Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
NURSE EXECUTIVE CERTIFICATION (NE-BC®)
Verified Questions & Correct Answers — A+ Graded
Edition
Aligned with the ANCC Nurse Executive (NE-BC®) Examination Blueprint, AONL Nurse Executive Competencies, and Healthcare
Leadership Standards (2026/2027 Edition)
Examination Overview: This comprehensive 150-question certification practice examination mirrors the content domain
weighting, cognitive level distribution, and scenario-based design of the ANCC Nurse Executive, Advanced — Board Certified
(NEA-BC) and Nurse Executive, Board Certified (NE-BC) credentialing examinations. Cognitive levels are distributed as 25%
recall, 45% application, and 30% analysis. Approximately 75% of items are scenario-based (leadership situations, healthcare
administration scenarios, strategic decision-making, financial analysis, and quality improvement) and 25% are direct knowledge
items. Special inclusions encompass 15 leadership prioritization items, 10 financial management and budget calculation items, and
10 quality improvement tool and methodology items.
Structure: Section 1: Leadership, Communication, & Relationship Management (25) • Section 2: Organizational & Healthcare
Systems Management (25) • Section 3: Financial Management & Resource Allocation (20) • Section 4: Human Resource
Management & Workforce Development (20) • Section 5: Quality Improvement & Patient Safety (20) • Section 6: Strategic
Planning & Innovation (15) • Section 7: Legal, Regulatory, & Ethical Issues (15) • Section 8: Healthcare Policy, Advocacy, &
Population Health (10).
Section 1: Leadership, Communication, & Relationship Management
Q1: A nurse executive is leading a hospital-wide initiative to improve patient-centered care. The executive
consistently shares a compelling vision of the future, inspires staff with optimism about achievable change,
demonstrates personal commitment through visible daily actions, and recognizes individual staff contributions. Which
leadership theory best describes this approach?
A. Transactional leadership, because the leader uses rewards to shape behavior
B. Transformational leadership, because the leader inspires and elevates followers toward a shared
vision *[CORRECT]*
C. Laissez-faire leadership, because the leader empowers staff to make independent decisions
D. Autocratic leadership, because the leader drives the change agenda from the top down
Correct Answer: B
Rationale: Transformational leadership (Bass & Avolio) is characterized by the four "I"s: idealized influence, inspirational
motivation, intellectual stimulation, and individualized consideration. The ANCC NE-BC® blueprint and AONL Nurse Executive
Competencies identify transformational leadership as a foundational competency for executing system-level change.
Transactional leadership relies on contingent rewards and management-by-exception; laissez-faire abdicates decision-making;
and autocratic leadership centralizes authority without inspiring followers. None of those approaches produce the sustainable
cultural change described in the scenario.
Q2: A nurse manager confides to the CNO that she feels overwhelmed, has been short-tempered with her staff, and
notices she reacts defensively to feedback. According to Goleman’s emotional intelligence framework, which domain
is the manager most directly describing a deficit in, and what is the appropriate developmental action?
A. Deficit in social awareness; the manager should focus on empathic listening and reading team cues
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 1
,Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
B. Deficit in self-management; the manager should focus on techniques to regulate emotional reactions
C. Deficit in self-awareness; the manager should engage in reflective practice, journaling, and
360-degree feedback *[CORRECT]*
D. Deficit in relationship management; the manager should focus on coaching and conflict resolution skills
Correct Answer: C
Rationale: Self-awareness is the foundational domain of Goleman’s emotional intelligence model and involves recognizing one’s
emotions, strengths, weaknesses, triggers, and their impact on others. The manager’s ability to identify her overwhelm and
defensive reactions actually signals emerging self-awareness, but her inability to act on these insights indicates the developmental
need remains in this domain. Reflective practice, journaling, and 360-degree feedback are evidence-based methods to strengthen
self-awareness (AONL competency: Communication & Relationship Management). Social awareness, self-management, and
relationship management are downstream domains that build on self-awareness.
Q3: A nurse executive is paged simultaneously with four issues at 7:00 a.m.: (1) a medication error involving a
pediatric patient being investigated by the charge nurse; (2) a heated argument between a physician and a staff nurse
on a medical-surgical unit; (3) a phone call from the CFO requesting immediate discussion of a $400,000 negative
budget variance; and (4) an email from the compliance officer about an unreported HIPAA breach discovered the
night before. Which action should the nurse executive take FIRST?
