CNML Exam Preparation

CNML Preparation and Resources

The American Organization for Nursing Leadership (AONL) provides a list of suggested references to assist candidates preparing for the Certified Nurse Manager and Leader (CNML) exam. These references include key textbooks, professional publications, and other educational materials covering nursing leadership, management, healthcare systems, financial management, and quality improvement.

At BoardCerts, we incorporate recommended references and the CNML exam blueprint into the development of our question bank. This ensures that our resources are accurate, relevant, and closely aligned with the knowledge and competencies required for nurse manager and leader certification.

Key Concepts on CNML Exam

Exam Categories: Percentage Distribution

Communication and Relationship Building

Health Care Environment and Clinical Principles

Leadership

Professionalism

Business Skills and Principles

CNML Blueprint and Focus Areas

Area of Focus	Subtopics	Number of Questions	Percent of Exam
Communication and Relationship Building	A. Relationship Management Develops relationships across the care continuum to build alliances and partnerships and achieve common goals Manages conflicts and disagreements in a constructive manner Identifies the internal and external relationships that impact the work of the department/unit to achieve department/unit goals Interprets organizational and strategic realities (e.g., labor costs, different models of care delivery, key performance indicators (KPI), supply chain disruption, etc.) to navigate changes Recognizes the impact on staff of the organization’s decisions and takes appropriate action B. Effective Communication Communicates with clarity and integrity to build trust with all stakeholders Identifies and understands different communication styles Utilizes appropriate communication style when engaging different audiences Practices transparency and honesty to demonstrate authenticity Builds trust by listening to and engaging staff and others C. Influencing Behaviors Exchanges ideas to gain cooperation from others to accomplish goals Uses information from multiple sources (e.g., evidence from research, data, reports) to gain consensus and commitment from stakeholders Coaches staff in their development (e.g., conflict management, active listening, communication, etc.) Creates policies and initiatives to influence desired departmental behaviors	25	25%
Health Care Environment and Clinical Principles	A. Nursing Practice and Application Assists with the development of care delivery models and environmental design to ensure the delivery of safe patient care that is evidence-based, accessible, affordable, and equitable Recognizes the impact of internal and external factors on care delivery and departmental/unit finances Integrates patient quality and safety measures into the care environment Formulates objectives and priorities to implement plans of care delivery consistent with long-term interests of the department/unit B. Economics and Policy Supports alignment of the department with organizational strategies and with current developments in healthcare economics, policy, and legislation Maintains knowledge of population health Influences healthcare policy through advocacy at various levels of government, as it affects safety, quality, accessibility, and affordability of healthcare C. Regulation Maintains knowledge of regulatory and accreditation standard/rule changes Seeks resources in support of their department/unit’s compliance regarding regulatory requirements Ensures compliance with accreditation standards and local, state, and federal regulatory standards Participates in response to identified deficiencies D. Evidence-Based Practice Evaluates current department/unit practices to determine strengths and barriers in implementing evidence-based practices Promotes integration of evidence-based research into practice at the unit level Supports staff by providing resources for implementation of evidence-based practices E. Patient Safety and Quality Maintains knowledge of patient safety and improvement sciences Ensures the incorporation of patient safety and improvement sciences with department/unit practices Participates in risk assessment (e.g., FMEA, root cause analysis, etc.) to ensure safe, compliant, and effective care delivery Implements processes that result in prompt escalation of potential performance gaps by utilizing system processes and staff at the unit level	18	18%
Leadership	A. Systems and Complex Adaptive Thinking Builds a shared vision that articulates and influences others to translate vision into action Develops new insights into situations by questioning conventional approaches Encourages staff to develop new and innovative ideas Removes barriers to help implement new cutting-edge programs/processes Creates and executes strategies for complex situations (e.g., addressing safety issues with workload capacity, increasing nursing time at bedside, reducing hospital-acquired conditions (HACs), etc.) Participates in nursing and organizational strategy planning and execution B. Change Management Acts as a catalyst for change by seeking new information and ideas Adapts to new information, changing conditions, and unexpected obstacles Assesses through analytics (e.g., gap analysis, SWOT, etc.) if change is necessary Utilizes common change models (e.g., Kotter, Lewin) and other tools for change (e.g., PDSA, Lean methods) Supports staff in managing departmental changes C. Diversity, Equity, Belonging and Inclusion Recognizes unconscious and systemic bias in care delivery, business operations, and through external influences Leads and supports initiatives that address racism, discrimination, and bias in care delivery and business operations Encourages creative tension and differences of opinions Fosters an inclusive workplace where diversity and individual differences are valued and maximized to achieve the vision and mission of the organization Develops the ability of others to perform and contribute to the achievement of their goals consistent with the organization’s