports not intended for IV drugs B) A double-check system for medication administration C) To facilitate a critical incident reporting structure that fosters a "without blame) unit culture D) All of the Above E) Only C D) All of the above Rationale: The CNL should support the staff to identify all opportunities for improving safety in this situation. Data reported by ICU quality committee reflect challenges in the management of the septic patient. As a CNL in the ICU, all of the following are first steps in evaluating the delivery of client care except: A) Knowledge of sepsis guidelines B) Critical care clinicians staffing ratios C) Use of clinical decision support systems D) Differentiating sepsis from systemic inflammatory response syndrome (SIRS) D) Differentiating sepsis from systemic inflammatory response syndrome (SIRS) Rationale: Nursing leadership & advocacy reviews & evaluates care guidelines & protocols
Your colleagues have identified challenges in the process of inserting an IV line. To gain a better understanding of what this process entails, you: A) Directly observe the IV line insertion process & time each step of the process B) Create a workflow diagram tracing the path of the nurse during the line insertion process C) Engage the IV team to reeducate the nurses D) All of the Above E) A & B E) A & B Rationale: Proper assessment of a clinical situation can expose issues of policy, compliance, or the need for education. The result of a workflow diagram of a clinician illustrates an excessive amount of walking to obtain supplies. Reducing the waste of motion adds value-added time that ultimately benefits: A) The patient B) The clinician C) Documentation D) None of the above A) The patient Rationale: Process improvement enhances patient safety & nursing time at bedside for the patient & family
Your team is looking at the delays in the discharge process. Your cause & effect diagram includes: A) A run chart B) A Gannt chart C) A fishbone diagram D) A high-level flowchart C) A fishbone diagram Rationale: A fishbone diagram is a useful tool to identify themes of clinical issues. Categories such as equipment, personnel, communication, & so on can be identified. You are leading a palliative care team in the ICU. Ethical competence is best defined as: A) The ability to recognize potential & actual ethical issues arising from the clinical practice B) The collaboration with a multicultural workforce C) The understanding of the physical, emotional, & spiritual health parameters of the ICU patient D) The skill set to define, design, & implement culturally competent health care providers. A) The ability to recognize potential & actual ethical issues arising from clinical practice Rationale: The CNL's role in ethics is highlighted in AACN's White Paper
Sustaining process improvement requires the use of appropriate learning principles & strategies. The CNL function that best utilizes this competency is: A) Advocate B) Educator C) Clinician D) Information manager B) Educator Rational: CNL competencies are described in the AACN White Paper How can the CNL make the greatest impact on the health care organization? A) By representing the microsystem B) By representing the mesosystem C) By representing the patient and family D) By representing the nursing profession A) By representing the microsystem Rationale: The CNL functions as the change agent at the microsystem level, engaging frontline staff in best practices to better patient outcomes. By leading which unit initiative can the CNL directly impact the financial health of the entire institution? A) Reducing readmissions B) Recruitment of new nursing staff
C) Improving documentation compliance D) Encouraging staff to report safety events and near misses A) Reducing readmissions Rationale: Medicare reimbursement rates include a penalty to those health care institutions with 30-day readmission rates that are higher than national benchmamrks. The concept that an organization is in a continued state of change describes which organizational theory: A) systems theory B) Classic theory C) Contingency theory D) Chaos theory D) Chaos theory Rationale: The chaos theory is based on the principle that a system can maintain itself only if change is occurring somewhere in the organization all the time. Chaos & change are seen as means of survival. The new hospital CNO works hard to cultivate a shared vision of leaders & followers motivating each other toward their highest potential. This is an example of which type of leadership? A) Transformational leadership B) Transactional leadership C) Situational leadership