A. Call the CFO back to address the budget variance before it affects quarterly reporting
B. Go to the medical-surgical unit to de-escalate the physician-nurse conflict
C. Engage the compliance officer immediately to initiate the HIPAA breach investigation and mitigation
*[CORRECT]*
D. Review the medication error report and contact the pediatric patient’s family
Correct Answer: C
Rationale: This is a prioritization question testing the leader’s ability to apply a risk-based triage framework. A confirmed or
potential HIPAA breach triggers mandatory federal reporting timelines (notification to affected individuals no later than 60 days
from discovery; HHS notification thresholds), creates escalating legal exposure, and carries civil monetary penalties up to
$50,000 per violation. The compliance issue must be addressed first to preserve evidence, initiate the breach analysis, and meet
regulatory deadlines. The medication error, conflict, and budget variance are all significant but lack the immediate regulatory
clock and external reporting obligations of a HIPAA breach.
Q4: During a shared governance council meeting, two staff nurses strongly disagree about the appropriate staffing
model for a telemetry unit. The discussion becomes heated and one nurse tells the other, "Your idea is unrealistic and
shows you don’t understand bedside practice." Using the Thomas-Kilmann Conflict Mode Instrument, which response
by the nurse executive BEST demonstrates the collaborating mode?
A. Postpone the discussion and ask both nurses to submit written proposals for review at the next meeting
B. Assert the executive’s authority and select a model that splits the difference between both proposals
C. Facilitate a structured dialogue that explores the underlying concerns of both nurses to seek a
mutually agreeable solution *[CORRECT]*
D. Encourage the nurses to defer to the more experienced nurse’s recommendation to maintain team harmony
Correct Answer: C
Rationale: The collaborating mode in the Thomas-Kilmann framework is both assertive and cooperative, seeking a win-win
solution that fully addresses the concerns of all parties. This approach is appropriate when relationships and outcomes are both
highly important, as in shared governance. Facilitation explores underlying interests rather than positions, generating integrative
solutions. Postponing (avoiding), splitting the difference (compromising), and deferring (accommodating) all sacrifice either the
relationship or the quality of the outcome. AONL competency: Communication & Relationship Management explicitly endorses
collaboration as the preferred conflict mode for nurse executives.
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 2
,Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
Q5: A newly promoted nurse manager is struggling to influence peers in multidisciplinary meetings. The CNO
coaches the manager to develop "referent power." Which set of behaviors would MOST effectively build referent
power?
A. Citing organizational policies, clinical evidence, and regulatory standards during discussions
B. Building authentic relationships, demonstrating integrity, and modeling the values the manager
advocates *[CORRECT]*
C. Leveraging the formal title and reporting structure to compel compliance with decisions
D. Distributing resources such as schedule preferences and educational funding to supporters
Correct Answer: B
Rationale: Referent power, one of French and Raven’s six bases of power, derives from followers’ identification with,
admiration for, and liking of the leader. It is built through authenticity, integrity, trustworthiness, and congruence between
espoused and enacted values. Citing policies builds expert or informational power; leveraging title builds legitimate power;
distributing resources builds reward power. Referent power is the most durable and least coercive basis of influence, and AONL
identifies it as essential for nurse executives who must lead through influence rather than authority across multidisciplinary
settings.
Q6: A nurse executive is implementing a new electronic health record (EHR) across five hospitals. The executive
forms a guiding coalition of clinical champions, communicates an urgent vision, removes barriers by securing
additional training resources, celebrates short-term wins such as go-lives on individual units, and explicitly anchors the
changes into job descriptions and competency assessments. Which change management framework is being applied?
A. Lewin’s three-stage change model (unfreeze, change, refreeze)
B. Kotter’s 8-step model for leading change *[CORRECT]*
C. Prochaska and DiClemente’s transtheoretical model of behavior change
D. Gladwell’s tipping point framework
Correct Answer: B
Rationale: Kotter’s 8-step model includes: create urgency, form a guiding coalition, develop a vision and strategy, communicate
the change vision, empower broad-based action, generate short-term wins, consolidate gains and produce more change, and
anchor new approaches in the culture. The scenario explicitly describes steps 2, 4, 5, 6, and 8. Lewin’s model is conceptually
related but uses the unfreeze-change-refreeze sequence; Prochaska’s model applies to individual health behavior change;
Gladwell’s framework is a popular-press diffusion model. AONL Nurse Executive Competencies reference Kotter as a primary
evidence-based change framework.
