CLINICAL NURSE LEADER (CNL)
CERTIFICATION EXAM 2025 SUMMER
QUESTIONS AND ANSWERS GRADED A+
NEWEST
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.
AD
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
CERTIFICATION EXAM 2025 SUMMER
QUESTIONS AND ANSWERS GRADED A+
NEWEST
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.
AD
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
