NRS 2012 FINAL EXAM LATEST
2026/2027 COMPREHENSIVE EXAM
100% ACCURATE |OAKLAND UNIVERSITY
ORIGINAL (GRADED A)
What level of education does the CNL require?
Master's
CNLs are NOT
considered APRNs
Drake: "Master's prepared clinical nurse leaders: 2 to 10 years post-graduation"
- CNLs were satisfied with their educational preparation
- Education included leadership courses in ethics, care environment management, and research
- Clinical experiences and clinical courses were also provided; included different populations and
environments
Hulett & Shatto: "Clinical nurse leaders: illuminating and leading the future"
Roles/responsibilities include:
- Create collaborative programs for education and clinical experiences,
- Form strong leaders who will demonstrate willingness to form connections for best nursing
evidence-based practices
- Work to form advanced specialty training to secure leadership skills
- Resolve and improve nursing related issues r/t QI
- Refine competency in regard to cross-cultural advocacy
,Clavo-Hall: "Roles enacted by clinical nurse leaders across the healthcare spectrum: A
systematic literature review"
- CNLs work alongside the nursing staff to ensure optimal care for the patients
- Care plans are evaluated and compared to determine the effectiveness in achieving the
patient's desired outcome
- Facilitate and oversee smooth transitions of patient care and out of the hospital setting
- Facilitate and oversee the probability of reaching the patient's health care goals
- Improve safety, efficiency, and quality of care
- Evaluate the costs associated w/ their health care systems to determine what is necessary for
care interventions and what can be limited
"HOW CAN THIS BE IMPROVED?"
- Look @ all of the factors listed and identify how they can enhance each area to ensure an
optimal, well-oiled healthcare team
- Stay on top of EBP to support patient care
Clinical Nurse Leaders: Summary
- CNL graduates were highly satisfied with their education
- The role expansion for practicing CNLs allow them to enhance patient outcomes and improve
units
- CNLs help reduce costs due to quality improvement
Clinical Nurse Leaders: Nursing Implications
- Improve patient and healthcare system outcomes to decrease costs
3 METHODS
- Deliver safe and comprehensive patient care
- Utilize interdisciplinary collaboration
- Use evidence-based criteria to assess the quality of patient care and system functionality
within the healthcare microsystem
,- CNL role was to help achieve better health, better care, and better value
- CNLs are not utilized to their full potential
Vitale & Lyons: "The State of Nurse Anesthesia Practice and Policy: An Integrative Review"
- CRNAs are APRNs that are licensed as independent practitioners who deliver anesthesia, pain
management, and related care to patients of all ages and health complexities
- CRNAs collaborate w/ other disciplines to provide the best and most effective care possible
- CRNAs are not used to their full potential
- SOP is further complicated by differences in regulation
- No increase in patient mortality rate
- In comparison with anesthesiologists, CRNAs that practice independently had a significantly
lower rate of complications
- More likely to provide anesthesia for more vulnerable populations
Hensel: "Operating Room Personnel Viewpoints about Certified Registered Nurse
Anesthetists"
- SOP is determined by their level of education, state and instituition regulations
- CRNA practice independent vs. supervised
- All CRNAs are responsible for preanesthetic assessments, implementation of anesthesia plans
of care, administering medications, and controlling airways
- CRNAs provide low-cost anesthesia care
- 7x more expensive to educate an anesthesiologist over a CRNA
- Obstacles in a predominant CRNA include perceptions in regard to liability and safety,
resistance from anesthesiologists
- No differences in quality or safety b/w CRNAs and anesthesiologists
Boyd & Meenan: "CRNA Engagement During the COVID-19 Crisis: Optimization of
Resource Management Organizational Climate, and Contributions to Care"
- CRNAs were able to take full ownership of their capabilities in NYC system hospital during the
pandemic
- SOP was expanded
, - CRNAs took on leadership roles as APRNs to oversee patients as first call providers
- When CRNAs collaborate equally w/ physicians they experienced autonomy, respect, and a
broadened SOP, patient's care needs are met beyond expectations
CRNAs: Nursing Implications
- The American Association of Nurse Anesthesiology provides the foundation for practice to
guarantee patient-centered practice
- One cannot become a CRNA w/o a BSN or DNP
- It is a learned, specialized, and evidence-based profession that requires many years of
education and clinical experience before graduate school
- CRNAs are at the forefront of enhancing and improving patient experiences and outcomes
John Wiley & Sons: "What is a midwife?"
- Certified nursing midwives are RNs that have graduated from a nurse midwife program
- CNM's must pass a national certification exam
- CNMs work in many different settings
- They care for women during pregnancy, labor, birth, and the postpartum period
Association of Women's Health, Obstetric, and Neonatal Nurses: "Midwifery"
- CNMs interact with the woman, her family, other HCPs, and ancillary services
- CNMs first assess the mom, fetus or neonate, and her family and subsequently orient them to
the hospital setting
A midwife strives to be an advocate for the woman
1. Respect a woman's choice of birth setting and facilitate care in that setting if necessary
2. Facilitate efficient and respectful transitions of care
3. Incorporate principles of effective communication into policies and procedures regarding
interdisciplinary collaboration
4. Support a woman's access to reliable and unbiased info about care options
2026/2027 COMPREHENSIVE EXAM
100% ACCURATE |OAKLAND UNIVERSITY
ORIGINAL (GRADED A)
What level of education does the CNL require?
