Clin Nurse Leader Exam with Accurate
Solutions
Gap Analysis - ANSWER-Compares ACTUAL performance with POTENTIAL/desired
performance
Evaluates the strengths and weaknesses of the team in relation to required outcomes
A good tool for analysis to gain better understanding of the team's functioning
3 phases of knowledge transfer when using EBP - ANSWER-1. Knowledge creation and
distillation (research and recommendations for clinical practice)
2. Diffusion and Dissemination (distribute info to users, partner with organizations like
professional nursing orgs)
3. Implementation and Institutionalization (end user adoption - health care systems
adopt practices)
Examples of restraining forces in Lewin's Change theory - ANSWER-work against the
driving forces to inhibit change
example: want to quit smoking but live with people who smoke so hard to quit in that
living situation
Examples of driving forces for Lewin's change theory - ANSWER-factors that support
change or push patient towards necessary changes
such as the drive to quit smoking to breathe easier
Peplau's Theory of Interpersonal Relations - ANSWER-focuses on relationship between
patient and nurse
4 phases:
1. Orientation - seeks help through appts, treatment, etc. for RN to determine patients
need for assistance
2. Identification - help identify who can help, set goals of care
3. Exploitation - receives care from rN
4. Resolution - care is completed
Total patient care. - ANSWER-One nurse is responsible for planning, organizing and
delivery of care to a
,particular client or group of clients during the assigned shift
Primary nursing - ANSWER-a method of care in which the same RN assigned to same
patient over time; assumes 24 hour responsibility for planning, directing, and evaluating
client care from the time of admission through discharge
team nursing - ANSWER-a nursing care pattern; a team of nursing staff is led by an RN
who decides the amount and kind of care each person needs - each member
responsible for certain cares such as ADLs or meds
Each team member is able to contribute their own special expertise or skills caring for
the client
Continuity of care may suffer if daily assignment of team varies and client is exposed to
many different caregivers.
relative risk - ANSWER-used when the study involves comparing the likelihood, or
chance, of an event occurring between two groups
ratio of the absolute risk of a disease among the exposed group to the absolute risk of
the disease among the unexposed group in an epidemiologic study
confidence interval - ANSWER-the range of values within which a population parameter
is estimated to lie based on a random sample of the population.
The most common interval is the 95% confidence interval. It represents the range that
one can be 95% confident that the population parameter lies.
confounding - ANSWER-distortion in the degree of association because researcher
failed to control, or eliminate the confounding variable, damaging the internal validity of
an experiment.
occurs when two variables are associated in such a way that their effects on a response
variable cannot be distinguished from each other
internal validity - ANSWER-extent to which a piece of evidence supports a claim about
cause and effect & degree to which the results of a study are not due to bias or
confounding
External validity - ANSWER-the degree to which the results of the original study are
applicable to a population other than the one initially targeted = generalizability
,An oral glucose tolerance test (OGTT) measures - ANSWER-your blood sugar after you
have gone at least eight hours without eating and two hours after you drink a glucose-
containing beverage. This test can be used to diagnose diabetes or prediabetes.
Oral Glucose Tolerance Test (OGTT) result of 150 means what?
A. Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g
OGTT
within 1 week.
B. The results are within normal limits and do not meet the threshold for the diagnosis of
gestational diabetes.
C. A fasting blood sugar should be checked as soon as possible.
D. Based on this abnormal value, the 3-hour OGTT is not required. - ANSWER-A.
Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g OGTT
within 1 week.
Rationale: If your blood glucose is higher than 140 mg/dL, the next step is the oral 3-
hour glucose tolerance test. This test will determine if you have gestational diabetes.
After performing the literature review and developing a PICOT question, what should
you do next before implementation?
A. Form a team of stakeholders
B. Develop a comparison group
C. Talk to the manager
D. Start the implementation process - ANSWER-A. Form a team of stakeholders
Rationale: After performing the literature review and developing a PICOT question, you
should create a team of stakeholders to ensure the intervention has the appropriate
resources to make the study successful.
Pt has a blood sugar of 58 with headache and blurry vision.
Which of the following interventions is appropriate for the nurse to tell the CNL?
