Clin Nurse Leader Exam Questions with Correct Answers Graded A+
Gap Analysis - Answers Compares ACTUAL performance with POTENTIAL/desired performance
Evaluates the strengths and weaknesses of the team in relation to required outcomes
A good tool for analysis to gain better understanding of the team's functioning
3 phases of knowledge transfer when using EBP - Answers 1. Knowledge creation and distillation
(research and recommendations for clinical practice)
2. Diffusion and Dissemination (distribute info to users, partner with organizations like professional
nursing orgs)
3. Implementation and Institutionalization (end user adoption - health care systems adopt practices)
Examples of restraining forces in Lewin's Change theory - Answers work against the driving forces to
inhibit change
example: want to quit smoking but live with people who smoke so hard to quit in that living situation
Examples of driving forces for Lewin's change theory - Answers factors that support change or push
patient towards necessary changes
such as the drive to quit smoking to breathe easier
Peplau's Theory of Interpersonal Relations - Answers focuses on relationship between patient and nurse
4 phases:
1. Orientation - seeks help through appts, treatment, etc. for RN to determine patients need for
assistance
2. Identification - help identify who can help, set goals of care
,3. Exploitation - receives care from rN
4. Resolution - care is completed
Total patient care. - Answers One nurse is responsible for planning, organizing and delivery of care to a
particular client or group of clients during the assigned shift
Primary nursing - Answers a method of care in which the same RN assigned to same patient over time;
assumes 24 hour responsibility for planning, directing, and evaluating
client care from the time of admission through discharge
team nursing - Answers a nursing care pattern; a team of nursing staff is led by an RN who decides the
amount and kind of care each person needs - each member responsible for certain cares such as ADLs or
meds
Each team member is able to contribute their own special expertise or skills caring for the client
Continuity of care may suffer if daily assignment of team varies and client is exposed to
many different caregivers.
relative risk - Answers used when the study involves comparing the likelihood, or chance, of an event
occurring between two groups
ratio of the absolute risk of a disease among the exposed group to the absolute risk of the disease
among the unexposed group in an epidemiologic study
confidence interval - Answers the range of values within which a population parameter is estimated to
lie based on a random sample of the population.
The most common interval is the 95% confidence interval. It represents the range that one can be 95%
confident that the population parameter lies.
confounding - Answers distortion in the degree of association because researcher failed to control, or
eliminate the confounding variable, damaging the internal validity of an experiment.
,occurs when two variables are associated in such a way that their effects on a response variable cannot
be distinguished from each other
internal validity - Answers extent to which a piece of evidence supports a claim about cause and effect &
degree to which the results of a study are not due to bias or confounding
External validity - Answers the degree to which the results of the original study are applicable to a
population other than the one initially targeted = generalizability
An oral glucose tolerance test (OGTT) measures - Answers your blood sugar after you have gone at least
eight hours without eating and two hours after you drink a glucose-containing beverage. This test can be
used to diagnose diabetes or prediabetes.
Oral Glucose Tolerance Test (OGTT) result of 150 means what?
A. Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g OGTT
within 1 week.
B. The results are within normal limits and do not meet the threshold for the diagnosis of gestational
diabetes.
C. A fasting blood sugar should be checked as soon as possible.
D. Based on this abnormal value, the 3-hour OGTT is not required. - Answers A. Based on a value greater
than 140 mg/dL, the patient should have 3-hour 100-g OGTT
within 1 week.
Rationale: If your blood glucose is higher than 140 mg/dL, the next step is the oral 3-hour glucose
tolerance test. This test will determine if you have gestational diabetes.
After performing the literature review and developing a PICOT question, what should you do next before
implementation?
A. Form a team of stakeholders
B. Develop a comparison group
C. Talk to the manager
, D. Start the implementation process - Answers A. Form a team of stakeholders
Rationale: After performing the literature review and developing a PICOT question, you should create a
team of stakeholders to ensure the intervention has the appropriate resources to make the study
successful.
Pt has a blood sugar of 58 with headache and blurry vision.
Which of the following interventions is appropriate for the nurse to tell the CNL?
A. The patient is experiencing hyperglycemia and should be given a protein snack.
B. The patient is experiencing hyperglycemia and should be given insulin and 1 cup of milk.
C. The patient is experiencing hypoglycemia and should be given insulin and 1 cup of orange juice. D.
The patient is experiencing hypoglycemia and should be given 1 cup of skim milk. - Answers D. The
patient is experiencing hypoglycemia and should be given 1 cup of skim milk.
Rationale: The patient's fasting blood sugar is below 60 mm/dL and is symptomatic. She must be treated
for hypoglycemia by drinking 1 cup of skim milk, or 1⁄2 cup of juice, or 1⁄2 cup of soft drink.
As a trial CNL, whose buy-in will be the most important in fully implementing the CNL role in the
hospital?
