• 50 questions

Clinical Nurse Leader Practice Test

Unofficial CNL exam practice on leadership, clinical outcomes and the care environment, weighted like the blueprint.

Which ethical principle is embodied by the phrase "first, do no harm"?

Pick an answer, then press Check answer. Then you see Correct or Not quite, with the reason. Keys: A to D pick, Enter checks.

Print covers the next 35 questions. Share this set copies a link to the same questions in the same order.

Exam mode: 35 questions, 45 minutes.

More options

Unofficial practice questions, not affiliated with the Commission on Nurse Certification (CNC) or AACN. Bank checked October 12, 2026.

The real exam, as its certifying body describes it

Questions
140
Time limit
180 minutes
Format
Computer-based, multiple choice with a single answer; some questions come in a case study
Scoring
Reported as pass or fail on a scale of 150 to 500; 350 or more passes

Checked October 12, 2026 against CNL Certification Exam page and CNL Certification Exam Blueprint, aacnnursing.org. Rules change, so confirm with the agency itself before your test.

AACN's own CNL exam page

Next step Dosage calculation practice testAGNP practice test

All 50 questions

Nursing leadership 15

  • A clinical nurse leader coaches a new nurse on discharge teaching about a blood thinner. Which approach checks that the patient understood? AHRQ, Health Literacy Universal Precautions Toolkit, Tool 5: Use the Teach-Back Method, Overview. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A clinical nurse leader sorts the findings of a microsystem assessment by the five Healthy People 2030 domains of social determinants of health. Which is one of those domains? Healthy People 2030, Social Determinants of Health, What are social determinants of health?. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A clinical nurse leader wants to replace the unit's shift report. She starts by showing staff why the old routine fails, to loosen their attachment to it. Which step of Lewin's model is this? Wikipedia, "Change management", Kurt Lewin's 3-step change model. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
Show all 50 questions (47 more)

Nursing leadership, continued

  • A nurse asks the clinical nurse leader whether walking a patient can be delegated to assistive personnel. Under the "right circumstance", what must be true? NCSBN and ANA, National Guidelines for Nursing Delegation, Five Rights of Delegation. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A nurse delegates a task to assistive personnel, who accepts it. Who keeps overall accountability for the patient? NCSBN and ANA, National Guidelines for Nursing Delegation, Definitions. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A nurse phones a physician and opens with her name, the patient's name and "he has new chest pain and his blood pressure is falling". Which SBAR step is this? AHRQ, TeamSTEPPS 3.0, Tool: SBAR, Tool: SBAR. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A patient can find, understand and use dosing instructions to decide how to take a new medicine. Which term does Healthy People 2030 use for this ability? Healthy People 2030, Health Literacy in Healthy People 2030, definitions. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A patient with decision-making capacity refuses a recommended amputation after hearing the risks. The team honors the refusal. Which ethical principle does this respect? Wikipedia, "Medical ethics", Patient autonomy. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • A team uses Kotter's 8-Step Process to lead a change in discharge teaching. What is the first stage? Wikipedia, "Change management", John Kotter's 8-Step Process for Leading Change. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • Besides information, what does a handoff transfer during a transition in patient care? AHRQ, TeamSTEPPS 3.0, Tool: Handoff, Tool: Handoff. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • During a rapid response, the leader calls for a chest x-ray. A nurse answers "ordering a chest x-ray now", and the leader replies "correct". Which communication tool is this? AHRQ, TeamSTEPPS 3.0, Tool: Check-Back, Tool: Check-Back (or Repeat-Back). Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • How does AHRQ describe care coordination? AHRQ, Care Coordination, opening. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • Under the "right task" of delegation, where must a delegated activity fall? NCSBN and ANA, National Guidelines for Nursing Delegation, Five Rights of Delegation. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • Which ethical principle is embodied by the phrase "first, do no harm"? Wikipedia, "Medical ethics", Non-maleficence. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.
  • Which statement matches the clinical nurse leader role as the AACN competencies describe it? AACN, Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice (October 2013), Introduction. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain I: Nursing Leadership.

