NSG 444A Exam 4 V1 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Exam 4) | Grand Canyon University
1. Which tasks are appropriate for a Registered Nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)? Select all that apply.
A. Assisting a stable patient with ambulation
B. Performing a sterile dressing change on a post-operative wound
C. Measuring and recording intake and output
D. Feeding a patient who is not at risk for aspiration
E. Providing discharge education to a patient’s family
F. Obtaining vital signs on a stable patient
Correct Answer: A, C, D, F
Explanation: The RN is responsible for delegating tasks that do not require clinical
judgment, assessment, or teaching. Tasks such as ambulation of stable patients, I&O
measurement, and basic feeding are within the scope of a UAP. Education and sterile
procedures must be performed by licensed nursing staff to ensure patient safety and
adherence to standards of care.
,2. A new graduate nurse experiences a period of frustration and disillusionment with the
reality of the nursing profession. What is this phenomenon called?
A. Cognitive Dissonance
B. Moral Distress
C. Reality Shock
D. Burnout
Correct Answer: C
Explanation: Reality shock occurs when a new nurse moves from the educational
environment to the professional work setting and finds expectations are inconsistent. This
transition involves stages like the honeymoon, shock, and recovery phases. Understanding
this process helps the new nurse develop coping mechanisms to remain in the profession
long-term.
3. Which ethical principle is the nurse practicing when they advocate for a patient’s right to
refuse a life-saving blood transfusion based on religious beliefs?
A. Beneficence
B. Justice
C. Fidelity
D. Autonomy
Correct Answer: D
, Explanation: Autonomy refers to the patient’s right to self-determination and making their
own healthcare decisions. The nurse’s role is to ensure the patient is fully informed and
that their choices are respected by the healthcare team. Supporting a patient’s refusal of
treatment, even if it contradicts the nurse’s personal views, is a fundamental application of
autonomy.
4. A nurse is triaging victims at the scene of a mass casualty incident. A patient is found with
an open femur fracture, is conscious, and has a respiratory rate of 28. Which triage tag should
the nurse assign?
A. Green (Minor)
B. Black (Deceased)
C. Red (Immediate)
D. Yellow (Delayed)
Correct Answer: D
Explanation: A yellow tag is assigned to patients who require significant medical care but
can wait for a short period without immediate threat to life. While an open femur fracture
is serious, the patient is stable (conscious with respiration under 30) and does not meet the
immediate ‘Red’ criteria. Proper triage ensures that the most critically injured patients
receive care first during a disaster response.
Practice | Actual Q&A with Rationale (NSG444A
Exam 4) | Grand Canyon University
1. Which tasks are appropriate for a Registered Nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)? Select all that apply.
A. Assisting a stable patient with ambulation
B. Performing a sterile dressing change on a post-operative wound
C. Measuring and recording intake and output
D. Feeding a patient who is not at risk for aspiration
E. Providing discharge education to a patient’s family
F. Obtaining vital signs on a stable patient
Correct Answer: A, C, D, F
Explanation: The RN is responsible for delegating tasks that do not require clinical
judgment, assessment, or teaching. Tasks such as ambulation of stable patients, I&O
measurement, and basic feeding are within the scope of a UAP. Education and sterile
procedures must be performed by licensed nursing staff to ensure patient safety and
adherence to standards of care.
,2. A new graduate nurse experiences a period of frustration and disillusionment with the
reality of the nursing profession. What is this phenomenon called?
A. Cognitive Dissonance
B. Moral Distress
C. Reality Shock
D. Burnout
Correct Answer: C
Explanation: Reality shock occurs when a new nurse moves from the educational
environment to the professional work setting and finds expectations are inconsistent. This
transition involves stages like the honeymoon, shock, and recovery phases. Understanding
this process helps the new nurse develop coping mechanisms to remain in the profession
long-term.
3. Which ethical principle is the nurse practicing when they advocate for a patient’s right to
refuse a life-saving blood transfusion based on religious beliefs?
A. Beneficence
B. Justice
C. Fidelity
D. Autonomy
Correct Answer: D
, Explanation: Autonomy refers to the patient’s right to self-determination and making their
own healthcare decisions. The nurse’s role is to ensure the patient is fully informed and
that their choices are respected by the healthcare team. Supporting a patient’s refusal of
treatment, even if it contradicts the nurse’s personal views, is a fundamental application of
autonomy.
4. A nurse is triaging victims at the scene of a mass casualty incident. A patient is found with
an open femur fracture, is conscious, and has a respiratory rate of 28. Which triage tag should
the nurse assign?
A. Green (Minor)
B. Black (Deceased)
C. Red (Immediate)
D. Yellow (Delayed)
Correct Answer: D
Explanation: A yellow tag is assigned to patients who require significant medical care but
can wait for a short period without immediate threat to life. While an open femur fracture
is serious, the patient is stable (conscious with respiration under 30) and does not meet the
immediate ‘Red’ criteria. Proper triage ensures that the most critically injured patients
receive care first during a disaster response.
