NSG 4700 Exam 3 V3 | NSG 4700
Leadership & Management in Nursing
Practice | Actual Q&A with Rationale
(NSG4700 Exam 3) | Galen
1. A nurse manager is implementing a Quality Improvement (QI) program for a medical-
surgical unit. Which principles should the nurse manager include as core components of the
QI process? Select all that apply.
A. Focusing on the system rather than the individual
B. Utilizing data to drive decision-making
C. Standardizing processes to minimize variation
D. Adopting a punitive approach to error reporting
E. Engaging interdisciplinary teams in the process
F. Prioritizing customer (patient) needs and satisfaction
Correct Answer: A, B, C, E, F
Explanation: Quality Improvement is a systematic approach focused on enhancing patient
outcomes by analyzing and improving organizational processes. It emphasizes a non-
punitive culture of safety where data is used to identify areas for growth rather than
individual blame. Successful QI initiatives involve collaboration across disciplines and
prioritize the safety and satisfaction of the patient.
,2. An unexpected occurrence involving death or serious physical or psychological injury is
occurring on the unit. How should the nurse manager document this event according to The
Joint Commission (TJC)?
A. A medical error
B. A benchmark deviation
C. A sentinel event
D. A non-compliance issue
Correct Answer: C
Explanation: A sentinel event is defined by TJC as an unexpected occurrence involving
death, permanent harm, or severe temporary harm. These events are called ‘sentinel’
because they signal the need for immediate investigation and response. Identifying a
sentinel event triggers a mandatory root cause analysis to prevent future occurrences.
3. A nurse manager is conducting a retrospective analysis of a medication error that occurred
on the unit. What is the primary purpose of performing a Root Cause Analysis (RCA)?
A. To determine the underlying system failures that led to the event
B. To identify which staff member is responsible for the error
C. To provide a basis for terminating the involved nurse
D. To satisfy legal requirements for malpractice insurance
Correct Answer: A
,Explanation: Root Cause Analysis (RCA) is a structured method used to identify the ‘root’
of a problem rather than just the symptoms. It shifts the focus from individual blame to
system-level factors such as workflow, communication, or equipment. The ultimate goal is
to implement corrective actions that address the systemic issue and improve overall safety.
4. A hospital is seeking Magnet Status. Which characteristic is a primary indicator of a
Magnet-designated facility?
A. Decentralized decision-making and nursing autonomy
B. High nurse-to-patient ratios in every department
C. A strict hierarchical leadership structure
D. Use of agency nurses to fill staffing gaps
Correct Answer: A
Explanation: Magnet status is awarded to healthcare organizations that demonstrate
nursing excellence and innovations in professional practice. A key component of this model
is shared governance, which empowers bedside nurses to participate in decision-making.
Facilities with this designation typically show higher rates of nurse satisfaction and better
patient outcomes.
5. The nurse is preparing to delegate tasks to an Unlicensed Assistive Personnel (UAP). Which
tasks are appropriate for the nurse to delegate? Select all that apply.
A. Assisting a stable patient with ambulation
B. Calculating the intake and output for a client
, C. Evaluating the effectiveness of a pain medication
D. Performing a sterile dressing change
E. Providing basic hygiene and skin care
Correct Answer: A, B, E
Explanation: Nurses can delegate stable, routine tasks that do not require clinical
judgment or the nursing process to UAPs. Tasks such as ambulation, hygiene, and recording
measurements are within the UAP scope of practice. Assessment, evaluation, and sterile
procedures must be performed by a licensed nurse.
6. A nurse manager is evaluating the performance of a staff nurse and notices that because
the nurse is always on time, they receive high scores in all other categories. What type of
appraisal bias is this?
