NSG 4700 Final Exam V2 | NSG 4700 Leadership & Management in
Nursing Practice | Actual Q&A with Rationale (NSG4700 Final Exam) |
Galen
1. A nurse manager is observing a staff nurse who is mentoring a new graduate. The manager
recognizes that the staff nurse is using transformational leadership when she performs which
action?
A. Focuses on the daily operations and task completion.
B. Maintains a hands-off approach and lets the graduate work independently.
C. Uses rewards and punishments to motivate the new graduate.
D. Inspires the new graduate to reach their full potential and vision.
Answer: D
Rationale: Transformational leadership involves inspiring and motivating followers to
achieve extraordinary outcomes. This style focuses on the growth and development of the
individual rather than just the exchange of rewards. The leader acts as a role model and
encourages innovation within the clinical setting.
2. Which task is most appropriate for the RN to delegate to an Unlicensed Assistive Personnel
(UAP)?
A. Performing an initial admission assessment on a stable patient.
B. Evaluating the effectiveness of pain medication administered.
C. Assisting a client who is two days postoperative with ambulation.
D. Providing discharge instructions regarding new medications.
Answer: C
Rationale: Delegation to UAPs should involve tasks that are routine and do not require
clinical judgment or assessment. Ambulation of a stable postoperative patient falls within
the scope of supportive care. The RN must always evaluate the patient’s stability before
delegating tasks to ensure safety.
3. A nurse manager is dealing with a conflict between two nurses regarding the holiday
schedule. The manager tells the nurses to ‘work it out themselves.’ Which conflict
management style is being used?
A. Accommodating
B. Collaborating
C. Competing
,D. Avoiding
Answer: D
Rationale: Avoiding is a conflict management style where the person chooses not to
address the issue directly. By telling the nurses to work it out without intervention, the
manager is distancing themselves from the conflict. This style is often used when the issue
is minor or when the manager believes the parties can resolve it independently.
4. Using Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Stabilizing the new change into the unit’s permanent culture.
B. Implementing the new electronic health record system.
C. Educating staff about the need for a new fall prevention protocol.
D. Conducting a post-implementation audit of the new procedures.
Answer: C
Rationale: The unfreezing stage involves creating awareness of the need for change and
overcoming resistance. During this phase, the leader must demonstrate why the current
status quo is no longer effective. This preparation is essential before moving into the actual
change process.
5. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client whose IV pump is alarming due to an empty bag.
B. A client requesting a PRN medication for chronic back pain.
C. A client with a new onset of chest pain and diaphoresis.
D. A client scheduled for discharge in two hours.
Answer: C
Rationale: Prioritization should always follow the ABC (Airway, Breathing, Circulation)
framework. Chest pain and diaphoresis indicate a potential cardiovascular emergency that
requires immediate intervention. The other tasks are important but do not pose an
immediate threat to life.
6. What is the primary purpose of the ‘Root Cause Analysis’ (RCA) process in a hospital
setting?
A. To assign blame to the individual responsible for a clinical error.
B. To fulfill requirements for professional liability insurance.
C. To document the error for legal defense purposes only.
D. To identify system failures that contributed to a sentinel event.
, Answer: D
Rationale: Root Cause Analysis is a structured process used to investigate the underlying
causes of a safety event. It focuses on system-wide improvements rather than individual
performance issues. The ultimate goal is to prevent the recurrence of the event by
modifying processes.
7. A nurse is using the SBAR tool to communicate with a physician. Which statement
represents the ‘B’ in SBAR?
A. The patient’s heart rate is 110 beats per minute.
B. I am calling because the patient’s blood pressure has dropped.
C. The patient was admitted yesterday with a diagnosis of pneumonia.
D. I suggest we order a chest X-ray to check for fluid.
Answer: C
Rationale: The ‘B’ in SBAR stands for Background, which provides relevant clinical history
related to the current situation. This includes the reason for admission and any significant
medical history. It helps the receiver understand the context of the current problem being
reported.
8. A nurse manager is creating a budget and starts at zero each year, justifying every expense.
This is known as:
A. Incremental budgeting
B. Zero-based budgeting
C. Fixed budgeting
D. Operating budgeting
Answer: B
Rationale: Zero-based budgeting requires managers to justify all expenses for each new
budget cycle, starting from a base of zero. This method discourages ‘inflationary’ budgeting
where last year’s figures are simply increased. It ensures that all resources are allocated
based on current needs rather than historical spending.
9. Which ethical principle is violated when a nurse provides false information to a patient to
‘protect’ them from bad news?