D) Remind the patient why he is in the hospital & remove the food B) Provide education to the patient & family about consuming a heart-healthy diet Rationale: You are in the room currently & can provide real-time education to the patient & family. It is an opportunity to educate the patient/family on how to make heart-healthy choices. As a follow-up you should place a consult for the nutritionist to follow-up. As the CNL on a Cardiothoracic step-down unit, what is the one recommendation you would make to decrease the chance of readmission of your patient population? A) Visiting nursing for all patients B) All follow-up appointments scheduled prior to patient discharge C) Pharmacy to visit with each patient prior to discharge home to review medications D) All patients should be enrolled in a cardiac rehab program D) All patients should be enrolled in a cardiac rehab program Rationale: All patients should be enrolled in a cardiac rehab program to assist the patient with making permanent lifestyle changes required to improve their health, well-being, & success after their illness. Because these programs provide ongoing support, teaching & monitoring of health, it is the best choice. You know teaching was effective to a cardiac patient & his wife with the following statement: A) "I can still have a burger & fries on to two times a week"
B) "It is okay for my wife to bring in a pizza while I'm here; after all the hospital food is not that good" C) "I should limit my salt intake & increase fiber in my diet" D) "If my husband wants fried shrimp, it's okay because it's seafood" C) "I should limit my salt intake & increase fiber in my diet" Rationale: Cardiac patients should be on a sodium-restricted diet. Fried foods & high-fat foods should be very limited & /or excluded from the diet. You are the CNL on a geriatric unit. When walking down the hall, you notice a high-risk fall patient attempting to get out of bed alone. After assisting the patient & ensuring safety, what should you do? A) Report the incident to nursing management B) Identify the patient's nurse & nursing assistant & confront them with the incident C) Develop a new fall prevention policy & post it in the unit conference room for all staff to view D) Obtain the fall statistics & present them at the next unit staff meeting & develop a team to look at revising a fall prevention committee D) Obtain the fall statistics & present them at the next unit staff meeting & develop a team to look at revising a fall prevention committee Rationale: Using objective data to determine the trends on the unit will allow the CNL to determine a baseline fall rate for the unit. Starting a fall prevention committee will empower frontline staff to determine with evidence-based research which implementation will best meet the needs of the patient population & the staff.
C) When explaining the self meal order program to patients, instruct patients to notify staff when they order meals D) Have the meal service notify the unit secretary when meal orders are placed by patients A) Develop an interdisciplinary team, including unit staff, nutritionist, diabetic educator, & meal service team members to investigate the self meal order program. Rationale: Having an interdisciplinary team look at the entire process of the self meal order program will provide the team with innovative solutions to the problem. After completing unit audits, you have noticed the nurses are not completing AIR cycles documentation with pain management (AIR: assessment, intervention, reassessment). What should be done to improve documentation?: A) Tell the unit management which staff are documenting inappropriately B) Reeducate staff on the hospital documentation policy C) Remind staff of pain documentation during staff meetings & charge report D) Provide staff with a self-audit sheet as a way to review their own documentation during their shifts. D) Provide staff with a self-audit sheet as a way to review their own documentation during their shifts. Rationale: Giving staff a checklist will assist them in staying organized during their busy day. This will provide them a way to double check all their documentation before ending a shift. It also empowers staff to take ownership of their work.
You are listening to report with a novice nurse. As part of mentoring new staff & supporting clinical decision making, you ask the new nurse which patient she would like to assess first. Which patient should this nurse assess first? A) 46yo receiving IV antibiotics therapy B) 60yo s/p liver biopsy C) 56yo with pneumonia D) 72yo hip replacement impatiently waiting for discharge B) 60yo s/p liver biopsy Rationale: Post-op liver biopsy patients have an increased risk of bleeding & need close monitoring after the procedure. The question does not indicate how recently the biopsy was done & therefore this is the best choice based on the information provided. To help patients maintain healthy skin while in the hospital, all of the following should be considered except: A) Provide patient with Q2h positioning/turning if patient is unable to self- position B) Ensure adequate protein intake C) Use bed surfaces known to prevent skin complications D) Allow patient to refuse bathing for days if uninterested, as the pt has the right to refuse care D) Allow patients to refuse bathing for days if uninterested, as the patient has the right to refuse care Rationale: While the patient does have the right to refuse care, a patient who would disengage with personal grooming for multiple days should draw the