Q7: A nurse executive is leading implementation of a sepsis bundle protocol. Resistance is concentrated among
veteran ICU nurses who state, "We’ve always managed sepsis well without this protocol." Which initial strategy BEST
addresses this resistance using a Kotter-consistent approach?
A. Mandate compliance through a unit-level audit and progressive discipline for non-adherence
B. Engage the most respected veteran ICU nurse as a clinical champion and co-design the
implementation with the ICU team *[CORRECT]*
C. Replace the veteran nurses on the implementation committee with younger, more receptive staff
D. Delay implementation until the next budget cycle when additional educational resources are available
Correct Answer: B
Rationale: Engaging opinion leaders as champions and co-designing implementation with frontline staff aligns with Kotter’s
steps of building a guiding coalition and empowering broad-based action. It also reflects Lewin’s principle that resistance
decreases when stakeholders participate in designing change. The Institute for Healthcare Improvement’s Framework for Spread
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 3
, Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
and Rogers’ Diffusion of Innovations both identify opinion leader engagement as the single most powerful predictor of adoption.
Mandates (A) drive resistance underground, replacement (C) destroys credibility, and delay (D) allows resistance to solidify.
Q8: A nurse executive is coaching a director of nursing who repeatedly arrives unprepared to leadership meetings and
provides vague updates. Using the GROW coaching model, which question BEST exemplifies the "Reality" stage?
A. What would a successful leadership meeting look like for you six months from now?
B. What specific information do you currently review before each meeting, and from what sources?
*[CORRECT]*
C. What options do you have for improving your meeting preparation process?
D. What will you commit to doing differently before next Tuesday’s meeting?
Correct Answer: B
Rationale: The GROW coaching model (Whitmore) sequences four stages: Goal, Reality, Options, and Way forward (Will). The
Reality stage explores the current state objectively, including facts, behaviors, and available data. Option B asks the coachee to
describe current preparation practices, which is the Reality stage. Option A is the Goal stage; Option C is the Options stage; Option
D is the Way Forward stage. The AONL Communication & Relationship Management competency identifies structured coaching
models such as GROW as best practice for developing nurse leaders.
Q9: A nurse executive wants to develop authentic leadership capacity among the next generation of nurse managers.
Which combination of practices is MOST consistent with Walumbwa and Avolio’s four-component model of
authentic leadership?
A. Self-awareness, relational transparency, balanced processing, and internalized moral perspective
*[CORRECT]*
B. Inspirational motivation, intellectual stimulation, idealized influence, and individualized consideration
C. Task-oriented behavior, relationship-oriented behavior, situational adaptation, and outcome accountability
D. Servanthood, stewardship, community building, and commitment to others’ growth
Correct Answer: A
Rationale: Walumbwa and Avolio (2008) defined authentic leadership through four components: self-awareness, relational
transparency, balanced processing of information, and an internalized moral perspective. Option B describes Bass’s
transformational leadership dimensions. Option C reflects situational/contingency leadership theories (Hersey-Blanchard).
Option D reflects Greenleaf’s servant leadership. AONL recognizes authentic leadership as foundational to building trust, ethical
climates, and psychological safety, all of which are tied to nurse retention and patient outcomes in the literature (Wong &
Laschinger, 2013).
Q10: A chief nursing officer observes that two nursing units with similar acuity and staffing have very different
cultures: Unit A reports near-miss events at three times the rate of Unit B. Which initial action by the CNO BEST
reflects a just culture approach?
