CNL Questions 1-50. Accurate answers provided. Latest version 2022. Rated A+

A new graduate nurse approaches you and states she needs help removing a PICC. Which of the following is the best response when acting as a horizontal leader?* a. remove the PICC yourself b. tell her to find the poli ...

A new graduate nurse approaches you and states she needs help removing a PICC. Which of the following is the best response when acting as a horizontal leader?* a. remove the PICC yourself b. tell her to find the policy and then remove the PICC c. help jenny find the policy and review it with her. Coach her while she removed the PICC and provide feedback. d. help jenny find the policy and refer her to a nurse with 12 years of experience for assistance. - ☑☑c. help jenny find the policy and review it with her. Coach her while she removed the PICC and provide feedback The clinical nurse leader (CNL) acts as a horizontal leader by helping the new graduate nurse to learn through sharing knowledge and coaching, rather than doing the task for the nurse. *What organizational theory is used with rapid, unpredictable, and constant change?* a. Systems theory b. Chaos theory c. Change theory d. Traditional theory - ☑☑b. Chaos theory Chaos theory is used to understand rapidly changing, unpredictable health care environments. *a 65 YO AA male was admitted to your microsystem with hyperglycemia. The patient has a history of HTN, gout, obesity, and smoking. The patient has a family history of DM and HTN. Which statement by the patient demonstrates his understanding of modifiable risk factors for DM?* a. "As I get older, my risk for DM increases" b. "I know that a family history of DM is a risk factor, so I will educate my children on DM prevention." c. "I will keep a record of all my blood sugars to take to my doctor's appointments." d. I will attend a smoking cessation class, because I know smoking increases my risk for DM." - ☑☑d. I will attend a smoking cessation class, because I know smoking increases my risk for DM." Modifiable risk factors are lifestyle factors that a person can alter in order to prevent disease. Smoking cessation class is an intervention for modifying the risk factor of smoking. *Your hospital is currently trialing the integration of the clinical nurse leader (CNL) role. At the end of the trial implementation period how can you, as the CNL, best illustrate the effectiveness of your role during this trial?* a. Refer to increased patient satisfaction scores over the course of the trial b. Present data that demonstrates the effect of the CNL and outcomes achieved over the course of the trial. c. Present a list of projects and tasks completed over the course of the trial. d. Refer to your performance review over the course of the trial. - ☑☑B The CNL should present the effect and outcomes to illustrate the importance of the integration of his or her role. Increased patient satisfaction is not necessarily directly related to the CNL. Presentation of projects and tasks completed does not address measurable outcomes. Performance review of the individual does not indicate outcomes were affected. *You are a CNL on an oncology unit. Recently, there has been an increase in the number of CAUTIs on your unit. After shadowing nurses and aides you observed a variety of* *practices, techniques, and expectations surrounding daily catheter care. Your hospital does not have a current policy or procedure regarding catheter care. As the CNL, what should you do next?* a. review current evidence for catheter care practice and disseminate evidence to the staff b.form an interdisciplinary team meeting to evaluate current hospital catheter care policies c. create a rubric for educating patients and staff on catheter care d. discuss with the unit manager the clinical issue and create a set of evidence-based unit expectations and practices for the unit. evaluate the need to address this issue with a hospital wide policy or procedure. - ☑☑d. discuss with the unit manager the clinical issue and create a set of evidence-based unit expectations and practices for the unit. evaluate the need to address this issue with a hospital wide policy or procedure. CNLs should gather and disseminate evidence to solve clinical problems; however, that should not be the initial step. Further review of hospital practices and policies may come after this issue is addressed. Creation of a rubric for educating patients and staff on catheter care may come after reviewing evidence. The CNL should act to solve the clinical issue in the short term, and evaluate the need for a larger policy to address gaps in practice hospital-wide. *A 50 YO F with stage 3 COPD presents tot he ED with increased SOB. Based on these lab results, what is the acid-base disorder* pH 7.25 PaCO2 50 mmHg HCO3 22 mEq/L PO2 75 SpO2 88% Na + 136 BUN 18 a. uncompensated respiratory acidosis b. metabolic acidosis c. respiratory acidosis d. uncompensated respiratory acidosis - ☑☑a. uncompensated respiratory acidosis Based on the clinical scenario, the pH is decreased (less than 7.35); therefore, the patient has acidosis. The PaCO2 is elevated (more than 45 mmHg), which is also consistent with the pH. The HCO3 is within normal limits, which suggests the kidneys are not compensating. COPD is commonly associated with respiratory acidosis. *A CNL evaluates a 17YO patient who has been a victim of rape. The patient has visible bruising and a head laceration. After the CNL's assessment, law enforcement officials have contacted the CNL requesting* *information regarding the attack and the visible injuries seen during the visit. The CNL knows she must first:* a. take pictures and complete the rape kit b. provide law enforcement with records as requested c. call the patient's parents first d. explain to the patient in order to obtain consent for release of records - ☑☑d. explain to the patient in order to obtain consent for release of records Rationale: Legally, there must be consent from the patient to share information with law enforcement and to abide by Health Insurance Portability and Accountability Act (HIPAA) regulations. *A CNL in the NICU is collecting data on the hours worked weekly by the staff nurses. The CNL wants to see if there is a normal distribution of hours worked. What technique is the best to display the distribution of the data collected?