CNL EXAM (Mock Exam) Questions and
Correct Answers
Patient satisfaction scores in the emergency department (ED) have shown a downward
trend over the past three quarters. As a clinical nurse leader (CNL) in the ED, your focus is
to:
A) Create a script for the triage nurse in welcoming the patient
B) Assign a volunteer to welcome patients to the hospital
C) Compare desired outcomes with national and state standards
D) Write a letter of apology to each dissatisfied patient
ANS C: Client care outcomes are a measure of quality practice. CNLs must know how to
compare desired outcomes that will improve safety, effectiveness, timeliness, efficiency, quality,
and the degree to which they are client centered.
A lack of compliance with deep vein thrombosis (DVT) prophylaxis has been identified in
retrospective chart reviews of all ischemic stroke patients in your organization. As a CNL
on the neurological unit, your primary goal will include:
A) Challenging the guidelines on primary prevention of ischemic stroke written by the
American Stroke Association
B) Gaining an understanding of how DVT prophylaxis is initiated on each stroke patient on
your unit
C) Developing an organization-wide educational program on DVT prophylaxis
D) Developing a unit-based team of nursing personnel to investigate the problem
,ANS B: White Paper: One competency is that of a systems analyst. A CNL participates in a
system review and conducts a microsystem analysis, identifying a clinical issue with a focus on a
particular population.
Which of the following actions illustrates the CNL professional value of altruism?
A) Leading an interdisciplinary team looking at the remote cardiac monitoring process
B) Sponsoring a meeting with the monitor technicians to understand their barriers in the
cardiac monitoring process
C) Flow mapping the admission process of the remote cardiac-monitored patient
D) Editing the policy for the remote cardiac monitoring process
ANS B: Altruism is a concern for the welfare and well-being of others. In professional practice,
altruism is reflected by the CNL's concern for the welfare of clients, other nurses, and other
health care providers.
The results of a quarterly report identify an increase in patient falls on the telemetry unit.
Your first action will be to:
A) Implement hourly rounding
B) Gain an understanding of patient care practices on the telemetry unit
C) Assign patient personal alarms to all patients at risk
D) Revise the current fall risk documentation form
ANS B: Assessment includes gathering information about the health status of the client and
analyzing and synthesizing those making judgments about nursing interventions on the basis of
findings, evaluation, and managing of individual care outcomes.
,Several near misses were identified by ICU nurses who had mistaken invasive lines for
intravenous ports for medication administration. You have completed an analysis of the
issue. Your recommendations include:
A) A double-check system for medication administration
B) To facilitate a critical incident reporting structure that fosters a "without blame" unit
culture
C) A visual signal on all ports not intended for intravenous drugs
D) All of the above
ANS D: The CNL should support the staff to identify all opportunities for improving safety in
this situation
You are using failure mode and effect analysis (FMEA) to anticipate the risk of medication
errors in the ICU related to invasive lines. You begin your FMEA analysis with:
A) The effects of each failure
B) The potential cause of each failure
C) Process mapping
D) Specific defects and delays in the medication administration process
ANS C: Utilizing tools for process improvement can provide new insights into routine practices.
The result of a workflow diagram of a clinician illustrates an excessive amount of walking
to obtain supplies. Reducing the waste of motion adds value-added time that ultimately
benefits:
A) The patient
, B) The clinician
C) Documentation
D) None of the above
ANS A: Process improvement enhances patient safety and nursing time at the bedside for the
patient and family.
Your team is looking at the delays in the discharge process. Your cause and effect diagram
includes:
A) A run chart
B) A Gantt chart
C) A fishbone diagram
D) A high-level flowchart
ANS C: A fishbone diagram is a useful tool to identify themes of clinical issues. Categories such
as equipment, personnel, communication, and so on can be identified.