A. Investigate why Unit B underreports and discipline managers who fail to encourage reporting
B. Conduct a culture of safety survey on both units and share results transparently with staff to drive
improvement *[CORRECT]*
C. Reorganize both unit leadership teams to signal that patient safety is a top priority
D. Implement a mandatory reporting quota to ensure both units submit equal numbers of events
Correct Answer: B
Rationale: A just culture (Marx, 2001) distinguishes between human error, at-risk behavior, and reckless behavior, and creates
an environment in which staff feel safe reporting errors and near-misses without fear of unjust punishment. Higher reporting
rates often indicate greater psychological safety, not worse performance. A culture of safety survey with transparent feedback
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 4
NURSE EXECUTIVE CERTIFICATION (NE-BC®)
Verified Questions & Correct Answers — A+ Graded
Edition
Aligned with the ANCC Nurse Executive (NE-BC®) Examination Blueprint, AONL Nurse Executive Competencies, and Healthcare
Leadership Standards (2026/2027 Edition)
Examination Overview: This comprehensive 150-question certification practice examination mirrors the content domain
weighting, cognitive level distribution, and scenario-based design of the ANCC Nurse Executive, Advanced — Board Certified
(NEA-BC) and Nurse Executive, Board Certified (NE-BC) credentialing examinations. Cognitive levels are distributed as 25%
recall, 45% application, and 30% analysis. Approximately 75% of items are scenario-based (leadership situations, healthcare
administration scenarios, strategic decision-making, financial analysis, and quality improvement) and 25% are direct knowledge
items. Special inclusions encompass 15 leadership prioritization items, 10 financial management and budget calculation items, and
10 quality improvement tool and methodology items.
Structure: Section 1: Leadership, Communication, & Relationship Management (25) • Section 2: Organizational & Healthcare
Systems Management (25) • Section 3: Financial Management & Resource Allocation (20) • Section 4: Human Resource
Management & Workforce Development (20) • Section 5: Quality Improvement & Patient Safety (20) • Section 6: Strategic
Planning & Innovation (15) • Section 7: Legal, Regulatory, & Ethical Issues (15) • Section 8: Healthcare Policy, Advocacy, &
Population Health (10).
Section 1: Leadership, Communication, & Relationship Management
Q1: A nurse executive is leading a hospital-wide initiative to improve patient-centered care. The executive
consistently shares a compelling vision of the future, inspires staff with optimism about achievable change,
demonstrates personal commitment through visible daily actions, and recognizes individual staff contributions. Which
leadership theory best describes this approach?
A. Transactional leadership, because the leader uses rewards to shape behavior
B. Transformational leadership, because the leader inspires and elevates followers toward a shared
vision *[CORRECT]*
C. Laissez-faire leadership, because the leader empowers staff to make independent decisions
D. Autocratic leadership, because the leader drives the change agenda from the top down
Correct Answer: B
Rationale: Transformational leadership (Bass & Avolio) is characterized by the four "I"s: idealized influence, inspirational
motivation, intellectual stimulation, and individualized consideration. The ANCC NE-BC® blueprint and AONL Nurse Executive
Competencies identify transformational leadership as a foundational competency for executing system-level change.
Transactional leadership relies on contingent rewards and management-by-exception; laissez-faire abdicates decision-making;
and autocratic leadership centralizes authority without inspiring followers. None of those approaches produce the sustainable
cultural change described in the scenario.
Q2: A nurse manager confides to the CNO that she feels overwhelmed, has been short-tempered with her staff, and
notices she reacts defensively to feedback. According to Goleman’s emotional intelligence framework, which domain
is the manager most directly describing a deficit in, and what is the appropriate developmental action?
A. Deficit in social awareness; the manager should focus on empathic listening and reading team cues
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 1
,Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
B. Deficit in self-management; the manager should focus on techniques to regulate emotional reactions
C. Deficit in self-awareness; the manager should engage in reflective practice, journaling, and
360-degree feedback *[CORRECT]*
D. Deficit in relationship management; the manager should focus on coaching and conflict resolution skills
Correct Answer: C
Rationale: Self-awareness is the foundational domain of Goleman’s emotional intelligence model and involves recognizing one’s
emotions, strengths, weaknesses, triggers, and their impact on others. The manager’s ability to identify her overwhelm and
defensive reactions actually signals emerging self-awareness, but her inability to act on these insights indicates the developmental
need remains in this domain. Reflective practice, journaling, and 360-degree feedback are evidence-based methods to strengthen
self-awareness (AONL competency: Communication & Relationship Management). Social awareness, self-management, and
relationship management are downstream domains that build on self-awareness.
Q3: A nurse executive is paged simultaneously with four issues at 7:00 a.m.: (1) a medication error involving a
pediatric patient being investigated by the charge nurse; (2) a heated argument between a physician and a staff nurse
on a medical-surgical unit; (3) a phone call from the CFO requesting immediate discussion of a $400,000 negative
budget variance; and (4) an email from the compliance officer about an unreported HIPAA breach discovered the
night before. Which action should the nurse executive take FIRST?
