CNL Exam
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
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
