Certified Academic Clinical Nurse Educator Practice Test

NLN-CNEcl test Format | Course Contents | Course Outline | test Syllabus | test Objectives

Exam Code: NLN-CNEcl
Exam Name: NLN Certified Academic Clinical Nurse Educator
Number of Questions: 130 multiple-choice questions (100 scored, 30 unscored pretest questions).
Time Allotted: 2 hours (120 minutes).
Passing Score: Determined by a criterion-referenced standard (exact percentage not publicly disclosed).
Delivery Method: Computer-based testing at approved Pearson VUE test centers or online via remote proctoring.

- Function Within the Education and Health Care Environments
- Understanding the mission, vision, and policies of the nursing program and clinical institution.
- Navigating legal and ethical issues in clinical education (e.g., HIPAA, FERPA, patient safety).
- Collaborating with faculty, preceptors, and healthcare professionals to align clinical experiences with program outcomes.
- Managing resources and clinical placements effectively.

- Accreditation Standards: Criteria set by bodies like the Commission on Collegiate Nursing Education (CCNE) for nursing programs.
- Scope of Practice: Defined responsibilities of the clinical nurse educator within academic and clinical settings.
- Interprofessional Collaboration: Working with other healthcare disciplines to enhance student learning.
- Clinical Placement: Arranging student assignments in healthcare settings to meet learning objectives.

- Facilitate Learning in the Health Care Environment
- Applying adult learning theories (e.g., Knowles’ Andragogy) to clinical teaching.
- Using evidence-based teaching strategies to support skill acquisition.
- Fostering critical thinking and clinical reasoning through Socratic questioning and case-based learning.
- Managing diverse learners, including multigenerational and culturally diverse students.

- Clinical Judgment: The process by which students interpret and respond to clinical situations.
- Socratic Questioning: A teaching method using probing questions to stimulate critical thinking.
- Andragogy: Adult learning theory emphasizing self-directed learning.
- Evidence-Based Practice (EBP): Integrating research, clinical expertise, and patient values into teaching.

- Apply Teaching and Learning Strategies in the Clinical Environment
- Designing clinical learning experiences aligned with course objectives.
- Using simulation, role-playing, and debriefing to enhance learning.
- Adapting teaching strategies to individual learner needs and clinical contexts.
- Integrating technology (e.g., electronic health records, virtual simulation) into clinical education.

- High-Fidelity Simulation: Advanced, realistic simulations using mannequins or virtual platforms.
- Debriefing: Reflective discussion post-simulation to reinforce learning.
- Competency-Based Education: Teaching focused on achieving specific, measurable skills.
- Formative Feedback: Ongoing feedback to guide student improvement during clinical experiences.

- Assess and Evaluate Learning in the Clinical Environment
- Developing and using evaluation tools (e.g., rubrics, checklists) to assess clinical competencies.
- Providing constructive feedback to support student growth.
- Ensuring fair and unbiased evaluations aligned with program standards.
- Identifying and addressing performance gaps in students.

- Summative Evaluation: Final assessment of student performance at the end of a clinical rotation.
- Formative Evaluation: Ongoing assessment to monitor progress and provide feedback.
- Objective Structured Clinical Examination (OSCE): Standardized method to assess clinical skills.
- Reliability and Validity: Ensuring evaluation tools consistently and accurately measure competencies.

- Facilitate Learner Development and Socialization
- Guiding students in developing professional identity and ethical behavior.
- Promoting socialization into the nursing profession through mentorship and role modeling.
- Addressing learner challenges, such as anxiety or lack of confidence, in clinical settings.
- Encouraging lifelong learning and professional development.

- Professional Socialization: The process of acquiring the values, norms, and behaviors of the nursing profession.
- Mentorship: Providing guidance and support to foster student growth.
- Self-Efficacy: A student’s belief in their ability to perform clinical tasks.
- Reflective Practice: Encouraging students to reflect on experiences to enhance learning.

- Engage in Scholarship, Leadership, and Professional Development
- Participating in scholarly activities (e.g., research, publications, presentations) related to clinical education.
- Demonstrating leadership in curriculum development and program evaluation.
- Pursuing continuing education to stay current with nursing education trends.
- Advocating for the role of clinical nurse educators within academic and healthcare communities.

