Clinical nurse leader certification exam (CNL) Questions 151-200 (Answered)

Clinical nurse leader certification exam (CNL) Questions 151-200 (Answered) Document Content and Description Below Clinical nurse leader certification exam (CNL) Questions 151-200 (Answered) *You are the CNL in an outpatient pediatric clinic. The most common diagnosis for your patient population is asthma, and your patients are frequently seen at local emergency departments (EDs) for asthma exacerbations. Which action most directly optimizes the level of function in daily life for these patients?* A. Provide or reinforce previous education to patients and families on asthma and inhaler use B. Review discharge orders and ensure that all clients are prescribed a long- and shortacting inhaler C. Provide an in-service at local schools to educate teachers on managing asthma exacerbations in children D. Advocate for the development of a nurse phone triage to answer urgent patient and family asthma concerns - Answer B—Rationale: Many of these interventions can help promote knowledge on what to do in the event of an asthma exacerbation; however, ensuring that each patient has the proper inhalers best optimizes the daily level of function. *As the CNL, you recognize that leveraging technology and information systems is an important part of acting toward high quality, patient-centered, lateral integration. Which of the following are examples of using technology and information systems to benefit patient care?* A. Use of bed alarms and use of call lights B. TV in patient rooms with many channels, use of call lights, guest Wi-Fi Internet access, and e-readers available with e-books for patients C. Use of bed alarms, use of call lights, remote telemetry, and barcoded supplies, and medications D. TV in patient rooms with many channels, guest Wi-Fi Internet access, and e-readers available with e-books for patients - Answer C—Rationale: This answer addresses technology used in patient care while the others address technology used in patient experience and satisfaction. *Which of the following is not a part of the National Patient Safety Guidelines (NPSG)?* A. Improve the accuracy of patient identification B. Reduce the risk of health care-associated infections C. Improve patient satisfaction D. Prevent health care-associated pressure ulcers - Answer C—Rationale: While a part of the NPSGs, improving patient satisfaction it is not, by itself, an NPSG.*During the 5P assessment, you find out that 64% of patients have Medicare, 18% have Medicaid, 16% have private insurance, and 2% have no insurance. You can conclude that the majority of your patients are what type of payer source?* A. First-party payer B. Second-party payer C. Fourth-party payer D. Third-party payer - Answer D—Rationale: Third-party payers include government and private insurance entities. *A staff nurse is performing a literature review on the best tool for determining health literacy for diabetic patients. When analyzing and appraising the literature, what methods can the nurse use to determine if the study is flawed?* A. Are the results of the literature reliable and critical? B. Are the results of the literature effective and modifiable? C. Are the results of the literature valid and reliable? D. Are the results of the literature valid and modifiable? - Answer C—Rationale: Three questions to consider when appraising any study: Are the results for the study valid? Are the results reliable? Will the results be applicable to study? *The CNL provides integration of care by working with multiple interdependent and independent disciplines, breaking down barriers, and proactively managing care across the continuum. This describes a(n):* A. Vertical leader B. Lateral integrator C. Outcomes manager D. Systems analyst - Answer B—Rationale: Lateral integration of care involves the delivering and coordination of care using a multidisciplinary approach. The CNL can oversee care provided by the health care team, identify barriers, and work with the team to proactively manage potential problems. *A nurse on your unit has a question about required documentation for a patient with a nasogastric (NG) tube to wall suction. You guide her to what resource?* A. The unit charge nurse B. Hospital policy/procedure manual C. The States Board of Nursing Scope of Practice D. The Joint Commission website - Answer B—Rationale: The most reliable resource is the hospital policy and procedure manual. While the charge nurse may be a source of knowledge, it is not the best or official source. *You are the CNL on a medical unit and recognize a frequently readmitted patient with uncontrolled diabetes. You view this patient in terms of Prochaska and DiClemente's Stages of Change model and recognize that:*A. Patients may spiral in and out of stages forward and backward. B. Timelines for patients may vary to progress through the stages; however, they always progress forward. C. The stages have been well studied and the timeline and progression are the same for all patients. D. Prochaska and DiClemente's Stages of Change model does not apply to this patient. - Answer A—Rationale: Prochaska and DiClemente's Stages of Change model states that each patient may experience each phase at different speeds, and may move forward or backward repeatedly through the stages. *Consideration of your unit's nurse workflow, specific challenges and needs of clients on your unit, staff experiences, and staff ratios are examples of which of the following important CNL function components?