A. Halo effect
B. Recency effect
C. Leniency error
D. Central tendency
Correct Answer: A
Explanation: The halo effect occurs when an appraiser allows one positive characteristic
of an employee to overshadow other areas of performance. This leads to an inaccurately
high overall rating that may not reflect the nurse’s actual clinical competence. Managers
Leadership & Management in Nursing
Practice | Actual Q&A with Rationale
(NSG4700 Exam 3) | Galen
1. A nurse manager is implementing a Quality Improvement (QI) program for a medical-
surgical unit. Which principles should the nurse manager include as core components of the
QI process? Select all that apply.
A. Focusing on the system rather than the individual
B. Utilizing data to drive decision-making
C. Standardizing processes to minimize variation
D. Adopting a punitive approach to error reporting
E. Engaging interdisciplinary teams in the process
F. Prioritizing customer (patient) needs and satisfaction
Correct Answer: A, B, C, E, F
Explanation: Quality Improvement is a systematic approach focused on enhancing patient
outcomes by analyzing and improving organizational processes. It emphasizes a non-
punitive culture of safety where data is used to identify areas for growth rather than
individual blame. Successful QI initiatives involve collaboration across disciplines and
prioritize the safety and satisfaction of the patient.
,2. An unexpected occurrence involving death or serious physical or psychological injury is
occurring on the unit. How should the nurse manager document this event according to The
Joint Commission (TJC)?
A. A medical error
B. A benchmark deviation
C. A sentinel event
D. A non-compliance issue
Correct Answer: C
Explanation: A sentinel event is defined by TJC as an unexpected occurrence involving
death, permanent harm, or severe temporary harm. These events are called ‘sentinel’
because they signal the need for immediate investigation and response. Identifying a
sentinel event triggers a mandatory root cause analysis to prevent future occurrences.
3. A nurse manager is conducting a retrospective analysis of a medication error that occurred
on the unit. What is the primary purpose of performing a Root Cause Analysis (RCA)?
A. To determine the underlying system failures that led to the event
B. To identify which staff member is responsible for the error
C. To provide a basis for terminating the involved nurse
D. To satisfy legal requirements for malpractice insurance
Correct Answer: A
,Explanation: Root Cause Analysis (RCA) is a structured method used to identify the ‘root’
of a problem rather than just the symptoms. It shifts the focus from individual blame to
system-level factors such as workflow, communication, or equipment. The ultimate goal is
to implement corrective actions that address the systemic issue and improve overall safety.
4. A hospital is seeking Magnet Status. Which characteristic is a primary indicator of a
Magnet-designated facility?
A. Decentralized decision-making and nursing autonomy
B. High nurse-to-patient ratios in every department
C. A strict hierarchical leadership structure
D. Use of agency nurses to fill staffing gaps
Correct Answer: A
Explanation: Magnet status is awarded to healthcare organizations that demonstrate
nursing excellence and innovations in professional practice. A key component of this model
is shared governance, which empowers bedside nurses to participate in decision-making.
Facilities with this designation typically show higher rates of nurse satisfaction and better
patient outcomes.
5. The nurse is preparing to delegate tasks to an Unlicensed Assistive Personnel (UAP). Which
tasks are appropriate for the nurse to delegate? Select all that apply.
A. Assisting a stable patient with ambulation
B. Calculating the intake and output for a client
, C. Evaluating the effectiveness of a pain medication
D. Performing a sterile dressing change
E. Providing basic hygiene and skin care
Correct Answer: A, B, E
Explanation: Nurses can delegate stable, routine tasks that do not require clinical
judgment or the nursing process to UAPs. Tasks such as ambulation, hygiene, and recording
measurements are within the UAP scope of practice. Assessment, evaluation, and sterile
procedures must be performed by a licensed nurse.
6. A nurse manager is evaluating the performance of a staff nurse and notices that because
the nurse is always on time, they receive high scores in all other categories. What type of
appraisal bias is this?
A. Halo effect
B. Recency effect
C. Leniency error
D. Central tendency
Correct Answer: A
Explanation: The halo effect occurs when an appraiser allows one positive characteristic
of an employee to overshadow other areas of performance. This leads to an inaccurately
high overall rating that may not reflect the nurse’s actual clinical competence. Managers
