NUR 2058 Exam 4 Actual Exam V2 | NUR 2058 Dimensions of Nursing
Practice (NUR2058 Exam 4) | Rasmussen
1. A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel (UAP) on a
medical-surgical unit. Which task is most appropriate for the RN to delegate to the UAP?
A. Evaluating a patient’s response to pain medication administered thirty minutes ago.
B. Measuring and recording the intake and output of a patient with a urinary catheter.
C. Performing a sterile dressing change on a central venous catheter site.
D. Assisting a stable patient with their first ambulation after hip replacement surgery.
Answer: B
Rationale: The measurement and recording of intake and output is a routine task that does
not require clinical judgment or nursing assessment. Assessing the response to medication
and performing sterile procedures involve professional nursing knowledge and cannot be
delegated to UAPs. The first ambulation after surgery requires an assessment of stability
and is typically reserved for the RN or physical therapist.
2. A nurse experiences distress when the family of a terminally ill patient insists on continuing
aggressive treatment against the patient’s previously stated wishes. What term best
describes this nurse’s experience?
A. Compassion fatigue
B. Vicarious traumatization
C. Burnout
D. Moral distress
Answer: D
Rationale: Moral distress occurs when a professional knows the right thing to do but is
unable to carry it out due to institutional or situational constraints. This differs from
burnout, which is a general exhaustion related to workplace stress over time. Compassion
fatigue specifically involves the loss of ability to empathize with patients due to repeated
exposure to suffering.
3. The nurse manager is dealing with two staff nurses who are in a conflict regarding the
holiday work schedule. The manager decides to use a ‘collaborative’ strategy. Which action
by the manager best demonstrates this strategy?
A. Asking both nurses to sacrifice part of their preferred schedule to meet in the middle.
B. Directing the nurses to follow the seniority rules as stated in the unit policy.
,C. Assigning the schedule based on the manager’s own preference to avoid further
argument.
D. Inviting both nurses to a meeting to identify their underlying needs and create a new
schedule that satisfies both.
Answer: D
Rationale: Collaborative conflict resolution involves a win-win approach where both
parties work together to find a solution that satisfies all needs. This differs from
compromise, which involves both parties giving something up. Collaboration focuses on
problem-solving and long-term relationship building within the nursing team.
4. When applying the ethical principle of ‘Autonomy,’ which nursing action is most
appropriate?
A. Ensuring that the patient receives their scheduled medications on time to prevent
symptoms.
B. Providing the patient with all the information necessary to make an informed decision
about surgery.
C. Keeping a patient’s medical information confidential and not sharing it with their family
members.
D. Performing a procedure that the patient’s family requested, even if the patient is
hesitant.
Answer: B
Rationale: Autonomy refers to the patient’s right to self-determination and making their
own healthcare decisions. Providing complete information for informed consent is the
direct application of supporting a patient’s autonomy. Confidentiality is related to privacy,
while timely medication is more aligned with beneficence or non-maleficence.
5. A nurse is sued for malpractice following a patient fall. To prove negligence, which four
elements must be established by the plaintiff?
A. Harm, lack of care, patient complaint, and medical error.
B. Error, intention, damage, and witnesses.
C. Duty, breach of duty, causation, and injury.
D. Neglect, policy violation, physical trauma, and financial loss.
Answer: C
Rationale: To successfully prove negligence in a legal setting, the plaintiff must
demonstrate that the nurse had a duty to the patient, that duty was breached, the breach
directly caused the harm, and actual injury occurred. Missing any one of these elements
, usually results in a failed malpractice claim. This legal standard ensures that healthcare
providers are held accountable for actions that directly lead to patient harm.
6. Which QSEN competency focuses on using data to monitor the outcomes of care processes
and using improvement methods to design and test changes to continuously improve the
quality and safety of healthcare systems?
A. Patient-Centered Care
B. Informatics
C. Evidence-Based Practice
D. Quality Improvement
Answer: D
Rationale: Quality Improvement (QI) is the specific QSEN competency that involves data
monitoring and process changes to improve healthcare outcomes. Informatics focuses on
information technology, while Evidence-Based Practice focuses on integrating research
with clinical expertise. Understanding these competencies is essential for modern
professional nursing practice.
7. A nurse is using SBAR to communicate with a physician regarding a change in a patient’s
status. Which statement represents the ‘R’ in SBAR?
A. ‘The patient’s blood pressure has dropped to 90/50 and their heart rate is 110.’
B. ‘I am calling about Mr. Jones in room 402 who is experiencing sudden shortness of
breath.’
C. ‘I recommend that we start the patient on a fluid bolus and order a chest X-ray
immediately.’
D. ‘The patient had a hip replacement yesterday and has been stable until this afternoon.’
Answer: C
Rationale: In the SBAR communication tool, ‘R’ stands for Recommendation, where the
nurse suggests a course of action to the provider. The other options represent Situation (B),
Background (D), and Assessment (A). Effective communication via SBAR reduces errors
and improves patient safety during handoffs and status changes.
8. A nurse manager exhibits ‘Transformational Leadership’ when they:
A. Focus on day-to-day operations and use a system of rewards and punishments to
manage staff.
B. Empower staff to participate in decision-making and inspire them with a shared vision
for the future.
