CNL MOCK EXAM QUESTIONS AND
ANSWERS ALL CORRECT
A nurse approaches you and expresses her knowledge deficit regarding the difference
between signs and symptoms of left- and right-sided heart failure. You explain the
physiology between the two types of failure and identify which of the following has a
primary symptom of right-sided heart failure?
Peripheral edema
Shortness of breath on exertion
Heart murmur and distended veins
Cool extremities and weak peripheral pulses - Answer- A- Right-sided heart failure
leads to congestion of systemic capillaries. This generates excess fluid accumulation in
the body and usually affects the dependent parts of the body first.
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 - Answer- 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 - Answer- 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 - Answer- 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 - Answer- 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 - Answer- A. Application of
knowledge that impacts patient outcomes is the most significant indicator.
How can the CNL make the greatest impact on the health care organization?
A) By representing the microsystem
B) By representing the mesosystem
C) By representing the patient and family
D) By representing the nursing profession - Answer- ANS A: The CNL functions as the
change agent at the microsystem level, engaging frontline staff in best practices to
better patient outcomes.
The concept that an organization is in a continued state of change describes which
organizational theory:
A) systems theory
B) classical theory
C) contingency theory
D) Chaos theory - Answer- ANS D: The chaos theory is based on the principle that a
system can maintain itself only if change is occurring somewhere in the organization all
the time. Chaos and change are seen as means of survival.
Before beginning data collection, what is the primary key factor to determine?
A) Personnel to collect data
B) A secure database for holding data
, C) Operational definitions of data
D) A user-friendly collection method - Answer- ANS C: Operational definitions clearly
define what is to be collected and avoid confusion for those collecting the data. Clear
operational definitions also helps those who are interpreting the data. Failure to
determine operational definitions may result in data that are inaccurate
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 - Answer- 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 -
Answer- 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 - Answer- 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 - Answer- ANS B: Assessment
includes gathering information about the health status of the client and analyzing and
ANSWERS ALL CORRECT
A nurse approaches you and expresses her knowledge deficit regarding the difference
between signs and symptoms of left- and right-sided heart failure. You explain the
physiology between the two types of failure and identify which of the following has a
primary symptom of right-sided heart failure?
Peripheral edema
Shortness of breath on exertion
Heart murmur and distended veins
Cool extremities and weak peripheral pulses - Answer- A- Right-sided heart failure
leads to congestion of systemic capillaries. This generates excess fluid accumulation in
the body and usually affects the dependent parts of the body first.
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 - Answer- 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 - Answer- 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 - Answer- 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 - Answer- 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 - Answer- A. Application of
knowledge that impacts patient outcomes is the most significant indicator.
How can the CNL make the greatest impact on the health care organization?
A) By representing the microsystem
B) By representing the mesosystem
C) By representing the patient and family
D) By representing the nursing profession - Answer- ANS A: The CNL functions as the
change agent at the microsystem level, engaging frontline staff in best practices to
better patient outcomes.
The concept that an organization is in a continued state of change describes which
organizational theory:
A) systems theory
B) classical theory
C) contingency theory
D) Chaos theory - Answer- ANS D: The chaos theory is based on the principle that a
system can maintain itself only if change is occurring somewhere in the organization all
the time. Chaos and change are seen as means of survival.
Before beginning data collection, what is the primary key factor to determine?
A) Personnel to collect data
B) A secure database for holding data
, C) Operational definitions of data
D) A user-friendly collection method - Answer- ANS C: Operational definitions clearly
define what is to be collected and avoid confusion for those collecting the data. Clear
operational definitions also helps those who are interpreting the data. Failure to
determine operational definitions may result in data that are inaccurate
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 - Answer- 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 -
Answer- 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 - Answer- 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 - Answer- ANS B: Assessment
includes gathering information about the health status of the client and analyzing and
