, Question 1
A nurse manager is implementing a shared governance council. Which
structural element most directly empowers bedside nurses to influence unit
practice decisions while preserving accountability to the organization?
A. A council composed primarily of nursing administrators who report to
the CNO
B. A council with decision-making authority over clinical practice,
co-chaired by a staff nurse and a manager
C. An advisory committee that submits recommendations to the medical
executive committee
D. A task force that rotates membership every six months without formal
authority
Correct Answer: B - A council with decision-making authority
over clinical practice, co-chaired by a staff nurse and a manager
RATIONALE
Shared governance requires actual decision-making authority over
nursing practice, not merely advisory input, and co-leadership by staff
nurses and managers balances empowerment with organizational
accountability. Options A, C, and D lack the structural authority or
staff-nurse control essential to authentic shared governance.
Question 2
During a rapid response, the nurse leader must communicate a patient's
deteriorating status to the intensivist. Which SBAR component is most often
omitted yet critical for prompting immediate intervention?
A. Situation - stating the patient's chief complaint
B. Background - listing the patient's admission history
C. Assessment - articulating the nurse's clinical impression and concern
D. Recommendation - explicitly requesting what is needed next
Correct Answer: D - Recommendation - explicitly requesting
Page 2
,what is needed next
RATIONALE
The Recommendation component is frequently omitted, yet it converts
information into action by specifying what the nurse needs (e.g.,
bedside evaluation, transfer, orders). Without an explicit request, the
receiver may not act urgently despite adequate Situation, Background,
and Assessment data.
Question 3
Which leadership style is most congruent with transformational leadership
when a unit is adopting evidence-based practice changes amid staff resistance?
A. Transactional - linking compliance to rewards and sanctions
B. Laissez-faire - allowing staff to self-determine adoption pace
C. Transformational - articulating a shared vision and intellectually
stimulating staff
D. Autocratic - mandating adoption through positional authority
Correct Answer: C - Transformational - articulating a shared
vision and intellectually stimulating staff
RATIONALE
Transformational leaders inspire through idealized influence,
inspirational motivation, intellectual stimulation, and individualized
consideration, which are most effective in overcoming resistance to
change. Transactional, laissez-faire, and autocratic approaches do not
foster intrinsic commitment needed for sustained EBP adoption.
Question 4
A nurse is delegating to unlicensed assistive personnel (UAP). Which task is
appropriately delegated under most state nurse practice acts?
A. Administering a PRN oral analgesic to a stable patient
B. Reinforcing discharge instructions about a new medication
Page 3
, C. Obtaining vital signs on a stable postoperative patient
D. Assessing a new patient's pain level and response to intervention
Correct Answer: C - Obtaining vital signs on a stable
postoperative patient
RATIONALE
Vital sign collection on stable patients is a standard delegated task to
UAP because it does not require nursing judgment. Medication
administration, patient teaching, and assessment are non-delegable
nursing responsibilities under the ANA and NCSBN delegation
framework.
Question 5
Which action by a charge nurse best demonstrates effective conflict resolution
using the Thomas-Kilmann 'collaborating' mode?
A. Directing both parties to follow the current policy without discussion
B. Withdrawing from the dispute to allow emotions to settle
C. Facilitating a joint session where each party's underlying concerns are
identified and integrated into a mutual solution
D. Splitting the difference by having each party concede one point
Correct Answer: C - Facilitating a joint session where each
party's underlying concerns are identified and integrated into a
mutual solution
RATIONALE
Collaborating seeks a win-win outcome by openly addressing
underlying interests and generating integrated solutions, which is the
Thomas-Kilmann mode most associated with durable conflict
resolution. Avoiding, competing, and compromising yield less optimal
or less durable outcomes.
Page 4
A nurse manager is implementing a shared governance council. Which
structural element most directly empowers bedside nurses to influence unit
practice decisions while preserving accountability to the organization?
A. A council composed primarily of nursing administrators who report to
the CNO
B. A council with decision-making authority over clinical practice,
co-chaired by a staff nurse and a manager
C. An advisory committee that submits recommendations to the medical
executive committee
D. A task force that rotates membership every six months without formal
authority
Correct Answer: B - A council with decision-making authority
over clinical practice, co-chaired by a staff nurse and a manager
RATIONALE
Shared governance requires actual decision-making authority over
nursing practice, not merely advisory input, and co-leadership by staff
nurses and managers balances empowerment with organizational
accountability. Options A, C, and D lack the structural authority or
staff-nurse control essential to authentic shared governance.
Question 2
During a rapid response, the nurse leader must communicate a patient's
deteriorating status to the intensivist. Which SBAR component is most often
omitted yet critical for prompting immediate intervention?
A. Situation - stating the patient's chief complaint
B. Background - listing the patient's admission history
C. Assessment - articulating the nurse's clinical impression and concern
D. Recommendation - explicitly requesting what is needed next
Correct Answer: D - Recommendation - explicitly requesting
Page 2
,what is needed next
RATIONALE
The Recommendation component is frequently omitted, yet it converts
information into action by specifying what the nurse needs (e.g.,
bedside evaluation, transfer, orders). Without an explicit request, the
receiver may not act urgently despite adequate Situation, Background,
and Assessment data.
Question 3
Which leadership style is most congruent with transformational leadership
when a unit is adopting evidence-based practice changes amid staff resistance?
A. Transactional - linking compliance to rewards and sanctions
B. Laissez-faire - allowing staff to self-determine adoption pace
C. Transformational - articulating a shared vision and intellectually
stimulating staff
D. Autocratic - mandating adoption through positional authority
Correct Answer: C - Transformational - articulating a shared
vision and intellectually stimulating staff
RATIONALE
Transformational leaders inspire through idealized influence,
inspirational motivation, intellectual stimulation, and individualized
consideration, which are most effective in overcoming resistance to
change. Transactional, laissez-faire, and autocratic approaches do not
foster intrinsic commitment needed for sustained EBP adoption.
Question 4
A nurse is delegating to unlicensed assistive personnel (UAP). Which task is
appropriately delegated under most state nurse practice acts?
A. Administering a PRN oral analgesic to a stable patient
B. Reinforcing discharge instructions about a new medication
Page 3
, C. Obtaining vital signs on a stable postoperative patient
D. Assessing a new patient's pain level and response to intervention
Correct Answer: C - Obtaining vital signs on a stable
postoperative patient
RATIONALE
Vital sign collection on stable patients is a standard delegated task to
UAP because it does not require nursing judgment. Medication
administration, patient teaching, and assessment are non-delegable
nursing responsibilities under the ANA and NCSBN delegation
framework.
Question 5
Which action by a charge nurse best demonstrates effective conflict resolution
using the Thomas-Kilmann 'collaborating' mode?
A. Directing both parties to follow the current policy without discussion
B. Withdrawing from the dispute to allow emotions to settle
C. Facilitating a joint session where each party's underlying concerns are
identified and integrated into a mutual solution
D. Splitting the difference by having each party concede one point
Correct Answer: C - Facilitating a joint session where each
party's underlying concerns are identified and integrated into a
mutual solution
RATIONALE
Collaborating seeks a win-win outcome by openly addressing
underlying interests and generating integrated solutions, which is the
Thomas-Kilmann mode most associated with durable conflict
resolution. Avoiding, competing, and compromising yield less optimal
or less durable outcomes.
Page 4