* a. run chart b. fishbone chart c. failure modes and effects analysis (FMEA) chart d. histogram - ☑☑d. histogram Histogram is a graphical representation, showing a visual impression of the distribution of data. *Your peds onc unit is considering the implementation of a social/activity program for clients that would provide volunteer social interactions and age-appropriate activities to admitted clients. As the CNL for this unit, you recognize this intervention as a way to:* a. Be helpful to the floor staff by distracting clients b. Be a wasteful expenditure c. meet the psychosocial needs of clients d. prevent poor client experience rating on d/c surveys. - ☑☑c. meet the psychosocial needs of clients While social interaction and activities may provide distraction to clients and prevent poor client experiences, such a program would most importantly meet the holistic needs of young clients that may otherwise be neglected during a lengthy hospital stay. They also act to integrate such services with the medical care being delivered, meeting the CNL's call to develop and integrate services across settings in a holistic manner. *When assessing a new microsystem, the CNL will often use a tool known as the "5 Ps." As a CNL, you recognize the "5 Ps" to include are:* A. Purpose, patients, process, patterns, professionals B. Patients, providers, policies, patterns, prevention C. Purpose, patients, providers, patterns, prevention D. Patients, process, professionals, policies, patterns - ☑☑A. Purpose, patients, process, patterns, professionals *Mr. J is an 80YO who lives alone. He had fallen and was found by his neighbors. Mr. J has a history of multiple falls, CHF, MI,DM, and asthma. Mr. J is admitted to the hospital with a hip fracture. Using an interdisciplinary approach, who should the CNL include in the plan of care initially?* A. Clinical care manager, medical social worker, clinical nutritionist, CNL, and physician B. Clinical care manager, medical social worker, clinical nutritionist, physical therapist, registered nurse, CNL, and physician C. Speech therapist, clinical care manager, medical social worker, CNL, registered nurse, and nursing supervisor D. Clinical care manager, medical social worker, CNL, registered nurse, and nurse manager - ☑☑B. Clinical care manager, medical social worker, clinical nutritionist, physical therapist, registered nurse, CNL, and physician An interdisciplinary team is composed of many disciplines who work together toward a patient's and family's common goals, such as safe discharge coordination. Learning to advocate for clients occurs by communicating effectively with other interdisciplinary team members, including nurses in other settings. The opportunity to learn and work in an interdisciplinary team will provide the best opportunity to give patients the best outcome. *As the CNL on a telemetry unit, you are performing a root cause analysis (RCA) due to the high volume of CAUTIs over the last 6 months. Realizing that the Centers for Medicare & Medicaid are on a pay-for-performance basis, you develop a CAUTI task force in an effort to reduce cost. This is an example of which of the following?* A. Implementing cost reduction and savings B. Anticipating risk and designing plans of care to improve outcomes C. Evaluating the effect of the health care financing on care access and patient outcomes D. Applying basic business and economic principles to the microsystem - ☑☑B. Anticipating risk and designing plans of care to improve outcomes CNLs must have the ability to critically evaluate and anticipate risks to client safety; this is a critical component role. *You notice a trend of increased central line bloodstream infection (CLBSI) on your unit. You conduct a literature search and, after critiquing and synthesizing the available evidence, you find that central line bundles have been shown to decrease CLBSI. You want to implement this bundle on your unit, and plan to evaluate the effect of this change. Which of the following best describes this process?* A. Plan-Do-Study-Act (PDSA) B. Research C. Process improvement D. Evidence-based practice (EBP) - ☑☑D. Evidence-based practice (EBP) EBP involves applying the best available research evidence, clinical expertise, and patient preferences to improve a clinical outcome. *A CNL rounds with Dr. Camper on a Spanish-speaking patient. The CNL asks the physician to call an interpreter, but the MD states that it is not necessary because the patient's daughter speaks English. However, the CNL insists and ensures an interpreter is present. What CNL role was fulfilled?* A. Educator B. Team manager C. Clinician D. Client advocate - ☑☑D. Client advocate Client advocacy is a hallmark of the CNL's role. As a client advocate, the CNL assumes accountability for the delivery of high-quality care, including the evaluation of care outcomes and provision of leadership in improving care. *During the policy formulation phase, all of the following are correct except:* A. Possible solutions are offered. B. Political circumstances are considered. C. A problem is identified. D. Policy decisions are adjusted to accommodate changing circumstances or needs. - ☑☑D. Policy decisions are adjusted to accommodate changing circumstances or needs. Policy formulation is the development of effective and acceptable courses of action in order to address what has been placed on the policy agenda. This should include the following characteristics: (a) The problem is identified, (b) possible solutions are offered, (c) political circumstances are considered, and (d) policy makers, stakeholders, and legislative staff are involved. *The unit implemented bedside reporting 6 months ago, but the change has not been sustained. As a CNL, you begin to participate in bedside reporting and provide constructive, immediate feedback to the nurses for improvement. What best describes this situation?* A. Mentoring B. Transformational leadership C. Coaching D. Precepting - ☑☑C. Coaching The CNL coaches by evaluating team members and providing constructive feedback. Mentoring is a long-term relationship between two individuals focused on clinical advancement. *Jane, a CNL, successfully implemented an evidence-based practice (EBP) project utilizing music therapy to help with pain control in sickle cell patients on a medical-surgical unit. Jane was asked by the CNO to implement the project within the medical division. What system will Jane be working in?* A. Mesosystem B. Macrosystem C. Microsystem D. Unit system - ☑☑A. Mesosystem The mesosystem encompasses multiple microsystems, such as a medical division within a hospital. *Judy has a family history of type 2 diabetes. After education, Judy knows she can help to prevent diabetes by maintaining a healthy weight, healthy eating habits, and daily physical activity. Judy is exhibiting what type of prevention strategies?* A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention - ☑☑A. Primary prevention The purpose of primary prevention is to prevent the onset of chronic illness, focusing on healthy lifestyle habits and behaviors. *You are a CNL on a surgical unit. Your unit has just hired several new graduate nurses. As the CNL, what is your role in relationship to these new team members?* A. Provider of all clinical education