NR446 COLLABORATIVE HEALTHCARE
EXAM 1 PRACTICE QUESTIONS AND
ANSWERS
1. A nurse manager is implementing a new evidence-based practice bedside shift report.
Which leadership style is most effective for ensuring long-term staff buy-in and professional
growth?
A. Transformational leadership
B. Laissez-faire leadership
C. Autocratic leadership
D. Transactional leadership
Answer: A
Conceptual Explanation: Transformational leadership focuses on inspiring and
empowering staff to participate in the change process, fostering long-term commitment
and professional development, which is ideal for implementing EBP.
2. Which task is most appropriate for the RN to delegate to an experienced Unlicensed
Assistive Personnel (UAP)?
A. Assisting a client with a new diagnosis of stroke to eat for the first time.
,B. Providing discharge instructions regarding wound care to a stable client.
C. Collecting a clean-catch urine specimen from a client with a suspected UTI.
D. Titrating oxygen flow for a client with chronic obstructive pulmonary disease (COPD).
Answer: C
Conceptual Explanation: Collecting a specimen is a routine, non-invasive task. Assisting a
high-risk patient with first-time feeding, teaching, and titrating medications or oxygen
require the specialized judgment of an RN.
3. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with chronic kidney disease who has a potassium level of 5.1 mEq/L.
B. A client with a chest tube who has 150 mL of drainage in the last hour.
C. A client who is 48 hours post-appendectomy with a temperature of 100.2°F (37.9°C).
D. A client receiving IV heparin for a DVT with a PTT of 1.5 times the control.
E.
Answer: B
Conceptual Explanation: Sudden increased chest tube drainage (over 70-100 mL/hr)
indicates potential active hemorrhage and is the highest priority using the ABC framework.
4. A nurse manager notes an increase in medication errors on the unit. Which action should
the manager take first?
A. Conduct a root cause analysis to identify systemic factors.
, B. Issue formal written warnings to nurses who made the errors.
C. Require all nurses to attend a mandatory medication safety seminar.
D. Increase the frequency of nurse performance evaluations.
Answer: A
Conceptual Explanation: According to ‘Just Culture’ and quality improvement principles,
the first step is to identify the underlying cause of the errors (system vs. individual) before
implementing interventions.
5. A nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which task is within the
LPN’s scope of practice?
A. Performing the initial admission assessment on a new client.
B. Administering a scheduled dose of subcutaneous insulin.
C. Developing a nursing care plan for a client with complex needs.
D. Evaluating the effectiveness of a new pain management protocol.
Answer: B
Conceptual Explanation: LPNs can administer medications (routes vary by state, but SQ is
standard) and care for stable patients. Initial assessments, care planning, and evaluation
are RN responsibilities.
6. The nurse is practicing the ethical principle of fidelity when performing which action?
A. Allowing a client to refuse a life-saving blood transfusion.
EXAM 1 PRACTICE QUESTIONS AND
ANSWERS
1. A nurse manager is implementing a new evidence-based practice bedside shift report.
Which leadership style is most effective for ensuring long-term staff buy-in and professional
growth?
A. Transformational leadership
B. Laissez-faire leadership
C. Autocratic leadership
D. Transactional leadership
Answer: A
Conceptual Explanation: Transformational leadership focuses on inspiring and
empowering staff to participate in the change process, fostering long-term commitment
and professional development, which is ideal for implementing EBP.
2. Which task is most appropriate for the RN to delegate to an experienced Unlicensed
Assistive Personnel (UAP)?
A. Assisting a client with a new diagnosis of stroke to eat for the first time.
,B. Providing discharge instructions regarding wound care to a stable client.
C. Collecting a clean-catch urine specimen from a client with a suspected UTI.
D. Titrating oxygen flow for a client with chronic obstructive pulmonary disease (COPD).
Answer: C
Conceptual Explanation: Collecting a specimen is a routine, non-invasive task. Assisting a
high-risk patient with first-time feeding, teaching, and titrating medications or oxygen
require the specialized judgment of an RN.
3. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with chronic kidney disease who has a potassium level of 5.1 mEq/L.
B. A client with a chest tube who has 150 mL of drainage in the last hour.
C. A client who is 48 hours post-appendectomy with a temperature of 100.2°F (37.9°C).
D. A client receiving IV heparin for a DVT with a PTT of 1.5 times the control.
E.
Answer: B
Conceptual Explanation: Sudden increased chest tube drainage (over 70-100 mL/hr)
indicates potential active hemorrhage and is the highest priority using the ABC framework.
4. A nurse manager notes an increase in medication errors on the unit. Which action should
the manager take first?
A. Conduct a root cause analysis to identify systemic factors.
, B. Issue formal written warnings to nurses who made the errors.
C. Require all nurses to attend a mandatory medication safety seminar.
D. Increase the frequency of nurse performance evaluations.
Answer: A
Conceptual Explanation: According to ‘Just Culture’ and quality improvement principles,
the first step is to identify the underlying cause of the errors (system vs. individual) before
implementing interventions.
5. A nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which task is within the
LPN’s scope of practice?
A. Performing the initial admission assessment on a new client.
B. Administering a scheduled dose of subcutaneous insulin.
C. Developing a nursing care plan for a client with complex needs.
D. Evaluating the effectiveness of a new pain management protocol.
Answer: B
Conceptual Explanation: LPNs can administer medications (routes vary by state, but SQ is
standard) and care for stable patients. Initial assessments, care planning, and evaluation
are RN responsibilities.
6. The nurse is practicing the ethical principle of fidelity when performing which action?
A. Allowing a client to refuse a life-saving blood transfusion.
