NSG 444A Exam 1 V1 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Exam 1) | Grand Canyon University
1. A nurse manager is discussing Benner’s stages of clinical competence with a group of new
graduates. Which characteristic best describes the ‘Novice’ stage?
A. The nurse perceives situations as wholes rather than in terms of chopped-up parts.
B. The nurse has a feeling of mastery and the ability to cope with and manage the many
contingencies of clinical nursing.
C. The nurse can demonstrate marginally acceptable performance and has prior experience
in actual situations.
D. The nurse has no experience of the situations in which they are expected to perform.
Correct Answer: D
Explanation: According to Patricia Benner, the novice stage is characterized by a lack of
experience and a reliance on objective rules to guide performance. Novices are often task-
oriented and need specific guidelines to function safely within the clinical environment.
This stage typically applies to nursing students and new graduates who are entering a new
specialty area where they have no previous exposure.
2. A charge nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which of the
following tasks are appropriate for the nurse to delegate? (Select All That Apply)
A. Assisting a client with a stable gait to the bathroom.
,B. Performing an initial head-to-toe assessment on a new admission.
C. Collecting a clean-catch urine specimen.
D. Recording the client’s intake and output.
E. Evaluating a client’s response to pain medication.
F. Providing discharge teaching to a client about new prescriptions.
Correct Answer: ACD
Explanation: Delegation to UAP should involve tasks that are routine, non-invasive, and do
not require clinical judgment. Assisting with ambulation for a stable client, collecting
specimens, and recording I&O are within the UAP’s scope of practice. Assessment,
evaluation, and teaching are tasks that require professional nursing judgment and must be
performed by the Registered Nurse (RN).
3. A nurse is caring for a group of clients. Using the principles of prioritization, which client
should the nurse assess first?
A. A client with type 2 diabetes whose pre-meal blood glucose was 150 mg/dL.
B. A client who is 1-day postoperative following an appendectomy and reports a pain level
of 4/10.
C. A client with a history of heart failure who reports a new onset of shortness of breath
and a cough.
D. A client who requires a dressing change for a chronic pressure ulcer.
,Correct Answer: C
Explanation: The nurse should prioritize clients using the ABC (Airway, Breathing,
Circulation) framework. New onset shortness of breath and a cough in a client with heart
failure could indicate acute pulmonary edema, which is a life-threatening complication. The
other clients are relatively stable and their needs, while important, are not immediate
respiratory emergencies.
4. Which ethical principle is the nurse demonstrating when they uphold a client’s right to
refuse a recommended medical treatment?
A. Beneficence
B. Autonomy
C. Non-maleficence
D. Fidelity
Correct Answer: B
Explanation: Autonomy refers to the right of a self-governing individual to make their own
decisions about their healthcare. By respecting a client’s refusal of treatment, the nurse
acknowledges the client’s independence and right to choose. This principle is fundamental
to informed consent and the ethical practice of nursing in various clinical settings.
5. A nurse manager is utilizing transformational leadership. Which behavior is consistent with
this leadership style?
A. Focusing on day-to-day operations and maintaining the status quo.
, B. Motivating employees through a system of rewards and punishments.
C. Empowering staff to participate in decision-making and fostering a shared vision.
D. Making all decisions independently without consulting the team.
Correct Answer: C
Explanation: Transformational leadership involves inspiring and motivating staff to
achieve higher levels of performance by fostering a collaborative environment. These
leaders focus on the growth and development of their team members while working
toward a common goal. This style contrast with transactional leadership, which relies on
monitoring and rewards for compliance.
6. A nurse is involved in a Root Cause Analysis (RCA) following a sentinel event. What is the
primary purpose of an RCA?
A. To identify the specific individual responsible for the error and initiate disciplinary
action.
B. To satisfy legal requirements and prepare for potential litigation.
C. To document the event in the client’s medical record for insurance purposes.
D. To identify system-wide failures and prevent the recurrence of the event.
Correct Answer: D
Explanation: Root Cause Analysis (RCA) is a structured process used to investigate the
underlying causes of a sentinel event or medical error. The focus is on identifying system
Practice | Actual Q&A with Rationale (NSG444A
Exam 1) | Grand Canyon University
1. A nurse manager is discussing Benner’s stages of clinical competence with a group of new
graduates. Which characteristic best describes the ‘Novice’ stage?
