CNL EXAM 2025 | CLINICAL NURSE LEADER
EXAM | ALL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | ALREADY
GRADED A+ | VERIFIED ANSWERS | JUST
RELEASED
Jason is on a med-surg unit for end-stage liver disease and has a DNR.
The patient's discharge plan is to home today with family and hospice.
When the CNL rounds with the resident physician at 0900, the patient is
alert and oriented and ambulating around the room with no assistance.
Now Jason is just waiting for his family to come pick him up. At 1200, the
patient's nurse comes to the CNL and states that Jason is acting "funny."
When the CNL goes into the room, Jason is unsteady when ambulating, his
mentation is altered, and his speech is not clear. Jason's nurse notifies the
resident physician about the change in Jason, and the physician states that
he has been discharged and that if he refuses to leave, security will escort
him out.
After the team meeting the resident orders a STAT ammonia level. The
CNL knows that the ammonia level is elevated when it comes back as:
A) 80 mg/dL
B) 42 mg/dL
C) 22 mg/dL
D) 39 mg/dL ---------CORRECT ANSWER-----------------A) 80 mg/dL
Rationale: An ammonia level above 80 micrograms/dL is elevated. The
normal range for ammonia level is 15-45 micrograms/dL.
James started working as a new CNL on a medical-surgical unit. James is
trying to focus on becoming a strong horizontal leader. James recognizes
that he needs a horizontal leader "tool kit" of skills. This tool kit includes:
A) Evidence-based practice, healthcare outcomes, lateral integration, use
of feedback, coaching, and leading teams
B) Evidence-based practice, healthcare outcomes, lateral integration, and
verbal communication
,C) Evidence-based practice, healthcare outcomes, vertical integration,
coaching, and leading teams
D) Evidence-based practice, healthcare outcomes, vertical integration, and
use of feedback ---------CORRECT ANSWER-----------------A) Evidence-
based practice, healthcare outcomes, lateral integration, use of feedback,
coaching, and leading teams
Rationale: The CNL tool kit includes evidence-based practice,
healthcare outcomes, lateral integration, use of feedback, coaching,
and leading teams. CNLs use what is called lateral integration, not
vertical integration. Use of feedback is another piece of the tool kit
which promotes effective communication, including verbal and
nonverbal communication.
Three CNLs each work in a 12-bed
microsystem. These three microsystems make up one medical-surgical unit
in a large healthcare system. The CNLs have regular meetings to be sure
they are providing consistent high-quality care to patients throughout the
unit. These meetings also allow the CNLs the opportunity to share
information on what they have done in their microsystem to mentor and
coach the staff nurses as well as ensuring that ideas they have for potential
changes are evidence based and align with the unit, nursing, and
healthcare system goals.
These CNLs are role models for which type of leadership?
A) Horizontal Leadership
B) Servant Leadership
C) Lateral Integration Leadership
D) Team Oriented Leadership ---------CORRECT ANSWER-----------------A)
Horizontal Leadership
Rationale: The three CNLs are demonstrating Horizontal Leadership,
as they are working horizontally across the microsystems and using
mentoring and coaching with the staff nurses. Servant leadership is a
leadership philosophy in which the main goal of the leader is to serve
and share power, while putting the needs of the employees first so
they may develop and perform as highly as possible. Team Oriented
Leadership is not an official type of leadership, and Lateral Integration
is a role of the CNL and not a leadership style.
,A new graduate nurse, Mary, approaches you and states that she needs
help inserting a nasogastric tube (NG). Which of the following is the best
response when acting as a horizontal leader?
A) Go gather the needed supplies and insert the NG tube yourself as Mary
watches.
B) Help Mary find the policy to insert the NG tube and then put the NG tube
in as Mary watches.
C) Help Mary find the policy and review this with her. Then coach Mary as
she inserts the NG tube and provide real-time feedback.
D) Find the policy and go over it with Mary. Then advise Mary to ask the
charge nurse for assistance with inserting the NG. ---------CORRECT
ANSWER-----------------C) Help Mary find the policy and review this with her.
Then coach Mary as she inserts the NG tube and provide real-time
feedback.
Rationale: The CNL acts as a horizontal leader by coaching the new
nurse as she performs the task and providing feedback as the task is
being completed.