Clinical outcomes management 19

  • A clinical nurse leader counts the new pressure injuries that develop on the unit each month. Which epidemiologic measure is this? Wikipedia, "Prevalence", Difference between prevalence and incidence. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A clinical nurse leader designs a follow-up call for patients sent home. Which complication is most common after discharge? AHRQ PSNet primer, Readmissions and Adverse Events After Discharge, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A community program offers mammography to women who have no symptoms. Which level of prevention is this? Wikipedia, "Preventive healthcare", Overview. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A delirium screen is positive in 90 of 100 patients who truly have delirium. What does the 90% describe? Wikipedia, "Sensitivity and specificity", lead section. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A hospital's publicly reported scores come from a survey that asks discharged patients about their recent stay, including communication with nurses. Which survey is it? CMS, HCAHPS: Patients' Perspectives of Care Survey, HCAHPS Overview. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A patient asks which part of Medicare helps pay for an inpatient hospital stay. What is the answer? Medicare.gov, What Part A covers, What Part A covers. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A patient going home with heart failure is taught to track his weight. Which change should prompt a call to the provider? MedlinePlus Medical Encyclopedia, "Heart failure - home monitoring", Checking Your Weight. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A patient who smokes says, "I know it is hurting me, and I keep weighing the pros and cons, but I am not ready to pick a date." Which stage of the transtheoretical model is this? Wikipedia, "Transtheoretical model", Stages of change. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • A screening service carries a grade D from the US Preventive Services Task Force. What is the suggestion for practice? US Preventive Services Task Force, Grade Definitions, Grade Definitions. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • After a heart attack, a patient enters a cardiac rehabilitation program to limit disability. Which level of prevention is this? Wikipedia, "Preventive healthcare", Overview. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • Besides accurate written information, what do effective handoffs require? AHRQ PSNet primer, Handoffs, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • By oversight, a patient's home blood pressure medicine is left off the admission orders. Which process is designed to catch this? AHRQ PSNet primer, Medication Reconciliation, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • In the transtheoretical model, how long has a person in the maintenance stage sustained the new behavior? Wikipedia, "Transtheoretical model", Stages of change. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • Surgery performed on the wrong site is an example of which category of adverse event? AHRQ PSNet primer, Never Events, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • What does an I statement from the US Preventive Services Task Force mean? US Preventive Services Task Force, Grade Definitions, Grade Definitions. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • What does the Hospital Readmissions Reduction Program do when a hospital has excess readmissions? CMS, Hospital Readmissions Reduction Program, opening. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • When should a patient with heart failure weigh himself at home? MedlinePlus Medical Encyclopedia, "Heart failure - home monitoring", Checking Your Weight. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • Which condition has a 30-day readmission measure in the Hospital Readmissions Reduction Program? CMS, Hospital Readmissions Reduction Program, measures. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.
  • Which practice does AHRQ's patient safety primer call a cornerstone of preventing healthcare-associated infections? AHRQ PSNet primer, Healthcare-associated Infections, Prevention of HAIs. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain II: Clinical Outcomes Management.

Care environment management 16

  • A clinical nurse leader plots the unit's weekly fall rate in time order to see whether a change helped. Which tool is this? Institute for Healthcare Improvement, Run Chart Tool, opening. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • A falls program costs the unit $40,000 and produces a net income of $10,000. What is the return on investment? Wikipedia, "Return on investment", lead section. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • A unit tries a new rounding script with one nurse on one shift, studies what happened and then decides what to change. Which method is this? Institute for Healthcare Improvement, How to Improve: Model for Improvement, Testing Changes. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • After a serious adverse event, a team begins a root cause analysis. What is its central tenet? AHRQ PSNet primer, Root Cause Analysis, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • An infusion pump library has no dose limits, so a keying slip by a nurse reaches the patient. In Reason's terms, what is the missing dose limit? AHRQ PSNet primer, Systems Approach, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • Before a new insulin protocol goes live, a team wants to find where and how the process might fail. Which tool fits? Institute for Healthcare Improvement, Failure Modes and Effects Analysis (FMEA) Tool, opening. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • For a question about whether a treatment works, which source ranks highest in the hierarchy of evidence? Wikipedia, "Hierarchy of evidence", lead section. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • How did the BPCI Advanced model pay for a clinical episode? CMS Innovation Center, BPCI Advanced, What was BPCI Advanced?. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • How does an electronic health record differ from an electronic medical record? ONC, Electronic Health Records and Their Benefits, What is an EHR?. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • In the diffusion of innovations, which group of adopters takes up a new practice last? Wikipedia, "Diffusion of innovations", lead section. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • In the Model for Improvement, which question do a team's measures answer? Institute for Healthcare Improvement, How to Improve: Model for Improvement, Establishing Measures. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • In the PICO format for a clinical question, what does the C stand for? Wikipedia, "PICO process", lead section. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • Nurses on a unit override most medication warnings without reading them. What is this called? AHRQ PSNet primer, Alert Fatigue, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • To save time, a nurse skips a required barcode scan, a shortcut that has become common on the unit. How does a just culture classify this? AHRQ PSNet primer, Culture of Safety, Background. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • What does the Hospital Value-Based Purchasing Program do? CMS, Hospital Value-Based Purchasing Program, What is the Hospital Value-Based Purchasing (VBP) Program?. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.
  • Which is an example of clinical decision support? ONC, Clinical Decision Support, How CDS Tools Support Care Decisions. Outline: CNL Certification Exam Blueprint (exams of January 2023 to April 2027), Domain III: Care Environment Management.

