Nurse Manager and Leader (CNML) Practice
Examination 100% Verified Answers 2026
LATEST UPDATE
1. Which budgeting approach requires managers to justify all expenditures for
each new period, not just changes from the previous year?
A) Incremental budgeting
B) Zero-based budgeting
C) Flexible budgeting
D) Capital budgeting
Answer: B
Rationale: Zero-based budgeting starts from a "zero base" and requires
justification of every expense for each new budget period.
2. A nurse manager is analyzing a monthly variance report. The nursing unit's
salary expenses exceeded the budgeted amount by 8%. The manager should first:
A) Implement a hiring freeze
B) Analyze the root cause of the variance, such as overtime, agency usage, or
higher patient acuity
C) Reduce staff education funds
D) Mandate staff to take unpaid time off
Answer: B
Rationale: Variance analysis requires investigation of the underlying causes before
taking corrective action.
,3. The nurse manager is preparing a capital budget request for a new telemetry
monitoring system. Which of the following is a characteristic of a capital
expenditure?
A) Recurring monthly expense
B) Item with a useful life of more than one year and a cost exceeding an
organizational threshold
C) Expense for disposable supplies
D) Staff salary
Answer: B
Rationale: Capital expenses are major, long-term investments such as equipment
and facilities, not recurring operational costs.
4. A unit's total nursing hours (productive plus non-productive) for a pay period
are 2,760, and patient days are 400. What is the hours per patient day (HPPD)?
A) 6.0
B) 6.9
C) 5.6
D) 7.5
Answer: B
Rationale: HPPD = total nursing hours / patient days = 2, = 6.9.
,5. A nurse manager is evaluating the cost-effectiveness of a new wound care
product. Which analysis method compares the cost of the intervention to the
clinical outcomes achieved?
A) Cost-benefit analysis
B) Cost-effectiveness analysis
C) Break-even analysis
D) Revenue analysis
Answer: B
Rationale: Cost-effectiveness analysis compares costs to a non-monetary outcome
(e.g., wound healing rates), unlike cost-benefit which monetizes both costs and
benefits.
6. In a shared governance model, the nurse manager's role is to:
A) Make all decisions independently
B) Facilitate staff decision-making and remove barriers
C) Replace unit-based councils
D) Delegate all financial decisions to staff
Answer: B
Rationale: Shared governance empowers staff to make practice decisions, with
managers supporting and enabling the process.
7. A staff nurse consistently arrives late. The nurse manager has provided verbal
counseling but the behavior continues. The next step in progressive discipline is:
A) Termination
, B) Written warning
C) Suspension without pay
D) Peer review
Answer: B
Rationale: Progressive discipline typically follows oral warning, written warning,
suspension, and then termination.
8. The nurse manager is developing a staffing plan based on patient acuity. The
primary benefit of an acuity-based staffing system is that it:
A) Reduces the number of nurses required
B) Matches nursing resources to patient needs and workload
C) Guarantees equal patient assignments
D) Eliminates the need for overtime
Answer: B
Rationale: Acuity-based staffing adjusts staffing levels based on the severity and
needs of patients, promoting safe, efficient care.
9. A nurse manager uses a Gantt chart for a project to implement a new electronic
health record module. The Gantt chart is most useful for:
A) Analyzing root causes
B) Displaying project tasks, timelines, and dependencies
C) Prioritizing problems by frequency
D) Evaluating financial performance
Examination 100% Verified Answers 2026
LATEST UPDATE
1. Which budgeting approach requires managers to justify all expenditures for
each new period, not just changes from the previous year?
A) Incremental budgeting
B) Zero-based budgeting
C) Flexible budgeting
D) Capital budgeting
Answer: B
Rationale: Zero-based budgeting starts from a "zero base" and requires
justification of every expense for each new budget period.
2. A nurse manager is analyzing a monthly variance report. The nursing unit's
salary expenses exceeded the budgeted amount by 8%. The manager should first:
A) Implement a hiring freeze
B) Analyze the root cause of the variance, such as overtime, agency usage, or
higher patient acuity
C) Reduce staff education funds
D) Mandate staff to take unpaid time off
Answer: B
Rationale: Variance analysis requires investigation of the underlying causes before
taking corrective action.
,3. The nurse manager is preparing a capital budget request for a new telemetry
monitoring system. Which of the following is a characteristic of a capital
expenditure?
A) Recurring monthly expense
B) Item with a useful life of more than one year and a cost exceeding an
organizational threshold
C) Expense for disposable supplies
D) Staff salary
Answer: B
Rationale: Capital expenses are major, long-term investments such as equipment
and facilities, not recurring operational costs.
4. A unit's total nursing hours (productive plus non-productive) for a pay period
are 2,760, and patient days are 400. What is the hours per patient day (HPPD)?
A) 6.0
B) 6.9
C) 5.6
D) 7.5
Answer: B
Rationale: HPPD = total nursing hours / patient days = 2, = 6.9.
,5. A nurse manager is evaluating the cost-effectiveness of a new wound care
product. Which analysis method compares the cost of the intervention to the
clinical outcomes achieved?
A) Cost-benefit analysis
B) Cost-effectiveness analysis
C) Break-even analysis
D) Revenue analysis
Answer: B
Rationale: Cost-effectiveness analysis compares costs to a non-monetary outcome
(e.g., wound healing rates), unlike cost-benefit which monetizes both costs and
benefits.
6. In a shared governance model, the nurse manager's role is to:
A) Make all decisions independently
B) Facilitate staff decision-making and remove barriers
C) Replace unit-based councils
D) Delegate all financial decisions to staff
Answer: B
Rationale: Shared governance empowers staff to make practice decisions, with
managers supporting and enabling the process.
7. A staff nurse consistently arrives late. The nurse manager has provided verbal
counseling but the behavior continues. The next step in progressive discipline is:
A) Termination
, B) Written warning
C) Suspension without pay
D) Peer review
Answer: B
Rationale: Progressive discipline typically follows oral warning, written warning,
suspension, and then termination.
8. The nurse manager is developing a staffing plan based on patient acuity. The
primary benefit of an acuity-based staffing system is that it:
A) Reduces the number of nurses required
B) Matches nursing resources to patient needs and workload
C) Guarantees equal patient assignments
D) Eliminates the need for overtime
Answer: B
Rationale: Acuity-based staffing adjusts staffing levels based on the severity and
needs of patients, promoting safe, efficient care.
9. A nurse manager uses a Gantt chart for a project to implement a new electronic
health record module. The Gantt chart is most useful for:
A) Analyzing root causes
B) Displaying project tasks, timelines, and dependencies
C) Prioritizing problems by frequency
D) Evaluating financial performance
