NSG 4700 Exam 3 V2 | NSG 4700
Leadership & Management in Nursing
Practice | Actual Q&A with Rationale
(NSG4700 Exam 3) | Galen
1. A nurse manager is delegating tasks to a Licensed Practical Nurse (LPN) on a medical-
surgical unit. Which task is appropriate for the nurse manager to delegate?
A. Initial assessment of a patient admitted with chest pain
B. Developing a plan of care for a patient with newly diagnosed diabetes
C. Administering oral medications to a stable patient
D. Evaluating the effectiveness of a patient’s pain medication
Correct Answer: C
Explanation: Administering oral medications to a stable patient is within the scope of
practice for an LPN. The nurse manager must remember that assessment, planning, and
evaluation are the responsibility of the Registered Nurse (RN) and cannot be delegated.
This follows the Five Rights of Delegation to ensure patient safety and professional
standards.
2. According to the Joint Commission, which of the following events would be classified as a
sentinel event? (Select All That Apply)
A. Patient suicide within a 24-hour healthcare setting
,B. Surgery performed on the wrong body part
C. A medication error that results in minor bruising
D. Hemolytic transfusion reaction involving incompatible blood
E. Abduction of any patient receiving care
F. A fall resulting in a minor skin tear
Correct Answer: A, B, D, E
Explanation: Sentinel events are unexpected occurrences involving death or serious
physical or psychological injury, or the risk thereof. Suicide, wrong-site surgery,
incompatible blood transfusions, and patient abductions all meet this high-severity
threshold. Minor errors or injuries like bruising or skin tears do not qualify as sentinel
events under standard regulatory definitions.
3. A nurse is using Lewin’s Change Theory to implement a new bedside reporting system.
During the ‘Unfreezing’ stage, which action should the nurse leader take?
A. Implement the new reporting forms on the unit
B. Audit the new process to ensure compliance
C. Support staff as they integrate the change into daily practice
D. Gather data to demonstrate the need for change
Correct Answer: D
,Explanation: Unfreezing involves creating the motivation to change by helping individuals
realize that the current status quo is no longer effective. Gathering data to highlight
problems with the old system is a key step in this initial phase. Without this stage, staff may
resist the transition because they do not see a valid reason for the disruption.
4. A nurse manager is preparing the annual budget and notices that the cost of supplies has
significantly exceeded the projected amount. This is an example of which type of variance?
A. Favorable variance
B. Unfavorable variance
C. Volume variance
D. Efficiency variance
Correct Answer: B
Explanation: An unfavorable variance occurs when the actual costs are higher than the
budgeted costs or when actual revenue is lower than projected. In this scenario, spending
more than planned on supplies directly negatively impacts the bottom line. Monitoring
these variances is essential for fiscal responsibility and adjusting unit operations
throughout the fiscal year.
5. In a healthcare organization, ‘Shared Governance’ is best described as a model where:
A. The Chief Nursing Officer makes all clinical decisions
B. Decisions are made top-down to ensure consistency
C. Physicians and administrators manage all unit-level operations
, D. Staff nurses are empowered to participate in decision-making regarding practice
Correct Answer: D
Explanation: Shared governance is a decentralized leadership model that gives staff
nurses a voice in clinical decision-making and policy development. This model is often a
requirement for achieving Magnet status because it fosters professional autonomy and
improves job satisfaction. It shifts the power dynamic from a traditional hierarchy to a
collaborative partnership.
6. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with a fracture who is requesting pain medication
B. A patient who is scheduled for discharge in one hour
C. A patient with heart failure who has developed new-onset shortness of breath
D. A patient with a post-operative fever of 100.4 F
Correct Answer: C
Explanation: Priority must be given using the ABC (Airway, Breathing, Circulation)
framework. New-onset shortness of breath indicates a potential respiratory emergency
that requires immediate intervention. The other patients have needs that are important but
not immediately life-threatening compared to a breathing compromise.
7. Which conflict resolution strategy is characterized by one party yielding to the other to
maintain harmony, often at the expense of their own goals?
