VERIFIED ANSWERS | GRADED A+| PASS ON FIRST ATTEMPT |
Patient satisfaction scores in emergency department have shown a downward trend over
the past three quarters. As a clinical nurse leader in ED focus is to:
A) Create a script for triage nurse in welcoming the patient
B) Assign a volunteer to welcome patients to the hospital
C) Compare desired outcomes with national & state standards
D) Write a letter of apology to each dissatisfied patient - ANSWER C) Compare desired
outcomes with national & State standards
Rationale: 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.
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 B) Sponsoring
a meeting with the monitor technicians to understand their barriers in the cardiac
monitoring process
Rationale: Altruism is a concern for the welfare & 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.
You are a CNL on the tele unit & 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
1
,B) Drawing the scheduled cardiac enzymes q8h
Reviewing the patient care guidelines & protocols related to hourly rounding
D) The CNL balances both the charge role & the preceptor role simultaneously - ANSWER
A) The CNL discusses with the physician the rationale for discontinuing cardiac monitoring in
the hospice patient
Rationale: Critical thinking underlies independent & interdependent decision making. Critical
thinking includes questioning, analysis, synthesis, interpretation, inference, inductive &
deductive reasoning, intuition, application, & creativity.
You are a CNL selected to lead a team focused on implementing a multidisciplinary clinical
pathway for acute ischemic stroke & 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 BP
C) Liver dysfunction
D) Current smoking
E) Diabetes mellitus - ANSWER C) Liver Dysfunction
Rationale: Independent stroke predictors include age, systolic BP, hypertension, diabetes
mellitus, current smoking, established cardiovascular disease (any one of myocardiac
infarction, angina, coronary insufficiency, congestive heart failure, or intermittent
claudication), Afib, & left ventricular hypertrophy on ECG.
A lack of compliance with 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
2
,D) Developing a unit-based team of nursing personnel to investigate the problem. -
ANSWER B) Gaining an understanding of how DVT prophylaxis is initiated on each stroke
patient on your unit.
Rationale:
White Paper: One competency is that of a systems analyst. A CNL participates in a system
review & conducts a microsystem analysis, identifying a clinical issue with a focus on a
particular population.
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 11am
D) Total number of discharged patients leaving by llam - ANSWER C) Number of discharge
orders on your unit entered before 11am
Rationale: A CNL as an outcomes manager uses data to change practice & to improve
outcomes. Selecting the most appropriate goals & targets will provide meaningful
information.
Electronic nursing documentation has recently been instituted in organization. Select a
response that best defines a clinical decision support:
A) A reminder to save & 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 - ANSWER C) A pop-up to initiate the discharge
instruction sheet with every physician discharge order.
Rationale: CDS is a computer-based program designed to assist clinicians in making clinical
decisions by filtering & integrating vast amounts of information & providing suggestions for
clinical intervention.
CNL focus on projects within a clinical microsystem. A clinical microsystem can be best
described as:
3
, A) A department-wide program focused on improving continuity of care & patient
satisfaction
B) Trending the post-op care on all surgical units
C) The clinical & business processes of a single unit within an organization
D) All medical & surgical units guided by a chief nursing officer - ANSWER C) The clinical &
business processes of a single unit within an organization
Rationale: The microsystem is described by the AACN White Paper as the practice level of
the CNL.
All are part of the data necessary for a CNL to fully understand & assess his or her clinical
unit except:
A) The organization financial statement
B) The target population & age distribution
C) The percentage of FTEs
D) Rate of nosocomial infections
E) Fall rates - ANSWER A) The organization financial statement
Rationale: 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.
The results of a quarterly report identify an increase in patient falls on the tele unit. Your
first action will be to:
A) Implement hourly rounding
B) Gain an understanding of patient care practices on the tele unit
C) Assign patient personal alarms to all patients at risk
D) Revise the current fall risk documentation form - ANSWER B) Gain an understanding of
patient care practices on the tele unit
Rationale: Assessment includes gathering information about the health status of the client &
analyzing & synthesizing those making judgments about nursing interventions on the basis
of findings, evaluation, & managing of individual care outcomes.
