CNL Practice Questions Exam Questions and
Correct Answers
1. A new graduate nurse, Jenny, approaches you and states she needs help removing a
peripherally inserted central catheter (PICC). Which of the following is the best response
when acting as a horizontal leader?
A. Remove the PICC yourself
B. Tell Jenny to find the policy and then remove the PICC
C. Help Jenny find the policy and review it with her. Coach Jenny while she removes the
PICC and provide feedback
D. Help Jenny find the policy and refer her to a nurse with 12 years of experience for
assistance
Answer C—Rationale: The clinical nurse leader (CNL) acts as a horizontal leader by helping the
new graduate nurse to learn through sharing knowledge and coaching, rather than doing the task
for the nurse.
2. What organizational theory is used with rapid, unpredictable, and constant change?
A. Systems theory
B. Chaos theory
C. Change theory
D. Traditional theory
,Answer B—Rationale: Chaos theory is used to understand rapidly changing, unpredictable health
care environments.
3. A 65-year-old African American male was admitted to your microsystem with
hyperglycemia. The patient has a history of hypertension, gout, obesity, and smoking. The
patient has a family history of diabetes and hypertension. Which statement by the patient
demonstrates his understanding of modifiable risk factors for diabetes?
A. "As I get older, my risk for diabetes increases."
B. "I know that a family history of diabetes is a risk factor, so I will educate my children on
diabetes prevention."
C. "I will keep a record of all my blood sugars to take to my doctor's appointments."
D. "I will attend a smoking cessation class, because I know smoking increases my risk for
diabetes."
Answer D—Rationale: Modifiable risk factors are lifestyle factors that a person can alter in order
to prevent disease. Smoking cessation class is an intervention for modifying the risk factor of
smoking.
4. Your hospital is currently trialing the integration of the clinical nurse leader (CNL) role.
At the', 'end of the trial implementation period how can you, as the CNL, best illustrate the
effectiveness of your role during this trial?
A. Refer to increased patient satisfaction scores over the course of the trial
B. Present data that demonstrates the effect of the CNL and outcomes achieved over the
course of the trial
,C. Present a list of projects and tasks completed over the course of the trial
D. Refer to your performance review over the course of the trial
Answer B—Rationale: The CNL should present the effect and outcomes to illustrate the
importance of the integration of his or her role. Increased patient satisfaction is not necessarily
directly related to the CNL. Presentation of projects and tasks completed does not address
measurable outcomes. Performance review of the individual does not indicate outcomes were
affected.
5. You are a CNL on an oncology unit. Recently, there has been an increase in the number
of catheter- associated urinary tract infections (CAUTIs) on your unit. After shadowing
nurses and aides you observed a variety of practices, techniques, and expectations
surrounding daily catheter care. Your hospital does not have a current policy or procedure
regarding catheter care. As the CNL, what should you do next?
A. Review current evidence for catheter care practice and disseminate evidence to the staff
B. Form an interdisciplinary team meeting to evaluate current hospital catheter care
policies
C. Create a rubric for educating patients and staff on catheter care
D. Discuss with the unit manager the clinical issue and create a set of evidence-based unit
expectations and practices for the oncology unit. Evaluate the need to address this issue
with a hospital-wide policy or procedure
Answer D—Rationale: CNLs should gather and disseminate evidence to solve clinical problems;
however, that should not be the initial step. Further review of hospital practices and policies may
come after this issue is addressed. Creation of a rubric for educating patients and staff on catheter
, care may come after reviewing evidence. The CNL should act to solve the clinical issue in the
short term, and evaluate the need for a larger policy to address gaps in practice hospital-wide.
6. A 50-year-old woman with a history of stage 3 chronic obstructive pulmonary disease
(COPD) presents to the emergency department (ED) with increased shortness of breath.
Based on your lab results, what is the acid-base disorder?
Labs as follows: pH 7.25 PaCO2 50 mmHg HCO3 22 mEq/L PO2 75 SpO2 88% Na + 136
BUN 18
A. Uncompensated respiratory acidosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Uncompensated respiratory acidosis
Answer A—Rationale: Based on the clinical scenario, the pH is decreased (less than 7.35);
therefore, the patient has acidosis. The PaCO2 is elevated (more than 45 mmHg), which is also
consistent with the pH.', 'The HCO3 is within normal limits, which suggests the kidneys are not
compensating. COPD is commonly associated with respiratory acidosis.
7. A CNL evaluates a 17-year-old patient who has been a victim of rape. The patient has
visible bruising and a head laceration. After the CNL's assessment, law enforcement
officials have contacted the CNL requesting information regarding the attack and the
visible injuries seen during the visit. The CNL knows she must first:
A. Take pictures and complete the rape kit
B. Provide law enforcement with a record as requested
Correct Answers
1. A new graduate nurse, Jenny, approaches you and states she needs help removing a
peripherally inserted central catheter (PICC). Which of the following is the best response
when acting as a horizontal leader?
