NSG 4700 Exam 4 V2 | NSG 4700 Leadership & Management in
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 4) |
Galen
1. A nurse manager is implementing a new evidence-based practice protocol on the unit.
Which stage of Lewin’s Change Theory involves creating the motivation or readiness for
change?
A. Unfreezing
B. Moving
C. Refreezing
D. Transitioning
Answer: A
Rationale: Unfreezing is the first stage of Lewin’s Change Theory, where the status quo is
challenged and readiness for change is established. During this phase, the manager must
identify the need for change and ensure that staff members understand the rationale
behind it. By creating a sense of urgency, the manager helps individuals let go of old habits
and prepare for the new protocol.
2. When a nurse delegates a task to an unlicensed assistive personnel (UAP), who remains
ultimately accountable for the outcome of the task?
A. The UAP performing the task
B. The charge nurse on duty
C. The unit nurse manager
D. The delegating RN
Answer: D
Rationale: While the UAP is responsible for the performance of the task, the delegating RN
retains clinical accountability for the patient’s outcome. The RN must ensure the task was
completed correctly and document the findings appropriately. Accountability cannot be
delegated; only the authority to perform the specific task is transferred.
3. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient who is 1-hour postoperative and reports sudden shortness of breath.
B. A patient with a history of COPD who has an oxygen saturation of 91%.
C. A patient with a pain level of 8/10 scheduled for physical therapy.
,D. A patient awaiting discharge who needs education on insulin administration.
Answer: A
Rationale: The nurse should prioritize the postoperative patient with sudden shortness of
breath using the ABC (Airway, Breathing, Circulation) framework. Sudden respiratory
distress could indicate a life-threatening complication such as a pulmonary embolism. The
other patients are either stable or their needs do not present an immediate threat to life.
4. Which leadership style is characterized by the leader making decisions independently
without input from the staff?
A. Authoritarian
B. Laissez-faire
C. Democratic
D. Transformational
Answer: A
Rationale: Authoritarian leadership, also known as autocratic leadership, involves a leader
who maintains total control and makes all decisions. This style is most effective in
emergency situations where rapid decision-making is critical for safety. However, it can
lead to decreased staff morale and stifled creativity if used in routine clinical practice.
5. A nurse manager is dealing with a conflict between two staff members. The manager
encourages both parties to voice their concerns and works with them to find a solution that
satisfies both. Which conflict management strategy is being used?
A. Avoiding
B. Collaborating
C. Compromising
D. Smoothing
Answer: B
Rationale: Collaborating is a win-win strategy where both parties work together to reach a
common goal. It involves open communication and a commitment to resolving the
underlying issues rather than just the symptoms. This method is highly effective for
building long-term relationships and improving team dynamics.
6. What is the primary purpose of the Nurse Practice Act in each state?
A. To provide a salary scale for registered nurses.
B. To protect the public by defining the scope of nursing practice.
C. To advocate for nurses’ rights in the workplace.
, D. To determine the staffing ratios for acute care hospitals.
Answer: B
Rationale: The Nurse Practice Act is a set of laws established to protect the health and
safety of the public. It defines the legal scope of practice for nurses and sets standards for
licensure and education within a specific state. Nurses are responsible for knowing and
adhering to the regulations set forth in their state’s act.
7. A hospital is working toward achieving Magnet status. Which characteristic is central to the
Magnet Recognition Program?
A. A focus on reducing the cost of patient care.
B. Nursing excellence and professional nursing practice.
C. Increasing the number of licensed practical nurses on staff.
D. A strictly hierarchical management structure.
Answer: B
Rationale: The Magnet Recognition Program recognizes healthcare organizations that
provide high-quality patient care and nursing excellence. It emphasizes professional
development, shared governance, and evidence-based practice among the nursing staff.
Achieving this status is a mark of distinction that reflects a positive work environment and
superior patient outcomes.
8. An RN is preparing to delegate tasks to an LPN. Which of the following tasks is most
appropriate for the LPN?
A. Performing a complex initial assessment on a new admission.
B. Administering an oral medication to a stable patient.
C. Developing the initial nursing care plan for a patient with heart failure.
D. Providing discharge teaching to a patient with a new colostomy.
Answer: B
Rationale: LPNs are trained to perform tasks such as administering medications to stable
patients and performing routine treatments. Assessments, nursing care plans, and initial
education are the responsibilities of the RN. The RN must always consider the complexity
and stability of the patient before delegating.