Master's
CNLs are NOT
considered APRNs
Drake: "Master's prepared clinical nurse leaders: 2 to 10 years post-graduation"
- CNLs were satisfied with their educational preparation
- Education included leadership courses in ethics, care environment management, and research
- Clinical experiences and clinical courses were also provided; included different populations and
environments
Hulett & Shatto: "Clinical nurse leaders: illuminating and leading the future"
Roles/responsibilities include:
- Create collaborative programs for education and clinical experiences,
- Form strong leaders who will demonstrate willingness to form connections for best nursing
evidence-based practices
- Work to form advanced specialty training to secure leadership skills
- Resolve and improve nursing related issues r/t QI
- Refine competency in regard to cross-cultural advocacy
,Clavo-Hall: "Roles enacted by clinical nurse leaders across the healthcare spectrum: A
systematic literature review"
- CNLs work alongside the nursing staff to ensure optimal care for the patients
- Care plans are evaluated and compared to determine the effectiveness in achieving the
patient's desired outcome
- Facilitate and oversee smooth transitions of patient care and out of the hospital setting
- Facilitate and oversee the probability of reaching the patient's health care goals
- Improve safety, efficiency, and quality of care
- Evaluate the costs associated w/ their health care systems to determine what is necessary for
care interventions and what can be limited
"HOW CAN THIS BE IMPROVED?"
- Look @ all of the factors listed and identify how they can enhance each area to ensure an
optimal, well-oiled healthcare team
- Stay on top of EBP to support patient care
Clinical Nurse Leaders: Summary
- CNL graduates were highly satisfied with their education
- The role expansion for practicing CNLs allow them to enhance patient outcomes and improve
units
- CNLs help reduce costs due to quality improvement
Clinical Nurse Leaders: Nursing Implications
- Improve patient and healthcare system outcomes to decrease costs
3 METHODS
- Deliver safe and comprehensive patient care
- Utilize interdisciplinary collaboration
- Use evidence-based criteria to assess the quality of patient care and system functionality
within the healthcare microsystem
,- CNL role was to help achieve better health, better care, and better value
- CNLs are not utilized to their full potential
Vitale & Lyons: "The State of Nurse Anesthesia Practice and Policy: An Integrative Review"
- CRNAs are APRNs that are licensed as independent practitioners who deliver anesthesia, pain
management, and related care to patients of all ages and health complexities
- CRNAs collaborate w/ other disciplines to provide the best and most effective care possible
- CRNAs are not used to their full potential
- SOP is further complicated by differences in regulation
- No increase in patient mortality rate
- In comparison with anesthesiologists, CRNAs that practice independently had a significantly
lower rate of complications
- More likely to provide anesthesia for more vulnerable populations
Hensel: "Operating Room Personnel Viewpoints about Certified Registered Nurse
Anesthetists"
- SOP is determined by their level of education, state and instituition regulations
- CRNA practice independent vs. supervised
- All CRNAs are responsible for preanesthetic assessments, implementation of anesthesia plans
of care, administering medications, and controlling airways
- CRNAs provide low-cost anesthesia care
- 7x more expensive to educate an anesthesiologist over a CRNA
- Obstacles in a predominant CRNA include perceptions in regard to liability and safety,
resistance from anesthesiologists
- No differences in quality or safety b/w CRNAs and anesthesiologists
Boyd & Meenan: "CRNA Engagement During the COVID-19 Crisis: Optimization of
Resource Management Organizational Climate, and Contributions to Care"
- CRNAs were able to take full ownership of their capabilities in NYC system hospital during the
pandemic
- SOP was expanded
, - CRNAs took on leadership roles as APRNs to oversee patients as first call providers
- When CRNAs collaborate equally w/ physicians they experienced autonomy, respect, and a
broadened SOP, patient's care needs are met beyond expectations
CRNAs: Nursing Implications
- The American Association of Nurse Anesthesiology provides the foundation for practice to
guarantee patient-centered practice
- One cannot become a CRNA w/o a BSN or DNP
- It is a learned, specialized, and evidence-based profession that requires many years of
education and clinical experience before graduate school
- CRNAs are at the forefront of enhancing and improving patient experiences and outcomes
John Wiley & Sons: "What is a midwife?"
- Certified nursing midwives are RNs that have graduated from a nurse midwife program
- CNM's must pass a national certification exam
- CNMs work in many different settings
- They care for women during pregnancy, labor, birth, and the postpartum period
Association of Women's Health, Obstetric, and Neonatal Nurses: "Midwifery"
- CNMs interact with the woman, her family, other HCPs, and ancillary services
- CNMs first assess the mom, fetus or neonate, and her family and subsequently orient them to
the hospital setting
A midwife strives to be an advocate for the woman
1. Respect a woman's choice of birth setting and facilitate care in that setting if necessary
2. Facilitate efficient and respectful transitions of care
3. Incorporate principles of effective communication into policies and procedures regarding
interdisciplinary collaboration
4. Support a woman's access to reliable and unbiased info about care options