How this list was compiled: Our own questions, written to the three domains of the Clinical Nurse Leader (CNL) Certification Exam Blueprint of the Commission on Nurse Certification, for exams administered between January 2023 and April 2027 (https://www.aacnnursing.org/portals/0/PDFs/CNL/CNL-Exam-Content-Outline.pdf, linked from https://www.aacnnursing.org/our-initiatives/education-practice/clinical-nurse-leader/cnl-certification/Exam, read 2026-10-12), in its weights of 31, 37 and 32 percent. The bank holds 15, 19 and 16 questions in that order. Every fact was read on 2026-10-12 in the public page the question names: AHRQ's TeamSTEPPS 3.0 tools, patient safety primers (PSNet), health literacy toolkit and care coordination page; the Institute for Healthcare Improvement; CMS and Medicare.gov program pages; ONC's health IT pages; Healthy People 2030; the US Preventive Services Task Force grade definitions; the National Guidelines for Nursing Delegation of NCSBN and ANA; AACN's 2013 CNL competencies; MedlinePlus; and the Wikipedia articles named on the questions. Licence: Questions, choices and explanations are original work of this site.

How it works

This free clinical nurse leader practice test has 50 questions of our own on the CNL Certification Exam blueprint. It is unofficial and not affiliated with or endorsed by the Commission on Nurse Certification (CNC) or the American Association of Colleges of Nursing.

Read the full guide

What the CNL exam covers

The blueprint for exams from January 2023 to April 2027, read October 12, 2026, has three domains: nursing leadership 31%, clinical outcomes management 37% and care environment management 32%. The 50 questions are split 15, 19 and 16.

Pace of the timed test

The timed test here asks 35 questions in 45 minutes: a quarter of the real exam's questions in a quarter of its time.

Where the answers come from

AHRQ's TeamSTEPPS tools and patient safety primers, the Institute for Healthcare Improvement, CMS program pages, Healthy People 2030, the delegation guidelines of NCSBN and ANA, and named Wikipedia articles for change, ethics and evidence terms.

  • The blueprint names tools by name: FMEA, root cause analysis, PDSA cycles, return on investment, value-based purchasing and bundled payments.

Questions and answers

How many questions are on the CNL exam?

140 multiple-choice questions in 3 hours, by AACN's CNL exam page. 130 are scored and ten are pre-test items for future exams.

What is a passing score on the CNL exam?

A scaled score of 350 or greater on a scale of 150 to 500. Results are reported as pass or fail, and a candidate who fails gets a report by content area.

Who can take the CNL certification exam?

By AACN's exam page: someone in the last term of, or a graduate of, an accredited master's or post-master's CNL program. Full certification also requires registered nurse licensure. Faculty of CNL programs have a separate route.

Are these real CNL exam questions?

No. The 50 questions were written for this page from the public blueprint and the public page each one names. The certifying body's own practice exam and self-assessment were not opened or used.

More tests

Show 8 more

Browse Safety and Trades