A staff nurse was asked to take a patient's weight in order for a physician to
calculate the appropriate dose for a new drug. The nurse documented the
weight with just a number. It is discovered that the nurse actually
documented the weight in pounds instead of kilograms and subsequently
the patient was given the incorrect dose of the medication.
This resulted in a sentinel event. The CNL for the microsystem creates an
interprofessional team to do a root cause analysis. Which type of
leadership is the CNL demonstrating?
A) Servant Leadership
B) Interprofessional Leadership
C) Horizontal Leadership
D) Team-Based Leadership ---------CORRECT ANSWER-----------------C)
Horizontal Leadership
, Rationale: A root cause analysis is performed whenever a sentinel
event occurs. A horizontal leader would develop a team of other
disciplines to perform the RCA.
You are a CNLL on a urology/transplant floor. Your unit has several new
graduate nurses. As a CNL, what is your role in relationship to these new
team members?
A) Resource to assist with nursing tasks
B) Coach and mentor
C) Provide all clinical education
D) Evaluator for performance ---------CORRECT ANSWER-----------------B)
Coach and mentor
Rationale: As a CNL, being an educator is part of the role; however,
the CNL does not provide ALL clinical education for staff members.
The CNL does assist with nursing tasks but is not just a resource to
do the nursing tasks. The CNL is supposed to mentor and coach staff.
After building relationships with nursing staff on a transplant unit, the CNL
identifies nursing staff wanting professional development to advance their
roles in nursing. She then develops an informational plan for the staff on
how they can (1) obtain their BSN degree, (2) take the transplant
certification exam, and/or (3) advance up the clinical ladder. What is the
most important aspect of horizontal leadership is the CNL is
demonstrating?
A) Acting as a role model by having obtained a graduate degree in
nursing
B) Demonstrating higher order critical thinking and problem-solving skills
C) Developing effective working relationships within the interprofessional
team to influence outcomes
D) Appraising and evaluating coordinated care activities for individuals in
the microsystem ---------CORRECT ANSWER-----------------C) Developing
effective working relationships within the interprofessional team to influence
outcomes
EXAM | ALL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | ALREADY
GRADED A+ | VERIFIED ANSWERS | JUST
RELEASED
Jason is on a med-surg unit for end-stage liver disease and has a DNR.
The patient's discharge plan is to home today with family and hospice.
When the CNL rounds with the resident physician at 0900, the patient is
alert and oriented and ambulating around the room with no assistance.
Now Jason is just waiting for his family to come pick him up. At 1200, the
patient's nurse comes to the CNL and states that Jason is acting "funny."
When the CNL goes into the room, Jason is unsteady when ambulating, his
mentation is altered, and his speech is not clear. Jason's nurse notifies the
resident physician about the change in Jason, and the physician states that
he has been discharged and that if he refuses to leave, security will escort
him out.
After the team meeting the resident orders a STAT ammonia level. The
CNL knows that the ammonia level is elevated when it comes back as:
A) 80 mg/dL
B) 42 mg/dL
C) 22 mg/dL
D) 39 mg/dL ---------CORRECT ANSWER-----------------A) 80 mg/dL
Rationale: An ammonia level above 80 micrograms/dL is elevated. The
normal range for ammonia level is 15-45 micrograms/dL.
James started working as a new CNL on a medical-surgical unit. James is
trying to focus on becoming a strong horizontal leader. James recognizes
that he needs a horizontal leader "tool kit" of skills. This tool kit includes:
A) Evidence-based practice, healthcare outcomes, lateral integration, use
of feedback, coaching, and leading teams
B) Evidence-based practice, healthcare outcomes, lateral integration, and
verbal communication
,C) Evidence-based practice, healthcare outcomes, vertical integration,
coaching, and leading teams
D) Evidence-based practice, healthcare outcomes, vertical integration, and
use of feedback ---------CORRECT ANSWER-----------------A) Evidence-
based practice, healthcare outcomes, lateral integration, use of feedback,
coaching, and leading teams
Rationale: The CNL tool kit includes evidence-based practice,
healthcare outcomes, lateral integration, use of feedback, coaching,
and leading teams. CNLs use what is called lateral integration, not
vertical integration. Use of feedback is another piece of the tool kit
which promotes effective communication, including verbal and
nonverbal communication.