vision and mission, corresponding with individual needs Provides feedback and opportunities for others to learn through formal and informal methods, corresponding with individual needs Creates, promotes, and protects a culture that supports staff, patients/clients, and stakeholders D. Decision Making Seizes opportunities and takes calculated risks to advance the department/unit’s mission and vision Identifies and objectively analyzes department/unit problems and issues Evaluates availability, relevance, and accuracy of information Generates and evaluates alternative solutions Makes decisions that impact department/unit operations and incorporates an understanding of the impact and implications of those decisions Makes timely, equitable, and appropriate decisions when data is available and when it is limited Delegates responsibilities based on scope of practice, education, appropriate competence, and experience Fosters professional governance in philosophy, structure, and implementation Empowers the team to make independent decisions that affect their practice E. Transformation and Innovation Encourages the use of the organization’s framework on advancing innovation Allocates resources for the development of innovation teams or methods Supports the implementation of innovative ideas	25	25%
Professionalism	A. Professional Accountability Upholds professional ethical principles in decision-making through personal, department/unit, and staff accountability Supports, promotes, and role-models standards of nursing and leadership professional practice (clinical, educational, certification, and leadership) for colleagues and constituents Solicits feedback from trusted sources about personal strengths and opportunities for improvement and incorporates the information into practice Maintains competency through nationally recognized leadership certification Participates in professional organizations that advance one’s leadership practice and career development Encourages staff to engage in their career development B. Organizational Accountability Aligns behavior with personal values and determines fit with the organization’s culture Ensures the voice of the patient is central and present in decision-making Ensures a culture of accountability by holding self and others accountable for measurable, high-quality, and cost-effective outcomes Follows up regularly with staff to ensure that desired outcomes are being achieved Recognizes career opportunities for staff based on strengths and interests Exhibits leadership presence (e.g., attending team meetings, vocal participation, fostering discussions, leading rounds, etc.) C. Health Equity and Social Determinants of Health Reviews the organization’s needs assessment to identify current health equity issues Creates an action plan to close gaps in department/unit health equity issues Provides staff with tools and resources to provide culturally competent care (e.g., translation resources, discharge materials, appropriate referrals) Supports staff participation in community-based activities that address community care Coordinates and facilitates orientation related to culturally competent care Evaluates culturally competent care through performance appraisals Monitors performance data to ensure the delivery of culturally competent care D. Governance Interacts with and educates the organization’s governing body regarding healthcare and the value of nursing as directed by senior leadership Interacts with and educates the organization’s governing body regarding quality and patient safety principles as directed by senior leadership Articulates the governing body's (e.g., Board) role in how the organization’s mission is achieved Assists leadership in preparing reports for the Board	14	14%
Business Skills and Principles	A. Financial Management Manages the department budget by understanding and utilizing the organization’s financial processes Maintains knowledge of reimbursement models that affect care delivery Maintains knowledge of healthcare economics and business models to set priorities and measurable goals Participates in the creation of the department budget Manages the department budget (e.g., allocation of resources, staffing, supply chain management, etc.) Monitors the department budget to ensure accuracy of expenses and identify variances Makes budget adjustments as indicated by variances Supports financial health as influenced by nursing and other clinical decisions and outcomes B. Strategic Management Communicates high-reliability concepts to staff (e.g., safety huddles, use of evidence, deferring to expertise, etc.) as identified by the organization Utilizes multiple sources of evidence-based data in goal setting and decision-making Ensures departmental objectives are in place to achieve the strategic mission Participates in the negotiation, monitoring, and management of contracts and service agreements Aligns and creates nursing/clinical objectives, goals, and tactics required to achieve the organization’s strategic outcomes Recognizes and supports the benefit and impact of technology on care delivery, clinical information, and financial outcomes Uses evidence-based metrics to align department/unit goals and objectives with patient outcomes C. Human Resource Management Builds and manages a diverse workforce based on organizational and professional nursing goals, clinical goals and outcomes, data, budget considerations, and staffing needs Ensures that employees are recruited, selected, onboarded, educated, evaluated, and recognized according to established standards, applicable employment laws, and the organization’s mission, vision, and values Manages a multisector workforce and a variety of work situations Assesses the unit’s culture to ensure the presence of a safe and healthy work environment Addresses gaps associated with the cultural assessment of a safe and healthy work environment Advances organizational policies that allow employees to practice at the top of their education and/or license Establishes mechanisms that provide for identification and mentoring of staff for career progression	18	18%

