Clinical Nurse Leader (Cnl) Quiz Sample
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- 1.
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
Correct Answer
C. Compare desired outcomes with national and state standardsExplanation
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.Rate this question:
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- 2.
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
Correct Answer
B. Sponsoring a meeting with the monitor technicians to understand their barriers in the cardiac monitoring processExplanation
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.Rate this question:
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- 3.
You are a CNL on the telemetry unit and orienting a newly graduated nurse. Critical thinking is best demonstrated when:
- A.
The CNL discusses with the physician the rationale for discontinuing cardiac monitoring in the hospice patient
- B.
Drawing the scheduled cardiac enzymes every 8 hours
- C.
Reviewing the patient care guidelines and protocols related to hourly rounding
- D.
The CNL balances both the charge role and the preceptor role simultaneously
Correct Answer
A. The CNL discusses with the pHysician the rationale for discontinuing cardiac monitoring in the hospice patientExplanation
Critical thinking underlies independent and interdependent decision making. Critical thinking includes questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity.Rate this question:
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- 4.
You are a CNL selected to lead a team focused on implementing a multidisciplinary clinical pathway for acute ischemic stroke and transient ischemic attack. The risk assessment tool that you have adopted identifies all of the following as independent stroke risk factors except:
- A.
Age
- B.
Systolic blood pressure
- C.
Liver dysfunction
- D.
Current smoking
- E.
Diabetes mellitus
Correct Answer
C. Liver dysfunctionExplanation
Independent stroke predictors include age, systolic blood pressure, hypertension, diabetes mellitus, current smoking, established cardiovascular disease (any one of myocardial infarction, angina or coronary insufficiency, congestive heart failure, or intermittent claudication), atrial fibrillation, and left ventricular hypertrophy on ECG.Rate this question:
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- 5.
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
Correct Answer
B. Gaining an understanding of how DVT propHylaxis is initiated on each stroke patient on your unitExplanation
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.Rate this question:
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- 6.
You are working on improving the patient discharge process. Which of these targets would best reflect clinical microsystem outcomes?
- A.
Hospital length of stay
- B.
Time of discharge order for all medical patients to the actual time the patient left
- C.
Number of discharge orders on your unit entered before 11 a.m.
- D.
Total number of discharged patients leaving by 11 a.m.
Correct Answer
C. Number of discharge orders on your unit entered before 11 a.m.Explanation
A CNL as an outcomes manager uses data to change practice and to improve outcomes. Selecting the most appropriate goals and targets will provide meaningful information.Rate this question:
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- 7.
Electronic nursing documentation has recently been instituted in your organization. Select a response that best defines a clinical decision support:
- A.
A reminder to save and sign your admission assessment
- B.
A visual red alert when a patient’s potassium is 6.8 mEq/L
- C.
A pop-up to initiate the discharge instruction sheet with every physician discharge order
- D.
An electronic nursing care plan
Correct Answer
C. A pop-up to initiate the discharge instruction sheet with every pHysician discharge orderExplanation
CDS is a computer-based program designed to assist clinicians in making clinical decisions by filtering and integrating vast amounts of information and providing suggestions for clinical intervention.Rate this question:
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- 8.
In 2008, the Centers for Medicaid and Medicare Services (CMS) collaboratively with the Centers for Disease Control and Prevention enacted a new payment provision related to eight hospital-acquired conditions. Hospital falls and traumas occurring during a hospital stay will not receive CMS reimbursement. Health promotion, risk reduction, and disease prevention are core competencies of the clinical nurse leader. As a CNL on the telemetry unit, you have recognized the importance of this issue. Which level within a system does this issue affect?
- A.
Microsystem
- B.
Mesosystem
- C.
Macrosystem
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
One concept of health care systems involves three levels of building together to make up complex organizations.Rate this question:
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- 9.
Clinical nurse leaders focus on projects within a clinical microsystem. A clinical microsystem can be best described as:
- A.
A department-wide program focused on improving continuity of care and patient satisfaction
- B.
Trending the postoperative care on all surgical units
- C.
The clinical and business processes of a single unit within an organization
- D.
All medical and surgical units guided by a chief nursing officer
Correct Answer
C. The clinical and business processes of a single unit within an organizationExplanation
The microsystem is described by the AACN White Paper as the practice level of the CNL.Rate this question:
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- 10.
All are part of the data necessary for a CNL to fully understand and assess his or her clinical unit except:
- A.
The organization financial statement
- B.
The target population and age distribution
- C.
The percentage of full-time equivalents (FTEs)
- D.