A. Remove the PICC yourself
B. Tell Jenny to find the policy and then remove the PICC
C. Help Jenny find the policy and review it with her. Coach Jenny while she removes the
PICC and provide feedback
D. Help Jenny find the policy and refer her to a nurse with 12 years of experience for
assistance
Answer C—Rationale: The clinical nurse leader (CNL) acts as a horizontal leader by helping the
new graduate nurse to learn through sharing knowledge and coaching, rather than doing the task
for the nurse.
2. What organizational theory is used with rapid, unpredictable, and constant change?
A. Systems theory
B. Chaos theory
C. Change theory
D. Traditional theory
,Answer B—Rationale: Chaos theory is used to understand rapidly changing, unpredictable health
care environments.
3. A 65-year-old African American male was admitted to your microsystem with
hyperglycemia. The patient has a history of hypertension, gout, obesity, and smoking. The
patient has a family history of diabetes and hypertension. Which statement by the patient
demonstrates his understanding of modifiable risk factors for diabetes?
A. "As I get older, my risk for diabetes increases."
B. "I know that a family history of diabetes is a risk factor, so I will educate my children on
diabetes prevention."
C. "I will keep a record of all my blood sugars to take to my doctor's appointments."
D. "I will attend a smoking cessation class, because I know smoking increases my risk for
diabetes."
Answer D—Rationale: Modifiable risk factors are lifestyle factors that a person can alter in order
to prevent disease. Smoking cessation class is an intervention for modifying the risk factor of
smoking.
4. Your hospital is currently trialing the integration of the clinical nurse leader (CNL) role.
At the', 'end of the trial implementation period how can you, as the CNL, best illustrate the
effectiveness of your role during this trial?
A. Refer to increased patient satisfaction scores over the course of the trial
B. Present data that demonstrates the effect of the CNL and outcomes achieved over the
course of the trial
,C. Present a list of projects and tasks completed over the course of the trial
D. Refer to your performance review over the course of the trial
Answer B—Rationale: The CNL should present the effect and outcomes to illustrate the
importance of the integration of his or her role. Increased patient satisfaction is not necessarily
directly related to the CNL. Presentation of projects and tasks completed does not address
measurable outcomes. Performance review of the individual does not indicate outcomes were
affected.
5. You are a CNL on an oncology unit. Recently, there has been an increase in the number
of catheter- associated urinary tract infections (CAUTIs) on your unit. After shadowing
nurses and aides you observed a variety of practices, techniques, and expectations
surrounding daily catheter care. Your hospital does not have a current policy or procedure
regarding catheter care. As the CNL, what should you do next?
A. Review current evidence for catheter care practice and disseminate evidence to the staff
B. Form an interdisciplinary team meeting to evaluate current hospital catheter care
policies
C. Create a rubric for educating patients and staff on catheter care
D. Discuss with the unit manager the clinical issue and create a set of evidence-based unit
expectations and practices for the oncology unit. Evaluate the need to address this issue
with a hospital-wide policy or procedure
Answer D—Rationale: CNLs should gather and disseminate evidence to solve clinical problems;
however, that should not be the initial step. Further review of hospital practices and policies may
come after this issue is addressed. Creation of a rubric for educating patients and staff on catheter
, care may come after reviewing evidence. The CNL should act to solve the clinical issue in the
short term, and evaluate the need for a larger policy to address gaps in practice hospital-wide.
6. A 50-year-old woman with a history of stage 3 chronic obstructive pulmonary disease
(COPD) presents to the emergency department (ED) with increased shortness of breath.
Based on your lab results, what is the acid-base disorder?
Labs as follows: pH 7.25 PaCO2 50 mmHg HCO3 22 mEq/L PO2 75 SpO2 88% Na + 136
BUN 18
A. Uncompensated respiratory acidosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Uncompensated respiratory acidosis
Answer A—Rationale: Based on the clinical scenario, the pH is decreased (less than 7.35);
therefore, the patient has acidosis. The PaCO2 is elevated (more than 45 mmHg), which is also
consistent with the pH.', 'The HCO3 is within normal limits, which suggests the kidneys are not
compensating. COPD is commonly associated with respiratory acidosis.
7. A CNL evaluates a 17-year-old patient who has been a victim of rape. The patient has
visible bruising and a head laceration. After the CNL's assessment, law enforcement
officials have contacted the CNL requesting information regarding the attack and the
visible injuries seen during the visit. The CNL knows she must first:
A. Take pictures and complete the rape kit
B. Provide law enforcement with a record as requested
