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CNL Questions 1-50 with verified and Updated Answers

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CNL Questions 1-50 with verified and Updated Answers *Af 40-year oldf postpartumf patientf withf chronicf HTNf andf gestational f DMf whof isf gravidaf 5paraf 4f isf transfe rredf fromf L&Df tof thef postpartumf unitf withf LRf at...

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  • October 16, 2024
  • 18
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • cnl questions 1 50 with verified and updated answ
  • af 40 year oldf postpartumf patientf withf ch

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  • CNL

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CNL Questions 1-50 with verified and
Updated Answers

*Af40-year-
oldfpostpartumfpatientfwithfchronicfHTNfandfgestationalfDMfwhofisfgravidaf5paraf4fisftransfe
rredffromfL&DftofthefpostpartumfunitfwithfLRfatf125fmL/hr.f*f*Uponfassessmentfoffthefpatient,
fthefnursefnoticesfthefpatient'sffundusfisfthreeffingerbreathsabovefumbilicusfandftofthefrightf

offmidlinefandfherfbladderfisfpalpable.fThefnursefalsofnotesfmoderateftofheavyfbleedingfandf
affullfbladderfandfnotifiesfthefCNL.fAsfafCNL,fthefmostfimportantfnursingfinterventionfisfto:*

A.fEncouragefthefnurseftofmassageftheffundusfandfheplockfthefpatient
B.fEncouragefthefnurseftofcallfthefphysicianfstatftoforderfMetherginef(methylergonovinefmal
eate)
C.fEncouragefthefnurseftofmonitorfthefpatientfoverfthefnextfhourfbecauseftherefarefnofriskffac
torsffor
afpostpartumfhemorrhage
D.fEncouragefthefnurseftofstraightfcatherizefthefpatientftofdecreaseftheflikelihoodfoffa
postpartumfhemorrhagef-fCORRECTfANSWER-
D.fEncouragefthefnurseftofstraightfcatherizefthefpatientftofdecreaseftheflikelihoodfoffa
postpartumfhemorrhage

Thefpatientfisfatfriskfforfafhemorrhagefdueftofbeingfafmultiparafandfhavingfaffull
bladder.fMetherginefisfcontraindicatedfinfpatientsfwithfhypertension.

*Af50fYOfFfwithfstagef3fCOPDfpresentsftotfhefEDfwithfincreasedfSOB.fBasedfonftheseflabfre
sults,fwhatfisfthefacid-basefdisorder*
pHf7.25f
PaCO2f50fmmHg
HCO3f22fmEq/Lf
PO2f75
SpO2f88%f
Naf+f136
BUNf18

a.funcompensatedfrespiratoryfacidosis
b.fmetabolicfacidosis
c.frespiratoryfacidosis
d.funcompensatedfrespiratoryfacidosisf-fCORRECTfANSWER-
a.funcompensatedfrespiratoryfacidosis

Basedfonfthefclinicalfscenario,fthefpHfisfdecreasedf(lessfthanf7.35);ftherefore,fthe

,patientfhasfacidosis.fThefPaCO2fisfelevatedf(morefthanf45fmmHg),fwhichfisfalsofconsistentf
withfthefpH.
ThefHCO3fisfwithinfnormalflimits,fwhichfsuggestsfthefkidneysfarefnotfcompensating.fCOPDfi
sfcommonly
associatedfwithfrespiratoryfacidosis.

*Af6-year-
oldfboyfisfinfcriticalfconditionffollowingfafcarfaccident.fThefpatientfhasfheadftraumafandfintern
alfbleeding.fThefpatient'sfparentsfhavefstatedfmultipleftimesfthatftheyfarefJehovah'sfWitness
esfandfdofnotfwantftheirfsonftofreceivefblood.fThefCNLfknowsfthatfthefbloodftransfusionfisfne
ededfimmediatelyfandfcouldfsavefthefboy'sflife.fWhichfofftheffollowingfstatementsfisfthefbestft
hingfforfthefCNLftofdo?*

A.fListenftofthefparents,fasfU.S.fminorsfhavefnoflegalfrightsfandfremainfunderfparentalfjurisdi
ction
B.fObtainfafcourtforderfinfthefbestfinterestfoffthefchildftofreceivefblood,fbasedfonfthe
avoidancefoffphysicalfharm
C.fBasedfonfreligiousfbeliefs,fdofnotfgivefblood
D.fFollowfthefphysician'sfdecisionftofgivefbloodfsincefthefphysician'sfdecisionfoverridesfthefp
arentalfdecisionf-fCORRECTfANSWER-
B.fObtainfafcourtforderfinfthefbestfinterestfoffthefchildftofreceivefblood,fbasedfonfthefavoidanc
efoffphysicalfharm

Thefchild'sfinterestsfasfwellfasfthefstatefpoliciesfoutweighfthefparentalfrightsftofrefusefmedic
alftreatmentfforfafminor.fAfcourtforderfisfneededftofenforcefthis.