Survey results of the nursing staff reflect poor perceptions and a discomfort with
addressing spiritual issues with patients. The ultimate success of focused staff education
can be measured by:
A) ! Trending quarterly patient satisfaction scores pertaining to spiritual care during
hospitalization
B) A follow-up survey of the staff after the education to solicit feedback
C) An open discussion of how the nurse would address spiritual care in a given scenario
D) Feedback shared during discharge phone calls
Correct Answers
Patient satisfaction scores in the emergency department (ED) have shown a downward
trend over the past three quarters. As a clinical nurse leader (CNL) in the ED, your focus is
to:
A) Create a script for the triage nurse in welcoming the patient
B) Assign a volunteer to welcome patients to the hospital
C) Compare desired outcomes with national and state standards
D) Write a letter of apology to each dissatisfied patient
ANS C: Client care outcomes are a measure of quality practice. CNLs must know how to
compare desired outcomes that will improve safety, effectiveness, timeliness, efficiency, quality,
and the degree to which they are client centered.
A lack of compliance with deep vein thrombosis (DVT) prophylaxis has been identified in
retrospective chart reviews of all ischemic stroke patients in your organization. As a CNL
on the neurological unit, your primary goal will include:
A) Challenging the guidelines on primary prevention of ischemic stroke written by the
American Stroke Association
B) Gaining an understanding of how DVT prophylaxis is initiated on each stroke patient on
your unit
C) Developing an organization-wide educational program on DVT prophylaxis
D) Developing a unit-based team of nursing personnel to investigate the problem
,ANS B: White Paper: One competency is that of a systems analyst. A CNL participates in a
system review and conducts a microsystem analysis, identifying a clinical issue with a focus on a
particular population.
Which of the following actions illustrates the CNL professional value of altruism?
A) Leading an interdisciplinary team looking at the remote cardiac monitoring process
B) Sponsoring a meeting with the monitor technicians to understand their barriers in the
cardiac monitoring process
C) Flow mapping the admission process of the remote cardiac-monitored patient
D) Editing the policy for the remote cardiac monitoring process
ANS B: Altruism is a concern for the welfare and well-being of others. In professional practice,
altruism is reflected by the CNL's concern for the welfare of clients, other nurses, and other
health care providers.
The results of a quarterly report identify an increase in patient falls on the telemetry unit.
Your first action will be to:
A) Implement hourly rounding
B) Gain an understanding of patient care practices on the telemetry unit
C) Assign patient personal alarms to all patients at risk
D) Revise the current fall risk documentation form
ANS B: Assessment includes gathering information about the health status of the client and
analyzing and synthesizing those making judgments about nursing interventions on the basis of
findings, evaluation, and managing of individual care outcomes.
,Several near misses were identified by ICU nurses who had mistaken invasive lines for
intravenous ports for medication administration. You have completed an analysis of the
issue. Your recommendations include:
A) A double-check system for medication administration
B) To facilitate a critical incident reporting structure that fosters a "without blame" unit
culture
C) A visual signal on all ports not intended for intravenous drugs
D) All of the above
ANS D: The CNL should support the staff to identify all opportunities for improving safety in
this situation
You are using failure mode and effect analysis (FMEA) to anticipate the risk of medication
errors in the ICU related to invasive lines. You begin your FMEA analysis with:
A) The effects of each failure
B) The potential cause of each failure
C) Process mapping
D) Specific defects and delays in the medication administration process
ANS C: Utilizing tools for process improvement can provide new insights into routine practices.
The result of a workflow diagram of a clinician illustrates an excessive amount of walking
to obtain supplies. Reducing the waste of motion adds value-added time that ultimately
benefits:
A) The patient
, B) The clinician
C) Documentation
D) None of the above
ANS A: Process improvement enhances patient safety and nursing time at the bedside for the
patient and family.
Your team is looking at the delays in the discharge process. Your cause and effect diagram
includes:
A) A run chart
B) A Gantt chart
C) A fishbone diagram
D) A high-level flowchart
ANS C: A fishbone diagram is a useful tool to identify themes of clinical issues. Categories such
as equipment, personnel, communication, and so on can be identified.
Survey results of the nursing staff reflect poor perceptions and a discomfort with
addressing spiritual issues with patients. The ultimate success of focused staff education
can be measured by:
A) ! Trending quarterly patient satisfaction scores pertaining to spiritual care during
hospitalization
B) A follow-up survey of the staff after the education to solicit feedback
C) An open discussion of how the nurse would address spiritual care in a given scenario
D) Feedback shared during discharge phone calls
