Nursing Leadership & Management Exam Q&A –
WGU D120 OBJECTIVE ASSESSMENT ACTUAL EXAM
STUDY GUIDE 2025/2026 COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES || 100% GUARANTEED PASS <LATEST
VERSION>
Domain 1: Leadership & Management Theories
1. A nurse manager decides to implement a new scheduling system based solely on their own
experience, without input from the staff. Which leadership style is this manager
demonstrating?
A) Democratic
B) Laissez-faire
C) Autocratic ✓
D) Transformational
Rationale: An autocratic leader makes decisions independently with little or no input from the
team. This top-down approach is efficient in crises but often decreases staff morale and
engagement.
2. A nurse leader who inspires the team with a vision for excellent patient care and motivates
them to exceed their own expectations is exhibiting which leadership style?
A) Transactional
B) Transformational ✓
C) Servant
D) Democratic
Rationale: Transformational leaders focus on inspiring change and motivating followers to
achieve a shared vision through charisma, inspiration, and intellectual stimulation.
3. Which management function involves determining the organization's goals and the means
to achieve them?
A) Organizing
B) Leading
C) Planning ✓
D) Controlling
,Rationale: Planning is the foundational management function that involves setting objectives
and deciding in advance how they will be accomplished.
4. A nurse manager who focuses on rewarding staff for meeting performance standards and
correcting deviations is using which leadership style?
A) Transformational
B) Servant
C) Transactional ✓
D) Laissez-faire
Rationale: Transactional leadership is based on a system of rewards and punishments for
performance. It focuses on maintaining the status quo and ensuring tasks are completed.
5. According to Maslow's Hierarchy of Needs, which level must be met first?
A) Self-actualization
B) Love and Belonging
C) Safety Needs
D) Physiological Needs ✓
Rationale: Maslow's theory is a pyramid. Physiological needs (food, water, shelter) form the
base and must be reasonably satisfied before an individual is motivated to fulfill higher-level
needs.
6. A staff nurse feels empowered, trusted, and has a high degree of autonomy. The unit
manager likely subscribes to which theory?
A) Theory X
B) Theory Y ✓
C) Transactional Leadership
D) Autocratic Leadership
Rationale: Theory Y managers believe employees are self-motivated, responsible, and creative.
They create an environment of empowerment and trust, in contrast to Theory X, which assumes
employees are lazy and need constant supervision.
Domain 2: Quality Improvement, Safety, & Patient-Centered Care
7. The primary goal of a Root Cause Analysis (RCA) is to:
A) Determine which individual is at fault for an error.
B) Identify system-level failures that led to an adverse event. ✓
C) Punish staff members involved in a sentinel event.
D) Immediately resolve a single patient safety issue.
Rationale: RCA is a structured method used to analyze serious adverse events. The focus is on
underlying system and process failures, not individual blame, to prevent future occurrences.
,8. What is the purpose of the SBAR (Situation, Background, Assessment, Recommendation)
communication tool?
A) To document a patient's full history
B) To provide a structured framework for hand-off communication ✓
C) To replace the physician's progress notes
D) To delegate tasks to nursing assistants
Rationale: SBAR standardizes communication, especially during hand-offs or critical situations,
ensuring concise, relevant, and accurate information is shared, which reduces errors.
9. A hospital is collecting data on central line-associated bloodstream infections (CLABSIs) to
benchmark its performance against national standards. This is an example of:
A) Performance appraisal
B) Quality improvement ✓
C) Fiscal accountability
D) Risk management
Rationale: Quality improvement involves systematic, data-driven activities designed to improve
healthcare services and patient outcomes. Benchmarking against national standards is a core QI
activity.
10. Which action best demonstrates patient-centered care?
A) Completing all tasks on the care plan by the end of the shift.
B) Involving the patient and family in developing the plan of care. ✓
C) Following all physician orders without question.
D) Ensuring the patient's room is clean and organized.
Rationale: Patient-centered care respects and responds to individual patient preferences,
needs, and values, ensuring they are the source of control in their own care decisions.
11. The "Just Culture" model in healthcare aims to:
A) Focus solely on punishing individuals for errors.
B) Balance accountability for choices with a non-punitive environment for system issues. ✓
C) Eliminate all medical errors through strict policies.
D) Encourage staff to hide mistakes to avoid reprimand.