A. Compromising
Leadership & Management in Nursing
Practice | Actual Q&A with Rationale
(NSG4700 Exam 3) | Galen
1. A nurse manager is delegating tasks to a Licensed Practical Nurse (LPN) on a medical-
surgical unit. Which task is appropriate for the nurse manager to delegate?
A. Initial assessment of a patient admitted with chest pain
B. Developing a plan of care for a patient with newly diagnosed diabetes
C. Administering oral medications to a stable patient
D. Evaluating the effectiveness of a patient’s pain medication
Correct Answer: C
Explanation: Administering oral medications to a stable patient is within the scope of
practice for an LPN. The nurse manager must remember that assessment, planning, and
evaluation are the responsibility of the Registered Nurse (RN) and cannot be delegated.
This follows the Five Rights of Delegation to ensure patient safety and professional
standards.
2. According to the Joint Commission, which of the following events would be classified as a
sentinel event? (Select All That Apply)
A. Patient suicide within a 24-hour healthcare setting
,B. Surgery performed on the wrong body part
C. A medication error that results in minor bruising
D. Hemolytic transfusion reaction involving incompatible blood
E. Abduction of any patient receiving care
F. A fall resulting in a minor skin tear
Correct Answer: A, B, D, E
Explanation: Sentinel events are unexpected occurrences involving death or serious
physical or psychological injury, or the risk thereof. Suicide, wrong-site surgery,
incompatible blood transfusions, and patient abductions all meet this high-severity
threshold. Minor errors or injuries like bruising or skin tears do not qualify as sentinel
events under standard regulatory definitions.
3. A nurse is using Lewin’s Change Theory to implement a new bedside reporting system.
During the ‘Unfreezing’ stage, which action should the nurse leader take?
A. Implement the new reporting forms on the unit
B. Audit the new process to ensure compliance
C. Support staff as they integrate the change into daily practice
D. Gather data to demonstrate the need for change
Correct Answer: D
,Explanation: Unfreezing involves creating the motivation to change by helping individuals
realize that the current status quo is no longer effective. Gathering data to highlight
problems with the old system is a key step in this initial phase. Without this stage, staff may
resist the transition because they do not see a valid reason for the disruption.
4. A nurse manager is preparing the annual budget and notices that the cost of supplies has
significantly exceeded the projected amount. This is an example of which type of variance?
A. Favorable variance
B. Unfavorable variance
C. Volume variance
D. Efficiency variance
Correct Answer: B
Explanation: An unfavorable variance occurs when the actual costs are higher than the
budgeted costs or when actual revenue is lower than projected. In this scenario, spending
more than planned on supplies directly negatively impacts the bottom line. Monitoring
these variances is essential for fiscal responsibility and adjusting unit operations
throughout the fiscal year.
5. In a healthcare organization, ‘Shared Governance’ is best described as a model where:
A. The Chief Nursing Officer makes all clinical decisions
B. Decisions are made top-down to ensure consistency
C. Physicians and administrators manage all unit-level operations
, D. Staff nurses are empowered to participate in decision-making regarding practice
Correct Answer: D
Explanation: Shared governance is a decentralized leadership model that gives staff
nurses a voice in clinical decision-making and policy development. This model is often a
requirement for achieving Magnet status because it fosters professional autonomy and
improves job satisfaction. It shifts the power dynamic from a traditional hierarchy to a
collaborative partnership.
6. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with a fracture who is requesting pain medication
B. A patient who is scheduled for discharge in one hour
C. A patient with heart failure who has developed new-onset shortness of breath
D. A patient with a post-operative fever of 100.4 F
Correct Answer: C
Explanation: Priority must be given using the ABC (Airway, Breathing, Circulation)
framework. New-onset shortness of breath indicates a potential respiratory emergency
that requires immediate intervention. The other patients have needs that are important but
not immediately life-threatening compared to a breathing compromise.
7. Which conflict resolution strategy is characterized by one party yielding to the other to
maintain harmony, often at the expense of their own goals?
A. Compromising
