NSG 4700 Exam 4 V3 | NSG 4700
Leadership & Management in Nursing
Practice | Actual Q&A with Rationale
(NSG4700 Exam 4) | Galen
1. A nurse manager is preparing a presentation about the ‘Five Rights of Delegation.’ Which
components should be included to ensure the staff understands safe delegation practices?
(Select all that apply)
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Medication
E. Right Direction/Communication
F. Right Supervision/Evaluation
Correct Answer: A, B, C, E, F
Explanation: According to the National Council of State Boards of Nursing (NCSBN), the
Five Rights of Delegation include the right task, circumstance, person,
direction/communication, and supervision/evaluation. Right medication is not one of the
delegation rights, but rather one of the rights of medication administration. Understanding
,these rights helps ensure that the nurse remains accountable for patient outcomes when
assigning tasks to unlicensed assistive personnel or other staff.
2. A nurse manager is using Lewin’s Change Theory to implement a new electronic health
record system. Which action should the nurse manager take during the ‘unfreezing’ stage?
A. Inform the staff about the reasons for the change and the benefits.
B. Recognize and provide rewards for those using the new system.
C. Implement the new system on a pilot unit.
D. Evaluate the effectiveness of the new documentation process.
Correct Answer: A
Explanation: The unfreezing stage is the first step in Lewin’s Change Theory, where the
manager identifies the need for change and prepares the staff for it. This phase involves
breaking down existing habits and creating awareness of the necessity for a transition. By
communicating the rationale and benefits, the manager helps minimize resistance among
the nursing staff.
3. Which conflict resolution strategy is being used when a nurse manager tells two staff
members that they must both give up something to reach an agreement regarding a
scheduling dispute?
A. Avoiding
B. Collaborating
C. Compromising
,D. Competing
Correct Answer: C
Explanation: Compromising involves both parties making concessions to reach a middle-
ground solution where neither side gets exactly what they want. This strategy is often used
when time is limited or when the parties have equal power. It helps maintain a level of
harmony by ensuring that both individuals feel heard, even if their full demands are not
met.
4. A nurse leader is demonstrating transformational leadership qualities. Which
characteristics are typical of this leadership style? (Select all that apply)
A. Uses contingent rewards to motivate staff
B. Inspires others with a shared vision
C. Empowers staff to participate in decision-making
D. Focuses strictly on day-to-day operations
E. Encourages intellectual stimulation and growth
F. Builds strong relationships based on trust
Correct Answer: B, C, E, F
Explanation: Transformational leaders focus on inspiring and motivating followers to
achieve extraordinary outcomes and develop their own leadership capacity. They use
charisma, intellectual stimulation, and individualized consideration to empower their
, teams. Unlike transactional leaders who rely on rewards and punishments (contingent
rewards), transformational leaders aim for long-term organizational growth.
5. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 110/70 mmHg who is due for a scheduled medication.
B. A client who is 2 hours postoperative and reports a pain level of 4 out of 10.
C. A client with a new onset of shortness of breath and an oxygen saturation of 88%.
D. A client who needs a dressing change for a stage II pressure injury.
Correct Answer: C
Explanation: Using the ABC (Airway, Breathing, Circulation) prioritization framework, the
client with shortness of breath and low oxygen saturation is the most unstable. Respiratory
distress takes precedence over routine medications, moderate pain, and wound care.
Immediate intervention is required to prevent further clinical deterioration in this patient.
6. What is the primary purpose of the ‘Just Culture’ model in a healthcare organization?
A. To ensure all staff members are punished for clinical errors.
B. To eliminate all nursing documentation requirements.
C. To promote an environment where errors are reported without fear of retribution.
D. To assign blame to the individual who made the mistake.
Correct Answer: C
Leadership & Management in Nursing
Practice | Actual Q&A with Rationale
(NSG4700 Exam 4) | Galen
1. A nurse manager is preparing a presentation about the ‘Five Rights of Delegation.’ Which
components should be included to ensure the staff understands safe delegation practices?
(Select all that apply)
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Medication
E. Right Direction/Communication
F. Right Supervision/Evaluation
Correct Answer: A, B, C, E, F
Explanation: According to the National Council of State Boards of Nursing (NCSBN), the
Five Rights of Delegation include the right task, circumstance, person,
direction/communication, and supervision/evaluation. Right medication is not one of the
delegation rights, but rather one of the rights of medication administration. Understanding
,these rights helps ensure that the nurse remains accountable for patient outcomes when
assigning tasks to unlicensed assistive personnel or other staff.
2. A nurse manager is using Lewin’s Change Theory to implement a new electronic health
record system. Which action should the nurse manager take during the ‘unfreezing’ stage?
A. Inform the staff about the reasons for the change and the benefits.
B. Recognize and provide rewards for those using the new system.
C. Implement the new system on a pilot unit.
D. Evaluate the effectiveness of the new documentation process.
Correct Answer: A
Explanation: The unfreezing stage is the first step in Lewin’s Change Theory, where the
manager identifies the need for change and prepares the staff for it. This phase involves
breaking down existing habits and creating awareness of the necessity for a transition. By
communicating the rationale and benefits, the manager helps minimize resistance among
the nursing staff.
3. Which conflict resolution strategy is being used when a nurse manager tells two staff
members that they must both give up something to reach an agreement regarding a
scheduling dispute?
A. Avoiding
B. Collaborating
C. Compromising
,D. Competing
Correct Answer: C
Explanation: Compromising involves both parties making concessions to reach a middle-
ground solution where neither side gets exactly what they want. This strategy is often used
when time is limited or when the parties have equal power. It helps maintain a level of
harmony by ensuring that both individuals feel heard, even if their full demands are not
met.
4. A nurse leader is demonstrating transformational leadership qualities. Which
characteristics are typical of this leadership style? (Select all that apply)
A. Uses contingent rewards to motivate staff
B. Inspires others with a shared vision
C. Empowers staff to participate in decision-making
D. Focuses strictly on day-to-day operations
E. Encourages intellectual stimulation and growth
F. Builds strong relationships based on trust
Correct Answer: B, C, E, F
Explanation: Transformational leaders focus on inspiring and motivating followers to
achieve extraordinary outcomes and develop their own leadership capacity. They use
charisma, intellectual stimulation, and individualized consideration to empower their
, teams. Unlike transactional leaders who rely on rewards and punishments (contingent
rewards), transformational leaders aim for long-term organizational growth.
5. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 110/70 mmHg who is due for a scheduled medication.
B. A client who is 2 hours postoperative and reports a pain level of 4 out of 10.
C. A client with a new onset of shortness of breath and an oxygen saturation of 88%.
D. A client who needs a dressing change for a stage II pressure injury.
Correct Answer: C
Explanation: Using the ABC (Airway, Breathing, Circulation) prioritization framework, the
client with shortness of breath and low oxygen saturation is the most unstable. Respiratory
distress takes precedence over routine medications, moderate pain, and wound care.
Immediate intervention is required to prevent further clinical deterioration in this patient.
6. What is the primary purpose of the ‘Just Culture’ model in a healthcare organization?
A. To ensure all staff members are punished for clinical errors.
B. To eliminate all nursing documentation requirements.
C. To promote an environment where errors are reported without fear of retribution.
D. To assign blame to the individual who made the mistake.
Correct Answer: C