Rate of nosocomial infections
- E.
Fall rates
Correct Answer
A. The organization financial statementExplanation
A comprehensive assessment of the clinical unit is a foundation for the work of the CNL but does not include the financial statement of the organization. In comprehending the “big picture” of the organization, the CNL should have an understanding of the financial health of the institution.Rate this question:
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- 11.
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
Correct Answer
B. Gain an understanding of patient care practices on the telemetry unitExplanation
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.Rate this question:
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- 12.
You have been asked to lead the telemetry fall prevention committee. Which combination of team members would best suit the initial phase of this group?
- A.
A behavioral health APRN
- B.
A staff nurse
- C.
A physical therapist
- D.
The nurse manager
- E.
All of the above
- F.
Only A, B, and D are needed
Correct Answer
E. All of the aboveExplanation
Health promotion and disease prevention knowledge includes methods to keep an illness or injury from occurring, diagnosis, and treating a disease in its early course. CNLs need to work with an interdisciplinary team to make ethical decisions, develop, and monitor comprehensive, holistic plans of care. There is a strong correlation between patient falls and delirium. Exercise programs focused on strength, functional performance, and balance training are effective steps in reducing inpatient falls.Rate this question:
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- 13.
As a CNL in the ICU, you have observed several prolonged and fragmented processes of starting an intravenous line in a critically ill patient. All of the following considerations are necessary in identifying a theme for your improvement process except:
- A.
A thorough review of the clinical unit
- B.
The manager’s mandate for change
- C.
The alignment with the organization’s strategic priorities
- D.
Input from the patient’s family
Correct Answer
B. The manager’s mandate for changeExplanation
Specific mandates for change would be considered as the team “drills down” for further information.Rate this question:
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- 14.
The hospital is looking to utilize cardiac monitor watchers. Your analysis includes all of the following except:
- A.
A review of an online ECG monitoring education program
- B.
Identifying a clinical issue with a focus on a specific population
- C.
Conducting a trend analysis of outcome data
- D.
Analyzing barriers and facilitators with the organization
Correct Answer
A. A review of an online ECG monitoring education programExplanation
Systems analysis and risk anticipation are the competencies of the CNL.Rate this question:
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- 15.
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 visual signal on all ports not intended for intravenous drugs
- B.
A double-check system for medication administration
- C.
To facilitate a critical incident reporting structure that fosters a “without blame” unit culture
- D.
All of the above
- E.
Only C
Correct Answer
D. All of the aboveExplanation
The CNL should support the staff to identify all opportunities for improving
safety in this situation.Rate this question:
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- 16.
Data reported by the ICU quality committee reflect challenges in the management of the septic patient. As a CNL in the ICU, all of the following are first steps in evaluating the delivery of client care except:
- A.
Knowledge of sepsis guidelines
- B.
Critical care clinicians staffing ratios
- C.
Use of clinical decision support systems
- D.
Differentiating sepsis from systemic inflammatory response syndrome (SIRS)
Correct Answer
D. Differentiating sepsis from systemic inflammatory response syndrome (SIRS)Explanation
Nursing leadership and advocacy reviews and evaluates care guidelines and protocols.Rate this question:
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- 17.
A fellow staff nurse is struggling to understand the use of a clinical decision support system (CDSS) in the management of her septic patient. Your initial teaching strategy includes:
- A.
Sharing the latest clinical research
- B.
An understanding of expected and actual outcomes
- C.
Defining the purpose of CDSS
- D.
Exploring challenges, risks, and benefits
Correct Answer
C. Defining the purpose of CDSSExplanation
CDSS supports a safe patient culture and should be designed to help providers.Rate this question:
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- 18.
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
Correct Answer
C. Process mappingExplanation
Utilizing tools for process improvement can provide new insights into routine practices.Rate this question:
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- 19.
Your colleagues have identified challenges in the process of inserting an intravenous line. To gain a better understanding of what this process entails, you:
- A.
Directly observe the intravenous line insertion process and time each step of the process
- B.
Create a workflow diagram tracing the path of the nurse during the line insertion process
- C.
Engage the IV team to reeducate the nurses
- D.
All of the above
- E.
A and B
Correct Answer
E. A and BExplanation
Proper assessment of a clinical situation can expose issues of policy, compliance, or the need for education.Rate this question:
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- 20.
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
Correct Answer
A. The patientExplanation
Process improvement enhances patient safety and nursing time at the bedside for the patient and family.Rate this question:
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Current Version
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Mar 22, 2023Quiz Edited by
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Feb 11, 2013Quiz Created by
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