A. The chief nursing officer (CNO)
B. The unit manager
C. The members of the interdisciplinary team
D. The staff affected by your outcomes - Answers The chief nursing officer (CNO)
CNO will have the most influence in your hospital
Orem's self care deficit theory - Answers The nurse's actions are directed toward assisting the patient to
assume responsibility for self-care & based on the premise that all individuals are capable of self-care
Gap Analysis - Answers Compares ACTUAL performance with POTENTIAL/desired performance
Evaluates the strengths and weaknesses of the team in relation to required outcomes
A good tool for analysis to gain better understanding of the team's functioning
3 phases of knowledge transfer when using EBP - Answers 1. Knowledge creation and distillation
(research and recommendations for clinical practice)
2. Diffusion and Dissemination (distribute info to users, partner with organizations like professional
nursing orgs)
3. Implementation and Institutionalization (end user adoption - health care systems adopt practices)
Examples of restraining forces in Lewin's Change theory - Answers work against the driving forces to
inhibit change
example: want to quit smoking but live with people who smoke so hard to quit in that living situation
Examples of driving forces for Lewin's change theory - Answers factors that support change or push
patient towards necessary changes
such as the drive to quit smoking to breathe easier
Peplau's Theory of Interpersonal Relations - Answers focuses on relationship between patient and nurse
4 phases:
1. Orientation - seeks help through appts, treatment, etc. for RN to determine patients need for
assistance
2. Identification - help identify who can help, set goals of care
,3. Exploitation - receives care from rN
4. Resolution - care is completed
Total patient care. - Answers One nurse is responsible for planning, organizing and delivery of care to a
particular client or group of clients during the assigned shift
Primary nursing - Answers a method of care in which the same RN assigned to same patient over time;
assumes 24 hour responsibility for planning, directing, and evaluating
client care from the time of admission through discharge
team nursing - Answers a nursing care pattern; a team of nursing staff is led by an RN who decides the
amount and kind of care each person needs - each member responsible for certain cares such as ADLs or
meds
Each team member is able to contribute their own special expertise or skills caring for the client
Continuity of care may suffer if daily assignment of team varies and client is exposed to
many different caregivers.
relative risk - Answers used when the study involves comparing the likelihood, or chance, of an event
occurring between two groups
ratio of the absolute risk of a disease among the exposed group to the absolute risk of the disease
among the unexposed group in an epidemiologic study
confidence interval - Answers the range of values within which a population parameter is estimated to
lie based on a random sample of the population.
The most common interval is the 95% confidence interval. It represents the range that one can be 95%
confident that the population parameter lies.
confounding - Answers distortion in the degree of association because researcher failed to control, or
eliminate the confounding variable, damaging the internal validity of an experiment.
,occurs when two variables are associated in such a way that their effects on a response variable cannot
be distinguished from each other
internal validity - Answers extent to which a piece of evidence supports a claim about cause and effect &
degree to which the results of a study are not due to bias or confounding
External validity - Answers the degree to which the results of the original study are applicable to a
population other than the one initially targeted = generalizability
An oral glucose tolerance test (OGTT) measures - Answers your blood sugar after you have gone at least
eight hours without eating and two hours after you drink a glucose-containing beverage. This test can be
used to diagnose diabetes or prediabetes.
Oral Glucose Tolerance Test (OGTT) result of 150 means what?
A. Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g OGTT
within 1 week.
B. The results are within normal limits and do not meet the threshold for the diagnosis of gestational
diabetes.
C. A fasting blood sugar should be checked as soon as possible.
D. Based on this abnormal value, the 3-hour OGTT is not required. - Answers A. Based on a value greater
than 140 mg/dL, the patient should have 3-hour 100-g OGTT
within 1 week.
Rationale: If your blood glucose is higher than 140 mg/dL, the next step is the oral 3-hour glucose
tolerance test. This test will determine if you have gestational diabetes.
After performing the literature review and developing a PICOT question, what should you do next before
implementation?
A. Form a team of stakeholders
B. Develop a comparison group
C. Talk to the manager
, D. Start the implementation process - Answers A. Form a team of stakeholders
Rationale: After performing the literature review and developing a PICOT question, you should create a
team of stakeholders to ensure the intervention has the appropriate resources to make the study
successful.
Pt has a blood sugar of 58 with headache and blurry vision.
Which of the following interventions is appropriate for the nurse to tell the CNL?
A. The patient is experiencing hyperglycemia and should be given a protein snack.
B. The patient is experiencing hyperglycemia and should be given insulin and 1 cup of milk.
C. The patient is experiencing hypoglycemia and should be given insulin and 1 cup of orange juice. D.
The patient is experiencing hypoglycemia and should be given 1 cup of skim milk. - Answers D. The
patient is experiencing hypoglycemia and should be given 1 cup of skim milk.
Rationale: The patient's fasting blood sugar is below 60 mm/dL and is symptomatic. She must be treated
for hypoglycemia by drinking 1 cup of skim milk, or 1⁄2 cup of juice, or 1⁄2 cup of soft drink.
As a trial CNL, whose buy-in will be the most important in fully implementing the CNL role in the
hospital?
A. The chief nursing officer (CNO)
B. The unit manager
C. The members of the interdisciplinary team
D. The staff affected by your outcomes - Answers The chief nursing officer (CNO)
CNO will have the most influence in your hospital
Orem's self care deficit theory - Answers The nurse's actions are directed toward assisting the patient to
assume responsibility for self-care & based on the premise that all individuals are capable of self-care