A. The patient is experiencing hyperglycemia and should be given a protein snack.
B. The patient is experiencing hyperglycemia and should be given insulin and 1 cup of
milk.
C. The patient is experiencing hypoglycemia and should be given insulin and 1 cup of
orange juice. D. The patient is experiencing hypoglycemia and should be given 1 cup of
skim milk. - ANSWER-D. The patient is experiencing hypoglycemia and should be given
1 cup of skim milk.
Rationale: The patient's fasting blood sugar is below 60 mm/dL and is symptomatic. She
must be treated for hypoglycemia by drinking 1 cup of skim milk, or 1⁄2 cup of juice, or
1⁄2 cup of soft drink.
, As a trial CNL, whose buy-in will be the most important in fully implementing the CNL
role in the hospital?
A. The chief nursing officer (CNO)
B. The unit manager
C. The members of the interdisciplinary team
D. The staff affected by your outcomes - ANSWER-The chief nursing officer (CNO)
CNO will have the most influence in your hospital
Orem's self care deficit theory - ANSWER-The nurse's actions are directed toward
assisting the patient to assume responsibility for self-care & based on the premise that
all individuals are capable of self-care
1st step: identifying and prioritizing the client's unmet self-care needs (deficits).
2nd step: selecting methods of assisting the client to compensate for or overcome his
self-care deficits.
Leininger's Culture Care Theory - ANSWER-Theory of cultural care diversity and
universality -
Integrates patients' cultural traditions, values and beliefs into care plans
Care fits with or have beneficial meaning and health outcomes for people of different or
similar culture backgrounds.
similar to transcultural nursing
(CPOE) Computerized physician order entry - ANSWER-Feature of the EHR that
assures standardized, legible communication of the medical plan of care to other
members of the healthcare team
Helps prevent errors
(HIE) health information exchange - ANSWER-Allows for multiple health care
organizations serving a client to share health information across electronic networks ,
allows for timely access to client information for providers
Although have to be careful with protected health information/HIPAA
perceived conflict (felt conflict) - ANSWER-perceive that their situation is characterized
by incompatibility and interdependence
Solutions
Gap Analysis - ANSWER-Compares ACTUAL performance with POTENTIAL/desired
performance
Evaluates the strengths and weaknesses of the team in relation to required outcomes
A good tool for analysis to gain better understanding of the team's functioning
3 phases of knowledge transfer when using EBP - ANSWER-1. Knowledge creation and
distillation (research and recommendations for clinical practice)
2. Diffusion and Dissemination (distribute info to users, partner with organizations like
professional nursing orgs)
3. Implementation and Institutionalization (end user adoption - health care systems
adopt practices)
Examples of restraining forces in Lewin's Change theory - ANSWER-work against the
driving forces to inhibit change
example: want to quit smoking but live with people who smoke so hard to quit in that
living situation
Examples of driving forces for Lewin's change theory - ANSWER-factors that support
change or push patient towards necessary changes
such as the drive to quit smoking to breathe easier
Peplau's Theory of Interpersonal Relations - ANSWER-focuses on relationship between
patient and nurse
4 phases:
1. Orientation - seeks help through appts, treatment, etc. for RN to determine patients
need for assistance
2. Identification - help identify who can help, set goals of care
3. Exploitation - receives care from rN
4. Resolution - care is completed
Total patient care. - ANSWER-One nurse is responsible for planning, organizing and
delivery of care to a
,particular client or group of clients during the assigned shift
Primary nursing - ANSWER-a method of care in which the same RN assigned to same
patient over time; assumes 24 hour responsibility for planning, directing, and evaluating
client care from the time of admission through discharge
team nursing - ANSWER-a nursing care pattern; a team of nursing staff is led by an RN
who decides the amount and kind of care each person needs - each member
responsible for certain cares such as ADLs or meds
Each team member is able to contribute their own special expertise or skills caring for
the client
Continuity of care may suffer if daily assignment of team varies and client is exposed to
many different caregivers.
relative risk - ANSWER-used when the study involves comparing the likelihood, or
chance, of an event occurring between two groups
ratio of the absolute risk of a disease among the exposed group to the absolute risk of
the disease among the unexposed group in an epidemiologic study
confidence interval - ANSWER-the range of values within which a population parameter
is estimated to lie based on a random sample of the population.
