WGU D345 - Comprehensive
Assessment BY DR .COLE WITH
CORRECT ANSWERS AND RATIONALE
GRADED A+ UPDATED 2026 NEW!!
Section 1: Professional Identity and Leadership (Questions 1-20)
1. A nurse manager is implementing a new evidence-based protocol for fall prevention. Staff
members are resistant to the change, stating, "We have always done it this way." According to
Lewin's Change Theory, which action should the manager take first?
A. Mandate the new protocol and enforce consequences for non-compliance.
B. Provide education and data on the benefits of the new protocol to the staff.
C. Abandon the new protocol to maintain staff satisfaction.
D. Discharge the most resistant staff members to set an example.
Answer: B
Rationale: Lewin's Change Theory involves three stages: Unfreezing, Moving/Changing, and
Refreezing. Providing education and data helps "unfreeze" the current state by demonstrating why
the old method is no longer adequate and creating motivation for change. This addresses the "we've
always done it this way" mindset before implementing (Moving) or sustaining (Refreezing) the
change.
2. A staff nurse notices a colleague diverting narcotics. After confronting the colleague, who denies
it, what is the nurse's immediate professional and legal obligation?
A. Continue to monitor the colleague for further suspicious behavior.
B. Report the suspicion directly to the state police.
C. Report the observation to the nurse manager or supervisor immediately.
D. Warn other staff members to be cautious around the colleague.
Answer: C
,Rationale: The professional nurse's duty is to protect patient safety and uphold the integrity of the
profession. The immediate next step after a direct observation and an unsatisfactory confrontation
is to follow the chain of command and report the suspicion to an immediate supervisor. This allows
for a proper, confidential investigation. Reporting directly to law enforcement or warning other staff
could be considered slander if the suspicion is unproven and disrupts the formal investigative
process.
3. A nurse leader asks, "What does optimal patient care on our unit look like to you?" This is an
example of what type of leadership behavior?
A. Laissez-faire leadership
B. Transactional leadership
C. Transformational leadership
D. Authoritarian leadership
Answer: C
Rationale: Transformational leaders inspire and motivate followers by creating a shared vision,
encouraging innovation, and empowering them to contribute to a higher purpose. Asking a
visionary, open-ended question that focuses on a shared ideal goal ("optimal patient care") is a
hallmark of transformational leadership.
4. A charge nurse assigns a new graduate nurse to care for a patient with a complex chest tube
drainage system. The new graduate expresses feeling unprepared. The charge nurse states, "This is
how you learn," and does not provide support. This charge nurse is demonstrating what
management style?
A. Democratic
B. Paternalistic
C. Laissez-faire
D. Transformational
Answer: C
Rationale: A laissez-faire leader provides little to no direction, supervision, or support, leaving team
members to fend for themselves. This style is dangerous, especially for inexperienced staff, as it fails
to ensure patient safety and does not promote professional development. The charge nurse's "sink
or swim" approach is a classic example.
,5. A nurse is assigned to care for a patient who practices a religion that prohibits blood transfusions.
The patient is anemic and requires a transfusion to survive. What is the nurse's primary ethical
responsibility?
A. Convince the patient's family to override the decision.
B. Administer the blood transfusion because the patient's life is at risk.
C. Respect the patient's autonomy and support their informed decision.
D. Initiate a psychiatric consultation to assess the patient's competency.
Answer: C
Rationale: The ethical principle of autonomy dictates that a competent, informed adult patient has
the right to accept or refuse medical treatment, even if that decision leads to death. The nurse's
primary role is to respect and support this right, ensuring the decision is well-informed.
Paternalistically overriding this decision, even with good intentions, is an ethical violation.
6. A nursing team is comprised of one RN, two LPNs, and one unlicensed assistive personnel (UAP).
This is an example of which type of nursing care delivery model?
