NSG 4700 Final Exam V1 | NSG 4700 Leadership & Management in
Nursing Practice | Actual Q&A with Rationale (NSG4700 Final Exam) |
Galen
1. A nurse manager is using transformational leadership to implement a new evidence-based
practice on the unit. Which action best demonstrates this leadership style?
A. Offering a financial bonus to nurses who complete the training by the deadline.
B. Setting a clear schedule for implementation and monitoring compliance strictly.
C. Allowing the staff to decide for themselves whether they want to adopt the new practice.
D. Inspiring staff by sharing a vision of how the change will improve patient outcomes.
Answer: D
Rationale: Transformational leadership focuses on inspiring and motivating followers to
achieve a common goal through a shared vision. Unlike transactional leadership, which
relies on rewards and punishments, transformational leaders empower their team to
innovate and grow. This approach fosters an environment where staff feel personally
invested in the success of the new initiative.
2. A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN). Which task is
most appropriate for the RN to delegate?
A. Developing a plan of care for a client newly admitted with heart failure.
B. Administering an initial dose of intravenous push medication.
C. Evaluating a patient’s understanding of discharge instructions.
D. Performing a sterile dressing change on a stable post-operative patient.
Answer: D
Rationale: Performing sterile dressing changes is within the scope of practice for an LPN
when the patient is stable. Tasks involving assessment, planning, or evaluation require the
advanced clinical judgment of an RN. Delegating the dressing change allows the RN to focus
on more complex clinical responsibilities while ensuring the patient receives necessary
care.
3. A nurse is experiencing moral distress. Which situation is most likely to cause this feeling?
A. Knowing the right course of action but being unable to carry it out due to institutional
constraints.
B. Being asked to work a double shift due to a staffing shortage.
C. Disliking a coworker’s personality and finding it difficult to collaborate.
,D. Feeling overwhelmed by the technical complexity of a new piece of equipment.
Answer: A
Rationale: Moral distress occurs when a professional knows the ethically correct action to
take but feels powerless to act on it. This often happens due to rigid hospital policies,
hierarchical pressures, or legal limitations. Addressing moral distress is crucial for nurse
retention and maintaining a healthy work environment.
4. When using Lewin’s Change Theory, what is the primary goal of the ‘unfreezing’ stage?
A. Integrating the new change into the permanent daily routine.
B. Creating awareness of the need for change and overcoming resistance.
C. Identifying potential resistors and removing them from the project.
D. Implementing the actual steps and procedures of the new system.
Answer: B
Rationale: The unfreezing stage is the first step in Lewin’s model, where the leader
prepares the group for change by breaking down existing mindsets. This involves
demonstrating why the status quo is no longer viable and building readiness for a
transition. Effective unfreezing minimizes resistance and ensures the team is receptive to
the upcoming movement phase.
5. A nurse manager is reviewing the annual budget. A large purchase of new infusion pumps
would fall under which category?
A. Operating budget
B. Personnel budget
C. Capital budget
D. Cash budget
Answer: C
Rationale: Capital budgets are used for large, long-term investments such as expensive
equipment or facility renovations. These items typically have a high cost and a useful life of
more than one year. In contrast, the operating budget covers daily expenses like supplies
and utility costs.
6. Which conflict management strategy involves both parties giving up something to reach a
solution?
A. Collaborating
B. Competing
C. Compromising
, D. Avoiding
Answer: C
Rationale: Compromising is a ‘lose-lose’ or ‘middle ground’ approach where each party
yields a portion of their demands. While it achieves a quick resolution, it may not address
the underlying causes of the conflict as effectively as collaboration. This strategy is often
used when time is limited or when the goals are only moderately important.
7. A nurse is practicing the ethical principle of autonomy. Which action best illustrates this?
A. Ensuring a patient is not harmed during a procedure.
B. Treating all patients fairly regardless of their insurance status.
C. Supporting a patient’s decision to refuse chemotherapy despite a poor prognosis.
D. Providing the most effective treatment available for a patient’s condition.
Answer: C
Rationale: Autonomy refers to the right of patients to make their own decisions about
their healthcare. Nurses uphold this principle by providing necessary information and
respecting the choices patients make, even if they disagree. This principle is fundamental to
informed consent and patient-centered care.
8. What is the primary purpose of a Root Cause Analysis (RCA) after a sentinel event?
A. To discover underlying system failures that contributed to the event.
B. To identify which specific employee was responsible for the error.
C. To provide documentation for legal defense against malpractice suits.
D. To punish the staff involved to prevent future occurrences.
Answer: A
Rationale: Root Cause Analysis is a process-oriented approach used to identify the basic
factors that caused a sentinel event. The focus is on fixing system vulnerabilities rather
than blaming individuals for human error. By addressing these systemic issues, the facility
can implement changes that prevent the recurrence of similar incidents.
9. A nurse is using the SBAR tool to communicate with a physician. What does the ‘B’ stand
for?