Rationale: Just Culture fosters an environment where staff feel safe reporting errors without
fear of blame, while still holding individuals accountable for reckless behavior.
12. A near-miss event (a potential error that was caught) occurs on the unit. The most
appropriate initial action by the nurse is to:
A) Discuss it only with the charge nurse to avoid paperwork.
B) File an incident report to document the event for system improvement. ✓
, C) Reprimand the individual who almost made the error.
D) Ignore it since no harm came to the patient.
Rationale: Reporting near-misses is a critical component of a safety culture. It allows the
organization to analyze and fix system flaws before they cause actual patient harm.
Domain 3: Legal & Ethical Issues
13. A patient with a terminal diagnosis is alert and oriented and refuses a life-saving blood
transfusion. The nurse's most ethical action is to:
A) Administer the transfusion because it saves lives.
B) Coerce the patient into accepting the treatment.
C) Document the refusal and uphold the patient's autonomy. ✓
D) Ask the family to override the patient's decision.
Rationale: The ethical principle of autonomy grants a competent patient the right to refuse
treatment, even if the refusal may result in death.
14. What is the primary purpose of the Health Insurance Portability and Accountability Act
(HIPAA)?
A) To ensure billing accuracy
B) To protect patient privacy and confidentiality ✓
C) To mandate staff-to-patient ratios
D) To regulate medication administration
Rationale: HIPAA is a federal law that establishes national standards to protect sensitive patient
health information from being disclosed without the patient’s consent or knowledge.
15. A nurse witnesses a patient fall. The nurse's first priority is to:
A) Call the risk manager.
B) Check the patient for injury and provide care. ✓
C) Fill out an incident report.
D) Notify the physician.
Rationale: The nurse's first priority is always the clinical assessment and safety of the patient.
Administrative actions follow after the patient is stabilized.
16. A patient tells the nurse, "I'm going to leave this hospital right now, no matter what." The
nurse should first:
A) Physically restrain the patient to prevent injury.
B) Notify security to lock the doors.
C) Assess the patient's decision-making capacity and inform them of the risks of leaving against
medical advice (AMA). ✓
D) Tell the patient they are not allowed to leave.
WGU D120 OBJECTIVE ASSESSMENT ACTUAL EXAM
STUDY GUIDE 2025/2026 COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES || 100% GUARANTEED PASS <LATEST
VERSION>
Domain 1: Leadership & Management Theories
1. A nurse manager decides to implement a new scheduling system based solely on their own
experience, without input from the staff. Which leadership style is this manager
demonstrating?
A) Democratic
B) Laissez-faire
C) Autocratic ✓
D) Transformational
Rationale: An autocratic leader makes decisions independently with little or no input from the
team. This top-down approach is efficient in crises but often decreases staff morale and
engagement.
2. A nurse leader who inspires the team with a vision for excellent patient care and motivates
them to exceed their own expectations is exhibiting which leadership style?
A) Transactional
B) Transformational ✓
C) Servant
D) Democratic
Rationale: Transformational leaders focus on inspiring change and motivating followers to
achieve a shared vision through charisma, inspiration, and intellectual stimulation.
3. Which management function involves determining the organization's goals and the means
to achieve them?
A) Organizing
B) Leading
C) Planning ✓
D) Controlling
,Rationale: Planning is the foundational management function that involves setting objectives
and deciding in advance how they will be accomplished.
4. A nurse manager who focuses on rewarding staff for meeting performance standards and
correcting deviations is using which leadership style?
A) Transformational
B) Servant
C) Transactional ✓
D) Laissez-faire
Rationale: Transactional leadership is based on a system of rewards and punishments for
performance. It focuses on maintaining the status quo and ensuring tasks are completed.
5. According to Maslow's Hierarchy of Needs, which level must be met first?
A) Self-actualization
B) Love and Belonging
C) Safety Needs
D) Physiological Needs ✓
Rationale: Maslow's theory is a pyramid. Physiological needs (food, water, shelter) form the
base and must be reasonably satisfied before an individual is motivated to fulfill higher-level
needs.
6. A staff nurse feels empowered, trusted, and has a high degree of autonomy. The unit
manager likely subscribes to which theory?
A) Theory X
B) Theory Y ✓
C) Transactional Leadership
D) Autocratic Leadership
Rationale: Theory Y managers believe employees are self-motivated, responsible, and creative.