4
Patient satisfaction scores in emergency department have shown a downward trend over
the past three quarters. As a clinical nurse leader in ED focus is to:
A) Create a script for triage nurse in welcoming the patient
B) Assign a volunteer to welcome patients to the hospital
C) Compare desired outcomes with national & state standards
D) Write a letter of apology to each dissatisfied patient - ANSWER C) Compare desired
outcomes with national & State standards
Rationale: 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.
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 B) Sponsoring
a meeting with the monitor technicians to understand their barriers in the cardiac
monitoring process
Rationale: Altruism is a concern for the welfare & 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.
You are a CNL on the tele unit & 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
1
,B) Drawing the scheduled cardiac enzymes q8h
Reviewing the patient care guidelines & protocols related to hourly rounding
D) The CNL balances both the charge role & the preceptor role simultaneously - ANSWER
A) The CNL discusses with the physician the rationale for discontinuing cardiac monitoring in
the hospice patient
Rationale: Critical thinking underlies independent & interdependent decision making. Critical
thinking includes questioning, analysis, synthesis, interpretation, inference, inductive &
deductive reasoning, intuition, application, & creativity.
You are a CNL selected to lead a team focused on implementing a multidisciplinary clinical
pathway for acute ischemic stroke & 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 BP
C) Liver dysfunction
D) Current smoking
E) Diabetes mellitus - ANSWER C) Liver Dysfunction
Rationale: Independent stroke predictors include age, systolic BP, hypertension, diabetes
mellitus, current smoking, established cardiovascular disease (any one of myocardiac
infarction, angina, coronary insufficiency, congestive heart failure, or intermittent
claudication), Afib, & left ventricular hypertrophy on ECG.
A lack of compliance with 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
2
,D) Developing a unit-based team of nursing personnel to investigate the problem. -
ANSWER B) Gaining an understanding of how DVT prophylaxis is initiated on each stroke
patient on your unit.
Rationale:
White Paper: One competency is that of a systems analyst. A CNL participates in a system
review & conducts a microsystem analysis, identifying a clinical issue with a focus on a
particular population.
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 11am
D) Total number of discharged patients leaving by llam - ANSWER C) Number of discharge
orders on your unit entered before 11am
Rationale: A CNL as an outcomes manager uses data to change practice & to improve
outcomes. Selecting the most appropriate goals & targets will provide meaningful
information.
Electronic nursing documentation has recently been instituted in organization. Select a
response that best defines a clinical decision support:
A) A reminder to save & 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 - ANSWER C) A pop-up to initiate the discharge
instruction sheet with every physician discharge order.
Rationale: CDS is a computer-based program designed to assist clinicians in making clinical
decisions by filtering & integrating vast amounts of information & providing suggestions for
clinical intervention.
CNL focus on projects within a clinical microsystem. A clinical microsystem can be best
described as:
3
, A) A department-wide program focused on improving continuity of care & patient
satisfaction
B) Trending the post-op care on all surgical units
C) The clinical & business processes of a single unit within an organization
D) All medical & surgical units guided by a chief nursing officer - ANSWER C) The clinical &
business processes of a single unit within an organization
Rationale: The microsystem is described by the AACN White Paper as the practice level of
the CNL.
All are part of the data necessary for a CNL to fully understand & assess his or her clinical
unit except:
A) The organization financial statement
B) The target population & age distribution
C) The percentage of FTEs
D) Rate of nosocomial infections
E) Fall rates - ANSWER A) The organization financial statement
Rationale: 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.
The results of a quarterly report identify an increase in patient falls on the tele unit. Your
first action will be to:
A) Implement hourly rounding
B) Gain an understanding of patient care practices on the tele unit
C) Assign patient personal alarms to all patients at risk
D) Revise the current fall risk documentation form - ANSWER B) Gain an understanding of
patient care practices on the tele unit
Rationale: Assessment includes gathering information about the health status of the client &
analyzing & synthesizing those making judgments about nursing interventions on the basis
of findings, evaluation, & managing of individual care outcomes.
4
