NSG 4700 Exam 2 V3 | 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 health record system. According to
Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Training staff members on how to use the new software interfaces.
B. Sharing data about the high rate of medication errors associated with the current paper
system.
C. Integrating the new electronic system into the daily nursing workflow permanently.
D. Evaluating the efficiency of the new system three months after implementation.
Answer: B
Rationale: Unfreezing is the first stage of Lewin’s change model, which involves creating
readiness for change by helping people see that the status quo is no longer acceptable. By
sharing data regarding medication errors, the manager highlights the necessity for a new
system to ensure patient safety. This step is crucial for overcoming resistance and
preparing the team for the transition to a new process.
2. Which task is most appropriate for a registered nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)?
A. Assisting a stable patient with their first ambulation after a knee replacement.
B. Feeding a patient who has a high risk for aspiration and dysphagia.
C. Assessing a patient’s pain level two hours after surgery.
D. Obtaining vital signs on a patient who just returned from the recovery room.
Answer: A
Rationale: RNs should delegate tasks that do not require clinical judgment, assessment, or
teaching to UAPs. Assisting a stable patient with ambulation is a routine task that falls
within the scope of a UAP, provided the patient is not acutely unstable. Tasks like assessing
pain or feeding high-risk patients require professional nursing knowledge and should not
be delegated.
3. A nurse manager is reviewing the annual budget and notices that the cost of medical
supplies has exceeded the projected amount. This is an example of which type of budget
variance?
A. Unfavorable variance
B. Favorable variance
,C. Capital expenditure variance
D. Revenue variance
Answer: A
Rationale: An unfavorable variance occurs when the actual costs of operation are higher
than the budgeted or projected costs. In this case, spending more on supplies than planned
reduces the available profit or funding for other services. Monitoring these variances
allows managers to identify waste and adjust procurement strategies to remain fiscally
responsible.
4. A charge nurse is utilizing the ‘Avoiding’ strategy during a conflict between two staff
members. Which statement best describes this approach?
A. Both parties agree to meet in the middle to resolve the issue quickly.
B. The nurse chooses not to acknowledge the conflict in hopes it will resolve itself.
C. One party gives up their own needs to satisfy the other party’s demands.
D. All involved parties work together to find a solution that satisfies everyone.
Answer: B
Rationale: Avoiding is a conflict management style where one chooses not to address the
conflict, effectively postponing or ignoring the issue. While this may provide a temporary
reprieve, it often leads to a ‘lose-lose’ situation because the root cause of the problem is
never addressed. This strategy is only appropriate when the issue is trivial or when
emotions are too high for productive discussion.
5. When using SBAR communication, in which section should the nurse include the patient’s
current medications and allergies?
A. Background
B. Situation
C. Assessment
D. Recommendation
Answer: A
Rationale: The Background (B) section of the SBAR tool is used to provide relevant clinical
information that sets the stage for the current problem. This includes the patient’s medical
history, current medications, and known allergies, which are vital for context. Providing
these details ensures that the provider has a comprehensive understanding of the factors
influencing the patient’s current status.
, 6. A hospital is pursuing Magnet status. Which characteristic is primarily associated with this
recognition?
A. High nurse-to-patient ratios compared to national averages.
B. A centralized management structure with top-down decision making.
C. Empowerment of bedside nurses through shared governance.
D. Exclusion of LPNs from the care delivery model.
Answer: C
Rationale: Magnet status is awarded to hospitals that demonstrate excellence in nursing
through strong leadership, professional development, and high-quality patient outcomes. A
key component of this is shared governance, which gives bedside nurses a voice in clinical
decision-making and hospital policy. This empowerment leads to higher job satisfaction
and improved patient safety metrics.
7. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient who is 2 hours post-op from a thyroidectomy with a new onset of stridor.
B. A patient with a history of COPD who has an oxygen saturation of 91%.
C. A patient with diabetes whose blood glucose is 150 mg/dL.
D. A patient scheduled for discharge who needs instructions on wound care.
Answer: A
Rationale: Stridor after a thyroidectomy indicates potential airway obstruction due to
edema or bleeding, which is a life-threatening emergency. According to the ABC (Airway,
Breathing, Circulation) priority framework, airway issues must be addressed immediately.
The other patients are relatively stable or have findings that are expected for their
conditions.
8. A nurse manager uses a ‘Laissez-faire’ leadership style. What is a common result of this
approach in a high-stress unit?
A. Strict adherence to rules and procedures by all staff members.
B. Staff members feeling unsupported or lack of direction.
C. Increased innovation due to high levels of direct supervision.
D. Rapid decision making during emergencies led by the manager.
Answer: B
Rationale: Laissez-faire leadership is characterized by a ‘hands-off’ approach where the
leader provides little to no direction. In a nursing environment, this can lead to confusion,
lack of accountability, and decreased productivity because staff may not have the guidance
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 2) |
Galen
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Training staff members on how to use the new software interfaces.
