ANCC Nurse Executive Certification Exam (NE-BC
Exam) New 2025 Version with All Questions 150 from
Actual Exam with 100% Correct Answers and
Rationale
Section 1: Systems Leadership and Management (Questions 1–26)
1. A nurse executive is developing a strategic plan for a unit merger. What is the priority
step?
A) Conduct a SWOT analysis.
B) Implement immediate changes.
C) Hire new staff.
D) No analysis needed. Correct Answer: A) Conduct a SWOT analysis.
Rationale: SWOT (Strengths, Weaknesses, Opportunities, Threats) informs strategic
planning. ANCC Domain 1: Strategic planning.
2. A hospital budget shows a deficit. What financial management action?
A) Review variance reports and adjust staffing.
B) Ignore deficit.
C) Increase salaries.
D) Cut supplies.
Correct Answer: A) Review variance reports and adjust staffing.
Rationale: Variance analysis identifies cost-saving opportunities. ANCC Domain 1:
Financial management.
3. A unit has high turnover. What quality improvement initiative?
A) Implement staff satisfaction surveys.
B) No initiative.
C) Fire staff.
D) Ignore turnover.
Correct Answer: A) Implement staff satisfaction surveys.
Rationale: Surveys identify root causes of turnover. ANCC Domain 1: Quality
improvement.
4. A nurse executive leads a change to electronic health records. What model?
A) Kotter's 8-step change model.
B) No model.
C) Lewin's model.
D) Both A and C.
Correct Answer: D) Both A and C.
Rationale: Both models guide organizational change. ANCC Domain 1: Change
management.
5. A hospital aims for Magnet status. What priority?
A) Evidence-based practice integration.
B) No integration.
C) Staffing increase.
D) Ignore Magnet.
, Correct Answer: A) Evidence-based practice integration.
Rationale: EBP is a Magnet criterion. ANCC Domain 1: Systems leadership.
6. A unit budget exceeds costs. What action?
A) Analyze expenses and reallocate resources.
B) Ignore excess.
C) Cut bonuses.
D) Hire more staff.
Correct Answer: A) Analyze expenses and reallocate resources.
Rationale: Cost analysis optimizes budget. ANCC Domain 1: Financial management.
7. A quality improvement project shows low hand hygiene compliance. What intervention?
A) Staff education and audits.
B) No intervention.
C) Punish non-compliance.
D) Ignore compliance.
Correct Answer: A) Staff education and audits.
Rationale: Education and monitoring improve adherence. ANCC Domain 1: Quality
improvement.
8. A nurse executive manages a merger. What leadership style?
A) Transformational leadership.
B) No style.
C) Autocratic.
D) Laissez-faire.
Correct Answer: A) Transformational leadership.
Rationale: Inspires change during mergers. ANCC Domain 1: Leadership styles.
9. A hospital implements a new policy. What evaluation?
A) Pre- and post-implementation metrics.
B) No evaluation.
C) Ignore policy.
D) Staff survey only.
Correct Answer: A) Pre- and post-implementation metrics.
Rationale: Measures policy effectiveness. ANCC Domain 1: Systems evaluation.
10. A budget includes capital expenses. What example?
A) Purchasing new equipment.
B) Salaries.
C) Supplies.
D) Utilities.
Correct Answer: A) Purchasing new equipment.
Rationale: Capital expenses are long-term assets. ANCC Domain 1: Financial
management.
11. A unit has low patient satisfaction. What QI tool?
A) Fishbone diagram for root cause.
B) No tool.
C) Blame staff.
D) Ignore satisfaction.
Correct Answer: A) Fishbone diagram for root cause.
Rationale: Identifies causes of issues. ANCC Domain 1: Quality improvement tools.
, 12. A nurse executive leads a diversity initiative. What strategy?
A) Cultural competency training.
B) No training.
C) Ignore diversity.
D) Hire only one group.
Correct Answer: A) Cultural competency training.
Rationale: Promotes inclusive environment. ANCC Domain 1: Systems leadership.
13. A hospital faces a staffing shortage. What management?
A) Recruitment and retention programs.
B) No programs.
C) Cut hours.
D) Ignore shortage.
Correct Answer: A) Recruitment and retention programs.
Rationale: Addresses turnover. ANCC Domain 1: Systems management.
14. A QI project on falls. What metric?
A) Fall rates per 1,000 patient days.
B) No metric.
C) Staff hours.
D) Ignore falls.
Correct Answer: A) Fall rates per 1,000 patient days.
Rationale: Standard QI measure. ANCC Domain 1: Quality metrics.
15. A budget variance is negative. What cause?
A) Overtime expenses.
B) No cause.
C) Revenue increase.
D) Ignore variance.
Correct Answer: A) Overtime expenses.
Rationale: Common cause of negative variance. ANCC Domain 1: Financial analysis.
16. A nurse executive implements a new system. What evaluation?
A) Balanced scorecard.
B) No evaluation.
C) Staff survey only.
D) Ignore system.
Correct Answer: A) Balanced scorecard.
Rationale: Measures performance. ANCC Domain 1: Systems evaluation.
17. A merger affects morale. What leadership?
A) Transformational to inspire.
B) Autocratic.
C) No leadership.
D) Laissez-faire.
Correct Answer: A) Transformational to inspire.
Rationale: Motivates during change. ANCC Domain 1: Leadership.
18. A unit budget for supplies. What management?
A) Inventory control.
