NSG 444A Exam 3 V2 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Exam 3) | Grand Canyon University
1. A nurse manager is conducting a staff development session regarding the Five Rights of
Delegation. Which elements must the nurse include as part of these professional standards?
Select all that apply.
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Direction and Communication
E. Right Supervision and Evaluation
F. Right Financial Compensation
Correct Answer: A, B, C, D, E
Explanation: The Five Rights of Delegation are established by the National Council of State
Boards of Nursing (NCSBN) to ensure patient safety. These rights include the Right Task,
Right Circumstance, Right Person, Right Direction/Communication, and Right
Supervision/Evaluation. Financial compensation is an administrative concern and not one
of the clinical rights of delegation used for patient care assignments.
,2. A registered nurse (RN) is caring for a group of patients on a medical-surgical unit. Which
patient should the nurse assess first?
A. A patient with a history of heart failure who has 2+ pitting edema in the lower
extremities.
B. A patient with pneumonia who has a new onset of confusion and an oxygen saturation of
88%.
C. A patient who underwent a cholecystectomy 4 hours ago and reports a pain level of 6 out
of 10.
D. A patient with diabetes mellitus whose morning blood glucose level is 160 mg/dL.
Correct Answer: B
Explanation: The patient with pneumonia who is newly confused and has low oxygen
saturation takes priority based on the ABC (Airway, Breathing, Circulation) framework.
New onset confusion often indicates hypoxia, which is an acute and life-threatening
condition. The other patients are either stable or reporting expected post-operative
findings that do not take precedence over respiratory distress.
3. When resolving a conflict between two staff members, a nurse manager encourages both
parties to work together to find a solution that satisfies everyone’s concerns. Which conflict
management strategy is being utilized?
A. Avoiding
B. Competing
,C. Compromising
D. Collaborating
Correct Answer: D
Explanation: Collaborating is a ‘win-win’ strategy where all parties work together to reach
a mutually beneficial solution. This approach requires high levels of cooperation and
assertiveness from all involved individuals. It is considered the most effective way to
resolve conflict when time and resources allow for in-depth discussion.
4. A nurse is providing care based on the principle of autonomy. Which action by the nurse
best demonstrates this ethical principle?
A. Ensuring the patient receives the prescribed medication on time.
B. Truthfully answering a patient’s questions about their terminal diagnosis.
C. Providing the same quality of care to all patients regardless of their socioeconomic
status.
D. Respecting a patient’s decision to refuse a life-saving blood transfusion.
Correct Answer: D
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare, even if the healthcare provider disagrees. By respecting a
refusal of treatment, the nurse honors the patient’s self-determination. The other options
represent beneficence, justice, and veracity, respectively.
, 5. A nurse is preparing to delegate tasks to a Licensed Practical Nurse (LPN) and an Unlicensed
Assistive Personnel (UAP). Which tasks are appropriate for the RN to delegate? Select all that
apply.
A. Performing an initial admission assessment on a new patient.
B. Administering oral medications to a stable patient (LPN).
C. Assisting a patient with ambulation for the first time after surgery (UAP).
D. Recording intake and output for a patient on a fluid restriction (UAP).
E. Providing tracheostomy care for a patient with a chronic stoma (LPN).
F. Developing a plan of care for a patient with complex needs.
Correct Answer: B, D, E
Explanation: RNs are responsible for tasks involving clinical judgment, such as initial
assessments, first-time ambulation after surgery, and developing care plans. LPNs can
administer medications and perform tracheostomy care for stable patients. UAPs can
perform routine tasks like recording intake and output, but should not perform tasks that
require the RN’s immediate clinical evaluation like initial post-op ambulation.
6. A nurse manager is implementing a new bedside shift report protocol. According to Lewin’s
Change Theory, which action represents the ‘unfreezing’ stage?
A. Creating a sense of urgency by showing staff that the current report method leads to
errors.