A. Total Patient Care
B. Functional Nursing
C. Team Nursing
D. Primary Nursing
Answer: C
Rationale: Team nursing involves a group of healthcare personnel with varying levels of education,
skills, and licensure working together under the direction of a professional nurse (the RN team
leader) to provide care to a group of patients. The RN delegates tasks appropriately to the LPNs and
UAP.
7. During an ethical committee meeting regarding a terminally ill patient, the nurse provides
detailed, factual information about the patient's unmanaged pain and suffering. What role is the
nurse fulfilling?
A. Patient educator
B. Patient advocate
C. Case manager
D. Expert witness
, Answer: B
Rationale: A patient advocate speaks on behalf of the patient when they are unable to do so,
ensuring their needs and wishes are central to the decision-making process. By presenting objective
data about the patient's suffering, the nurse is advocating for the patient's comfort and quality of
life to be prioritized in the ethical discussion.
8. A newly licensed nurse is struggling with time management. Which task should the nurse identify
as the highest priority to complete first during a shift?
A. Ambulating a stable post-operative patient.
B. Documenting the morning assessment.
C. Administering a patient's scheduled insulin before breakfast.
D. Checking the crash cart for the next month's expiration dates.
Answer: C
Rationale: Prioritization should be based on time-sensitive and life-threatening needs. Insulin
administration is tightly linked to a meal (breakfast) and failure to administer it on time can lead to
immediate hypo- or hyperglycemia, a serious safety risk. While documentation and checking the
crash cart are important, they are not as immediately time-sensitive for patient safety as pre-meal
insulin. Ambulation can be delegated or postponed.
9. A nurse manager tells a staff nurse, "If you agree to be the chair of the unit practice council, I will
ensure you get the holiday time off you requested." This is an example of which type of leadership?
A. Transformational
B. Servant
C. Transactional
D. Emotional
Answer: C
Rationale: Transactional leadership is based on a system of rewards and punishments to achieve
compliance. The manager's offer of a specific, tangible reward (holiday time off) in exchange for a
specific task (chairing a council) is a classic transactional interaction.
Assessment BY DR .COLE WITH
CORRECT ANSWERS AND RATIONALE
GRADED A+ UPDATED 2026 NEW!!
Section 1: Professional Identity and Leadership (Questions 1-20)
1. A nurse manager is implementing a new evidence-based protocol for fall prevention. Staff
members are resistant to the change, stating, "We have always done it this way." According to
Lewin's Change Theory, which action should the manager take first?
A. Mandate the new protocol and enforce consequences for non-compliance.
B. Provide education and data on the benefits of the new protocol to the staff.
C. Abandon the new protocol to maintain staff satisfaction.
D. Discharge the most resistant staff members to set an example.
Answer: B
Rationale: Lewin's Change Theory involves three stages: Unfreezing, Moving/Changing, and
Refreezing. Providing education and data helps "unfreeze" the current state by demonstrating why
the old method is no longer adequate and creating motivation for change. This addresses the "we've
always done it this way" mindset before implementing (Moving) or sustaining (Refreezing) the
change.
2. A staff nurse notices a colleague diverting narcotics. After confronting the colleague, who denies
it, what is the nurse's immediate professional and legal obligation?
A. Continue to monitor the colleague for further suspicious behavior.
B. Report the suspicion directly to the state police.
C. Report the observation to the nurse manager or supervisor immediately.
D. Warn other staff members to be cautious around the colleague.
Answer: C
,Rationale: The professional nurse's duty is to protect patient safety and uphold the integrity of the
profession. The immediate next step after a direct observation and an unsatisfactory confrontation
is to follow the chain of command and report the suspicion to an immediate supervisor. This allows
for a proper, confidential investigation. Reporting directly to law enforcement or warning other staff
could be considered slander if the suspicion is unproven and disrupts the formal investigative
process.
3. A nurse leader asks, "What does optimal patient care on our unit look like to you?" This is an
example of what type of leadership behavior?