*af65fYOfAAfmalefwasfadmittedftofyourfmicrosystemfwithfhyperglycemia.fThefpatientfhasfafh
istoryfoffHTN,fgout,fobesity,fandfsmoking.fThefpatientfhasfaffamilyfhistoryfoffDMfandfHTN.fW
hichfstatementfbyfthefpatientfdemonstratesfhisfunderstandingfoffmodifiablefriskffactorsfforfD
M?*

a.f"AsfIfgetfolder,fmyfriskfforfDMfincreases"
b.f"IfknowfthatfaffamilyfhistoryfoffDMfisfafriskffactor,fsofIfwillfeducatefmyfchildrenfonfDMfpreven
tion."
c.f"Ifwillfkeepfafrecordfoffallfmyfbloodfsugarsftoftakeftofmyfdoctor'sfappointments."
d.fIfwillfattendfafsmokingfcessationfclass,fbecausefIfknowfsmokingfincreasesfmyfriskfforfDM."f
-fCORRECTfANSWER-
d.fIfwillfattendfafsmokingfcessationfclass,fbecausefIfknowfsmokingfincreasesfmyfriskfforfDM."

Modifiablefriskffactorsfareflifestyleffactorsfthatfafpersonfcanfalterfinforderfto
preventfdisease.fSmokingfcessationfclassfisfanfinterventionfforfmodifyingfthefriskffactorfoffs
moking.

*Afclientfwithfcomplexfbehaviorfconcernsfisfgettingfreadyftofbefdischargedftofafskilledfnursin
gffacility.fHowever,fthefclientfhasfexpressedfthatfhefwishesftofstayfinfthefhospitalfandfnotfbefdi
scharged.fAsfthefCNL,fyourfbestfactionfwouldfbefto:*

, A.fInformfthefpatientfandfhisforfherffamilyfthatftheyfmustfgofandfremainingfonfthefunitfisfnotfanf
option
B.fAdvocateflettingfthefclientfstayfonfthefunitfonefextrafday,fthenfdischargeftomorrow
C.fIdentifyfthefclient'sfconcernsfandfcollaboratefwithfthefcarefteamftofseeftheyfarefaddressed
D.fAskftheffamilyftofhelpfencouragefthefclientftofdischargeftofthefskilledfnursingffacilityf-
fCORRECTfANSWER-

C.fIdentifyfthefclient'sfconcernsfandfcollaboratefwithfthefcarefteamftofseeftheyfarefaddressed

Clientsfcanfoftenfexperiencefapprehensionfwhenfchangingfcarefsettings.
Identifyingfspecificfconcernsfandfworkingfrapidlyftofensureftheyfarefaddressedfinfcollaborati
onfwithfother
membersfoffthefcarefteamfcanfgreatlyfreducefafclient'sfhesitation.fAdditionally,fsuchfcollabor
ation
ensuresfotherfmembersfoffthefcarefteamfarefawarefoffthefclients'fconcerns,fpossiblyfprovidin
gfadditional
informationfandfinsightfregardingfthefclientsfandftheirfcarefneeds

*AfCNLfevaluatesfaf17YOfpatientfwhofhasfbeenfafvictimfoffrape.fThefpatientfhasfvisible
bruisingfandfafheadflaceration.fAfterfthefCNL'sfassessment,flawfenforcementfofficialsfhavefc
ontactedfthefCNLfrequesting*f*informationfregardingfthefattackfandfthefvisiblefinjuriesfseenf
duringfthefvisit.fThefCNLfknowsfshefmustffirst:*

a.ftakefpicturesfandfcompletefthefrapefkit
b.fprovideflawfenforcementfwithfrecordsfasfrequested
c.fcallfthefpatient'sfparentsffirst
d.fexplainftofthefpatientfinforderftofobtainfconsentfforfreleasefoffrecordsf-
fCORRECTfANSWER-

d.fexplainftofthefpatientfinforderftofobtainfconsentfforfreleasefoffrecords

Rationale:fLegally,ftherefmustfbefconsentffromfthefpatientftofsharefinformationfwithflaw
enforcementfandftofabidefbyfHealthfInsurancefPortabilityfandfAccountabilityfActf(HIPAA)fre
gulations.

*AfCNLfinfthefEDfisfauditingfstrokefpatients'fchartsfandfthefadministrationfofftPAfandfnoticesft
hatfonlyf83%foffpatientsfwhofarefeligibleftofreceiveftPAfarefreceivingfit.fThefCNLfknowsfthatfth
ef83%fadministrationfratefisfbelowfthefnationalfbenchmark.fThefCNLfidentifiesfthatftherefisfaft
imeflagfinfMRI.fThefCNLfcreatesfafstrokefteamftofdevelopfafguidelinefimplementationfactionf
planftofimprovefthefprocessfofftimingfoffthefMRI.fWhatfisfthefbestftoolfutilizedfbyfthefCNLfinfim
plementingfchange?*

A.fResearchfstudy
B.fMeta-analysis
C.fPlan-Do-Study-Actf(PDSA)
D.fStandardize-Do-Study-Actf(SDSA)f-fCORRECTfANSWER-C.fPlan-Do-Study-
Actf(PDSA)

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