CNL Exam with Accurate Solutions
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: - Correct Answers-Compare desired outcomes with national and state
standards
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: - Correct Answers-Gaining
an understanding of how DVT prophylaxis is initiated on each stroke patient on your unit
Which of the following actions illustrates the CNL professional value of altruism? -
Correct Answers-Sponsoring a meeting with the monitor technicians to understand their
barriers in the cardiac monitoring process
The results of a quarterly report identify an increase in patient falls on the telemetry unit.
Your first action will be to: - Correct Answers-Gain an understanding of patient care
practices on the telemetry unit
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: - Correct Answers-1. A double-check system for
medication administration
2. To facilitate a critical incident reporting structure that fosters a "without blame" unit
culture
3. A visual signal on all ports not intended for intravenous drugs
4. All of the above
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: - Correct Answers-Process mapping
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: - Correct Answers-The patient
Your team is looking at the delays in the discharge process. Your cause and effect
diagram includes: - Correct Answers-A fishbone diagram
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: - Correct Answers-Trending quarterly patient
satisfaction scores pertaining to spiritual care during hospitalization
How can the CNL make the greatest impact on the health care organization? - Correct
Answers-Representing the microsystem
The concept that an organization is in a continued state of change describes which
organizational theory: - Correct Answers-Chaos theory
Before beginning data collection, what is the primary key factor to determine? - Correct
Answers-Operational definitions of data
As the CNL on a Cardiothoracic step-down unit, what is the one recommendation you
would make to decrease the chance of readmission of your patient population?
A) Visiting nursing for all patients
B) All follow-up appointments scheduled prior to patient discharge
C) Pharmacy to visit with each patient prior to discharge home to review medications
D) All patients should be enrolled in a cardiac rehab program - Correct Answers-All
patients should be enrolled in a cardiac rehab program
After careful review of unit processes, you have determined that the self meal order
program was introduced 3 months ago. With this program, patients have the ability to
order meals when they are ready to eat rather than eating at predetermined times set by
the hospital. This change has altered the timing of medications previously given with
meals. What does the CNL do to improve the process? - Correct Answers-Develop an
interdisciplinary team, including unit staff, nutritionist, diabetic educator, and meal
service team members to investigate the self meal order program
After completing unit audits, you have noticed the nurses are not completing AIR cycles
documentation with pain management (AIR: assessment, intervention, reassessment).
What should be done to improve documentation? - Correct Answers-Provide staff with a
self-audit sheet as a way to review their own documentation during their shifts
You are listening to report with a novice nurse. As part of mentoring new staff and
supporting clinical decision making, you ask the new nurse which patient she would like
to assess first. Which patient should this nurse assess first? - Correct Answers-60-year-
old s/p liver biopsy
Over the past few weeks, nurses on the 30-bed medical unit have been complaining the
MD orders related to oxygen do not match what the patient is receiving. Often the
patient has more than one oxygen order at the same time. This leads to confusion for
nursing and respiratory care staff and could harm the patient. How can the CNL improve
the practice? - Correct Answers-Using the informatics team as support, create a hard
stop in the computer that does not allow the physician to activate a new oxygen order
without discontinuing the previous order
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: - Correct Answers-Compare desired outcomes with national and state
standards
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: - Correct Answers-Gaining
an understanding of how DVT prophylaxis is initiated on each stroke patient on your unit
Which of the following actions illustrates the CNL professional value of altruism? -
Correct Answers-Sponsoring a meeting with the monitor technicians to understand their
barriers in the cardiac monitoring process
The results of a quarterly report identify an increase in patient falls on the telemetry unit.
Your first action will be to: - Correct Answers-Gain an understanding of patient care
practices on the telemetry unit
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: - Correct Answers-1. A double-check system for
medication administration
2. To facilitate a critical incident reporting structure that fosters a "without blame" unit
culture
3. A visual signal on all ports not intended for intravenous drugs
4. All of the above
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: - Correct Answers-Process mapping
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: - Correct Answers-The patient
Your team is looking at the delays in the discharge process. Your cause and effect
diagram includes: - Correct Answers-A fishbone diagram
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: - Correct Answers-Trending quarterly patient
satisfaction scores pertaining to spiritual care during hospitalization
How can the CNL make the greatest impact on the health care organization? - Correct
Answers-Representing the microsystem
The concept that an organization is in a continued state of change describes which
organizational theory: - Correct Answers-Chaos theory
Before beginning data collection, what is the primary key factor to determine? - Correct
Answers-Operational definitions of data
As the CNL on a Cardiothoracic step-down unit, what is the one recommendation you
would make to decrease the chance of readmission of your patient population?
A) Visiting nursing for all patients
B) All follow-up appointments scheduled prior to patient discharge
C) Pharmacy to visit with each patient prior to discharge home to review medications
D) All patients should be enrolled in a cardiac rehab program - Correct Answers-All
patients should be enrolled in a cardiac rehab program
After careful review of unit processes, you have determined that the self meal order
program was introduced 3 months ago. With this program, patients have the ability to
order meals when they are ready to eat rather than eating at predetermined times set by
the hospital. This change has altered the timing of medications previously given with
meals. What does the CNL do to improve the process? - Correct Answers-Develop an
interdisciplinary team, including unit staff, nutritionist, diabetic educator, and meal
service team members to investigate the self meal order program
After completing unit audits, you have noticed the nurses are not completing AIR cycles
documentation with pain management (AIR: assessment, intervention, reassessment).
What should be done to improve documentation? - Correct Answers-Provide staff with a
self-audit sheet as a way to review their own documentation during their shifts
You are listening to report with a novice nurse. As part of mentoring new staff and
supporting clinical decision making, you ask the new nurse which patient she would like
to assess first. Which patient should this nurse assess first? - Correct Answers-60-year-
old s/p liver biopsy
Over the past few weeks, nurses on the 30-bed medical unit have been complaining the
MD orders related to oxygen do not match what the patient is receiving. Often the
patient has more than one oxygen order at the same time. This leads to confusion for
nursing and respiratory care staff and could harm the patient. How can the CNL improve
the practice? - Correct Answers-Using the informatics team as support, create a hard
stop in the computer that does not allow the physician to activate a new oxygen order
without discontinuing the previous order