They create an environment of empowerment and trust, in contrast to Theory X, which assumes
employees are lazy and need constant supervision.
Domain 2: Quality Improvement, Safety, & Patient-Centered Care
7. The primary goal of a Root Cause Analysis (RCA) is to:
A) Determine which individual is at fault for an error.
B) Identify system-level failures that led to an adverse event. ✓
C) Punish staff members involved in a sentinel event.
D) Immediately resolve a single patient safety issue.
Rationale: RCA is a structured method used to analyze serious adverse events. The focus is on
underlying system and process failures, not individual blame, to prevent future occurrences.
,8. What is the purpose of the SBAR (Situation, Background, Assessment, Recommendation)
communication tool?
A) To document a patient's full history
B) To provide a structured framework for hand-off communication ✓
C) To replace the physician's progress notes
D) To delegate tasks to nursing assistants
Rationale: SBAR standardizes communication, especially during hand-offs or critical situations,
ensuring concise, relevant, and accurate information is shared, which reduces errors.
9. A hospital is collecting data on central line-associated bloodstream infections (CLABSIs) to
benchmark its performance against national standards. This is an example of:
A) Performance appraisal
B) Quality improvement ✓
C) Fiscal accountability
D) Risk management
Rationale: Quality improvement involves systematic, data-driven activities designed to improve
healthcare services and patient outcomes. Benchmarking against national standards is a core QI
activity.
10. Which action best demonstrates patient-centered care?
A) Completing all tasks on the care plan by the end of the shift.
B) Involving the patient and family in developing the plan of care. ✓
C) Following all physician orders without question.
D) Ensuring the patient's room is clean and organized.
Rationale: Patient-centered care respects and responds to individual patient preferences,
needs, and values, ensuring they are the source of control in their own care decisions.
11. The "Just Culture" model in healthcare aims to:
A) Focus solely on punishing individuals for errors.
B) Balance accountability for choices with a non-punitive environment for system issues. ✓
C) Eliminate all medical errors through strict policies.
D) Encourage staff to hide mistakes to avoid reprimand.
Rationale: Just Culture fosters an environment where staff feel safe reporting errors without
fear of blame, while still holding individuals accountable for reckless behavior.
12. A near-miss event (a potential error that was caught) occurs on the unit. The most
appropriate initial action by the nurse is to:
A) Discuss it only with the charge nurse to avoid paperwork.
B) File an incident report to document the event for system improvement. ✓
, C) Reprimand the individual who almost made the error.
D) Ignore it since no harm came to the patient.
Rationale: Reporting near-misses is a critical component of a safety culture. It allows the
organization to analyze and fix system flaws before they cause actual patient harm.
Domain 3: Legal & Ethical Issues
13. A patient with a terminal diagnosis is alert and oriented and refuses a life-saving blood
transfusion. The nurse's most ethical action is to:
A) Administer the transfusion because it saves lives.
B) Coerce the patient into accepting the treatment.
C) Document the refusal and uphold the patient's autonomy. ✓
D) Ask the family to override the patient's decision.
Rationale: The ethical principle of autonomy grants a competent patient the right to refuse
treatment, even if the refusal may result in death.
14. What is the primary purpose of the Health Insurance Portability and Accountability Act
(HIPAA)?
A) To ensure billing accuracy
B) To protect patient privacy and confidentiality ✓
C) To mandate staff-to-patient ratios
D) To regulate medication administration
Rationale: HIPAA is a federal law that establishes national standards to protect sensitive patient
health information from being disclosed without the patient’s consent or knowledge.
15. A nurse witnesses a patient fall. The nurse's first priority is to:
A) Call the risk manager.
B) Check the patient for injury and provide care. ✓
C) Fill out an incident report.
D) Notify the physician.
Rationale: The nurse's first priority is always the clinical assessment and safety of the patient.
Administrative actions follow after the patient is stabilized.
16. A patient tells the nurse, "I'm going to leave this hospital right now, no matter what." The
nurse should first:
A) Physically restrain the patient to prevent injury.
B) Notify security to lock the doors.
C) Assess the patient's decision-making capacity and inform them of the risks of leaving against
medical advice (AMA). ✓
D) Tell the patient they are not allowed to leave.
