Clinical Nurse Leader (Cnl) Quiz Sample

20 Questions | Total Attempts: 1175

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Clinical Nurse Leader (Cnl) Quiz Sample

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Questions and Answers
  • 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. 
    • 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. 
    • 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