- Scholarship of Teaching: Research and dissemination of effective teaching practices.
- Transformational Leadership: Inspiring and motivating others to achieve educational goals.
- Continuing Professional Development (CPD): Ongoing learning to maintain and enhance expertise.
- Curriculum Mapping: Aligning clinical experiences with program outcomes.

- NLN Core Competencies: The foundation of the exam, defining the knowledge and skills of clinical nurse educators.
- Test Blueprint: A guide outlining the exam’s content areas, weighting, and question distribution.
- Clinical Faculty: Educators (e.g., adjunct faculty, clinical instructors, preceptors) responsible for clinical teaching.
- Learning Outcomes: Specific, measurable goals for student performance in clinical settings.
- Next-Generation NCLEX (NGN): The updated NCLEX format emphasizing clinical judgment, relevant to clinical teaching strategies.
- Interprofessional Education (IPE): Teaching students to collaborate with other healthcare professionals.
- Cultural Competence: Providing inclusive education that respects diverse backgrounds.

- Facilitating Learning in the Clinical Setting
- Clinical Teaching Strategies:
- Pre-conferences and post-conferences
- Role modeling, demonstration, and return demonstration
- Simulation and virtual clinical experiences
- Case-based learning and reflective practice

- Student-Centered Learning:
- Individualized learning plans
- Active learning techniques
- Scaffolding and zone of proximal development (Vygotsky)

- Clinical Judgment & Critical Thinking:
- Tanner’s Clinical Judgment Model
- Concept mapping
- Socratic questioning

- Assessment and Evaluation in Clinical Education
- Formative vs. Summative Evaluation
- Objective Structured Clinical Examinations (OSCEs)
- Competency-Based Evaluation
- Benner’s Novice to Expert Model
- Entrustable Professional Activities (EPAs)
- Providing Constructive Feedback
- Feedback models (e.g., Pendleton’s, Sandwich method)
- Remediation strategies for struggling students
- Legal & Ethical Considerations in Evaluation
- Due process, fairness, and documentation
- Handling student appeals

- Curriculum Design & Implementation
- Alignment with AACN Essentials & NLN Competencies
- Clinical Objectives & Outcomes
- SMART goals
- Bloom’s Taxonomy (affective, cognitive, psychomotor domains)
- Clinical Scheduling & Logistics
- Preceptor models (dedicated, shared)
- Managing clinical site shortages
- Interprofessional Education (IPE)
- TeamSTEPPS®, collaborative learning

- Role of the Clinical Nurse Educator
- Leadership & Advocacy
- Promoting evidence-based practice (EBP)
- Advocating for students and patients
- Professional Development
- Continuing education (CNE, CNEcl renewal)
- Mentoring novice educators
- Legal & Ethical Responsibilities
- FERPA (student privacy)
- HIPAA compliance in clinical settings
- Liability and malpractice concerns

- Evidence-Based Practice (EBP) in Clinical Education
- Integrating Research into Clinical Teaching
- PICO(T) framework
- Teaching students to appraise literature
- Quality Improvement (QI) Projects
- PDSA (Plan-Do-Study-Act) cycles
- Clinical outcomes measurement

- Simulation & Technology in Clinical Education
- High-Fidelity vs. Low-Fidelity Simulation
- Debriefing Models (e.g., Debriefing for Meaningful Learning [DML])
- Virtual Clinical Experiences
- Telehealth simulations
- Electronic health record (EHR) training
- Gamification & Digital Tools
- Adaptive quizzing (e.g., Kahoot!, H5P)

- Cultural Competence & Diversity in Clinical Teaching
- Culturally Responsive Pedagogy
- Implicit bias training
- Social determinants of health (SDOH)
- Teaching in Diverse Clinical Settings
- Language barriers & interpreter use
- Religious/cultural considerations in patient care

- Managing Challenges in Clinical Education
- Student Incivility & Professionalism Issues
- Conflict Resolution (student-staff, student-patient)
- Clinical Site Issues
- Unsafe staffing ratios
- Site cancellations & alternative arrangements

- Andragogy: Adult learning theory (Knowles)
- Competency-Based Education (CBE): Focus on mastery of skills over time spent
- Entrustable Professional Activities (EPAs): Tasks learners can perform unsupervised
- Formative Assessment: Ongoing feedback (e.g., clinical evaluations)
- Summative Assessment: Final evaluation (e.g., clinical pass/fail)
- Preceptorship: One-on-one student mentoring by a nurse
- Reflective Practice: Encouraging self-assessment (e.g., journals)
- Scaffolding: Gradually reducing support as competence grows

