CNL Exam 56 Questions with Verified Answers
CNL Roles - CORRECT ANSWER Systems analyst/risk anticipator
Team manager
Outcomes manager
Information
... [Show More] manager
Clinician
Client advocate
Member of a profession
Educator
Lifelong learner
Organizational Theories - CORRECT ANSWER Classical: focus on structure
Neoclassical: structure with human component
Systems: everything is interrelated
Contingency: organization is contingent on environment
Chaos: organization is adapting to environment
Leadership Theories - CORRECT ANSWER Quantum: fluid leadership (chaos theory)
Charismatic: lead by personality attractiveness (e.g. Hitler)
Transactional: focuses on tasks, short-term goals, policies and procedures
Transformational: strong commitment to organization, empowers followers to reach full potential, visionary
Relational/connective: teamwork, collaboration to reach common goal
Leadership Theories 2 - CORRECT ANSWER Servant: followers desire to serve leader
Shared: everyone is responsible
Autocratic: leader makes all decisions
Bureaucratic: follows organizational policies only
Directive: gives guidance and directions
Supportive: focuses on needs of followers
Leadership Theories 3 - CORRECT ANSWER Trait theory: leaders are born
Behavioral theory: leaders can be made
Contingency theory: leadership is contingent on internal and external factors, changes with situation
Relationship Oriented Structures - CORRECT ANSWER Shared governance: nurses have control over their own practice
Heterarch structure: lateral connections only, opposite of hierarch
Self-organizing: ppl mutually change behaviors w/internal or external demands
Ethical Theories - CORRECT ANSWER Deontology: motives determine value of act
Teology: outcomes determine value of act (e.g. Machiavelli)
Justice and Equity: action that is fair to all
Relativism: ethics are relative to person, place, time, culture
Virtue Ethics: ppl must be developed to act virtuously
Virtues of Nursing - CORRECT ANSWER Compassion: desire to alleviate suffering
Discernment: acuteness of judgement
Trustworthiness: trust is well-founded or deserved
Integrity: firm adherence to code of conduct or ethical value
Ethical Principles - CORRECT ANSWER Beneficence: do good to others, maintain balance of benefit & harm
Non-maleficence: do no harm
Justice: fairness
Autonomy: respect for other's rights to self-determination
Fidelity: keeping one's promise
Respect for others
Veracity: telling the truth
Decision Making - CORRECT ANSWER Group Think: all members think alike
Rational/normative: logical, well-rounded choices
Descriptive/bounded rationality: limited ability of decision maker to act on decision
Delphi: opinions gathered not face to face
Normative: elicits questions, ideas, reactions from a group
Conflict Management Techniques - CORRECT ANSWER Avoiding: ignore conflict
Accommodating: 1 side gives in to other
Competing: 2 or 3 sides compete for goal
Compromising: each side gets and gives up something
Negotiating: agreement, but not consensus
Collaborating: both sides win - best outcome
Confronting: stops conflict immediately
Power - CORRECT ANSWER Referent: admiration/respect for person
Connection: based on person's links to other influential people (e.g. son of senator)
Information: based on access to valued data
Reward: based on rewards offered by manager
Coercive: based on penalties offered by manager
Legitimate: based on hierarchical rank
Expert: based on possession of skills/knowledge/competence (e.g. IT guy)
Delegation - CORRECT ANSWER Responsibility: obligation to do task
Accountability: accepting results of actions
Budgeting - CORRECT ANSWER Direct costs: $ that directly affects pt care (e.g. nurse salaries)
Indirect costs: $ that doesn't directly affect pt care (e.g. lighting, water, paint)
Cost centers: smallest unit of area of cost in an organization (e.g. a department in a company; a unit in a hospital)
Fixed costs: $ set regardless of changes
Variable costs: $ changes based on census, supplies, revenues, etc.