B) No control.
C) Overstock.
Exam) New 2025 Version with All Questions 150 from
Actual Exam with 100% Correct Answers and
Rationale
Section 1: Systems Leadership and Management (Questions 1–26)
1. A nurse executive is developing a strategic plan for a unit merger. What is the priority
step?
A) Conduct a SWOT analysis.
B) Implement immediate changes.
C) Hire new staff.
D) No analysis needed. Correct Answer: A) Conduct a SWOT analysis.
Rationale: SWOT (Strengths, Weaknesses, Opportunities, Threats) informs strategic
planning. ANCC Domain 1: Strategic planning.
2. A hospital budget shows a deficit. What financial management action?
A) Review variance reports and adjust staffing.
B) Ignore deficit.
C) Increase salaries.
D) Cut supplies.
Correct Answer: A) Review variance reports and adjust staffing.
Rationale: Variance analysis identifies cost-saving opportunities. ANCC Domain 1:
Financial management.
3. A unit has high turnover. What quality improvement initiative?
A) Implement staff satisfaction surveys.
B) No initiative.
C) Fire staff.
D) Ignore turnover.
Correct Answer: A) Implement staff satisfaction surveys.
Rationale: Surveys identify root causes of turnover. ANCC Domain 1: Quality
improvement.
4. A nurse executive leads a change to electronic health records. What model?
A) Kotter's 8-step change model.
B) No model.
C) Lewin's model.
D) Both A and C.
Correct Answer: D) Both A and C.
Rationale: Both models guide organizational change. ANCC Domain 1: Change
management.
5. A hospital aims for Magnet status. What priority?
A) Evidence-based practice integration.
B) No integration.
C) Staffing increase.
D) Ignore Magnet.
, Correct Answer: A) Evidence-based practice integration.
Rationale: EBP is a Magnet criterion. ANCC Domain 1: Systems leadership.
6. A unit budget exceeds costs. What action?
A) Analyze expenses and reallocate resources.
B) Ignore excess.
C) Cut bonuses.
D) Hire more staff.
Correct Answer: A) Analyze expenses and reallocate resources.
Rationale: Cost analysis optimizes budget. ANCC Domain 1: Financial management.
7. A quality improvement project shows low hand hygiene compliance. What intervention?
A) Staff education and audits.
B) No intervention.
C) Punish non-compliance.
D) Ignore compliance.
Correct Answer: A) Staff education and audits.
Rationale: Education and monitoring improve adherence. ANCC Domain 1: Quality
improvement.
8. A nurse executive manages a merger. What leadership style?
A) Transformational leadership.
B) No style.
C) Autocratic.
D) Laissez-faire.
Correct Answer: A) Transformational leadership.
Rationale: Inspires change during mergers. ANCC Domain 1: Leadership styles.
9. A hospital implements a new policy. What evaluation?
A) Pre- and post-implementation metrics.
B) No evaluation.
C) Ignore policy.
D) Staff survey only.
Correct Answer: A) Pre- and post-implementation metrics.
Rationale: Measures policy effectiveness. ANCC Domain 1: Systems evaluation.
10. A budget includes capital expenses. What example?
A) Purchasing new equipment.
B) Salaries.
C) Supplies.
D) Utilities.
Correct Answer: A) Purchasing new equipment.
Rationale: Capital expenses are long-term assets. ANCC Domain 1: Financial
management.
11. A unit has low patient satisfaction. What QI tool?
A) Fishbone diagram for root cause.
B) No tool.
C) Blame staff.
D) Ignore satisfaction.
Correct Answer: A) Fishbone diagram for root cause.
Rationale: Identifies causes of issues. ANCC Domain 1: Quality improvement tools.
, 12. A nurse executive leads a diversity initiative. What strategy?
A) Cultural competency training.
B) No training.
C) Ignore diversity.
D) Hire only one group.
Correct Answer: A) Cultural competency training.
Rationale: Promotes inclusive environment. ANCC Domain 1: Systems leadership.
13. A hospital faces a staffing shortage. What management?
A) Recruitment and retention programs.
B) No programs.
C) Cut hours.
D) Ignore shortage.
Correct Answer: A) Recruitment and retention programs.
Rationale: Addresses turnover. ANCC Domain 1: Systems management.
14. A QI project on falls. What metric?
A) Fall rates per 1,000 patient days.
B) No metric.
C) Staff hours.
D) Ignore falls.
Correct Answer: A) Fall rates per 1,000 patient days.
Rationale: Standard QI measure. ANCC Domain 1: Quality metrics.
15. A budget variance is negative. What cause?
A) Overtime expenses.
B) No cause.
C) Revenue increase.
D) Ignore variance.
Correct Answer: A) Overtime expenses.
Rationale: Common cause of negative variance. ANCC Domain 1: Financial analysis.
16. A nurse executive implements a new system. What evaluation?
A) Balanced scorecard.
B) No evaluation.
C) Staff survey only.
D) Ignore system.
Correct Answer: A) Balanced scorecard.
Rationale: Measures performance. ANCC Domain 1: Systems evaluation.
17. A merger affects morale. What leadership?
A) Transformational to inspire.
B) Autocratic.
C) No leadership.
D) Laissez-faire.
Correct Answer: A) Transformational to inspire.
Rationale: Motivates during change. ANCC Domain 1: Leadership.
18. A unit budget for supplies. What management?
A) Inventory control.
B) No control.
C) Overstock.
