CNL certification review. (answered + rationales)

CNL certification review. (answered + rationales) A team charter includes all except which of the following? A. Clearly defined goals B. Specific outcomes C. Team member roles D. Time allotted for each activity D. Rationale: A team charter is an essential written agreement defining what the team is going to accomplish, how success will be measured, and defining team member roles. As a clinical nurse leader (CNL), you know a potential use of a patient's individual electronic health record is its use in A. Finding relevant evidence-based literature B. Performing a root cause analysis C. Implementing a best practice change D. Reviewing unit practice trends B. Rationale: Each is a potential use of healthcare information technology, but only the root cause analysis involves the use of a patient's medical record. Lateral integration is based on the understanding of which of the following? A. Patient-specific healthcare needs B. The interdependency of all healthcare disciplines C. The variety of healthcare delivery settings D. Changes in patient care needs over time B. Rationale: Lateral integration is based on the understanding that all disciplines of healthcare are interdependent and essential in providing complete care to the patient. When performing ongoing assessment of a process or system, the clinical nurse leader (CNL) should include all of the following, except: A. Efficacy B. Satisfaction C. Efficiency D. Ease of change D. Rationale: Ease of change may be considered; however it should not prevent the CNL from taking action to improve a system or process that improves safety, efficacy, satisfaction, efficiency, or quality of care. As a clinical nurse leader (CNL) on an acute care floor, you recognize the importance of lateral integration. Which of the following examples of your role as a CNL illustrates the role of ongoing evaluation in lateral integration? A. Performing risk analysis to ensure client safety B. Assessing the appropriateness and relevancy of current or newly emerging healthcare information C. Synthesizing data to find a common goal D. Fostering rapport across professional boundaries B. Rationale: Assessing new or current information is key to the process of ongoing evaluation. Performing a risk analysis to ensure client safety is part of the early coordination stages. Synthesizing data is the role of collaboration. Fostering rapport is a key aspect of communication. As a clinical nurse leader (CNL) on an acute care floor, you recognize the importance of lateral integration. Which of the following examples of your role as a CNL illustrates the role of collaboration in lateral integration? A. Monitoring the plan of care for specific patients and populations B. Clearly delegating tasks and responsibilities within a team C. Translating from discipline-specific language to a common message and goals D. Keeping all members of the team informed of current status and process C. Rationale: Translating the message to form a common goal exemplifies collaboration within a team. Monitoring involves ongoing evaluation; clear delegation of tasks is an important aspect of coordination; updating on status is clear communication. Monitoring involves _____________ _______________. ongoing evaluation clear delegation of tasks is an important aspect of _____________. coordination updating on status is clear _______________. communication Performing a risk analysis to ensure client safety is part of the early _____________ stages. coordination In order to practice horizontal leadership, the clinical nurse leader (CNL) needs a "tool kit" of skills. These include all except which of the following? A. Vertical integration B. Use of feedback C. Healthcare outcomes D. Guiding EBP practice A. Rationale: Critical skills in order to practice horizontal leadership include guiding evidence-based practice, healthcare outcomes, lateral integration, use of feedback, coaching, and leading teams. The clinical nurse leader (CNL) facilitates, coordinates, and oversees care provided by the healthcare team. This best describes which of the following roles? A. Risk anticipator B. Lateral integrator C. Team manager D. Outcomes manager B. Rationale: Lateral integration of care involves the CNL as the leader of care; overseeing care provided by the healthcare team; identifying barriers; and working with the team to proactively manage potential problems. Fostering rapport is a key aspect of _________________ communication synthasizing data is ___________ collaboration A male patient seen at your clinic says he has recently purchased a gym membership and requests information about what types of exercises he should start with when beginning. As the clinical nurse leader (CNL) for the clinic, you recognize this patient is most likely in which of Prochaska and DiClemente's Transtheoretical Model for stages of change: A. Contemplation B. Preparation C. Action D. Maintenance B. Rationale: Based on Prochaska and DiClemente's Transtheoretical Model, this patient is in the preparation stage; he has taken some steps toward action showing he is seriously planning change in the near future through financial commitment and research. He has not yet reached the action phase because he has not yet modified the behavior Irene is a clinical nurse leader (CNL) in a small community hospital. Irene was tasked with leading an interdisciplinary team to improve the transition from emergency room (ER) to the medical unit. During a meeting, the ER nurses and the medical unit nurses argue over the cause of delays, blaming one another. The team is now disruptive and not focused on the goals of this group. Which of the following should the CNL do first to resolve this conflict? A. Define the problem. B. Develop plan of action. C. Evaluate underlying causes. D. Determine an approach. A. Rationale: The first step in problem solving is to define the problem. Diane is a 43-year-old female who has been readmitted three times in the past 6 months with chronic obstructive pulmonary disease (COPD) exacerbations. Diane has been described as noncompliant with taking her medications and she continues to smoke half a pack of cigarettes daily. Which of the following best describes the first critical step when developing a plan of care for Diane? A. Refer Diane to a smoking cessation class. B. Coordinate with respiratory therapy to teach Diane correct technique for inhalers. C. Auscultate Diane's lungs to evaluate for wheezing. D. Ask Diane what she feels is causing her to come back to the hospital. D. Rationale: Developing a therapeutic relationship is the first step in a clinical assessment. It is important to obtain information from the patient, including his or her perspective and goals. The clinical nurse leader (CNL) is asked to lead an interdisciplinary team in developing a pathway to help improve the discharge process. The CNL helps the team create an agreement that focuses on goals, outcomes, and team member roles. Which of the following best describes the team leader tool the CNL is creating? A. Team agenda B. Team ground rules C. Team charter D. Team evaluation C. Rationale: team charter is an essential written agreement defining what the team is going to accomplish, how success will be measured, and defining team member roles. There are three dimensions of safety: safety climate (compliance with rules and no-fault error reporting); teamwork climate (collaboration and communication); and which of the following? A. Employee climate (teamwork and engagement) B. Positive perceptions of management (working conditions, opinions of management) C. Positive perceptions of coworkers (engagement and low turn-over rates) D. Caring climate (values, ethics, and patient experience) B. Rationale: Hudson et al identified position perception of management as the third dimension. A 24-bed critical care unit has experienced an increase in ventilator-associated pneumonia (VAP) within the past year. The clinical nurse leader (CNL) is asked to facilitate a workgroup focused on developing a plan to prevent VAP. Which of the following best exhibits how the CNL promotes communication within the team? A. Assigns each member a role, ensuring everyone understands his or her job. B. Engages the team in shared decision making before finalizing a plan. C. Shares clear goals, messages, and plans with the team throughout the process. D. Synthesizes the input from the team to find common themes and goals. C. Rationale: The CNL communicates within a team by fostering the flow of information and serving as a translator. The CNL actively solicits input and shares information with the team. Which of the following defines horizontal leadership? A. It is a leadership style that depends on high levels of communication from management to meet goals. B. Managers and team members set predetermined goals together, and employees agree to follow the direction and leadership of the manager to accomplish those goals. C. It values the input of team members and peers, but the responsibility of making the final decision rests with the participative leader. D. It is a philosophy of organizational leadership whereby the structure promotes equality and an "open-door policy."