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NLN-CNEcl PDF sample Questions

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Killexams.com test Questions and Answers
Question: 1294
A clinical nurse educator is conducting a post-conference for junior nursing students after a shift in a rehabilitation unit. The educator uses reflective practice to debrief a situation where a student failed to recognize signs of autonomic dysreflexia in a 40-year-old male with a T6 spinal cord injury (BP 180/100 mmHg, headache). Using Johns� Model of Structured Reflection, which question should the educator ask to guide the student�s reflection?
1. What knowledge gaps contributed to missing the signs of autonomic dysreflexia?
2. How could you have prioritized interventions to manage the patient�s blood pressure?
3. What external factors influenced your assessment of the patient�s symptoms?
Answer: A
Explanation: Johns� Model emphasizes identifying knowledge gaps to Improve practice. Asking about gaps that led to missing autonomic dysreflexia encourages the student to reflect on clinical knowledge deficiencies (e.g., recognizing triggers like bladder distension), promoting targeted learning. External factors and interventions address broader or subsequent steps in the model.
Question: 1295
A nursing educator is evaluating the effectiveness of a new teaching strategy based on the Next-Generation NCLEX (NGN) standards. Which of the following assessment methods best aligns with NGN�s emphasis on clinical judgment?
1. Simulation-based assessments that require critical thinking and decision-making
2. Written multiple-choice exams focusing on recall of facts
3. Standardized tests that assess basic nursing knowledge
Answer: A
Explanation: Simulation-based assessments require students to apply their knowledge in realistic scenarios, promoting critical thinking and clinical judgment, which are central to the NGN framework.
Question: 1296
In a clinical education setting, a nursing educator is introducing students to quality improvement projects. Which of the following elements is essential for ensuring stakeholder engagement throughout the QI process?
1. Providing a detailed budget for the project
2. Conducting a single meeting to gather initial feedback
3. Communicating the project�s goals and expected outcomes regularly
Answer: C
Explanation: Regular communication of goals and outcomes is crucial for maintaining stakeholder engagement and ensuring their ongoing support and input throughout the quality improvement process.
Question: 1297
A clinical nurse educator is addressing a situation where a student nurse interrupts a staff nurse�s patient discharge teaching to correct a minor detail, frustrating the nurse and confusing the patient. The educator must intervene to correct this unprofessional behavior. Which intervention is most effective?
1. Engage the student in a reflective discussion on teamwork and patient-centered communication.
2. Issue a verbal warning and limit the student�s participation in discharge teaching.
3. Require the student to observe discharge teaching without contributing.
Answer: A
Explanation: A reflective discussion promotes understanding of teamwork and patient- centered communication, fostering professionalism and aligning with NLN competencies for collaboration. A warning or restriction limits learning without addressing the behavior�s cause.
Question: 1298
A nursing educator is implementing a new curriculum focused on interprofessional collaboration. Which of the following strategies would best facilitate adult learners in developing teamwork skills?
1. Conducting individual assessments on collaboration skills
2. Engaging students in interprofessional team simulations with debriefing sessions
3. Providing lectures on the importance of teamwork without practical application
Answer: B
Explanation: Engaging students in interprofessional team simulations allows for practical application of collaboration skills, fostering teamwork and communication in a realistic context.
Question: 1299
A nursing student is assigned to a patient with heart failure, requiring titration of a furosemide infusion (starting at 5 mg/hour, increasing by 2.5 mg/hour based on urine output <50 mL/hour). The student calculates the titration correctly but doubts their ability to manage complex therapies, citing fear of errors. To promote professional identity, which intervention is most effective?
1. Discuss a case study where a nurse�s timely titration improved patient outcomes.
2. Provide a furosemide titration protocol and have the student follow it.
3. Assign the student to observe a heart failure nurse�s titration process.
Answer: A
Explanation: Discussing a case study highlights the nurse�s role in impactful care, reinforcing professional identity and confidence. This approach connects clinical actions to professional purpose. A protocol ensures safety but lacks inspiration, and observation is passive, not fostering identity development.
Question: 1300
A nursing student is assessing a patient with congestive heart failure (CHF). Which lab value would be most significant in determining the severity of the patient�s condition?