C. Avoid making decisions and allow the staff to function independently without any
guidance.
Practice (NUR2058 Exam 4) | Rasmussen
1. A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel (UAP) on a
medical-surgical unit. Which task is most appropriate for the RN to delegate to the UAP?
A. Evaluating a patient’s response to pain medication administered thirty minutes ago.
B. Measuring and recording the intake and output of a patient with a urinary catheter.
C. Performing a sterile dressing change on a central venous catheter site.
D. Assisting a stable patient with their first ambulation after hip replacement surgery.
Answer: B
Rationale: The measurement and recording of intake and output is a routine task that does
not require clinical judgment or nursing assessment. Assessing the response to medication
and performing sterile procedures involve professional nursing knowledge and cannot be
delegated to UAPs. The first ambulation after surgery requires an assessment of stability
and is typically reserved for the RN or physical therapist.
2. A nurse experiences distress when the family of a terminally ill patient insists on continuing
aggressive treatment against the patient’s previously stated wishes. What term best
describes this nurse’s experience?
A. Compassion fatigue
B. Vicarious traumatization
C. Burnout
D. Moral distress
Answer: D
Rationale: Moral distress occurs when a professional knows the right thing to do but is
unable to carry it out due to institutional or situational constraints. This differs from
burnout, which is a general exhaustion related to workplace stress over time. Compassion
fatigue specifically involves the loss of ability to empathize with patients due to repeated
exposure to suffering.
3. The nurse manager is dealing with two staff nurses who are in a conflict regarding the
holiday work schedule. The manager decides to use a ‘collaborative’ strategy. Which action
by the manager best demonstrates this strategy?
A. Asking both nurses to sacrifice part of their preferred schedule to meet in the middle.
B. Directing the nurses to follow the seniority rules as stated in the unit policy.
,C. Assigning the schedule based on the manager’s own preference to avoid further
argument.
D. Inviting both nurses to a meeting to identify their underlying needs and create a new
schedule that satisfies both.
Answer: D
Rationale: Collaborative conflict resolution involves a win-win approach where both
parties work together to find a solution that satisfies all needs. This differs from
compromise, which involves both parties giving something up. Collaboration focuses on
problem-solving and long-term relationship building within the nursing team.
4. When applying the ethical principle of ‘Autonomy,’ which nursing action is most
appropriate?
A. Ensuring that the patient receives their scheduled medications on time to prevent
symptoms.
B. Providing the patient with all the information necessary to make an informed decision
about surgery.
C. Keeping a patient’s medical information confidential and not sharing it with their family
members.
D. Performing a procedure that the patient’s family requested, even if the patient is
hesitant.
Answer: B
Rationale: Autonomy refers to the patient’s right to self-determination and making their
own healthcare decisions. Providing complete information for informed consent is the
direct application of supporting a patient’s autonomy. Confidentiality is related to privacy,
while timely medication is more aligned with beneficence or non-maleficence.
5. A nurse is sued for malpractice following a patient fall. To prove negligence, which four
elements must be established by the plaintiff?
A. Harm, lack of care, patient complaint, and medical error.
B. Error, intention, damage, and witnesses.
C. Duty, breach of duty, causation, and injury.
D. Neglect, policy violation, physical trauma, and financial loss.
Answer: C
Rationale: To successfully prove negligence in a legal setting, the plaintiff must
demonstrate that the nurse had a duty to the patient, that duty was breached, the breach
directly caused the harm, and actual injury occurred. Missing any one of these elements
, usually results in a failed malpractice claim. This legal standard ensures that healthcare
providers are held accountable for actions that directly lead to patient harm.
6. Which QSEN competency focuses on using data to monitor the outcomes of care processes
and using improvement methods to design and test changes to continuously improve the
quality and safety of healthcare systems?
A. Patient-Centered Care
B. Informatics
C. Evidence-Based Practice
D. Quality Improvement
Answer: D
Rationale: Quality Improvement (QI) is the specific QSEN competency that involves data
monitoring and process changes to improve healthcare outcomes. Informatics focuses on
information technology, while Evidence-Based Practice focuses on integrating research
with clinical expertise. Understanding these competencies is essential for modern
professional nursing practice.
7. A nurse is using SBAR to communicate with a physician regarding a change in a patient’s
status. Which statement represents the ‘R’ in SBAR?
A. ‘The patient’s blood pressure has dropped to 90/50 and their heart rate is 110.’
B. ‘I am calling about Mr. Jones in room 402 who is experiencing sudden shortness of
breath.’
C. ‘I recommend that we start the patient on a fluid bolus and order a chest X-ray
immediately.’
D. ‘The patient had a hip replacement yesterday and has been stable until this afternoon.’
Answer: C
Rationale: In the SBAR communication tool, ‘R’ stands for Recommendation, where the
nurse suggests a course of action to the provider. The other options represent Situation (B),
Background (D), and Assessment (A). Effective communication via SBAR reduces errors
and improves patient safety during handoffs and status changes.
8. A nurse manager exhibits ‘Transformational Leadership’ when they:
A. Focus on day-to-day operations and use a system of rewards and punishments to
manage staff.
B. Empower staff to participate in decision-making and inspire them with a shared vision
for the future.
C. Avoid making decisions and allow the staff to function independently without any
guidance.