Financial Information - CORRECT ANSWER Operating budget: cost of doing business
Capitol budget: cost of growing business
Cash flow budget: amount going in and out over a time period
Zero-based budgeting: all expenses are justified, no $ left at the end of each period
Change Theories - CORRECT ANSWER PDSA - Plan Do Study Act: cycle of evaluating change
Lewin's Unfreeze-Change/Move-Refreeze - change agent, driving forces, restraining forces
Roger's Diffusion of Innovation - innovators, early adopters, early majority, late majority (largest group), laggards (will never change)
Roger's Diffusion of Innovation - CORRECT ANSWER Knowledge: 1st exposed, but not inspired (e.g. hears about harmful effects of smoking)
Persuasion: interested and seeking info (e.g. asks HCP about effects of smoking/steps to quitting)
Decision: decides whether to adopt or reject change (e.g. tells HCP decision to quit smoking)
Implementation: uses the innovation (e.g. stops buying packs of cigarettes, chewing gum instead)
Confirmation: decides to use innovation fully (e.g. lung capacity increased, pt reports being smoke-free for 3 months)
Change Agent Strategies - CORRECT ANSWER Power-coercive: applies power from authority, economic sanctions, or political clout (e.g. don't text and drive or you'll get a ticket)
Empirical-rational: assumes ppl are rational and will follow self-interest (e.g. don't text and drive or you will get hurt)
Normative-reeducative: assumes ppl act in accordance with social norms and values (e.g. don't text and drive - "everyone's doing it')
Research Terms - CORRECT ANSWER Internal validity: results are not due to bias or confounding factors
Confounding: distortion due to mixing of effects
External validity: results are applicable in other populations
Confidence Interval (CI): the reliability of an estimate, usually 95%
Odds Ratio (OR): ratio of two odds (e.g. odds of exposure in cases vs odds of exposure in controls)
Relative Risk (RR): absolute risk of disease among exposed vs absolute risk of disease among unexposed
Quantitative Researh - CORRECT ANSWER Descriptive
Correlation
Quasi-experimental
Experimental
Qualitative Research - CORRECT ANSWER Phenomenological: captures the "lived experience"
Grounded Theory: explores how ppl define reality and how their beliefs are related to their actions
Ethnographic: describes culture
Historical: examines past
Measurement Tools - CORRECT ANSWER Root Cause Analysis (RCA): process to evaluate potential causes after a serious/sentinel event occurs
Failure Models and Effects Analysis (FMEA): studies potential failures in process and analyzes consequences of those failures; done prior to serious event occurrence
Tables & Charts - CORRECT ANSWER Bar graph: displays categorical data (e.g. demographics of area)
Histogram: displays continuous data, usually bars are touching (e.g. weight of adults 18-35 in an area)
Pareto chart: have descending bars (individual values) and ascending line graph (totals)
Fishbone diagram: cause and effect analysis
Control chart: upper and lower control limits are horizontal lines, data is plotted as dots and a line is drawn connecting the mean values
Scatter diagram: data is plotted as dots
Types of preventable errors - CORRECT ANSWER Medications-nurse last line of defense
Surgery-wrong site
Diagnostic inaccuracy-wrong treatment
Equipment failure-IV pump
System failure-lack of double check
Transfusion error
Laboratory-mislabeled
Security-child abduction
Crossing the Quality Chasm - CORRECT ANSWER Recommends reinvention of the health care system to foster innovation and improve delivery of care.
What is a Clinical Nurse Leader? - CORRECT ANSWER A generalist, expert nurse who:
Is accountable for clinical and cost outcomes for a specific group of patients on a unit
Designs, implements and evaluates plans of care
Coordinates, delegates and supervises the care provided by the interdisciplinary health care team
Ten Assumptions of the CNL role - CORRECT ANSWER 1.Practice at the microsystems level
2.Client care outcomes are the measure of Quality Practice
3.Practice guidelines are based on evidence
4.Client-centered care is intra- and interdisciplinary
5.Information will maximize self-care and client decision making
6.Nursing assessment is the basis for theory and knowledge development
7.Good fiscal stewardship is a condition of quality care
8.Social justice is an essential nursing value
9.Communication technology will facilitate the continuity and comprehensiveness of care
10. The CNL must assume guardianship for the nursing profession
Practice at the microsystems level - CORRECT ANSWER Accountable for outcomes of clinical populations
Coordinates direct care activities of nursing staff & other care providers
Lateral integration of care services
Leadership skills
Unit & systems level
2. Client care outcomes are the measure of Quality Practice - CORRECT ANSWER Improve
› Safety
› Effectiveness
› Timeliness
› Efficiency
› Quality
› Client-centeredness
Compare outcomes to benchmarks
› Nurse-sensitive indicators- Practices that nurses "own", such as falls, pressure ulcers, restraints
3. Practice guidelines are based on evidence - CORRECT ANSWER Application of research to the clinical setting
Resolution of clinical problems
Dissemination of results
Seek evidence that challenges current
practice
4. Client-centered care is intra- and interdisciplinary - CORRECT ANSWER CNL coordinates variety of team members
› Includes nurses in other areas
Effective communication
5. Information will maximize self-care and client decision making - CORRECT ANSWER CNL responsible for educating clients & families
CNL must teach other care providers