A. Behavior
B. Beliefs
C. Background
D. Benefit
Nursing Practice | Actual Q&A with Rationale (NSG4700 Final Exam) |
Galen
1. A nurse manager is using transformational leadership to implement a new evidence-based
practice on the unit. Which action best demonstrates this leadership style?
A. Offering a financial bonus to nurses who complete the training by the deadline.
B. Setting a clear schedule for implementation and monitoring compliance strictly.
C. Allowing the staff to decide for themselves whether they want to adopt the new practice.
D. Inspiring staff by sharing a vision of how the change will improve patient outcomes.
Answer: D
Rationale: Transformational leadership focuses on inspiring and motivating followers to
achieve a common goal through a shared vision. Unlike transactional leadership, which
relies on rewards and punishments, transformational leaders empower their team to
innovate and grow. This approach fosters an environment where staff feel personally
invested in the success of the new initiative.
2. A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN). Which task is
most appropriate for the RN to delegate?
A. Developing a plan of care for a client newly admitted with heart failure.
B. Administering an initial dose of intravenous push medication.
C. Evaluating a patient’s understanding of discharge instructions.
D. Performing a sterile dressing change on a stable post-operative patient.
Answer: D
Rationale: Performing sterile dressing changes is within the scope of practice for an LPN
when the patient is stable. Tasks involving assessment, planning, or evaluation require the
advanced clinical judgment of an RN. Delegating the dressing change allows the RN to focus
on more complex clinical responsibilities while ensuring the patient receives necessary
care.
3. A nurse is experiencing moral distress. Which situation is most likely to cause this feeling?
A. Knowing the right course of action but being unable to carry it out due to institutional
constraints.
B. Being asked to work a double shift due to a staffing shortage.
C. Disliking a coworker’s personality and finding it difficult to collaborate.
,D. Feeling overwhelmed by the technical complexity of a new piece of equipment.
Answer: A
Rationale: Moral distress occurs when a professional knows the ethically correct action to
take but feels powerless to act on it. This often happens due to rigid hospital policies,
hierarchical pressures, or legal limitations. Addressing moral distress is crucial for nurse
retention and maintaining a healthy work environment.
4. When using Lewin’s Change Theory, what is the primary goal of the ‘unfreezing’ stage?
A. Integrating the new change into the permanent daily routine.
B. Creating awareness of the need for change and overcoming resistance.
C. Identifying potential resistors and removing them from the project.
D. Implementing the actual steps and procedures of the new system.
Answer: B
Rationale: The unfreezing stage is the first step in Lewin’s model, where the leader
prepares the group for change by breaking down existing mindsets. This involves
demonstrating why the status quo is no longer viable and building readiness for a
transition. Effective unfreezing minimizes resistance and ensures the team is receptive to
the upcoming movement phase.
5. A nurse manager is reviewing the annual budget. A large purchase of new infusion pumps
would fall under which category?
A. Operating budget
B. Personnel budget
C. Capital budget
D. Cash budget
Answer: C
Rationale: Capital budgets are used for large, long-term investments such as expensive
equipment or facility renovations. These items typically have a high cost and a useful life of
more than one year. In contrast, the operating budget covers daily expenses like supplies
and utility costs.
6. Which conflict management strategy involves both parties giving up something to reach a
solution?
A. Collaborating
B. Competing
C. Compromising
, D. Avoiding
Answer: C
Rationale: Compromising is a ‘lose-lose’ or ‘middle ground’ approach where each party
yields a portion of their demands. While it achieves a quick resolution, it may not address
the underlying causes of the conflict as effectively as collaboration. This strategy is often
used when time is limited or when the goals are only moderately important.
7. A nurse is practicing the ethical principle of autonomy. Which action best illustrates this?
A. Ensuring a patient is not harmed during a procedure.
B. Treating all patients fairly regardless of their insurance status.
C. Supporting a patient’s decision to refuse chemotherapy despite a poor prognosis.
D. Providing the most effective treatment available for a patient’s condition.
Answer: C
Rationale: Autonomy refers to the right of patients to make their own decisions about
their healthcare. Nurses uphold this principle by providing necessary information and
respecting the choices patients make, even if they disagree. This principle is fundamental to
informed consent and patient-centered care.
8. What is the primary purpose of a Root Cause Analysis (RCA) after a sentinel event?
A. To discover underlying system failures that contributed to the event.
B. To identify which specific employee was responsible for the error.
C. To provide documentation for legal defense against malpractice suits.
D. To punish the staff involved to prevent future occurrences.
Answer: A
Rationale: Root Cause Analysis is a process-oriented approach used to identify the basic
factors that caused a sentinel event. The focus is on fixing system vulnerabilities rather
than blaming individuals for human error. By addressing these systemic issues, the facility
can implement changes that prevent the recurrence of similar incidents.
9. A nurse is using the SBAR tool to communicate with a physician. What does the ‘B’ stand
for?
A. Behavior
B. Beliefs
C. Background
D. Benefit