A. The nurse perceives situations as wholes rather than in terms of chopped-up parts.
B. The nurse has a feeling of mastery and the ability to cope with and manage the many
contingencies of clinical nursing.
C. The nurse can demonstrate marginally acceptable performance and has prior experience
in actual situations.
D. The nurse has no experience of the situations in which they are expected to perform.
Correct Answer: D
Explanation: According to Patricia Benner, the novice stage is characterized by a lack of
experience and a reliance on objective rules to guide performance. Novices are often task-
oriented and need specific guidelines to function safely within the clinical environment.
This stage typically applies to nursing students and new graduates who are entering a new
specialty area where they have no previous exposure.
2. A charge nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which of the
following tasks are appropriate for the nurse to delegate? (Select All That Apply)
A. Assisting a client with a stable gait to the bathroom.
,B. Performing an initial head-to-toe assessment on a new admission.
C. Collecting a clean-catch urine specimen.
D. Recording the client’s intake and output.
E. Evaluating a client’s response to pain medication.
F. Providing discharge teaching to a client about new prescriptions.
Correct Answer: ACD
Explanation: Delegation to UAP should involve tasks that are routine, non-invasive, and do
not require clinical judgment. Assisting with ambulation for a stable client, collecting
specimens, and recording I&O are within the UAP’s scope of practice. Assessment,
evaluation, and teaching are tasks that require professional nursing judgment and must be
performed by the Registered Nurse (RN).
3. A nurse is caring for a group of clients. Using the principles of prioritization, which client
should the nurse assess first?
A. A client with type 2 diabetes whose pre-meal blood glucose was 150 mg/dL.
B. A client who is 1-day postoperative following an appendectomy and reports a pain level
of 4/10.
C. A client with a history of heart failure who reports a new onset of shortness of breath
and a cough.
D. A client who requires a dressing change for a chronic pressure ulcer.
,Correct Answer: C
Explanation: The nurse should prioritize clients using the ABC (Airway, Breathing,
Circulation) framework. New onset shortness of breath and a cough in a client with heart
failure could indicate acute pulmonary edema, which is a life-threatening complication. The
other clients are relatively stable and their needs, while important, are not immediate
respiratory emergencies.
4. Which ethical principle is the nurse demonstrating when they uphold a client’s right to
refuse a recommended medical treatment?
A. Beneficence
B. Autonomy
C. Non-maleficence
D. Fidelity
Correct Answer: B
Explanation: Autonomy refers to the right of a self-governing individual to make their own
decisions about their healthcare. By respecting a client’s refusal of treatment, the nurse
acknowledges the client’s independence and right to choose. This principle is fundamental
to informed consent and the ethical practice of nursing in various clinical settings.
5. A nurse manager is utilizing transformational leadership. Which behavior is consistent with
this leadership style?
A. Focusing on day-to-day operations and maintaining the status quo.
, B. Motivating employees through a system of rewards and punishments.
C. Empowering staff to participate in decision-making and fostering a shared vision.
D. Making all decisions independently without consulting the team.
Correct Answer: C
Explanation: Transformational leadership involves inspiring and motivating staff to
achieve higher levels of performance by fostering a collaborative environment. These
leaders focus on the growth and development of their team members while working
toward a common goal. This style contrast with transactional leadership, which relies on
monitoring and rewards for compliance.
6. A nurse is involved in a Root Cause Analysis (RCA) following a sentinel event. What is the
primary purpose of an RCA?
A. To identify the specific individual responsible for the error and initiate disciplinary
action.
B. To satisfy legal requirements and prepare for potential litigation.
C. To document the event in the client’s medical record for insurance purposes.
D. To identify system-wide failures and prevent the recurrence of the event.
Correct Answer: D
Explanation: Root Cause Analysis (RCA) is a structured process used to investigate the
underlying causes of a sentinel event or medical error. The focus is on identifying system
