FIED ANSWERS | GRADED A+| PASS ON FIRST ATTEMPT | BRAND
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 out-
comes are a measure of quality practice. CNLs must know how to compare desired out-
comes 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 ret-
rospective 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 Ameri-
can 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 - AN-
SWER ANS B: White Paper: One competency is that of a systems analyst. A CNL partici-
pates 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 car-
diac monitoring process
1
,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: Altru-
ism 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 synthesizing
those making judgments about nursing interventions on the basis of findings, evaluation,
and managing of individual care outcomes.
Several near misses were identified by ICU nurses who had mistaken invasive lines for intra-
venous 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 cul-
ture
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 op-
portunities for improving safety in this situation
You are using failure mode and effect analysis (FMEA) to anticipate the risk of medication er-
rors 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
2
,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 bene-
fits:
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 meas-
ured by:
A) ! Trending quarterly patient satisfaction scores pertaining to spiritual care during hospital-
ization
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
3
, 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 pa-
tient outcomes.
The concept that an organization is in a continued state of change describes which organiza-
tional 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 sys-
tem 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 de-
fine what is to be collected and avoid confusion for those collecting the data. Clear opera-
tional definitions also helps those who are interpreting the data. Failure to determine opera-
tional definitions may result in data that are inaccurate
4
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 out-
comes are a measure of quality practice. CNLs must know how to compare desired out-
comes 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 ret-
rospective 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 Ameri-
can 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 - AN-
SWER ANS B: White Paper: One competency is that of a systems analyst. A CNL partici-
pates 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 car-
diac monitoring process
1
,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: Altru-
ism 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 synthesizing
those making judgments about nursing interventions on the basis of findings, evaluation,
and managing of individual care outcomes.
Several near misses were identified by ICU nurses who had mistaken invasive lines for intra-
venous 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 cul-
ture
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 op-
portunities for improving safety in this situation
You are using failure mode and effect analysis (FMEA) to anticipate the risk of medication er-
rors 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
2
,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 bene-
fits:
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 meas-
ured by:
A) ! Trending quarterly patient satisfaction scores pertaining to spiritual care during hospital-
ization
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
3
, 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 pa-
tient outcomes.
The concept that an organization is in a continued state of change describes which organiza-
tional 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 sys-
tem 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 de-
fine what is to be collected and avoid confusion for those collecting the data. Clear opera-
tional definitions also helps those who are interpreting the data. Failure to determine opera-
tional definitions may result in data that are inaccurate
4