A. Autonomy
B. Veracity
C. Beneficence
D. Justice
Nursing Practice | Actual Q&A with Rationale (NSG4700 Final Exam) |
Galen
1. A nurse manager is observing a staff nurse who is mentoring a new graduate. The manager
recognizes that the staff nurse is using transformational leadership when she performs which
action?
A. Focuses on the daily operations and task completion.
B. Maintains a hands-off approach and lets the graduate work independently.
C. Uses rewards and punishments to motivate the new graduate.
D. Inspires the new graduate to reach their full potential and vision.
Answer: D
Rationale: Transformational leadership involves inspiring and motivating followers to
achieve extraordinary outcomes. This style focuses on the growth and development of the
individual rather than just the exchange of rewards. The leader acts as a role model and
encourages innovation within the clinical setting.
2. Which task is most appropriate for the RN to delegate to an Unlicensed Assistive Personnel
(UAP)?
A. Performing an initial admission assessment on a stable patient.
B. Evaluating the effectiveness of pain medication administered.
C. Assisting a client who is two days postoperative with ambulation.
D. Providing discharge instructions regarding new medications.
Answer: C
Rationale: Delegation to UAPs should involve tasks that are routine and do not require
clinical judgment or assessment. Ambulation of a stable postoperative patient falls within
the scope of supportive care. The RN must always evaluate the patient’s stability before
delegating tasks to ensure safety.
3. A nurse manager is dealing with a conflict between two nurses regarding the holiday
schedule. The manager tells the nurses to ‘work it out themselves.’ Which conflict
management style is being used?
A. Accommodating
B. Collaborating
C. Competing
,D. Avoiding
Answer: D
Rationale: Avoiding is a conflict management style where the person chooses not to
address the issue directly. By telling the nurses to work it out without intervention, the
manager is distancing themselves from the conflict. This style is often used when the issue
is minor or when the manager believes the parties can resolve it independently.
4. Using Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Stabilizing the new change into the unit’s permanent culture.
B. Implementing the new electronic health record system.
C. Educating staff about the need for a new fall prevention protocol.
D. Conducting a post-implementation audit of the new procedures.
Answer: C
Rationale: The unfreezing stage involves creating awareness of the need for change and
overcoming resistance. During this phase, the leader must demonstrate why the current
status quo is no longer effective. This preparation is essential before moving into the actual
change process.
5. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client whose IV pump is alarming due to an empty bag.
B. A client requesting a PRN medication for chronic back pain.
C. A client with a new onset of chest pain and diaphoresis.
D. A client scheduled for discharge in two hours.
Answer: C
Rationale: Prioritization should always follow the ABC (Airway, Breathing, Circulation)
framework. Chest pain and diaphoresis indicate a potential cardiovascular emergency that
requires immediate intervention. The other tasks are important but do not pose an
immediate threat to life.
6. What is the primary purpose of the ‘Root Cause Analysis’ (RCA) process in a hospital
setting?
A. To assign blame to the individual responsible for a clinical error.
B. To fulfill requirements for professional liability insurance.
C. To document the error for legal defense purposes only.
D. To identify system failures that contributed to a sentinel event.
, Answer: D
Rationale: Root Cause Analysis is a structured process used to investigate the underlying
causes of a safety event. It focuses on system-wide improvements rather than individual
performance issues. The ultimate goal is to prevent the recurrence of the event by
modifying processes.
7. A nurse is using the SBAR tool to communicate with a physician. Which statement
represents the ‘B’ in SBAR?
A. The patient’s heart rate is 110 beats per minute.
B. I am calling because the patient’s blood pressure has dropped.
C. The patient was admitted yesterday with a diagnosis of pneumonia.
D. I suggest we order a chest X-ray to check for fluid.
Answer: C
Rationale: The ‘B’ in SBAR stands for Background, which provides relevant clinical history
related to the current situation. This includes the reason for admission and any significant
medical history. It helps the receiver understand the context of the current problem being
reported.
8. A nurse manager is creating a budget and starts at zero each year, justifying every expense.
This is known as:
A. Incremental budgeting
B. Zero-based budgeting
C. Fixed budgeting
D. Operating budgeting
Answer: B
Rationale: Zero-based budgeting requires managers to justify all expenses for each new
budget cycle, starting from a base of zero. This method discourages ‘inflationary’ budgeting
where last year’s figures are simply increased. It ensures that all resources are allocated
based on current needs rather than historical spending.
9. Which ethical principle is violated when a nurse provides false information to a patient to
‘protect’ them from bad news?
A. Autonomy
B. Veracity
C. Beneficence
D. Justice