Three CNLs each work in a 12-bed
microsystem. These three microsystems make up one medical-surgical unit
in a large healthcare system. The CNLs have regular meetings to be sure
they are providing consistent high-quality care to patients throughout the
unit. These meetings also allow the CNLs the opportunity to share
information on what they have done in their microsystem to mentor and
coach the staff nurses as well as ensuring that ideas they have for potential
changes are evidence based and align with the unit, nursing, and
healthcare system goals.
These CNLs are role models for which type of leadership?
A) Horizontal Leadership
B) Servant Leadership
C) Lateral Integration Leadership
D) Team Oriented Leadership ---------CORRECT ANSWER-----------------A)
Horizontal Leadership
Rationale: The three CNLs are demonstrating Horizontal Leadership,
as they are working horizontally across the microsystems and using
mentoring and coaching with the staff nurses. Servant leadership is a
leadership philosophy in which the main goal of the leader is to serve
and share power, while putting the needs of the employees first so
they may develop and perform as highly as possible. Team Oriented
Leadership is not an official type of leadership, and Lateral Integration
is a role of the CNL and not a leadership style.
,A new graduate nurse, Mary, approaches you and states that she needs
help inserting a nasogastric tube (NG). Which of the following is the best
response when acting as a horizontal leader?
A) Go gather the needed supplies and insert the NG tube yourself as Mary
watches.
B) Help Mary find the policy to insert the NG tube and then put the NG tube
in as Mary watches.
C) Help Mary find the policy and review this with her. Then coach Mary as
she inserts the NG tube and provide real-time feedback.
D) Find the policy and go over it with Mary. Then advise Mary to ask the
charge nurse for assistance with inserting the NG. ---------CORRECT
ANSWER-----------------C) Help Mary find the policy and review this with her.
Then coach Mary as she inserts the NG tube and provide real-time
feedback.
Rationale: The CNL acts as a horizontal leader by coaching the new
nurse as she performs the task and providing feedback as the task is
being completed.
A staff nurse was asked to take a patient's weight in order for a physician to
calculate the appropriate dose for a new drug. The nurse documented the
weight with just a number. It is discovered that the nurse actually
documented the weight in pounds instead of kilograms and subsequently
the patient was given the incorrect dose of the medication.
This resulted in a sentinel event. The CNL for the microsystem creates an
interprofessional team to do a root cause analysis. Which type of
leadership is the CNL demonstrating?
A) Servant Leadership
B) Interprofessional Leadership
C) Horizontal Leadership
D) Team-Based Leadership ---------CORRECT ANSWER-----------------C)
Horizontal Leadership
, Rationale: A root cause analysis is performed whenever a sentinel
event occurs. A horizontal leader would develop a team of other
disciplines to perform the RCA.
You are a CNLL on a urology/transplant floor. Your unit has several new
graduate nurses. As a CNL, what is your role in relationship to these new
team members?
A) Resource to assist with nursing tasks
B) Coach and mentor
C) Provide all clinical education
D) Evaluator for performance ---------CORRECT ANSWER-----------------B)
Coach and mentor
Rationale: As a CNL, being an educator is part of the role; however,
the CNL does not provide ALL clinical education for staff members.
The CNL does assist with nursing tasks but is not just a resource to
do the nursing tasks. The CNL is supposed to mentor and coach staff.
After building relationships with nursing staff on a transplant unit, the CNL
identifies nursing staff wanting professional development to advance their
roles in nursing. She then develops an informational plan for the staff on
how they can (1) obtain their BSN degree, (2) take the transplant
certification exam, and/or (3) advance up the clinical ladder. What is the
most important aspect of horizontal leadership is the CNL is
demonstrating?
A) Acting as a role model by having obtained a graduate degree in
nursing
B) Demonstrating higher order critical thinking and problem-solving skills
C) Developing effective working relationships within the interprofessional
team to influence outcomes
D) Appraising and evaluating coordinated care activities for individuals in
the microsystem ---------CORRECT ANSWER-----------------C) Developing
effective working relationships within the interprofessional team to influence
outcomes