9. In a quality improvement process, what does the ‘P’ in the PDSA cycle stand for?
A. Plan
B. Practice
C. Prioritize
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 4) |
Galen
1. A nurse manager is implementing a new evidence-based practice protocol on the unit.
Which stage of Lewin’s Change Theory involves creating the motivation or readiness for
change?
A. Unfreezing
B. Moving
C. Refreezing
D. Transitioning
Answer: A
Rationale: Unfreezing is the first stage of Lewin’s Change Theory, where the status quo is
challenged and readiness for change is established. During this phase, the manager must
identify the need for change and ensure that staff members understand the rationale
behind it. By creating a sense of urgency, the manager helps individuals let go of old habits
and prepare for the new protocol.
2. When a nurse delegates a task to an unlicensed assistive personnel (UAP), who remains
ultimately accountable for the outcome of the task?
A. The UAP performing the task
B. The charge nurse on duty
C. The unit nurse manager
D. The delegating RN
Answer: D
Rationale: While the UAP is responsible for the performance of the task, the delegating RN
retains clinical accountability for the patient’s outcome. The RN must ensure the task was
completed correctly and document the findings appropriately. Accountability cannot be
delegated; only the authority to perform the specific task is transferred.
3. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient who is 1-hour postoperative and reports sudden shortness of breath.
B. A patient with a history of COPD who has an oxygen saturation of 91%.
C. A patient with a pain level of 8/10 scheduled for physical therapy.
,D. A patient awaiting discharge who needs education on insulin administration.
Answer: A
Rationale: The nurse should prioritize the postoperative patient with sudden shortness of
breath using the ABC (Airway, Breathing, Circulation) framework. Sudden respiratory
distress could indicate a life-threatening complication such as a pulmonary embolism. The
other patients are either stable or their needs do not present an immediate threat to life.
4. Which leadership style is characterized by the leader making decisions independently
without input from the staff?
A. Authoritarian
B. Laissez-faire
C. Democratic
D. Transformational
Answer: A
Rationale: Authoritarian leadership, also known as autocratic leadership, involves a leader
who maintains total control and makes all decisions. This style is most effective in
emergency situations where rapid decision-making is critical for safety. However, it can
lead to decreased staff morale and stifled creativity if used in routine clinical practice.
5. A nurse manager is dealing with a conflict between two staff members. The manager
encourages both parties to voice their concerns and works with them to find a solution that
satisfies both. Which conflict management strategy is being used?
A. Avoiding
B. Collaborating
C. Compromising
D. Smoothing
Answer: B
Rationale: Collaborating is a win-win strategy where both parties work together to reach a
common goal. It involves open communication and a commitment to resolving the
underlying issues rather than just the symptoms. This method is highly effective for
building long-term relationships and improving team dynamics.
6. What is the primary purpose of the Nurse Practice Act in each state?
A. To provide a salary scale for registered nurses.
B. To protect the public by defining the scope of nursing practice.
C. To advocate for nurses’ rights in the workplace.
, D. To determine the staffing ratios for acute care hospitals.
Answer: B
Rationale: The Nurse Practice Act is a set of laws established to protect the health and
safety of the public. It defines the legal scope of practice for nurses and sets standards for
licensure and education within a specific state. Nurses are responsible for knowing and
adhering to the regulations set forth in their state’s act.
7. A hospital is working toward achieving Magnet status. Which characteristic is central to the
Magnet Recognition Program?
A. A focus on reducing the cost of patient care.
B. Nursing excellence and professional nursing practice.
C. Increasing the number of licensed practical nurses on staff.
D. A strictly hierarchical management structure.
Answer: B
Rationale: The Magnet Recognition Program recognizes healthcare organizations that
provide high-quality patient care and nursing excellence. It emphasizes professional
development, shared governance, and evidence-based practice among the nursing staff.
Achieving this status is a mark of distinction that reflects a positive work environment and
superior patient outcomes.
8. An RN is preparing to delegate tasks to an LPN. Which of the following tasks is most
appropriate for the LPN?
A. Performing a complex initial assessment on a new admission.
B. Administering an oral medication to a stable patient.
C. Developing the initial nursing care plan for a patient with heart failure.
D. Providing discharge teaching to a patient with a new colostomy.
Answer: B
Rationale: LPNs are trained to perform tasks such as administering medications to stable
patients and performing routine treatments. Assessments, nursing care plans, and initial
education are the responsibilities of the RN. The RN must always consider the complexity
and stability of the patient before delegating.
9. In a quality improvement process, what does the ‘P’ in the PDSA cycle stand for?
A. Plan
B. Practice
C. Prioritize
