NSG 4700 Exam 2 V2 | NSG 4700 Leadership & Management in
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 2) |
Galen
1. A nurse manager is implementing a new electronic documentation system and notes that
several staff members are resisting the change. According to Lewin’s Change Theory, which
action should the manager take during the ‘unfreezing’ stage?
A. Provide technical training on the new software functionality.
B. Explain the reasons for the change and why the old system is no longer efficient.
C. Reward staff who successfully complete their first shift using the new system.
D. Assign ‘super-users’ to each shift to troubleshoot problems.
Answer: B
Rationale: The unfreezing stage is the first step of Lewin’s model where the leader must
create the motivation for change. This involves helping employees understand why the
status quo is no longer acceptable. By explaining the inefficiencies of the old system, the
manager facilitates the readiness for change.
2. A nurse manager is evaluating a staff nurse’s performance. The manager observes that the
nurse is excellent at clinical skills but struggles with delegating tasks to UAPs. Which type of
conflict is the nurse likely experiencing?
A. Interpersonal conflict
B. Organizational conflict
C. Intergroup conflict
D. Intrapersonal conflict
Answer: D
Rationale: Intrapersonal conflict occurs within the individual when they are faced with
internal struggles, such as a lack of confidence in delegating. This often stems from a
conflict between one’s personal values or perceived competencies. The manager should
support the nurse in building trust in the delegation process to resolve this internal
struggle.
3. Which task is most appropriate for a nurse to delegate to an experienced Unlicensed
Assistive Personnel (UAP)?
A. Assessing a patient’s pain level after administering medication.
B. Feeding a patient who is at high risk for aspiration.
,C. Obtaining vital signs on a stable patient scheduled for discharge.
D. Teaching a patient how to use an incentive spirometer.
Answer: C
Rationale: Obtaining vital signs on a stable patient is a routine, non-invasive task that falls
within the UAP’s scope of practice. Assessing, teaching, and managing high-risk feeding
involve clinical judgment which must be performed by a licensed nurse. Proper delegation
ensures that the RN can focus on complex patient needs while maintaining safety.
4. A nurse leader is using a democratic leadership style to decide on new scheduling policies.
What is a primary characteristic of this style?
A. The leader makes all decisions independently to save time.
B. The leader encourages staff participation and seeks consensus.
C. The leader provides little to no direction to the staff.
D. The leader relies strictly on organizational rules and policies.
Answer: B
Rationale: Democratic leadership is characterized by shared decision-making and high
staff involvement. This style fosters a sense of ownership among employees and often leads
to higher job satisfaction. While it may take longer to reach a decision, the outcomes are
usually more sustainable due to staff buy-in.
5. A hospital is performing a Root Cause Analysis (RCA) after a medication error occurred.
What is the primary purpose of an RCA?
A. To identify which nurse was responsible for the error and issue a warning.
B. To track the cost associated with the medical error for the finance department.
C. To provide documentation for legal defense in case of a malpractice suit.
D. To identify system-level factors that contributed to the error to prevent recurrence.
Answer: D
Rationale: Root Cause Analysis is a process used to investigate underlying causes of errors
rather than focusing on individual blame. It looks at system vulnerabilities such as
communication breakdowns or faulty equipment. The ultimate goal is to implement
process changes that improve patient safety across the organization.
6. A nurse manager is preparing the annual budget and needs to purchase three new
ventilators for the ICU. Under which category should these be placed?
A. Capital budget
B. Personnel budget
, C. Operating budget
D. Cash budget
Answer: A
Rationale: The capital budget is used for long-term investments and expensive equipment
that has a lifespan of several years. Items like ventilators usually meet the cost threshold
required to be categorized as capital assets. In contrast, the operating budget covers day-
to-day expenses like supplies and utilities.
7. During a staff meeting, two nurses disagree on the best way to organize the supply room.
One nurse gives in completely to the other’s preferences just to keep the peace. Which
conflict management strategy is being used?
A. Competing
B. Avoiding
C. Accommodating
D. Collaborating
Answer: C
Rationale: Accommodating involves one party sacrificing their own goals to satisfy the
needs or desires of the other party. It is often used when the issue is less important than
maintaining a harmonious relationship. However, if used too frequently, it can lead to
resentment from the party that always gives in.
8. Which of the following best describes the ‘Right Supervision’ in the five rights of
delegation?
A. The nurse provides clear, concise, and complete instructions for the task.
B. The nurse checks if the patient’s condition is stable enough for delegation.
C. The nurse ensures the UAP has the correct certification for the unit.
D. The nurse monitors the task and evaluates the outcome after completion.
Answer: D
Rationale: Right Supervision involves the RN providing guidance, monitoring the
performance of the task, and following up to evaluate the results. The RN remains
accountable for the overall care of the patient even when a task is delegated. Effective
supervision includes providing feedback to the delegatee to ensure quality care.
9. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient who had a colonoscopy 4 hours ago and is complaining of gas pain.
