CNL Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

Agree to withhold the diagnosis because the family knows her best: A competent patient's right to information belongs to her, not her family. Withholding at the family's request violates autonomy.

Explore with the patient how much she wants to know and who should be present: Correct. Asking the patient about her information preferences respects autonomy and any cultural values she holds. Disclosure then happens on her terms, which may include family involvement.

Tell her the full diagnosis right away to fulfill the duty of veracity: Truthfulness matters, but unrequested, abrupt disclosure ignores the patient's own preferences about how and whether she receives information.

Request a court-appointed guardian to make disclosure decisions for her: Guardianship is for patients who lack capacity. This patient has capacity, so the request is inappropriate and disrespectful.

For a patient with capacity, the patient, not the family, decides how much to know and who is present. Ask her before disclosing or withholding.

Answer: D

Document the physician's response and recheck vital signs in 4 hours: Documenting does not protect a patient showing signs of sepsis and shock. Waiting 4 hours could be fatal.

Ask the primary nurse to call the same physician a third time using SBAR: Repeating the same request to a provider who has twice declined to act delays care. Escalation is needed.

Wait for interdisciplinary morning rounds to raise it with the attending: Delaying until rounds ignores an acute deterioration that needs immediate response.

Activate the rapid response team and escalate via the chain of command: Correct. Hypotension, fever, tachycardia and altered mentation suggest sepsis with possible shock. Rapid response activation and chain-of-command escalation get timely care and protect the patient.

When a provider does not act on a patient's deterioration, use the rapid response system and the chain of command. Do not keep waiting or keep repeating the same call.

Answer: C

A patient with a Braden score of 19: Scores of 19–23 generally mean no significant risk. This patient is the lowest risk of the four.

A patient with a Braden score of 16: Scores of 15–18 mean mild (at-risk) status. This patient needs standard prevention but is not the highest priority.

A patient with a Braden score of 11: Correct. Lower Braden scores mean greater risk, and 10–12 is high risk. This patient needs the most intensive prevention bundle.

A patient with a Braden score of 14: Scores of 13–14 mean moderate risk, which is less than a score of 11.

On the Braden Scale (6–23), lower scores mean higher risk: 15–18 mild, 13–14 moderate, 10–12 high, 9 or below very high.

Answer: D

0.2 per 1,000 central line days: This misplaces the decimal: 3 ÷ 1,500 = 0.002, and multiplied by 1,000 that is 2.0, not 0.2.

0.5 per 1,000 central line days: This does not follow from the data. It may come from inverting or mis-scaling the ratio.

5.0 per 1,000 central line days: This would require 7.5 infections over 1,500 line days. It overstates the rate.

2.0 per 1,000 central line days: Correct. CLABSI rate = (number of CLABSIs ÷ central line days) × 1,000 = (3 ÷ 1,500) × 1,000 = 2.0.

Device-associated infection rate = infections ÷ device days × 1,000. Using device days as the denominator lets units of different sizes be compared fairly.

Answer: C

40%: This divides cost by savings ($40,000 ÷ $100,000), which reverses the ROI formula.

60%: This divides net gain by savings ($60,000 ÷ $100,000). ROI divides net gain by the investment.

150%: Correct. ROI = (savings − cost) ÷ cost = ($100,000 − $40,000) ÷ $40,000 = 1.5, or 150%.

250%: This is the benefit-to-cost ratio ($100,000 ÷ $40,000 = 2.5). It does not subtract the investment first.

ROI = (financial gain − investment) ÷ investment × 100. Subtract the cost before dividing.

Answer: D

Two consecutive points below the median just after the protocol starts: Two points on one side of the median can easily happen by chance. They do not meet run-chart rules for a signal.

One unusually low point in the month after staff education: A single low point is not a shift. An astronomical point is judged against the rest of the data, and one value alone does not show sustained change.

Points that cross the median line every month since the protocol began: Frequent crossing of the median shows random variation around a stable median, not a shift.

Six or more consecutive points below the median after implementation: Correct. In run-chart rules, a shift is six or more consecutive points all above or all below the median. It signals nonrandom change.

Run-chart rules: shift = 6 or more consecutive points on one side of the median; trend = 5 or more points steadily rising or falling; too few or too many runs and astronomical points also signal nonrandom variation.