CNML Resources

1. Effective Leadership and Management in Nursing, 9th ed. (2017). Sullivan, E. J.

2. Leadership and Management in Nursing, 4th ed. (2010). Grohar-Murray, M., DiCroce, H. M., and Langan, J.

3. Leadership and Nursing Care Management, 7th ed. (2021). Huber, D., and Joseph, M.

4. Leadership Roles and Management Functions in Nursing, 11th ed. (2020). Huston, C.

5. Leading and Managing in Nursing, 7th ed. (2018). Yoder-Wise, P. S.

6. Management and Leadership for Nurse Administrators, 8th ed. (2018). Roussel, L., Thomas, P., and Harris, J.

7. Quantum Leadership: Advancing Innovation, Transforming Health Care, 5th ed. (2017). Porter-O'Grady, T., and Malloch.

8. The Leadership Challenge, 7th ed. (2023). Kouzes, J., and Posner, B.

9. Learning Leadership (2016). Kouzes, J., and Posner, B.

10. Resonant Leadership (2005). Boyatzis, R., and McKee, A.

11. Primal Leadership: Realizing the Power of Emotional Intelligence. Goleman, D., et al.

12. Crucial Conversations, 3rd ed. (2021). Patterson, K., et al.

13. Getting to Yes: Negotiating Agreement Without Giving In (2011). Fisher, R.

14. Influence, New and Expanded: The Psychology of Persuasion (2021). Cialdini, R.

15. Influencer: The New Science of Leading Change, 2nd ed. (2013). Grenny, J., et al.

16. Legal and Ethical Issues in Nursing, 6th ed. Guido, G. W.

17. Evidence-Based Practice for Nurses: Appraisal and Application, 5th ed. Schmidt, N., and Brown, J.

18. Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice (2018). Melnyk, B., and Fineout-Overholt, E.

19. Leadership for Evidence-Based Practice, 2nd ed. Weberg, D.

20. Policy and Politics in Nursing and Health Care. Mason, D., Perez, A., et al.

21. Nurses Making Policy: From Bedside to Boardroom, 2nd ed. (2019). Patton, R. M., Zalon, M. L., and Ludwick, R.

22. Budgeting Concepts for Nurse Managers, 4th ed. Finkler, S., and McHugh, M.

23. Financial and Business Management for the Doctor of Nursing Practice, 3rd ed. Waxman, K. T., and Knighten, M.

24. Penner's Economics and Financial Management for Nurses and Nurse Leaders, 4th ed. Waxman, K. T., and Knighten, M.

25. Baker's Health Care Finance: Basic Tools for Nonfinancial Managers, 6th ed. Ross, T.

26. Gapenski's Healthcare Finance: An Introduction to Accounting and Financial Management, 7th ed. Reiter, K., and Song, P.

27. Business Model Generation: A Handbook for Visionaries, Game Changers, and Challengers. Osterwalder, A., and Pigneur, Y.

28. Human Resource Management, 15th ed. Mathis, R., and Jackson, J.

29. Healthcare Human Resource Management. Flynn, W., Valentine, S., et al.

30. High Reliability Organizations: A Healthcare Handbook for Patient Safety and Quality, 2nd ed. Oster, C., and Braaten, J.

31. Good to Great in the Social Sector. Collins, J.

32. Leading Change (2012). Kotter, J.

33. Change: How Organizations Achieve Hard-to-Imagine Results in Uncertain and Volatile Times (2021). Kotter, J. P., et al.

34. Diffusion of Innovation, 1st ed. (1962). Rogers, E. M.

BoardCerts CNML Question Bank

The BoardCerts CNML question bank is meticulously designed to align with the official exam blueprint, ensuring you focus on the most relevant material for success.

Purchase CNML Question Bank

CNML Exam Preparation

CNML Preparation and Resources

Key Concepts on CNML Exam

Exam Categories: Percentage Distribution

CNML Blueprint and Focus Areas

CNML Resources

BoardCerts CNML Question Bank

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CNML Exam Preparation