B. Sharing data about the high rate of medication errors associated with the current paper
system.
C. Integrating the new electronic system into the daily nursing workflow permanently.
D. Evaluating the efficiency of the new system three months after implementation.
Answer: B
Rationale: Unfreezing is the first stage of Lewin’s change model, which involves creating
readiness for change by helping people see that the status quo is no longer acceptable. By
sharing data regarding medication errors, the manager highlights the necessity for a new
system to ensure patient safety. This step is crucial for overcoming resistance and
preparing the team for the transition to a new process.
2. Which task is most appropriate for a registered nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)?
A. Assisting a stable patient with their first ambulation after a knee replacement.
B. Feeding a patient who has a high risk for aspiration and dysphagia.
C. Assessing a patient’s pain level two hours after surgery.
D. Obtaining vital signs on a patient who just returned from the recovery room.
Answer: A
Rationale: RNs should delegate tasks that do not require clinical judgment, assessment, or
teaching to UAPs. Assisting a stable patient with ambulation is a routine task that falls
within the scope of a UAP, provided the patient is not acutely unstable. Tasks like assessing
pain or feeding high-risk patients require professional nursing knowledge and should not
be delegated.
3. A nurse manager is reviewing the annual budget and notices that the cost of medical
supplies has exceeded the projected amount. This is an example of which type of budget
variance?
A. Unfavorable variance
B. Favorable variance
,C. Capital expenditure variance
D. Revenue variance
Answer: A
Rationale: An unfavorable variance occurs when the actual costs of operation are higher
than the budgeted or projected costs. In this case, spending more on supplies than planned
reduces the available profit or funding for other services. Monitoring these variances
allows managers to identify waste and adjust procurement strategies to remain fiscally
responsible.
4. A charge nurse is utilizing the ‘Avoiding’ strategy during a conflict between two staff
members. Which statement best describes this approach?
A. Both parties agree to meet in the middle to resolve the issue quickly.
B. The nurse chooses not to acknowledge the conflict in hopes it will resolve itself.
C. One party gives up their own needs to satisfy the other party’s demands.
D. All involved parties work together to find a solution that satisfies everyone.
Answer: B
Rationale: Avoiding is a conflict management style where one chooses not to address the
conflict, effectively postponing or ignoring the issue. While this may provide a temporary
reprieve, it often leads to a ‘lose-lose’ situation because the root cause of the problem is
never addressed. This strategy is only appropriate when the issue is trivial or when
emotions are too high for productive discussion.
5. When using SBAR communication, in which section should the nurse include the patient’s
current medications and allergies?
A. Background
B. Situation
C. Assessment
D. Recommendation
Answer: A
Rationale: The Background (B) section of the SBAR tool is used to provide relevant clinical
information that sets the stage for the current problem. This includes the patient’s medical
history, current medications, and known allergies, which are vital for context. Providing
these details ensures that the provider has a comprehensive understanding of the factors
influencing the patient’s current status.
, 6. A hospital is pursuing Magnet status. Which characteristic is primarily associated with this
recognition?
A. High nurse-to-patient ratios compared to national averages.
B. A centralized management structure with top-down decision making.
C. Empowerment of bedside nurses through shared governance.
D. Exclusion of LPNs from the care delivery model.
Answer: C
Rationale: Magnet status is awarded to hospitals that demonstrate excellence in nursing
through strong leadership, professional development, and high-quality patient outcomes. A
key component of this is shared governance, which gives bedside nurses a voice in clinical
decision-making and hospital policy. This empowerment leads to higher job satisfaction
and improved patient safety metrics.
7. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient who is 2 hours post-op from a thyroidectomy with a new onset of stridor.
B. A patient with a history of COPD who has an oxygen saturation of 91%.
C. A patient with diabetes whose blood glucose is 150 mg/dL.
D. A patient scheduled for discharge who needs instructions on wound care.
Answer: A
Rationale: Stridor after a thyroidectomy indicates potential airway obstruction due to
edema or bleeding, which is a life-threatening emergency. According to the ABC (Airway,
Breathing, Circulation) priority framework, airway issues must be addressed immediately.
The other patients are relatively stable or have findings that are expected for their
conditions.
8. A nurse manager uses a ‘Laissez-faire’ leadership style. What is a common result of this
approach in a high-stress unit?
A. Strict adherence to rules and procedures by all staff members.
B. Staff members feeling unsupported or lack of direction.
C. Increased innovation due to high levels of direct supervision.
D. Rapid decision making during emergencies led by the manager.
Answer: B
Rationale: Laissez-faire leadership is characterized by a ‘hands-off’ approach where the
leader provides little to no direction. In a nursing environment, this can lead to confusion,
lack of accountability, and decreased productivity because staff may not have the guidance