1. Serum creatinine; normal range is 0.6-1.2 mg/dL
2. B-type natriuretic peptide (BNP); normal range is < 100 pg/mL
3. Hemoglobin; normal range is 12-16 g/dL
Answer: B
Explanation: A BNP level of = 100 pg/mL indicates heart failure severity, making it a critical lab value for nurses to monitor in patients with CHF.
Question: 1301
During a clinical rotation, a nursing student encounters a patient who expresses reluctance to follow a prescribed treatment due to cultural beliefs. What should the nurse do first to address this situation?
1. Insist on the treatment plan without further discussion.
2. Explore the patient's cultural beliefs and concerns regarding the treatment.
3. Refer the patient to another healthcare provider for a different opinion.
Answer: B
Explanation: Exploring the patient's cultural beliefs and concerns allows the nurse to understand the patient's perspective and work collaboratively towards a respectful care plan.
Question: 1302
In a clinical setting, a nursing educator is utilizing the PDSA (Plan-Do-Study-Act) cycle to implement a new hand hygiene protocol. After the "Do" phase, the educator collects data on infection rates. What is the next step in the PDSA cycle?
1. Implement the new protocol permanently
2. Train additional staff on the new protocol
3. Analyze the data collected during the "Do" phase
Answer: C
Explanation: In the PDSA cycle, after the "Do" phase, the next step is to analyze the data collected to assess the effectiveness of the intervention before deciding on further actions.
Question: 1303
A clinical nurse educator observes a student struggling to use Socratic questioning effectively when teaching a patient about post-operative care after a cholecystectomy. The student�s questions are leading and do not promote patient understanding. Which intervention best supports the student in refining Socratic questioning skills to enhance patient education?
1. Provide a list of sample Socratic questions for the student to memorize and use.
2. Conduct a role-play where the educator models open-ended questions, such as �Can you explain what you understand by �activity restrictions�?� with feedback.
3. Assign a studying on Socratic questioning techniques in patient education.
Answer: B
Explanation: Socratic questioning requires practice and feedback to develop open-ended, reflective prompts. Role-play with modeling and feedback allows the student to observe effective techniques and refine their approach, aligning with NLN-CNEcl competencies for facilitating learning. Memorizing questions limits adaptability, and studying alone does not provide practical application.
Question: 1304
A nurse educator is assessing students' understanding of reflective practice. Which question best evaluates their comprehension of its purpose in clinical education?
1. How does reflective practice contribute to your professional growth and patient care improvement?
2. What are the steps of the nursing process?
3. Why is it important to pass clinical exams?
Answer: A
Explanation: This question directly addresses the purpose of reflective practice, focusing on its role in professional growth and enhancing patient care, which is essential for nursing education.
Question: 1305
A nurse educator is preparing to teach students about the significance of using the PICO(T) framework in clinical research. Which of the following examples best demonstrates an effective use of the framework in a research question?
1. In adults with type 2 diabetes, does a low-carbohydrate diet compared to a standard diet lead to better glycemic control over six months?
2. What is the most effective medication for managing diabetes?
3. In patients with diabetes, how does dietary intervention affect health outcomes?
Answer: A
Explanation: This question effectively utilizes the PICO(T) framework by clearly identifying the population (adults with type 2 diabetes), intervention (low-carbohydrate diet), comparison (standard diet), outcome (glycemic control), and time frame (six months).
Question: 1306
Following a simulation of a pediatric asthma exacerbation, the educator conducts a debriefing using the Gather-Analyze-Summarize (GAS) framework. A student incorrectly administered 2.5 mg of albuterol via nebulizer instead of the ordered 5 mg. Which question should the educator ask during the Analyze phase to promote critical thinking?
1. What led you to choose 2.5 mg of albuterol?
2. How can you prevent this error in the future?
3. Why is 5 mg the standard dose for asthma? D) What resources did you use to verify the dose?
Answer: A
Explanation: The Analyze phase of the GAS framework focuses on understanding the reasoning behind actions. Asking what led to the incorrect dose encourages the student to reflect on their decision-making process, identifying errors (e.g., misreading the order). Questions about prevention or resources are more suited to the Summarize phase, and explaining the standard dose is less relevant to analyzing the error.
Question: 1307