A. Laissez-faire leadership
B. Transactional leadership
C. Transformational leadership
D. Authoritarian leadership
Answer: C
Rationale: Transformational leaders inspire and motivate followers by creating a shared vision,
encouraging innovation, and empowering them to contribute to a higher purpose. Asking a
visionary, open-ended question that focuses on a shared ideal goal ("optimal patient care") is a
hallmark of transformational leadership.
4. A charge nurse assigns a new graduate nurse to care for a patient with a complex chest tube
drainage system. The new graduate expresses feeling unprepared. The charge nurse states, "This is
how you learn," and does not provide support. This charge nurse is demonstrating what
management style?
A. Democratic
B. Paternalistic
C. Laissez-faire
D. Transformational
Answer: C
Rationale: A laissez-faire leader provides little to no direction, supervision, or support, leaving team
members to fend for themselves. This style is dangerous, especially for inexperienced staff, as it fails
to ensure patient safety and does not promote professional development. The charge nurse's "sink
or swim" approach is a classic example.
,5. A nurse is assigned to care for a patient who practices a religion that prohibits blood transfusions.
The patient is anemic and requires a transfusion to survive. What is the nurse's primary ethical
responsibility?
A. Convince the patient's family to override the decision.
B. Administer the blood transfusion because the patient's life is at risk.
C. Respect the patient's autonomy and support their informed decision.
D. Initiate a psychiatric consultation to assess the patient's competency.
Answer: C
Rationale: The ethical principle of autonomy dictates that a competent, informed adult patient has
the right to accept or refuse medical treatment, even if that decision leads to death. The nurse's
primary role is to respect and support this right, ensuring the decision is well-informed.
Paternalistically overriding this decision, even with good intentions, is an ethical violation.
6. A nursing team is comprised of one RN, two LPNs, and one unlicensed assistive personnel (UAP).
This is an example of which type of nursing care delivery model?
A. Total Patient Care
B. Functional Nursing
C. Team Nursing
D. Primary Nursing
Answer: C
Rationale: Team nursing involves a group of healthcare personnel with varying levels of education,
skills, and licensure working together under the direction of a professional nurse (the RN team
leader) to provide care to a group of patients. The RN delegates tasks appropriately to the LPNs and
UAP.
7. During an ethical committee meeting regarding a terminally ill patient, the nurse provides
detailed, factual information about the patient's unmanaged pain and suffering. What role is the
nurse fulfilling?
A. Patient educator
B. Patient advocate
C. Case manager
D. Expert witness
, Answer: B
Rationale: A patient advocate speaks on behalf of the patient when they are unable to do so,
ensuring their needs and wishes are central to the decision-making process. By presenting objective
data about the patient's suffering, the nurse is advocating for the patient's comfort and quality of
life to be prioritized in the ethical discussion.
8. A newly licensed nurse is struggling with time management. Which task should the nurse identify
as the highest priority to complete first during a shift?
A. Ambulating a stable post-operative patient.
B. Documenting the morning assessment.
C. Administering a patient's scheduled insulin before breakfast.
D. Checking the crash cart for the next month's expiration dates.
Answer: C
Rationale: Prioritization should be based on time-sensitive and life-threatening needs. Insulin
administration is tightly linked to a meal (breakfast) and failure to administer it on time can lead to
immediate hypo- or hyperglycemia, a serious safety risk. While documentation and checking the
crash cart are important, they are not as immediately time-sensitive for patient safety as pre-meal
insulin. Ambulation can be delegated or postponed.
9. A nurse manager tells a staff nurse, "If you agree to be the chair of the unit practice council, I will
ensure you get the holiday time off you requested." This is an example of which type of leadership?
A. Transformational
B. Servant
C. Transactional
D. Emotional
Answer: C
Rationale: Transactional leadership is based on a system of rewards and punishments to achieve
compliance. The manager's offer of a specific, tangible reward (holiday time off) in exchange for a
specific task (chairing a council) is a classic transactional interaction.