The most common interval is the 95% confidence interval. It represents the range that
one can be 95% confident that the population parameter lies.
confounding - ANSWER-distortion in the degree of association because researcher
failed to control, or eliminate the confounding variable, damaging the internal validity of
an experiment.
occurs when two variables are associated in such a way that their effects on a response
variable cannot be distinguished from each other
internal validity - ANSWER-extent to which a piece of evidence supports a claim about
cause and effect & degree to which the results of a study are not due to bias or
confounding
External validity - ANSWER-the degree to which the results of the original study are
applicable to a population other than the one initially targeted = generalizability
,An oral glucose tolerance test (OGTT) measures - ANSWER-your blood sugar after you
have gone at least eight hours without eating and two hours after you drink a glucose-
containing beverage. This test can be used to diagnose diabetes or prediabetes.
Oral Glucose Tolerance Test (OGTT) result of 150 means what?
A. Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g
OGTT
within 1 week.
B. The results are within normal limits and do not meet the threshold for the diagnosis of
gestational diabetes.
C. A fasting blood sugar should be checked as soon as possible.
D. Based on this abnormal value, the 3-hour OGTT is not required. - ANSWER-A.
Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g OGTT
within 1 week.
Rationale: If your blood glucose is higher than 140 mg/dL, the next step is the oral 3-
hour glucose tolerance test. This test will determine if you have gestational diabetes.
After performing the literature review and developing a PICOT question, what should
you do next before implementation?
A. Form a team of stakeholders
B. Develop a comparison group
C. Talk to the manager
D. Start the implementation process - ANSWER-A. Form a team of stakeholders
Rationale: After performing the literature review and developing a PICOT question, you
should create a team of stakeholders to ensure the intervention has the appropriate
resources to make the study successful.
Pt has a blood sugar of 58 with headache and blurry vision.
Which of the following interventions is appropriate for the nurse to tell the CNL?
A. The patient is experiencing hyperglycemia and should be given a protein snack.
B. The patient is experiencing hyperglycemia and should be given insulin and 1 cup of
milk.
C. The patient is experiencing hypoglycemia and should be given insulin and 1 cup of
orange juice. D. The patient is experiencing hypoglycemia and should be given 1 cup of
skim milk. - ANSWER-D. The patient is experiencing hypoglycemia and should be given
1 cup of skim milk.
Rationale: The patient's fasting blood sugar is below 60 mm/dL and is symptomatic. She
must be treated for hypoglycemia by drinking 1 cup of skim milk, or 1⁄2 cup of juice, or
1⁄2 cup of soft drink.
, As a trial CNL, whose buy-in will be the most important in fully implementing the CNL
role in the hospital?
A. The chief nursing officer (CNO)
B. The unit manager
C. The members of the interdisciplinary team
D. The staff affected by your outcomes - ANSWER-The chief nursing officer (CNO)
CNO will have the most influence in your hospital
Orem's self care deficit theory - ANSWER-The nurse's actions are directed toward
assisting the patient to assume responsibility for self-care & based on the premise that
all individuals are capable of self-care
1st step: identifying and prioritizing the client's unmet self-care needs (deficits).
2nd step: selecting methods of assisting the client to compensate for or overcome his
self-care deficits.
Leininger's Culture Care Theory - ANSWER-Theory of cultural care diversity and
universality -
Integrates patients' cultural traditions, values and beliefs into care plans
Care fits with or have beneficial meaning and health outcomes for people of different or
similar culture backgrounds.
similar to transcultural nursing
(CPOE) Computerized physician order entry - ANSWER-Feature of the EHR that
assures standardized, legible communication of the medical plan of care to other
members of the healthcare team
Helps prevent errors
(HIE) health information exchange - ANSWER-Allows for multiple health care
organizations serving a client to share health information across electronic networks ,
allows for timely access to client information for providers
Although have to be careful with protected health information/HIPAA
perceived conflict (felt conflict) - ANSWER-perceive that their situation is characterized
by incompatibility and interdependence