A. Call the CFO back to address the budget variance before it affects quarterly reporting
B. Go to the medical-surgical unit to de-escalate the physician-nurse conflict
C. Engage the compliance officer immediately to initiate the HIPAA breach investigation and mitigation
*[CORRECT]*
D. Review the medication error report and contact the pediatric patient’s family
Correct Answer: C
Rationale: This is a prioritization question testing the leader’s ability to apply a risk-based triage framework. A confirmed or
potential HIPAA breach triggers mandatory federal reporting timelines (notification to affected individuals no later than 60 days
from discovery; HHS notification thresholds), creates escalating legal exposure, and carries civil monetary penalties up to
$50,000 per violation. The compliance issue must be addressed first to preserve evidence, initiate the breach analysis, and meet
regulatory deadlines. The medication error, conflict, and budget variance are all significant but lack the immediate regulatory
clock and external reporting obligations of a HIPAA breach.
Q4: During a shared governance council meeting, two staff nurses strongly disagree about the appropriate staffing
model for a telemetry unit. The discussion becomes heated and one nurse tells the other, "Your idea is unrealistic and
shows you don’t understand bedside practice." Using the Thomas-Kilmann Conflict Mode Instrument, which response
by the nurse executive BEST demonstrates the collaborating mode?
A. Postpone the discussion and ask both nurses to submit written proposals for review at the next meeting
B. Assert the executive’s authority and select a model that splits the difference between both proposals
C. Facilitate a structured dialogue that explores the underlying concerns of both nurses to seek a
mutually agreeable solution *[CORRECT]*
D. Encourage the nurses to defer to the more experienced nurse’s recommendation to maintain team harmony
Correct Answer: C
Rationale: The collaborating mode in the Thomas-Kilmann framework is both assertive and cooperative, seeking a win-win
solution that fully addresses the concerns of all parties. This approach is appropriate when relationships and outcomes are both
highly important, as in shared governance. Facilitation explores underlying interests rather than positions, generating integrative
solutions. Postponing (avoiding), splitting the difference (compromising), and deferring (accommodating) all sacrifice either the
relationship or the quality of the outcome. AONL competency: Communication & Relationship Management explicitly endorses
collaboration as the preferred conflict mode for nurse executives.
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 2
,Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
Q5: A newly promoted nurse manager is struggling to influence peers in multidisciplinary meetings. The CNO
coaches the manager to develop "referent power." Which set of behaviors would MOST effectively build referent
power?
A. Citing organizational policies, clinical evidence, and regulatory standards during discussions
B. Building authentic relationships, demonstrating integrity, and modeling the values the manager
advocates *[CORRECT]*
C. Leveraging the formal title and reporting structure to compel compliance with decisions
D. Distributing resources such as schedule preferences and educational funding to supporters
Correct Answer: B
Rationale: Referent power, one of French and Raven’s six bases of power, derives from followers’ identification with,
admiration for, and liking of the leader. It is built through authenticity, integrity, trustworthiness, and congruence between
espoused and enacted values. Citing policies builds expert or informational power; leveraging title builds legitimate power;
distributing resources builds reward power. Referent power is the most durable and least coercive basis of influence, and AONL
identifies it as essential for nurse executives who must lead through influence rather than authority across multidisciplinary
settings.
Q6: A nurse executive is implementing a new electronic health record (EHR) across five hospitals. The executive
forms a guiding coalition of clinical champions, communicates an urgent vision, removes barriers by securing
additional training resources, celebrates short-term wins such as go-lives on individual units, and explicitly anchors the
changes into job descriptions and competency assessments. Which change management framework is being applied?
A. Lewin’s three-stage change model (unfreeze, change, refreeze)
B. Kotter’s 8-step model for leading change *[CORRECT]*
C. Prochaska and DiClemente’s transtheoretical model of behavior change
D. Gladwell’s tipping point framework
Correct Answer: B
Rationale: Kotter’s 8-step model includes: create urgency, form a guiding coalition, develop a vision and strategy, communicate
the change vision, empower broad-based action, generate short-term wins, consolidate gains and produce more change, and
anchor new approaches in the culture. The scenario explicitly describes steps 2, 4, 5, 6, and 8. Lewin’s model is conceptually
related but uses the unfreeze-change-refreeze sequence; Prochaska’s model applies to individual health behavior change;
Gladwell’s framework is a popular-press diffusion model. AONL Nurse Executive Competencies reference Kotter as a primary
evidence-based change framework.