B. Collecting data to evaluate the effectiveness of the new protocol.
Practice | Actual Q&A with Rationale (NSG444A
Exam 3) | Grand Canyon University
1. A nurse manager is conducting a staff development session regarding the Five Rights of
Delegation. Which elements must the nurse include as part of these professional standards?
Select all that apply.
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Direction and Communication
E. Right Supervision and Evaluation
F. Right Financial Compensation
Correct Answer: A, B, C, D, E
Explanation: The Five Rights of Delegation are established by the National Council of State
Boards of Nursing (NCSBN) to ensure patient safety. These rights include the Right Task,
Right Circumstance, Right Person, Right Direction/Communication, and Right
Supervision/Evaluation. Financial compensation is an administrative concern and not one
of the clinical rights of delegation used for patient care assignments.
,2. A registered nurse (RN) is caring for a group of patients on a medical-surgical unit. Which
patient should the nurse assess first?
A. A patient with a history of heart failure who has 2+ pitting edema in the lower
extremities.
B. A patient with pneumonia who has a new onset of confusion and an oxygen saturation of
88%.
C. A patient who underwent a cholecystectomy 4 hours ago and reports a pain level of 6 out
of 10.
D. A patient with diabetes mellitus whose morning blood glucose level is 160 mg/dL.
Correct Answer: B
Explanation: The patient with pneumonia who is newly confused and has low oxygen
saturation takes priority based on the ABC (Airway, Breathing, Circulation) framework.
New onset confusion often indicates hypoxia, which is an acute and life-threatening
condition. The other patients are either stable or reporting expected post-operative
findings that do not take precedence over respiratory distress.
3. When resolving a conflict between two staff members, a nurse manager encourages both
parties to work together to find a solution that satisfies everyone’s concerns. Which conflict
management strategy is being utilized?
A. Avoiding
B. Competing
,C. Compromising
D. Collaborating
Correct Answer: D
Explanation: Collaborating is a ‘win-win’ strategy where all parties work together to reach
a mutually beneficial solution. This approach requires high levels of cooperation and
assertiveness from all involved individuals. It is considered the most effective way to
resolve conflict when time and resources allow for in-depth discussion.
4. A nurse is providing care based on the principle of autonomy. Which action by the nurse
best demonstrates this ethical principle?
A. Ensuring the patient receives the prescribed medication on time.
B. Truthfully answering a patient’s questions about their terminal diagnosis.
C. Providing the same quality of care to all patients regardless of their socioeconomic
status.
D. Respecting a patient’s decision to refuse a life-saving blood transfusion.
Correct Answer: D
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare, even if the healthcare provider disagrees. By respecting a
refusal of treatment, the nurse honors the patient’s self-determination. The other options
represent beneficence, justice, and veracity, respectively.
, 5. A nurse is preparing to delegate tasks to a Licensed Practical Nurse (LPN) and an Unlicensed
Assistive Personnel (UAP). Which tasks are appropriate for the RN to delegate? Select all that
apply.
A. Performing an initial admission assessment on a new patient.
B. Administering oral medications to a stable patient (LPN).
C. Assisting a patient with ambulation for the first time after surgery (UAP).
D. Recording intake and output for a patient on a fluid restriction (UAP).
E. Providing tracheostomy care for a patient with a chronic stoma (LPN).
F. Developing a plan of care for a patient with complex needs.
Correct Answer: B, D, E
Explanation: RNs are responsible for tasks involving clinical judgment, such as initial
assessments, first-time ambulation after surgery, and developing care plans. LPNs can
administer medications and perform tracheostomy care for stable patients. UAPs can
perform routine tasks like recording intake and output, but should not perform tasks that
require the RN’s immediate clinical evaluation like initial post-op ambulation.
6. A nurse manager is implementing a new bedside shift report protocol. According to Lewin’s
Change Theory, which action represents the ‘unfreezing’ stage?
A. Creating a sense of urgency by showing staff that the current report method leads to
errors.
B. Collecting data to evaluate the effectiveness of the new protocol.
