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CLINICAL NURSE LEADER (CNL) CERTIFICATION EXAM WITH
PRACTICE EXAM ALL 550 QUESTIONS AND CORRECT DETAILED
SOLUTIONS JUST RELEASED THIS YEAR
Clinical Nurse Leader (CNL) Certification EXAM 1
QUESTION: James started working as a new CNL on a medical-surgical unit. James is trying to
focus on becoming a strong horizontal leader. James recognizes that he needs a horizontal
leader "tool kit" of skills. This tool kit includes:
A. Evidence-based practice, healthcare outcomes, lateral integration feedback, coaching, and
leading teams
B. Evidence-based practice, healthcare outcomes, lateral integration , use of , and verbal
communication
C. Evidence-based practice, healthcare outcomes, vertical integration and leading teams
D. Evidence-based practice, healthcare outcomes, vertical integration feedback - ANSWER✔✔A.
Evidence-based practice, healthcare outcomes, lateral integration feedback, coaching, and
leading teams
QUESTION: Gina is a CNL at a university health center and she is asked by a new nurse to insert
an intravenous (IV) line for him because he is still uncomfortable with this skill. As a horizontal
leader, Gina decides that the best action is to:
A. Develop a training session to educate new nurses on IV insertions.
B. Inform the new nurse that she will help coach him throughout the process of inserting the IV.
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C. Inform the new nurse that inserting IVs is not her job.
D. Inform the new nurse that he will do it this time and seek out a nurse educator for proper IV
insertion training. - ANSWER✔✔B. Inform the new nurse that she will help coach him
throughout the process of inserting the IV.
QUESTION: A new CNL in a large healthcare system is in a discussion with other CNLs about
how Traditional Systems thinking had created a vicious cycle of: (a) designing a system, (b) when
the system did not act as predicted, then (c) redesigning the system. And this vicious cycle was a
result of top leaders attempting to control the evolution of complex systems by intentions and
clear thinking. The CNL states to the group that there is a more effective current type of
leadership or thinking in healthcare systems based on science that has examined complex
organizations and this type of leadership/thinking involves a complex interactive dynamic style
from which adaptive outcomes can emerge. Which type of more effective leadership/thinking is
the CNL referring to in his or her discussion?
A. Transformational Leadership
B. Servant Leadership
C. Leading by Example
D. Complexity Leadership - ANSWER✔✔D. Complexity Leadership
QUESTION: Effective interprofessional communication and collaboration are important
components of providing safe patient care. The CNL knows that the foundation of effective
collaboration among the interprofessional team is:
A. Mutual trust, respect, and clinical competence
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B. Clinical competence, years of experience, and certifications
C. Complete documentation in the SBAR, EMR, and progress notes
D. Time management and leadership skills - ANSWER✔✔A. Mutual trust, respect, and clinical
competence
As a CNL utilizing horizontal leadership, it is also important for the CNL to be aware of the
different theories that serve as a foundation of healthcare delivery. Which theory is derived
from the chaos model and is used to understand a rapidly changing, unpredictable healthcare
environment?
A. Change Theory
B. Systems Theory
C. Unpredictable Theory
D. Complexity Theory - ANSWER✔✔Complexity theory
used to understand a rapidly changing, unpredictable healthcare environment. It has its origins
in the chaos model (e.g., changes are rapid, random, and frequent) (Cannon & Boswell, 2010)
QUESTION: John, a 28-year-old male, is admitted to the progressive care unit after a
tracheostomy placement following a respiratory distress episode. Prior to admission John was
living independently at home. John has been in the hospital for 68 days and has regressed to
only being able to stand for several minutes at a time. The clinical case manager (CCM)
mentioned in the morning huddle that the patient's discharge options are limited at this time.
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As a leader, who should the CNL include in the team to discuss the process of discharge
planning before finalizing the plan with John?
A. Physician, staff nurse, social worker, CCM, patient, physical therapy, occupational therapy,
and speech therapy
B. Rehabilitation liaison, physician, and speech therapist)
C. Patient's family, physician, and social worker
D. Skilled nursing facility liaison, CCM, staff nurse, and dietician - ANSWER✔✔A. Physician, staff
nurse, social worker, CCM, patient, physical therapy, occupational therapy, and speech therapy
QUESTION: A staff nurse was asked to take a patient's weight in order for a physician to
calculate the appropriate dose for a new drug. The nurse documented the weight with just a
number. It is discovered that the nurse actually documented the weight in pounds instead of
kilograms and subsequently the patient was given the incorrect dose of the medication. This
resulted in a sentinel event. The CNL for the microsystem creates an interprofessional team to
do a root cause analysis. Which type of leadership is the CNL demonstrating?
A. Servant Leadership
B. Interprofessional Leadership
C. Horizontal Leadership
D. Team-Based Leadership - ANSWER✔✔C. Horizontal Leadership
A root cause analysis is performed whenever a sentinel events occurs. A horizontal leader would
develop a team of other disciplines (e.g., physician, pharmacist, and staff nurse) to perform the
root cause analysis.