In a exact faculty meeting, discussions arose about the ethical implications of using simulation technology in nursing education. What should be the primary consideration in this discussion?
1. The impact of simulation on student learning outcomes and patient safety.
2. The cost of simulation equipment and maintenance.
3. The preference of faculty members regarding teaching methods.
Answer: A
Explanation: The primary consideration should be the impact of simulation on student learning outcomes and patient safety, as these factors directly relate to the quality of nursing education and healthcare delivery.
Question: 1308
A clinical nurse educator is mapping a gerontology rotation to a program outcome requiring students to assess fall risk. The educator designs a scenario with a patient having a Morse Fall Scale score of 60. Which mapping strategy ensures alignment?
1. Mapping to CDC guidelines
2. Aligning with hospital fall prevention policies
3. Linking to a course objective on fall risk assessment
Answer: C
Explanation: Linking to a course objective on fall risk assessment ensures alignment with the program outcome. Hospital policies and CDC guidelines are not specific to educational outcomes.
Question: 1309
In the context of formative evaluations, which practice is most effective in promoting a growth mindset among nursing students?
1. Highlighting errors without providing solutions
2. Encouraging self-reflection and goal-setting based on feedback
3. Providing feedback only at the end of the rotation
Answer: B
Explanation: Encouraging self-reflection and goal-setting fosters a growth mindset, helping students view feedback as a tool for improvement rather than as criticism.
Question: 1310
A summative assessment evaluates a student�s ability to manage a patient with a sodium level of 128 mEq/L. The student correctly identifies hyponatremia but fails to restrict fluids, a critical intervention. The rubric weights assessment at 50%, intervention at 40%, and documentation at 10%. The student scores 45/50, 30/40, and 9/10. Does the student pass with an 85% threshold?
1. Yes, with a score of 87%
2. No, with a score of 84%
3. No, with a score of 82%
Answer: B
Explanation: Summative assessment determines final competency. The student�s scores (45/50, 30/40, 9/10) total 84/100 (84%), below the 85% threshold, so they do not pass. The failure to restrict fluids is a significant intervention error, reflected in the score.
Question: 1311
A clinical nurse educator is tasked with evaluating a clinical course�s alignment with NLN Competency IV (Participate in Curriculum Design and Evaluation of Program Outcomes) and AACN Essentials Domain 8 (Informatics and Healthcare Technologies). The course includes a telehealth simulation for a patient with a blood glucose of 250 mg/ dL (normal: 70-110 mg/dL) and a history of non-adherence. Which evaluation method best assesses informatics competency and curriculum outcomes?
1. A written test on telehealth protocols.
2. A simulation debrief where students analyze their use of telehealth tools and patient education strategies, scored by a rubric.
3. A psychomotor checklist for telehealth equipment setup.
Answer: B
Explanation: NLN Competency IV requires evaluating program outcomes, and AACN Essentials Domain 8 emphasizes informatics application. The correct method uses debriefing to assess telehealth tool use and patient education, aligning with informatics and outcome evaluation. Exams or checklists focus on knowledge or psychomotor skills, not informatics competency.
Question: 1312
A clinical nurse educator is mentoring a novice instructor who is unsure about the scope of practice for an academic clinical nurse educator as defined by the National League for Nursing (NLN). The novice instructor is assigned to oversee a cohort of students in a critical care unit and questions whether they are authorized to perform hands-on patient care during clinical instruction. According to the NLN�s 2020 Scope of Practice for Academic Clinical Nurse Educators, which of the following best describes the educator�s role in this scenario?
1. The educator may perform hands-on patient care only if employed by the clinical facility.
2. The educator may perform hands-on patient care to model clinical skills, provided it
aligns with institutional policies.
3. The educator is prohibited from performing hands-on patient care to maintain focus on student supervision.
Answer: B
Explanation: The NLN�s 2020 Scope of Practice allows clinical nurse educators to engage in hands-on patient care to model clinical skills or facilitate learning, provided it complies with institutional policies and does not detract from their primary role of student supervision. This flexibility supports effective teaching while ensuring patient safety. Prohibiting hands-on care entirely limits teaching effectiveness, and requiring facility employment is not a universal NLN stipulation.
Question: 1313
A nursing student is caring for a patient with chronic obstructive pulmonary disease (COPD) exacerbation, with an oxygen saturation of 88% on 2L nasal cannula and a respiratory rate of 28 breaths/min. The student expresses low self-efficacy in managing respiratory distress, stating, �I don�t think I can handle this if it gets worse.� Which mentorship strategy by the clinical nurse educator is most effective in building the student�s confidence in this clinical task?