* A. Ongoing evaluation B. Collaboration C. Advanced clinical assessment D. Knowledge management - Answer A—Rationale: These are examples of a CNL continuing to assess and reassess important aspects of the care delivery system and used processes. including the monitoring not only of patient outcomes but experiences at each step of the care process, which embodies the ongoing evaluation aspect of the CNL as a lateral integrator. *Quality improvement (QI), as a function of the CNL role, is related to which core role competency of the CNL?* A. Client advocacy B. Clinician C. Risk anticipator D. Team manager - Answer C—Rationale: QI is a direct function of risk anticipation. *Your hospital has just completed a study comparing outcomes in rehospitalization rates for CHF patients who received predischarge teaching from an advanced practice registered nurse (APRN) with those who received pre-discharge teaching from an RN. In the analysis of data, what resulting p value would indicate that the intervention had a significant result?* A. .05 B. .8 C. .10 D. .22 - Answer A—Rationale: A value less than 0.05 is a significant statistical finding in research.*A professor is discussing the difference between quantitative and qualitative research. As a CNL student, you are aware that quantitative research is related to numeric data with statistical analysis, while qualitative research focuses on non-numeric forms of research. Which of the following is an example of a quantitative study?* A. Personal interviews B. Randomized controlled trial (RCT) C. Ethnography D. Phenomenology - Answer B—Rationale: RCT is a quantitative research process that is a true experiment; it is the strongest design to support cause-and-effect relationships, in which subjects are randomly selected. *Elizabeth, an 87-year-old female, is admitted to the orthopedic unit with a fractured hip. Elizabeth lives at home alone, but her retired son lives just 2 hours away and comes to visit her often. The physical therapist comes to you and states he is recommending that Elizabeth go to a rehabilitation center prior to returning home. When Elizabeth is told that she will require rehabilitation, she becomes visibly upset and states she refuses to go to a facility. Utilizing an interdisciplinary approach, you ask the social worker, case manager, physician, and physical therapist to help create a plan for Elizabeth. Which of the following is the best plan for Elizabeth?* A. Convince Elizabeth to go to a rehabilitation facility where she will receive 24-hour care and 3 hours of therapy a day B. Keep Elizabeth in the hospital until she has fully recovered, then discharge her home C. Discharge Elizabeth home and arrange for a physical therapist to come to her house once a week D. Contact Elizabeth's son, inform him of Elizabeth's refusal of the rehabilitation facility, and have him help develop an alternative to the original plan for her discharge - Answer D—Rationale: The CNL generally needs to involve multiple disciplines in the plan for discharge, but the CNL must also encourage the patient and family to participate. Elizabeth was not willing to go to a rehabilitation center, so the best option would be for her to go home with her son where she can be safe and monitored, while receiving home health services. *A staff nurse is curious about whether emptying the nasogastric (NG) suction canister is a task that can be delegated to a CNA. You, the CNL, guide her to what resource?* A. The unit charge nurse B. Hospital policy/procedure manual C. The State Board of Nursing Scope of Practice D. The Joint Commission website - Answer C—Rationale: The most reliable source for what tasks may be delegated is the individual state's scope of practice. *The CNL on the unit has an idea to generate a new EBP study. He has conducted a literature review and critical appraisal. The CNL has also developed a collaborative interprofessional team to be part of the planning process. He has established a date forthe research design meeting. What pertinent information should be included in his outline of the study in preparation for this meeting?* A. Form an interprofessional team B. Perform a review of literature C. Consult with another CNL D. Indicate the aim of the study and research question - Answer D—Rationale: When developing a study outline for a meeting, questions related to the study that should be answered include: Is this idea feasible and clinically important? What is the aim of the study, along with the research question or hypothesis to be tested? What are the potential sources of data? Are there valid and reliable instruments to measure the desired outcomes? What should be the inclusion and exclusion criteria for the potential study participants? What ar