CLINICAL NURSE LEADER (CNL) CERTIFICATION EXAM WITH
PRACTICE EXAM ALL 550 QUESTIONS AND CORRECT DETAILED
SOLUTIONS JUST RELEASED THIS YEAR
Clinical Nurse Leader (CNL) Certification EXAM 1
QUESTION: James started working as a new CNL on a medical-surgical unit. James is trying to
focus on becoming a strong horizontal leader. James recognizes that he needs a horizontal
leader "tool kit" of skills. This tool kit includes:
A. Evidence-based practice, healthcare outcomes, lateral integration feedback, coaching, and
leading teams
B. Evidence-based practice, healthcare outcomes, lateral integration , use of , and verbal
communication
C. Evidence-based practice, healthcare outcomes, vertical integration and leading teams
D. Evidence-based practice, healthcare outcomes, vertical integration feedback - ANSWER✔✔A.
Evidence-based practice, healthcare outcomes, lateral integration feedback, coaching, and
leading teams
QUESTION: Gina is a CNL at a university health center and she is asked by a new nurse to insert
an intravenous (IV) line for him because he is still uncomfortable with this skill. As a horizontal
leader, Gina decides that the best action is to:
A. Develop a training session to educate new nurses on IV insertions.
B. Inform the new nurse that she will help coach him throughout the process of inserting the IV.
, Page 2 of 258
C. Inform the new nurse that inserting IVs is not her job.
D. Inform the new nurse that he will do it this time and seek out a nurse educator for proper IV
insertion training. - ANSWER✔✔B. Inform the new nurse that she will help coach him
throughout the process of inserting the IV.
QUESTION: A new CNL in a large healthcare system is in a discussion with other CNLs about
how Traditional Systems thinking had created a vicious cycle of: (a) designing a system, (b) when
the system did not act as predicted, then (c) redesigning the system. And this vicious cycle was a
result of top leaders attempting to control the evolution of complex systems by intentions and
clear thinking. The CNL states to the group that there is a more effective current type of
leadership or thinking in healthcare systems based on science that has examined complex
organizations and this type of leadership/thinking involves a complex interactive dynamic style
from which adaptive outcomes can emerge. Which type of more effective leadership/thinking is
the CNL referring to in his or her discussion?
A. Transformational Leadership
B. Servant Leadership
C. Leading by Example
D. Complexity Leadership - ANSWER✔✔D. Complexity Leadership
QUESTION: Effective interprofessional communication and collaboration are important
components of providing safe patient care. The CNL knows that the foundation of effective
collaboration among the interprofessional team is:
A. Mutual trust, respect, and clinical competence
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B. Clinical competence, years of experience, and certifications
C. Complete documentation in the SBAR, EMR, and progress notes
D. Time management and leadership skills - ANSWER✔✔A. Mutual trust, respect, and clinical
competence
As a CNL utilizing horizontal leadership, it is also important for the CNL to be aware of the
different theories that serve as a foundation of healthcare delivery. Which theory is derived
from the chaos model and is used to understand a rapidly changing, unpredictable healthcare
environment?
A. Change Theory
B. Systems Theory
C. Unpredictable Theory
D. Complexity Theory - ANSWER✔✔Complexity theory
used to understand a rapidly changing, unpredictable healthcare environment. It has its origins
in the chaos model (e.g., changes are rapid, random, and frequent) (Cannon & Boswell, 2010)
QUESTION: John, a 28-year-old male, is admitted to the progressive care unit after a
tracheostomy placement following a respiratory distress episode. Prior to admission John was
living independently at home. John has been in the hospital for 68 days and has regressed to
only being able to stand for several minutes at a time. The clinical case manager (CCM)
mentioned in the morning huddle that the patient's discharge options are limited at this time.
, Page 4 of 258
As a leader, who should the CNL include in the team to discuss the process of discharge
planning before finalizing the plan with John?
A. Physician, staff nurse, social worker, CCM, patient, physical therapy, occupational therapy,
and speech therapy
B. Rehabilitation liaison, physician, and speech therapist)
C. Patient's family, physician, and social worker
D. Skilled nursing facility liaison, CCM, staff nurse, and dietician - ANSWER✔✔A. Physician, staff
nurse, social worker, CCM, patient, physical therapy, occupational therapy, and speech therapy
QUESTION: A staff nurse was asked to take a patient's weight in order for a physician to
calculate the appropriate dose for a new drug. The nurse documented the weight with just a
number. It is discovered that the nurse actually documented the weight in pounds instead of
kilograms and subsequently the patient was given the incorrect dose of the medication. This
resulted in a sentinel event. The CNL for the microsystem creates an interprofessional team to
do a root cause analysis. Which type of leadership is the CNL demonstrating?
A. Servant Leadership
B. Interprofessional Leadership
C. Horizontal Leadership
D. Team-Based Leadership - ANSWER✔✔C. Horizontal Leadership
A root cause analysis is performed whenever a sentinel events occurs. A horizontal leader would
develop a team of other disciplines (e.g., physician, pharmacist, and staff nurse) to perform the
root cause analysis.