1. Assign the student to observe a pulmonary function test to understand COPD pathophysiology better.
2. Provide a checklist of interventions for COPD exacerbation and review it with the student.
3. Have the student assist a senior nurse in administering nebulizer treatments and adjusting oxygen therapy under guidance.
Answer: C
Explanation: Building self-efficacy involves hands-on experience and guidance from a mentor. Assisting a senior nurse in managing nebulizer treatments and oxygen therapy provides the student with a mastery experience under supervision, directly addressing their fear of managing respiratory distress. This approach is more effective than passive observation or reviewing a checklist for building confidence in clinical skills.
Question: 1314
A clinical nurse educator is leading a task force to develop a clinical competency
framework. A study reports a 0.55 effect size for competency-based education on student outcomes (p=0.01). Which leadership action should the educator prioritize?
1. Propose a framework with validated assessment tools.
2. Develop the framework without stakeholder input.
3. Suggest competencies without evaluation metrics.
Answer: A
Explanation: Proposing a framework with validated tools aligns with the study�s findings (effect size=0.55) and ensures measurable outcomes, demonstrating leadership. Developing without input or suggesting competencies without metrics lacks collaboration and rigor.
Question: 1315
In an EHR training session, students document care for a patient with sepsis (lactate: 3.8 mmol/L, WBC: 16,000/mm�). The educator notices errors in antibiotic order entry. Which strategy best improves accuracy?
1. Simulating EHR with decision-support prompts
2. Allowing students to skip order entry
3. Providing a paper-based antibiotic guide
4. Assigning a post-session quiz
Answer: A
Explanation: Simulating EHR with decision-support prompts guides students to correct antibiotic orders, mirroring clinical systems. Skipping entry avoids learning, paper guides are less interactive, and quizzes do not address real-time errors.
Question: 1316
When evaluating the effectiveness of simulation experiences in nursing education, which of the following criteria is most important for assessing student learning?
1. Student satisfaction ratings of the simulation experience
2. The number of simulations completed by each student
3. The extent to which students can apply learned skills to real-world clinical situations
Answer: C
Explanation: Assessing the application of learned skills in real-world situations is a critical measure of the effectiveness of simulation experiences in nursing education.
Question: 1317
A clinical preceptor is guiding a student to achieve a learning outcome: �Apply evidence- based strategies to manage pain in postoperative patients.� The patient, 48 hours post- abdominal surgery, reports pain at 8/10, with a heart rate of 100 bpm and blood pressure of 140/90 mmHg. The medication order includes morphine 4 mg IV every 4 hours PRN. Which student action best meets the learning outcome?
1. Encourage non-pharmacologic interventions like deep breathing
2. Administer morphine 4 mg IV and reassess pain in 30 minutes
3. Hold the morphine dose due to elevated vital signs
Answer: B
Explanation: The learning outcome emphasizes evidence-based pain management. Morphine 4 mg IV is appropriate for severe pain (8/10), and reassessment in 30 minutes ensures efficacy and safety, aligning with evidence-based protocols. Non-pharmacologic interventions are adjunctive, not primary, and holding morphine ignores the patient�s pain severity.
Question: 1318
A faculty member is developing a research project that requires ethical approval. Which of the following elements is crucial to include in the proposal for it to be considered ethically sound?
1. A detailed marketing strategy for the findings
2. The potential benefits of the research
3. Personal opinions of the researcher
Answer: B
Explanation: Including the potential benefits of the research in the ethical approval proposal demonstrates the study's positive impact and justifies the need for conducting the research.
Question: 1319
In the context of Benner�s Novice to Expert model, which of the following statements best describes the transition from the proficient to the expert level?
1. Experts require less experience than proficient nurses to understand clinical situations.
2. Proficient nurses rely on analytical reasoning while experts use intuition.
3. Proficient nurses can identify relevant issues, while experts can predict outcomes based on prior knowledge.
4. The transition is marked by a decrease in the ability to adapt to new situations.
Answer: B
Explanation: Proficient nurses use analytical reasoning, whereas expert nurses often rely on intuition and deep experiential knowledge to make clinical decisions.

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