Q7: A nurse executive is leading implementation of a sepsis bundle protocol. Resistance is concentrated among
veteran ICU nurses who state, "We’ve always managed sepsis well without this protocol." Which initial strategy BEST
addresses this resistance using a Kotter-consistent approach?
A. Mandate compliance through a unit-level audit and progressive discipline for non-adherence
B. Engage the most respected veteran ICU nurse as a clinical champion and co-design the
implementation with the ICU team *[CORRECT]*
C. Replace the veteran nurses on the implementation committee with younger, more receptive staff
D. Delay implementation until the next budget cycle when additional educational resources are available
Correct Answer: B
Rationale: Engaging opinion leaders as champions and co-designing implementation with frontline staff aligns with Kotter’s
steps of building a guiding coalition and empowering broad-based action. It also reflects Lewin’s principle that resistance
decreases when stakeholders participate in designing change. The Institute for Healthcare Improvement’s Framework for Spread
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 3
, Nurse Executive Certification (NE-BC(R)) - 2026/2027 Edition A+ Graded - Verified Q&A
and Rogers’ Diffusion of Innovations both identify opinion leader engagement as the single most powerful predictor of adoption.
Mandates (A) drive resistance underground, replacement (C) destroys credibility, and delay (D) allows resistance to solidify.
Q8: A nurse executive is coaching a director of nursing who repeatedly arrives unprepared to leadership meetings and
provides vague updates. Using the GROW coaching model, which question BEST exemplifies the "Reality" stage?
A. What would a successful leadership meeting look like for you six months from now?
B. What specific information do you currently review before each meeting, and from what sources?
*[CORRECT]*
C. What options do you have for improving your meeting preparation process?
D. What will you commit to doing differently before next Tuesday’s meeting?
Correct Answer: B
Rationale: The GROW coaching model (Whitmore) sequences four stages: Goal, Reality, Options, and Way forward (Will). The
Reality stage explores the current state objectively, including facts, behaviors, and available data. Option B asks the coachee to
describe current preparation practices, which is the Reality stage. Option A is the Goal stage; Option C is the Options stage; Option
D is the Way Forward stage. The AONL Communication & Relationship Management competency identifies structured coaching
models such as GROW as best practice for developing nurse leaders.
Q9: A nurse executive wants to develop authentic leadership capacity among the next generation of nurse managers.
Which combination of practices is MOST consistent with Walumbwa and Avolio’s four-component model of
authentic leadership?
A. Self-awareness, relational transparency, balanced processing, and internalized moral perspective
*[CORRECT]*
B. Inspirational motivation, intellectual stimulation, idealized influence, and individualized consideration
C. Task-oriented behavior, relationship-oriented behavior, situational adaptation, and outcome accountability
D. Servanthood, stewardship, community building, and commitment to others’ growth
Correct Answer: A
Rationale: Walumbwa and Avolio (2008) defined authentic leadership through four components: self-awareness, relational
transparency, balanced processing of information, and an internalized moral perspective. Option B describes Bass’s
transformational leadership dimensions. Option C reflects situational/contingency leadership theories (Hersey-Blanchard).
Option D reflects Greenleaf’s servant leadership. AONL recognizes authentic leadership as foundational to building trust, ethical
climates, and psychological safety, all of which are tied to nurse retention and patient outcomes in the literature (Wong &
Laschinger, 2013).
Q10: A chief nursing officer observes that two nursing units with similar acuity and staffing have very different
cultures: Unit A reports near-miss events at three times the rate of Unit B. Which initial action by the CNO BEST
reflects a just culture approach?
A. Investigate why Unit B underreports and discipline managers who fail to encourage reporting
B. Conduct a culture of safety survey on both units and share results transparently with staff to drive
improvement *[CORRECT]*
C. Reorganize both unit leadership teams to signal that patient safety is a top priority
D. Implement a mandatory reporting quota to ensure both units submit equal numbers of events
Correct Answer: B
Rationale: A just culture (Marx, 2001) distinguishes between human error, at-risk behavior, and reckless behavior, and creates
an environment in which staff feel safe reporting errors and near-misses without fear of unjust punishment. Higher reporting
rates often indicate greater psychological safety, not worse performance. A culture of safety survey with transparent feedback
Aligned with ANCC NE-BC(R) Blueprint | AONL Competencies Page 4