B. A patient who is requesting pain medication for chronic back pain rated 6/10.
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 2) |
Galen
1. A nurse manager is implementing a new electronic documentation system and notes that
several staff members are resisting the change. According to Lewin’s Change Theory, which
action should the manager take during the ‘unfreezing’ stage?
A. Provide technical training on the new software functionality.
B. Explain the reasons for the change and why the old system is no longer efficient.
C. Reward staff who successfully complete their first shift using the new system.
D. Assign ‘super-users’ to each shift to troubleshoot problems.
Answer: B
Rationale: The unfreezing stage is the first step of Lewin’s model where the leader must
create the motivation for change. This involves helping employees understand why the
status quo is no longer acceptable. By explaining the inefficiencies of the old system, the
manager facilitates the readiness for change.
2. A nurse manager is evaluating a staff nurse’s performance. The manager observes that the
nurse is excellent at clinical skills but struggles with delegating tasks to UAPs. Which type of
conflict is the nurse likely experiencing?
A. Interpersonal conflict
B. Organizational conflict
C. Intergroup conflict
D. Intrapersonal conflict
Answer: D
Rationale: Intrapersonal conflict occurs within the individual when they are faced with
internal struggles, such as a lack of confidence in delegating. This often stems from a
conflict between one’s personal values or perceived competencies. The manager should
support the nurse in building trust in the delegation process to resolve this internal
struggle.
3. Which task is most appropriate for a nurse to delegate to an experienced Unlicensed
Assistive Personnel (UAP)?
A. Assessing a patient’s pain level after administering medication.
B. Feeding a patient who is at high risk for aspiration.
,C. Obtaining vital signs on a stable patient scheduled for discharge.
D. Teaching a patient how to use an incentive spirometer.
Answer: C
Rationale: Obtaining vital signs on a stable patient is a routine, non-invasive task that falls
within the UAP’s scope of practice. Assessing, teaching, and managing high-risk feeding
involve clinical judgment which must be performed by a licensed nurse. Proper delegation
ensures that the RN can focus on complex patient needs while maintaining safety.
4. A nurse leader is using a democratic leadership style to decide on new scheduling policies.
What is a primary characteristic of this style?
A. The leader makes all decisions independently to save time.
B. The leader encourages staff participation and seeks consensus.
C. The leader provides little to no direction to the staff.
D. The leader relies strictly on organizational rules and policies.
Answer: B
Rationale: Democratic leadership is characterized by shared decision-making and high
staff involvement. This style fosters a sense of ownership among employees and often leads
to higher job satisfaction. While it may take longer to reach a decision, the outcomes are
usually more sustainable due to staff buy-in.
5. A hospital is performing a Root Cause Analysis (RCA) after a medication error occurred.
What is the primary purpose of an RCA?
A. To identify which nurse was responsible for the error and issue a warning.
B. To track the cost associated with the medical error for the finance department.
C. To provide documentation for legal defense in case of a malpractice suit.
D. To identify system-level factors that contributed to the error to prevent recurrence.
Answer: D
Rationale: Root Cause Analysis is a process used to investigate underlying causes of errors
rather than focusing on individual blame. It looks at system vulnerabilities such as
communication breakdowns or faulty equipment. The ultimate goal is to implement
process changes that improve patient safety across the organization.
6. A nurse manager is preparing the annual budget and needs to purchase three new
ventilators for the ICU. Under which category should these be placed?
A. Capital budget
B. Personnel budget
, C. Operating budget
D. Cash budget
Answer: A
Rationale: The capital budget is used for long-term investments and expensive equipment
that has a lifespan of several years. Items like ventilators usually meet the cost threshold
required to be categorized as capital assets. In contrast, the operating budget covers day-
to-day expenses like supplies and utilities.
7. During a staff meeting, two nurses disagree on the best way to organize the supply room.
One nurse gives in completely to the other’s preferences just to keep the peace. Which
conflict management strategy is being used?
A. Competing
B. Avoiding
C. Accommodating
D. Collaborating
Answer: C
Rationale: Accommodating involves one party sacrificing their own goals to satisfy the
needs or desires of the other party. It is often used when the issue is less important than
maintaining a harmonious relationship. However, if used too frequently, it can lead to
resentment from the party that always gives in.
8. Which of the following best describes the ‘Right Supervision’ in the five rights of
delegation?
A. The nurse provides clear, concise, and complete instructions for the task.
B. The nurse checks if the patient’s condition is stable enough for delegation.
C. The nurse ensures the UAP has the correct certification for the unit.
D. The nurse monitors the task and evaluates the outcome after completion.
Answer: D
Rationale: Right Supervision involves the RN providing guidance, monitoring the
performance of the task, and following up to evaluate the results. The RN remains
accountable for the overall care of the patient even when a task is delegated. Effective
supervision includes providing feedback to the delegatee to ensure quality care.
9. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient who had a colonoscopy 4 hours ago and is complaining of gas pain.
B. A patient who is requesting pain medication for chronic back pain rated 6/10.
