Clinical Nurse Leader (Cnl) Quiz Sample
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- 1.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
- 2.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
- 3.You are a CNL on the telemetry unit and 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
- B.
Drawing the scheduled cardiac enzymes every 8 hours
- C.
Reviewing the patient care guidelines and protocols related to hourly rounding
- D.
The CNL balances both the charge role and the preceptor role simultaneously
- 4.You are a CNL selected to lead a team focused on implementing a multidisciplinary clinical pathway for acute ischemic stroke and 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 blood pressure
- C.
Liver dysfunction
- D.
Current smoking
- E.
Diabetes mellitus
- 5.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
- 6.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 11 a.m.
- D.
Total number of discharged patients leaving by 11 a.m.
- 7.Electronic nursing documentation has recently been instituted in your organization. Select a response that best defines a clinical decision support:
- A.
A reminder to save and 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
- 8.In 2008, the Centers for Medicaid and Medicare Services (CMS) collaboratively with the Centers for Disease Control and Prevention enacted a new payment provision related to eight hospital-acquired conditions. Hospital falls and traumas occurring during a hospital stay will not receive CMS reimbursement. Health promotion, risk reduction, and disease prevention are core competencies of the clinical nurse leader. As a CNL on the telemetry unit, you have recognized the importance of this issue. Which level within a system does this issue affect?
- A.
Microsystem
- B.
Mesosystem
- C.
Macrosystem
- D.
All of the above
- 9.Clinical nurse leaders focus on projects within a clinical microsystem. A clinical microsystem can be best described as:
- A.
A department-wide program focused on improving continuity of care and patient satisfaction
- B.
Trending the postoperative care on all surgical units
- C.
The clinical and business processes of a single unit within an organization
- D.
All medical and surgical units guided by a chief nursing officer
- 10.All are part of the data necessary for a CNL to fully understand and assess his or her clinical unit except:
- A.
The organization financial statement
- B.
The target population and age distribution
- C.
The percentage of full-time equivalents (FTEs)
- D.
Rate of nosocomial infections
- E.
Fall rates
- 11.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
- 12.You have been asked to lead the telemetry fall prevention committee. Which combination of team members would best suit the initial phase of this group?
- A.
A behavioral health APRN
- B.
A staff nurse
- C.
A physical therapist
- D.
The nurse manager
- E.
All of the above
- F.
Only A, B, and D are needed
- 13.As a CNL in the ICU, you have observed several prolonged and fragmented processes of starting an intravenous line in a critically ill patient. All of the following considerations are necessary in identifying a theme for your improvement process except:
- A.
A thorough review of the clinical unit
- B.
The manager’s mandate for change
- C.
The alignment with the organization’s strategic priorities
- D.
Input from the patient’s family
- 14.The hospital is looking to utilize cardiac monitor watchers. Your analysis includes all of the following except:
- A.
A review of an online ECG monitoring education program
- B.
Identifying a clinical issue with a focus on a specific population
- C.
Conducting a trend analysis of outcome data
- D.
Analyzing barriers and facilitators with the organization
- 15.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 visual signal on all ports not intended for intravenous drugs
- B.
A double-check system for medication administration
- C.
To facilitate a critical incident reporting structure that fosters a “without blame” unit culture
- D.
All of the above
- E.
Only C
- 16.Data reported by the ICU quality committee reflect challenges in the management of the septic patient. As a CNL in the ICU, all of the following are first steps in evaluating the delivery of client care except:
- A.
Knowledge of sepsis guidelines
- B.
Critical care clinicians staffing ratios
- C.
Use of clinical decision support systems
- D.
Differentiating sepsis from systemic inflammatory response syndrome (SIRS)
- 17.A fellow staff nurse is struggling to understand the use of a clinical decision support system (CDSS) in the management of her septic patient. Your initial teaching strategy includes:
- A.
Sharing the latest clinical research
- B.
An understanding of expected and actual outcomes
- C.
Defining the purpose of CDSS
- D.
Exploring challenges, risks, and benefits
- 18.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
- 19.Your colleagues have identified challenges in the process of inserting an intravenous line. To gain a better understanding of what this process entails, you:
- A.
Directly observe the intravenous line insertion process and time each step of the process
- B.
Create a workflow diagram tracing the path of the nurse during the line insertion process
- C.
Engage the IV team to reeducate the nurses
- D.
All of the above
- E.
A and B
- 20.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
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