6. Nursing assessment is the basis for theory and knowledge development - CORRECT ANSWER Assess individual, health problem, & context in which those problems are manifested
Assessment data are classified, stored, retrieved, analyzed & integrated into information systems
7. Good fiscal stewardship is a condition of quality care - CORRECT ANSWER CNL accountable for cost-effective & efficient use of human, environmental & material resources
Understand context of practice
› Identify high cost/high volume activities
› Compare to benchmarks
8. Social justice is an essential nursing value - CORRECT ANSWER Social justice addresses health disparities
CNL responsible for addressing variations
in clinical outcomes among various groups
May influence policy at the systems level
or higher
9. Communication technology will facilitate the continuity and comprehensiveness of care - CORRECT ANSWER Use of distance technologies
› Sustain therapeutic relationships
› Monitor the course of illness & health on a continuous basis
› Provide care
10. The CNL must assume guardianship for the nursing profession - CORRECT ANSWER CNL expected to assume positions in
› Professional, policy & regulatory organizations
› Leadership positions in healthcare facilities & practice plans
› Faculty
Clinical Nurse Leader role - CORRECT ANSWER Clinician
Outcomes manager
Client advocate
Educator
Information manager
Systems analyst/Risk anticipator
Team manager
Member of a profession
Lifelong learner
Types of Medical Errors - CORRECT ANSWER Medications-nurse last line of defense
Surgery-wrong site
Diagnostic inaccuracy-wrong treatment
Equipment failure-IV pump
System failure-lack of double check
Transfusion error
Laboratory-mislabeled
Security-child abduction
what is crossing the quality of chasm - CORRECT ANSWER Recommends reinvention of the health care
system to foster innovation & improve
delivery of care
What is a CNL? - CORRECT ANSWER A generalist, expert nurse
clinician who:
>Designs, implements and
evaluates plans of care
>Coordinates, delegates and
supervises the care provided
by the interdisciplinary health
care team
Who are CNL's accountable for? - CORRECT ANSWER for clinical and
cost outcomes for a specific
group of patients on a unit
What are the ten assumption of the CNL Role? - CORRECT ANSWER 1. practice at the Microsystem levels
2. Client care outcomes are the measure of quality practice
3 Practice guidelines are based on evidence
4. client centered care is intra & interdisciplinary
5. Information will maximize self-care and client decision-making
6. Nursing assessment is the basis for theory and knowledge development
7.Good fiscal stewardship is a condition of quality care
8.Social Justice is an essential nursing value
9.Communication technology will facilitate the continuity and comprehensiveness of care
10.The CNL must assume guardianship for the nursing profession
Describe Practice at the microsystem levels? - CORRECT ANSWER Accountable for outcomes of clinical
populations
Coordinates direct care activities of
nursing staff & other care providers
Lateral integration of care services
Leadership skills
Unit & systems level
nurse sensitive indicators? - CORRECT ANSWER something related to nursing care - practices that nursing owns
i.e. IV filtration; pressure ulcers; fall risk; braden test
Describe Client care outcomes are the measure of quality practice - CORRECT ANSWER Improve
› Safety
› Effectiveness
› Timeliness
› Efficiency
› Quality
› Client-centeredness
Compare outcomes to benchmarks
› Nurse-sensitive indicators
Describe Practice guidelines are based on evidence - CORRECT ANSWER Application of research to the clinical setting
Resolution of clinical problems
Dissemination of results
Seek evidence that challenges current
practice
describe client centered care is intra & interdisciplinary - CORRECT ANSWER CNL coordinates variety of team
members
› Includes nurses in other areas
Effective communication
Describe - Information will maximize self-care and client decision-making - CORRECT ANSWER CNL responsible for educating clients &
families
CNL must teach other care providers
Describe - Nursing assessment is the basis for theory and knowledge development? - CORRECT ANSWER Assess individual, health problem, &
context in which those problems are
manifested
Assessment data are classified, stored,
retrieved, analyzed & integrated into
information system
Describe- Good fiscal stewardship is a condition of quality care - CORRECT ANSWER CNL accountable for cost-effective &
efficient used of human, environmental
& material resources
Understand context of practice
› Identify high cost/high volume activities
› Compare to benchmark
Describe - Social Justice is an essential nursing value? - CORRECT ANSWER Social justice addresses health disparities
CNL responsible for addressing variations
in clinical outcomes among various
groups
May influence policy at the systems level
or higher
Describe - Communication technology will facilitate the continuity and comprehensiveness of care - CORRECT ANSWER Use of distance technologies
› Sustain therapeutic relationships
› Monitor the course of illness & health on a
continuous basis
› Provide care
Describe - The CNL must assume guardianship for the nursing profession - CORRECT ANSWER CNL expected to assume positions in
› Professional, policy & regulatory organizations
› Leadership positions in healthcare facilities & practice plans
› Faculty
Describe the Clinical Nurse Leader Role - CORRECT ANSWER Clinician
Outcomes manager
Client advocate
Educator
Information
manager
Systems analyst/Risk
anticipator
Team manager
Member of a
profession
Lifelong learner
Healthcare should be: - CORRECT ANSWER safe
effective
patient-centered
timely
efficient
equitable [Show Less]